Hello Mom & Dad 2

Well, it is almost a month now that I have been in Somalia. That was pretty quick. I don’t feel the chill of January in Canada in my bones, skin, or in fact anywhere. I guess it has been a month then.


I’ll get into the specifics of what I’m doing here later. For now, some comments about Galcayo. I still don’t know if I like it here. There is one thing that keeps happening to me that I’m not too happy about. Kids, (little boys around 6-10 years old) keep putting on angry faces and generally show off that they don’t like you. Driving to the airport one day, a group of kids were playing, then one yelled something in our general direction (probably, “hey, here come some white folks”) and the group divided, some cheering and waving, some yelling and putting their fists in the air. One kid ran up to the car and tried spitting on it as it passed. Funny little kid; really makes me wonder though.


To be fair, I remember being a kid and up to no good around the neighborhood; occasionally throwing something at a moving train, road sign, or whatever I wanted to, regardless of right and wrong. No malice in my actions to the train or signs, but maybe just finding an outlet for my rebellious youth. I wonder if this is the same with these kids.


Today, a kid (probably no more than 8) came to the door of a store I was in, and was holding a knife. This wasn’t a butter knife, but something you bring hunting small game with. Anyway, he held it there and started saying some things and waving it around, then he put on that same angry face and started pointing at people with the knife. As many times before, I looked around at others to see if their faces would let me know how I should react to this. And there, around the store, a couple people watched this kid, like it was a 3 o’clock in the morning infomercial, no emotion on their stare. My assistant turned back to the storekeeper to conclude our business, and there I was, just looking at this kid, confused. I didn’t feel threatened at all, as this kid was about the size of my five-year-old nephew, but this is leading to a trend. What is going on here? Not with this kid, but many of the kids. This kid was the most vocal and active of the ones I’ve seen, but his face was similar to the others. I believe this kid hates me, my skin colour, and/or finds me as an outlet for his rebellious youth; a focus for some frustration he holds.


There is a wonderful word I have learned recently, “Bufis.” Bufis defined: Descriptive to a 3rd person, (“that man is Bufis!”) Descriptive to an object built by a person: (“See how they build that wall, kind of on an angle?” “Yeah.” “Bufis.” “Yup.”) Descriptive to a person, based on something they did, ie: non-logic thinking, (“I thought I would try to improve the system. The building didn’t work out so well because not everyone knew the new system.” “What was wrong with ‘the metric system’?” “There is always room for improvement, no?” “You are Bufis.”) A person, a building, a system, a discontinuity in the logic, all constitutes “Bufis”. Now that I have learned this word, I hear it all the time. “Blah blah blah, bufis.” “Haa (Somali for ‘yes’)” I think my Somali speaking skills have doubled since I learned that one word.


I don’t know yet whether I can use “Bufis” to describe my observation of these kids. I think not. I think Bufis is a good word to describe a situation like, “wouldn’t it be funny if that was the last gas station for the next 200kms.” But 150kms into the road without a station, it isn’t funny anymore, it has stopped being a Bufis situation; it is serious. I’m curious to learn more about Somalis and why the kids wear angry faces so young. What at first looked Bufis, now isn’t funny any more.


Speaking of learning Somali. I’ve been confused lately about all the greetings, so today I compiled the ones I know:

• Quora wanaagsan – Good Breakfast
• Malin wanaagsan – Good Day
• Subaah wanaagsan – Good Morning
• Duhur wanaagsan – Good Mid-day
• Qado wanaagsan – Good Lunch
• Galap wanaagsan – Good Afternoon
• Fe-ed wanaagsan – Good Evening
• Asho wanaagsan – Good Dinner

Haben wanaagsan – Good Night


The funny thing is, I still don’t know how to say hello in Somali. Usually I revert to Salaam, (Arabic), but everything else here is a “good (quick think hard. Is it morning, or evening? Is the person going to a meal? Hurry, pick one!) afternoon.” It seems hard, but for every phrase I have learned (except for Bufis), an English one or two can be thought of. Just a note: I’m still enjoying learning the language, turtip, turtip, (slowly slowly.)


So, this is the 6th day of the TB program we are starting up. Unfortunately, Irene (our Doctor) is stuck in Nairobi right now. She went to Ethiopia to visit a similar TB program there, but just a couple days before she was to fly in, the organization that provides us with most of our flights, had some problems, and all flights are cancelled. So, she comes in a week when we charter our own flights.


But, we have started 6 days ago. Starting a TB program sounds big, and it is, just we are doing those little steps at the beginning of a big hike. The first few steps are almost effortless.


The project will do the following activities.

• Take over the responsibility of two existing, but not-supported, clinics (treating approximately 200 patients now.)
• Evaluate the existing clinics, clinic staff and facilities.
• Train staff as needed.
• Prepare for large increases in patients.
• Once those two clinics are running smoothly, then spread out a little to the 120km stretch of land between the two clinics by setting up TB referral systems and rough diagnostics in more remote areas. Still with most treatment in the two centres.
• Further along the timeline, we would offer diagnotsitcs and treatment to nomadic rural patients who do not have access to the current health facilities, yet suffer from TB all the same.

The last parts of this will be done in 4-6 months from now. Right now, we’re just taking baby steps. We have been given a room in the clinic, set up an office, had a local carpenter build us some tables, bought some chairs, cell phones, books, paper, etc. We have met with the staff and have heard 20 ways how the salary is not enough and not acceptable. As well, there is a bunch of administration that is now part of my job description as Project Coordinator. Security guidelines have to be changed to incorporate our program running outside of town. Job descriptions need to be finalized. Orders still need to be going out and coming in. Etc, etc.


The issue regarding staff salaries is a funny one. In many aspects I believe it is a wonderful textbook example of a two-sided negotiation; Directors vs. Shareholders, Labour vs. Management, or maybe even Israel vs. Palestine. There are parts that are unfair all around, and it is a matter of sorting out which ones can and cannot be agreed on. Today was a good day in this negotiation, but let me give you a little background.


During my briefings, I heard many times, “those Somalis are difficult people to deal with. They will ask, ask, ask, and it will take a lot of effort not to loose your shirt in the meetings. Taking over the clinics is tricky too, Steve. They haven’t been paid for the last year since that other NGO left, and now they want MSF to pay last year’s salary as well as hire all their staff and pay more than our regular salary scale. Bon chance!” Gulp, “Er, thanks.”


At my first meeting with the staff, within two minutes, after a couple pleasantries came the comments, “What do you plan to pay us?” and before I could answer, “That is hardly enough.”


As I said, this negotiation has been a rewarding challenge. Rewarding, because I am applying some formal negotiating ideas I’ve been learning, and to date, the staff are satisfied, and we have built a relationship, solving this problem together. I think it really helped explaining how MSF wasn’t like other NGOs, paying salaries and leaving, but rather working with staff, ensuring quality care, living in the communities we work in, etc. Also, as if by cue, a couple of staff members said things like, “I was in a refugee camp in Kenya, and MSF was there before others arrived, and they didn’t get involved in the politics, just like you said Steve.” Good luck working with me here in Galcayo, so far.


Anyway, things with the program are going well. We have some big challenges ahead of us, mostly focusing our program to something achievable. Right now, it is plainly obvious, there is absolutely so much TB in Somalia, and to treat it all, is not a reasonable goal at the moment. Now, we must build on what is here, (skills and clinics) and take it from there. Note: Back in July, MSF built a feeding centre to take over control of malnourished children treatment. Mortality rates in the hospital were approximately 45%, very unacceptable. Anyway, within some months, numbers rose from 30 to 50 to 80 to 120, very quickly. Most people say that once the population knows there is treatment somewhere, everyone travels there to get treatment. We think similar things will happen with us starting to take over the TB clinic. Right now there are 200 people in the two clinics we are taking over, I’m concerned that number will grow quickly.


That isn’t my biggest concern with the program though. More on that below. Have to go now.


Lots of Love,


Steve