A little insecurity, and a lot of questions

04-03-2005

I guess this is how the emails started at one point.

It has felt like a while since I've written, even though it was just a few weeks +/-. Yes, I have found my feet here. Rising to the position of PC, has gone quite smoothly in fact. I think lots of my experiences in a 'chain of command' type of work has prepared me well. About a week ago, Jocelyne (the PC of the Galcayo North and Galcayo South Projects) was on vacation, so I took over her duties as well. Anyway, in that week there was a bunch of security related incidents, expat staff changes, an evacuation of the south team, and many other tricky events, all happening in that one week I was in charge. Everyone says I handled it very well, and, I think I agree. At no other time in my time here had we had any tricky incident, like all those combined. It felt good to handle the responsibility well. (I see my experience coming out, when newer people in the project are running around like mad, working on small things, when there is no 'emergency'. At times like those, I take my Fridays completely off, and make sure I get a little nap in the afternoon too. I think some people didn't like how I wouldn't work through the night, burning myself out, for small things. Then, when the week came when things were much busier, and much bigger things, many people were quite tired of the extra load, but I was able to use some of that reserve energy. Things like that are making me feel like I'm getting good at the game.)

I mentioned 'insecurity' above. What I mean by that is, there is a little tension in Somalia now, with the return of the exile Government. Also, the Government wants foreign peacekeeper troops to come in and assist in stabilizing the country. Some people don't want foreign troops. Anyway, there is some uncertainty here as to what will happen. Last week, there were some delegations from peacekeeping troop bodies (African Union, Arab League, etc) and the President and Prime Minister of Somalia, all visiting Galcayo. As such, we stayed in the living compound for a couple days. All the staff told us that there would be no problems and everyone in Galcayo welcomes the new Government and peacekeeping troops, but still we thought it best to hold back (actually orders from Amsterdam, but we agreed it would be alright, and things in the hospital and clinics would continue without us, alright.) It turned out that the delegation visits were very peaceful, and there was no increase in tensions in town too. Good to see. Fortunately, our staff is understanding of us, when we show signs of being very shy.
One more thing, we haven't been going to the internet cafe lately, and therefore I haven't been checking my mail there.

Things with the TB program are pretty difficult. The problems revolve around who to treat and who not to treat. TB treatment has to continue for 6 months, or else drug resistance will form. The problem is, we cannot (logistically right now) provide housing and food for people to stay in Galcayo. So, people who come for a handful of pills, then want to go home, cannot be admitted. Patients even promise to stay for 6 months (a Mother will promise anything when holding her 50% weight sick child), but then when he looks better, her other commitments (I have to care for my family back home) become a more pressing priority, they try to leave (or default from the program). As such, drug resistance may form, and TB will be harder to treat later. So, there are some difficult decisions about not treating some people because of the greater public health risk that that can cause. That is the biggest difficulty here, so much to treat, so little resources to treat with, and therefore a choice must be made. Fortunately, or unfortunately, I am somewhat removed from administering those choices to the patients. Irene, our TB Doctor does that. My job is to push the admission policy and the progress of the project. But, it is a small team, and I feel the difficulties too.

The other problem is, there are so many needs here. Just outside town, there are some IDP camps (Internally Displaced Persons Camps. Pretty much refugees that haven't crossed an international boundary.) These camps are in horrible conditions, yet nothing is, or will be done about them. There are thousands of people living there, with horrible water, sanitation, food, shelter, and health conditions. We cannot take on any more activities in our mission (MSF Holland), other sections of MSF are at their maximum capacity, and other NGO's aren't interested in Somalia. With the Tsunami, some attention did come to Somalia, (along with a small pile of money), but the needs we are seeing are far far greater than the Somalia tsunami needs. True, more than a hundred people died, and thousands were displaced, but there are hundreds dying of TB (for instance) in Somalia every month, and thousands displaced already.
Some of the team here are pretty upset that much WFP food was taken from our allocation, and sent to the coast. We are running vital feeding programs here, with hundreds of malnourished childred in the program, and much food was diverted to the coast, where much of the needs analysis didn't find needs. (We have seen some reports from a well known agency (but I keep the name to myself) about the situation in Somalia, detailing the impact of the Tsunami, but written completely from the desk. This was a theoretical report.

Also, on the road one day, we met a convoy bringing different delegates around. One was coming to Galcayo to see the hospital and talk with the other PC. We decided to travel with the convoy, and try to say hi to the Governor and some other delgates. Anyway, they stopped at the side of the road, near an IDP camp. All the cars emptied. The people gathered to hear the host say something like, "and this is one of the IDP camps. Horrible, horrible, needs are many, needs are great, put that in the report." A couple of questions were asked, then people loaded back up, ready for the next stop on the delegate tourist trail. The lady visiting the hospital arrived at 1300 and within 20 minutes had finished her, "in depth analysis of the health care facilities in Galcayo" and was on the road again. I bet a 30 page report will be made by that visit, and millions of Euros will be granted, or reduced, and sadly, our reports, written after years of in-the-field research will only receive what is left over from the next tsunami.
I have heard some reports from Nairobi that there is a pile of money for Tsunami relief, yet no one knows how to spend it, there isn't that much to do, and there are much greater needs elsewhere in the country. Frustrating I guess the word is.

This time here has shown me some things about the politics behind the aid money. The Tsunami efforts go along with this too. Politics and the media, control the money. Somalia, isn't a sexy place to invest in, and we see that everyday. In recruiting for the next expats to continue the projects, no one wants Somalia. In funding the TB project, we haven't got a donor yet, this is coming from MSF's emergency fund (for the undesireable corners of the world).
So, why am I here, what is it all about, what would be the answer to the problems here??? I don't know. I would like to know. Sometimes I think I know. Then something happens, and I realise, I don't know. I'm thinking though, that I would like to pursue some more education on knowing. Maybe get involved in the U of T Peace and Conflict Studies program, or other related topics. I see the complicated inputs to the situation here, and I want to have more tools to understand it.

A few years ago, when I was thinking of starting this journey, a driving force was, "not having the answers." Well, sitting around in Toronto, thinking about the answers to problems in a different world, wasn't getting me any closer to answering them. So, here I am. Unfortunately I'm not any closer to answering the problems, but at least I'm in the atmosphere of solving the problems, and where I am, makes me much more driven to answering them. (When stuck on a problem of how am I going to build something a certain way, I find by surrounding myself with the problem, some answers come out, not all, but enough. This works with cooking, woodwork, coastal navigation, and maybe with the meaning of life and relief work.)

As for my upcoming R&R, I am looking forward to it. I plan on going to Zanzibar again, as I enjoyed it the first time I went there, and this time I think I deserve it even more. (Well, deserve is a hard one to measure, but I will appreciate it.) I am hoping for 10 days out, but may not get it all, as the flight schedules are a little uncertain at the moment. I think the management team is impressed with my work, but maybe because of that, they want me to remain in. We see.

Funny that your school kids are asking your age Mom. People here are asking my age too. Last week when I was in charge of 12 other people in the three projects, I was sent an overview of all the expats in the mission. I was the second youngest of 30, but in charge of 12 others. In the TB clinic, when meeting with the national staff, they all were telling their ages, then the group went silent as the translator said, "now they all want to hear how many years you have. Abdulahi doesn't think you are old at all, and Mohamed Kafhar thinks you are the youngest here and asks should we still have you as a boss, if you are younger than everyone else. " "I'm 30, and yes I am still the boss." Fortunately, I have gained their respect after working with them, but it is a tricky starting off point.

Last week, another tricky situation occurred with regards to my age. We evacuated the South Galcayo team because of the changing climate in Somalia (security wise) and there wasn't a dedicated PC to spend the time to analyse the situation and carry on liaising with the elders. This will be a temporary evacuation, but Amsterdam and Nairobi pushed this. I was to deliver the news to the elders. Before the meeting, the elders and I were sitting down, without a translator. We had greeted each other, but without language. They started talking, and I could tell it was all about me. I heard some numbers and some other words I know now, but no comprehension of the conversation, beyond guessing. At one point they all laughed then looked at me. ("Okay, I know that was about me!" I thought out loud.) In my best Somali (which is more like verbs and nouns put together 2 or 3 at a time.) I said, "Please speak slowly." "My Somali is not good." "Little by little, I understand." "Thank you." They had a good laugh at that one, then their conversation sped up considerably, and I think,ever-so-slightly, their respect for the kid (me) grew. The meeting did get a bit heated as they thought MSF was stopping the hospital program, but with a lot of listening and a little Somali here and there, the end went well. I wonder if they will laugh at the next 30 year old through their way.

Well, it is Friday afternoon, and it is still sunny. I should go and do my laundry. (Funny thing here, the laundry ladies won't wash the most important clothing I have. So, Friday's we all get out our underclothes and do our own. No complaints about that, just odd to have a perfectly cleaned compound, bedsheets, room, other clothes, etc, but have to do a 5 minute washing.)
The Mosque is calling people to prayer again, it must be close to 1500 now. It will be odd being home, with no Mosque calling through the day, casualling informing the non-Muslims what time of the day it is.

Lots of Love,
Steve