Yesterday, I was teaching Malo, my generator man, and electrical know-how worker about percentage. The generator fuel reads as percentage on the little control screen, and I was trying to explain that one of our generator readings jumped around between 0 and 86% when it was running. I think he understood, ‘de facto’, but not, as they say ‘de jure’. The principle was lost on him. We have been building without a tape-measure since I came here. I was proud of my own foresight in bringing a nice big 8 metre tape measure, which I learnt to the boys to build doors and roof-trusses. Since arriving here, and with the help of Tyler, my predecessor, we have all but completed a four-room isolation Tukul. I am proud of this, and it means that extreme cases of Tuberculosis, Kala-Azar and Malaria can live next to each other without fear of cross-infection. It seems that it is the double-infected who are the most difficult to bring back from the edge. We did all of this building without a working tape-measure, as mine got broken the first day. Secretly, I think the boys were so fascinated with it that they kept unravelling it all the way, and ruined it. Maybe it was on its way out anyway.

So all this week I have been compiling the monthly Logistics Order whilst my tech-team, 10 national staff, and 10-12 daily national workers, have been digging latrines, building, and cleaning-out the chaotic Logistics Store. I long for shelves, but shelf-building requires tape measures. On the plane that came this morning, came, finally, a whole bag full of tape measures. The first I knew of it was Riek, one of the newly-contracted Log Boys, running to find me in the office. ‘Look, look, Tape Measures!’. I ran back to the store with him, and into much jubilation and hand-shaking. Christmas had come early to Lankien. It is wonderful to see this kind of commitment, both to MSF and to learning and skill.

But this morning’s plane was not on a tape-measure mission. On Wednesday night, whilst I watched a DVD after work, in the comfort of the communal Tukul, midwife Shiela was in the delivery-room of the Ante-Natal Clinic in a bloodbath.

I had wondered where she was at the end of the day on Wednesday, and simply assumed that she had gone early to bed. It turned out that just as the working day normally finishes (dusk), a mother turned up in the delivery room half-way through childbirth with a prolapsed umbilical chord. She described what happens here, where we are without ultrasound or capacity for caesarean section, with only a doppler on the belly, and a tool like an ear-trumpet for listening to the heart-rate of the baby, which, fluctuating with each contraction, was being starved of blood, and dropping to zero, then fighting-back again. ‘They’ll fight for a long time to survive, eh.’ she says, ‘But in the end, what can you do?’ Just as she was finishing ‘clearing-up the mess’, another mother came in, dragging the body and legs of her breached new-born in the dirt, the head still inside her. Sheila had to birth the rest of the delivery outside the Ante-Natal Clinic, as there is only one delivery room. ‘Ah, well, at least the mothers survived’.

So today’s plane was for a ‘green-lit’ (emergency) flight. A patient in a problem childbirth was flown-in from Yuai, one of our outreach clinics. The plane came here from HQ, dropping-off tape-measures, picking up Shiela, and then on to Yuai. It returned, coming to a perfunctory stop on the airstrip and I helped to open the door for Shiela, and carry out the mother on a stretcher.

Lifting her off the stretcher and onto our clinic stretcher left a pool of blood which reminded me again of how close to life-and-death we are here. As a logistician I am aware of the work’s importance, but the specialists often do their thing behind the closed doors of the Tukuls. The night-time still-borns were difficult for Shiela, having to ‘do it all by feel’. She had no torch or radio with her, and anyway had been too busy to call for help. She had said there was nothing I could have done, but that night I had gone to bed cursing the fact that we were still waiting for light-bulbs from HQ to illuminate the Maternity clinic, and that I had not foreseen that I could have helped somehow to make Shiela’s work easier.

During childbirth, the mothers hardly utter a peep here, if anything a soft cooing which Shiela imitates, and it sounds like the warbling of a wood-pigeon or a dove. This is their birthing cry. Without medication of any kind. Without exception. Kathrin and Shiela laugh about the profanities uttered by the average western mother at 1cm dilation, and we wonder together that childbirth is, in fact, not the great leveller across cultural conditioning. Shiela likens their stoicism to the North American Indians.

But it is so easy to get things wrong here. And it may seem that tape-measures and Logistics are secondary, but we all depend on each other. Last night I was out of action with food-poisoning, and so I was not able to check water levels in the water-tower. The generator pumps water up to it, 10,000 litres. Then there is a tap which we hold the key to, which Logistics switch on to supply the whole compound. This morning there was no water in the tap in the kitchen (nor, of course, in the delivery room), and I was still sick. Laraine had managed to get us organised for the plane with minimal help from me, but of course when the mother came into the A.N.C., there was no water for the procedure. I had asked our national staff ‘Bo’ to have it ready, but it was again somehow lost in translation, and I had more than a mild panic. It was easily remedied, it turned-out, but it shows that the margins for error can be minuscule at times, and have huge impacts.

Shiela is a careful, gentle, and consummately professional medic, whose life experience working with the displaced North-American Indian population on reservations belies the fact that this is her first mission. We have bonded a great deal because of her combination of warmth and capability, and her strong personal history of taking adventure at any opportunity. We compare notes on cycling and spots along US Route 66 which we have both visited, and she has, over the weeks, regaled me with tales of her and Rick’s (her partner)’s coast-to-coast trans-continental bike ride, and her self-build housing projects in the mountains of the Mid-West.

She deals with birth and death as a profession, and has a loving but philosophical attitude to death, as do the Nuer themselves, she reports. It was only the other night that I found out that her partner Rick had in fact died two years ago, but he was so alive in my – and obviously her – life, that it prompted me to write out my late father’s favourite quote for her:

Immortal Love

They that love beyond the world cannot be separated by it.
Death cannot kill what never dies.
Nor can spirits ever be divided, that love and live in the same divine principle, the root and record of their friendship.
If absence be not death, neither is theirs.
Death is but crossing the world, as friends do the seas; they live in one another still….
This is the comfort of friends, that though they may be said to die, yet their friendship and society are, in the best sense, ever present, because immortal.

Monday morning was the most daunting morning so far.

The drums have been constant this week. I wondered how one man could keep the same rhythm through the night and well into the afternoon of the next day. Sundays are the most tuneful days, though, with church harmonies and drumming drifting across from the church. Sudanese seem to spend their entire day drifting in and out of song, and working or walking next to folk suits my musical brain very well. Today I heard a liberation song, and as I write, the Mamas are cleaning and preparing our evening food in a happy tumult of quiet song.

Today, Riek, the younger new worker with good English, said that everybody would be sad. We had just seen Tyler onto his final plane, and it was very emotional for the whole community, so I said I was sad, too.

‘No, we are sad today, but we will be sad when you go in nine months’. I have barely been here nine days, and was deeply touched at how much I have already been welcomed into the life of the community. I also feel for these folks, as they must be terrified every time a new ‘cor-medit’ or ‘boss’ is due to arrive for their nine-month stint. Somehow MSF have managed to filter a certain type of character into their organisation, and I have not yet met an expat who does not display the basic characteristics of gentleness, open-mindedness and conscientious professionalism. But one could slip through the net, and these peoples’ lives would be hugely disrupted, their open respect and camaraderie would be assaulted by any abuse from an unscrupulous expat worker. I already feel deeply protective, even having only been here for one ‘rotation’. (Time here is measured in the flight rotations of our MSF plane – every ten days it comes with its one-ton limit of supplies and people, and takes returns to HQ in Loki).

A tsetse fly has been biting me this lunchtime whilst I have been sat at the communal table in the shade. Sleeping sickness is relatively uncommon in this region, but they are evil horseflies with pointed abdomens, and their aggression makes you incredulous. The 8 foot by 4 foot table is the centre of life for us all here, where all things – official and unofficial – get discussed. Work starts at 8am after breakfast round the table. Then it stops at 1pm, and resumes at 3.30pm until six. Each of us has ongoing work before, after, and in-between, some of us on-call, me on duty to switch things like water supply and generators On Saturdays, in the afternoon, we do not work, but have a meeting, where everybody talks about their week. It is chaired by our Kenyan Project Co-ordinator, Sammi.

Indeed, it seems to be MSF policy and tradition everywhere to have this over-table-exchange. Last night, at Tyler’s leaving party, it was an unspoken expectation that we would all address him with our thoughts, congratulations, and individual expressions of love and respect. Then a response would be voiced by him to whoever’s speech, declaring his positive observations, respect, and appreciation. It is a bit daunting as an exercise in ‘public’ speaking, but wonderful to revive that very under-rated practice of eulogy.

Friendship here comes fast, when work, professional respect, and constant society all bundle into one, cemented by that superglue bond of adversity. After we had been to the market and bought some small comedy presents for him, we all showered and cooked some food. Midwife Sheila even managed to cook a cake in an improvised steam-oven! While this was going on, and after I had penned a rather lame attempt at a comedy reference, I got a call from the compound gate. Riek, again, was at the gate with a small billy-goat that he said Sammi had ordered. My slight disbelief manifested itself more because I knew food was already being cooked, and nevertheless, I would expect the slaughter, preparation, and cooking of a whole goat to take at least an afternoon.

I was slightly dumbfounded when Sammy led the goat away, kicking and baulking, and returned less than an hour later with several pieces of still-warm butchered cuts. I helped him wrap them in seasoning and foil, and we put them into the oil-drum oven grill which rusts next to the compound entrance-gate. Needless to say, the meat was delicious, and prepared in this Kenyan way by Sammi.

Every morning, I have been running on the hardened clay airstrip. Getting up at dawn is a lovely procedure when you have had enough sleep, with the African sunrise through the receding bush, and the early-morning people giggling and staring and the playful gang of dogs wanting to join in on the running game . This morning, I gave my aching legs a rest, and took the duty to check and report the airstrip landing conditions to our Logistic HQ in Loki via satellite phone. No running for me today, after a 1am bedtime, after Tyler’s leaving party.

The market is a vast and dusty affair of straw-built stands and mud Tukuls (huts), and stalls selling Darfurian and Somalian-traded bits and bobs. Matches with elephants on, old-style tin torches, soap bars, cheap short-wave ‘world service’ radios, goats; all this is covered in dust, and packaged in that unique fifties colonial packaging seen everywhere in Africa. It is so charming and indescribable to be amongst this ‘product’ again; it’s effect on the minutiae of your everywhere-everyday activity would be very difficult to recapture in a film, yet it is the thing, maybe above all others, that lets you know you are in Africa. Children play in dust-bowls full of billowing rubbish, and the open defacation is politely ignored by all protagonists in the trading.

An ancient and broken-down monument to British imperialism haunts the wide entrance to the market, with its collapsed suspension. A drop-side flat-bed Commer lorry, made in Coventry, I believe, in the nineteen fifties, starting to be slowly buried in the drifting dust, emits a grey-painted, Golgotha-esque presence, and, like a clocktower, marks the centre of the village of Lankien.

Just now I heard my first motorised vehicle since being here – apart, that is, from the regular planes and occasional helicopter, landing right outside the sorgum (reed-grass) walls of the MSF compound. A donkey is currently eyor-ing in the road, but dry season is here, and before long we hope for a truck to make the two week trip from the capital with heavy supplies like cement, timber, and batteries for our ailing solar-bank. The oxygen machines are the biggest concern, as they need to run through the night, and it is a huge waste of resources to have to run the generator all night for this life-preserving service. Our current batteries seem to be struggling with this load, and although voltages remain high, and we don’t have the equipment to test them properly, they are getting old now, and do not hold a charge during empirical testing.

Generator fuel supply is balanced against immediate health-care, and indeed, it is in these fine balances that our jobs, as logisticians, lie. South Sudan is one of the more difficult locations in terms of supply, and I shall be taking charge of this for the project in ten days-time while Laraine goes on leave for nearly three weeks. My coming week will be filled with learning <em>again</em>, of the way that procurement is done, with the strict and organised protocols stamped into the age-old field practices of MSF.

Arriving at Jomo Kenyatta was a proper re-introduction to Africa. Plywood-painted booths on a little concours, which sell mainly mobile phone credit, which was handy, as I had instructions to get a local SIM card. Subsequently a call to ‘Vincent’, the MSF-contracted taxi-driver, and then meeting with his deputy, Danson, who took me to a small shopping centre and Massai market. I didn’t really want to buy spears and beads, and the wireless wasn’t happening, so I called, and asked to go early to my noon destination at ‘Wilson International’. I had an amazing flight in the mid-day sun in a little twelve-seater turbo-prop plane, which we had to virtually crawl into, with our individual packs of ‘in-flight snacks’ in paper-bags. Like a lear-jet, but miniature. Take-off and flight were rougher than the later flight in the smaller plane, and I was really tired from the over-nighter from London to Nairobi. These swathes of Kenyan desert drifted under the wings of the plane, and a million capilliaries of dried-out streams rooted to tributaries of the eventual Nile, and meanwhile I drifted in and out of a rocky consciousness.

Loki is an airstrip running along the Sudan-Kenya border, with the border town of Loki on one side. ‘A lot hotter than Kenya’ was the immediate impression, as I walked across the tarmac. I wasn’t sure where to go, but saw a small kiosk with ‘Immigration’ written on it. I had a briefing paper, and as I was coming off the phone with a contact from the sheet, a Kenyan came up to me and introduced himself: Gabriel, the mechanic.

We drove down the dusty on-horse tarmac, onto a dirt road, and another, following a sign ‘Hotel California’. I was reminded of the lyric: ‘you can check out any time you like, but you can never leave’, but when we got to the MSF compound, it was tranquil and luxuriously laid-out, with even a sky deck. We had driven along what seemed like half a mile of warehouse wall, and I was deeply preoccupied with my lack of knowledge of the MSF logistics system, of which this was the storage area. Shahid, who I had talked to on the phone at the ‘Airport’ quickly reassured me in the compound of whose roles were whose, what I would be expected and not expected to do straight away, and gave me a great introduction to the South Sudan scene.

Three days later saw me back on the Airstrip, checking-in and ready to fly to Lankien, about which, by now, I had heard so much.

‘You have a Kenyan visa for twenty-four hours, but you have been here for three days. Why?’. The customs man was distinguished and friendly, but it was true; I had not known which country Loki was in, had done what I was told, but had forgotten, getting over my arrival fatigue, to tie-in my new knowledge of where I was with how I had got here, and what had come before.

He let me off, and we flew, this time more awake, and after prayers in the cockpit with the pilot, out again, and into Southern Sudan.

Lankien appeared through the windscreen, and immediately I realised it was bigger than I had expected. Scores of people were there to meet the little plane as it taxied to a rocky standstill; amongst them Laraine, who I had corresponded with, and Tyler, who I was to replace. It quickly became apparent that people were open and laid-back, but as I was given the grand tour, I was completely bewildered by the amount of work that had been done and was on-going.

It was a huge information overload, especially given the seeming inscrutible nature of the tall, Nuer tribespeople who, despite tremendous friendliness, seemed more poised and noble in demeanour than other African folk I have lived with before. Tyler obviously had cultivated a loyal and hard-working workforce here, but their abilities, aptitudes, preferences, payscale, language, even names, seemd totally unfathomable to me that first day. As I was walked around the mud buildings of the surprisingly extensive health centre, I was also made repeatedly aware of the fact that I was to cover for Laraine in supply and human resource logistics too, within three weeks from now.

I gradually realised that Tyler’s workforce were more self-sufficient than I had feared, that things would, to an extent, run themselves if I were to make mistakes, and most importantly, that I was to be here for nine months, and that I was not expected to ‘run with it’ immediately, as I would be in the world of Film Production on location. I was greeted at the airstrip by Shiela, an american midwife who gave me a big hug, and immediately made me feel welcome with her care over what I needed immediately to know; where to go with my bag, etc.

I wanted to help unload the plane, and tried a bit, but was equally aware of not knowing how things were, and where they went. After going around the compound, trying to take in what was solar-powered, which water system was linked to which, what drains went to what cesspits, how the latrine pits worked, and a million other things, I had a very calming meeting with Sammi, the Project Coordinator. He gave me the necessary security briefings, and then we went to pick my Tukul (mud hut) in the compound. Buildings here are made from upright posts, set in the ground, with woven wattle sticks in-between, which are then ‘daubed’ with the fine clay-mud three times , and they are topped with a round, thick-thatched cone-shaped pointed roof. They are relatively cool, and, although the thatch can house a lot of the (rather large) African bats, I have slept very well in mine every night so far.

I knew that an important first task when I arrived was to look at the second generator, which had been out-of order for the last two months. In the confusion and bewilderment of the first forty-eight hours, I thought it might be therapeutic for me to focus on this, despite worrying about the time being needed to learn the broader job. Luckily for me, I finally managed to have a moment of inspiration about re-polarising a relay magnet, thereby re-polarising the Alternator magnet, which seems to have made the thing work well again.

At the end of the first day, there was wine-drinking around the table at the expat compound entrance – the nerve-centre of life here – but it was commented how seldom this happened, so I decided to save the bottle of Penderyn I had brought along for my first saturday night ‘on the job’, and we had a great evening of talking and drinking. The DVDs I had brought are going down well, too, and it is great to feel so welcome in an environment of such like-minded, gentle, and hard-working folk.

I still am looking around me now, sat at the table, and looking at the compound fence, behind which the cattle are roaring and snorting, waiting to be driven to their ‘camps’ which will follow the receding water-source away from the drying plains of Nyirol. The fence is made of Sorgum, the main – possibly only – local crop, a tall thick grass reed, and is bulging in need of reinforcement. Everywhere, there is work to do, and at some point very soon, it will be in my hands to see to it. But today is a day off, and we took the frisbee to the airstrip, and taught the crowd of kids how to throw, making a spectacle of ourselves to the cattle-drovers, and constant stream of pedestrian traffic over the well-used communal area. Last night we all ‘went to town’ – to the market, and had a can of the local brew opposite a Chai seller’s stall. Some of the locals are unfeasibly tall – six foot ten sometimes, and often dressed in traditional loose robes.

Today we cook for ourselves, and I hope to knock something together later from the supplies that we keep in the storeroom next to the office. Last night I killed a scorpion which was wandering around by our feet, but the excitement reassured me that the advent of scorpions is relatively rare. Hundreds of frogs are around at the moment, but there is no overload of mosquitoes, and the lizzards and frogs seem to keep many other insects at bay. Snakes are also one to watch, but, as a medical organisation, we keep all the necessary serums to treat any eventuality. Karate kid is playing on the DVD, and I am preparing to sign off and enjoy the rest of my well-earned day off.