Tag Archives: logistics

Franco and the Plumpynut Bandits: Mad Max Continued

Leave a Reply

This week started off rough. It is an emotional rollercoaster here, our project has a lot of visitors, and visitors always come from the capital with their own need to achieve interactive project results. Whether it be advising, assisting, or monitoring, it is always developmental, and always takes up our time. We have such limited resources that even the precious UHT milk running out ahead of time, or a particular treat being used up that maybe someone has waited to have for months, goes unnoticed by the visitor from the real world. Tensions are dealt with well, but the situation of potential insecurity is constantly in the background demanding vigilance and astuteness. Limits are imposed, too, on how much we are permitted to do, and this is my biggest difficulty.

The Mad Max truck returns.

Things have improved this week, though. My truck reappeared across the dusty plains with PlumpyNut which had been portaged 1km through the improbable swamp, at a cost of SDG1.50 (0.40 euros) per box. I have spent the week finishing the new Out-Patients Department, disciplining guards, trying to teach the Commissioner’s men how electricity works with the Market Borehole (again), all the usual challenges. Also, however, I have been negotiating cargo logistics between Nairobi, Loki, Bor and Lankien. This has been a bit more like the work I am used-to. A lot less complicated, but with a lot bigger rogue/ checkpoint ambush probablity.

This turned out with a good result, after a lot of negotiation, motive analysis, conversational acrobatics, and bated breath, but I found myself quietly infuriated by patronising congratulations – why do they think I came here? Does nobody ever read a CV? It was interesting to discover how my tolerance was affected by tensions and external factors. Normally, I’m on to the next job before I have a chance to think about it.

Franco and the Plumpynut Bandits: Mad Max Revisited

Leave a Reply

OK, I think we are all agreed here: the dry season is starting. For fun, we got the thermometer out today. 110 in the shade. Nevertheless, we are still cut-off from supply by – incredibly – water! Most of my time now is taken-up with water management. Whether it be trying to get my guards to stop marauding villagers running the hospital borehole dry, or lobbying and supporting the Local Commissioner to take responsibility for the town borehole, we are the only organisation in this part of the ‘New South Sudan’ with expertise and tools to create and maintain water supply. It is deeply ironic, then, that on the one hand water is our holy grail, and in the story that follows, is our enemy.

When Laraine, the other Logistician here in Lankien was on leave, and I was in charge of all the Logistics here, I ended up requiring several Cargo plane flights. There was one day, when a truck had been sent over-optimistically from Loki with Cargo for us. In desperation, we ended-up using a bush Cargo Plane to shuttle it from the other side of the swamp to here in episodes. This is an account of it which I wrote at the time:

Cargo plane at Lankien International

…There are now four cars (Four Wheel Drive) in the village, and it feels like an invasion. We are still cut-off by truck, but I am told that supply is only a matter of weeks away. It is too risky to travel and assess the impassable part of the road ourselves, so all information is composed from local sources. Meanwhile, Aeroplanes remain our lifeline. When a plane comes, and after it has been meticulously packed with all the supplies, which first have to be ordered four months in advance, then picked from a stock across the border, then loaded according to urgency versus weight, we receive a ‘Flight Schedule’, ‘Flight Manifest’, and ‘Packing Lists’. These should correspond with what we have requested, give or take. Then, at dawn, I have to check the Airstrip, and report to our Flight Co-ordinator in Loki, who will then allow the plane to take-off. We then have to keep the airstrip clear of dogs, donkeys, cattle, random NGO equipment, and rubbish. The plane lands, we offload, check-of all the cargo, and the plane can go. In theory.

On the first day of Dornier flights, there was a flight from an MSF plane from another project, to refuel from our stocks here. This used-up the fuel we had left – two drums of ‘JetA1’. This flight took off. Minutes later, the Dornier arrived with four new drums of fuel. These were the beginning of the stock from the stranded truck.

On the next Dornier load-up, another MSF plane had already turned-up – the scheduled regular rotation. As the Cargo unloaded, the MSF one taxied through the human faeces, shreds of old mosquito nets, piles of plastic waste, tumbleweed and dust, and over the dried-out mud, turned at the end, and started to build-up speed for take-off . It was at about 50 knots, I suppose, when my eye was caught by Riek running after one of the many wild dogs that haunt that end of the runway where they slaughter animals. The dog ran out, straight for the plane, and I have two fantastic photos of the plane, cloud of dust behind, with a dog running literally for its undercarriage. It was a heart-stopping moment. There were MSFers on board, too, but the plane was able to stop, turn, and have another go. Miraculously, the dog survived.

It is now one month since that time, and guess what: we are STILL waiting for the road. The area between us and the supply route is cut-off by swamps, and, although usually dry by now, it was ruined by some ill-advised civil engineering over rainy season, which seems to have done more harm than good. An MSF truck and trailer waits the other side of the swamp, with essential supplies – pipes to plumb the ever-growing Out-Patients Department, propane to run the Laboratory Fridge and cook, Cement to keep-up with the Latrines construction in the fight against cholera outbreaks, and Plumpynut (nutritional food supplements) for the malnourished and recovering Kala-Azar and Tuberculosis victims. This is cargo which our supply centre are reluctant to put on the planes all the way, because of its weight. It has taken two weeks to travel up from our ‘remote’ HQ at the Kenyan border.

It is always a battle of the budgets. There is a price applicable to every Kilo in weight that is brought to our project, and this ‘Transport Surcharge’ is massive. It took me a long time to be convinced to work with MSF. I had seen how Aid worked in countries like Liberia where I worked during the build-up to that infamous civil war for a different Relief Project, and it was only the fact that MSF is guaranteed to commit at least 75% of funding to field operations that made me, after 20 years of consideration, apply. But that commitment shows. There is no wastage here on the ground.

So on Tuesday, when we walked into the market in search of a place to have tea, and a huge six-wheel drive Russian Ural lorry appeared out of the dust like some kind of Out –of-Place, tattered Cold War Juggernaut, it took a moment to register first, that there was a vehicle in the market, and second, that this was the first moment of a huge opportunity.. Absent-minded for a moment, I lapsed back into traffic mode immediately and for a second carried on walking. Then it struck me. Today, this big commercial ‘Mad Max’ style truck, coming, it turned-out, with news of our MSF truck stuck in the swamps, was not to be missed, our biggest chance of supply. We are days away from running out of Diesel for the generator, and are out of propane for cooking food. Latrines will overflow before long, and it may be weeks and big bucks before we can get the stranded load ferried by cargo plane. I started running through the dust after the disappearing ragged hulk.

The driver, ‘Franco’ was friendly, and the first thing I said to myself, with unconcealed glee, was ‘He speaks English!’. I knew I had to try to make arrangements with this driver to retrieve our cargo, bit by bit, across the muddy swamps of Central Africa. But Communication across borders and deserts is painstakingly slow, and there is a list of challenges. Different accents, hell, different languages – Swahili, Arabic, Nuer and English; bad Sat-Phone reception and long-distance HF ‘Bush’ Radio. It is frustrating to know, from our supply and ordering system, that Unimogs are approved MSF standard (huge Mercedes-built ‘Go-Anywhere’ machines). I have used these Unimogs in the ‘swamps’ of West Wales, and if any project ever needed one of these, it was us.

But it is what it is. By the next evening I had managed to co-ordinate between the key players: Field HQ in Loki (Kenya/Sudan border); our Contracted Truck Company in Nairobi (Kenya); their driver at the flooded bridge over the swampland at Pathai; the 6×6 Truck owner in Bor (Sudan), and his driver here in Lankien. Payments between two transport companies across two countries had been co-ordinated, with me in the middle, and the MSF system was working like clockwork.

There is a long queue of NGO vehicles lined-up there in Pathai, waiting to come back in to South Sudan now the Referendum is over, but I persuaded him – with a bit of backslapping/handshaking, some major ‘Truck Admiration’, and a cup of tea – to do a deal with me! MSF remains the only organisation with any active presence in Lankien, so maybe this also helped to persuade all the right people to have all the right conversations with each-other. The biggest struggle was getting hold of his boss in Bor. We had to call a taxi-driver friend of his on Sat-Phone, who drove to the yard and found him. There is much more mobile phone technology than water here (although not in Lankien), but there is no electricity infrastructure in place to charge them. Landlines, of course, don’t really feature.

This is the kind of work I thrive on in the film world – making difficult things happen on film locations, finding the man who can, getting amongst the community – but I do not usually have to do it ‘blind’. All of the places I talk to are imagined to me. I have never visited them. In three months since arriving, I have not gone more than 500 metres from this compound for security reasons. So I have to guess at what is – and what isn’t – possible in these ‘Outside World’ locations around me. As I write, the truck is on its way through the bush to do what it does best. Its tyres are ragged and hissing with air, the front wheels splay apart jauntily, but it is the essence of Red Army ruggedness, and is well-capable of wrenching our MSF truck and its vital load through the mud. Spirits are high.

Week 4

Leave a Reply

Anybody who remembers the first Star Wars movie will recall the monster in the sewage-crusher that our heroes got trapped-in. I went to check up on a latrine which we were decommissioning in our ‘TB village’. This is a compound of some twenty tukuls, mainly residential, where patients suspected of having tuberculosis live, whilst being monitored for developing symptoms. I spent a few seconds looking down into the slurry before it was filled-in, and felt that ‘vertigo’ compulsion to look down from a great height. As I was taking my eye away from the effluence, it was caught by a big yellow eye looking back at me. A huge fat lizard-like creature had made its home there, living off the flies. It was at least a foot and a half long, and I wondered if it was a monitor-lizard, or just one of the many four-inch lizards around, which had become massive, gorging itself on the thousands of flies which live down the warm, disgusting hole.

But the other things living off flies here are the chorus of amazingly colourful birds. I do not know any of the species names apart from the African Bee-Eater, but they are a constant blaze of incandescent light at the corner of the eye. It may be that they have found a particular haven in our compound, safe from children I have seen toying with small birds before eating them around Africa. They capture them and keep them by a string around the foot, and it can seem cruel to the western eye. It is hard to imagine that happening here, though; people seem so gentle and dignified. No doubt, all will become clear, but Felix, the compound cat, flea-ridden as he is, does not seem remotely interested in these little birds either, although I did find the wing of what must have been a juvenile African Kite lying around in the dirt the other day.

This week has seen me take over responsibility for all the supply to the clinic. This is done through our HQ in Loki, where half of our stock for the project is stored – along with stock for the other projects in South Sudan. Weight limits for flights, and monthly consumption rates have to be juggled with each 10-day plane flight (‘rotation’). If we get it wrong, anything can happen, from having no UHT milk for tea (local milk risk of brucellosis) to no second booster for a course of vaccinations. ‘Don’t overthink it’ was the best advice I’ve had from Laraine, the LogAdmin going on leave and handing her job over to me. Yesterday we were working til 10.30pm compiling our medical ‘buffer’ order for the next month, when we may have our supply interrupted for reasons to do with the Referendum. Every medicine has an MSF code which must be found, and a weight, and expiry date, all of which has to be taken into account. Confused? I was. All I know is that last night, for a 700kg load restriction, we clocked up a 1250Kg demand. So now I have to request a new flight, or slot it into a cargo flight which I hope will come the day before New Years Eve.

At 3.30am I was awoken by Daniel, Medical Team Leader, saying that the generator, which had been running because a patient was on the Oxygen Generator had ‘passed away’. I have been in increasing contact with death this week, more babies dying, and reports of someone dying from a gunshot wound in our outreach project. When people die, family members waste no time in their burial. At 5.30am, I was again awoken by Bo Gatluak, one of my Logistics team, who needed to bury his brother. It was he who had been on oxygen, and Bo needed a pick/hoe to dig his grave. My heart went out to him, as I imagined the lone soul digging in the gloaming of dawn. I asked if he needed help, and as I spoke I realised that he would have plenty of help from his family and friends.

So many things have happened this week which merit reporting, and which I was saving for the blog, but my memory has been distracted by the panic of the new handover from Larraine, and I seem to have forgotten so much in the daily panic. I will remember, in time, but the helter-skelter at the moment, jumping from one situation into another, without even time to think to myself ‘This is Mental!’ renders me wholly preoccupied with surviving in the job in hand.

As I browse through past postings, I notice some typing errors. This will be due to all the keyboards here being full of dust. In fact, everyday I am filthy with it. People spit in it, and one of my responsibilities, for Water and Sanitation (WatSan), is to supervise the prohibition of open defecation around the clinics. What with the ‘sputum’ from TB positive patients (everybody spits in the dust here as a habit), and the other fluids that end-up on the ground, drying to dust, and then getting blown up by the gusts of wind, and breathed-in, it’s a constant battle against infection. My nose now doesn’t smell the smells it did when I first arrived – the ‘normal’ smells of the In-Patient’s Department, the Kala-Azar Clinic – but I can still smell the carefully constructed pit-latrines, from down-wind. The other day, I tried to have an English-Nuer conversation with Majok, whose job it is to try and enforce sanitation in the Hospital compound. During a ‘translation lull’, I watched absently as one of the lady patients walked over to a newly-built corrugated iron pit-latrine building. These are simple, but with custom-made foot-pads, and well-constructed ergonomics, they are highly effective and familiar to the Nuer people. We put a new one together at least every week, to keep up with them filling.

It baffles me to know what went through her head as she spotted this building, for which everybody knows the use, and how she clearly thought: ’what a great thing to defecate BEHIND’! I realized at the same time as Majok spotting her, and the cry went up to take a crap INSIDE, but with language and culture being so impenetrable, it does sometimes seem two steps forward and one step back…

A Ruby in the Dust: I hope to post more photos than I have on Facebook, but sat-link is very difficult. Then I could show a picture of our clinical laboratory. Sammy, our Kenyan former acting project coordinator, is in charge of the lab. Here he meticulously investigates sputum, blood, and stool, looking for evidence of Malaria, Kala-Azar, Tuberculosis, HIV, and loads of other tropical diseases. It is incredible to see the place where this all happens; a low Tukul (mud-hut), beset by dusty gusts of wind, with stick and rope poking through the mud walls and a bilingual sign saying ‘Laboratory’. It just struck me last week at the team meeting, when Sammy was reading-off his statistics, what an amazing feat it is to achieve reliable laboratory conditions in this environment.

I went looking for a list of data, so that I could go through the long-winded job of ordering new supplies for the lab. I have been in there before, but not when it is in full swing. It was a bit like going into the Tardis. Suddenly, ultra-violet light on desks, lighting-up microscope slides on a squeaky-clean surface. A high-tech microscope glowing with its micro-image, and a technician diligently logging and rechecking his findings. For a moment, it felt like Boots The Chemists, until a glance at the wall above, with thatch sticking through the mud, and a big flat spider scuttling after a termite, reminded me I was where I was. The lab is the closest I come to home.

One of the many areas of my work which I am trying to strengthen is supervision of the guards. Since arriving here, I had, until recently, had no time whatsoever to get to know the names and faces of my Nuer guards. There is little, if any, English spoken amongst them, and they work shifts through night and day. They guard the flow of village people wanting water, and I try to balance the needs of the clinics with the needs of the community for our limited supply of borehole-pumped water. Discipline is something which I am trying to foster, across the spectrum, as it will be our reference-point in the midst of any panic. This has to be done by example, of course, and through a friendly appreciation of mutual professionalism. The other day we took-in a gunshot wound through the leg, but not a critical one, and as I received the soldier at the gate, our guards were very good with making sure that the incoming recognized the ‘No Guns’ sticker which adorns all of our gates, and left their weapons outside.

Of course, certain colleagues wanted to make sure their friend was all right, and so I let them look through the mosquito net gauze and communicate with the sedated man. There is much suspicion of our medical techniques (particularly in childbirth), so it is important to be transparent, but also to be firm that our doctors are doing a professional job, and must not be disturbed from their work.. This seemed to go quite well, and I hoped I was able to enforce a calm and clear respect reciprocation across the language barrier.
It was great to see Doctor Hanna in action. She is a tough first mission medical doctor from Holland, who sends my logistics boys away when they go to her with work injuries, healthily dismissing them as ‘big babies’. Like all the team, she is thoughtful and caring, but takes no prisoners when it matters. Together with Daniel and the other doctors, they are a formidable force, and the man was treated quickly and discharged. We are in safe hands, and our protection is in our impartiality.

‘Temoignage’ is an interesting key part of the ethos of MSF. It goes hand in hand with the medical agenda, and it is interesting for me to be in a position, for the first time in my adult life, perhaps, where I think it important and justified to express my opinion. This is why I dare to write this blog, and what lets me forgive myself for what might seem like ‘talking all about me’. Here is what MSF has to say about Temoignage and Independence:

Witnessing (témoignage) consists of:

  • The presence of volunteers among people in danger, motivated by concern for the fate of fellow human beings and a willingness to be at their side and to listen to them, as well as to carry out medical work among them, and
  • Reporting on the situation and on the fate of these people, which is seen as a duty. Where MSF is present as a witness to large-scale human rights violations, such as forced population displacements, sending refugees back from their country of refuge (refoulement), genocide, crimes against humanity and war crimes, then MSF may ultimately be forced to make public denunciations.

Independence

  • MSFs independence is, above all, an independence of spirit that has its roots in an independent judgement and a critical attitude towards the way in which humanitarian interventions are both made use of and abused.
  • An independent spirit is a prerequisite for independent action, ensuring a free choice in regard to where and how to intervene, when to start an operation and when to end it.
  • This operational independence implies an independent organisation. MSF refuses to intervene under pressure from any authority, whether ‘de jure’ or ‘de facto’, or to be manipulated into seeming either to support any such body or to act as an alibi for any of them. MSF therefore maintains the strictest independence from any organisation or de facto authority (be it political, religious, economic, financial or other). However, the search for independent financing must respect certain ethical safeguards and the values held by the MSF movement.
  • This overall independence must be respected by each member of MSF, who must at all times refrain from linking the organisation with their own political and other affiliations.

(Chantilly Document, MSF Guiding Principles)

Remaining a voluntary organisation is an important factor in maintaining and renewing an uncompromising spirit, refusing to be bound by routine and the risk of institutionalisation.

These are the words that made me decide to work for MSF.