Bahai Beach 72

Bahai Beach 72

Farewell party

June 24, 2007

Has it been a year?
Indeed I am off on July second and I came July first. Yet I have another mission under the belt. There were ups and downs. There was the good fortune to work with fantastic, inspiring people but also difficult folks. At times I wanted to explode and at times I have been laughing so much tears popped up. It all came bye over the last 12 months.

Tropical medicine is my training but I seem to be a sand lover. Last night’s party was in a beach atmosphere. Nothing better than sharing a beer, dancing the night away barefoot. Eating a sheep prepared over a grill. And then there were the speeches from partners, colleagues and friends. Many emphasized the mad hatter approach. Chasing people in the car in the morning with a whip like approach. Existentialist Angst over the broken wheelbarrow. The level of frustration I can cause for others but also the joy of working with one who forgets easily irritation and can apologize for quirky behavior.

Alphan talking about my action plan to take 50 kilo of sand and 50 liter of water home to prepare a mini Chad on my balcony but first and foremost to punish IRC for pissing me off (or being vexed, thank you Alphan never knew it meant the same as being pissed off) that the truck had already left (Thanks Marc, you know how to trigger me!)

Or Fabrice the pharmacist rolling in the fore mentioned wheelbarrow imitating a slightly irritated Ashis abusing the logistical department. Making fun of my crack up French, insisting that c’est pas serieuse is understandable in French. Threatening to go to Marc to complain (which I never did leaving the threat pretty feebly hanging in the air)

Mohammed Macousse who clearly had kind words to say about our time together.

Melel our Midwife made a beautiful speech and then invited the health team to take control of the dance floor. That they truly did.

Or that the entire IRC team but mainly the Health Team consists of bandits et bandites. This is what I truly believe bye the way (quote Marc). There is a level of joyfulness in the medical team which makes the work in 55 degrees Celsius, with monotonous food, sand mountains, swarms of flies a plenty, without restaurants or clubs, with a host population that is not always very welcoming a charm.

O yes the party: Tim took the first price for best chicken dancer. Sadjina (assistant health coordinator) the price for biggest fruitcake and Celestine was a superb dj.
Highest percentage of staff members showing up: SOS with a 100% percent score.
The sheep was tender. Merci Francois and Opportune. Despite curfew Audrey and Balde of UNHCR popped.

Given the nature of the place the party was over at 12:00 at night. Yet for a full three hours the dance floor was not empty. What made me happy is to sit back a bit and watch the crowd go wild while hearing the song Guantanamo. It is the nickname for our two compounds. Guantanamo 1 + 2. Although at times with all the restrictions and curfews Bahai may feel a bit like a prison at the end of the day it is the staff that makes this place brilliant.

Sitting behind the turn table after all had left I played a chill out set and pondered on what a great opportunity and blessing it has been for me to live, work and learn here.

Namaskar,

Ashis

http://www.flickr.com/photos/56208021@N00/

Bahai Beach 71

Bahai Beach 71

Tribute to Sancho Yoda

June 17, 2007

My first meeting with my buddy Sancho was at the airstrip in Bahai. He had come to pick me up and on the first 25 minutes back to the camp I am quite sure he managed only to slip in his name and two – three other words. My random generator was happily producing noise and statements in form and shape as where is the nearest camel shop I need to buy one, or rather two to start a breeding program. If there is no milk available I will buy a cow as I cant drink this phony powder milk. Yoda sat through this rant with am ever increasing smirch on his face. He must have thought finally a like-minded fool has been sent to the desert.

What became clear to me directly was that Sancho was full of quasi-philosophical useless tidbits of information and that every conversation with a doubt ended up in two giggly two year olds (mentally). I was duly named Dr Chewbacca due to my sexy hairstyle and apelike beard and to Strike back I called him Sancho Yoda. Sancho, the sidekick of don Quixote, but perhaps the real main event. Yoda because he looked like a midget about 1000 year old and he had the tendency to spread messages of intense perceived wisdom.

As neither of us is interested in being a hero we considered each other to be the eternal sidekicks. Born to remain in shadow. Despite fluffy beard growth. Schemes to conquer and dominate the world. It was he who introduced me to the greatest tribute to a rock song by Tenacious D.

The highlight of our meandering journey through Chad must have been the night spent underneath a truck watching I love Huckabees. Instead of the overrated stars in the Chadian desert we spent a night looking at the nuts and bolts of truck.
This is a far mightier sight than the Milky Way and the basis of the greatest conversation in our history.

Being a logistician and for that a logistical coordinator of a complex country which went through plenty of human resource gaps means that you are often seen in my eyes as the human waste manager of the project. ‘No one else will do the job, bring it to logistics.’ Despite evacuations, crises, shortage of staff, financial constraints, theft, violence he kept is cool for over a year.

His commitment to Purchase tracking sheets was legendary. For those of you less versed in IRC jargon it is a document showing the physical whereabouts of all purchased items including their administrative status. Every Sunday Yoda spent hours behind a computer slowly scraping and tweaking the system until his department was up to shape and it no longer took 120 days to buy items on average but 13. Given the dearth of available items a formidable task. Whenever an unhappy coordinator or manager would write an e-mail to complain about such and such a cheerful, cheeky e-mail would be received the same day taking away all fear and putting a smile on the face.

For me, being moody having a buddy in the form and shape of an American Idol addicted to Florida Flowery shirts has made a huge difference. Whenever I felt my patience had been tried be would sooth me with his wicked psychobabble.

As I write he is and always will be the person I have missed most when absent.
Where are the nights when he was my neighbor and we could keep awake the entire compound with our schoolchild like giggling?

Sure we will giggle again soon when we meet in Los Angeles. And where does this sidekick live?

Hollywood! As if there is another place in LA.

Being a storyteller means picking up the pen. A lot has happened and I hope to read about his dreams, experiences and life soon.

Thank you Yoda for being you.

Namaskar,

Ashis

Bahai Beach 70

Bahai Beach 70

A smile a day keeps the doctor away

June 17, 2007

Weeks of grumpiness seem to have disappeared overnight. I guess I am truly enjoying my final weeks here. Drawing in as much as possible the scents, the colors, the people and the environment as whole.

Parfait an UNHCR staff member has the fastest shoulders of the Northern hemisphere. It means he can shake faster than a supernova. Before he gets into the shoulder mode he starts of with a chicken dance routine, scratching the earth with his toes, rolling his eyes and wobbling his head as if struck by an epileptic attack. As today a priest visited town for the first time in months the national staff from the Staff were elated. A sheep was slaughtered and a special celebration for the arrival of their spiritual guide was organized where the choir sang and others danced.

Not all ngo staff was as lucky as I was today. Two friends I looked up were either plastifying the new ration cards or in meeting. While waiting for an audience for one of the queens I bumped into Parfait. This one-man cabaret show was telling about the time he was interviewed for a job with two of Chad’s most well known comedians. The assignments were simple and two fold. One minute of laughing in front of a camera and one minute of crying. As Parfait relieved his act deep belly laughter was heard all around. At first apparently he had been shy but while seeing the face of the comedian we roared out in laughter and ended up rolling of his chair. Round one: won.

Round he started to demonstrate how we cried. I happily joined in and 15 seconds later wails and sobs were heard and tens of people came to see what was happening. As we crashed to ground in deep sorrow he ripped my shirt leaving me half nude. It was all the more reason for me to burst out laughing.

As we moved on through the village we stumbled into a local bar where we met the local secretary of the district with his finance man. A fine discussion opened up about the responsibilities of the different players in Bahai. Topics passing along the evening; the legal status of the refugees and the capacity of the government to help them and provide security for the refugees and humanitarian aid workers.

A small girl who was sitting in the house was terrorized by my beard and light skin. As the parents insisted she would give me a piece of cake she turned away and hid under the skirts of her mother.

The local ants have found a good pastime as well at night. The game is to sting Ashis as much as possible. Yet I cannot move into my room as I am used to sleep outdoors. I do wonder how I will handle it in the Netherlands and Canada/USA. Perhaps I will take my hammock and search for two trees where ever I want to sleep

Despite the invasion of the ants (living in the cracks of my porch) I am sure over the next 2 weeks I will keep on smiling making sure the doctor can go away.

Namaskar

Ashis

Bahai Beach 69

Bahai Beach 69

Eggs & Kut Kuts

June 9, 2007

Surprise, surprise! It seems my chooks have noticed my nearing departure and in a ploy to keep me here they are working on my conscience. Fourteen eggs have been produced in two days. They know that when I leave there will be a rush at their house and they will end up in the cooking pot. I have therefore applied for passports and visa so our chook emporium can happily expand in the Netherlands. My parents have a nice garden and I am sure they will feel at home there. And the weather is much less extreme there as well.

For those of you who wonder; kut kut is Zaghawa for chicklet.

On Monday, Tuesday and Wednesday an information campaign was held for the women in the camp. Three days in three different zones community health workers, traditional birth attendants, midwives and doctors addressed the brightly dressed crowds varying from 150-450 women and 30-150 children. The focus was on antenatal and postnatal check ups and births in the health center. With a question and answer game about 40 t-shirts were given to those who answered most questions correct. I was the lucky one to be praising the women on their changes in health seeking behavior. Only 4 months ago the vast majority of deliveries took place in the home and now about 90% take place in the health center. Such a wave of warmth hit me after and during each presentation. To be called Papa of the camp or having 450 woman applauding every second sentence you speak is unique and something I will not forget. Our goal was to increase the knowledge of the women of our services. Looking at the numbers (>2200 attending women in 12 sessions) and the enthusiasm we must have done well. At the last meeting a very senior traditional birth attendant, not working for us took the megaphone and explained that now the services in the health center are so good she can retire in peace. Crashing waves of applause followed her spirited words.

All day long in the mean time artillery fire could be heard (about 16 shots) on the Sudanese side of the border. In one case the smoke could be seen. It remains surrealistic. Kids keep on playing, meetings continue, business as usual.

Part of the business is to hand over the responsibility of decisions to the refugees themselves. In our case it means to the elected health committee. For two months they have been meeting and last week their first formal decision, a choice between two candidates for the post of pharmacist. Let it bet he beginning of a string of decisions for the benefit of the community.

Yesterday I was trying to assure the transportation of my books and heavy items by truck to N’Djamena by truck. By air we are allowed to carry only 15 kilo so you can imagine that big bags needed to be sent en route. I ended up vexed because Marc told me the truck had already left early in the morning. I stumped out of the dinner and was about to start cursing when I met Alphan, our education manager. As we have the right to take quite a lot of luggage to and from the project I told him to punish IRC I would take 1 bag with 50 kilo of sand, as well as a bag of 50 liter of water. Like this I could recreate my sleeping condition in the Netherlands as it has been here. Sleeping on sand. One gets used to it after all. Both Alphan and I ended up crying with laughter and he set out to find me some prime sand that day. Tim has been asked to find me the water. Samples from bladders, the lake and random other places will be appreciated.

As it is a day not laughed is a day not lived!

Namaskar

Ashis

Bahai Beach 68

Bahai Beach 68

Osman Imam

June 7, 2007

His father was an imam and he himself is well versed in the Koran. While at university he tried to give the Zaghawa language an own alphabet. The Zaghawas have several dialects but no script. They use Arabic fonts or their camel marking system to write. As Zaghawa is a complex language the attempt did not completely succeed but it did result in Osman’s master thesis. And imagine he had only two copies of this thesis. One copy he kept in his house in Omboro and one in the university of El Fasher. The first copy went up into flames when janjaweed burned his house

When I fist met Osman, who works as the general administrator in the health program in Oure Cassoni I was straight away touched by his love for history and his way of working. One of the first tasks I was asked to do is to reduce the staff by about 20 people. Not an easy thing to do but with the help of Osman and Adam we selected the group and after a ceremony thanking them for their 2 years of service the health staff was reduced in number.

Osman has big 70’s styled spectacles, a beard and always is ready to take on any work required in the health center. I have seen him work as administrator, supervisor of cleaners, assistant pharmacist, translator, mediator, help to the finance department, tour guide, register, supervisor of guards, supervisor of constructions, delegate, Where ever there is a gap, because of illness he can double. Whenever I am too tough on the refugee staff he takes of the edge with a joke. He assures that meetings in the health team never take more than 1 hour and that nobody jumps outside of the agenda. It is with him I do all the verbal autopsies (the visits to the parents of the children who have died to examine the possible cause) & visit the families who have lost a relative. It is he who calls you Yasir Arafat when you are too late for breakfast

After fatur (breakfast) lentils with bread mostly we sometime stay behind to discuss work or religion. After all a meal is not complete unless you have drunk a cup of tea. Osman is a Muslim of the Sufi tradition and he has taught me a lot about Zaghawa history, proverbs, culture, beliefs and jokes.

He has nine children and two wives and is the owner of a grinding mill, 2 donkeys and a camera. His youngest son is a fighter. In the first months of his life he broke his leg. Then he developed prolonged periods of vomiting. In the end he was so ill he became malnourished and had to be admitted for a blood transfusion, therapeutic feeding and anti biotic treatment in Bahai Hospital. There the young baby had the bad fortune to have fragile veins. All his veins were tried but no success. Even a needle in his bone marrow did not allow the blood to be given. That night the worst was feared, but starting the following morning he started to drink again, stopped vomiting and slowly recuperated so much he went back to the camp in 10 days. Then after a period in the supplementary feeding center he has now become a nice and chubby toddler. All the time Osman told me he had faith in our treatment. His family was insisting to take the child to the next hospital, a fore hour drive, but he believed in the recovery of his son and that is just what happened.

Osman cares deeply for his community. At night he comes to health center to assure all is well. Making sure that the guard is awake, the nurse and midwife are present and that there are no other problems.

Today I gave him a copy of a Zaghawa – English dictionary. He jumped in the air and gave me a big hug. Let us hope he hooks up with the man, David, who made this possible. Perhaps 20 years later that Osman expected but his dream of a script for his beloved Zaghawa language is possible.

Namaskar

Ashis

Bahai Beach 67

Bahai Beach 67

What makes the heart tick?

June 3, 2007

Human touch, a story, sharing experience all this and more makes the human condition worthwhile. Imagine a world without myths, folk stories, songs, dance and laughter. You might as well not live.

Here in Oure Cassoni I am delighted daily with the stories of the Zaghawa’s. Despite their plight live moves on. For 11 months and 66 Bahai Beaches I have been trying to share the ups and downs of their lives with friends, family and anyone who wants to know more.

On first thought it is easy to presume life is horrendous, hard after being victim of mass murder, rape, destruction of houses, theft of all livelihood. No one will claim life is easy in a refugee camp when you have lost everything. Yet for me my Sudanese coworkers, patients and friends do not give me a feeling of hopelessness instead I think it is here I first realized what the word resilience truly means.

Never give up!
Whatever is thrown on your path.
Is there a choice?

Colorful anecdotes of their customs, traditions are shared daily during our shared meal of lentils and bread. It gives to airy nothing a local habitation and a name. The stories sometimes shiver my spine and I so much wish I could share them with more people. Not as a spokesperson. There are enough refugees eloquent to slam home the message.

Advocacy and humanitarian do not always gel well. Ask Mr. Rubenstein of the Save the Darfur Coalition.
Yet the story of people themselves should be the starting point of any action or intervention. What is their viewpoint? All to often conclusion are drawn for refugees

People are people. Whatever their religion, skin color or nationality. All have sad, touching, funny and sage stories to tell. It is there where the deepest gap in communication lies. Reporters come for 3-4 days write a piece and whiz of to the next article. In depth and continuing communication is lacking.

The I-Act initiative with camera teams in the camps to have people tell their stories to a world wide audience via the Internet is something that has impressed me a lot. How can one not be touched when a personal story is being told? Having direct interaction would make it even harder for the world to not want to act in the reality that is called Darfur.

What makes a heart tick is an easy question to answer:

It is the real life story of any refugee.

Let us work on getting those stories out there

Namaskar

Ashis

Bahai Beach 66

Bahai Beach 66

Car stolen

June 3, 2007

Yesterday for the first time in three weeks I pretended I was fit enough for a desert kick about. In front of Guantanamo 2 (the nickname of the national staff compound) there is a huge desert pitch with two goals. It was just a matter of putting on my sliver boots and rounding up the boys for a match. The number of participants fluctuates a lot. The game is started with small goals and about 10 people and end with huge goals and 22-26 people. Every Friday and Saturday UNHCR, ACTED, IRC, SOS join to forget and enjoy.

An event not likely to be forgotten is the theft of one of our Toyota Land cruisers. Car thefts seemed to be less common but well there you are. One car less to work with and most likely increased security measures when driving around. For me being on foot is seems a lesser risk.

Our massive truck has finally taken 39 boxes of medication for the hospital and the camp. Besides that there were mango, beer and other food items in the truck. And for other programs there were items as well in the truck.

In the camp little by little constructions are being completed. Materials are being put into place. This week the reproductive health department will get 5 boxes full of material for safe delivery and motherhood. Both a plumber and an electrician have come to Bahai. With our new 2 KVA generator finally deliveries at night do not have to be done under torchlight or worse without light. It is so hard to recruit for people who are willing to come to our Bahai Beach.

Next week we will have a campaign to inform future and present parents in the camp to utilize the maternal health care facility. What is done there and why it is so important will be explained in big meetings in the different zones. I think I mentioned before in the past about 40% of the deliveries took place in the maternity, but since 3 months numbers have been rising and this month the number was 89%. Having a safe pregnancy, delivery and aftercare is extremely important for mother and child health. When I came 11 months ago I can vividly remember the mother that came to the hospital on her own with a placenta blocking the exit of the child. She had come after hours of labor and just when an emergency airplane was arranged it was already too late. She had died. Not all death is preventable but I am quit sure the abnormality of the position of the baby and the bleeding during pregnancy would be noted, an echo would be done and early reference to a surgical unit would be arranged.

The supplementary feeding program seems to have several benefits. As said more mothers come for deliveries and check ups now. But the ulterior goal is a healthy pregnancy, with a healthy baby and mother. That seems to be the case. Over the last months the average weight of the babies seem to increase. which in it self will lead to less risk of early illness and death for the newborns.

The clinical health department is doing well as well. With Dr Remy in the camp as a supervisor and the two new nurses working in the health post and health center the quality of the consultations is going up. Finally monitoring of our Sudanese nurses can take place and (examination) bedside is frequent. Protocols are being used as they are now all getting translated into Arabic. The best indicator is that the last 23 days there have been no deaths in the camp.

In the laboratory we have found an assistant to our lab technician so the laboratory is now manned 6 days a week and with the generator in the camp the light microscope works as well. An example of the increased capacity of the lab is the discovery through Widal testing that out of the tens of fever of unknown origin there are actually cases of Typhoid fever in the camp.

The public health department can then follow this up by house visits and mapping of the cases to see if we have clusters. Also health messages are sent to the community to come to the health center/post when there is a display of certain symptoms. I was happy to give a session for the community health workers on typhoid fever and the public health risks and measures to take. Next week we are focusing on prevention and treatment of cholera. Cholera from a public health perspective is a bigger challenge given the nature of the camp; high density of population, hygienic and sanitary practices, flies, slaughtering of animals and the cohabitation of tens of thousands of animals in the camp. Animals roaming around free are picturesque but also a health hazard.

Namaskar

Ashis

Bahai Beach 65

Bahai Beach 65

Adam-Yellow eyes

May 27, 2007

From the first day I arrived in the camp I have had a great time with Adam. He is my Public Health Community Health Worker Supervisor. On top of that he is also one of the Zone Leaders in the camp and teaches mathematics. He is one year older than I am. Last week we started joking around about a box match between the two of us for which we would invite the entire camp to watch. Let us see how we end this week. Punching each other black eyes or as little boys we are: Big words, little action!

In Sudan Adam trained as a mathematician at the university and he played a big role in his community. In the early days of the escape from Sudan he manifested as a man with endless energy, love for his community, great organizational skills and a wicked sense of humor. While the IRC was still working under the trees and the Sudanese refugees were dying in great numbers he was one of the first to help IRC set up health care. Till today he plays an important role in mobilizing the community.

As he has a gift for the gab his speeches at leaders meetings are sometimes inflammatory. Yet I believe he truly cares and will do everything within his power to make the camp as good as possible and more important we a temporary solution before the Zaghawas can turn home. Most journalists zoom in on him because he has lion like eyes and is a human beat box for snappy one-liners.

As a boy he was once challenged by a friend to kick a ball. A little later only did he realize that he did not kick a ball but a rock wrapped up in paper. His friend wanted to pull his leg. And the result was a broken foot. As his father was a very strict father he had to walk straight whenever his father was around and could only limp when around his kind-hearted mother.

Today I lent him a book he was interested in as he had me seen carrying it around. It was a Deepak Chopra book called ways to peace. I am interested to hear what he thinks of this Indian Ayurvedic doctor.

He trains the community health workers on integrated management of childhood illness and does pre and post test of these classes him-self. Every class I walk in to give a bit of in depth background. This week he was involved in the registration of the newborns after October 2005 in zone C of which he is zone leader. For two days the health center was devoid of his laughter and bright smile.

Today I shared camel meat with him. As I was wearing my black turban he was asking me if I was a Janjaweed or a Touareg. I told him that during meals we eat, after meals we can sort out these questions

Namaskar

Ashis

Bahai Beach 64

Bahai Beach 64

Oure Cassoni updates

May 27, 2007

The story of the prisoners escaping jail with the use of a spoon I will surely not forget. Yesterday I walked by the prison and found to my great surprise that the hole in the wall is still in place. Although I must add a big rock has been shoved into the hole so that escape is hard.

In the camp I visited the boy who was chained to a wall in very dire circumstances. As I visited his room now has a door and a roof so he is not exposed to sand and sun and he does not have to be attached by a rope. He also follows creative therapy twice a week and is improving week by week.

Hagar our old friend (4 years old) has returned from a stay in Sudan and is eating at our breakfast every morning again. He looks happy and talks a lot nowadays. Pointing out when we should go and eat (11.00), that he needs water to wash his hands and that we should be quit while eating.

In the village arms a plenty. Looking at the soldiers one wonders at times how old some of them are? They can look like 14 or 15. Small banditry may be less these days but now we have bored young guys running around time looking for a good time.

My chickens seem to have recovered from the loss of their brothers and sisters. I am still awaiting renewed production of eggs. But they whispered to me that 45 degrees is not a good temperature for them to be very active in that field. I am happy of late to be in contact with several other chicken farmers. So experiences can be exchanged. As I will be leaving soon I am making travel arrangements for the chicken as well. If I leave them here I am sure the will end up in the chicken soup. I like my chooks too much for seeing that happen.

In the market the old Mimi is happily limping around. When I call her she comes to be stroked. She looks well fed. Our two Mimi’s in the compound tend to spend copious amounts of time in my room. I sometimes wonder if they read my books there?

At times even in case of a medical emergency it is not possible to arrange an airplane. Luckily there is a hospital with a surgeon in Iriba, 100 kilometers and about a 4-hour drive away. A pregnant lady presented to the hospital with all signs of an extra uterine pregnancy and she was very pale. In Bahai two blood transfusions could be given and this morning at 05.00 Dr Ponce escorted the lady in an ambulance to Iriba. There with his colleagues he operated on the lady and despite losing more than 3 liters blood she pulled through the operation. She received another blood transfusion and is now stable

Tomorrow a weeklong campaign will start to register all the children born after October 2005. It is important for them and their families for several reasons. Receiving an official registration by the Chadian government is one reason and it will also lead to an addition on the ration cards. There are families where there are 5 children but rations are received for 3 only. It may seem simple to register an estimated 800-1000 children but witnesses need to be present at the registration. Most of the midwives and traditional birth attendants will be assisting.

Amongst other things we are preparing for the rainy season. A cholera contingency plan is being rolled out, constructions are being sped up, and materials are pre-positioned. And it seems we will have a generator in the health center next week.


Namaskar

Ashis

Bahai Beach 63

Bahai Beach 63

Gorilla escapes

May 22, 2007

My o my some antibiotics need to be praised like anything. After hobbling around, complaining and being ill for 10 days today all of a sudden I am starting to feel energetic again. It must have helped the afternoon was spent napping but praise to Cefixime.

What also must have helped is the fact that due to meetings I stayed back in Bahai for two days. Two days spent to pour over the budgets with the donors (UNHCR) and ourselves to see if there is any more money to squeeze out of the budget or all money has been spend all ready. It seems we are good in spending money. In a way it is not surprising at all. Considering the act that Chad is land locked and Bahai is amongst the points in Africa furthest away from a coast/port it becomes logic that items like a bag of cement are 4 times more expensive than in the capital N’Djamena. Also given the minuteness of Bahai no technicians (read mechanic, plumber, electrician can be found in the village) and if the come they ask for the moon to come to end of the world. Eleven months ago I was pretty ambitious about building structures in the camp. The reality is slow it goes.

Amongst the headaches for us in the next months will be rupture of drugs. Then again given the long time it takes for items to be delivered in Chad it is as it is. Even in the capital basic drugs cannot always be bought in large quantities or are sold for exorbitant prices. Also there is the raining season or rather lack of rainy season to worry us. The lake like last year is getting empty and anxiously clouds are being hoped and perhaps prayed for. Then the president of the Republic is presently in the East to discuss with the rebels all kind of peace agreements. In lieu of that there is a massive increase in troops in and around Bahai.

In the camp in the mean time we are de-worming all children between 6 months and 5 years. Also we are giving them vitamin A. Roughly 3000 children are supposed to receive treatment in this campaign and the refugee public health team mainly does this exercise. Tomorrow I will be back in the camp. There will be a lot of small improvements over the next 2 weeks. We are constructing 7 examination couches and 7 cupboards. Also 15 washing points (small water containers) will be put in place so the nurses do not have to walk to wash their hands.

As I write this many of the protocols have been translated in Arabic and have been transformed in to poster so the staff can peep on them incase they forget the fine details of a treatment/diagnosis. Our laboratory is in full swing now, remains to find a refugee laboratory assistant so the services can be provided 6 days a week instead of three days.

Despite all constraints over the last 11 months they has been a clear improvement in quality and quantity of services. Our national staff team has increased in depth and strength and so have the refugees. Now with the health committee in place we hope that even on a management level the refugees can take over the services.

For all of you not living in the Netherlands. A 180-kilo Gorilla has escaped from his cage in a zoo in Rotterdam, leaving 4 people wounded. That in itself is sad. What surprises me is that it is still first page news 5 days after the event. Any way it is as it is. As the Beatles sang Let it be, let it be.

Namaskar

Ashis

Bahai Beach 62

Bahai Beach 62

Cows eat books

May 17th

The ice chilly waters of Ma Ganga are still pristine at Rishikesh a vibrant village with a healthy quota of spiritual seekers from with in and outside India. I like the place because it is right mix of nice people, spirituality, yoga light, lost travelers, waterfalls and peaceful monkeys.

In the morning I take my dip in the river feeling my pulse drop to 30 beats a minute a tranquil awareness and yet much better than last time when I visited around January and the water was truly ice cold. While I was reading a book on tantrism a cow came up and started munching away at my book. Blessed the book I thought and I let the four legged bovine happily munch away. Monkeys also seemed to be after my books. Whispering ‘Ashis forget about knowledge from books find wisdom.’ Well the dear monkeys were happily awarded with a bag of bananas and naturally a book on the history of India.

Birds aplenty in the valley swooping over or casually hopping around looking for dazed spiritual seekers to feed them breadcrumbs, Everyday at sun down an aarti (fire sacrifice) is held for Shiva. About 100 saffron clad orphans with 3-5 musicians chanting Sanskrit hymns for Krishna, Vishnu and Shiva. A robbed long bearded priest leads the ceremony. Every time I go to Rishikesh this is where I find inner peace. Children chant their devotion to Universal love. Little basket filled with flowers, candles, and incense float away on the river and in the middle of the ceremony tens of fire holders passed around to cleanse the sins. The peacefulness of the ceremony is hard to describe and should be experienced by all.

In the village a man walks around dressed up as hanuman, the mythical monkey king and servant to Rama. The faithful ever reliable friend how plays a major role in India’s most known story the Ramayana. He grunts with such a mischievous glint in his eyes and poses beautifully with his attire and mace, rupees flock to his pockets easily.

Anywhere in India where there is a spiritual site beggars and handicapped people flock. Yet this is not the bustling and scamming of the big cities but a more serene facet of the religion. While on a pilgrimage people tend to be more generous. Also the spaced out new converts to yoga or the old school adepts from all over the world chip in. And there are the sadhu’s. This being where the Beatles came to meet Shri Maharishi for a long long time the Shaivite monks are found here. Some phony, many funny, some dealing bhang, some doing severe penance (think about holding your hand up in the air for 17 years, or standing on your head for 8 years. You can meet generation next young Indians coming to combine parasailing, hiking, a religious dip and grandmothers who have always wanted to visited this sacred place. Rishikesh lies smack in the beginning of Char Dam. The four springs of the most spiritual river in India. In fact a goddess called Ganga who was forced to leave her celestial Milky Way to make the parched earth fertile again. As she did not enjoy leaving her peaceful abode she crashed into the earth with such force that the entire planet was about to drown. It was then that Shiva; Lord of destruction was asked by all the Gods and humans in earth to save the planet. By using his Rastafarian dreadlocks he tamed the river. Ever since Shiva and Ma Ganga are in cosmic union.

I missed out on the visit of the sources as they are opened only late in April when I had moved on for Mumbai and Goa of which in a later Bahai Beach perhaps more.

Bahai Beach 61

Bahai Beach 60

Tomorrow some time

May 17, 2007

Snotty nose, coughing out my lungs, fever a splitting headache has doused the inspiration by my muse. Even as I type away now one of the Mimi’s is trying to curl her way up the keyboard. And then I was more or less obliged to sacrifice my rooster for the sake of extended sleeping hours of my felloe workers. The chicken soup did not taste that well on that day.

With all our fine-tuned planning most of the health staff in the camp is out at the same time. It actually leads me to do more hands on work again. Checking out the babies, seeing the more difficult cases in the clinic and today’s delivery. A 15 year old with female genital mutilation presented while in labor. I asked Zahara to step behind and to let one of the other midwives do the delivery. The young girl did not flinch and the progress of the labor was steady. In the final stages of such a delivery a cut (episiotomy) needs to be done. The head came out slowly and as I had asked to check for the umbilical cord the midwife found that it was wrapped around the neck. She rapidly clamped the cord with two clamps and then cut it after which the baby girl could be born. Like the mother it was a strong child so it started to cry instantly. Observing deliveries like today’s gives a very good feeling. When a danger symptom/sign presents the midwives know how to act rapidly.

As I walked out of the delivery room after checking the baby I walked into the meeting of our Health Committee. The theme of their meeting was neonatal mortality. In an attempt to understand the problem they had to write down root causes and most of the essential causes were mentioned. Next week they will work on solutions for each and every cause. Step by step responsibility in the camp is being handed back to the refugees.

It is also seen at other levels. My community health supervisor is the first teacher for the community health workers. Yet not all is love and peace. The monthly meeting with the refugee community leaders turned out to be a three and half hour blood fest, where accusations flew left and right and tempers flared.

Perhaps it is due to the heat. This month is supposed to be the month for early rains. All we have had so far is some splatters of drops. Next month will be the hottest month with historically no rain until the July/August rains arrive.

I realize every day I go to the camp the completion of a cycle is nearing. As my mind wanders I try to frame my thoughts about the progress over the last year. Given the nature of the last 11 months, the dynamics, the obstructions, the obstacles maintaining a status quo should be perceived as a success yet clearly at points there is an increase in strength of the program. It is a joyful thought I will cherish while l put my drowsy head to rest.

For those of you awaiting stories of India. I am sure the muse will return soon-ish. After all I cannot be in mourning for my rooster too long there are other chooks to take care of.

Just a final little story I managed to buy a digital video camera and I was in full conviction that I had a tape as well. Yet on an arrival the tape was a head cleaning tape. O well. I hope I can find somebody to find me a Panasonic tape in N’Djamena

Namaskar,

Ashis

Bahai Beach 60

Bahai Beach 60

Back to Chad

May 6, 2007

A long break in India has done a world of good. Time for reflection. Visit of family and friends and lots of loitering. Bahai Beach 61 or 62 will be devoted to parts of my trip in India.

Here in April a lot of positive changes. Our translator is back in Bahai. We have a new female and male nurse. Three verandas and a shower have been built and more constructions are underway. Nowadays > 85% of the mothers in the camp deliver in the maternity ward, supplementary food is being distributed to over 400 breastfeeding mothers and pregnant women.

The weather varies from hot to cooking hot. In the afternoons one sees the refugee, national and international staff huddle in the shadow trying to ward off the swarms of flies and escape from heatstroke. Today luckily the sky was clouded and a mild breeze has been blowing all day. Unlike N’djamena or Abeche nights here are generally very tolerable. Food distribution has been going on since Tuesday and long lines of donkeys and people are making a great panorama of vivid colors and movement.

Not all-good news from Chad. While the house constructed for the major pump at the Chateau was effectively crashed into by a water tanker a full three days after completion of the building. The whole building has to be rebuilt from scratch delaying the introduction of the gravity based water distribution system. It is similar callousness that has caused our fence to be smashed by another water tanker. Then we have armed boys in town from different denomination and the old adagio guns lead to trouble holds true. Shots can be heard on a regular basis, most is not target practice. Our Congolese loggie managed to tango with a motorbike in Rwanda leading to a bad fracture of his foot. Wishing him a speedy recovery from here. The saddest news by far however is the departure of my Jedi knight buddy Mr. Sancho Yoda. He has rejoined Princess Adriana. May the force be forever with him. Hope to see you sooner in LA!

In the camp despite our efforts a mother decided that the traditional way of healing was better for her child. She there fore left the hospital with her dehydrated and malnourished baby and had a traditional healer carve the little one with more than 50 incisions by razorblade. It is clear that these avoidable deaths are hard to accept yet there lays the challenge of the work. When to act and when to accept other choices, other treatment modalities. We hope to find out this week what made the mother take this path. As per the story the child was born outside of wedlock and is a big problem in the camp.

Since several months we have a health committee in place, which will ultimately manage the health care infrastructure, the committee consists of male and female refugees only and there are advisory members from IRC. The issue of scarification is definitely one of the issues that need to be addressed. Even if the practice is much less common than 4 years ago. Preventable death is an issue that with the help of the leaders and the health committee can be addressed.

My end of contract is rapidly nearing. There are so many things I would still like to do. But for now I will focus on a limited amount of things. Drug Management System, preparedness for the rainy season (yes even in the desert we can have torrential floods) cutting off access to the camp for days to weeks.

For today this will do.

Tomorrow a parable from India or more about Chad

Namaskar,

Ashis

Bahai Beach 59

Bahai Beach 59

Remembering Ethiopia

April 3, 2007.

At 04.45 this morning an emotional moment took place. I had to inform the chicken that I would be out of time for 1 month and that someone else will have to sing for them in the time being. Many people have warned me that in my absence the chicken will not be safe and might end up in the cooking pot. To lessen the threat I have bribed the guards and cooks to take extra care and there is a functional barbed wired gate with high movement sensor closed camera system in place. One cannot be lax with one’s family and investment.

The reason for the early rise and shine was a magnificent car trip from Bahai to Abeche, through Iriba (other refugee camps) and Biltine (proposed site, but also site of heavy combat between Chadian Government Troops and rebels several months ago. All in all it was a nine and a half journey. It was amazing to see how only about 30 minutes south of Bahai the landscape turned from austere Sahel to Savannah like heaven. It has to be said that in the entire journey we met only about 9 other vehicles (or I was sleeping). It reminded me of the contrast with the Netherlands were you go from bumper-to-bumper from and to work. Endless space, few people a camel here and there all with a background of red earth and thorny trees. Navigating through dry riverbeds called wadi’s. It took us about three hours to get to Iriba (the place we evacuated the triplets to remember).

From Iriba to Biltine was the most beautiful part of the route. Jagged peaks and a narrowing valley, winding paths through a low hill range, slithering snakes (1.5 meters this time) and we let him pass. Rocks stacked as if there was intervention of Titans to stack them up as building towers. An eagle soaring in the air, unexpected there were some huge trees in the middle of a wadi. Frisian Dutch (koetjeboe) cows as if lost in the landscape.

Ethiopia is on my mind. It is mainly the landscape but 7 charred Russian tanks strewn across the roadside help as well. David had overcome these Goliath Monstrous Machines. In Ethiopia I wondered often how many children you could give full vaccination for the price of one of these nonsensical War machines. There the tendency to decorate the muzzle of the canon with flowers I did not overcome. Sitting on top of the heavily steel clad Fools toys pondering on the use of these weapons. In Ethiopia as well the scarce water wells were heavily used by marauding bands of camels, cattle, sheep, goats and their herdsmen. Beautifully decorated while walking behind their living money bank.

This is what the young men living in Oure Cassoni used to do. Walk around with their herds to find those spots where grass and water was available in the dry season. Some say the fundament of the conflict on Darfur is the century old clash between nomads (pastoralist) and tribes with a more sedentary lifestyle (cultivators) With an increase of population and a decrease of available resources; water, wood, pasture/farming grounds have become hotly contested. It is sort of conflict of the sort you can find in different countries in Africa. Alas despite sparse positive environmental health from Africa (Notable exception Niger where because people have stopped chopped trees indiscriminately on their cultivation grounds amongst other reasons the percentage and density of forests has increased)

Combined with failing old reconciliation methods and increase in the level of sophistication of weapons. Rocket Propelled Grenades for example are a daily thing to see in Bahai. And there is a plethora of other reasons; projected oil revenues, uranium? , Quest for an arabization of Sudan and a de-Africanisation movement.

In Ethiopia it was called voluntary moves from the highlands to the sparsely populated low lands near the Sudani border. These regions were having so little inhabitants because of rampant kala azar (parasite disease), malaria and rampant malnutrition because of crop failures. Added to this deadly cocktail was; lack of health care services, HIV, Tuberculosis, lack of schooling, poor drinking water facilities.

The highlands in Ethiopia are indeed beautiful and highly populated. I am sure there is no easy solution but sending people ‘against their will’ to disease-infested areas without proper survival tools is not justified.

My stream of consciousness on Ethiopia came to screeching halt when we arrived in Abeche. Time to meet new colleagues and push for a ticket to India. The first hurdle (getting to Abeche) has been taken.

Namaskar

Ashis


\

Bahai Beach 58

Bahai Beach 58

Mr. Mathias’ departure

April 1, 2007

Take a ride on the magic carpet. Hop along, sing a song. Smoke a sheesha. Share nonsensical stories and emotions of the day. All visitors leave with a smile.

Beam me up Scottie,

I clearly was referring to my mat yesterday an intriguing zone where reality and fiction get tangled. For today more sense; after all yesterday was March 31st Fool. It is not a coincidence that in Chad on March 31st one is taken for a ride by each and every one.

Cuckoo, cuckoo.

The weekly rest and recreation at the UNHCR is in full progress (sauna and spa facilities supplied by Jerome and Audrey) and it gives an escape from ‘Work, work, work’ to quote the little civilians in Warcraft.

Today however given my lengthy break I need to prepare a handover for next month for the national staff, give a little (mis)-guidance. Something to look forward is the party to celebrate Mr. Mathias’ near one and a half year stay here. Although he is moving on to greener pastures it has been a great pleasure to have worked with him. Always a smile, happy-go-easy, great knowledge of his work and of the project, the refugees, great drinker and the best dancer of Bahai by miles. I wish him a great next assignment with numachoma in mountains, Primus or Castle in barrels, environmental challenges to work on and a place nearer to his family. The unforgettable moment with him was surely when after an extended drought rains finally hit Bahai. My o my the pressure must have been dragging you down, but the joy in your eyes and the 2 hour rain-dance justified your massive headache the next morning.

So this afternoon/evening I am putting on my dancing cap (paraphrasing Alphan’s thinking camp) and shake the good old tail-feathers.

Never all is roses and sunshine. In the camp one of our staff members has been assaulted with a stick. Also some of our national staff members have difficulty sleeping. It is a mixture of workload, stress, insecurity, isolation from family and friends, lack of quality of life. They need to be praised for doing the difficult work they are doing. It is not an easy job. This afternoon I am sure we can all forget for some hours and give Mr. Mathias a great farewell.

Namaskar,

Ashis

Bahai Beach 57

Bahai Beach 57

Snakes, camels and spiders

March 31st, 2007

Take a ride on the magic carpet. Hop along, sing a song. Smoke a sheesha. Share nonsensical stories and emotions of the day. All visitors leave with a smile. The leisure dome is also by connection to the sand and elements. The elements are in the form of wind and sun, but also snakes and spiders. Several days ago a huge serpent slithered passed my mat. Dangerous or not was the main question in my mind. According to Alphan the education Meister it was, Dr Ponce said it was too small (20 centimeters) to do any damage at all. But before any of us could cage the reptile it was chopped in two by the guards and eaten by one of the Mimi’s. Yes indeed the little kittens have become big cats, climbing our trees, dashing out of the compound and coming back hours later and now utilized as a serpent protection force. Yet the chickens still in their mind are still mysterious creatures. They are not sure how to handle the feathery creatures. My chooks in the mean time are officially labeled not sane. I called in a veterinarian to study their breeding behavior and indeed there seems to be a casual link between their owner and themselves. We are going into family therapy starting April 2, 2007.

I am looking forward as it may solve the riddle of the eggs and lead to swift production of the well-needed eggs. We have fallen slightly behind the targets for control of the egg market in Bahai. In the mean time Sunday I have arranged a tour to Oure Cassoni by camel. It has been a while and there is a need to explore alternative transportation methods. Of late there are petrol ruptures in Bahai and several NGO’s are looking in to the possibility of using camels as transportation means. After all they are sturdy and steady animals, require freely available food and water. The camels come in shades qualities. It requires a trained eye to spot out the bargain and when you are being taken for a ride.

Saturday it was the day of the birth of the Prophet Mohammed. This is a festive day for our Muslim brothers and sisters. Due to some miscommunications several of our staff got a well-deserved long weekend. Bare in mind that Friday and Saturday are working days albeit half days.

So on Saturday I went with an action plan to sir some pots. Using big ladles and with the help of the traditional birth attendants food is mixed and prepared. All hyped to work on my triceps I was mildly disappointed when we arrived late in the camp. The reason was bemusing; the gendarmes in fine frenzy left Bahai without petrol in their vehicles. After 5 minutes they realized and we had to return for another car. I missed out on my physical exercise but the good news is we will catch up later this week.

More good news, after lengthy deliberations it has been decided we will build a near Olympic size swimming pool (6 by 3 meters) and a diving board. The water we will smartly harvest by catchment of rainwater, storage in under water cisterns and to reduce evaporation we shall build an overhead shelter. Soon we will be twisting by the pool drinking pina colada and risking third degree burn wounds. Our new piscine will be the heart of social life in Bahai and there are plans to add an out side bar with state of the art sound system. Lounging in the afternoon, deep house at night and in the early morning low fi. We hope the theme park in our compound will be a major success and that the peeps will be queuing up to join the Bahai Party Squad. The motto: ‘Here to serve humanity while having a good time’

Namaskar,

Ashis

Bahai Beach 56

Bahai Beach 56

Uum Zahra

March 29, 2007

Her radiant smile and warm handshake brightens up my every day come to the camp. Our standard first line is: ‘How many Zahra’s and how many Ashis’s.’ Our code for how many newborn girls and boys in Oure Cassoni. I wish for the girls and she for the boys. Seldom do you meet someone with such a positive energy. After a night without sleep because of three deliveries she will not go home for a sleep. ‘No Ashis, there is work to be done’

Since the age of fifteen she has been working as a midwife and her training was in a big city in Sudan called El Fasher. Thirty years of experience.

She had to flee her beloved Omboro 3 years ago. Janjaweed and Government of Sudan troops were burning her house and that of her neighbors. Antonovs were bombing the village before. Zahra like many in the village overnight lost six close neighbors and had to rush away in to the mountain to seek shelter. Packing some essential belongings in her two donkeys a six-day walk on a dangerous voyage through the desert to attempt to reach neighboring Chad. During the flight troops were in hot pursuit and Antonovs were strafing the terrain with bombs.

Bahai and its surrounding filled up with 18.000 refugees from her and two neighboring villages; Kornoi and Farawaya. Refugees were camping out under the trees and the already vulnerable water well was heavily taxed. Zahra’s donkeys died within three days in Bahai because of the poor quality of the water.

Her sister who had two young children passed away after three months leaving her to take care of them. When I asked her yesterday if she wanted to go back to her village her answer was crisp and clear. “Not until my niece and nephew have completed there school. ‘ As the International Rescue Committee was looking for qualified health staff Zahra was amongst the first to be recruited and as I wrote about some mails ago a first health post was set up under a tree to take care of the health of the Sudanese refugees.

Three years later and Zahra received her diploma from the Chadian Ministry of Health as a midwife and nurse with distinction as she said one of the best things to happen to her since many years. During that ceremony she was given a new name by the leaders of the community; Uum Zahra, Mother of the community.

The last two months with the help of Melel the Reproductive Health department has received an immense boost. Before 30 women came per day for antenatal check ups and now the number has nearly tripled, breastfeeding mothers & pregnant women (about 300) get supplementary feeding, blood group screening is being done as is screening for syphilis, deworming takes place as well as addition of folic acid and iron tablets to prevent anemia. As a result instead of 5 deliveries per week in the health center we see about 8-10 deliveries and Dr Remy sees all the babies. The fledgling department needs expansion. We have found 1 midwife extra in the camp, hired ten traditional birth attendants and we will be building two extra consultation rooms.

And this week there were 4 workshops on gender based violence and clinical management of rape survivors for protection staff, nurses, midwives, traditional birth attendants and community health workers. Roughly ninety people trained by Sonia an expert form IRC from New York. It was extremely insightful concerning ones own prejudices and conceptions. From here on we hope to integrate parts of this approach in our health programs overall.

Zahra and her team are working magic. And every day I have the pleasure to see her radiant smile.

As long as there are people like Zahra the spirit of the Sudanese refugees can never be crushed. No bombing or other violence will chase them away.

Namaskar,

Bahai Beach 55

Bahai Beach 55

The system is getting tweaked.

March 26, 2007

After the bombardment an immense silence prevailed. Some obligatory barking by the Chadian Government and we all returned to business as usual. The wounded of the bombing are doing well.

My chicken are definitely delusional; after 40 days of breeding STILL no chickies running around the compound. I guess I will have to wake them from their self-induced delirium. Who is behind this plot to waste the precious time of my two hens? Are the roosters here up to the job? Is it impossible to breed in March? Who can enlighten me?

I have found a nice website which answers at least some of my questions. Google Brahma chicken in Holland and you will find some answers at least

So how about me; does 9 months of sand in your lead to permanent brain damage or can it lead to growth?

Well at least my goatee is really like a goat’s. Cannot be bothered anymore to shave and it makes me fit in with the crowd in the camp. As well in the local discotheques. Flashy lights, fierce Kalashnikovs fire, Stroboscopes, goatees and local beauties figure a plenty in this oasis. I cannot think of any village in the world with a better nightlife. Sheesha’s as evening treat, bright starlight, a puffing generator on the background. Time to reflect and plan for future world domination. Perhaps some more time in this heaven on earth perhaps not.

I like to work in programs not are not well settled yet or a bit chaotic. The day-to-day adjustment of what is possible forces you to be proactive and reactive at the same time. Will the next phase of the Oure Cassoni program be a bit too calm? On the other hand I feel a very strong commitment to our refugees

The program is getting stronger on a day-to-day basis and that is a good feeling. Our refugee staff is getting trainings twice a week in 4 different groups. The laboratory is slowly, slowly deploying. Surprise, surprise there may be a mirror microscope requiring no electricity so we can do blood films, urine and stool examination in the camp itself. This week a very sensitive topic: clinical management of victims of sexual violence will be discussed in three workshops. It has not been addressed enough in our program and I hope these session will kick start a broader discussion about women’s health.

And then there is a visit of our major donor and at the same time the medical coordinator of UNHCR will be shedding her light on the weaknesses and strengths of our program. Drug orders for the next six months are due as is the monthly report, health incentive staff, a one month hand over, hiring of three staff members and the day to day things.
Busy is good and my energy level is still high. Yet a break in India is something I am really looking forward to. Explore the motherland and loiter. Ponder some more about the when and where I will be in the second half of 2007.

This weekend our shower was fixed and a truckload of mangoes were sent. Bravo. Life is getting better. In the day the thermometer is starting to hit the 40’s again. I wonder how hot it gets here. At least the nights are always reasonably cool.

The dream of a sauna as we had in Ethiopia will not be achieved but you can’t always get what you want. But if you try sometimes you get what you need.

Hasta la pasta,

Ashis

Bahai Beach 54

Bahai Beach 54

Birthday gorilla on the loose

March 22, 2007

‘O what a beautiful morning, o what a beautiful day
I’ve got this wonderful feelin’, everything’s going my way’

At 00.00 I ripped open a surprise packet from Australia. My o my I was flooded with gifts; books, speculaas, candy, chocolate, lollypops, an Australia rocks t-shirt, crèmes, dreams, candles, incense…

What a delight.

And then this morning in memory of Dance Valley (flower shower from airplanes over a dance festival) our neighbor Omar decided to send a silver bird with some firework in the morning and in the afternoon.

Things got only better over the course of the day. Two healthy baby boys added to Oure Cassoni population. Our second day of supplementary feeding for pregnant and breastfeeding women in the camp was a massive success with more than 130 women showing up. Things are moving and shaking. The construction team is building a veranda for the reproductive health clinic.

At 14.00 we had what I consider to be the best moment of the day. In a fine ceremony 3 of our nurses and five of our midwives were given official Chadian certification for their work. This is a day of immense success. After three years they get go-ahead from the Chadian Ministry of Health to be working as qualified staff in our health structures. While I was praising them in a speech explosions could be felt and heard across the border.

Silver birds with nasty cargo.

Yet fearlessness is the keyword. Our ceremony continued and as one of the leaders remarked on exactly the same day 3 years ago this happened to their home village Kornoi and they had to flee. He praised Zahara our chief midwife and said her title from now on would be ‘Mother’ Zahara. With smiles on their faces our 8 heroes received their certificates after being lauded by Sylvie, Osman and in presence of several Zone leaders, Dr Camilo, one of the founding fathers of the camp was there as well and for the refugee that was very special as well

This was a special and surrealistic moment where fear was overcome with resilience.

We also found another qualified midwife. Things are coming together in the camp.

The sweetest moment was when Okke sang me some birthday songs. This youngster has a bright career ahead of him as a rock star.

Tonight we are eating sheep. I will tear apart some ribs. Chat with friends on skype.

It was been a great birthday.

My one wish has come true today. Better quality of services for the refugees. Things can only get better over the next months and years. Despite the violence vibrancy and positivism rules the waves for a day.

Namaskar,

And a gazillion thanks to all the staff for making this place a better place,

Ashis

Post scriptum

My friend Gogo just walks in to share the sheesha I lit up with in his hand a heart of sweets. Cool gift!

And the chicken just dropped by to sing me a song as well; kuckoolekoo

Bahai Beach 53

Bahai Beach 53

March 20, 2007

Mother India calling

The sheesha is bubbling again. Tobacco is freely available on the market and with Yoda we hang out at night looking for the world’s best and worst song. Downloading from the Internet the hunt is on. Anyone want to chip in?

Today I have got my holiday approved and the Bahai Beach episodes in the month of April will be coming from India. On the hit list are; meet and greet the Dalai Lama, finding a nest in the Himalayas to call a home, meditation in ice cold rivers, visiting friends and family around the sub continent, stocking up on good books, chilling, incense, funky humor, loitering, bargaining for nonsense on different markets, games of karam, ludo, pimp pam pets. Being home in short!

The team in the camp is almost up to full strength and I can feel progress being made on a daily basis. It is a slow but steady process. As the security situation has improved over the last weeks and months we can focus on consolidation instead of fire fighting all day. The arrival of the new country director and the return of Marc will surely help in the process. Also in Abeche we have two new staff members; a security officer, who although I have only seen him sleep (my fault for never being around during normal hours) looks rock solid and a new base manager in Abeche; Frederic. With the truck moving up and down with materials essential items, as there are drugs and materials are arriving in rapid succession. It is a good time to take a break after 9 months in the project.

Like the last time before a break it is also an opportunity to reflect on the future, present and the past. As for the future it is becoming tempting to stay a bit longer as then I can see the reap the fruits of the seeds sown over the last months. Yet travel and seeing family and friends around the world is tempting as well. Another path as there is exploring shamanism, reiki, further study appeals as well. I need to make up the balance and decide over the next weeks what I truly want. The work in the field is definitely something that makes me happy. On the other hand a real social life remains low key here in the field.

Presently the team is changing, old friends like Mr. Mathias will soon be leaving and new people are turning into old hands. The smile is still on my face every day as I wake up and that is a great feeling.

The camp has been rocked by some very sad events over the last three days. First a
13-year old boy was stabbed with a knife in the lung and he is still fighting for his life after an evacuation to Abeche. Then yesterday a man got stabbed in the side by his son. The knife must have severed vital organs as he bled to death within a half hour. Today I visited the wake for the gentleman. He was one of our staff members. About 100 men and 50 women were praying in separate spaces for the deceased. The men read out suras from the Koran and the beads go rapidly through the hands to accompany the prayers. This mourning will last three days and will be repeated after about 40 days and thereafter yearly.

It is still unclear if there is an increase of violence or if these events are isolated and exceptional. The suspects for the two crimes are both in jail. Yet I cannot begin to understand the sadness that both families must go through.

The day also included a visit of the Dutch Ambassador for Cameroon, Chad and Central African Republic. He came with a team of three and it was fun to be talking with Yolanda and three compatriots in Dutch for half of the day. Discussing the difficulties faced in the field but also to talk about the resilience of the refugees. He also promised to send herring and eels on Queensday. Let us hope I return on time to sample some of those typical Dutch treats in N’Djamena. It reminds me of the days when I could pop over to the herring stall on the bridge near my house in Amsterdam and eat my favorite fish.

Well another day has gone bye. By all means send me a list of the worst song you know and the best. It is fun to down load them and make my song collection as eclectic as can be.


Namaskar,

Ashis

Bahai Beach 52

Bahai Beach 52

Mimi’s mystery

Sunday 18 March 2007

Reports come fast and thick. First there was a singular sighting by one staff member but then a clear pattern. This was followed by multiple sightings by multiple people. Mimi, our handicapped limping black former cat is more pleased to stay on the Libyan market with the local population then with our decked out compound.
Bless the kitten.

Thos reminds me of the potential threats my chooks (and future kutkuts= chickies) are going to have to face. The more or less hyper intelligent Mimi’s have found out that one can eat birds. Luckily early in life they have been traumatized by all kinds of birds so a learned trait – fear for winged beings – may still be in place.

Well as you can read I have plunged head forward back into the work in Oure Cassoni. There is a plethora of visitors coming bye/ there right now. Again ranging from donors, our new country director, security/health/gender based violence advisors from New York, journalist, the Dutch Ambassador for Cameroon and Chad.

As a health team we have the pleasure of hosting the doctor who has set up the camp. His name is Dr Camillo and when he came in the beginning of 2004 there was not yet a camp. As he showed in a slide presentation there were 8000 people living in the wadi (dry river bed) in the middle of nowhere and 8000 people living under trees as well in the village of Bahai. For those that arrived in Bahai they shared one water well with the 6000 inhabitants of the village and all the animals.

What remained of the animals that is. The first loss concerning their animals they faced was the thefts and butchering of their stock in the attacks by janjaweed. Then during the trek here some animals died. In a third batch they sold their livelihood for very low prices to assure at least some food. And the final hit was the bad quality of the drinking water leading to massive number of deaths of the livestock. There were images of piles of tens of donkeys, goats being burned. And this happened on a daily basis.

In Zaghawa culture money is represented by livestock. Mainly camels, but also donkeys and goats are the way to express wealth and power. Some of my staff have told me they lost all their (200) camels, 300 goats and 50 donkeys. Imagine losing all your income in a span of two/ three months…

Then over the next months, March and April 2004 there was a steep rise in deaths amongst the tree dwellers. As they stated themselves ‘The sky is their shadow’ and ‘When you have nothing you might as well be dead’ It was the time when there tens of deaths per month due to malnutrition, diarrhea, meningitis and respiratory tract infections. Surprisingly those that were dying were mainly in the category 50 years and older.

To assure health care access a central tree was found in both sites and that is where with help of freshly recruited nurses, midwives and community health workers mobile clinics were started.

After the needs became clear finally in April 2004 Oure Cassoni was founded as a ‘temporary camp’. Two more weeks and the third year anniversary will take place. Yet to put things in to perspective the Chad program for refugees is still the baby amongst all IRC refugee programs worldwide. The sad reality is that many refugees are forced to live in squalid conditions for five, ten or even twenty years.

I would like to thank Dr Camilo for sharing the story of the exodus and arrival in Bahai with us. It gives a perspective and a reminder where we come from and where we are despite all constraints. Major strides forward have been made, but also major steps need to be taken. Slowly but steady we are moving forward.

Namaskar,

Ashis Brahma

Post Scriptum

Yoda and I were having one of our loquacious conversations about the meaning of life when he poured out one of his ad hoc gems in the context of quality of the work we are doing in Chad: “I cannot accept any mediocrity in the work, but for my own mediocrity”

And in the market I was walking around with my Rasta man cap when a man came up to me and inquired as to why I was wearing a child’s cap and children’s glasses. My response: “ O the girl who sold me the items ensured me they where adults’” Leaving the man bewildered and myself with a smirk from here to N’Djamena.

Bahai Beach 51

Bahai Beach 51

Chasing Hippo’s

March 14, 2007

Once every 6 weeks we get to leave the proverbial bubble. One tends to forget there is more in life than refugees, sand and camels in this world. On Thursday 3 of us hopped on a plane and lo and behold the peasants hit the big city 2 flights later.

This was by far my best break. There are nightclubs to relief the pressure. Imagine an energized Ashis hopping up and down on the dance floor. Different discos are familiar with the sight by now. There are some more visits left to round up the remaining few that have not been visited. Meeting up with witty compatriots. Talking with my adorable eye doctor about the differences but mainly parallels between Islam and Hinduism. Cherishing the endless amounts of addax (chatter boxing) between two friends looking to maximize the laughter. Jokes about his Keralite descent and my phony Marxism.

Just outside of N’Djamena there is a small village where you can sit on the riverbank of the Chari River. It is as idyllic as it gets. Watermelons and mango orchards with splattering of birds chilping away. The beautiful kingfisher hanging above the water looks for a glint of shadow of a prey. The egrets wading through the undeep parts of the water. A hawk observes form in a tree. The quiet of nature and peaceful as Chad can also can be.

One tends to forget while in Bahai that not the entire country is in a state of emergency. True large parts of Chad are heavily militarized riddled with low (or even high) intensity conflict. But there is also the delightful countryside. A place where fishermen carve up pieces of soap to attach to their fishing lines and where with wooden boats they ride the river waves as lords of the water. Catfish the size of your underarm are sold for $6 per 10 pieces. There where the local sultan comes out to greet you as you are a special guest of the village.

As the level in the river is relatively low it is possible to play a match of cricket on the bank of the river. Another nice scene was the visit of the Chadian honorary consul to India. He flew over to Chad from India to give a party in the Meridian for diplomats and business people. For token sake there were 5 Indians as well but the vast majority of visitors were Chadians and embassy people. To assure that in the Indian report of this event there were some Indians present we (3) were rounded up and a photo was duly taken. What I liked most about it was the fact that I got taste the entire range of Meridian pastries. They have an excellent pastry chef there and 15 different cakes and pies were sampled and compared leading to the conclusion that there should be more of these invitations so deeper investigations into the matter could be made.

Talking about photos do check out www.newsweek.com . There is a very nice article in Oure Cassoni camp with Angelina Jolie and on photo 9 you might recognize someone.
Right now I am hoping that my stand bye place for the flight to Bahai turns into a solid seat so I can return to my bubble and do my work there.

Just to keep you up to speed. Yoda made a tough and courageous call. A lady pregnant of triplets had delivered one child in the camp but then for the next 24 hours there was no progress for the other 2 babies. With the team he decided to send her by route to Iriba where MSF operates an operation theatre. The lady and the 2 other babies (completing the triplets) are now fine.

It seems I am entering the bubble again. This time I have the pleasure to know that a break (holiday) may be up sooner than later.



Namaskar,

Ashis

Bahai Beach 50

Bahai Beach 50

Two difficult deliveries in two days

March 5th, 2007.

The energy level of the doc is kind of low of late. Time to tank up in N’Djamena. Have a swim, eat fish and fruit and sleep in an air-conditioned room. Perhaps even a hotel as the guesthouse in the capital doubles as an office and I am not so much interested in that. A few weeks after that I am planning to go to India (f I get my full leave days)

Yesterday when we arrived early in the camp straight away we were asked to see a difficult delivery.

A young lady had been in labor for more than 10 hours and despite the fact that the head was nearly outside of the birth canal the last centimeters seemed too far. While doing a vaginal digital inspection it became clear why. The head of the baby was in a slight mal presentation and the lady had suffered from female genital mutilation. In other words her vagina had been sutured close leaving an opening of 5 centimeter. No longer am I surprised to see this in Oure Cassoni and even though the official number of women having FGM is 48 in the camp, all the woman I have seen during delivery have been incised and sutured. With external pressure to the uterus and a firm episiotomy (cut to open up space for the head of the baby to pass through the baby was born. Yet when clamping off the umbilical cord the clamp was not used correctly and an arterial umbilical vessel started to shower blood over Zahara and myself. Within 5 seconds the clamps where back on and Zahara and I could look and laugh at each other as the child and mother were doing well. All present in the delivery room learnt a valuable lesson that the umbilical cord and the clamping thereof is a delicate affair.

Another lesson learnt is that 6 midwives present at the delivery makes the delivery a busy and highly inefficient affaire.

This morning again we left early due to the food distribution taking place in Oure Cassoni starting today. On arrival we found that two children had been delivered during the night. Two healthy baby girls although one was only 1.2 kilo and she needs close follow up.

There was a 17-year-old girl delivering her first born. As she had been in labor for over 12 hours the TBA had decided it was time for the mother-to-be to start pushing out the baby but the baby head had not proceeded far enough in the birth canal for that. This girl/mother had also been cut. After the delivery it became pretty clear that the exit of the birth canal was narrow and obstructed as the head was very much deformed and the baby came out without breathing, blue and floppy.

Here what the midwives do is grab the baby by the ankles and slap it on the back. If that does not work the child is also hit on the feet while water is being thrown at it. What the baby girl needed was to have all the mucous sucked out of her nose and throat clogging up her capacity to breath and a ‘kiss of life’.

The feeling when a child is not breathing for 2 minutes is very stressful I can assure you. The good thing about this girl was that he heart was beating firmly and rapidly. After mouth to mouth-nose breathing for about 1 minute she started to hiccup, clear her mucous and breath on her own.

An observation on my side after this narrow escape to the midwives;

“A human is not a fish, it requires oxygen in air in order to breath”
“Many hands make the work light but too many hands make it a mess”

At the moment of delivery of the baby there must have been 7 midwives, 3 relatives and myself in the delivery room. In the building because of the other two deliveries there were another 15 women and as it was nearing consultation time another 10 pregnant ladies were awaiting on the porch.

Well at least this week the majority 6/7 deliveries are taking place in the health center. Let us hope this mini trend continues and the difficult and at risk deliveries are observed early and helped out in an appropriate way as well as referred on time when needed.

The lady we had referred to Bahai on Friday with generalized convulsions was returned back today with a healthy baby boy n her arms.

Reproductive Health was originally not supposed to be part of my tasks but as there is no expatriate manager and only since one month a doctor I do tend to lend a hand when needed.

Well next time more about the other programs.

Namaskar,


Ashis

Bahai Beach 49

Bahai Beach 49

Urgent transfer.

March 2, 2007.

The maternity was a hub of activity this morning. The two boy twins are both doing well. After I did a check up of these delightful newborns and was about to write up the history of them a 20-year-old pregnant lady started convulsing.

Her mouth was contorting; her arms and legs were flying left and right. With three tongue depressors and some bandage we rapidly devised a protection for her tongue. Often in attacks like this people can bite their tongue causing heavy blood loss. Three midwives were holding her down while we struggled to get a perfusion in her arm. Only when two more people lent a hand did we manage to find a vein and keep the drip in. She was convulsing and having contractions at the same time and that endangers the baby. Diazepam was given and after 3 bouts of convulsions she improved

As there are limited ways to follow up a case like this straight away the convoy leader was informed at 11.00 about the urgent situation for this lady to assure a rapid descent to Bahai Hospital. Even a caesarean may have been necessary (hence a flight to Abeche). All the more reason to speed up the transfer. Yet here the poor security situation shows it impact. As we travel in convoy with other NGO’s under guidance of a vehicle filled up with gendarmes it takes some time to arrange transportation back. In fact our plan time of departure was 12.30 and despite all best intentions we did not manage to leave before 12.45.

In the car she started talking with her sister again and right now she is under observation in Bahai Hospital were she is under close observation. We hope to hear later tonight that she has delivered her child safely. Eclampsia can rapidly kill mother and child. Even after delivery she still needs treatment and follow up. Also her next pregnancy (not so much choice in Chad) will be monitored closely.

In the car you can get angry about the lack of organizational skill to alleviate a potential life threatening situation, or and that is probably the more positive approach, be appreciative that she was in the health center during the day when the problems started.

It is not always easy to remain patient for things happening here in Bahai and Oure Cassoni. I talked before about the gunshots being fired in town not being considered as a dangerous thing. Or the fact that once again the town is flooded with armed boys & men. Yet given all constraints and all threats it so much more helpful to look at events from a positive perspective.

It is fun to live with 30+ people in a compound, for several weeks no car has been stolen, the refugees are still hanging in there, nobody went on strike when we paid them nearly 3 weeks late, water is still available in the camp, construction after having been on hold for several months are now en route to be made. A half fence is better than none, even if the water truck has managed to smash it after only 2 weeks. Bread with lentils in the camp has been changed for the treats of sardines from a tin and goat meat, on and on.

In the end of the day if you cannot smile about the life you are living who can.

I started this morning singing and dancing. Teasing my national staff and in a very good mood despite or because of the sandstorm and it is how I wish to end the day. A big chunky smile on my face.

Every is not falling apart,
No slowly, very slowly there is improvement in the camp.

For today that means hanging up curtains for patient privacy in the health post.
And the promise made by two logisticians that before I leave the project for good three investigations coaches will have been made.

My self I am after locks on the market as well as cooking pots so we can start the distribution of supplementary foods to the pregnant and breast feeding women.

25 small changes make one big change

Namaskar,

Ashis

Bahai Beach 48

Bahai Beach 48

Green men with expensive toys in town.

February 28th, 2007

The heroine from Tomb Raider must have a huge following in Chad. Boys and men are flocking like pigeons on the Dam Square in Amsterdam. Is there something in the air?

Well as precaution we left the camp early today. While we left there was a class going on with as a topic recognition of diarrheal disease, its danger signs and how to treatment. Education was going on and that is a good feeling.

We also had a meeting with teachers from Zone A to explain our coming visit to their school to classify the children with ringworm in two categories. There are the severe and the simple cases, category one requiring tablets and category two requiring crème. Now I am hoping for a quiet day so we can visit the camp tomorrow to follow up here.

End of the month also means I need to take some time to write a report on the activities of the last 4 weeks. Our doctor is hanging out in Abeche getting training in HIV counseling and the treatment of tuberculosis. It means I am seeing patients again in the camp. As there is our one HIV positive patient who without treatment was doing reasonably well. Today I was informed he is dehydrated so I sent a nurse with perfusion and ORS. If he does not get better in his home environment we can always send him to the hospital for palliative care. It is the reality of Africa.

We lost another young man, most likely to HIV this week. Treatment for this disease in Chad in the district hospital of Chad is not available. Ben, my assistant public health manager has just come to tell me I have a big part in his play about ‘Prevention of HIV’. I am looking forward to do a little bit of health education acting. As we have been doing blood tests for syphilis we are finding this sexual transmitted disease in pregnant women. It is time to address this issue in the community. Both in Bahai as well as in the camp.

My chickens are complaining a lot about the sound pollution of helicopters and vehicles plying bye at high speed. They have written up a petition so I go out there to speak to these bad boys. Pip em down, less noise, eggs are being bred, chooks require rest. Talking about birds, one of the Zaghawa sub-tribes is called Anju. Anju is a bird with bright colors. This bird can never be chased from the houses of the Anju Zaghawa hence they are known as the Anju.

Today in the news; Chad to reject UN troops. Perhaps they have been looking at their neighbor too much, or the present regime thinks it can squash the ongoing rebellion easily. While I am reading a book on recent African history, including a lot of violence and chaos the scenario is repeating it self in Chad. Future historian may shine their lights on the situation of this part of the world. I was pondering how to get a hold of a book by Samantha Power on different genocides in the world when Sancho Pancho walked into the compound with exactly that book under his arm. Yesterday we got to hang out like the 6-year olds we really are and it does me tons of good that he is around. Another merry sidekick to rule the world!

Silly boys rule Bahai.

Two boys and a band of noisy chooks.

Namaskar,

Ashis

Bahai Beach 47

Bahai Beach 47

Sancho Yoda in town

February 27th, 2007

With the arrival of Yolanda form Holanda, Brahim, Sacho Yoda it seems Bahai is brightening up again. Only dark spot is Audrey leaving on an expedition to find Gelato Baboons in the Simian Mountains, but I am sure she will be back soon. The big gorilla in the mean time is eagerly awaiting some slam dancing & fish eating in N’Djamena. Over the past 8 months I have met plenty of people who are stationed in N’Djamena but have visited Bahai. Time to harass them!

I wonder who has figured out yet who was our mystery guest? Next week I shall reveal…
What I can say is that all our visitors are genuinely impressed with the resilience of the refugees living in the camp. One could imagine a group of repressed, sad people but as I have written before they are a mighty bunch. Super heroes.

No not always easy to work with and for but worth every single minute.

The most interesting moment of the day for me came when we were discussing female genital mutilation. As to assure that the tradition was kept alive a trick procedure has been devised. Instead of cutting the clitoris and the labia a small incision is made so the girl bleeds and then the older women confirm that the girl is now ‘proper’ and circumcised. I was surprised to hear such a brilliant solution. Ancient culture respected and no harm done to the girl. And the men suckered. Discussing this practice our Health Officer mentioned that it is not an Islamic practice (found in the Koran) and therefore the roots of this practice are cultural.

Remember the boy I mentioned a couple of blogs ago who was tied to the wall. Well SOS Kinderdorf has returned and they have a special unit to take care of mentally challenged children. He will be the first to be consulted, to be given walking practice daily (he has contractures because he always squats). He will come for play therapy and the family will be explained that our young friend needs stimulation. The positive thing is that when you do stimulate him he responds instantly.

On arrival home I was pleasantly surprised with a local treat: locust. Yummy they taste great. Tomorrow I will serve them to my buddies in the compound to see who likes them and who does not. Another thing lined up for tomorrow is a visit to the school in zone A so finally all children there can be examined for the severity of their ringworm. It will mean seeing up to 500 kids tomorrow. Well all the more fun.

And some more good news; drugs are arriving and have arrived. Hopefully all we are missing presently is in the boxes. Although in the end of the day most of the essential drugs are available in both the hospital as well as the camp
Bye the way does anyone know how to fix a fridge? After 6 months ours is still broken. Finding a mechanic is impossible and even after an extended visit to Abeche (for our fridge) it is still not cooling. The irony of the country is that a new fridge needs to be bought when it breaks down. Sad but Chad.

Catch you later,

Hasta la pasta

Ashis

Bahai Beach 46

Bahai Beach 46

Visitors

February 26th, 2007

Scores of people want to come and hang out at our beloved Bahai Beach. Political activists, donors, observers, exploration teams, humanitarian workers, ambassadors, journalists, photographers, cameramen, movie stars and philosophers.

Amongst the quoted reasons for a visit to our beach resort:
Quality of the beach at lake Carriari, funky nightlife, exquisite gastronomy of the region, fine market, tons of sand for kids to play in, proximity to Sudan, proxy for Sudan and lastly the wild life. As Sudan or rather Darfur is impossible to visit nowadays the media visits the camp closest to the Sudanese border.

Our friends at UNHCR double as innkeepers at times with between 2-10 visitors. Some of the visitors have huge expectations of the Bahai experience and expect high maintenance care. After all they are big fish. And fish in a desert need good care.

Yet it also brings an opportunity for the refugees to present their story to the world. To assure that their present status remains an embarrassment to political leaders worldwide. How many years more of talks of intervention of UN troops? The refugees are very articulate in expressing their needs for protection and their hopes and expectations for a peaceful future. If only world leaders could some a similar passion and interest to do something about the shame beyond shame talking place presently.

Spates of visits, high profile or not also give the impression that something might happen. What I find admirable is that the refugee community does not give up despite hollow words a plenty and little action taken (by governments around the world in a concerted effort) to ameliorate their urgent problems.

Yet normal life continues and so the Bahai hospital received a patient from Bao. She had delivered her 7th baby but she did not deliver her entire placenta. When the family managed to come to our hospital after seven days she had a high-grade fever and signs of sepsis and shock. Despite maximal efforts of the team in the hospital the lady died.

Maternal deaths remain a huge problem in this part of the world for a plethora of reasons;

Lack of access to obstetric care (this lady traveled about 140 kilometers over non existent roads)
Lack of nutrition (many of the women are anemic due to lack of proper nutritional practice)
Frequent deliveries in short periods (No time for recuperation)
Female genital mutilation, in this part of the world many women have their vagina sutured so a delivery requires a cut always (risks of infection, bleeding, prolonged delivery, obstructed delivery).
Unsafe delivery practice with infection like tetanus as a consequence.

In the camp in the mean time we had a similar case. It was a lady with a retained placenta. Due to custom she preferred a delivery with an untrained traditional birth attendant. That is her personal choice. However when a complication developed things were less good. For hours out midwives had to argue and insist that the lady required further medical care. Her placenta was eventually removed manually but it was a not so easy scene for our midwife who got threatened in the process

There must have been something in the air because there were miscommunication and arguments all over the camp. At least it is not cooking hot with the sturdy wind to flow a steady flow of sand in your face. I am dreaming of snowy slopes. Perhaps I should go to Dharamsala this April. Hang out with the Dalai Lama.

On that note,

Om shanti

Ashis

Bahai Beach 45

Bahai Beach 45

Busy days

February 22nd, 2007

The heat strikes.

Mr Mathias had been presented with a precious gift. A minute gazelle. Left on it’s own the animal passed away. The sun has started to burn again. Winter is over!

The warm weather will make it able to sleep outside for all, but during the day there is no place to find shelter. Fikiri our new logistician was born on the lakeside so I will propose to him to open a swimming club at lake Carriari. It should be fun splashing around in the main water reservoir for the entire region.

Today the water collection truck broke down so we have been with out water since the morning. Solutions are rapidly found and one of the other trucks was dispatched to arrange the water situation.

Flies adore this heat and today visit to the market will likely end in a purchase of a flyswatter. Sometimes you see on television a lethargic kid too weak to swipe of the flies of his face. It is not a matter of lethargy the flies are just too persistent.

Oure Cassoni has received visitors from WHO to ascertain what skin diseases are causing mouth and head lesions in the camp. The doctor and the lab technician were well experienced in outbreak control and I realized again that one of the things I like most about medicine are our friendly parasites.

Worm, virus, protozoa, bacteria bring em on. I will have them for breakfast. The interaction between them and us. The mediating immune system I find it inspiring. Spent a large portion of last night reading up on obscure disease like bejel. As I wrote in the last post I am thinking about different paths for after this mission. I feel an urge to absorb some more knowledge; epidemiology, healing, medical anthropology. I will see what appeals most and how I can combine it with work or perhaps be a full time student again.

In the camp in the mean time there are some health practices deleterious to the health of babies. Consider cutting the uvula (the thing dangling from your palate as one. Common believe is that when a baby vomits it is because of that thing dangling and irritating him/her. One might as well have it cut with a razorblade. A young baby is now admitted in the hospital trying to deal with this problem. The WHO doctor told me that in the regions he had worked this was the prime cause for malnutrition of babies.

On Monday we will have a superstar visitor (John I guess you know) I shall happily write about the visit on Monday. It seems the Timster, Marckie Mark and myself are all geared up. It far outshines the visit of the American ambassador yesterday. He came by plane to see what the situation is like for the refugees, local community and humanitarian aid workers.

My chooks are on the way to have offspring I hope. It has been a while since the two of them are hatching eggs and it seems the cats have become accustomed to the chickens.

Our weekly meeting should start now and afterwards I am sure to visit the market. I have money in my pocket for the first time since 3 weeks and I will go on a mango spree. Yahoo.

Catch you later,

ashis brahma

Mango’s not available but I had BBQ meat and a guava drink.