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.

Bahai Beach 44

Bahai Beach 44

Busy days

February 17th, 2007

For the last week both the Health Coordinator Sylvie as well as Dr Ponce are out of Bahai. It means that the responsibilities of their jobs come to be shared amongst the other members of the health staff.

Luckily the hospital has been calm for the last few days. Dr Ponce is in meetings with the Ministry of Health to assure the deployment of a doctor, an administrator, several nurses, a lab technician and a pharmacist. After all it is a Government District Hospital and to be honest it would be a shame if the equipment, the medication and the infrastructure cannot be utilized in the near future. Our Ngo has been trying to hand over the responsibility back to the authorities for quite some time now. Today I took the new head of office of UNHCR for a visit to the hospital and as he said compared to many other hospitals this was a well-organized place. With a functional operation theatre, a laboratory, a generator, a pharmacy and a new kitchen under construction.

A stroll in the market today and a guava drink made life very agreeable on Sunday. A nice sandy wind and a light sun made the temperature agreeable. And then there was the Saturday night film night. A silly Jennifer Lopez was so bad it became good again. More important hanging out at the UNHCR once in a while gives a different and pleasant perspective.

We are moving up our staff numbers to 27. Unfortunately we only have 2 vehicles and that does not make life easy for planning the programs. It means at times people have to stay back in the office because there is no place in the cars. And that indeed means the office is up and functional again. For those of you who have not seen try www.flickr.com (ashisbrahma). After the massive rains in August 2006 and the increased security threats of November we have worked a lot from the compound. But with so many people around and a new logistician in place (Fikiri) our beloved office compound is back in full swing. It makes it easier in some ways to separate work from leisure. Read not being at work 24/7. Yet giving all the back log due to reduced access, reduced staffing we all need to work hard to improve again the services

The last months have no cakewalk. And the next few will not be either. The security situation has not improved much. It is hard to see that hoped for improvements in the health department have been delayed. Examples are planned constructions (on hold for 5 months), introduction of training programs, proper drug management systems, yet with the return of key staff I have the feeling we might see rapid improvement of several components of the program.

First and foremost as I wrote before in the reproductive health care department. It is where by the help of traditional birth attendants we can increase visits to the Maternity ward before and after delivery. But also supply supplementary feeding to breastfeeding and pregnant women. The hope is to prevent women from becoming anemic and malnourished and assuring the increase of the average birth weight of the children born in the camp.

It has been nearly 8 months since I am in Bahai. A holiday is looming soon and I am looking forward to that. Time to ponder on the route to be taken in the near future. Time to meet some old friends and family to reflect and discuss. Time to eat and meander, read and listen to music. Dance and travel freely without being locked up in a compound.
Time to breath in and out!

Until the next Bahai Beach

Namaskar,

Ashis

Bahai Beach 43

Bahai Beach 43

Car Crashes.

February 15th, 2007

Our third car (for 27 staffs) has been taken back to Abeche. There is some mechanical defect. En route yesterday the replacement vehicle had a car accident. Luckily our driver is ok and the car is more or less intact, but for some days more we are half stranded. Security limits are movements by foot and absence of cars the driving to and fro to the camp.

A sharp reminder that car accidents are dangerous here was when a vehicle toppled yesterday near the camp. It is said that one man died.

In the camp as every day there is good news and bad news. Amongst the good news is the arrival of treatment for the ringworm. The quality will allow us to start treating the severe cases. The less severe cases will have to be treated with a lotion. Our health center is flooded with cases.

The sad news was the death of a 1-month old child in the health center. Upon arrival it was clear that conventional treatment had taken place. With a knife about 50 small carvings were scratched into the baby. On arrival the child was in a very bad shape and despite or firm efforts it died nearly immediately of the blood infection. I talked about this practice with Adam and Zahara. In the past they said cases like this were very common but nowadays they were becoming more rare. Yet today proved that the health message about scarification may well be repeated as to avoid other needless loss of life.

Over the last days the wind has picked up again and it is freezing cold again at night. In the camp a distribution of blankets is taking place for the vulnerable. Just imagine how cold it must be in the more or less open desert. Even the cats are crawling back indoors every night after a period of sleeping outdoors. As always at night they have found the one person who is tapping away in the middle of the night to share some heat.

My chickens are getting fed up with their diet of rice and spaghetti. I have requested a chef cook for them from N’Djamena but unfortunately we are bound to a maximum number of people in the compound. The next two days will be long hard days of work, but on Sunday I go in hiding again. Time to ponder, relax and, well not visit the market after all after the bombardment it has been off limit. Perhaps we can challenge the boys from UNHCR or ACTED for a game of footy. We shall see….

My buddy Sancho Pancho is booked to come to Bahai for about three weeks and I am happy about that. Wise cracking at night time. A smile in the desert.

In a way it is a sad week as well. Sospeter the logistician is moving on. Soon he wil be in Congo looking for diamonds with another NGO. I wish him all the best. I am sure we will do very well.

For now my mind is void.

More later in the week,

Namaskar,

Ashis

Bahai Beach 42

Bahai Beach 42

Calmness prevails?

February 11, 2007

Two of my chickens have understood the message. Their role is to make sure I become Lord of the Chicken. Grandmaster of the Eggs. Number One Chicken farmer in Chad. One is having 2 and the other 7 eggs stuffed under their wing.

The weather is becoming warmer and the nights less cool. The kittens enjoy their sunbaths and play in the sand. I can sleep outdoors and gaze at the stars again at night. It is a great season just before the heat strikes and the fierce winds are over.

In the camp 3 children were born in the health center over night on Friday. Since the arrival of Melel our reproductive health assistant manager, an experienced midwife, services are picking up rapidly. More and more women come to the antenatal clinics and we hope that more pregnant ladies will decide to deliver in the health center. To assure that at the grassroots people are aware of our new enhanced services 10 traditional birth attendants have been taken in to service. The core duties of TBA’s include finding those women that are pregnant and promoting the utilization of the health services.

A lady popped up at the clinic. For three years she had been walking around with a bullet in her shoulder and it has become too painful for her to handle further. Monday she will be on the ambulance to have the bullet removed. At the same clinic our new doctor Remi is finding his work cut out for him. The nurses in the camp have always said that children below let us say 3 years are difficult to examine and diagnose. One of Dr Remi main tasks will be to supervise the nurses so they increase their skills and also to give a boost to the quality of the consultations.

With our team nearly reaching full strength (only missing 2 nurses and 2 translator and one expatriate Reproductive Health Manager) it seems business is back to usual. Yet there are only 3 cars in the project (usually 8) and only 27 people in Bahai (usually around 50) you can imagine not all services are back to full strength. The health department has been in ways lucky.

Yesterday for the first time since I am here a football match between UNHCR staff, IRC staff and random passer-byes. It ended in a thrashing. My team lost 4-0. More luck next time and at least I tackled several opponents in the process hurting myself more than anybody else. Such a relaxing day!

To make the day even better I went over to UNHCR. Two new satellites were installed and I was force fed with a round of 220+ canals (Most of which Arabic) by Audrey the Big Fish of UNHCR in Bahai. So I dozed off at 22.00 after I had rambled on for about an hour that I would collapse after being put through more punishment.
Dog-tired but happy as a little bird.
I said: “Calmness prevails?”

Why?

This morning we heard two loud explosions in the distance and a little bit after we felt the trembling of the earth, the windows/doors shaking and an even louder noise. The most likely explanation is that an airplane dropped bombs. I do not know about wounded or structures hit but so far it seems Bahai was not hit

Always when you are lulled into a false sense of security in this place instantly you are brusquely awoken. The consequences for today are:

No movements outside the compounds until further order.

At the end of the day of tomorrow we will find out more. The local authorities and UNHCR are investigating as I type this story.

To me it gives a feeling of awareness of where I am. Only last week two nights in row I heard gunfire. Anne asked what the noises were and all 4 people present who had calmly continued with what they were doing (watching TV, chatting, working online) responded that it were guns being fired. Some how you get used to it.

Aware and accommodated to it, making an assessment as to:

1. Hit the deck
2. Go to your room and lock the door
3. Continue as usual
4. Inform the security focal point to follow up
5. Await security briefing
6. Go on with what you are doing

Today I am sure that the church service continued for our national staff. Several people have just returned.

Well to all of you,

I am fine.

Dr Ponce will leave for N’Djamena for meetings with people from the Ministry of Health. But with Dr Remi around that does not mean that the responsibility for the hospital will fall completely on my shoulders.

So calmness does prevail

Namaskar,
Ashis

Bahai Beach 41

Bahai Beach 41

Sun is shining

06-02-2007

He was standing in a round mud hut. His leg tied to the wall. On the floor lies a bowl with the remains of a meal. A snotty nose but there was a smile on his face. While I squeezed into the minute room he looked up to me and put the free dangling stethoscope in his mouth. The boy was seven years old and could not speak a word. As his mother explained he got lost during the attack of the janjaweed on their village. Our friend got separated from his family and was found back after a day.

Ever since he has not talked.

I wondered looking into his dark brown eyes what would be going on in his mind. To be tied to the wall and having very few ways to express yourself. What had he gone through and what is going through today.

There is a NGO called SOS-Kinderdorp run by Jolanda in the camp focusing on psychosocial care. Whenever I feel less happy I go their center to watch children have therapeutic playing session. Surely he should be on the list for playing therapy and his family should receive support as well to help them out.

And then on Monday a 15 month boy was presented with an acute flaccid paralysis of his left arm. In medical terms that can mean many things but in a refugee setting in Chad one has to consider poliomyelitis. If that is the case mass vaccination campaigns need to be rolled out. But we are not there yet. It can be a host of other reasons. The boy was not so lucky in many aspects. At 15 months he still could not sit up, walk, talk. It seem she is partially blind. It looks like he has a heart rhythm problem. In all milestones of development he is behind. His young father and mother care for him passionately.

Bold heads, or patchy loss of hair. Many children in the camp were found to be suffering from a fungal infection. This will involve a major operation to treat all these children (estimate 3000) for the duration of 1 month at least. Such a large quantity of drugs we do not have in stock so I t needs to be bought locally. Chad being Chad (in other words landlocked) it is proving to be an expensive exercise.

The health team has been growing rapidly over the last month. A new doctor, Remi a mid wife Melel, two nurses coming in 2 weeks, a new expatriate midwife coming in March and the lab technician has been around for at least a month. In the hospital more or less the same story despite the absence of the Ministry of Health Staff our midwife, pharmacist, 2 nurses have returned. Finally it feels like there can be improvement again in the program. Giving time to reflect, plan ahead instead of panting all day and doing crisis management day in day out.

Today I spent explaining the new staff the principles of IRC. I managed to do one verbal autopsy of the death of a four-day-old baby and to visit the Health Post. This last visit was clearly due. We found a dirty Health Post, with examination rooms doubling as storage rooms. And to top it all of for the first time in 3 months we had a weekly regular meeting with the health staff.

The outbreak of skin disease is a serious concern and we are still scrambling to buy enough medication.

Well as I gaze at the moonlit night I wish you all a beautiful day.

Namaskar,

Ashis

Bahai Beach 40

Bahai Beach 40

The caps are on

February 1st, 2007

And the afternoon sun gives a mighty smile yet my colleagues are walking around with monkey caps, skiing coats, boots, shawls and skiing glasses. Me I say cold is mental and I walk around in a flimsy kurta pyama. The winds have come down the last couple of days and it makes a lot of difference. Sleeping outside is on the agenda again. The stars are just waiting to be gazed at. Is it full moon?

The cats have found there way in and out of my room. We struggle to share the minute bed. Just as I type this both of the cats come over to play. They like the apple sign on the back of my lap top. But how could I forget the most important news?

The eggs – omelet or future chooks – are back in production. One of my latest visits I found 8 eggs. I have left 4 with mother chook to be bred. Awaiting the stipulated 4 weeks to see the result. In the camp they have warned me that the winter is not over at all. It could still hit hard. I however tend to follow my chooks wisdom and weather information.

I started to tell you about the outbreak of skin disease in the camp. There are over 1500 cases of ringworm. This requires a major intervention based on:
1. Treatment
2. Health Promotion campaign
3. Active case finding and surveying

You can imagine that we have nowhere enough medication to treat such a vast quantity of kids. Normally a drug order will take more than 3 months to arrive in to our land locked `Chad. So exceptionally drugs need to be bought locally.

I spent the day today out of the camp piling up work on the logistician Fikiri. About 17 different structures need to either repaired or build in the camp. Things ranging from wooden/plastic structures for vaccinators, to an incinerator, shower for the delivering ladies and a latrine in the health post. Also I had to chase him about the urgent request to buy the necessary drugs. He took it in his stride with a bit Congolese smile.

Only a few months ago we were with 6-7 people in the compound. The team is getting bigger on a daily basis and on the last head count we reached 22. It would have been much more were it not for the lack of airplanes. One of the constraints here is that the over land road is dangerous and that there is limited capacity through the air. If an airplane is needed in another region more urgently or maintenance is taking place immediately it leads to a backlog of people flying in and out. Only our organization has 15 people waitlisted. A huge dysrupture to services and a major impact on planning.

Our Public Health Assistant Manager Ben left today for a 2 day seminar, but given the erratic flights he may be out for quite sometime because of it. With him went our other lab technician as well. Well at least they get a break from the isolation. I wonder at times however if Abeche is such a good place for a break..

If you recall well Abeche was taken by rebels two months ago and I am sad to say that fighting has increased again in the South of Chad. This around a village called Adre near the Sudanese border.

Over the last 1 month two reports have come out reflecting the situation in Chad

1. Human Right Watch
http://hrw.org/reports/2007/chad0107/

2. Amnesty International http://www.amnestyusa.org/news/document.do?id=ENGAFR200012007reflect

They give a clear reflection of what is taking place in this part of the world with vivid description of people who have suffered this vicious violence. It may not be a bed-side read but it does spell out why there is need for protection of the victims, persecution of the criminals and peace making.

Let nobody be able to say ich habe es nicht gewusst!

Namaskar,

Ashis

Bahai Beach 39

Bahai Beach 39

The video-man.

25th January 2007.

Ever since our assistant public manager Ben Tamam has been given a video camera all events in the camp are filmed, interviews are given and shots are made left and right. I must have mentioned many times that the amongst the refugee population there are substantial number of eloquent, funny and passionate speakers. Let us see if some of our videos can be placed on line.

An old patient came back to the hospital. It is a young man with a knee the size of a football. Amongst the plausible causes are; tuberculosis of the bone, chronic infection of the bone, cancer of muscle/bone, fungal infection. It is doubtful that conventional treatment of this condition will be able to solve his problem. It is much more likely that his under leg needs to be amputated. A difficult choice but right now he does not have a functional use of his leg either since 6 years. Long discussions were held with him and his father and finally Dr Ponce managed to come to an agreement that the two of them will be dispatched to Abeche for a third opinion and a possible operation.

In the camp there are many special patients lining up also. They all have disease which can not be treated in a primary health care center and sometimes even not in a district hospital. Examples are children with cataract of the lens, hernia of the groin or a lady anemia due to vaginal bleeding.

The public health department is starting up a campaign against skin disease. For the next three days all school going children will be checked as to seeing if there are ringworm, warts, herpes, furunkels and other skin lesions. There will be special training for the community health workers to spread the health message needed and a training for the nurses about recognition and correct treatment of different skin problems.

On Sunday the good old Dutch game of ‘paaltjes voetbal’ . Picture 8 men running around the compound defending a little brick as there goal while attacking other peoples brick. Among lots of laughter and clouds of dust. Kings of Bahai soccer were found and the day passed rapidly.

Later that evening if became clear how much we rely on the generator on a day to day basis for our electricity. It started to disfuncition the last week with hick ups and last night was halted at 3 O’clock smoking and sputtering. Thanks to one our drivers who worked the filter and engine for several straight hours I can send you this e-mail tonight.. I must enjoying the silence of the generator not humming in the back ground is a good feeling.

It is a quiet time to ponder and reflect on the last near seven months. We have been living through some very trying times. In fact there is still always the threat of car theft or violence. Convoys rule the daily visits to the camp and still after more than two months our teams are not complete. Life is lived in a barbed wire compound and only since recent small walks are permitted. The food however hard our brilliant cooks try still consist of canned vegetables, small variety of meats and no fruits, milk or cheese.

It has been a demanding time. A lot of the things I set out to do have not been achieved. Even if the reasons are understandable the fact that small construction work, ordering of drugs, introduction of all kinds of systems has not been completed requires a lot of patience. Not something which comes easy to me

The next 5 months the first thing required is patience and security. If these two factors are available the deployment of a full team should be possible. Finally the motto would be ‘Let’s boogie!’

Namaskar,

Ashis

Bahai Beach 38

Bahai Beach 38

Visitors

23 January 2007

‘On your right you may see a braiding donkey and rapidly after on your left a 4 year old helping his 9 year old sister preparing bricks. Bricks that will then be baked in the sun and together with mom will be constructed into a wall. This will act to keep out the merciless wind and sand. Less and less we rely on communal latrines and we actively promote the construction of family latrines. At your left the impact of the fore mentioned wind. This used to be a wooden construction with plastic sheeting. This construction has a function as a pre school. But now all that remains are the wooden poles. The plastic sheets are blowing in the wind. I cannot elaborate enough how harsh the circumstances are for the refugees in Oure Cassoni camp. In the summer it is up to 50 degrees and there is no dearth of water. Water in Lake Carriari may run out as the lake dries up like it did last summer. In the winter the desert climate is cold beyond belief and then around January the storm season (houboub) sets in to pound on the tents and housing in the camp. After three years not all tents are as crisp as they used to be. They beauty of resilience however prevails over the camp. Comparing to the three years ago major progress has been made. No more living under the trees without latrines, health structures, clean water or schools. Now there are schools, there is 350.000 liter water available per day for the camp, there are health post and a health centre and the shitting fields of old have been replaced by proper latrines. There has been a huge improvement in the overall health status of the camp. There are few cases of malnutrition, the number of children dying before reaching their second year of life has reduced and out breaks of communicable disease have reduced as well.’

Doubling as a tour guide duo: beauty (Ashis) and the brains (Joseph) meandered our way through the camp to give the visitors of USAID an honest view and explanation of the camp.

Mathias our Environmental Health Manager had a show stopper in the form of a demonstration of water testing. Ooh’s and Aah’s multifold when he showed the difference between the water from the lake and the water after intense treatment in reverse flow filtration, chlorination and aluminium sulphate deflocking. Not only does it sound impressive it looks impressive. On the top of a hillock there is a water reservoir and with a gravity flow based system and underground piping the camp can be supplied with water.

Alphan, our education manager demonstrated the pre-schools, primary school and talked about our new pride; secondary schooling. We are among the first in Chad to implement this in a refugee setting. Time and time again in meetings youth leaders and zone leaders come up with the lack of opportunity for their children to progress beyond primary school. This is a good opportunity and who knows when the first refugees will be ready to enter University. Although it is a sad thought that people have gone through large parts of their educational years inside a windy, isolated and desolate refugee camp it is the reality of the refugee.

These cats of ours are too cute. Sunday they spent the entire morning sitting in my dustbin basking in the sunlight, purring while observing my flock of chicken. They – the chicken that is – seem to be taking over the entire terrain again. In the morning they come out of their fenced housing and come to pick a worm or insect here and there. I wonder if my songs will start impressing them again. I have tried bargaining, seducing, pleading, begging but still no eggs. It is said they required a rooster. Well I have supplied. They required a stove in their house, installed and all. Now I am happily awaiting eggs. Still dreams exist of becoming the biggest chicken farmer of at least Bahai.

Yesterday in the camp a lady presented with a big belly. A hundred and seven centimeter circumference. She was pregnant of twins and was about 42 weeks. The babies were due to be delivered therefore. In the camp she came at 09.00 o’clock in the morning and the whole day the progression of her labor was slow. At the end of the day we took her to Bahai hospital where she was given a perfusion with medication and we tried to make the contractions more firm and coordinated. In the morning (we had to leave the hospital, leaving a nurse in charge) I was awoken at six. The babies had not come yet. So we had to scramble to make sure she could be evacuated to Abeche for an emergency caesarean. She has just left on the airplane.

More news to follow….

At 18.00 we heard that the mother is fine and that she has two healthy baby boys.

Namaskar,

Ashis

Bahai Beach 37

Bahai Beach 37

January 18, 2007

Yellow Nile

Today I was very lucky to meet an American linguist and missionary in the plane. We started talking and he explained that for the last 5 years he had been working on studying Zaghawa language. As a result he had just released a 1500 word dictionary French-Zaghawa. An English copy will be released soon. He also had a booklet of proverbs and an approach to write Zaghawa in three different ways (as it has no alphabet):

1. Roman spelling
2. Use of Arabic scriptures
3. Use of the camel marking used by the Zaghawa

It was all the more exciting for me as Osman Imam, our Health Administrator in the camp had been trying to develop an alphabet for Zaghawa in the eighties. But he abandoned the project as it was too complex. I am sure he will be over the moon.

And I thought about the teachers they lack teaching materials in their own language. They must be excited to be able to teach their own language. For all the right reasons Zaghawa are proud of their heritage. Or the nurses who now have a way to better understand the ailments the refugees have in the camp. Language brings you so much closer to others. And many of the women and children are not proficient in Arabic so they may suffer to express their worries and pains.

While the plane struggled through heavy sandstorms I was given a crash course on Zaghawa history. Apparently since the Nubian times they have been around. As fisher men mind you on the border of the Yellow Nile. What is now the Wadi Hawa or the dried up riverbed running through Chad into Sudan. Even 3 decades ago the river bed was teeming with life. Trees and animals but lately it has become as dry as the surrounding desert. Imagine fish jumping out of the river, giraffes strolling bye food aplenty and compare that to present days’ harsh environment.

As the river dried up the Zaghawa ancestors moved to different locations. Jebel Moon in Sudan and Kanem in Western Chad were two sites. Even today they can understand each other although the Westerns became market men (and therefore despised by the people from the East). In the East they became warrior nomads with huge amounts of cattle and later camels. By nature they enforced themselves into a position of lording over others. Even today you can start to understand why even though only 1 % of Chad is Zaghawa they still rule the country! The toughness and ruthlessness which is required to survive the desert environment on can see oozing through.

Zaghawa men are said to be afraid only of women laughter and songs. Picture this; Every time a young man enters a room all women present sing a song about how he got wounded in battle, in the back… A clear sign he was not a hero. Or having to hear your whole life that you were not brave enough to steal a camel as dowry (this is custom for the braver members of the tribe)

The same men that attack any animal without fear, who battle until the last man standing have shaking knees when their women sing.

As our plane landed in between copious amounts of sand being swept around us we awaited the arrival of a second plane. It circled the airport three times but due to lack of visibility they had to return to Abeche.

We were lucky. On arrival I rushed straight to my chooks. A head count and it seemed 5 youngsters were missing. Only later in the day after a search of the compound I located all of them. Phew a good moment. And we now have to black kittens with blue eyes.

Tomorrow I can return to the camp. I cannot wait to see. It is 4 degrees at night and I hope all people have warm covers to sleep. Stories need to be shared with Osman, Adam, Zahara and the others. Finally I have laptop with functioning DVD player so I can show them the CBS 60 minutes piece. Also we have a visitor Melissa, media expert who will do some interviews, make some photos and explain the working of a camera so the project of the photo exposition may take of.

All of you a good night,

Namaskar

Ashis

Bahai Beach 36

Bahai Beach 36

January 15, 2007

Kicking up some dust.

N’Djamena – Abeche by car is what I can recommend all. Fourteen hours of landscapes. Passing through little villages with mud brick round tukuls (houses) with straw roofs. Meeting camels and men on horse back with long spears. Even an anteater on a mission was spotted. They look so cute. The landscape becomes more and more mountainous and the road gets progressively more crap. At one point you can envision seeing a lady lying on her back in the distance. The natural rock formations are pilled up as if some one has helped to put up layer after layer. Luckily we did not need to progress to Bangui (capital of Central African Republic) as the mud path there looked really tough.
Halfway through the day our car went air born as the hole next to the road we hit was deeper then expected. Luckily to quote Joseph; “Stop!!! We lost our log frames” and not our lives. We could pick up some carton rolls containing posters with the IRC philosophy. The end of the journey was a nice encounter with the Chadian troops who were not pleased when one of cars almost ran through their barricade. It took some gentle explanation form our side to let us enter into Abeche.

Just thinking back it is less than 2 months ago when rebels took Abeche in a mighty swoop. The same rebels which now have switched allegiance and have joined the Government to eradicate other rebel groups still available. Let us hope the violence will stay under control.

In our neighboring country; a peace agreement, un troops can come, o sorry did we say that, no un troops and the rebels did not sign a peace agreement. How long can the Janus faced Omar el Basher get away with his rule and divide?

The camp is near! Our flight is booked on Thursday and I cannot wait to be back with my chickens. Friday inch Allah I may finally see what has happened in the camp. As I said when I left for a break I am sure they did an excellent job and there was Dr Ponce to cover so all things will be fine. Worries of course about the mental state of mind of the refugees. I just cannot imagine how they will feel after the bombarding near the camp. Just imagine the sight of the ugly sight of the Antonovs. The vicious planes used in the campaign to drive them out of Darfur in the first place. How much silly ness need they go through?

There is good news as well! We have hired a Chadian doctor and the Chadian midwife will be on the plane as well very soon towards Oure Cassoni and then somewhere next week we have a big medical meeting to set out the health priorities for 2007. And a photo exposition of people in the camp will be organized over the next two months. Youths will be given digital cameras and training. We hope to see some beautiful results. If all works out well all the photographers who have visited Oure Cassoni have been requested to send some of the photos they made so an exposition can be organized in the camp, in our Abeche office as well as our N’Djamena office. And we have deployed our huge Mercedes truck. It means that we are less dependant on other agencies to transport our goods to and from the camp. As a first shipment medication, computers, construction items as well generators may be sent.

For tomorrow and the day after in Abeche a media training is being planned. Looking forward to that as well. The intricacies of getting the story told. The story of the refugees.

And the next blog will be from Bahai again….


Lucky me,

Namaskar,

Ashis

Bahai Beach 35

Bahai Beach 35

January 10, 2007

And just when you think the worst has happened…

The beach in Cameroon was still sounding in my ears. Sand in my hair a smile on my bronzed face. Very relaxed. And then you hear that 10 kilometers from the Oure Cassoni bombs were dropped by a Sudanese Antonov. This in an open attempt to destroy the dam or perhaps a scare tactic? What is clear that Omar el Bashir is toning down his voice on intervention of UN troops in Sudan. But his action speaks for it self.

What must go through the mind of the refugees? This is how they were chased from their home villages. Fleeing to Chad in the hope for safety and then…
It seems that their hometowns of Kornoi and Omboro have been target for bombing as well. Split tongue president, master of divide and rule. But I just read the United States have worked hard to prepare for their embassy.
And the Chinese they just smile. Oil is coming their way so our buffoon has his buttocks covered in the Security Council as well. I must say that reading Jung Chang’s Mao biography has put me off beat a bit. He was such a ruthless leader. For his own personal fief 70 million people were executed, tortured or starved to death and the entire population suffered from his megalomania. In those days it was said that what happened was suppressed from the collective memory. Yet what refrains us from see the ugly reality in Sudan?

There is a painful unwillingness to interfere from the regional and international side. Time to speak up.

While events in Darfur are heating up the avian flu crises is popping up in Africa as well. Culling of the poultry as has been done in South East Asia and Europe has not been done yet. But it remains to be seen if these drastic measures are required.

And then the Chadians on the run are now over 100000 people. As we speak a mission is underway to investigate if IRC can help out in setting up a camp for those who have fled their homes. There is another IRC team in the Central African Republic to find out if the needs are there for a camp as well and then there is Cameroon where camps are considered as well. Cameroon being a very fertile country it for sure gives a different feel to camp life of Bahai.

Oure Cassoni now is under sand storms quite often. The chooks have built a windscreen as their lazy boss was too busy bumming around in Cameroon. Their food comes from their underground lair. When the wind gets really bad I am sure we can hide there.

Boys and girls, I will be on route again towards Bahai on Friday. I am curious to know how the camp is doing. Are people terrorized about the plane movements? Are they considering moving? How do they feel about the threat to the dam? These and many more questions come to mind.

But for now I am off to sleep.

Wielenklem,

Ashis

Bahai Beach 34

Bahai Beach 34

Cameroon

January third two thousand seven.

Dear all,

In Douala there is a main square called Hotel de Ville. It was there near a fountain I was playing checkers with one of the local men. Suddenly hue and cries. A white Ferrari rolled up and the boys and men in the park went crazy. It was Djemba Djemba a football player from the English Premiership. As his car was about to be trashed he handed over a huge bundle of money and sped of like grease lightning. And then it was like inferno hit the quiet park. One of the men had received the bundle and he ran to the public toilet. There he was besieged by about 50 men and boys demanding their share of the money. The ruckus caused disturbance to focus on the ongoing checkers game and I duly lost. I must say however the only game I won that day was because my host decided it was embarrassing to end the day with a zero. Riot police now popped up to keep the crowd of about 100 under control. I managed to slip in to the public toilet as some of the money was dispersed. No money for me however. The poor guy who received the money by now was only wearing his shorts as the rest was torn of his body. Seriously crowbars and stones were about to be used.

Money so funny….

In the camp in the mean time everything must be fine. Every day bad news is coming from Darfur where now the big cities are under siege as well. Effectively leaving the refugees or IDPs without access to the essentials. Perhaps they will come over to the Chadian side now. It seems here there is a lull in fighting with major groups signing peace agreements. Yet the camp has managed to transfer a pregnant lady to Bahai and then Abeche for a caesarean. The baby died but the woman survived. And a victim of a robbery got shot in the abdomen and evacuated to Abeche as well. Vaccinations are ongoing as are the consultations and health promotion activities. A self running system with minimal expatriates and national staff. It is sure now that a lot can be done bye the refugees themselves.

Being away now for several weeks now has given a chance to reflect.

Truly the refugees are underestimated at all times. They are true survivors, knowing all about desert life. We operate with more than 15 expatriate posts. It sounds so much to me. As a general rule the less people involved in decision making process the smoother things run. In other organisations people have the same sentiment. Somehow the activities that need to be done are done. For sure some other activities will lose out but what to do in a security environment like this. For me a lesson learnt is that I prefer small teams. A next mission my first question will be how big is the team? The second one: how difficult are the refugees perceived to be?

Forget about difficult… Zaghawa are easy they just know what the want. So if they are constructing houses it means they are preparing to slug it out in the desert some more.
Whenever I ask why the pick such a difficult environment to live in the answer is simple. This is DarZaghawa, our homeland. This is as close as we can be to our real home villages. And this is the lifestyle we are habituated to.
The camp is filled with positive feeling to me. There are adults going to school to learn Arabic. There is hope that the conflict will be resolved by either mediating either fighting. And there are the endless smiles of the children. The last weeks I spent at least an hour every day to walk through the camp. On my way to autopsy interviews or to see the functioning of different parts of the program. Everywhere you go you can hear OK OK. Or Ashis, Ashis. It makes a big smile pop up on my face every day I go to the camp. The administrative issues or the miscommunications within or between agencies are forgotten the moment a little Zaghawa girl comes up to you to hold your hand.

Or talking with the leaders who come up with solutions for the perceived problems in the camp. These endless meetings I have referred to in the past has more to do with not listening on our side or sending unclear messages on our side and there is the tradition of talking a lot by the big fish. Well I must say all sides are talking a lot. Perhaps at time a dialogue is more at place…


The chickens have entered my dream world now. I am being kept updated regularly. The cold is too much and the sandstorms are disturbing them. I have bee requested on arrival also to do something about all the snoring expatriates. The generator they can live with but all the high pitched and low groaning of the team in the field is just too much. They have officially requested for earplugs. As I am new to this business I wonder if anyone can help me out as t what size these darlings of mine require.

I miss my chicken and colleagues.

One day I will be back and well rested.

I am off to eat lobster on the beach

Namaskar

Ashis

Bahai Beach 33

Bahai Beach 33

December 25, 2006.

Peace, salaam to all on this joyous day.

To all who are with family and friends I wish you all your hearts desire. They are most likely right next to you. Here in Chad I feel like a purring cat. My break is doing wonders to the mind. It puts things into perspective. Let the negative emotions out and tank up on my positivism. A large part of that has had to do with Stacy and Gabriel.

http://www.stopgenocidenow.org/iact2/day3.php.

A website dedicated to end the crisis in Darfur. Gabriel and Stacy came out to Chad to talk with people in the camps around the Eastern parts of Chad. Inter-connectedness rules!
They would like to hook up young people between 13-17 from the USA with those in Chad. A way to make sure a better understanding develops between people from different continents. A relatively simple method as Internet can be used for this. Video messages can be recorded and sent to and fro.

Oure Cassoni has not left my mind or heart. I am sure that the systems are functioning smoothly as I heard that there was a transfer by car (arranged by the refugees) from O.C. to Bahai and then to Abeche by plane. The lady lost her baby but may well have died herself as the labor was obstructed. Yet she got operated in Abeche and she is doing well. Without medical expatriates in the field and only one national staff medical expatriate to run the system. I am very pleased. Self-reliance will make the system strong and expatriate positions redundant. The refugees in Oure Cassoni do very well for themselves. Make no mistake.

Here in N’Djamena we will have a medical meeting to plan for the first 6 months of 2006. Also we will address outstanding issues. Some of the plans are the introduction of functional laboratory with microscope in the camp, a check up center for newborns, construction of gates and fences, introduction of teaching curriculum. All up for debate naturally. What is a priority and what is achievable given the security situation. Outstanding issues include the preparation for an eventual departure of the camp. An exploratory mission to another site where there are several thousand Chadian on the run for violence, how to hand over the hospital back to the ministry of health, cost recovery. I can go on and sum up all the topics but it will be a long fruitful discussion I am sure.

In the mean time I have been looking around N’Djamena to get my working visa and my travel visa for Cameroon. But as in many Asian and African countries that takes some patience. Any way I am nearly off to Kenya and have absolutely no right to complain.

Well finally may peace come upon us. A dream perhaps but if you cannot dream you might as well not live. –Namaskar Ashis

Bahai Beach 32

Bahai Beach 32

December 21, 2006

Donkeys like sunbathing!

Nguebe was looking tired. Paying 150 environmental refugee staff is not the most exciting of tasks. On the way back from the health center I saw a dead donkey. This was a good opportunity to mobilize our environmental health man. Our driver and he drove over to check out the scene/. As Abubaker and he pulled out the rope to take the carcass to the outskirts of the camp the donkey shook his tail feather and clearly stated he was sun bathing---clearly not dead----

Is it time I go to an ophthalmologist?
Is the sun in Oure Cassoni too bright?
Are donkeys good con artists?
I do not know…

Our mass measles vaccination was a huge hit. More than 3200 children in class I and II were vaccinated in two days. Three schools were the hub of activity. With the help of Sylvie, Ben, Martin (Polish visitor) and the refugees we managed well. Sometimes cultures do clash however. Whips are still in use and it is a sore sight to see 6 year olds being hit on the head as well. One boy stole some crayons and the punishment was instant 5 whip strokes. This is hard to accept. Another culture? What to say when it was my own staff member supervising the whipping? I will talk with him when I am back in the camp.

The birth registration turned out less well. Ben the assistant public health manager managed to write 32 names in the registration book. About 120 were expected to come. But babies were being taken twice past the table to ensure double ration cards. And when two witnesses were requested besides father and mother our refugees insisted that one could be a father and a witness at the same time. Also it takes a member of CNAR (Chadian protection for refugees) about 30 minutes per form. Ben could occupy 4 of the CNAR agents. A sore sight for eyes.

In Abeche we ate at a restaurant run by Fafa. Fafa is a Chadian beauty of about 150 kilo. She was hitting hard on our Sospeter (logistician) leaning heavenly/heavily with her chest on his frame. When he finally got scared of the manhandling she lost her balance and crashed backwards in the trench running through the restaurant. It must be said she is an amazing cook and a grand personality. The brochettes were succulent.

The chickens have been left behind under close supervision of Francois the cook. He is understanding of their trauma and I am sure he will sing songs for them while I am off to scoot around Africa. Kenya is destination for diving and safari. I am sure it will be a great holiday. I can use some fruit, rest and dancing.

But how could I forget the news of the last days. There were two assassins in Bahai jail. Guess what?

One night the officer of gendarme ordered the jailers to take their dinner outside of the jail. When they returned 1 hour later there was a hole in the wall and 4 prisoners were out. Somehow while they were shackled they managed to use a huge knife to dig this hole and squeeze out of jail. Then they managed to roll across to the Sudanese border where according to the prefect it was naturally not possible to pursue then anymore. Zaghawa tribal law dictates that your brother will go to jail when you escape but in this case it was nicely forgotten that they are relatives of the prefect himself. One wonders; should we be grateful that they were in jail for 5 weeks period?
Here follows the reaction of some people in Bahai; ” Why were they in jail in first place. Nobody got killed?”

Mohammed Goni came to pick me up in the airport of N’djamena. He looks good. Lost some weight but he is gaining again. And his sunshine smile is back. He will be joining the work in the capital in 2 months.

Two kids in Abeche, one boy with a bladder stone and one with a splinter of wood in her eye were returned to Bahai today as well. Things are moving forward.

As all expatriate health staff is out of station and only two national health staff remain for hospital and camp it is a big test for our refugee staff. I have full confidence they will do well!
Empowered they are and we should acknowledge it.

I am quite sure to write before Christmas again,

So for now

Bravo Golf Juliet 3.9 out

Bahai Beach 31

Bahai Beach 31

Villa Chook

December 16

‘I strolled and found to my delight 11 eggs. One was actually hatching. It was a big surprise to me, as I had not noticed them before. But also I realized my chooks where in this magnificent wooden house with fireplaces and grass fields indoor. Overhead several parrots and….’
Wait I must have been dreaming. The little hut they have can hardly qualify as a villa and eggs are waiting for warmer days. A quick headcount and yes all present but alas no eggs. Seasonal breeding seems to be big in these parts of the world.

Cold showers on the other hand are popular. Our Captain of the Play-mobile brigade was some how delayed fro a departure from the camp. So we drove up to their base. That is a big word for 3 tents and a wooden structure with torn plastic sheeting several kilometers up hill near the chateau (gravity based distribution system). After some vague responses from the gendarmes and gentle prodding we found out the reason for the delay of the departure was the Captain’s bathing pattern. So then he finally finished and my o my did he smell fresh. We were on the move…
Until…At the gate the play-mobile brigade had to redistribute their 4 guns. Two for Bahai, two for Oure Cassoni…
Time to move?
No move as in batches of 2 there were the prayers of the soldiers. Two at a time so the others could guard the humanitarians. That giggly crowd was now wagering bets what would be the next reason for delay of departure. Lo and behold the bursting out of laughter when one of the Play-mobiles got tangled up in his turban.

The reason they are called Play-mobiles is because of their bright red coats, their casket helmets, the lacking of guns and their color full turbans. Turbans are found in a myriad of styles in the camp. And an essential item given the sand, wind, sun and now cold. Dr Ponce has a very fly way of wearing his dark green, Tim has a Saudi style wear (and the only black one in miles), and myself I like the Mogul style.

Mohammed Dria reported to me yesterday that the reason a bed was empty was because the lady who was admitted into it had died after childbirth. In 2006 there have been two maternal deaths from the camp and two from woman living in the district. Most likely there were more but two managed to come to the hospital. One of the reasons is that birth takes place in the home by traditional birth attendants with limited formal training, lack of materials and limited experience. Losing a woman in a natural process, as childbirth remains hard to accept and is always a tragedy. Always it needs to be remembered that until 2005 there was no functional hospital in the region. The nearest working hospital was at 70 kilometers away. Then there is the plethora of reasons; malnutrition of mother, female genital mutilation, limited antenatal services, traditional customs, multiple births, extreme young age mothers (15 or less) or older age (45 and more) and several other reasons. This case merits an investigation as to what went wrong.

In the camp I have become smitten with a black and white little goat. She is hopping around near to the hospital still suckling at her mother’s teat but as soon as she is old enough she may be promoted to guardian of the chook farm.

Other news from the camp:
The Goran population who are most likely from Chad and therefore by international definition (bla bla) not refugees but internally displaced people have by and large moved to the wadi. There they have shelter of the trees and it is slightly less cold. These Goran are herdsmen of camel and very few of them are registered in the camp so they do not receive petrol, food, blankets or any of the items distributed to the ‘real’ refugees. The distinction between the two groups is heart felt. Due to the dire circumstances in these regions and the insecurity their position is about as bad as the Zaghawa’s. Not enough rains for many years, banditry to steal their camels and goats, proxy war. It is just that they are not from the right side of the border to receive aid.

On a bigger scale in the rest of Chad due to the fighting going on around Guereda, Abeche and other places more South tens of thousands of Chadians are displaced. It will be a test case for the solidarity of the Chadian Government, UNHCR and the international aid community.
The Chadian Government as because their interest is to protect their citizens as well as host refugees. UNHCR as because being an IDP does not mean you cannot die of malnutrition. And the already scaled down aid community to deal with this ‘new’ group of people which is rapidly growing.

All through this a red threat or thread; the violence needs to stop. Chad is now making incursions in to Central African Republic and Sudan chasing rebels to their base. Sudanese supported rebels are fighting in Chad and Central African Republic. I cannot remember where I read that war between countries is history but all ingredients for a locking of horns between several countries is present.

And the French; the French are actively supporting CAR’s army by aerial bombardments (planes), helicopters and ground troops. To a lesser extent they are involved in Chad as well. Instead of by reflex always pointing to American Imperialism for once the French should look in to the mirror. Thousands are on the run because of the aerial bombardments in CAR.

Christmas is around the corner. A festival celebrating peace. Let the world stop ignoring ugly politics and come out against this unfolding nightmare.

Namaskar

Ashis

Bahai Beach 30

Bahai Beach 30

Return to sender. Address unknown

December 15, 2006.

MSF requested for their Plaster of Paris. We received them when there were soldiers a plenty in our hospital with fractures. But given the situation in Abeche MSF wanted them back. It took a while to locate them in our pharmacy but they were eventually found and put on a plane to Abeche. Surprise, surprise as they were returned the next day by plane! A smart cookie had seen the label IRC Bahai on them and decided it was best to return them.

Sometimes people are like boxes of POP as well. Should I stay or should I go. Do I have anything to say in the matter? Christmas is nearing but it does not feel like it all. What is noticeable is that many of our staff will be spending the festive season with their near and dear. It is good. Take the mind of the work.

My feathered friends – the male ones – my beautiful roosters have ended up in the soup. One of the guards was not aware that I had purchased two fine specimens.

What to do?

I must say that they are a very resistant bunch. We gone through heat spells, flush floods and one of these days I sure a snowstorm may hit us as well. Yet they keep on going. I can recommend to all have a troop of chooks. It makes you smile. And they are great to chase around the compound if you have nothing better to do.

It is time for some medical stories from the camp.

1. An eighteen-year-old young man was claimed to have been throwing bullets in the fire. The consequences; a bullet blasted through his hand and broke three metacarpals, some small bones and tore through muscle and several ligaments. Together with Mohammed Dria we did some reconstruction and put his hand back together.

2. We have taken under our wings the care for 2 of the psychiatric patients in the camp. One had to be tied down for several weeks as she had a reactive psychosis. She had lost her husband and young child over the last months and those horrible events made her breakdown. At least medication can be supplied and she no longer needs to be tied down.

3. Another lady hears voices---telling her that she will be killed. This causes her to be running away from all men and not sleeping at night. Her family does the best possible to take care of her but here also we hope medication will help. I managed to speak with her. Even shake her hand, but the moment I wanted to put my hand on her shoulder like a frightened deer she withdrew. It was such an intense moment. I cannot imagine how it must feel to be living in extreme fear all day.
4. Another traffic accident three days ago. One death. Four injured. You just cannot believe how people manage to crash into each other when there are so few cars and no roads but when you see how loaded the trucks are and at what speed they race it is clear that it is more a miracle we have so few deaths.

We had our deputy director visit the program. The refugee staff and Ben my assistant public health manager did a stellar tour. All questions could be answered. They made a very professional impression on Kurt. I was so happy! This is why I am doing this work. Osman, Adam, Zahara, Beshir, Yaya and all 73 others a million blessings
With humor they explained the constraints, problems and solutions found. More important they talked about the daily work in the Oure Cassoni camp. The pleasure they have in their work. Their commitment to serve their community. The feeling they give me is that with ease they can maintain the health services in the camp.

Mission accomplished?

Now to add to the basics;

1. A functional laboratory.
2. Introduction of regular follow up of the under 1 year olds
3. Improvement of the drug management system
4. Improvement of use of protocols
5. Further training to raise the quality of preventive, curative and reproductive services in the camp

Namaskar,


Ashis Brahma

p.s. I have been doing tours of the houses of my staff to find out yesterday that one of my nurses (male) has 19 children. Very impressive!
I am setting out to find the record holder in the camp. So far he and Umda are tied in the number one position.

One man came up to me a few days ago. His wife refuses to sleep with him. She wants to go to university. Hence she has been grey carded. (Next card red card) What will happen? Where will this story lead?
Zaghawa women are very strong willed/ I am sure he will end up side lined.

Bahai Beach 29

Bahai Beach 29

December 11, 2006

Ganatir Oasis welcomes all!

The rebel leader Mohammed Nouri has surfaced near Biltine. In fact at Ganatir the proposed site Oure Cassoni was going to be moved towards by UNHCR. In a fine frenzy Chadian Army rolled in only to get butchered. Now the president himself has come down to lead his troops personally. A decisive victory waits!?.

War is ugly but the only thing positive I can think of in this struggle is that the combats take place in swats of desert. Then again most of the soldiers probably are not even 18 yet. One can wonder if it is a choice. The Sudanese rebels and Government troops in the hospital are very similar. They come from very poor families and did not really have an alternative to earn money. Forced conscription is common as well.

The boys in the hospital are happy and almost hoping a bout as their traction has been removed. Most were about to walk out despite the metal pins so better do it in a proper way than in a bush way. Some how they must know or sense that Bahai may not be the best place to hang around a long time. Let us see if the Red Cross can solve their issue. Tomorrow we will have a crutch dance session. Let us see if the Old School Whodini or Grand Master Flash & The Furious Five are known here yet. If not my plight is to teach them some break dancing and electric boogey. I foresee a great afternoon,

A young girl in the hospital in the mean time with a splinter of wood in her eye was about to be sent to Abeche to a proper eye surgeon. If only she and her father could have waited 2 hours more the paper work would have been fixed and a flight to surgery arranged. They bailed; need to find them in the camp tomorrow. While she left a 23-year-old lady rolled in thin as a broomstick, vomiting, 4 months pregnant. We will do some laboratory tests tomorrow. Just today a newspaper article was published that HIV is on the rise in Darfur. We shall see. Slim disease as HIV is commonly called in parts of Africa will be popping up in the camp in the foreseeable future. It does not make it easy that extramarital sex is a topic that cannot be discussed. The same goes for family planning.

In the camp Agar, my three-year-old buddy has popped up again, His mother has a mental condition and sometimes he roams around to get as much food as he can. Other mental cases are still isolated at times. They are not allowed to live near the camp or are tied to wooden poles so they cannot hurt themselves or others. Luckily SOS Kinderdorp has a program to address these issues. Unfortunately they have left Bahai for security reasons.

Osman Imam, our administrator was very angry with me today as I had refused him entry in our vehicle yesterday while he had to go to Bahai. It made we happy because he trusts me enough to tell me in my face he is upset. We sat and talked and I could explain him why our rules are the way they are. Also that on Thursday he could raise the issue with our Field Coordinator, Country Director and Deputy Regional Director who happen to be on a visit.

Lunch today was camel meat and bread. Afterwards Umda (their tribal leader), Osman and I stayed behind and discussed the history of the Zaghawa people, Sufism and the differences between mystical Hinduism and Islam. The Zaghawas may have the name to be a difficult people, but to me they know very well what they want and they maintain their traditions. An environment to learn from the people I work with and the job I do.

So far outbreaks of disease are not taking place. Transportation of complex cases to Bahai and Abeche is ongoing. Two months of medication & materials is available in the camp. If we are forced to pull out I am sure the refugees will manage to do their own business. The only thing that worries me is the water supply. It is easy to sabotage and rebels and Sudanese government troops alike are using the lake.

Ashis himself is getting tired. I am not 99% cheerful as mostly. But when standing between my chickens or talking with Umda and Osman I know I am in the right place. Tired is a state of mind. Just need to sleep, take my cold showers, eat my meals and count the days. My next Rest and Recreation is due the 16th of January but depending on the developments I might take it a bit early so Dr Ponce can come into the project (or Sylvie)

Talking about my chooks or with them at times gives immense pleasure. Yesterday I talked to them about Beyond Borders. This is an Angelina Jolie movie about a doctor working in places like Ethiopia, Cambodia and Chechnya. They seem to think it was a sentimental tearjerker. I beg to differ. Yet to so many chooks one needs to listen.

No news from Mimi. I guess she is chasing the cats downtown. Wish the blessed cat a beautiful free spirited life.

Namaskar,

Ashis

Bahai Beach 28

Bahai Beach 28

December 7th, 2006

Where are the drivers?

Stress in the morning is never good. From 06.45 onwards ever more frantic calls summoning our drivers to come to the compound so we can make the 07.30 convoy. At one point Sheri walks to the UNHCR compound to confirm that our boys are all right. Yet no sign of them and the cars are in place. Is it true they slipped out before the change of guards?
To do what?
Go fishing?
Play ludo?
Alternative theories are popping up. Did they get stolen, are they kidnapped? A sense of worry is on the rise. And then the sleepy faces of our two drivers pop out of a room. They had heard the radio calls and overslept. And silly us could not find our drivers in our own compound!
In the Maternal and Child Health Center three women deliver in the last two days. One baby was so lucky to have its umbilical cord strung around its neck. The second baby girl born today had a knot in her umbilical cord. It was the seventh child of this mother and we were trying to understand why the baby took so long to pass through the birth canal. Both girls survived! The birth process is always an honor to be present at and working with Zahara and her crew of midwives is all my pleasure. Under direct supervision I can comment and demonstrate those things that can be improved and learn why there are problems with home deliveries and those in the health center. Many women do not eat on the day of labor and end up hypoglycemic and with feeble contractions. Some of the women have female genital mutilation and need to be ‘cut open’ before they can deliver. Last month seemed like a baby boom with 68 births.
General food distribution has been going on for 3 days and will hopefully be finished tomorrow. In the midst of donkeys, bags of corn, tins of soy-oil, dabbling children, horse-carts, armed guards and all the family cards one can see that there is a strong community sense. The last distribution only some people without family cards. The non-refugees (token holders other word for token = non-right, no refugee, no food) created huge ruckus last time. This time however it remains quiet. It is as if the refugee community realizes it may well be one of the last times.
Security in Chad may be in steep decline but Bahai seems like an oasis of peace. But that thought may well be an illusion. In the country on several occasions when there was an opportunity to loot the local community did just that.
I walked around the camp the last two days. There were to wakes to attend. The first was a lady who was 90 + . And then there was the boy of about 5 who had fallen into the fire and who died of the consequent sepsis. At such a gathering men and women are separate. The men pray together and share tea and a meal of Azida (it taste as it is named, acid). The women do just the same near by.
A boom of zag zag’s is taking place in the compound. I hope that Mimi will pop again but it seems she has gone on a quest leaving us without her feline capacity to catch the furry mice.
In a way working with a small team is good. There is a very direct with the refugee staff and a lot of responsibilities are on their shoulders. After all if they do not manage their drug stocks well when we are absent they themselves will suffer.
The men in the hospital are nearly all doing very well. About ten are still in traction with their upper leg fractures but most are happy they are not fighting presently. We hope the International Committee of Red Cross can find a durable solution. All have received crutches. The 3 year old with a calculus in the bladder has finally been put on an airplane with his mother to be operated upon. The lady who came 30 days after delivery looking swollen all over is now doing well.
And then in the camp I found a laboratory technician who used to teach at El Fasher in Sudan. This a good start, together with the materials that are already available to set up the laboratory in the camp.
The end of the day I spent running after kids and lifting them upside down. It causes an inner smile and is the biggest award of all.

Namaskar,

Ashis

Bahai Beach 27

Bahai Beach 27

December 3, 2006.

Goni walks, UNHCR flies out.

If you would the silence is getting eerie. The days are gone that 15 vehicles loaded with aid workers rolls to be camp. At best 5 vehicles nowadays and each and every day less and less people in the Land-cruisers. Our pre-emptive move seems to have been spot on. We are back to the skeleton of people to run the minimal of activities.

This morning another sample of the high level of stress our partners operate under. Iriba Base a mere 100 kilometers away could not be reached by Thuraya and instantly the rumors start spinning. “Attacks, rebel movements, looting of the UNHCR stores.” Ten minutes later the rumors it was confirmed the rumors were wrong. It was not a troop of bandit/rebels but Chadian troops rolling in to town. Where and when they show up is never relayed to the Aid Community and with all armed people here wearing a mixture of home dresses, uniforms and semi-uniform it is never clear who is what.

As this morning events unfolded UNHCR announced it is withdrawing from 3 sites in the three more Northern sites in Chad. Only yesterday we were dancing in their compound to the beats if the farewell party of the Head of Bureau. A wicked party lasting from a 15.00 till Six Thirty…
Indeed in the afternoon, your definition of a hot party gets a bit messed up here in the desert. At one point it must have looked like a celebrity bash with photographers a plenty running around taking shots left, right, up and down. Even our play-mobile soldiers joined in the fun.

The different NGO’s have different responses to the latest security threats. There are NGO’s that are still operating at full force despite all recent events, there are NGO’s that have scaled down to minimal services like IRC, some NGO’s will do that now and other NGO’s will halt all activities for the time being. For sure there is no right or wrong response here. All have different frames of security analysis and different guidelines, different levels of donor pressure, different in house capacity to respond. Inch Allah they will all return and full activities will resume at the camp. This evacuation will take place just before the lifeline in the camp in other words the food distribution. Let us wait and see how that happens.

N’Djamena is still not under siege. Hippotami are floating hither and thither in the Chari River. Cranes & herons compete to show off who has the biggest catch. And Goni walks. Our sturdy driver has made it. He will be released from the hospital any time soon and after several weeks of rest he will rejoin us. But never again he will work in Bahai. It is too dangerous for him as well it would not be right for him to work there again.

The roosters seem to understand that if they do not want to end up in the cooking pot silence is golden. Not a bit of excessive cuckolding so far. But on close observation I still not have found eggs. What else could I contribute to their well-being. My thoughts range from a heater to a Jacuzzi. Well when I make up my mind I shall inform you all. Back to sleep I have a long day ahead of me and we will see where it takes us.

Some hours ahead of time a meeting with the leaders of the community. It is clear that they have not been left behind for the first time. Measures have been put in place to maintain minimal services but for sure programs are not running as easy as they should. One of the essential activities for this month, the general food distribution has been planned for tomorrow instead of in 8 days. These days are always highly stress full and with the departure of many UNHCR staff members it will not be easier. Last month in one zone the distribution had to be stopped as one of our staff members got attacked by a group of women armed with knives and sticks. Again the plan is to hope for the best and prepare for the worst. The meeting ended as usual in a dispute over tokens. This word is one of my top 5 words in the camp.

Right after the meeting I was asked to attend a delivery by a young mother who did not manage to push out the head of the child easily. Thought I felt the umbilical cord around the neck and indeed that was the case. Zahara the midwife and I clamped the cord and cut it. Twenty seconds later a beautiful Zaghawa girl cried out. How majestic life can be.

The rest of the day we spent packing medications for two months with as destination the hospital. A contingency stock is in place there as well now. Actually after the delivery I was whistling and singing most of the afternoon. My, o my, this is a fantastic place to work.

Now could someone please solve the conflict so our community can go home?


Namaskar,

Ashis

Bahai Beach 26

Bahai Beach 26


Rebels on the loose

December 1,2006

Mimi has a new hobby; pretending to observe my chooks in all innocence behind the fence. Before she just to be terrified by creatures with feathers but now her curiosity or hunger has overtaken the fear of being attacked sparrows only one month ago. To make sure my chickens are safe I bought two guardians; a handsome white rooster and a massive brown/black speckled 5-kilo monster. Luckily the main combat the chicklets face is still the cold, because cold it is at night.

An armed truce would be nice in Chad, or a resolution of the civil war. Yet the situation in Chad is getting more and more tangled up. There are several rebel groups fighting the central government and to make matters worse they are starting to fight one another. If the acronyms would not be so deadly, FUC, SCUD it would almost be funny.

The camp in the mean time has been stocked up with extra medication, petrol to maintain the pump system for the water and all chemicals required to purify the water for a month. Preparation to make sure that in the case we are not able to access the camp essential activities for a prolonged period of time our refugee staff can maintain the essential services. On Thursday I had a meeting with all my health staff to run through a list of topics; vaccination, transfer of patients requiring hospital, communication with IRC. By asking their views one can clearly understand that evacuations of international or Chadian staff is not new to them. It has happened to them before and it will happen again. They have an organizational and hierarchical system in place. There are three leaders per zone (total 9 leaders), one Umda (traditional leader) and all blocks having their own leaders. In a joking yet serious way they offered me to sleep in the camp. To quote Adam Suleiman (Community Health Supervisor and Zone leader) “Bahai is not a safe place, but in Oure Cassoni nobody will touch the NGO community”. Also Osman Imam was pulling my leg. “Biltine the site that was offered as an alternative site (although there is no water and Janjaweed a plenty) is currently the scene of heavy fighting between two rebel groups and you want us to go there?”

Today is the celebration of President Deby’s take over of power. I t would be very predictable that fighting flares up to disturb this special day. What is sure that the rebels have an action plan this time unlike in April when they just rushed towards the capital and with help of the French got stopped. Will the French remain sitting on the fence this time? In the Central African Republic they have actively been involved in fighting cross-border rebels.

In the camp I met one of my favorite moms. Her plump and powerful looking 1 year old has been earmarked to become a warrior in Mini Arcua Minawi’s Sudanese Liberation Army. We always joke with one and other about at which birthday he will get his first Kalashnikov. Bittersweet. The rumors circulating in the meant time is that a group of rebels will come to Bahai soon to sensitize the community. Code language for recruitment of fresh battle flesh.

More and more children are being born in the health care center. The messages to the community must be coming through and this despite traditional views and customs. I do hope this trend continues. We have plans to engage with the traditional birth attendants. In Zaghawa culture a relative or neighbor, who has limited training, but has learnt from her mother or grandmother, usually assists a delivery. In the camp these customs still prevail. On the one hand one has to respect these customs yet on the other hand there is a high maternal and neonatal mortality rate. A delicate area our new Assistant Reproductive Health Manager will have a nice job to do.

The ongoing stress is at times disheartening. Especially the threats of bandits, rebels, local populations who are after assets or revenge (relatives of the assassins of Mohammed Omar Goni) I think about him a lot. He walked the fine line between life and death. And he lived! He is doing well. What a blessing the news of yesterday. At any given time I feel negative or scared I try to focus on the kids in the camp with their beautiful smiles. I guess a wise man was right when he wrote: “ The only thing to fear is fear it self.” I love my work. The isolation, hardship, wear and tear, fear… it is all part of a much larger game.

Namaskar,

Ashis

Bahai Beach 25

Bahai Beach

Thanksgiving day

23 November 2006

Francois our cook has made a feast meal; chicken in three styles ( tandoori-grilled and Chadian ) , potatoes smashed as well as roasted, salad, our famous red sauce and cake. He did an excellent job. Our dining hall was decorated with flashing Chinese red lights and a dj was spinning records. We also had a special guest; KC Herrman who is shooting a documentary about the relocalisation in the camp. I am preparing for a big clash with Gang (incoming field coordinator) . He loves chicken and I had informed him that the massive chicken we were eating could not be saved for him. Being a former middle weight boxing champ in Congo a bout is scheduled. Surprise surprise when I buy him a chicken Saturday and cook it for him as well.
There was another great piece of news as both air carriers gave as suspension form flights as we have to many non shows. I am sure this shall be solved though.
What will be harder to be solved is the increasing rift between the powers that be and the refugees represented by their leaders. On Wednesday the leaders were rushed to Bahai from the camp to meet a big big fish, however when push came to shove this hero had spent is time drinking tea with the local authorities leaving the camp leaders wait for 2 hours and then not speaking at all. O I forgot 2 representatives were invited in the rie to the airport.
It is hard enough to sell the relocalisation of the camp to the refugee community but the way the powers that be trample is sheer absurdism. Non dialogue as a way forward. Well our refugees are wise enough to resist. In the meantime our security is being guarded by the new playmobile police officers (coined by Dominique) as they were funky green helmets and red coats so they are good target practice. And they need to share 4 guns between the 12 of them. And then there are the flashy turbans in all colorzx of the rainbow but for camouflage. I do not know what these boys have learnt on their Police Academy but perhaps it is similar to the like named series of increasingly mediocre films starring Hightowers et all.
More good news; I shall be let out of the cage after our Health Coordinator comes back to Bahai around the 7th of December. NDjamena beware, mad boy on the loose. Our IRC demands have still not all been met but we are making progress. Yet the overall situation in Chad is bleak so it would not surprise me if we remain in minimal essential surfaces for some time to come.
My staff in the mean time is adorable. Adam has requested for 36 sunglasses as the sun is very harsh to the eyes. But actually I was not asked to supply no the sunglasses were already distributed if I could just pick up the tab. Bye the way they are darn flashy looking Raybaans from China. All most asked one for myself.
The camp is seeing more and more snotty noses. Believe it or not it is cold in the desert. Not only am I disallowed from sleeping outside it forms a good excuse for me to stay inside and not be frozen at night. Concerns are several neonatal deaths over the last month or two. Some how our follow up of high risk births is not ideal. When going into the camp and talking with the parents who just lost a baby (or actually their last 4) a solution must be found as well as a reason why this couple loses babies all the time: Sero- incompatability, cervix insufficience. And we are planning a vaccination campaign against measles next week a mass campaign so all children of eligible age are covered. I do not think I have touched on the sad news coming from the South. Fighting is intensifying and one humantarian aid worker from MSF has been killed, 5 are still missing. Very sad news indeed. It remains to be seen when interventions take place but it is clear that sooner or later similar to Darfur projects will be withdrawn due to the security risks. Leaving the refugees to fend for themselves. An undesired but possible outcome of political impotence.

The cat tips were well received thank you, And also all thank you for the reactions to the radio interview on www.theworld,org on the 20th of November with Lisa Mullins on PBR/BBC. Let us spread the message that this conflict deserves attention and a framework to come to a solution

The chicken all went through a health check up this morning after I spent half the morning chasing them to confirm their excellent health. It was a nice excercise and probably looked silly but I enjoyed chasing my chicklets. The grown up chickens are too fast for me anyways

Namaskar

Ashis

Bahai Beach 24

Bahai Beach 24

November 21, 2006

The convoy leaves…

This morning around 08.30 a convoy with IRC staff left for Abeche. Twenty nine of our national staff members are leaving until three indicators are met:

1. The two dacoits are sentenced according to the Chadian law and justice is dealt.
2. An increase of police officers to Bahai (as has been promised for 3 months now)
3. At the highest level in the country security of refugee camps and humantarian workers should be put back on the agenda.

I am proud that our staff were so firm in their conviction. Even the last 3 days 2 days gunshots were heard in town. They wish not to interrupt the program but want the minimum of safety to work in. The same goes for the expatriates. Two of us will return to Abeche and work from a remote control position. A feeling of sadness is also there. I know that several of our staff members wish not to come back to Bahai. Also going to minimum services is not the ideal scenario.
So in practice we have scaled down to a minute team of people. One vehicle available so we will we planning hard around all this one car. Remember there was a move planned. Well at least that has been put on hold for the time being. The powers that be have decided that water is an essential item to support life.
Spirits are high, the national staff that has remained behind has moved into the compound so the place is livened up. Today a large group of us were watching a James Bond movie for the first time in ages.
The camp in the mean time was fantastic. It feels like coming home every time I am there. We had a big meeting with all the refugee staff and they fully understood why we have suspended many of our activities. They themselves have fled for violence and wish nobody what has happened to them. The work to quote Osman Imam, our administrator at the health center will go on if for 3 days, 3 weeks or 3 months until our friends return.
Monday in the camp all snoozled up in the Toyota Landcruiser; at arrival it is quiet. Not many people at the health center. We are in between the diarrhoeal season and the season of respiratory tract infections. Time to talk with some of the zone leaders about the possibility of moving the camp in a more orderly way. The bottom line is that they are not against moving the camp, but want to have a strong voice in deciding where to. Fair enough I would say.
Never a dull moment in the camp though. As we were having lunch in one of the little restaurants (ful masri-Egyptian beans, salata tomatim with simsim and bread) a urgent call came from the security officer of UNHCR to inform us an injured man had arrived at the health center. He and four friends are from the camp but as goatherds men they had traveled into watery land 100 kilometer inside Sudan. There they encountered a troop of about 100 vehicles of Sudanese troops and janjaweed. After being pummeled with sticks they managed to run away but the last man Mohammed Suleiman was so unlucky to be hit by the bursts of fire of a Kalashnikov. As I asked Adam Suleiman (zone leader and my community health supervisor) why this happens his response was brief. They ‘janjaweed’ want to chase us Zaghawa of the land. A Zaghawa can be recognized by the earmarks his donkey has, the neck mark his camel has and his dark skin colour. All in this conflict are Muslim so is the amount of pigment in your skin a decisive factor if you have a right to live or not?
And then a ring on my satellite phone. An interview for www.theworld.org look under November 20th Chad interview. The whole interview will be made available as a podcast as well. I hope the message I want to make clear comes through. The vulnerable in Chad and Darfur deserve a better faith and no person with internet connection should be able to say that the magnitude of the drama taking place is unknown to them.
On a much lighter note. For those of you who are cat owners. Mimi or also known as our zagzag devourer has developed the bad habit of peeing on every couch or bed she sleeps. Does anybody know how to address this burning issue. I AM LUCKY THIS CAT IS TERRIFIED BY MY CHICKEN. Think about those fuzzy chicklets becoming prey. By the way as you must have understood the goat did not manage to escape and ended up as roast. In memoriam to him I have let the fence he had damaged in the original state.

Well I guess I am done for today,

More soon,

Namaskar,

Ashis

Bahai Beach 23

Bahai Beach 23

November 15

The soap continues….

Well and then there was a meeting and then another and slowly solidarity seems to be become more and more verbal but when it reaches concrete action the masterly crafty decision makers would like to go back to business as usual. At least within the IRC position about security is holding steady. Big fish are coming in today so decisions may be made today about where to go from here. Three boy scouts holding sling shots are not really a match to the heavily armed local dacoits, freedom fighters, army, loose elements, opportunists etcetera. Tis quiet and the powers that be are jumping off the camel hitting the dunes.
Highlight of the last meeting was a security officer who had the pertinence to ask what was the fundamental reason that our IRC staff does not want to work in these conditions anymore. His solution was to send a letter to the local authorities to highlight the present situation. This clown has been sent back after 2 days n Bahai Paradise.
More clowns are being flown in. Take a quick tour of the situation write up a bogus report about what is happening and how to proceed as nothing has happened. Wellcome to the real world Ashis. I sometimes wish I could tell you more about the absurdistic clownery going on here but we have partners and need to keep working with them despite all outrageous decisions taken.
On the move of the camp a little quiz
1. Camp moving where, when…really dude?
2. Neva
3. All ready in full swing
4. Postponed until the powers that be find a water rich environment

Answers next letter

Prize an all inclusive stay at Bahai Beach Paradise, flight too be self arranged.

Sancho Pancho and I are laughing about the tragicomedy of being in this situation. Wishing for better days to happen. And the battle for power rages on. The rebels/liberation front have announced their list of candidates for a Government including no people form the most populous part of the country the South. The civil war is being fueled by Sudan.
O yes we can hit lower and lower grounds yet.
Solidarity can be used as newspeak as well. Orwellian. We have a solidarity with you and with our wounded brother. If push comes to shove however we have a duty to go back to work. Security is an issue we can trample on with some 16 year old scouts coming over to save us. The beginning and focus of our escape plan. Let us shove our heads in the sand and pretend the houboub will blow all our troubles away.
Enough about this tragicomedy time for essential stuff.
I am preparing an evacuation plan for my chicken. They have given me reason to believe that they are no longer comfortable in Bahai. Either the singing in the morning is traumatizing them either the cold and violent climate will eventually lead to a displacement to a new site. I have got to make sure there is water in the new site though. Get some informed consent going. Sadly no eggs I guess our honeymoon is over.
Missing the kids in the camp. Due to current conditions we have not been to the camp since Saturday. We will see what happens. Sooner or later the camel trail must open up again.

Just a thought while inferno is breaking loose in Chad and the UN is squibling about sending troops in fancy resorts in Addis Abeba. Postponing because both countries need be involved in the decision making process. Chad has expressed its will to survival to accept a mix of African AMIS troops with UN troops. Can we for once bypass the dictatorship in Sudan. In my eyes enough shit is coming down to justify an appropriate response. Albeit late, better late than never. Central African Republic, Chad and Sudan are all suffering from destabilization. Truly the perpetrators of crimes against humanity are on all sides. Let us please intervene.

Namaskar,

Ashis

Bahai Beach 22

Bahai Beach 22

Rough awakening.

November 12, 2006

Saturday for the first time in seemingly eons I went for a walk to the market. Chat with the local kids, look for vegetables in the market or some fruits. A met our cook Francois there as he was shopping and we strolled back together. Chatting about Sunday and the meal we could prepare. All nice meats passed our minds and we settled on camel. We arrived back at around 16.00. There was an expatriate meeting planned so he went to the kitchen do his wizardry and I joined the others. At around five we hurt a burst of Kalashnikov being fired. We looked at each other and reasoned it sounded like a drunk soldier showing off. How wrong can one be. Ten minutes later neuf-sheesha, our driver on call arrived saying that a terrible accident had happened. Our driver Gony was shot and bleeding profusely in the hospital. Dr Pounce , Marc and I jumped in the car to see what we could do.
The incident had taken place not far from the hospital. And it seemed about two hundred people were gathered in and around the hospital. Gony was in the operation theatre being taken care of by 4 nurses. A rapid assessment learnt he had been hit in the leg twice and one bullet perforated his thorax. Instant surgical exploration of the wounds gave us the feeling that he was not in a very good shape and would need proper surgery in NDjamena. For the night we could give him a blood transfusion, pain treatment and cleaning (surgical ) of the wound as well as bandaging the wounds.
Direct contact with UNHCR led Gony to be evacuated to a hospital in N’Djamena where he is still being operated on. All of us pray that he will come through.
Sometimes you are lulled in a false sense of security. Today was such a day. The authorities are not in control anymore. Promises about new armed forces arriving have been pending, Pending and pending.
Oure Cassoni will be off limit for some days and perhaps we shall be locked down into our compound. The gliding scale we are on for a while now has reached a new low. The camp as such will suffer as well. That we have to move is clear. Now to find a proper other place.
The meal was a bit subdued but Tandoori Beef, dal , macaroni, liver, watermelon and oranges do go down well.
It is Monday morning and we shall stay inside our compound and office for at least three days or until the local authorities wake up and reinforce local security conditions.
It is sad there has to be serious injury to an aid worker before nothing changes once again . No walls or guards can protect us from violence of this type. The local community needs to be on our side and clearly they are not. Let me predict some things; intense meetings between UNHCR , national government and local government to send extra police officers, secure the border, catch the perpetrators of horrific crimes. Nice declaration signed and then due to lack of shoes or cars or guns (amazingly yes guns) the allotted police officers will remain in Head Quarters, the perpetrators will disappear as .
Oure Cassoni camp is very dear to me, steal cars all you want. Just do not have the cowardice to shoot a fellow staff member. I hope this is the un-crossable line that has been crossed so we can move forward to find another site and leave this town resembling a lawless den of many evil wishers as soon as possible. So far goes the goodwill of the local community. Perhaps I can not put my head around understanding nomadic norms and values but violence disgusts me. It is so casual and so accepted how will these people ever progress to more peaceful societies but for fighting till the last man standing. The longer you live here the more complex you realize this conflict is. It is definitely not something that just spun out of control in 2004. A multi factorial explanation must be sought, competing for scarce resources, break down of local reconciliation mechanisms, armed patriarchical society, foreign meddling (Usa, Erythrea, Ethiopia, Chad), divide et impare (Sudan), deforestation, desertification, free availability of arms, natural resources (oil). The region of Darfur and the other side BET in Chad are regions were there has never been strong central authority and the arms was always the chosen way to solve issues. But after clashes there was a reconciliation mechanism which seems to have broken down. One example I have written about is the dia. When a child or adult dies by accident or in combat 50 camels are to be paid for a woman and 100 for a man. It involves elaborate negotiations and once agreement is reached a ceremony is held to make peace between the different families. A meal is shared and there is peace again. For now I am sure too much blood has been shed and a solution is not lying around the corner.

Talking about which, when I peep around the corner I find a stack of work waiting for some attention. From the camp at the moment no real issues.

Take care,

Namaskar,

ASHIS

Bahai Beach 21

Bahai Beach 21

08-11-2006

Toma returns

For those of you avid readers somewhere a couple months ago a young lady was sent to N Djamena to have a breast amputation. There was a lot of crackle about this case as we do not have budget for taking care of cancer patients. Luckily the health coordinator and the country director were moved by the case and gave permission. In the process I was to see here pop in a private clinic in N Djamena were she was to be operated by a Chadian Gynaecologist trained in Cameroun. Guess what in due time she seem to be lost/ had a major haemorrhage (bleeding) but all out of the blue she popped up in Bahai yesterday. Radiant as ever. Best news of all. Believe in miracles ! The 6 kilo breast seems not even have been cancer (pathology) but a benign laesion. I just pray this is true but for now she is smiling.
The hospital is turning into a joyous place as well. The soldiers are peacefully playing cards and smoking cigarettes inside. And as men they are complaining about the plasters and sandbags hanging from their legs in traction. Delight full as these lads are in the hospital the reality is that for at least one more month all the beds will be taken by them and given the weather. Believe me or not it is cold outside tents are not an option. We are recruiting as ever for nurses. I wish they would have the courage to come up to Bahai.
The camp in the mean time is drawing one line. No move. No going anywhere. Well I guess that response is to be expected when you ask people to uproot their newly built mudbrick homes to return to tents. On the border of the camp in Sudan however Government of Sudan troops are being reported. Tension is rising between UNHCR and the refugees. Few people have signed up to be displaced and for sure at night they are being pressured to withdraw their signing up.
A new inhabitant has entered my villa domain for chicken. It is a bearded hairy bleating goat pretending to be a big bird. My chicks are becoming audacious again. Perhaps looking for their father. Running around the compound again in the morning.
Sandstorms a plenty since 3-4 days. I do not have enough warm clothes and need to go shopping urgently in the market to buy some woolens and a cap to cover my ears. O and our new Environmental Health Coordinator Tim has arrived. It took him 12 hours to get from the USA to Chad and about 12 days to get from the capital to the field. Well he is highly welcome. In a way I am a blessed man. Sancho Yoda is back in town and it seems he might be staying around to play some ludo with me. As usual he came completely under prepared with one shirt, two socks and three pants. O and this time he managed to take one book as well. Poor sod I will buy him some clothes. It is a good thing he gets married. I am surprised he got around so along without kicking the bucket. The good thing about him is that he does take the piss out of me as often as he can. Like to giggly schoolboys we are always up for mischief. Our latest plan is to shoot a cult film in Bahai. Spread the message of the downtrodden to the masses around the world. A Bunuelesque or rather Kafkaesque feature film leading to box office success. Big cash flow and major prices. Getting us to hob nob with the fertile famous. Keep on dreaming I guess.
The closest I got today was in a recorded interview on the World Radio (USA) which shall be broadcasted Friday.
Talking about toast. I did it 2 computers in 3 days. I guess Dell is happy with me as a customer. The last computer lasted about 36 hours. I was happily tapping away when I started smelling something funny. Mostly it is the lamp which is burning so we turned it off. Five minutes later `I realized it was not the lamp. Too bad before that the lap top decided to croak on me. Ribbit no more laptop for me. Recommendation has come for me to continue work by Papyrus and Goosefeather .
People I am just so far behind with work it is hilarious. Every time I make a serious attempt at catching up in Administration a computer gets fried due to excess energy input. Should I just wholly quiet touching these malign machines. I am still on the fence.

Well before I fall of I am taking my catnap. Tonight I will not try my conventional place but my bed outside not in the wind. To much sand in the ear is not good.

Sleep tight.

Namaskar,

Ashis

Bahai Beach 20

Bahai Beach 20

Water shortage

November 5, 2006

The ugly truth has been revealed. There is not enough water in the new site. It was revealed on Voice of America several days ago so I guess it is in the public domain. In the camp in the mean time mobilization to move is still in full gear. However despite all security threats there is rarely anybody to be seen at the registration tables for the move. Some big fish in Geneva has put his/her wishy washy mind that Oure Cassoni will be moved as per November 10th.
Where to ? Unknown.
Informing refugees ? Who cares.
Involving refugees in the decision making process ? No time.
I guess when this place was set up 2 and a half years ago security was considered. People in the camp however will decide them selves if where and when they want to move. Services will be phased out in the camp. Yet for at least until the last convoy in let us say 2 or 3 months services have to be provided.
Maybe I wish not to understand real politic. Maybe decisions about refugees are beyond my level of comprehension. Yet the procedure being followed now to me dehumanizes the beneficiaries to passive parcels to be shifted to A o no to B o no to C. In medical school I was taught about informed consent. I guess in self created emergencies these rules do not apply to UNHCR. It requires a functional cerebrum only to see that accepting a refugee camp smack on the border with Sudan near a major water supply (the only one in a wide circumference) is asking for problems.
I hear that the refugees themselves have refused to budge when settling in 2004 and in several moments afterwards. Yet when the move is imminent the back up place to go has no water reserves enough to cater to our population even if they wanted to move. Where was the real contingency plan?
Chad is a not exactly water rich. One of the prime requirements for a human to live are access to water, food and safe shelter. I pray we find water quick.
I shall not go into ad hoc other solutions being talked about. These points are not official yet and await to be aired on Voice of America/ being told to the refugee community and their leaders.
Tuesday the next Leader meeting is planned. I shall be present and know it will be a hot hot meeting as we say here. The message of the lack of water will be revealed and also the alternative plan.
On a lighter note the hospital situation is calm. Fractures take time to heal. All patients are stable. My concerns now are that we have no place to admit the usual number of local community and refugees in the hospital. The medical team is near complete and we are hiring extra temporary staff to cover the needs of the hospital.
Mimi is turning to be a menace to the local mice/gerbils and is doing well. Yesterday another party (read visiting at 1600 and leaving at 1800 due to strict curfew). I managed to move one leg on the dance floor for at least 10 minutes.
In attempt to enlarge our collection of Bahai Zoo we have purchased two white goat. I am hoping to convince the cook not to slaughter as they may be the hard core of a future herd of goats. We will find a local boy and he may take care. This afternoon however goat rib barbeque most likely will be on the menu.
The airing of the document on 60 minutes Searching for Yacub has opened my eyes about the true power of the media. There have been reactions a plenty. And because of internet I can access many of them. The discussion on the intervention of UN troops in the Darfurian conflict is taking an interesting turn and I do hope that the African Union together with the EU, US and UN can muster an appropriate peace keeping for. Else it is free for all and judging about the incidents in Central African Republic, Sudan and Chad this may well become a regional nightmare. In the media (New York Times) one can read how Chadian Arabs are copycatting the terror of Sudan but also that the Arab community is suffering from attacks from the Black Africans. I do not want to oversimplify a very complex conflict but I know that if no intervention is taking place anytime soon Endlosung, fight till the last man standing will take place. While the local, regional and world community has not been able/willing to intervene. I just can not understand why a minute (comparative) conflict in Lebanon troops are made available in a hush and a puff and here nearly three years of impotent talks show the perhaps true interest to our Muslim Black/Arab fellow beings.
Well I just would like the public opinion to sway into the Human Duty. Protect the vulnerable. Open eyes and ears. Learn to care about what is happening in the world.
Big words- perhaps, but history will judge us harshly for being passive and non caring.

Namaskar

Ashis

Bahai Beach 19

Bahai Beach 19

November 3, 2006

Time keeps on ticking.

While Mimi our black four month old cat but already an expert in catching mice is trampling the keyboard in attempt to lure me into giving food things developments are as usual rapid, chaotic and unpredictable. The little chicken for instance seem to feel that Mimi is a big furry brother of theirs. One day a family drama is bound to take place. I am trying to brief my chicklets but the seem impenetrable concerning security threats. Their mothers however are much wiser. For at least 3 weeks no eggs have been produced. Their must be an inbuilt anti Kalashnikov gene in the reproductive system of these birds. War means no eggs as the offspring will grow up in dire conditions.
In Bahai in the mean time the merchants are packing up shop, inhabitants are leaving to other places and there is an eerie silence despite the increased presence of rebels in the wadi. A senior Chadian Government Colonel from Bahai has been killed fighting in the South and a wake is taking place next to our office ass that is his residence. In the history of Chad April and December are known to be months of revolution. Even last April there was an attempted coup from Sudan by Chadian rebels. December is nearing and fights are going on inseveral places within Chad. Also in Darfur itself the heat is on. GoS looking for an Endlosing and the Zaghawa and other tribes looking to carve out there kingdom. In the media one may get the feeling that Arabs are out to destroy the Black Africans. Clearly there are Arab villages being looted and pillaged by Black African tribes. It is nasty business war but calling this nasty would be to kind.
Back in the camp power play all the time. I wish you could be present at meetings. Yesterday I chaired a meeting with the Protection and Public Health team about collaboration. One group has Social Workers and the other has Community Health Workers. It was the first meeting with the Expatriate and Inpatriate staffs of both teams present as well as the senior Refugee staff. It starts out calm and positive with women and men coming up with good suggestions then at one point the leaders join the fray the discussion with the shopping list approach and with condemnation of the litlle effort we have done. So to give an example a woman will deliver in the heath center when we give her a piece of soap, fruit, meat, sugar or perhaps a bag of money. Or that a vehicle is required for emergency services as the horse cart owner living in the camp lives far away. The bottom line is men refuse women to deliver in the health center and they are the decision makers. We have a big work in that department. It seems however that an assistant reproductive manager is coming soon. Maybe even today she will join to the camp. She is Chadian and speaks Arabic. In the community there are many Traditional Birth Attendants who do roughly 60% of deliveries. When a problem arises they come to us very late. We need to create an incentive for them to come to us with the problems before the problems turn in to catastrophy. Last two months we lost some new borns and even a mother due to lack of clarity about when they can or not come to the health care center (24/7) These are issues to be discussed on grass root as well as leader level. In the clinic in the mean time due to overdue holiday breaks for national staff we were very much understaffed however most are back now. Yippie – a – yaay.
Dear Doctor Ponce who has been working 12 hours a day for 3-4 weeks in the hospital is off for a weekend break in the capital and after that he will be doing an assessment of our possible new site near Biltine. F~rom the information gathered sofar the Ministry of Health is more present there. I guess beating one chicken and a guard is not hard to beat. Reports are due a budget for this highly chaotic move with a minute planning time. Remember first convoy is supposed to start to leave on the 10th of November to a site where there is nothing yet. We as an organization need to step up to tell UNHCR that even given security threats it is impossible to move a camp to another place without planning from a moral, medical but mostly a human point of view.

My pancakes are awaiting and so are a hospital, reports, new staff, a child requiring a bloodtransfusion I am off.

All be safe.

Take care,

Ashis

Bahai Beach 18

Bahai Beach 18

CBS 60 minutes show hits like a bomb.

UNHCR must be very pressed. On the second day of Id the refugees were surprised with the official news that the camp would be displaced. It is one of the most holy days in Islam and cultural sensitivity is not high up on the list in UNHCR. The reaction of the leaders of the camp was as united as predictable. Under no circumstance will the refugees vacate their houses in Oure Cassoni to the preposed site in Biltine. For the refugees this is the region where the Janjaweed came from the same Janjaweed that chased them from their houses. ‘Like jumping in a put with a stone around on a rope around your neck’ . ’Sending us to hell’ It seems the home work by UNHCR has not been done well. Part of arguments mentioned maybe be valid. There are Arab tribes living in Biltine (the new site) The second argument is that the cattle/goats are being herded in Sudan by the men can not be taken to the new site. The third argument that the present region is like their homeland. The host population is from the same tribe. After a while (4 hours) the meeting was suspended to respect the day of Id and to be able to spread the message to the whole of the camp the next day.
We are so blessed with the cooperation of other NGO’s. Bless the International Red Cross and International Medical Corps for sending nurses, surgeon and anaesthesist. All the wounded can finally get the required traction to their broken legs. There will be one hall in the hospital with about 12 men with a sandbag hanging on their leg. Great photo op. Even the young man whose leg was considered to be amputated yesterday is being given another chance to heal. In fact all patients are stable. Even the boy who got shot in the abdomen. He had blood in his abdomen and an injured kidney but he is going well. And our man with a bullet in his brain is smoking cigarettes. All soldiers smoke in the hospital after all. To make sure the smell is not too bad tons of incense is burnt on a daily basis. By now Dr Ponce my Cuban-Congolese brother needs a break. He has been doing an amazing job since October 7th non stop surgery and molding plasters, cleaning wounds. I wonder how we will organize that. At the same time plans are being made to move the camp. And he will do an assessment of our counterparts in other words the ministry of health in the new site. I have heard it looks much better. It has a functioning hospital. Which reminds me that in a meeting yesterday our Medical Director of the hospital showed up. He has still not bothered to inform us about the fact that he has found a new job in Abeche. Well I guess we are better off without him.
The camp in the mean time is a strange place. You can feel the mounting pressure. As the registration for the move has opened on day one no people came for registration. I am told that it is always like this when a camp is moved for usually security reasons. The manifestation of rebel infiltration in the camp in the mean time is more and more clear. It is highly likely that there is active enrollment of men and boys in the respective rebel fractions. Jeeps and weapons are found in the camp at all times. In an environment like this we can not work. The Sudanese Government may decide to bomb the camp as they can rightfully claim it is a rebel stronghold and that the status of refugee camp is being abused to create a base for their enemies.
Finally I have been able to hear the documentary on sixty minutes. It was about 13 minutes but it send out such a strong message. The storyline was about the schoolbooks of boy called Jacob found in Sudan after a village had been razed and the quest to locate the boy. Eventually he was located in Oure Cassoni camp and ended up being interviewed. He told the reporter that he lost several of his relatives and that he wanted his schoolbooks to remain in the Holocaust museum to assure that people can see what is going on presently in Sudan. I had the good fortune to air my views on the lack of involvement of the world community. And ended up being quoted the next day on CNN to emphasize the plight of the refugees but more over the impotence of the local and world community to address the issue. I can tell you that viewing the documentary really shook my world yesterday. Shawn, John and their team congratz. No Emmy required. Perhaps this can tip public opinion to intervention in this devilish conflict. You did a hell of a job.
In the mean time it is back to the camp. Today we have an HIV sensitation day and I have been asked to attend this training. Also I am working on a plan of action for the transfer of the camp. Like in an absurdistic novel I have visions of setting up shop. creating great facilities to realize after several months that the deafening silence is due to the lack of playing children in the camp.
Shall we suspend educational services in the mean time until it is confirmed when the move starts? How do we address all these challenges?

I will look in my crystal ball.

Chicken are under threat of night frost. Planning to build them a nice and cosy stove so they do not end up as ice statues.

Namaskar,

Ashis

Bahai Beach 17

Bahai Beach 17

Monday Id Fatur

For once the sun did not wake me up. Bursts of Kalashnikov fire, friendly fire for once. The local population is elated. No more fasting and big celebrations. Sheep are being prepared all over town. A month of fasting in a desert is not easy. Not drinking while it is up to 45 degrees Celsius makes people grumpy and sleepy in the afternoon. Inchallach energy levels of staff will be up and it is needed. Big work lies ahead. Sensitizing the refugee community and preparing them to leave for a camp located in a safer place further away from the Sudan – Chad border.
Saturday in the camp I had a very nice interesting discussion with some of my staff members. We were talking about the eminent threat. Antonovs (Russian planes used by the Sudanese airforce) are encroaching the Chadian airspace on a daily basis. These are the same planes that were used to bomb the villages of the refugees in Darfur. A trauma revisited. Look at the location of the pitched battle of Saturday 7th October with likely hundreds of deaths and wounded at a whopping 5 kilometer from Oure Cassoni camp. Who knows what may happen next time if a party decides to enter the refugee camp and use it as a battlefield. Given all that the answers of the staff were amazing. We will not move deeper into Chad. If we need to move we will go back to Sudan or to Libya. Allah will protect us and provide us with food and shelter if or rather when UNHCR and the INGO’s leave. Mayhap in a Kafkeskian twist a refugee camp may be set up for no refugees. Yet staying in this place is impossible given the security and water situation. My male staff made it perfectly clear that even if all the women and children wanted to move to the safer place one Zaghawa man saying no will suffice to refuse the move for all. Moving your house for a second time in 3 years is not easy. Their houses are mud brick construction which are really nice. Many people have sheep/goat/camels/donkeys and wish not to leave them behind. Oure Cassoni lies on the border to their home country and entry to it is very easy by either donkey or car. Many men are across the border tending to their herds knowing thqt their families are being taken care of in a refugee camp.
For us it implies running two camps for a limited time until all those refugees who wish to come to new site are transferred and then sadly we need to stop services at the old site. Old hands say that the reaction shown by the community are common. At first resistance but when the reality of the new camp sinks in more and more people may follow. For us to see if in this case it is true. Zagawas are fiercely independent and will make their own choices guided by their Umda (Sultan/King)
All the NGO’s working in Oure Cassoni have been visiting the new site. OXFAM is preparing a hydrological survey. Water points are being dug. Transportation of 25000 and a possible 15000 refugees more are being prepared. Setting up of a new camp while winding down the old site is being planned. I guess the whole transition is planned to take place in 3-4 months. If that is realistic is anyone ‘ s guess but that is what the time frame is.
The challenges that lie ahead are immense but I am confident that there is no other choice. The Chadian Government and UNHCR have decided that Oure Cassoni is not to be maintained at the current place. Let as plan for the worse and hope for the best.
On a lighter side I am proud that 7 chicklets are still winging it. On the way to grilled chicken according to some on the way to world conquering egg imperium according to me. They manage to roam freely in the morning but stay in their gate/residential area most of the time. Just to peek a boo at their beloving father early in the morning. A whited headed black bird is always popping up in the morning as well but our kingfisher seems to be less inclined hanging around violence. He or she has left.
The medical team is tired and they have done an amazing job. Taking care of over 100 injured soldiers in a war setting is just mind blowing. Deep deep respect to them. Three soldiers died in the hospital. One may still die. He refused amputation and is now septic (infection in the bloodstream) with a necrotic (dead tissue) leg. It may well be too late to save him. Yet only 2 days ago he in a clear state of mind refused to be helped. All his friends tried to convince him as well as the medical staff. His wiggling toes were proof to him that the leg was still functional. When the bandage was opened maggots crawled out. Disgusting as it may seem mostly they eat only dead tissue. Now his wound has progressed up to his hip. Amputation in a center like ours is impossible.
The camp has held well. Just a steep increase of cases of watery diarrhoea. We will map and try to find out if it is a single bladder, a latrine or a underusage of chlorine in the water. Luckily although cholera is around the corner in Sudan we are still unaffected. Essential services have been maintained even if the medical team could not go to the field every day.
Jan Pronk, the Dutch UN special envoy in Sudan is being kicked out of the country for saying what is clear. Sudan is continuing its cleansing of Darfur by airplanes. I am not saying that the Sudanese rebels are choirboys. After all most of the wounded and killed in the pitched battle of Carriari (the lake) were Government of Sudan and the attack took place during the month of Ramadan ( a month where war activities are usually stopped ) during the prepation of the meal to break the fast. Again against all war ethics. If you believe that there are just ways to fight battles at all?!
And the last disturbing fact many of the fighting rebels are not adults but boys. Child soldiers. When will the vicious cycle ever be broken. In the camp the only solution seen by the refugees is the immediate dispatch of UN troops. Why is 2 weeks of conflict in Lebanon enough to guarantee an influx of tens of thousand of UN troops and why is a far bigger conflict in Sudan ignored?
If anything I said on the CBS documentary 60 minutes called searching for Joseph aired yesterday in the USA I pray it to be the statement that it is time for people to stop closing their eyes and start caring again.

Have a great Id Faizal,

Namaskar,


Ashis

p.s. new photos of my chick farm will be posted today on www.flickr.com today

Bahai Beach 16

Bahai Beach 16

Round and about.

History of a camp on the move.
Can not even lift my heels and see what happens. Massive combat near the camp and the decision to move the camp can be made snap. Camels and trucks or by foot or dear refugees need to move again. After being bombed out of their original homes security leads them further away from their homes and into Chad. Given the precarious location perhaps an overdue decision is taken and water related issues (lack thereof), closeness to the war theater may be things of the past. As we are moving south and west there is a very big chance of fruits and vegetables to be available and maybe even milk of zebra’s.
As additional money making activities I am thinking of opening a well equipped camp site for expatriate staffs; Jacuzzis, sauna, discotheque etcetera. Bound to make a smashing amount of CFA’s.
As I talk over skype with my colleagues the intensity of the fighting and the casualities are coming through. On one day 104 soldiers with gunshot wounds were admitted. Three died only as to the valiant efforts of those working 24 hours a day to give these young men a chance. And then you read about Darfur. The fighting is picking of the Government of Sudan has suffered two big defeats, making their blood boil and unleashing again the demonized but also demonic Janjaweed (in this war none of the parties have clean hands) It is being said that when a military attack takes place often the vehicles are of NGO origin and a fleet of UNHCR, MSF, IRC, CARE vehicles mounted by a plenty soldiers and heavy machineguns attack other fleets of vehicles. Bombing from old Russian planes is taking place again. Ramadan is not even over. A time to reflect and to enjoy the brother/sisterhood of man.
Is it the oil, is it a quest for kingdoms, is it sheer madness or CIA induced ? Perhaps these and a myriad of other reasons.
The question why I am here for me is clear as it was the day I decided to take the post; No child deserves this. What adults do is their own right. Yet no child should be put through this.
Back to Holland and the UK a beautiful pool of babies has been added to the planet. All I managed to see and those I missed out on are what makes this planet a beautiful place. A place of hope that perhaps we will get it right one day.
Fruits-fish and milk. Sleep and loiter that is what I needed and I shall need again in 3 months. Mayhap in the Netherlands, maybe India maybe Mombasa I shall see. The distance gave time to reflect. To look back on the positive things happening in the camp. The enormous difficulties that are faced by the refugee population but also to a lesser extent those that are trying to help. The workload will be so high that there is only one way for the team and that is to gel and kick ass so while a group of 29000 are moved, a camp is built, normal things like water, sanitation, health, education go on as normally.
To all of you thank you for your thoughts, support, meditation, prayer etcetera. I feel it gives me the strength to keep smiling and digging in hard.
I am happy to be back with my chickens and colleagues. There is some mischief to be done.
Namaskar, Ashis

Bahai Beach 15

Bahai Beach 15


Novel attack.
01-10-2006

It becomes an elaborate play. A group of local dacoits enters a local ngo compound. They take hostage people present and start a frantic search for keys of the vehicle. The keyholder is so nervous that he forgets he has the keys in his pocket. In the mean time a security officer in hightened state of stress falls asleep on the floor. Four bandits move to their brothers of the police to kidnap some more people. They succeed and by now 10 people are held hostage. The guard of the compound escapes slithering his way over a wall and alerts the commander of the brigade. Just before he arrives some of the staff get smacked on the head as they are trying to send emergency signs by hand set. The bandits in a fine frenzy smash the front window of the car try to hot wire it but do not succeed. As the jeep of police arrives the crooks slip away by foot in the night. No one gets arrested and the hoodlums are still in town awaiting their next chance to heist a pick up.
To make matters better our gate is down to be rebuilt in a proper gate so at night we are without a gate with a vehicle in the compound that does not start. I guess at a point you just need to laugh about these events. Clearly the thieves are after cars and radios. No one has ever been robbed for money.
In the compound the chicken are breeding like anything. I lost count with the little ones. And therefore today I moved them to the gated enclosure. Mother chicken gave me a hard time to catch her before I managed to leave her in the fenced area.
There were two birthdays this week so we had a fantastic lunch with camel steak. In the camp in the mean time buildings are being reconstructed, gates are built, systems are put into place. It really is starting to look like a functional tweaked health care center. Yet I am curious how the big boss of UNHCR will respond when she visits.
O guess what today in open day light at 1100 in the morning one boy armed with a pistol stole the pick up they so much yearned for. One hour later it was spotted in Sudan and woo o woo the local police had no petrol to follow the perpetrators. In the larger picture at N Djamena and Abeche level heavy delegations are tumbling over the table with suggestions. We require extra police officers (fuel o and money would be nice UNHCR) Just cough it up. The thefts will continue but at least more of the people in Chad will benefit from your generosity. Somewhere in a compound today the brother of the president is laughing. He is our local sultan and he takes 10% of each and every deal made in Bahai. Bahai from the old days was a place where the outlaws used to hide, a place to meander, discuss and plan ahead like in a bad spaghetti western, but then eastern. If you lose the capacity to laugh about these events I guess you need to go. Safety wise I feel ok. I am trying to understand the motivation of the people here and it seems to be money spinning. How to milk the International community to the maximum. Their mandate after all is to take care of our Sudanese brothers in the process as we have no education.
As a short completion of the story. The awaited first clash between troops took place in Sudan leading to 30 plus casualties and unknown amounts of deaths. It was 5 kilometer away from the camp. Myself I was on route to N Djamena and now I am in Holland relaxing and trying to empty the mind. I shall comment more soon. My thoughts are with my colleagues.

Namaskar,

Ashis

Bahai Beach 14

Bahai Beach 14

Security training

The good thing about vistitors from abroad is that they bring a lot of knowledge, experience and sometimes good food. The down side is all feel that on top of the normal work program there are endless session in the day and at night. Sorry for those of you who felt I was inaccessible. In this case security advisors came, instructing our drivers on safe driving, awareness, convoy driving etc. etc. For ex and inpats there were many exercises on the context of the situation we are living in and the mental state that is security. 24 hours a day, 7 days a week and not only personal but also for the group. I guess the best illustration is the fact that we are currently in phase orange. This means dangerous times. At all time an evacuation may be imminent so at all times documents and a carry pack of 15 kilo need be on you near you. During the exercise it became clear that only 1 of us was carrying his hanset, two a sat phone (one switched off, the other flat battery etc.etc.) A lot can be improved any way. It was a good reality check.
Today in Oure Casssoni again a young man presented with a bullet wound in his leg. For me I do not ask about the reason why (as there is military around) just make sure the patient is stable and move him to the hospital. Another sad story is a 10 year old girl with a heart condition, valvular disease by rheumatic fever. That in it self happens, but the parents kept her home for two years. By now she does not eat, too tired, does not play and is tired all day. We hope to put her on prophylactic treatment, buff up her red blood cells and nutritional status and educate the parents.
My holiday is rapidly approaching. My head by now is filling up with the plans I have for the next 6 months. Always baring in mind that the entire context may change. The water may run out in May, rebels may attack the camp, there may be strikes by the refugees as we will reduce our staff numbers. A plethora of potential worries. Yet overall I feel the spirit of the team is picking up. In the meeting of two days ago my assistant managers were taking the piss out of me and that to me is a good feeling. New expatriates arrive, old expatriates leave. Soon I will be the most senior person (time wise in Bahai) It show how fast time flies. One day you are the first and one day you leave. The new team seems to be rock solid with logisticians with 100 years of experience (and look a likes of Marc Anthony), fresh (Dr Ponce a Cuban trained Congo Brazzavillian doctor), Aphons our former refugee from Guinee (what a harrowing stories he has to tell and where is he now, helping other refugees and having 2 of his 5 kids in Australia a country he never visited)
The bird farm is doing well: 6 chickies by now however there is an alert on avain influenza in the country. All potential investors need bare in mind the possible destruction of the poultry.
UNHCR woke up after realizing that in their stock there are 5800 bed nets finally they have started distributing (well tomorrow inchallah) Sancho Pancho and I have to do our spiel through the world of skype. The lucky bastard is based in NDjamena so he can dance pretty much every night leaving me to suffer the tightness of nightly curfews. Some of you have asked me to describe the compound, well I shall put some pictures up on www.flickr.com get there through www.bahai-beach.blogspot.com. It consists out of chickenshit, sand, two bucket shower a massive diner cum meeting hall. About 14 rooms for expatriates and visitors, a kitchen, a houselet for chickens, about 10 trees looking to grow to mastodonts. Since the attack the walls are being heightened up to 2.50 meters with barbed wire and lights on the exterior. An added advantage may be the availability of internet from 1800 till 0500 in the morning.
Nature wise we cohabitate with zag zag (gerbils), desert lizards, massive spiders, scorpions, kites, sparrows, kingfisher and several other birds, exhausting amounts of insects and other animals. The donkeys are the sweetest of all.

Ladies and Gents,

The convoy is beeping

I need to jump in the car,
This afternoon I shall construct a chicken fence


All be healthy

Until soon,


Namaskar

Ashis

Bahai Beach 13

Bahai Beach 13
19-09-2006

Ramadan

After Hilel ( when the moon disappears ) and reappears on either Friday or Saturday this week Ramadan will start. This has many consequences for the project. Working hours will be reduced for our refugee staff from 07.00-12.00 with emergency services only. It is said that only the really sick people will come so the workload will be less anyway. To be followed up. Let us pray that during Ramadan there will be relative peace in the Darfurian conflict. It coincides with the departure of the AMIS (African troops) on September 30 leaving Darfur completely open to warlords (janjaweed) and Sudanese rebel groups (JEM, SLA fraction) and the Government of Sudan to do as they please. From time to time I get really sad tiding of civilians being slaughtered in villages not so far away (<200 kilometer).
Today our first confirmed HIV patient entered the camp. He was staying at another camp (Iriba) but his parents were in Oure Cassoni so with the last energy and funds he had he came to our camp. He refuses treatment (intravenous perfusion) and looks severely dehydrated. His father is blind and his mother very old so they were looking for a third person to take care of their sick son. Traditional healers had come and given him certain amulets and cuts to his chest to purge the illness. Not unlike we were doing in Europe until perhaps 100 years ago. This healer (uruk) instructed the young man not to use Western treatment. The next days we will try to respect his wishes but try to at least alleviate his suffering. He has near continous diarrhoea and is too weak to eat or even drink. Perhaps with an iman and a local leader we may help him suffer less.
While I am writing this I am in the souk (market) smoking a sheesha. Due to the security situation there are two convoys per day back to Bahai. We missed the first one. In our vehicle are two malnourished children as their mother does not have breast milk so they are fed goat milk. The human intestine is not prepared for this so both kids have diarrhoea. One is severely malnourished and dehydrated. The other twin is also weak. Another lady had a fight with another lady and her four front teeth were smashed loose. There is no dentist here so I will consult with the doctor in the hospital of Bahai ( if he finally makes it to a plane, he was on the passenger list but has not been in his hospital for near three months now) If not perhaps I will extract the teeth before she swallows one of them at night.
Yesterday afternoon was a big framework day for IRC in which the programmatic framework was explained to the international and local staff. The format was a group discussion. IRC mainly works with refugees in conflict areas and has several principals. Just to mention some; building capacity, collaborating with local institutions, preparing to hand over, saving lives. The program components include; Gender Based Violence, Education, Protection, Environmental Health, Reproductive Health, Clinical Health and Public Health. We talked about the context of the conflict in Sudan and Chad to make sure that the philosophy of our organization is understood by all.
In the camp this week we had a vitamine A mass distribution, a bed net distribution to the orphans and close monitoring of the quarters where two suspected meningitis cases were found two weeks ago.
My break is coming up and I am looking forward to meeting all newborns, friends and family in the Netherlands and the UK. Once I get the confirmation of my tickets I will inform all so I can see a lot of you. Also fruit, fish and sleep are high up my list of things to do. After the mini break in the capital I realized how stress out and tired I really was. Still the majority of my health staff is out of the project the next weeks and the past weeks due to poor planning. Well it is at it is. Next year the holidays shall be more evenly spread. Then again one of my assistant managers has taken liberty and has returned back about 10 days late. He is not the first and for sure he will not be the last. So this afternoon I shall have to have a nice conversation with him. Perhaps he has found another job. I shall see.
Sancho Yoda has returned and I shall hope to hear that he is getting married soon as he went down on his knees in France.

Be healthy,

Love to all,

Namaskar,

Ashis

Bahai Beach 12

Bahai Beach 12

Grandfather Ashis,

Dear all. It has happened. Three little chicklets have popped out of the eggs and are cruising the compound. They look like daredevils as there are hawks in the air looking for fresh meat. A contraption is made so there is protection against the predators. And yesterday as well a Sudanese refugee came to give me 2 birds of an undefined status. They look like waterbirds and have huge feet, eating grass and insects.
I feel like a grandfather and the owner of a bird orphanage. It is an elating feeling I assure you. I have been in the camp for two days after my stay in the capital and there are as usual some problems. What is new?. At the distribution of yesterday the 4000 peoples who do not have a ration card and therefore do not get medication/tents etcetera where about to revolt. It took calm explanation of the UNHCR coordinator Angele to calm down the masses.
The dicotheques in N Djamena are places jam packed with French soldiers, beers, women and doumbolo (African music). The Meridien was a nice place to swim whilst looking at the cruising hippotami floating bye in the Chari river. In a way N Djamena reminds me of Khartoum as it is also built at the conjuncture of two rivers. Yet Chad is much less rich than Sudan. In N Djamena I managed to visit two of our referred patients. A 8 year old Goran boy who did not even cringe when his leg was dangling. Now his amputated half leg is curing well. His father a commandant in the army is looking for an orthesis. The other patient was a lady of 25 years with breast cancer. This morning the operation was done. It is palliative care (not meant to cure) but it is the best we can do for her. Even for Chadians chemotherapy is often beyond the means. The rules with UNHCR dictate that refugees get the same level care as the local population and not better.
The end of the week I spent counting tablets and reorganizing the pharmacy in our base, in the camp health center and health post with the help of the logistical team. The business is still unfinished but perhaps on Sunday I can do some mental relaxing exercise to either Wim Mertens or Dj Tiesto. Will see how the mind state is. The pressure over the last week has been building up, but finally on Monday Dr Kaboo is coming (the medical hospital director, who is more often on holiday/or piss drunk. Thank godmy colleague Dr Pounce will be his counter part and I can finally focus on the camp only .It has been a hard time and as some have noticed very straining. The smile on my face is back however especially when my rest and recreation was approved for October. London, Paris and Holland beware. Next holiday may be skiing in the Himalayas or diving on Zanzibar.
Tomorrow also I wish to finally built a house for my chicken they cause stress to my fellow expatriates and I can no longer protect them from the cooking pot. The shitting and the noise pollution is just too much. It seems tonight we will have a projected flick under the starlight.
Our Muslim staff is gearing up for Ramadan. They are eating a plenty and are eagerly looking at the moon as it is to be decided at which day Ramadan will start by spotting of the moon. Our working hours will change and they say also the workload. It is said that because of the cleansing effect of fasting less people fall ill. The fasting is one of the pillars of Islam and the inhabitants in the camp take it very serious.
From Sudan nothing but bad news, more and more fighting and in 15 day the African Troops from AMIS will be withdrawn leaving no peace keepers as the UN is denied entry. All ready the fighting has picked up. Even in Chad between Abeche and Bahai there are pitched battles between Chadian rebels and the Chadian Government. As stated in the last letter a lot of people may come or they may decide not to cross the desert and stay with there animals. There remains inside of me a feeling that this conflict will not be resolved soon and that the real political will to address the Genocide is lacking. Possibly because unlike the situation in South Sudan these people in the conflict are not Christians but both warring sides are Muslims. The Government of Sudan is clearly out to boot out what they call African elements and Arabise Sudan. Making sure they get their fare share of oil out of it. Well to end on a more positive note.
The kid we sent to Abeche with the appendicitis has been returned as the man with the hepatic abces (almost dead on departure)
Life throws some ugly curveballs but some beautiful ones as well.

Namaskar,

Ashis

Bahai Beach 11

Bahai Beach 11
12-09-2006

Pigeon soup

Hassan one of my favourite drivers today showed me the nest of two fledging pigeons growing to adulthood on top of my room. He told me this in complete confidentiality and then he informed me Wednesday he will make lovely pigeon soup. I guess I shall accept his invitation to dinner. Five hawks are semi settled near our compound eating our scraps and awaiting the little chicklets to pop out of the egg. .I have not found a defense mechanism yet to ward of these predators. There is a plan to construct an irrigated vegetable field so we do not become vitamin deficient. Slowly our team is coming back to full strength. Alphonse the education manager has come, Dominique the gender based violence manager will come next week and so will Dr Pounce, who shall work in the hospital. Temesgen the Evironmental Coordinator is leaving early and our Field Coordinator Giorgio will leave as well.
My last few days I spent in both the capital N Djamena as well as Abeche (regional capital). In N Djamena I found a bar where a Morgan Freeman look a like plays the guitar and with his band African Jazz is played all night. Dancing in the local clubs is like entering a military zone. All French conscripts passing there weekend. In the hospital in the mean time our patient with breast cancer is awaiting breast amputation and the young boy kicked by a camel has a well healed wound and stump. Now he needs to find a good orthesis to help him walk again. In Abeche our patient with a liver abces was fine and I was so happy to see him return to his family in good health again. His parents and brother were beaming with joy.
In the camp in the mean time a drama is taking place. A sixteen days old boy whose mother died after child birth is not doing well at all. The family however cruel it sounds is directing it towards infanticide. I pray tomorrow the local leaders or imam can interfere because this is unacceptable. I wish but I fear tonight death will strike. The boy was already in a coma and severely dehydrated. The good news is that our health clinics are getting more and more visitors. We hope the people in the camp feel the services are improving. More transfers to the hospital (24 last month) but today even 5 patients were taken. We refer roughly one patient a week for surgery/obstetrics/severe illness to the regional hospital. Also we have a labtechnician who is doing good work so that helps us in making the correct diagnosis and provide the right treatment.
News flash of the day; UNHCR is preparing for 15000 people to come to our camp in the next 1-4 weeks. A fourth zone will be opened. And we need to hire exgtra staff, stock up medication, prepare water, latrines, do health screenings etcetera. It seems the stories will never end here. Also the security situation is not getting any better. We have one convoy to and from the camp a day. Our vehicles are locked in the UNHCR compound. We are hoping for the best and preparing for the worst.
Somehow my batteries were empty the last two weeks. But as I stated reinforcements have arrived. And I can focus on my own two jobs; clinical and public health in the camp. There is also the next Rest and `Recreation I am looking forward to. Let us not hope it coincides with the major influx of Sudanese refugees who are expected to cross the border by foot with nothing yet again. And so while big words are spoken in New York the reality of the day is unchanged for the inhabitants of Darfur.
Let us start to care…


Namaskar,
Ashis

Bahai Beach 10

Bahai Beach 10
31-08-2006

Dear all,

Another harrowing event this night. It seems like Ali Baba’s 100 nights. Schecheradze needs to keep on spinning stories to appeal to the sultan and extend her own life by yet another night. As a world champion powernaps I was lying in front of my villa when I was rudely awaken from my sleep. Half sharp no specs a guy was flashing his knife and telling me to follow him. In the corner of the compound our 3 guards were forced to squat on the ground. Marc our logistician was also there and hoodlum number 2. This chap was carrying an AK-47/Kalashnikov. In Arabic instructions were dispersed. Luckily we understood they wanted the keys to the pick up. Very unfortunately first the arm of one guard, then the head of another and then my wrist was used as stick wielding practice. Finding the keys in the designated place was easy and the crooks left us with schreeching wheels. A third mischief maker jumped in. All this took place in about 15 minutes at about 22.20 at night. Within three minutes the military police arrived. Our guard has a huge bruise, was bleeding and a bit groggy. The other guard is ok. And me well I am tapping the letter with a left wrist that is swollen by about 50%, Luckily karate reflexes saved me from a splitting head ache.
What to feel for such losers; contempt, grief, anger, or just sorrow. Well in the end they lose out. Bullet in the brain or a Chadian jail either perspective will not lead to a stairway to heaven or endless virgins. No just sadness, humanity can be beautiful at it fullest when laughing, creating art, being just and honest but also intensely ugly. Shrug the shoulder and dip the wrist. Initial reflexes like revenge are primitive and futile. So what box the guys? Their reckoning will be there. I got a job to do. Sure we do not take incidents like this lightly here. Bruises and blood are apparently part of the deal.
And then my mini break got cancelled. As I have mentioned before at times one in two flights does get cancelled.
Let me give some good news as well; a fifth kokai, konya, jedad entai was purchased. She is grey blackish and has great potential for gulus. The lady who has breast cancer shall be taken to N Djamena on Monday…
The 4 suspected cases of meningitis ( two deaths) have so far not become more (cross finger) and cholera is still 50 kilometers away from us in Sudan. Let us hope custom service keeps it out. Then again cases of hepatitis E have been found in a village not far away from here. In the hospital most patients are doing well many referrals from the camp have been returned home. We are trying to make a collage of the returned patients and a photo when they left to give our health center a more human face. With the vaccinations in place at the Health Post and Health Center we are getting tons of happy young kids frolicking around. I shall sure miss this place when `I go for my break in Holland. It may sound weird but I get more then give here. A sense of belonging, daily steep learning curve, managing motivated and unmotivated staff. There may come a day soon when we fire all 43 community health workers to rehire those people in the camp who are willing to work a full day instead of a half day. As you can understand not all is rosewater and honey but the smile of kid that was sick and about to day only days earlier makes my day.
All be safe. I wish you peace and love.

Namaskar,

Ashis

Bahai Beach 9

Bahai Beach 9
30-08-2006

Desert thought raising aftermath.

Hawks a plenty… about 3 thousand of them. It can not be the one donkey lying rotting in the wadi. Explanations range from Convention on Black Hawk down, yearly mating ceremony to a Rave for Confused Hawks. However it may be it is an impressive sight to see these mighty birds circle around. I am holding my heart as after about 10 days I am expecting 5 chicklets to be popping out of the eggs and they are edible for these flying rovers.
Yesterday night was yet another laughable event. As our guards tend to sleep at night we invented a reverse guarding system whereby all the expatriates take shifts to be awake to ensure the guards do not fade away. Long pokes and buckets of waters to ensure their collaboration. In case of sleepiness photos are taken and the most eloquently sleeping guard shall win the Sleepy Guard of the Month Award (so far three candidates)
The way to the camp (25 kilometers) has changed over a week. It is green-green-grass with stretches of sand in between. All goats and birds are having a field day, storks (hence the birth explosion), herons and kakatoos. It is surreal to see camels go through the Dutch green fields. The wadi is teeming with life, frogs, snakes and perhaps fish.
Reinforcements are due. A Doctor Pounce has been localized and he is willing to leave ihis snuggly Brazzaville house to move over and reinforce our hospital team. The local Medical District Officer has disappeared from the face of the earth but this way at least I am not the only doctor in the entire region. We send about 25 people to the hospital for treatment and diagnosis ranging from difficult pregnancies (echo available) to premature babies, malnourished kids, stroke patients, hepatitis cases, meningitis cases, malaria cases, elephantiasis case to difficult deliveries. The Chadian doctors in the mean time seem evasive. Even an interview in Abeche (the third largest city around) seems to be to much effort. I am afraid once they see the reality of the field they will turn around and leave. Honestly I can not completely blame them. Life is expensive here, with little to nothing to do and even the local population seems to be slowly moving on to places where there is more water. Even the sturdy nomads here are running into problems. If not through the conflicts (Chadian and Sudanese) then through the arid conditions. Our lab technician in the mean time is awaiting his contract. Administrative procedures take its due time here and in the mean time the hospital and camp will just have to be without. The region has been without for 6 months anyway.
Because of concerted efforts of the NGO’s, mainly the IRC the hospital is slowly getting on its feet again, just praying for Ministry of Health involvement and commitment as well. Nowadays our vehicles are full of patients we take to and fro. The peeps in the camp seem to get the message that there is a second tier of care out there and they are starting to present to our Health Post and Health Center. Sometimes a sad story may find at least a small solution. One of the female refugees who has breast cancer and delivered an anencephalic child 2 weeks ago is allowed to go to N Djamena to meet an oncologist there. Even if the treatment is only palliative. I can not do anything for a 5 kilo breast in terms of pain control, nor proper diagnosis or treatment. Chemotherapy in the desert is far far away. I feel humbled when the husband profusely thanked me today. As he said after the Government of Sudan bombed their house and they had to flee Sudan chased by the Janjaweed the had nothing left. He was counting on our generosity. Generally for an NGO taking care of chronic cases/cancer is not within the mandate/budget but for this lady I became a knucklehead on a crusade and let us hope that at least something comes out of it for her. As because of Machavellian powerplay I may be with her in N Djamena to ensure a proper hand over to the oncologist. At the same time I may visit our young friend who lost a leg due to a camel kick.
The camp lies under multiple threats; infectious; malaria, meningitis, cholera, security; the region is still heating up, water security; still less water then last year and this year we ran out in July. Also a dam has been built upstream.
We have a new temporary Congolese kick ass (rightly called Gang not Ganga) as Field Coordinator in place who is teaching me valuable lessons. If you are a knucklehead at least follow your bosses instructions on what to do and then inform her/him about the extra’s you will do that day/week. Plan ahead. Work and play hard. Communicate at all times. I guess desert whispers are teaching me lessons. By now our departures to the camp are at 08.10 sharp, people are taking initiative and responsibility in the team, slacking is no longer tolerated but also rest is an essential in a trying environment. In a way the 5 prayers a day that my colleagues here follow are an inspiration. Five moments in the day to reflect on ourselves and the relationship with the Allmighty or the surrounding nature.
The guard is awake doing his duty to switch off the generator. May I write two pieces this week? We shall see ?
Try www.bahai-beach.blogspot.com and post a comment if you would. I am thinking of all of you and the kids popping out left and right.

Namaskar,

Ashis

Bahai Beach 8

Bahai Beach 8

Rain and heavy heavy quantities of it… Three little boys running around the compound half naked crying and screaming. Singing songs and taking showers. Forty five minutes of bliss in the desert. Unknown to the project that it could rain so hard in Bahai. Even the day before we had been out at the water side to worry about the lack of lake. Now buckets and buckets full of it in one. My chicken were hiding in a small tukul (wooden hut with straw roof) but several eggs floated off. The next morning at 0600 bad news. The office has collapsed. (check out www.flickr.com) Luckily nobody got hurt. Pascal and Marc and about 15 others worked hard to salvage what ever was in the office and soaking wet. From computers to files to cupboards etcetera. The hospital has also been affected. Several cracks in the walls and leakage of water into the walls. Downtown Bahai walls a plenty came tumbling down. As we tried to access the camp to make sure our Health structures and Watsan structures were intact we were halted by the wadi (dry riverbed in the desert for seasonal rains). A mean wadi by now, wading is all you can do, no can pass by vehicle. (Try www.google.eartAll remains to be seen tomorrow. The weather has attracted falcons a plenty. They are circling the water and also the compound. I hope my chickens by now are so fat that they can not be taken by the falcons.
Insects are swarming around the lit lap top screen. Tomorrow for the second day I shall be interviewed by the American CBS show 60 minutes. In the camp in the mean time we lost a child to meningitis. This disease can kill in less than 24 hours from the first sysmptom. This means red flags up. Every day we go for active case finding to ensure we do not have a deadly outbreak of this disease. Also a class was given to all health workers on early recognition of meningeal disease and medication was prepositioned at the health center so early treatment may be started on suspicion of bacterial meningitis.
Bed net distribution, staff members refusing to dip bednets, Kafka could not have made it up better. UNHCR sitting on their butts like the Lords of Poverty. The conflict going downhill. Rape as a weapon war being used in Sudan. Cholera around the corner. Half of the health team out of the project for a bit. Hence my ranting.
The good news is I am off for a hard weekend of partying in the capital of NDjamena and also to find Indian spices. Which reminds me with some South African we had a great braai with goat.

As the hour of curfew is nearing and nowadays we do not have internet in the compound any more I shall send this bitlet now

Namaskar

Ashis

Bahai Beach 7

Bahai Beach 7

The show must go on.

Yet again a very sad tiding. One of our Chadian lady workers in the Gender Based Violence Department passed away more or less unexpectedly in N’Djamena due to hypertensive crisis. Our thoughts are with her family and friends. Today the bare minimum of activities was maintained and the national staff is preparing a ceremony to remember her in the house she should to stay at in Bahai. This afternoon we will attend. It seems that bad tidings are the flavor of the day; three days ago our Clinical Health Assistant Alexis who had just returned from N’Djamena found out his father is in a coma in the Teaching Hospital in N’Djamena so he flew straight back the next day. The program in mean times faces some restraints as the other expatriate doctor has resigned. He felt sick and exhausted. The reproductive health department is without a captain again. It is also the department within the health sector that needs the most care/improvement.
On a lighter note; the chickens are doing extremely well. At five they pop up at my bedside (as I sleep outside) and sweetly ask me for food & water. Well I gladly please my ladies and add a song or two because a wise man from Mexico told me if you sing to the chickens they will lay more eggs. Lo and behold two days ago I sang; 6 eggs. Yesterday I forgot; 1 sole egg. Either the guards/mice are eating the eggs, either my voice is indeed a miracle maker. And then the sparrow who think the drinking point is a path and my back is a rock to rest on (and shit on as well.
The access to the camp is getting less easy; rain dances have led to relative abundant rains and instant pulpification of the roads. Mush all over. Shaking the booty when driving the 25 kilometers to the camp every morning at 08.05. My goal of the perfect departure at 08.00 has not been reached yet. But with the arrival of Marc our new logistician in the project and Gang the acting field coordinator there is new power in the project as well as experience. Luckily Marc is ornithologist and Gang owns a 750 chicken poultry so the wisdom is on board for world domination with my chickenfarm.
Cholera is a major headache. Just across the border in Sudan cases are being reported and there is regular transportation. Our preparations are in full swing to prevent outbreak in the camp. Preposition of fluids, oral rehydration solution, antibiotics, classes, early recognition, warning, surveillance, isolation ward constructed and trainings done. Now waiting to face the storm. Talking about which a houboub is nearing, big sand storm right towards the compound. And believe it or not internet access during the evening hours. Not only cholera is at the threshold but also malaria. And given the system of UNHCR we need permission from them to distribute the bed nets while they bumble up the attempts to get the required insecticides to dip the bed nets in up here. I have never been a fan of rules and regulations and truly at times I want to run up the wall and shake some sense into some people working there.
How could I forget I delivered a baby boy in the hospital and the parents want to call him Hashish (ya man spread the message; green leaves are a blessing) . Also a young man who was kicked by a camel was evacuated. He fractured his under leg and because lack of money his parents could take him to the health post only after 4 days and then from the health post Bao (120 kilometer) to Bahai after another 3 days. Sadly his leg will have to be amputated as there is gangrene and necrosis at his underleg. Do you remember the guy with acute flaccid paralysis? He will be coming back on Monday or Tuesday and he is almost recovered 100%.
Yoda Sancho Panchez and I have started a work out program. I am focusing on the triceps as huge as Arnold Swarzenegger in his better days. He is complaining to me about this tiny little patch on his foot. After tons and tons of ointment I have given up on his foot and will amputate when he sleeps. It might resolve my promlems

Bahai Beach 6

Bahai Beach 6

August 11, 2006

On Wednesday we were struck by a true tragedy. Behind the compound lies our septic tank. For reasons unknown to all the lid had been taken off the septic tank. At 1600 a group of children came to our gate crying that something had happened in the back of the compound. When the guard arrived a 5 year old girl was found inside the septic tank. She had fallen in and had drowned. The emotions running through the hearts and minds of the national staff ranged from disbelief, anger, sadness, shame, fear, sorrow. How could we have neglected such an important and basic practice? The police came to do an investigation where it was found that the incident was a tragic case but there had been no intent on our side. We pray for the family and the girl that has lost her life. All I can hope for is that we at our side at times reflect more on the procedures we have in our organization. It is near impossible to avoid accidents, but clearly we do not look good on this issue. As a consequence UNHCR needs to give all the NGOs in the area clearance to go to work for the rest of the week. Perhaps the host community does not take well to the loss of life of one of their children and all men in this community carry knives and possess guns in their houses. You may have read in the newspapers that across the border in Darfur but also in Sri Lanka humanitarian aid workers are becoming more and more a target to violence. Several projects across the border have been abandoned. Also the peace agreement between the Government of Sudan and Mini Minawi ( biggest Sudanese Liberation Armee ) is unraveling rapidly. Mini Minawi’s supporters form the majority of the people living in Oure Cassoni refugee camp. There is infighting in the SLA as well and several split ups are against the signing of the peace agreement. On top of all this the Chadian president Deby who hails from this region has been installed for a third term as president after changing the constitution to satisfy his needs. Many of his detractors come from his own family/clan the Zagawa. Again the population in our camp is also Zagawa but those that live across the border in Sudan.
On a lighter note I am currently the owner of 2 chickens. Two more are being brought today or Saturday. Friday it is Independence day in Chad so no work. I feed them with grains and rice and they are awaiting the completion of the villa I am building for them. As I tap Kutidai (Zagawa for hen) and Jedada Entai(Arab for hen) are pecking way at the grain I have purchased for them. Kokiak (Goran for hen) and the Sara term for hen are to follow suite soon. And somehow five sparrows find the neon lighting I have very interesting and sit on top of it every night. Mr mouse (zag zag) or desert rat also seems to like to hang out near my veranda.
With the holiday of our field coordinator the health coordinator will be acting field coordinator for three weeks and I shall be acting health coordinator for the same period. For the camp we have a monthly activity plan drawn up for all the different departments. Some of the things that we are doing this week include; paying the incentives to our refugee staff, filling holes (avoid mosquito breeding grounds), distribute bed nets to all pregnant women (about 300) and orphans (about 2000), have health campaigns about prevention of diarrhoeal disease, monthly stock inventory of the pharmacy, international drug order, prepare construction of a water basin in our health post and center, work on the quality of the drinking water (being trucked in form the dam), have an active malnutrition drive where the community health workers look for malnourished children, jobinterviews with laboratory technician and doctor, monthly report. One of the good things that did happen to us is the arrival of Charles a Congolese member of the Emergency Desk who will help us with drawing up of Memoranda of Understanding on different topics; agreement with Bahai Hospital as we have new funding there for a 6 month transitional period in which we try to hand over (again) the hospital to the authorities, reduction of refugee incentive staff members. I think I mentioned in the health department alone we had 108 when I came here, possibly around 70 would be a more effective figure. Also we are improving the pharmacy and storage of drugs in the camp and I can go on for a long time more.
Whenever Yoda Pancho and Dr ~Chewbaca get frustrated we get out our big football (look at www.flickr.com) and kick the ball or end up discussing the lesser and greater Philosophers of the last 3000 years. I am blessed with such a neighbor. He keeps me sane in times like these. No visits to the market this week.
Does anybody have a good suggestion for a weblog site. I am considering opening one.

Take care,
Namaskar,

Ashis

On Thursday all of a sudden 40 trucks with military rolled into the wadi. One kilometer from our base. Straight away we rushed to the compound. UNHCR found out it was Chadian Government troups. In the same night a soldier and a civilian got into a brawl over a women and the soldier shot the civilian in the abdomen. This morning we spent arranging a flight for the man as well as for a second case a young girl who had fallen in a hole. It is hot and the conflict in Darfur is getting more and more hot

Bahai Beach 5

Bahai Beach 5
05-08-2006

Mission chicken is about to succeed. I have decided to start up a chicken farm. After searching the local markets and considering the prices of an egg (about one $) calculations showed that it would be more fun to keep some hens. Sunday I am building a little house for them and Monday they shall move in. Names are being assessed and high on the list are the following: Jedada (Arabic for chicken) and the Sara, Goran and Zagawa names for a hen. Some people tell me I need a rooster as well otherwise there shall be no eggs. Well we shall see. In case it is required I shall distribute earplugs to the other expats before they strangle my rooster. The market is my place to chill out. And I have found jawafa, a sweet local fruit, which is then made into a fruit shake. Also the sheesha (waterpipe) is still one of my favourites. Slowly slowly my Arabic skills are improving and even some Zagawa words are picked up left and right. Zagawa is the tribe that has been chased out of Sudan by the Government of Sudan and the Janjaweed. On the othe side of the border things are heating up. There are more and more attacks on the local populations and humanitarian aid workers. Here in Chad there are always rumours of what may or may not happen. To illustrate the unpredictability of the Darfur conflict: Mini Minawi (Zagawa Sudanese Liberation Army) is now the third vice president of Sudan and is supported by George Bush et al as well. He was in Washington last week and until 1 month ago he was fighting GoS. Now the other rebel groups have turned on him. Our refugee community are mainly Mini Minawi followers. The camp I have visited 5 out of 6 days this week. And as I said last week it gives me energy to struggle through administrative battles as health incentive staff for 96 people and monthly reports (due Monday) about 16 pages. Luckily Sylvie the new health coordinator has arrived and she is great. Finally I have time to plan ahead instead of always be in the troubleshooting mode. Also our reproductive health doctor Joaquim (Burundian) has returned. But work has a natural tendency to be heaped upon our shoulders. UNHCR expects us (Sylvie, Joaquim or me) to chair the taskforce on HIV/AIDS for the region and camp. A brilliant challenge yet it has to fit in with all other ongoing business as cholera preparedness, clinical care, transfers to the hospital in Bahai, or by airplane to Abeche and N Djamena, clinical supervision, public health programs, teaching sessions, meetings, reporting, security awareness and all. In short a great way to learn how to multitask, prioritize, delegate and hand over. Fresh blood is coming into the program and it gives it a real boost. Also there is more of a work hard play hard atmosphere in the camp. Dr J likes his beers, dancing and music. And Sylvie is taking over the responsibilities I was covering as Acting Health Coordinator. Some good and some sad stories to tell as well. The sad story is a refugee arriving in Bahai hospital (25 kilometer from the camp) on Wednesday. Bravo Golf Julliet 39, my call sign went off and I was requested to come to the hospital immediately. A lady in labor had obstructed labor because her placenta was in the way of the delivery channel. While I was busy to arrange an evacuation by airplane she vomited once and collapsed. She died. If only she would have come two hours earlier she and her baby would have survived or if we had a surgeon (we = actually the Chadian Ministry of Health Bahai Hospital) on call. The good doctor however is now not on his post for 37 days. What ifs do not help. All I can wish for is that the job interviews we have next week will bring as a dedicated surgeon with a caring heart. It is well to be understood that living on the fringes of a desert are not first choice for many medical people. I am sure we will find one. Several applications have been sent as well for a laboratory technician. Both will increase the functionability of the hospital as well as save lives. The beautiful story was a 5 year old boy who drank pesticide. He was brought in respiratory failure and with brusque intervention we managed to pull him back. He left the clinic two days ago smiling and that just makes my week. And to top it all I had the good fortune to do a normal delivery a healthy baby girl in the new maternity clinic today. O yes it is raining I shall send some photos so you can see how urgent it was. The lake is empty and we truck water from the dam now (10 kilometers from the camp).

Let me stop here. I am still happy here and Yoda Pancho, my loggie mate is snoring to loud so I will have to take some of his ear plugs. He gave me a nick name as well: Dr Chewbaca. Me a Don Quixote to him or vice versa is unknown. Enigmatic paradox.

Take care,

Love and peace,

Ashis

Bahai Beach 4

Bahai Beach 4
30-07-2006

The Libyans are the main suppliers of goods in the souk (market). They travel in huge Mercedes Benz trucks convoys loaded so full that they are twice as broad as usual. You rarely meet more friendly people. In a mixture of French, English, Arabic and Hindi We exchange stories and share foods and teas in copious amounts. One can not leave without having a full belly. The bring to this isolated community: clothes (buying a FZ Barzalona Shirt), food items, but also satellites, television and other goodies. The souk provides opportunities to starta proper chicken farm in the compound. Need to haggle hard because as a khawadja (white man) the price for items is twice the local price. Also me being a leading expert on chicken they may sell me infertile, blind or mentally retarded chicken defeating my vision of an egg emporium in Chad with little outlets all over the country. If this plan is succesful however the camel breeding project is second on my list.
Water is becoming a major issue. Although it has rained it is not yet in the amounts we long for. Trucking is our second options from a dam about 10 kilometers from the camp. This body of water should suffice for about 3 months. In any scenario it needs to rain across the border in Sudan so with the gravity and aquifers it can fill up our Lake Cassoni and I can have a massive swimming pool to my disposition. Sancho Yoda, our midget logisticians is back in the project and we spend our nights exchanging list of most senseless movies- innuendo – mischief and other projects two 35 year old with the mindset of a 12 year would engage in. And new staff is about to be rolled in the project a new health coordinator and a member of the emergency response team. Charles (ERT) is here to reduce staff numbers in the health departments and work out a proper memorandum of understanding with the Ministry of Health Hospital at Bahai. And Sylvie will be here to coordinate the different departments: Reproductive, Clinical, Public and Hospital Health. I hear we are recruiting for a Hospital Manager as well. Let us wait and see what time brings us.
The most impressive story of this week was the prolonged labor and delivery of a child in the maternity ward in the camp. After an episiotomy (cut) and lots and lots of help the mother managed to push out a baby boy. No cry, no heartbeat, floppy, bluish immediately neonatal resussitation was started but after 15 minutes of mouth to nose mouth breathing, medication and heart massage the baby boy had to be declared as a stillborn. On seeing the sadness in my eyes the traditional birth attendants responded in a touching way. Dr Ashis do not worry, the mother is still alive and inshallah she will deliver again in a years time. No need to further express the survival mechanisms the Sudanese people in the camp are used to. Another boy took some traditional medicine or improperly prescribed drugs in the camp and developed a severe fixed drug skin eruption. He had blisters all over his body. Yet after nursing him properly he is improving day by day. As in all countries I have worked in the danger of HIV/AIDS is eminent. In our wards are two patients who have all the signs and symptoms of this lethal disease. The MoH hospital is understaffed however. The doctor is on a sick leave/strike/holiday and the lab technician has left them as well. And well we are at the end of the world in semi dessert how can you blame them ? I am getting to know the health staff better and better and overall I am very happy about their motivation and skills sets. They love teaching session and traditional birth attendants, nurses and community health workers each have 2 sessions a week on those topics that are relevant given the season or because they are basic skills for their work. Last week we discussed malaria, malaria in pregnancy, diarrhoea and prevention thereof. Also we have started a bed net distribution program for pregnant women and intermittent treatment of all pregnant women with an anti malarial drug in the second and third trimester. Malaria cases are expected to shoot up in the next two weeks. Every week a new challenge is up so the learning curve is still steep and is what I like. The final words for this week will be that although we have a total rupture of vaccines since 1 week, a case of acute flaccid paralysis is in the camp (possibly polio), incentives for the 96 health staff need be prepared, drug order for hospital and health centre are being arranged, weekly and monthly reports are due, rupture of water delivery may be on the way and many many more things going to the Oure Cassoni camp six days a week is like filling up my tank brimfull of asha (hope) and energy for the next weeks and months to come.

Namaskar,

Ashis

Thank you for all you for writing your tidings I really enjoy it.

For those of you who wish to see some pictures: try www.flickr.com and search for polio or ashis_brahma.

In due time a myspace photolog will bein place as well. But having difficulty uploading pictures there.

Bahai Beach 3

Bahai Beach 3

21-07-2006

Matthias picks up his shoe and smacks it on the floor. Bang another cockroach less in this world. But no it is a scorpion size about 8 centimeters. Both John and Matthias will be sleeping inside both have been bitten before and have felt the excruciating pain in the past. Frankly there is no treatment for a scorpion sting in our pharmacy. Luckily I have gone to the local uruk (traditional healer) and he has made a leather amulet to ward of scorpion stings, snake bites, knive stabbings and bullet wounds. Comes in handy these amulets.
Two days ago a young chap arrived who had been attacked with an axe like weapon. Part of his skull has crushed. All we could do here was stabilize him and get him evacuated to Abeche where there is a surgeon. By the way our Ministry of Health doctor has self evacuated and we pray that he may return here. Presently I am the only doctor in an area with 30000 refugees and 40000 host population and surgery is not my cup of tea. Challenges, challenges, John the Kenyan male midwife is traveling on Monday for a new mission in Liberia leaving me in charge of the Clinical – Public – Hospital – Mental -Reproductive Health for two weeks. The good news is we are recruiting a Chadian doctor and a new Health Coordinator shall be arriving Inshallah first week of August. As these interviews have to be done in Abeche I will probably fly up there next week to conduct them. The score for cancelled flights this week was 3/5 however. Mechanical failure.. Always good to hear when you are flying. We are encountering some sensitive political issues. The sultan is more or less demanding that we recruit local people only. It is hard to deny him many things as he is the brother of the Chadian president. Yet the illiteracy rate in this region is very high and trained doctors or labtechnicians are not available in the region. We have tried recruiting local nurses but there are just none. Some posts therefore stay open even if the budget is there because Chadians from outside the region are not always accepted.
The first party since I have arrived was in the UNHCR compound. Main guests were the staff member of UNHCR (security man) who was leaving, a gazelle (male), 2 ladies and about 40 men. Yet when the African music hit the speakers hips were churned a great mélange of dances from Benin, Burundi, Ethiopia and Holland were shown off. The cleg dance went down very well indeed. Since about a week I go to the souk (market) regularly to work on my Arabic and Zagawa, drink tea, gossip and get to know the people living in Bahai. In the camp nowadays we share breakfast with the Sudanese nurses. Either lentils, or beans or camel with bread.
An attempt is being made to contact the foci (healers by scriptures from the Koran) and bada (trained to remove djinn through there own two devils) yet it is culturally unacceptable for them to talk with a khawadja (foreigner). Overall besides the security the program is up and running with potential for improvement. Our expatriate staff numbers are low however and will not be replenished very past so although we are consolidating better to say we are trying to float.
Since the cock awoke me at 0430 and otherwise the pigeons at 0500 I am closing my eyes and want to thank all of you for writing it makes my day. Will attach a photo of the lake. Or what remains of it

Bahai Beach 2

Bahai Beach 2
17th July 2006

Dear friends,

Another week at the job and it has been mildly eventful.
Attending a leaders meeting is fun. After explanation of the activities of the main actors in the camp the leaders get the chance to put in their questions. Instantly the sea of white turbans releases snapping fingers. Elaborate introductions- blessing of all present and Allah and then sweet itinerary. Could UNHCR replace all 10000 tents before the rainy season (due now), can IRC take care of the roaming donkeys, we need 3 new traditional birth attendants as the Blacksmiths have different birthing customs than the Goran and Zaghawa, can you provide the rain to fall. When you are about to answer any of the above questions men and women will add on to the previous requests. Yet hearing all the dynamics-politics-clans-testing the NGO’s makes me realize I need to learn to be very prudent.
Traditional birth attendants were very happy this week as the new maternity ward had opened. A fresh 4-roomed white washed building (teaching room, 2 delivery rooms, 1 examination/storage room) Dr John gave an interactive teaching session on the delicate issues surrounding sexual transmitted diseases. In a role play two midwives demonstrated the difficulties of needing to address not only the one patient but also the partner and possible other 2 to 3 wives. Rich men in the refugee camp may have up to 4 wives and 20 children. Well what remains of it, when the janjaweed came some ran with only the clothes they had on. Some were more fortunate and crossed the border with up to 300 camels.
Outright sad was the news that our team leader of vaccinators younger brother had been killed fighting in Darfur (Sudan side). The medical team visited the ceremony to pay our respect to the mourning family.
On a lighter note this week: the gazelle (male) Ruby living in the UNHCR shall be mated with a female gazelle living in an adjoining refugee camp. An 85 year old lady was admitted with a snakebite. It took me a while to wrestle the snake off the lady and I ended up getting entangled (see attached photo for proof)
The market (souk) has finally been explored today: The Libyan market (truckers drive straight through the Sahel/Sahara) has sheeshas, tea stalls, plenty of Bibsi, shoes from China, phunky Football shirts (bartering hard for a Barceloona shirt), blankets, cup. All you need to be happy in a desert cum beach resort as Bahai Beach. One of the Libyan drivers actually had lived in Pakistan so I was able to exchange some Urdu with him. We ended up discussing who was the greatest Indian actor Shah Rukh Khan or Hritik Roshan.
We are awaiting the rains… No rain will put the camp and entire region in severe danger. All depends on one wadi (lake) photo will follow. If not tomorrow I shall perform a rain dance to ensure thunderstorms and driplets.
It was good to hear from all you wish you all the best and until the next week or for the lucky skypers : ashisbrahma

Namaskar Ashis

Bahai Beach 1

Bahai, july 9, 2006


Dear friends,

One week in the country and what a week it has been !
A calm start with a flight from Amsterdam to N’Djamena, the capital of Chad. The local club scene has potential with one or two discos and open air restaurants/ drinking holes. The one I visited (Carnivore) has live music, a local band and plenty a singers and dancers. Mustapha the driver and I chitchatted about the IRC and Chad. Sunday I spent visiting the market and eating at a Lebanese restaurant. Early next morning with a World Food Program airplane to Abeche which is a city in the south east of the county. It has a population of 72000 and many many NGO’s, UNHCR and the French military. It is the nerve centre for all the refugee camps in Eastern Chad. Due to the conflict in Darfur about 200000 refugees have spilled over from Sudan into Chad. There are about 12 refugee camps run by different NGO’s. The international rescue committee runs the most northern one near Bahai beach. It is called Oure Cassoni and has about 29000 beneficiaries. After one night in Abeche I flew with a teenie weenie aircraft to Bahai. From the air one sees sand, wadis (dry rock formations which from time to time contain water) tiny settlements and Acacia like trees. At the airport I was picked up by Pascal the logistician in one of the Toyota landcruisers. He is an American chap with a wicked sense of humor.
Whisked to the lovely compound (photos will follow) were the first surprise was awaiting me. I got the George Clooney suite! (try www.theirc.org or google Bahai+IRC) Any hair I find shall be sold on E-bay soon) At present our team is in transition but in Bahai we have about 7 male expats (from Kenya-Eritrea-Tanzania-Italy-USA-Burundi) After about 2 days shit hit the fan. About 35 local youths (including sons of the Sultan) came into the office armed with sticks and demanded jobs. It took the local gendarmerie and UNHCR 2 hours to get them out of our office and free our national and expat staff. Another common crime here is carjacking one car a month gets stolen from the different fleets available here. For now part of the program will be shut down and talks are being held at all levels to sort out the issues. The camp I have seen but once due these security issues but it looks ok. Two years and some permanent structures are up amongst a health post, health centre, maternity wards, schools. My job responsibilities have been adjusted as well: I am now the Public Health and Clinical Health Manager. In the team there are about 2 translators, two assistant managers, 4 Chadian nurses and in the camp; 39 Community Health Workers, 3 Team Leaders, 1 Supervisor and 6 Sudanese refugee nurses. John Kwenda, the present Health coordinator is giving me a two week handover to explain budgets, the program, the context etcetera. As some may have noticed there is internet facility when we have the generator on i.e. working hours in the office and perhaps after working hours in the compound. Therefore I can skype-msn messenger-yahoo. Our non local national staff (about 40) are staying in our compound for security reasons since the incident. Yesterday we watched Germany thrash Portugal as we have Camerounian tv reception. The food is ok to good – only thing missing is fresh fruit but what to expect in the desert. At night one can gaze at the stars. And during the day play with refugee children. The health status of the camp is not at all bad but always on the look out for outbreaks as there have been in the past: thypoid fever – mumps. Well it is 0700 in the morning now I am off for breakfast. Wish you all the best around the world and do drop a line when you find the time my yahoo-hotmail-gmail may all be used. The IRC e-mail address I shall keep for work only

Love and Truth---Namaskar Ashis