The Pilgrims Return

A few weeks ago I blogged about the chaos around the airport as people prepared and departed for the Hajj. I speculated as to whether there would be an equal amount of chaos when the travellers returned and this week I found out. The answer is 'yes'...

I obviously need to find out more about what the Hajj involves as I thought it lasted for 5 days, whereas it is about a month since most of the pilgrims left N'Djamena. I wonder what they have been doing all this time?

This week the metal barriers that were left behind a month ago have been put up again and the area all around has been full of randomly parked vehicles. There have been a lot of the orange Peugeot 504 taxis, that are as common in N'Djamena as matatus are in Nairobi or Kampala, as well as a number of new looking 4x4s. I guess the different modes of transport represent the relative wealth of those being picked up.

Inevitably there is the accompanying entourage of people awaiting the return of their family member and so every morning and afternoon I've had to negotiate my way through this crowd of cars and people. Each returning pilgrim seems to bring a large sack-like bundle with them, in stark contrast to their departure when I don't recall seeing any luggage. Those who take the taxi transport option load their luggage into the boot of the car. There are often several travellers sharing the same taxi so it isn't possible to close the boot. The suspension sags under the weight but the pilgrims are on the final leg of their journey home.

N'Djamena taxi

Health Care

I saw a statistic recently that Chad has the equivalent of one doctor for every 28,000 people. With the exception of South Sudan (which is the country that embodies the word 'exception') my impression of Chad is that the standard of health care generally available to the average person is the worst of all the African countries I have lived in.

One of the benefits we provide for our Chadian staff is to pay a percentage of their medical bills. As the person who authorises these payments I get to see the details of what they have been treated for and the medication they have been prescribed. Almost without exception and regardless of the true nature of the illness each person seems to be routinely prescribed high doses of pain killers, antibiotics and anti-malaria drugs. It is not uncommon for all these drugs plus the consultation and related tests to cost what would be a significant proportion of an individual's monthly salary. So not only are they being wrongly diagnosed and treated they are also being charged exorbitantly.

This week I have been unwell and when, after two days, I was feeling worse rather than better I decided the time had come to see a doctor. This enabled me to see first hand a hospital on the outskirts of N'Djamena that is trying to improve the health care that at least some Chadians can receive. The hospital at Guinebor II is funded, managed and run by a small team of expatriates, working alongside Chadian staff. Their primary goal is to provide health care services to the local population but as a 'sideline' they make themselves available to treat anyone from the international community who otherwise doesn't have access to 'quality' health care.

I arrived in the middle of the morning and there were maybe 100 people sitting on the ground, trying to stay in the limited shade that was available. It was difficult to know how many of these people were patients and how many were their accompanying family members. I first had to go to triage to be weighed and have my temperature, heart-rate and blood-pressure taken. Afia, the triage nurse, seemed highly amused by the 'narsara' (the generic Chadian word for 'white person') in her treatment room and smiled broadly throughout the whole process. When she had finished her initial assessment of me I was officially 'registered' as patient number 86 (presumably the 86th patient of the day) and handed my patient record book - half an exercise book with a picture of a footballer (who I think is Didier Drogba) on the cover...



My Chadian medical record - everything handwritten (in French) and mine to keep!

I then went to the cashier and paid 5,000 CFA (about £6) for my consultation with the doctor. This was the maximum amount a consultation would cost, with the lower amounts presumably for seeing less well-qualified staff. I'm somewhat embarrassed (but also very grateful as I was feeling pretty rough by this point) that Dr. Mark saw me ahead of some of his other patients who had been waiting longer than I had. He prescribed me a course of antibiotics, that cost another 1,500 CFA (about £1.80), and already today I am feeling a lot better.

I was impressed by the calm and order of the hospital, by how they are trying to develop the skills and responsibilities of their Chadian staff and by their commitment to improve the health care given to the local community at a more affordable price. You can read an account of a day at the hospital here.

Unfortunately for most of the residents of N'Djamena, including our staff, this hospital is too far out of the city for it to be a viable option for their treatment. However, it is encouraging to know that on Thursday of this week (as on every other day of the week) it provided a high level of health care to at least 86 people, in a country where such facilities are sadly in very short supply.

Charity

We've been having a bit of a clear out at the MAF compound - emptying out our store room and deciding what we really need to keep and what we will no longer use. It's been a bit reminiscent of my last assignment in South Sudan (albeit on a much smaller scale) where a large part of my job seemed to involve deciding how to dispose of things that those who have worked there before thought  worth keeping 'just in case'. Not being a natural hoarder I fine this approach difficult to understand although when you live somewhere where things are either hard to get hold of or very expensive I can see how it becomes the prevalent attitude.

So for the last few weeks there has been a pile of old furniture stacked in a corner of the compound, just outside my bedroom window, that we have decided we are never going to use. Storing anything wooden in an out-house, where every insect and animal in N'Djamena can access it, is not the best idea and what was probably once quite good furniture is now very definitely past its best. Every time I have opened my bedroom curtains and seen this furniture I have been reminded that we need to do something with it. As in most developing countries rubbish disposal in Chad is a major issue with there being no real 'system' in place and so getting rid of anything is always a challenge.

One of my expatriate colleagues suggested we should offer the furniture to our national staff. Something in me was reluctant to do this. I struggle with the idea of giving to others the things that we consider 'rubbish'. If it's not good enough for me then how come it is suddenly OK for someone else? The 'rich' westerners giving to the 'poor' Africans just seems to illustrate all that was wrong with colonialism and is still wrong today with a lot of humanitarian aid. Why do we think it is OK to just give the 'crumbs from our table'? Shouldn't we be giving the 'first fruits' instead?

Despite these misgivings, and mostly because I had no better solution, I decided this was the best option. I explained the situation to the staff on Friday and invited anyone who was interested in having some of the furniture to come to the compound today at 11.00 a.m. where they could share it out between them. I had visions of them being disappointed in the condition of the furniture and arguing about who would have the 'best' things but I needn't have worried. Five of the nine staff turned up and, after much discussion, they divided the furniture into what they considered nine equal piles (one for each member of staff). They then made a great show of drawing lots to see who would get which pile. After each person had claimed their pile there was clapping, cheering and congratulations. When all the furniture had been divided up one of the staff made a speech to thank me for my generosity in giving them these things.

The furniture is still outside my bedroom window as they need to organise to get it taken to their respective homes but they have gone away happy and I am left wondering about the nature of charity...

Snake Alert

Some days something can happen that turns a 'normal' day into a day to remember and today was such a day.

I was in my office diligently working through the financial reports for October and needed to check something with Tresor, the finance officer. I walked out of my office and around the corner towards the area where Tresor has his desk and there, slithering away from me along the floor, was a snake.

Tresor was not at his desk so I called out to Justine, who sits in the next office: 'Justine, un serpent'. She came into the office, took one look at the snake and went to get Albert to come and take a photograph! I can't say that was top of my priority list at the time...

We then summoned Luc, the guard, who came armed with a large metal pipe and a machete and proceeded to bash the snake with the metal pipe. I was somewhat concerned as the snake writhed about in both anger and agony that Luc was only wearing flip-flops on his feet and that the snake might decide to retaliate but I needn't have worried as Luc is clearly well-practised in snake-killings. Within a few minutes the snake was dead and had been thrown over the fence outside and all that was left were its blood and entrails on the office floor.

I have no idea what kind of snake it was - it was about 60cms long, quite thin and a green-brown colour. The Chadian view of snakes is that they are all 'tres dangereux', which in the absence of any other information seems a pretty good stance to take.

A 10 Step Guide to Eating Chocolate in a Hot Climate

1. Carefully consider when you may next receive chocolate and ration your consumption accordingly
2. Keep your chocolate in the fridge at all times
3. Only remove your chocolate from the fridge immediately prior to consumption
4. Calculate how much chocolate you can fit in your mouth in one go
5. Without removing the wrapping break off a piece of chocolate of the size you have calculated in step 4. above
6. Return any remaining chocolate to the fridge
7. Remove the wrapping from the piece of chocolate broken off in step 5. above
8. Put the whole piece in your mouth
9. Lick any melted chocolate from your fingers immediately to prevent leaving a sticky, chocolate residue on everything you touch
10. Savour the moment