Dispatches From Guiglo

Greetings from Guiglo

March, 2007

Could you see the eclipse?! It was brilliant here in Guiglo, a mid-size town in western Ivory Coast - east of Liberia, south of the zone de confiance which marks the divide between the government-held south of the country and the rebel-held north. I am here for six months, working as a "logistician / administrator" with Médecins Sans Frontières (MSF) / Doctors Without Borders.

As I was driving around town last night, delivering coffee (tin cans of Nescafe, not paper cups of latté) and batteries to our various night watchmen, I turned on the BBC just in time to hear that in a few hours there was going to be a total lunar eclipse, best viewed in Europe and Africa. Emily and I dragged chairs down from our terrace into the dusty yard, the house watchman-of-the-night pulled up his seat, and together we stared at the sky as the moon disappeared. From down the street came the banging of pots and pans as the young and so inclined of Guiglo paraded through town making noise to scare the cat that had caught the moon in its mouth, so that he would drop it and leave it in the sky. No, no one thought that a literal great cat in the sky was about to swallow the moon, or that their noise-making would bring the light back to the night, but what a great storyline for raucous street party!

I've been here for five weeks, and have spent a fair portion of that time wishing, for the first time in my life, that I'd gone to med school. I find myself frankly jealous of Emily - our 29-year-old Kiwi / Californian doctor. While she is treating illnesses believed to be brought on by sorcery, or bringing starving kids back from the brink, getting to know them as they slowly turn plump and healthy, I sit at my desk, shuffling papers. I fill out reports, create tracking sheets, make schedules and pay bills. I run shopping errands and organize cleaning and repair projects, and the only time I learn a kid's name is if it dies and I make the run to the cemetery to pay for the burial.

The cemetery is a little disconcerting at first, and then oddly, simply, beautiful. You follow a red dirt road out past the internally displaced persons camp, through rice fields, into the edge of a scraggly forest, where you pull up in front of a house. An older man or woman sitting in the yard yells something over a shoulder, and after a little while a teenager with a machete and a pickaxe appears in the doorway and climbs into the back of the Landcruiser, next to the tiny body you have brought with you, wrapped in its coarse grey blanket. You hang a left down a narrow track and a little deeper into the forest. Graves are scattered under the trees, some topped with cement blocks headstones, most no more than mounds of roiled earth. You follow the teenager through the maze of mounds towards the back of the clearing. The air is hot and heavy, the sounds in the grove belong to insects and birds, and maybe a breeze high in the trees. The teenager finds a smooth spot of earth and traces out a rectangle with the blade of his machete. Then he swings the pickaxe up over his head and back down into the soil. A second teenager appears with a shovel. They take turns, pickaxe and shovel, breaking up the earth, scooping it aside, their feet bare, their plastic sandals shuffled off to the side. A small rectangular hole is carved out of the red dirt. The bundle is brought from the Landcruiser and placed into the earth. Once an older male relative came with us; usually no one comes. Evariste, one of our drivers, says that in the four years he's been taking babies to the cemetery maybe once or twice a mother has come to watch the burial. Dirt is piled in to fill up the hole; a skinny branch is scavenged from a nearby bush and jammed into the end of the mound – an anonymous headstone that will be gone in the first good wind; I pay them 5000 francs, and that's that.

Guiglo is not the middle of nowhere. The main roads are paved, there is often electricity and running cold water and, yes, e-mail. It's cacao country, coffee country, timber country. The one large enterprise here is a timber mill. The size of the tree trunks being hauled down the road towards Abidjan is just heartbreaking. In the immediate vicinity the forest is already gone. It will begin raining soon, they say, and everything will turn to mud, but for now it's fine red dust. All over everything. You wipe it off and ten minutes later it's back. It's hot and humid and I'm covered always in a light sweat. Sometimes not so light. Goats and sheep and bony cows wander the streets, along with a medley of rusty red taxis and pedestrians and bicyclists. It's not China, but lots of men, young and old, get around on two wheels.

Me, too. I have a spiffy-looking (just don't look too close) bright Blue mountain bike. It has a rack and a water bottle and a kickstand. The brakes only sort of slow it down, and the gearing is iffy enough that my basic plan, in this relatively flat town, is to pedal hard when necessary and avoid shifting as much as possible. Still, it cost 50,000 francs. In a town where a day's physical labor - cleaning mosquito nets, digging drainage ditches, repairing broken fences - earns you 6,000.

Every morning there are four or six or eight or ten guys sitting waiting for me at the Therapeutic Nutrition Center (CNT), hoping that I will have such a day’s work to offer. On good days I can hire two or three or even four of them. Too often all I can say is, “sorry, maybe tomorrow.” The CNT is one of MSF's two projects here in Guiglo. It serves malnourished kids from the town, the camp, and the surrounding countryside. It's quiet at the moment - 25 or 30 kids - but the coming rainy months are the months of malaria and meningitis in West Africa, and an upswing in the morbidity rate inevitably leads to an increase in malnutrition cases. The other part of the project is the dispensaire - a free clinic that operates five days a week, treating some patients, referring others to the hospital. Our mandate here is fairly specific in terms of what care the doctors can and can't undertake.

We have three doctors - Emily and two Ivorians. Omer is from the Congo-Brazzaville. He's 29, and in his eleventh year with MSF. He's a nurse and our responsable de terrain, in charge of this project at the field level. Omer, Emily and I live together in a house that doubles as our office. Behind walls and a gate, with our three Landcruisers parked in getaway mode (backed in, gas tanks full) and a watchman on the premises 24/7 (a watchman, not a guard - no weapons in MSF, no weapons, no weapons, no weapons, little stickers on all the vehicles with big red x's drawn through a Kalashnikov, no weapons in MSF). Everyone says we are in a very volatile part of the country, and while I believe that to be true, on a day-to-day basis I have absolutely no sense of it.

So. It doesn't much feel like saving the world, but on the other hand, the lunar eclipse was spectacular, the grilled fish by starlight at the Ziplou Restaurant is delicious, and sometimes those skinny, skinny, skinny kids do get better.

Morning in Guiglo or, Size Matters

April, 2007

I wake up most mornings by six o'clock, when the church bells down the street start ringing. (I seem to be able to sleep through the 5am calls from the mosque.) The bells ring three times, pause, then three more times, a raucous jumble rather than an orderly tolling, and I know without opening my eyes what time it is. I sleep on a foam mattress, under a single sheet and a bright blue nylon mosquito net (there are very few mosquitoes now, at the end of the dry season, but I sleep better in the knowledge that I am inaccessible to the thumb-size cockroaches and hamster-sized beetles that occasionally wander the premises). According to the thermometer on my alarm clock, the temperature in my room varies little - from midnight lows of 28C (82F) to late-afternoon highs of 32C (90F); nights without electricity are pretty warm, but most of the time the fan in the corner of the room keeps me cool enough to sleep well.

At 6am it is still dark. No light glows through the curtains that I had made from some left-over fabric once apparently used to make gas-station-blue shirts for the staff. There is no glass in my windows. There is no glass in any of the windows in the house. There are heavy wooden louvered shutters, and screens, and iron bars in exploding sun patterns, but no glass. Around 6:30 I clamber out from under the mosquito net, take my bottle of filtered water down the hall to the bathroom, brush my teeth, put on my shorts, tennis shoes and yesterday's stinky t-shirt and head out into the courtyard to skip rope. The sun rises and sets quickly this close to the equator: while I skip and stretch, the glowing ball of morning rises behind the trees across the street; by the time I am done, it is day.

Okay, the truth is of course that I don't actually do this every morning. Some days I'm still in bed at 7am, and often enough I go two or even three days in a row without skipping rope or doing a single sit-up. Other days it really is like that.

Our courtyard is surrounded by a cement wall - no glass shards, no barbed wire, just cement, just high enough that what you see over it, from our terrace, is whatever the women in the street are carrying on their heads. You never see the woman, just the bundle of firewood floating past, or the plastic basin full of pineapples, or the tin bucket full of fish…

7am is the changing of the guard: the night watchman is replaced by the day watchman. We say our hellos and good-byes. We shake hands. There's a lot of hand-shaking. A girl shows up at the gate with our two daily loaves of bread - not quite a French baguette, a little shorter, a little fatter, but equally fresh and delectable every morning and already by lunchtime less delicious. I take my shower. Often there is cold running water available at the turn of a faucet handle. For those days when there’s not, we keep a 125-liter barrel full in each bathroom, and a pitcher for dumping the refreshing liquid over your head.

By 7:45 my assistant is at his desk, booting up the computer; the three drivers are peering under the hoods of the three Toyota Landcruisers; the vaccinatrice is filling her coolers with icepacks and getting her daily supplies out of the refrigerators; and the day is off and running.

My most recent project was to replace the roof over the registration pavilion at the dispensaire, and here is one of the things that I learned in the process: size matters. The guys were preparing to cut up the plastic sheeting that is the first layer of roofing (later topped by woven palm fronds called papos), when they realized that the carpenter hadn't brought his scissors. I tuned in to the conversation just as one of the guys, Tigana, who lives right next door, headed out the gate to get something to cut the plastic with. “Hey, I have a knife,” I said, proudly pulling my leatherman from my bag. I popped open the serrated blade and handed it to the guys, just as Tigana came back through the gate. Everyone smiled and thanked me for my help as I folded up my excellent little tool and Tigana’s machete sliced end to end across the plastic…

The rainy season - disturbingly overdue - seems finally to be arriving; I am woken often by downpours in the night. Whether it will be enough and in time for the cacao and coffee harvests remains to be seen, but the effects of even one night's rain is dramatic: the dust is tempered and where there was no grass at sundown there is a lawn by sunup. The abundance of mangoes dangling from trees all over town is slowly turning from green to orange. And the flame trees are blooming. If you've never seen a flame tree before, only ever read of them in novels set in Africa, the first time you see one, you nevertheless say to yourself, hmm, I bet that's a flame tree. Because what else could it be, so expansive and dramatic and. flamboyant! Which is precisely what they're called in French - des flamboyants. And then you have yourself a little African etymological lightbulb (!!!) moment.

I've been here for going on three months now, the half-way mark of my tour, which means it is time for my break: three weeks from yesterday I'll be getting off a plane in Paris, finding the arrival gate for Peter's flight from New York, and waiting for him to land. I'm looking forward to bleu cheese, red wine, chocolate ice cream and high-speed internet. Other than that, we want for very little here in Guiglo, and the days and weeks seem to fly by. It's Sunday morning and quiet. I'm going to get on my bike now and head up to the dispensaire to see the carpenter who is fixing an oops in our new roof. After that I'll probably spend an hour or two on some administrative stuff, and then have the afternoon for lolling about on the terrace with a book. Then tomorrow morning a new week will begin, with the muezzin's calls, the church's bells, and two crispy loaves of fresh bread.

The Beginning of the End

June, 2007

It is early June, and while the thermometer above my bed continues to hover day and night in the low 80s, the oppressive weight has gone out of the heat. A short bike ride up to the CNT still leaves clothes clinging to a sweaty body, but evenings are lovely, and last night at the Ziplou the breeze blowing through the courtyard restaurant as we ate our grilled fish was positively cool. The house is changing, too. Our responsable terrain has moved on, replaced by another nurse from Congo-Brazzaville. The doctor who will take over for Emily arrives in less than a week, and my replacement is due two or three weeks after that.

There have been moments when I thought my time here couldn't end fast enough, but more frequent have been the days when I would have been happy to extend my stay through the summer. And even when it wasn't fun, the time has never dragged. It is hard to believe that six months will soon have passed.

Today is a quiet Sunday. A 'real' Sunday, a day off. French toast for breakfast and hours lying on the terrace reading the New Yorker.

'Real' Sundays are supposed to be the rule, but in practice they are the exception. Last Sunday began with hopes and plans for doing not much. Then the radio blared: the cook at the CNT was down with malaria, and needed somebody to cover for her for the day. Rosalie, the substitute cook, doesn't have a phone, but lives next door to two of our staff who do have cell phones (nobody has a landline) and could walk across the courtyard and tell her to come to work. Last Sunday, however, the power was out, which takes the cell network with it, so I did what you do in Guiglo: hopped in the Landcruiser and hoped I could remember how to find Rosalie's house, having been there once before under similar circumstances.

Backing up in time to early May: the night before I left for Paris, the puits perdu - the drainage pit at the CNT that catches the water from the laundry and bathing areas - began to overflow. I left instructions to call the vidangeur (the guy who empties your septic tank); to call him every day if necessary. Unfortunately, the man who owns the camion de vidange (the truck into which the vidangeur empties your septic tank) is apparently not such a nice guy, and all of his drivers had quit, and nobody else was willing to work for him. So when the soapy greasy water began pouring across the street, Omer (our since-departed responsable terrain) had one of the day-laborers dig a quick hole outside the CNT fence to catch the run-off.

The morning after I got back from Paris, we began digging a big hole, a new puits, bigger than the original puits, three meters by three meters by almost three meters deep. The first foot of soil is dry and dark brown. After that you hit the thick red clay that is the reason the first puits overflows instead of absorbing the water like it's supposed to. This is not thirsty soil. It is thick, solid, heavy stuff already drunk with moisture. For five days two men with pickaxes and shovels worked their way down into the earth. We dug a trench from the old puits to the new puits and lay in a run of pvc pipe. We tossed a layer of rocks into the bottom of the new puits, laid beams across the top of the hole and planks across the beams and plastic sheeting across the planks and then shoveled a thick layer of earth back over everything. (I say "we." It is not me barefoot, sweating, heaving shovelfuls of solid red clay up over my head for eight hours a day. I watch and point and suggest and occasionally buy everyone plastic bags of chilled well-water from the woman across the street.)

The night after we finished, it poured rain.

Which brings us back to last Sunday morning. Having been to Rosalie's house once was apparently not enough; I had had to turn around and go back to the CNT to get someone to show me the way. As Denis guided me down the rutted red dirt roads (I had missed Rosalie's street by one turn), he mentioned casually that "your new puits perdu caved in last night."

We hadn't built a gutter along the roof of the building beside the puits to protect it from rainwater run-off; we had put way too much dirt back on top of the planks; we had chosen beams that didn't stretch far enough beyond the edge of the hole. It was a sad sight, the gouges in the wall of red clay where the beams had torn down through the soaked earth, splashing into the two feet of water at the bottom of the hole. It looked like a little catastrophe.

But here's the thing: Monday morning, you get some guys and some shovels and some ropes and some buckets and a ladder and they begin fixing it. And while you apologize for sending them down into the muck, they smile back at you, huge sincere grins, because they're working and at the end of the day they will be paid, and muck or no muck any day with work and an income is a good day. And by Tuesday afternoon, with an internal frame of new, longer, more massive beams supporting the original structure (which, remarkably, bent as it fell but did not break), a gutter on the roof above, and a shallow layer of dirt on top, the puits is up and running again.

The rest of that week I spent in the office: making sure each employee has an updated, signed job description on file, reading through old staff evaluations and planning new ones, reviewing and revising the project budget for the next six months...

Waste water and paperwork - that pretty much sums up how I have spent my days here. And I am afraid, to answer those of you who have asked, that in waste water and paperwork I don't see a book. My daily journal-writing slipped away early on, as the routine of days provided little in the way of adventure, variety, or cultural intimacy. So these few e-mail missives will most likely be the sum total of my written Guiglo stories.

And now it is almost July. I am lying in bed, iTunes shuffling from Alanis Morrissette to Yaz, rain pattering on the tin roof, and the cutest kitten in all of Ivory Coast curled up beside me. Her name is Djazu, she is grey and white and orange and in the week that she has been with us the mice have disappeared from the house. Tonight is our bon voyage party - Emily leaves on Monday, and in less than three weeks I too will be on my way to Paris to New York.

The last two weeks I have had some of the best fun of my six months here. At the same time that MSF France has decided to close their Ivory Coast operations by the end of the year, we have begun sending mobile clinics out to villages to the north and west of Guiglo (just to be sure sure sure there's nothing out there that would warrant staying on).

I went along, and suddenly found myself wading through the crush of mothers holding children, stuffing thermometers under arms (it's all malaria all the time), determining who gets in to see the doctor and who is "just fine - go play soccer!" It was, until we had a system and a routine and rolls of orange plastic crowd-control netting to force them into something resembling a line, a pocket of hectic insanity. It was also a blast; excellent to be a little bit out there and a little bit in the middle of it. (Everything is relative, and relatively, the scale of our mobile clinics is miniscule. When I pouted to the logistician from Abidjan about how hard it was every morning to have to choose one or two or none from the six or eight or a dozen day-laborers who wait so hopefully every morning, she told me about being faced one morning in Sudan with a crowd of two thousand men looking for work. I stopped complaining.)

The Guiglo experience has definitely been "MSF Lite" - fruits and vegetables, internet access and cell phones, electricity and running water. Still, it has confirmed what I believed every time I sent in a donation - Doctors without Borders is a brilliant organization, with a solid, laudable philosophical grounding, that is doing great work. That said, whether there is a place in it for me, a situation where I can wake up in the morning looking forward to how I will spend the day - where I will feel intellectually and creatively challenged - is, at the moment, unclear to me.

But for today - we have a party to prepare.

For tonight, we will dance!