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Financial administrator

Pakistan / 17.09.08

Michael Rowell

Michael Rowell, a financial administrator from Melbourne, is on his first mission with Médecins Sans Frontières in Islamabad, Pakistan. Here, Michael describes his experiences in his first eight months of working in the Médecins Sans Frontières project in the capital and from the field projects he has visited.

My mission experience as a financial controller or a ’FinCo’ is quite different to that of the field-based positions with Médecins Sans Frontières. For a start, I am based in the capital city Islamabad, and this has many advantages from a lifestyle perspective.  It is a clean, modern and planned city of around one million people, most of whom are very wealthy. In many ways it is very similar to Canberra with all its consulates and government buildings. As such, it does not have the vitality of the adjoining city of Rawalpindi where most of our staff live and where you can get a much better feel for how people live in large cities in Pakistan.

The houses in Islamabad are very large, even by Australian standards, and we live in a very comfortable house at the back of a large block that also has our separate office building at the front.  There are four of us in the house but we are always hosting visitors from the field or from headquarters or elsewhere. As a result, the numbers in the house often swell and on some occasions we have had ten people in the house. This makes for a very social atmosphere, especially on the weekends. One of the rituals that I enjoy here on a Sunday is when everybody in the house helps out in the kitchen to prepare a late morning brunch.

Michael Rowell in Pakistan.

There are 14 National Staff working on the team here in the capital and one of the immediate and lasting impressions I have is of the friendly and hospitable nature of the Pakistani people.  Every work day starts with a heartfelt greeting and a hug and a handshake (from the men only, of course). The work day also ends with a similar enthusiastic farewell. I have been welcomed into people’s homes at times of joy, on the birth of a child and at times of sorrow, on the death of a parent. I have enjoyed people’s generous hospitality on these occasions and also at a wedding feast for one of our staff.

One of the disadvantages of working in a coordination role in the capital is that you don’t get to see the effect on a daily basis of the work being done in our projects.  I try to compensate for this by getting to the field as often as I can and by reading the monthly medical reports which generally show a steady increase in the number of patients treated in our Maternal and Child Healthcare programs. 

These programs aim to help Afghans and Pakistanis affected by the conflicts in Afghanistan and western Pakistan. One common theme running through our programs is that the indicators consistently point to the poor state of maternal child health in the country.  Women and children have only limited access to healthcare particularly in rural areas due to cultural restrictions as well as a lack of quality affordable healthcare services.  Médecins Sans Frontières’s programs therefore target this group in particular throughout the country.

The Pediatric Unit at Chaman Hospital
Chaman Hospital, on the remote Pakistan/Afghanistan border about 200 km south of Kandahar

Just recently, after three years of negotiation with the government, the mission has been given approval to start some projects to assist those affected by the current violence in eastern Balochistan and we are about to commence a nutritional program there. However, it is not only medical assistance that we provide to the people in these areas. As FinCo, it is readily apparent to me from the size of our budget that there are significant economic benefits in the large number of people we employ and also in the improvements we make to the infrastructure of MoH facilities.

On my visits to our projects in Kuchlak and Chaman in the southwest of the country it has been gratifying to see the improvements that Médecins Sans Frontières has helped to make to the facilities for patients, even over the space of a couple of months.  In Kuchlak, these included a nutrition room (to replace the tent used previously the government) and a new antenatal consulting room that has allowed the existing space to be used as a second birthing room. In Chaman, which is on the border with Afghanistan, I was able to see the recently completed room for the new nutrition program, as well as discuss other major planned improvements to the facilities there. 

My visits to the field have been hampered by both the local security situation in the project areas and by other events in Pakistan and elsewhere. In two of our projects, in the North West Frontier Province (NWFP), we have not been able to have International Field Staff on the ground since June 2007. More recently, as a result of the escalation of violence in the region, any International Field Staff presence in the foreseeable future is unlikely. 

The security situation in Islamabad itself has been tense at times with actual or threatened suicide bombings occurring regularly.  Bombings of the nearby Danish embassy and a restaurant visited in the past by Médecins Sans Frontières staff have raised my awareness of the potential risk of working here, but not to a level yet where I feel in any real danger. In Chaman, International Field Staff are restricted to the hospital compound, so there is no scope to explore the town or the wider area on days off. In contrast, one of the luxuries that I have in the capital is the ability to take a walk for a couple of hours in the beautiful Margallah hills that surround Islamabad.

When I was offered the posting here in Islamabad, it was just prior to the assassination of Benazir Bhutto. Since then, there has been a general election, the economy is faltering with an escalating rate of inflation and the situation in the NWFP has become even more unsettled as a result of sectarian and tribal violence, as well as the government’s fight against extremists in the area.  There is now a constitutional crisis with impeachment proceedings currently underway against President Musharraf and this has the potential to further de-stabilise the country. I did not hesitate to accept the offer to work in Pakistan and am still enjoying the opportunity to work here with Médecins Sans Frontières at this very interesting and crucial time in the country’s history."


Since November 2007, MSF provides primary health care, ambulance service and distribution of relief items to the population of the conflict-ridden district of Swat, Northwest Pakistan. Due to security, no International Field Staff have been working in these projects since June 2007.

Location Map - Pakistan -

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