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FROM The Democratic Republic
of the Congo Tobias Ballerstedt, from Sydney, writes of his first impressions as logistician in eastern Democratic Republic of Congo (DRC), at a therapeutic and supplementary feeding centre in Kitchanga. This is Tobias’ third mission for Médecins Sans Frontières, he has done two previous missions to Iraq and Uganda. I arrived in Kitchanga in Eastern Congo on 11 September, not far away from the Ugandan border and I have since settled in quite well. The project is in two locations, Kitchanga and Kabati. In both sites we have a therapeutic feeding centre and run four to five supplementary feeding centres in the villages around. The numbers of hungry children are going down, and we are massively branching into the prevention of sexually transmitted infections and AIDS, and concentrating on the treatment of opportunistic diseases. It is interesting to come into a well established project where you don’t have to hit the ground running like my previous missions in Iraq and Uganda. Jean Pierre is the Congolese logistician who has been managing that side of the project for a few years. He is leaving soon to go to Goma on the Rwandan border so I’ll be on my own and a little stretched at first, but it’s all achievable. The difficult thing so far is communication where our cultures clash – I just don’t know the ways yet to reach the people here and it seems all to work informally, although that will come with time. I am never sure if my messages reach the receiver - although, surprisingly often, they often do. The work is all about supply: food for the staff, food for the nutritional projects, logistical items such as spare parts for the cars, drugs and medical equipment. I am also doing some repairs and construction. Most things here seem to be running fine from the outside, but when you dig deeper you find a lot of work needs to be done such as the weekly movement planning. There are eight cars in two sites with ten drivers who all require very careful negotiation, and I am still learning all their names and that will come with time too. And, there is always Administration to keep us busy as Congolese labour law is very complex and I am lucky to have Jules, a savvy administrator, working with us. Next week we start the yearly evaluations of staff, something that is always difficult but has to be done. It is also nice to know that I have learnt something from my previous missions, and the same thing goes for a lot of the construction and water and sanitation issues in the TFCs (Therapeutic Feeding Centre). A Therapeutic Feeding Centre or TFC, provides a carefully balanced and intensively managed dietary regimen with intensive medical attention, to rehabilitate the severely malnourished and improve (curative) and reduce excess mortality. High Energy Milk containing Dried Skim Milk, Vegetable oil, sugar and water is used in Phase 1 of the treatment process. In Phase 2 which is the nutritional rehabilitation phase via day care treatment, including a combination of High Energy Milk and banana, high-protein porridge and biscuits to take home. At the moment we are also running a rather large vaccination campaign, which is another logistical challenge. I didn’t have to do the planning as the campaign was half completed when I arrived. However I found it quite difficult to step into such a complex operation and learn other people’s logic and way of organising. The expatriate team is small - three in Kitchanga and two in Kabati. The logistician in Kabati is German and my Project Coordinator is a Dutch nurse. The third expat is an English doctor. We all get along very well. The daily routine starts at 7:30am and we try to stop around 6pm the latest. Dinner is after six, and the evenings are rather quiet with nowhere to go. At first, we watched a few movies, but often the choice of some of our colleagues is unbearable, which is one reason why we end up in our rooms so early. I also have few good talks with the team and its always interesting to hear their stories and their perspective on the whole situation here – which is very complex. So far, security has been OK for us – but that can change very quickly. For the local population, it is very different. There is an awful lot of pillaging, rape and abuse of civilians by anybody holding a gun and its quite hard to distinguish the different groups involved. The other night I was sitting in the office and realised that I could see my breath in the air! Luckily I was warned before coming here, and am now running around in a pair of fleece pants, last worn in a snow cave in the Alps. It is not always cold, though the temperature can easily reach 20-30 during the day. There are impressive downpours - every day for a couple of hours - as if somebody emptied a bucket over you - and wonderful thunderstorms. It feels like a Sydney winter - just without the glass in our windows. The compound is okay and shared with some of the national staff, who are mostly from Goma. There are double wooden walls between the rooms. My room is built of 1cm boards and floor space is about 14 square metres - furnished with a shelf, two chairs and a bed, in which I have learned to sleep in diagonally. The rats love the space in between and are quite active at night. We have pit latrines that are clean but smelly and bucket showers with hot water. There are two small courtyards and grouped around it are the radio room, four offices, the kitchen, our bedrooms and a dining/living area, in which the team watch movies every evening because we are unable to leave the compound due to insecurity in the area.
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:: First Impressions on mission