Christopher Lee is an engineer from Sydney currently on his first Médecins Sans Frontières field assignment, in Monrovia, Liberia, where Médecins Sans Frontières is running a paediatric hospital.
“It’s a sad time to be writing because we heard yesterday [20 November] of the new case of Ebola in a 10-year-old boy, and today another two members of the family have been confirmed positive I hear. It’s a big setback for the country and the people after they thought they had kicked Ebola – and a worry for our hospital because other health facilities may restrict admissions and our hospital may run out of space. Yesterday we opened another floor with extra beds to cope with potential demand.
My role here is very focused – to get a new fire escape stairway built – but it’s been very interesting to see the hospital’s work as well as the patients. Infection prevention and control is very strict, with screening for Ebola on admission, partitions between each bed, staff touching patients only with gloves etc. Anyone going into the wards has to wear scrubs and boots, so we logisticians are constantly putting them on and taking them off. They are very comfortable and cool, but don’t have enough pockets for a loggie! Common problems among the patients include malaria, diarrhoea, dehydration, malnutrition, sepsis, intoxication with traditional medicines, some tuberculosis and tetanus. The youngest last Sunday was just a day old and tiny, the oldest three years and even so rather small and thin. They have lovely names like Praise, Blessed, Success, Prayer, Solomon, Godgift, Lennie, Vera and tiny 1-day old Miracle, her young mum’s first born. She was reading her bible beside little Miracle (people are quite religious here and predominantly Christian).
"It’s good having another couple of Aussies here too. We collectively do our best to make our Australian presence felt!”
But of course my role is primarily outside the wards with a fair amount of time right now at my desk, doing drawings and calculations. It sounded a simple job from Sydney – “just build a fire escape” – but it is in fact a significant little project. It’s three storeys high, contains six tonnes of steel, and has a total design loaded weight of 30 tonnes. Then there are contract documents to prepare and a tender process to go through. I’ve suggested we paint the fire escape bright colours, in keeping with it being a children’s hospital and the project coordinator likes the idea so hopefully it’ll happen.
I’m considering overall fire protection for the hospital, which the excellent Logistics Team Leader, a Liberian with 20 years Médecins Sans Frontières service, was already working on. We’ve now got fire extinguishers well positioned throughout and are preparing escape route diagrams and fire exit signs, and are installing a fire water tank, a pump and, I hope, some hoses. We also plan to have the local fire service do some live fire training for staff. Unfortunately our local fire station has only a pick-up at present, so they can come to a fire but don’t bring any water or hoses but can use ours if we install them! The international staff team here are a good bunch, and the local staff are also good, especially the drivers who are impressively courteous despite terrible traffic and drive very carefully and safely. The living conditions are excellent, but I’m warned that I will never experience conditions like this again in Médecins Sans Frontières so I will enjoy them while I can!
I’ll tell you one funny story about listening to local wisdom. I’m puzzling about how to do the foundations for the stairway so they are strong enough for the loads involved. We don’t have any soil strength testing equipment here but I noticed some guys digging holesto erect a shelter. So I went round to see what the ground at the bottom of the holes was like – pretty soft actually. Then I asked the group of guys if they built other things. “Yes,” said one “in fact I built that block” pointing to our hospital. “Wow, really?” I said “and how did you do the foundations?”. “Five feet deep and six feet square, with 5/8th steel reinforcement. You have to get through this soft soil to the hard clay underneath”. He not only built part of the hospital but is also currently building an extension to the school. Suitably enlightened and humbled I returned to my desk to redesign the foundations – ‘Five feet deep, on the hard underlying clay’!
It’s Saturday evening, the sun has set over the sea which is just beyond our compound wall; I’ve had a swim in the surf with some of the others. All the best to the team back in Sydney. It’s good having another couple of Aussies here too. We collectively do our best to make our Australian presence felt!”
Note: This letter was written in November 2015.