MSF Diary (experience from the field) November 2009 – Nilza Angmo

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My Experiences with MSF

Hi I’m Nilza Angmo and come from Ladakh region of Jammu & Kashmir. I am an Obstetrician Gynaecologist with Public health background presently working with MSF as Deputy Medical coordinator in Armenia.

I started my career with MSF in 2007 with my first mission in Killinochchi, Sri Lanka in a Maternal and child health project and after that MSF has been an integral part of my life. After my Sri Lankan experience, I did another mission in Turkmenistan, also a maternal and child health project and now am in Armenia.

Looking back Sri Lanka was an emergency mission and I worked in the position of a consultant gynaecologist. It was a start-up mission in the General Hospital of Killinochchi and was full of challenges and there was a big turnover of MSF expats also. We got along well with local doctors and staff, and by the end of my mission I had developed good friendships. Security was a big concern but the risk was mitigated with well established security guidelines which were regularly updated, and there were clear cut evacuation plans. There were bunkers everywhere and we had one in our compound, which we had to go to on 2 occasions during my mission. It was interesting as I learnt some Tamil and enjoyed conversing with patients without translators sometimes. Apart from that, towards the end of my mission I got Dengue fever but my team members took care of me like a family and I recovered to continue my work with MSF.

What I learnt from my first mission, apart from professional enrichment, is that it is amazing how difficult periods bring us together; another thing was, how sharing information in a coordinated way can be very constructive and very productive and how to make the best use of resources that are available.

After my Sri Lanka experience Turkmenistan mission was a different experience, a stable context, former Soviet Union country. All of us expats from Germany, Ethiopia, Canada, Kenya and India lived together and worked in the hospital. The temperature was extreme with 50+ degrees Celsius in summer and – 10 in winter; I did have some problem with the heat but soon got acclimatised. Both in work and at home we worked in a very coordinated way and faced all the challenges together. I realise more and more that it is really a great responsibility for the respective supervisors (management and supervision of national staff is a major part of your job when you work as international field staff) to play a steering role and set professional and ethical norms and standards so that others can follow. I enjoyed working here as we had a dedicated team of National and MoH doctors who were eager to learn, I enjoyed doing training and upgrading their skills and in turn learnt a lot myself also. As of now the MSF project in Turkmenistan is closed, but thanks to all the international expats (5) before me, the skills of the local staff were acceptable and more than that what I see as an achievement is the doctors tried thinking and rationalizing the interventions rather than follow what has been handed down to them (there were still some old soviet practices). It is also encouraging to see national staff in that mission be expatriated to contribute on other MSF missions.

At present I am working as Deputy Medical coordinator in Armenia where we are implementing a MDR TB program. My husband is the Head of Mission cum Medical Coordinator so it has given us the opportunity to work together and commit for longer duration to the mission as well which is nice for both us and the project.

Working with MSF has given me the opportunity to provide medical needs of vulnerable populations and contribute towards the great work MSF does on an international scale. It has been an extremely gratifying professional experience. Working in diverse contexts with colleagues from different corners of the world, getting to know the different health systems in these countries and cultural experience of these places has been a very rewarding experience.

I hope to continue working with MSF and at the same time enjoy this experience of living and feeling different cultures. MSF has really broadened my outlook both professionally and personally. It has helped me overlook minor issues and remain focussed on my goal.

NILZA ANGMO, Deputy Medical coordinator: Mission in Armenia November 2009

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