Though I am a first missioner for MSF, I am not new to Africa or working with underprivileged people. Before joining MSF I worked for almost 17 years in India, Ethiopia and Sri Lanka, in various positions including as a community health specialist, programme officer and lecturer. In 2006, working with [the international health charity] Merlin gave me firsthand exposure to conflict and emergency environments.

Yet working for MSF was still a ‘dream come true’. I was inspired by MSF’s motto of advocacy: “Giving voice to the voiceless”.

I had first heard about MSF in 2000. A number of my classmates who were midwives and registered nurses had worked with MSF in different African and Asian countries. I used to listen to their stories with great curiosity and excitement. I was very timid then, and the thought of travelling to Africa and places of emergency or conflict was like travelling to the moon!

Curiosity and misconceptions

I was curious and excited, but put off applying, because I was afraid and because I thought my family would never accept it. But I kept on dreaming about working with MSF. I also had a misconception that MSF was only for medics, and that I would not be eligible with my qualifications. Hence I did not send in an application until last year.

In April 2011, one of my friends and colleagues from Merlin, who had worked with MSF since 2010, told me that MSF had an office in India and convinced me to apply online. I hesitantly send in an application, thinking that they would reject my application since I am not medical and do not have any experience of human resources or logistics. But, to my surprise, I was interviewed over the telephone and participated in the two-day assessment process. I was happy that I did not have to wait long before I received a call to work in a unique project in Nigeria.

Lead poisoning project

Zamfara state, in northwestern Nigeria, is an underdeveloped region, but is blessed with having gold in the rocks found in the area. Due to unsafe mining practices, the boon has turned out to be a bane for the people of the region. Children began to die in large numbers. The causes remained unknown until MSF’s emergency team [known as ‘NERU’] diagnosed it as lead poisoning. In 2010, an estimated 400 children died due to lead poisoning, and this marked the beginning of MSF’s unique project. MSF began its clinical intervention by treating children under five years old with a drug called succimer to flush the lead out of the body.

Arrival

Unfortunately there was quite some confusion upon my arrival in Abuja, and I waited for three long hours. The Federation Airport Association of Nigeria was very helpful. They gave me a mobile to call the project office and from then on things were arranged smoothly.

Working and living conditions

With 11 international staff (or ‘expats’) from nine countries, the expat house was full of fun when I arrived, and only rarely broke out into small disagreements. The house was “luxurious”, according to some experienced MSF colleagues who had worked in difficult conditions. But electricity was scarce, with one generator and an inverter. It went off after midnight until 6.30 the next morning, and during March to May the heat was at its peak, resulting in sleepless nights for some. It also affected the temperament of some people! I, however, survived this adverse climate without any problem because I am from a similar tropical country.

The working conditions were very cordial, even though we had discussions and arguments about the project. Despite the challenges of the rainy season, it was interesting to work on a unique project with full support from the emir (traditional leader and most influential person in the district) and the Ministry of Health and Environment.

Stuck in the mud

Travelling to the field took up much of our time, as we had to travel almost two hours to the villages. When it rained the roads were very bad, causing aches. Sometimes the vehicles get stuck, and though it was fun to be out there taking photographs, it was very tiresome for the men struggling to get the vehicles out of the mud. I learned a lot of practical things about vehicles during the rainy season!

© MSF

The other aspect of this project was to advocate for safer mining practices, through the media and lobbying with the Federal Ministry. An international conference was held in May 2012 in line with this issue. I got an opportunity to present in this conference, which was organised by MSF in conjunction with the Federal Ministry of Health.

We began an assessment process in a new village, Bagega, found to be contaminated with lead. One day, we arrived in the village at about noon to meet the health staff for our usual visit, and found a father sitting with a malnourished child in front of the clinic. The expat nurse looked at the child and found that it was in a bad condition. Unfortunately, just as our nursing staff began to stabilise the child, it breathed its last. However, there was another child in the same family in a similar condition who was taken to the lead ward on the same day, and that child was able to survive.

Superstition and tradition

There are lot of superstitions and traditional practices, for example: if a woman delivers twins, one child is given away, because it is a bad omen to keep both of them in the same house; girls get married very early, at the age of 13 years; and polygamy is practiced.

The security situation was not very good; the militant Islamist group Boko Haram attacked a church in Abuja just before I arrived, and there was an attack almost every Friday or Sunday in one or other of the neighbouring states. But fortunately Zamfara was unaffected while I was there, hence we continued going to the villages to treat children.

I had lots of practical learning during my stay in Nigeria – from my team and also from observation and experience. I thank MSF for giving me this unique opportunity.

– Saraswathy Achat