Fieldwork in Uganda, Budongo Forest (2011)

Fieldwork in Uganda, Budongo Forest (2011)

Sunday 28 December 2014

Always go on a second mission

I look outside the window, it's pitch black with only the comforting orange light on the wing flickering in a distance...showing the world down there that people cramped in uncomfortable positions in a small Airbus are flying over their houses. On our way to a next adventure. 

We are 5 people from Médecins Sans Frontières flying to Monrovia, Liberia. Next to me a young couple who are going to spend their end of the year in Morocco and I want to ask them if I can go with them instead of going to an ebola epidemic. I feel kind of connected to this woman because she also grasps the armchairs while flying through a heavy zone of turbulence....oh God, I still hate flying and the Xanax is not working properly!

Getting out of the plane and being hit by the instant heat, humidity and sweet smell of Africa is usually one of my favorite moments since I started working here. But I didn't smell it this time, something was different.
Outside there were no enthusiastic men trying to get your attention to offer you a taxi or to carry your luggage, the streets were empty and dark. When the epidemic hit the capital some weeks ago, a curfew was put in place and although the daily number of new cases has gone down, there are still new patients every day. This epidemic is far from over.

Arriving at the hotel we realized we forgot to give each other a last big hug before entering Liberia! No touch policy back in place and a new day at work tomorrow.

First day at work: epi team Monrovia, Liberia 2014






Thursday 20 November 2014

Business as usual

It's nice to put on again my shoes, after months of running around on sandals and wearing the same clothes every day (proudly showing a dusty mustache during the dry season) you feel like a new person walking on heels, trying to look elegant ... probably failing in every way but I couldn't care less because I just came back from an ebola mission!

Life continues as usual and I am trying my best to smoothly fit in again. Now that my 21 days of incubation period (no quarantine!) have passed I feel more relaxed and don't think too much damage was done to my mental and physical state. Besides the unforeseen and difficult circumstances I feel kind of good about my first experience as an aid worker and the curiosity of 'what else is there' is slowly making its way again to my head and heart. I knew the moment I signed my contract that this would change my life (again) and now I realize that there is no way back...I have become one of these strange expats, giving friends and family the impression to be a bit lost in life but actually knowing very well which direction to go. 

Does it matter that I don't manage to plan more than 3 days ahead since I got back? That I don't really care where we go for dinner or what the plan is for today, but want to leave all options open? Is it selfish that I can feel so close to someone for some precious moments and the next day want to be on my own again, planning my next biking holiday in Thailand? Or is this what it means to be an aid worker and finding ways to deal with the things you experience during life in a mission and the person you want/need to be in the outside world? 

No damage done...

Announcing that the paediatric and obstetric hospital was suspending activities due to the current ebola outbreak, Bo, Sierra Leone (Veerle Hermans, 2014)


              

Monday 6 October 2014

The daily updates

Dear disease surveillance officers and CDC colleagues,

Included the daily update for the treatment centre in Bo:

- 4 new admissions:
      2 from Freetown (1 confirmed, 1 suspect*) + 2 from Port Loko (probable)
*1 baby came with its mother, who is confirmed. The baby is negative, but was breastfed by his mother for some days so we will keep him in the suspected tent for observation. He also has nowhere to go for now...

- 1 confirmed patient died last night > burial team alerted

- 2 patients cured and discharged! They will go back to their family today
    (if they will let them go back into the quarentined areas)

Any news on the outreach activities to the area of the new cluster today? Than I know if I need to chase the GIS officer to update the maps.

Thank you!

Kind regards,

Veerle Hermans
Epidemiologist, MSF
Bo, Sierra Leone

Staff member, wandering around the treatment centre while it was under construction, Sierra Leone, 2014

Sunday 28 September 2014

Winter is coming

It's nice to see the seasons changing in Africa. Until now I never spent enough time in one place to see this actually happening. In July the long rainy season started for which we were warned by several heavy storms...and when I say heavy, I really mean HEAVY - read as: your room is flooded the next morning. This was followed by long days of grey skies and soft, but long lasting rains. I will not elaborate on my frustration about the decision not to allow us cycling during this season. There is definitely a correlation between my mental health and the amount of kilometers done on my bike. 

This week the treatment centre in Bo opened and has already seen 32 patients passing, of which several died quickly. The team has also been faced with difficult social consequences of the disease. A baby of 1,5 years old was brought to the centre but turned out to be negative. You would say, she is lucky, but she has lost both her parents and has no one to return to. And how can you comfort a baby like that wearing a spaceman suit? We are doing what we can in Sierra Leone, Liberia and Guinea, but it is very sad to see that the worst is yet to come.

I used to write long emails to friends and family about strange situations in the forest, working for conservation organizations. It helped to get it of my chest and to have a reality check with what the outside world was like. It was a life saver as taking Lariam for too long resulted in completely becoming paranoid and accepting situations that turned out to be unacceptable: it seemed almost normal being held hostage in the village or having to climb a tree because it is not safe to spent the night alone on the ground in the middle of the forest after being abandoned by your, again drunken, guides.

I didn't do that this time in Sierra Leone...maybe I accept my way of living, and other people also don't email me weekly with their daily adventures. Thank God there is Facebook!

As I am writing this, a big storm is roaring outside and it is actually quite calming, a bit like a winter evening back home. I think I am ready for hibernation...


Construction of Bo Case Management Centre, Sierra Leone, 2014

Sunday 17 August 2014

Vébola on holiday

With a backpack full of chocolate and cheese, I boarded an almost empty plane flying back to Sierra Leone after 2 weeks of holiday in familiar Belgium. For the first time in my life I actually stayed at home for a holiday. It often felt like I could as well sleep my way through these 2 weeks: no generator in the background, night by night less dreaming about ebola following you around and enjoying seeing family and friends again.

The last 2 months in Bo were demanding for the whole team, to Ebola or not to Ebola...that was the big question. From one week to another we switched from long-term mode (enjoying a free weekend once in a while) to emergency mode in the Bo project, having no idea how long this outbreak will last. Normal activities have to continue in the hospital as good as possible, but at the same time Ebola is breathing down your neck and we have to offer our support in surveillance activities and case management with limited staff available.

So I wanted to get out for a moment, to clear my head and have normal conversations again. But this was wishful thinking, being back in Belgium I saw it was a hot topic in the daily news, creating a certain nervous athmosphere among people. As an epidemiologist I have quite a comfortable (and amazingly interesting) position in the field: surveillance, mapping, line listing,...and therefore I am not too worried about getting infected. On the contrary, other people are more worried about you being a risk than you consider it yourself. What they don't mention in the evening news is that someone carrying the virus is not infectious if he/she doesn't show symptoms and that it is NOT airborne. You have to practically vomit in someone's face to transmit it and this was not really my plan to do. I checked my temperature daily (being slightly paranoid is not always harmful) and no fever means free pass to hugs and kisses!

Fear is a surviving mechanism, fight or flight reaction is to be expected. In this case the danger is not visible and very lethal, hence understandable that flight is a first choice. Presenting this in real life as people taking two steps back when they see you and will wait until the incubation period of 21 days is over before giving you a hug and a kiss. I didn't realize it would be like this coming back for holidays...having in my mind that I was advised to exchange as much bodily fluids as possible as it is not allowed in Sierra Leone, what a disillusion!
One of my African colleagues dryly made the note that even if a case ends up in Europe, it would not cause a lot of trouble: "Vous, les européens, se trouvent toujours dans des grandes maisons tous seuls,  une vie isolée et individuelle. L'Ebola n'aurait pas de la chance".

Normal activities ongoing, Bo, Sierra Leone [2014]



Sunday 29 June 2014

“Cordon” in real life setting?

After 3 weeks of being too tired to play tennis in the weekend I forced myself this morning and cycled over to Bo Club to meet the coach for another session on the court. On my way over there, I heard a woman shouting something at me in Kreo. I could pick up ‘ebola’ in her sentence so I stopped and asked someone to translate it for me: ‘you puwnis are well protected against ebola, but you will infect us and we will die’. As I continued my way I thought about what the women said. Maybe she has a point; we are protected in some way, because the last days a lot has been done to prepare ourselves for an outbreak in Bo. In the houses, chlorine buckets have been installed to wash our food and our ‘bodies’ to kill any virus trying to invade our system. The fact that you smell like a swimming pool the whole day is just a minor inconvenience.

However, it is sad to notice that a lot of people believe that the ‘white men’ are injecting the ebola virus in patients in the hospital. It shows again how important it is to really understand the cultural believes and ways of reasoning in the population, otherwise there is no way this outbreak will be contained soon. These believes and rumours result in people infected with ebola hiding and running away from the hospital, because they are scared. Soon all hospitals in Bo will be empty and all the children suffering from severe malaria will die at home, because their parents are too scared to come to the hospital. Off course they are scared! Everyone is very worried at the moment, puwni or not. 

Pharmaceutical companies don’t invest in finding treatment as it will not pay off the investment. Previous outbreaks have always been contained rather quickly and the number of people infected remained low compared to other diseases. Although there is a lack of treatment, the last months showed that people do fight the virus by themselves and walk out of the isolation ward in good health. Providing supportive treatment like fluids, malaria treatment and vitamins can help to make the body strong enough to fight the virus. That is why it is so important to come to the hospital and get this treatment, and above all, to prevent infecting other people. Too many have died already, this really needs to stop.


I didn’t manage to keep my eyes on the ball today…
Man climbing the waterfalls in Kenema, Sierra Leone, 2014

Saturday 7 June 2014

Love in the time of ebola

You hear people whispering it in the streets,…ebola….like saying it out loud would make it appear right in front of you. MSF plays an important role in the history of ebola, being one of the only organizations with hands-on experience in outbreaks. I wish I could be more of use, but besides explaining the role of primates in transmission of the virus, there is not a lot of expertise I can offer. I am still learning the basics of epidemiology and it was not really planned to get in the middle of all sorts of outbreaks.

In the meantime business goes on as usual, working long hours and reflecting on the things that happened during the day with a nice glass of marula. Since 7 years, I always try to hide somewhere on the 7th of June, not an easy thing to do in this setting. Some days I love it, when you learn new interesting things and you feel you get a very good bond with colleagues that become partners in crime. Other days I really wish to be back home in my nice comfort zone, so I could at least be with my family when my grandmother passed away last week or today with my friends, sharing memories about that special one we lost 7 years ago. I wish I could have told my grandmother that when working in Africa, I often take my second name ‘Clara’, her name, because no one can pronounce ‘Veerle’ (it becomes something like Veelie, Veurlie, Vierleu,...). She would have liked that.


Fortunately in crazy outbreak times like these, we got some good news! The gynaecology and obstetric ward of the hospital will stay functional until the new hospital closer to Bo is up and running and the expertise of handling complicated pregnancies and deliveries can safely be handed over to another hospital. The original plan was to close down the ward in June and continue the paediatric care, but as women often come from far away to safely deliver in the hospital and the maternal mortality is still high in the country it was decided to stay open. On moments like these it is great to be here: if the good news that no one would lose their job would be announced in a Belgian company, everyone would politely smile and quietly think, "yes, I still can redecorate my kitchen this summer", and then go back to work. But when the news was announced here, the midwifes got together, and danced in the rain around the hospital, laughing and singing. 

Midwifes dancing in the hospital after the good news, GRC, Sierra Leone.

Sunday 25 May 2014

A tree is the limit

On the road to Kenema, the 3th largest city in Sierra Leone: It’s nice to escape Bo for a day, certainly if you are in the good company of two beautiful women from DRC and Malawi, another Belgian and my good friend from Ivory Coast. Seeing the Gola forest passing by, I immediately think of the chimpanzees that (just like the people) are trying to survive in harsh circumstances. It must be nice to be able to go look for them and see how the populations are doing in Sierra Leone.

Being a ‘first missioner’ I have to get used to all the aspects of living the MSF life. Before coming to Sierra Leone I was working in complete different circumstances, i.e. tracking chimpanzees and gorillas in the forest of Eastern Cameroon. It has been the most interesting, but also most disturbing working experience so far. It is amazing to live in the forest, never knowing what to expect the next day. But there is one thing you need to be able to do your job, regardless of where you are. You need the support of the organization in all its aspects. There will always be unforeseen circumstances, but if you are abandoned in the forest by your drunken field guides and you are planning to climb a tree to spend the night to avoid the risk of being trampled by elephants, you realize that as flexible you want to be, everyone has a limit. It is not always easy now to deal with all the security rules and protocols that we have to respect in our professional and personal life with MSF, but I understand more than ever that you need this to be actual able to do your job without being distracted and always switching to survival mode to make it through the day.


I miss the forest, the pollution in the city is difficult for me, but I love the fact that I can be much more productive and actually contribute to the well-functioning of the hospital. They warned us during our training before departure that working for MSF is like a marriage: some days you just want to run away from it as fast as you can, but most of the days you feel how much you love this lifestyle and would do anything to make it work.
An average working day in Dja Faunal Reserve, Cameroon [2013]

Saturday 17 May 2014

Small Small

A paediatric mortality rate of 6% for the first quarter of 2014 was one of the results we presented this week in the hospital. The target of staying under an 8% mortality rate was achieved. Just looking at the numbers you want to clap in your hands and congratulate each other on the good work. 

But when I was walking back to the office, I saw a young father carrying his deceased child out of the hospital. For a second I thought he was holding a small gift, trying to show it to the people around him. Wrapped in a beautiful blue-yellow lappa, he was holding the child in front of him and with a certain grace he walked out of the hospital. 
At the exit, the paper put on the small bundle said that it was indeed his child and that he would appear in my statistics as ‘exit outcome: death diagnosed as severe malaria’.


All of a sudden you feel that this 6% is nothing to congratulate each other on.

Attempt to play tennis in Bo Club, Sierra Leone [2014]

Saturday 3 May 2014

New York Kisses

She was supposed to celebrate her 30th birthday today. It would have been our perfect excuse to organize a crazy party, to dress up as we did when we were 16 and drink (a bit) too much of that home-made cocktail.

So I promised her to get out of this life as much as I can for the both of us.

a birthday kiss [New York, 2006]

Sunday 20 April 2014

Welcome to Sweet Salone!

So, this is going to be my home for the next 12 months! Arriving in James Bond-style by speedboat, with an amazing sunset in the back makes me feel very welcome in this small unknown country.

When you think of Sierra Leone you think of a country somewhere hidden in Africa that was terrorized by a horrific war for almost a decade (and of Leonardo Dicaprio in Blood Diamond). But I see a whole different sight of Sierra Leone now: people are very welcoming, friendly, have a great sense of humour, party until the morning comes, dance in front of mirrors, drink ‘Star’ beer (which I as a good Belgian refuse to call ‘beer’) and the children shout ‘hellow hellow Puwni, I love you!’.

MSF started working here to provide medical care for refugees during the war. When the war ended it was decided to continue providing free health care for children and pregnant women and a hospital was built on the spot where there used to be a refugee camp. Plans are made to move the hospital more closely to the city center to make it more accessible.

It almost feels like I have a normal life now: getting up at 6am to go jogging, walking over to the office at 8am, meeting the team in the hospital at 11am, lunch at 1pm, analysing hospital data and getting intrigued by interesting epidemiological cases in the afternoon and going for a drink after work in the ‘under the palm tree’ bar.

Let’s not mention the fact that the heat is killing me and that it feels like I inhaled half of the Sahara which makes me cough like I have been smoking since I was 5…


It is hard to believe that not so long ago Freetown was under attack by an operation ‘no living thing’ and the sand on the now beautiful beaches was coloured blood red for days. Keep in mind that people forgive, but not easily forget.

On the road from Freetown to Bo, Sierra Leone

Tuesday 1 April 2014

Last Night in Belgium

Tomorrow by this time I will get out of that aeroplane and embrace the steady ground of Sierra Leone under my feet. The days before leaving for 12 months to go work as an epidemiologist for Médecins Sans Frontières have been wonderful and painful at the same time. Cycling my last 20 km back home after drinks last night, watching the stars (without crashing into traffic signs this time), I reminisced about the exciting things that are going to happen and that have happened so far.

Having lousy friends would make leaving a lot easier...now I feel lost having to go, knowing that this time a lot of things will change in everyone's' life. Being in our late 20's - early 30's asks for a certain evaluation of how life has been and how you will fill up the next decade. But where the hell is the right answer?

I sometimes hear people saying 'it's so courageous of you, going to Africa and work for this wonderful organization, I would never be able to do that!' Than I always smile and think, you have no idea how courageous your are yourself, I probably would never be able to do what you do either. Mutual respect creates a nice atmosphere.

In conclusion: I am nervous, scared, worried, but excited and curious at the same time. Lets get over this fear of flying (or take that Xanax) and fight that Ebola! I have the most wonderful friends and family in de world, it was great hanging around with them again for the last 6 months and I just want everyone to be safe, healthy and content. Finding your way is never easy, but you are all doing a great job, keep that in mind.

Last Night in our Roaring 20's - Farewell Belgium

Tuesday 11 March 2014

Like the legend of the phoenix

As an adrenaline junkie and a woman with high variety seeking behaviour (that's what the personality test said), my new professional perspective seem to meet up to my never ending search for 'that job'.

Ten days of training on personal communication, life in a mission, prioritize in emergency situations, refugee camps and how to deal with cholera outbreaks gives me a certain feeling of excitement and a weird species of butterflies in my stomach.

Off course it is not all as romantic as it sounds. Good thing I lost that idea working in conservation projects for a while...

Meeting new people who share this passion for a certain life style make me feel more 'sane'. On the other hand I need my friends and family at home to keep me with both feet on the ground. To stop me from jumping on the next flight to see 'that guy' (Judas's call) and to protect me from expecting to much from life and people. It's true, despite all the misery, war, destruction of the environment, bush meat trade, killing of innocent people,...it is important to remain a romantic soul, to cherish those weird butterflies and to jump on that next flight anyway....because we all need to go on that second mission!

[dancing in Denmark]

Friday 14 February 2014

If you want to improve, be content to be thought foolish and stupid [Epictetus]

Valentines’ week: 

cheesy movies on TV and bakeries throwing free donuts at your head so you can surprise your love with a huge sugarbomb in the morning (who said the food-sex strategy was only for chimpanzees and bonobos?).

To get in a romantic mood I started the week with watching Nymphomaniac part 2. It becomes painfully clear that you can be as free as you want until love comes into play,…wonderful, thinking about all these beautiful dark twisted fantasies (yes, I do like Kanye West) that we as decent human beings do not dare talk about. So thank you Lars von Trier!

To snap out of it, I finished the week with 'Serendipity', explained as 'fortuitous happenstance' by etymologists. Interesting how Jonathan and Sara want to control their beautiful clear sane fantasy on meeting again years after they first met. 

How can you not love this day?

[Antwerp city, view from the MAS]

Monday 3 February 2014

What's next?

Spending time travelling and working in projects around the world during the last couple of years I realise I have a backpack full of crazy stories and beautiful pictures which are often put in a corner when coming back. 

I don't want to bother everyone with my stories, nor organise evenings showing all my holiday and chimpanzee pictures. However, last week I had the opportunity to talk about my work as a researcher in primatology to a class of enthusiastic children. It was amazing seeing their eyes lighting up when I talked about all the endangered species in the forests of Cameroon, Uganda and DRC. They reminded me of myself, when my father took me to see Jane Goodall and how it completely changed my life. A girl asked me how a simple Belgian girl got the chance to work in such extraordinary circumstances...good question!

I guess anything is possible if only you want it enough...

[Pan troglodytes schweinfurthii, sitting in a tree in the Budongo Forest, Uganda]