Out of order: Free cake in Lashkar Gah, Helmand (May 2014)

[This post is being published out of order; it was written in May 2014]

There is free cake in this story, though you may not believe me at first. But trust me, there really is free cake, so read on…

The MSF mechanic testing our moody incinerator burner:

Flamethrower in Afghanistan

A couple of months ago, my mechanic in Lashkar Gah (provincial capital of Helmand, Afghanistan) requested a few days of annual leave to visit his relatives living in Pakistan, including two of his sons sent there for studies. Sadly, he wasn’t able to make the trip as planned; instead of spending father-son time with his young boys, he helped with funeral arrangements in Kandahar for his sister-in-law and her husband. Driving down a dirt road in one of the districts, their tractor hit a roadside bomb. When my mechanic arrived back to Lashkar Gah, he brought his phone to show me photos of the little that remained of the tractor – a few oversized shards of metal contorted into oversized barbed wire, sitting in the tall grass by the side of the road, serving no purpose to anyone.

He’s a tremendously funny guy, though – check out his beard:

Snowbeard in Lashkar Gah, Helmand, Afghanistan

In April, about a week before I left Lashkar Gah, my mechanic had a baby daughter born in the maternity at Bost Hospital. One evening several days later, he called me for help – his wife was unwell and he worried her condition was quickly becoming serious. He brought her to the hospital, where the maternity staff took care of her, and it all turned out quite well.

The following morning, I could see on his face that my mechanic hadn’t slept very well – a logical outcome after the stress of the previous night. As a general rule in Afghanistan, there is a separation between men and women. Owing to this cultural norm, men are not allowed inside maternities, with limited exceptions in some facilities for male hospital staff. He therefore had to return home after his wife was admitted, driving two female relatives to the hospital to act as his wife’s caretakers during her stay.

It came as no surprise to me that he was so tired, but as I spoke with him near the huge hospital generators, he appeared not to understand much of what I was saying. With faint signs of pain on his face, I asked if he had a headache and needed to see the staff doctor. His smile – a smile I knew very well after nearly nine months working together – told me that I was on the wrong track but that he would happily help clear my silly foreigner confusion (I was fortunate to manage a team of guys who were not shy to point out and correct my frequent incomprehension, but were also skilled at doing so without offending me at all).

Adjusting the fuel flow rate on an FG Wilson diesel generator

Letting loose a little laugh, he pointed to one ear and said “Sorry, my heering… no good – no workeen. Paroon (yesterday) nighte, my wipe go haspital. After, I bring anadder, stay haspital por my wipe. I am dribe near Kandaharadda (station for buses going to Kandahar), in prant ob maykanic shope. My car, here – fipty meeter derr – blast. My ear apter, no good. Yesterday, two ear, no good. Today, one ear ok, one ear steel no good. Bat, no problem.”

If you didn’t quite understand, allow me to translate: “Sorry, I’m not able to hear well. Yesterday night, I took my wife to the hospital, then I made a second trip to bring female relatives to stay with her. I was driving near the Kandahar bus station, past the mechanic shops, when there was an explosion fifty metres from my car. I couldn’t hear properly afterwards. Yesterday, my hearing was bad in both ears; today, I hear well in one ear but not the other. It’s no big deal, though – I’m fine.”

Later that day, as I drank sweet afternoon tea with my technical team in the workshop, the mechanic arrived with something to share: cake to celebrate not being dead. I joked that I was happy he was alive, because we got free cake as a result. While he understood my English better than he let on, he replied in Pashto, as he often did. I understood his words before my assistant could translate: “I’m not happy. If I were dead I wouldn’t need to spend money on this cake!” We all laughed with him, enjoyed a few minutes of cake and tea, then returned to our job of keeping Bost Provincial Hospital running.

Goodbye to Grandma

My grandma Anderson became a schoolteacher in rural Nova Scotia when she was just 17 years old. She especially enjoyed getting through to the classroom troublemakers, a skill at which she excelled. I was born in Nova Scotia, but moved to Vancouver before I could form any memories. I have only the vaguest of memories of Grandma visiting us in Vancouver one time, probably in the late eighties, and for some reason a particular hotel in the city sticks out in mind as the place where she stayed, though I’m not sure that I remember that correctly.

The first time I really got to see Grandma was my first visit to Nova Scotia when I was ten years old. My dad and my sisters and I spent a happy three weeks that summer in the Nova Scotia countryside visiting family, learning new card games in the living room, how to throw horseshoes at Uncle Roy’s and Aunt Gwen’s place nearby, and how to play darts and 8-ball in Grandma’s basement with Uncle John. Grandma cooked and cooked and cooked, feeding us huge meals and serving up all sorts of fancy desserts and baked goods like cookies and her famous Nanaimo bars. She was always ready for a hug, constantly telling us how much she loved us, just as she had been doing for years over the phone and in letters and cards from so many thousands of kilometres away.

Grandma Anderson and Josephine

I was lucky to have the chance to visit her and the rest of my extended family in Nova Scotia six more times over the next two decades. During those trips “back home”, Grandma regaled us with stories of her youth, walking for miles across the ice in wintertime, jumping out the schoolroom window, helping take care of her siblings, and having to put the lights out during the Second World War because her family lived on the Eastern Shore, their waterfront home overlooking the Atlantic Ocean, and there were submarines lurking about. Grandma taught me how to judge when peas are ripe for picking and let me help out in her vegetable garden, weeding around the yellow beans, scarlet runners, carrots, and onions.

In 2013, my sister Josephine shared one of the stories from Grandma Anderson’s youth, about the time Grandma was lost at sea:

Lost at Sea from Josephine Anderson on Vimeo.

Grandma's backyard

Each time I said goodbye to Grandma on her little back porch in East Ship Harbour, with the hill rolling down to the Atlantic ocean in the background, she’d tell me how much she loved me and how much she’d miss me. Each time we spoke on the phone she’d do the same. As the years went on and I began spending more and more time living and working overseas – oftentimes in countries making headlines for all the wrong reasons – Grandma would tell me how much she worried about me, how special all of us grandchildren were to her, how she could hardly wait to to hear that I’d arrived home again, safe and sound.

Like my other grandmother, Grandma loved her five grandchildren unconditionally. I don’t think we could have asked for anything better, and I hope that a younger generation will one day say the same about us.

My Grandma, Margaret Irene Anderson (née Monk), died at the admirable old age of ninety-two and a quarter on October 19th, 2014.

Grandma Anderson sitting in her living room

After the funeral mass at the Church of St Denis in East Ship Harbour, my brothers and I and three of my dad’s cousins lifted my grandmother’s coffin down onto the lowering device at the nearby cemetery, next to the resting places of her parents, three brothers, and husband, surrounded by over two dozen headstones bearing our family name Monk. The gentleman from the funeral home handed flowers to some of the women standing around, encouraging them to toss the flowers into the grave once the coffin was lowered down.

As our family and friends’ cars, parked along the gravel shoulder of Highway 7, gradually left to make their way eastward to the St Denis Parish Centre for the reception, I recalled as a very young boy learning over the phone that my brother Dan had broken his arm playing soccer with some older kids at school back in Nova Scotia, while the rest of us kids were already living in Vancouver. Out of the five of us, Dan had spent the most time with Grandma while he was growing up. She kept a photo of the two of them proudly displayed on the fridge, where she could see it every day.

Dan and I stayed behind at the grave after everyone had left. We asked and were allowed to help the guy from the funeral home to remove the lowering device and the artificial turf placed around the grave for the burial ceremony. The two of us bent down, dug our hands into the wet autumn earth just as Grandma had done so many times in her vegetable garden, tossed handfuls of soil gently down into the grave until the coffin was half obscured, wiped our hands clean on wet blades of grass growing over the graves of our long-dead Eastern Shore ancestors, thanked the funeral home gentleman, waved to the small backhoe as he arrived to finish the job we’d started, and walked softly out of the sloping cemetery to re-join the highway.

The Specific Ocean

In Lashkar Gah, the capital of Helmand Province, Afghanistan, there is a particularly gaudy roundabout. On the island at the centre of this roundabout stands a giant globe. Students here could be forgiven for achieving results below the average on geography tests, as this globe, adorned with peace doves and sitting atop a pedestal reminiscent of a massive melted candle, takes a somewhat liberal approach to the labelling of several geographic entities.

Global misnomers in Lashkar Gah, Helmand, Afghanistan

In this artistic interpretation of the world, the Atlantic ocean has been relocated and Americans are no longer people; they are mere statistics brought together.

Well, I suppose the globe guy didn’t get it entirely wrong…

A Day in the Life of an MSF Technical Logistician in Afghanistan

From the start of August 2013 to mid-April 2014, I managed the technical services team for Bost Provincial Hospital in Helmand, Afghanistan. It was a fantastic, if at times somewhat exhausting, job. There were days when I spent most of my time in the office, but much of the time I was lucky enough to spend the day running all over the place with my team. For my family and friends (or anyone else who’s interested) who’d like to know just what it is I was doing over there, I figured I’d tell you about a day on the ground. It’s a bit detailed, so you may want to skim through and just look at the photos! This post was written in December 2013, but I’m publishing it with a delay:

Saturday, which is the first weekday in Afghanistan:

06:15 – Wake up, get ready for the day. This involves trying to remember who I am, where I am, and what I need to do. I face tough questions each morning: which sock should I put on first – the right or left one? Which one of my six identical MSF shirts should I wear today? Precisely what day is it today? Once I’ve had a coffee, the world becomes a bit less confusing, and I realise that I only have a few minutes left to eat and rush to the car.

Afghan coffee mugs

07:20 – Enjoy the drive to work. I usually wave to some of our neighbours who are standing outside their homes or their shops, as well as children walking to school, drivers who stop to let our car cross an intersection, traffic cops who make cars stop to let us cross said intersection, and generally anyone who stares and looks like they could use a smile and a wave to start the day. We certainly get loads of smiles and waves back.

Heading to work in Lashkar Gah, Afghanistan

07:45 – Morning meeting.

08:00 – Check every room of the entire hospital with one of my staff, looking for windows cracked or shattered by a nearby explosion the previous night. Note down locations and dimensions to plan repairs, arrange help from the supply team, with our carpenter, to buy glass cut to size in the bazaar.

Hospital pharmacy window shattered by a nearby explosion, Bost Hospital, Helmand

09:15 – Zip over to the paediatric intensive care unit (PICU) to solve an urgent problem. In an ICU, hypothermia is a serious risk for patients – especially as the weather begins to cool, and particularly for the small bodies of children in NICU and PICU (neonatal and paediatric ICU). Newborns may be placed in incubators, but a toddler is usually kept warm on a bed fitted with a heat lamp. We didn’t have a suitably-sized bed with heat lamp for one of the little ones this morning, so I MacGyvered a fairly simple solution which satisfied the nurse in charge until we can order more medical heat lamps: First, I grabbed four wooden blocks, an extension cord, and two 1500 Watt electric space heaters from my stock. Next, a medic lifted a bed while I crawled around on the floor to place the wooden blocks under each of the bedposts, raising the underside of the mattress from 40cm to 60cm above the floor. Then I simply put the two space heaters under the bed; I placed one heater directly beneath where I expected the child’s chest/head to be, and the other heater under his legs/feet. I then plugged the heaters into the extension cord, put it under the bed, turned everything on, and the heat rose nicely up from the heaters to give a fairly uniform temperature on the mattress. Not perfect, but certainly better than nothing!

09:40 – Send a member of my team to the bazaar to buy a steel I-beam and get it cut into three pieces.

09:45 – Set up a work site in the Female Ward Burns Unit. We recently rehabilitated the female burns unit to accommodate half a dozen bedridden burns patients, but the number of people showing up has been higher than predicted, so we needed to create more space. Just as with energy, in this hospital space cannot be created; instead, it had to be converted from another type of space. Accordingly, we expropriated the nurses’ locker room next door, emptied it out, and used a blue marker to draw a lintel and doorway on the wall. On the other side of the same wall, the female burns unit was still in use, so we taped plastic sheeting up with the aim of stopping any dust coming in when we smash through the wall. We also used a lot of plastic sheeting to set up a work area on this side – as soon as the hole is opened, our guys will need a bit of space on each side to work, but we don’t want masonry dust entering the room. My staff members all wear industry-certified face masks to avoid breathing dust in, and protective glasses (when smashing things) to prevent irritation or injury from dust or masonry fragments.

Starting work on a new doorway in Bost Provincial Hospital, Helmand, Afghanistan

Now, if only our blue marker line drawing could actually cut a doorway as in a cartoon… Instead, we got out masonry drill bits to start cutting holes into the wall, cracked tiles off the wall with a hand-held chisel, fitted a chisel-bit into a hammer-drill to chip away at half-century-old mortar, and hacked and smashed at the wall with a pick-axe to remove the bricks. When you’re attacking a wall sixty centimetres thick, it takes a LOT of patience, persistence, and precision to progress!

Using a pick-axe to break through a 60cm-thick wall in Bost Provincial Hospital, Helmand

11:55 – Run over to the area beside our backup generators, to meet the heavy-lift crane truck that had just arrived. Several old but perhaps fixable generators and an autoclave had been sitting around outside, and needed to be relocated to a more suitable (read: out of the way) location. The crane truck lifted the largest generator onto a flatbed truck, then both vehicles circumnavigated the hospital in order to place the generator for us.

A crane lifts an old generator onto a flatbed truck at Bost Hospital

Following that, the flatbed truck – equipped with a less powerful crane – relocated the hospital gardeners’ hut as it was also blocking access for large vehicles that we may need to bring in for unforeseen work in the future.

A crane moves the gardeners shack at Bost Hospital

With the hut moved, the trucks no longer had to drive all the way around the hospital to pick up the remaining equipment, including the second generator, which we lined up neatly near the first.

Moving another generator at Bost Hospital

Next came the fascinating old Soviet generator trailer which had been sitting inconveniently at the bottom of the hospital water tower for untold years.

Relocating a Soviet-made generator trailer at Bost Hospital

Finally, we moved the “little” autoclave (it may only be the size of a large washing machine, but you wouldn’t want to try and lift it yourself!).

A crane moves an old autoclave at Bost Provincial Hospital, Afghanistan

13:25 – Eat a very late lunch. Kebabs from a nearby restaurant for me and my assistant, because our staff kitchen lunch was at 12:30 and is all gone by 13:00 most days.

14:00 – Start one of our guys scraping and sanding two big diesel tanks to prep them for new protective coats of paint. Ask our painter to coat I-beams in anti-rust paint. Send our electrician to repair the boiler in the hospital laundry, then to check all the outdoor lights around the hospital, and repair or replace as needed.

Scraping old paint off a diesel fuel storage tank

Painting steel I-beams with anti-rust paint

14:30 – Discuss with mechanic about one generator having trouble starting in the cold weather: we’ll have to use some starting spray until we come up with a longer-term solution. Place bricks under a recently-installed fuel pipe to protect it from people accidentally stepping on it. Collect the carbon steel pipes left over from our recently completed fuel system, return them to our warehouse.

Carbon steel fuel system

15:30 – Advise our plumber on the placement and installation of a handwashing sink for the new entrance to the female burns unit.

Installing a new handwashing sink in the female burns unit of Bost Provincial Hospital, Lashkar Gah

15:40 – Place old bricks around a newly-poured concrete path to the hospital waste zone in order to keep people from stepping on it, even though I know some people will take a shortcut at any cost here. Check to see which windows broken in the blast were completely repaired, and which ones were only temporarily covered for later repair.

Newly-poured concrete path to the hospital waste zone, Bost Hospital

16:00 – Wedge one I-beam into place above the doorway-to-be, on the off-chance that something could happen in the night to collapse part of the wall. We planned to finish chiselling away at the area above the new doorway in the morning, allowing us to fix the three I-beams with concrete to form a lintel. This allows us to safely remove the part of the wall which we need to use as a doorway; otherwise, the wall could collapse someday.

I-beam lintel above new doorway in Bost Provincial Hospital, Helmand, Afghanistan

The workday ends at 16:00 in wintertime here, because of the shortened daylight hours, but many of my technical team members stayed past 16:00 to finish up their work without asking for overtime. For instance, our mason put the finishing touches on some concrete work and took the time to clear the work site nicely and clean our masonry tools properly before putting everything away and going home. Once again, these guys really brightened my day with their hard-working attitude and big smiles.

Although I was exhausted by the day’s end, I was nevertheless happy with the day’s achievements, and ready to tackle another one after some much-needed sleep.