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Field notes from Xa Muteba, northern Angola
Jason Andean is a logistician from Tasmania who recently completed his first mission with Médecins Sans Frontières (MSF) in Xa Muteba in Northern Angola. For the last ten months I have been on a mission with MSF in Angola. The project is located in the Xa Muteba township of the Xa Muteba Municipality, in the north eastern Lunda Norte Province of Angola, fairly close to the Democratic Republic of Congo (DRC) border. The town sits in the middle of the 100km wide valley that is cut through the middle by the Cuango River which runs about 50 km by road from Xa Muteba. It is here that alluvial diamonds are extracted by an arrangement between the Angolan Government, mining agencies and private companies. Many young local men engage in illegal diamond mining, but are actively and brutally discouraged from doing so by the small private armies run by the big mining companies. The rest of the population of the area is generally engaged in very basic subsistence agriculture, usually of manioc - a plant whose sweet potato-like roots are used to make the local food staple funge. The MSF project provides basic health care, servicing a general population of around 40,000 - 50,000 people. It particularly focuses on the children under five, ante natal care and obstetrics, tuberculosis (TB) and HIV/AIDS for which Antiretroviral drugs (ARV’s) are provided. Child mortality is running at about 30% which is one of the main reasons for the continuing presence of MSF in Xa Muteba. HISTORY OF THE REGION During the war (which finished in 2002), the area around Xa Muteba was held by both the National Union for Total Independence of Angola (UNITA) and the armed forces of the MPLA government (Popular Movement for the Liberation of Angola) - resulting in heavy fighting on both sides. Continual ransacking, bombing and land mining of the towns in this area frequently forced the civilian population to take to the bush. Young men were seconded to fight for one side or the other and people of all ages were used as porters for military equipment and supplies resulting in their ill treatment and starvation.At the end of the war during 2002-2003, an area 14km from Xa Muteba was used as a major de-mobilisation camp for soldiers from both sides, as well as a feeding centre for the malnourished children of thousands of refugees returning from the Democratic Republic of Congo and other areas. MSF became involved in the demobilisation camp, running a therapeutic feeding centre and assessing the surrounding area. It soon became apparent that there were absolutely no health services for the returning population prompting the set up of a Basic Health Care project in Xa Muteba. By 2005 the project involved an expatriate team consisting of a Project Coordinator, a Medical Doctor, a Nurse, a Midwife and a Logistian and a local team of 18 national staff. MY ARRIVAL
I came to Xa Muteba in July 2005 as the new field logistician - a fresh recruit to MSF. My previous work experiences had been in the technical and project management areas of the entertainment and TV industries. Wow - what a change! I arrived in Xa Muteba after a gruelling two-day road trip to find that our accommodation was in a huge warehouse with standard MSF tents set up inside. Bedroom separations were made of bits of material and the whole place was covered in bat excrement and red dust from the street outside which was the main, and only, trucking route to the diamond mines and towns further east. My first big job was to build a new compound. A fantastically experienced and eternally calm assistant, Dié He, and I (with the assistance of about 45 other guys), built a combined office, warehouse and residence complex in three months. After this effort I had a week’s recuperation in Mozambique, only to return to a measles outbreak. The real work soon started as we began to get vaccines and medical supplies flown in along with an influx of expatriate and local MSF staff. We also set up another base in Cafunfo to service the north of the Municipality of Xa Muteba. This was a very interesting period for me. My work involved setting up the base in Cafunfo with communications, energy and accommodation whilst maintaining a supply of all items. In the mean-time Dié (my assistant) kept things flowing in Xa Muteba.
We were running vaccination teams from both locations, with our brand new English doctor, Sam, leading vaccination teams into the remote north of the municipality, going from village to village and vaccinating the children. It was here, when I was doing registration of the children, that I started to understand the extent of the war. Some parents had no idea of the birth date or age of their kids. One parent explained to me that for years he and his family were in the bush escaping the fighting. During this time they had no idea of what year it was, let alone the day or month. They were too busy trying to survive. December was a hard time for us on the project as the wet season hit and Chiara, our eternally happy Italian nurse who ran our outreach clinics, got malaria. Then I got it–- twice. The second bout, around Christmas, was somehow a double dose of both Falciparum and Ovale at the same time. Apparently Ovale hardly ever occurs in Africa. Trust my luck! The New Year soon kicked in and I started my logistics team on a construction and renovation programme, turning the old hospital building into a TB clinic. We built toilet and showers, an outdoor kitchen and cleaned up the health centre waste area. There was a fantastic feeling of accomplishment after months of not being able to gain access. The Extended Immunisation Programme (EPI) really started to get going with daily Polio, Tetanus, and Measles vaccinations. We rented permanent houses for the outreach clinics to better service the population. There was so much to do.
Time seemed to go by very quickly, and suddenly it was the end of my mission. The whole Xa Muteba team threw a really big party for me. We danced Kazomba, which is the national dance, and the team gave me a replica football shirt of Flavio, the striker from the Angolan national team. On my last night the MSF Medical Coordincator asked me if I would consider extending my time in Angola. What had seemed like a small cholera outbreak in February was now reaching epidemic proportions and MSF needed a logistician in N‘dalatando for an exploratory mission. Then started two of the most full-on weeks of my life - I was first involved in the exploratory mission and then went to Luanda to coordinate the construction of a new Cholera Treatment Centre (CTC). This was an intense building experience and after a two hour hand-over from a very experienced MSF logistician (who had to go off to another emergency somewhere else in the world), I got to work 14 hour days with 50 local workers. The buzz that kept us going was amazing. There were people getting sick from cholera all over town, and we all knew that the sooner we got the centre built, the sooner the medics could begin hydrating people and start saving lives. A week later the emergency team arrived, and I handed over the project just as we were about to open the first 100-bed section of the new CTC. I drove back to N’dalatando the next day to complete my last week in Angola .The situation had gotten a lot worse there however after a lot of negotiating, we managed to secure a new building to turn into another CTC. The best bit was that Dié (my assistant logistician from Xa Muteba) was sent to help me in the last two days. Jason is now back in Tasmania, Australia, on a break before considering
his next mission with MSF. » Read, listen and watch more updates and reports from Angola
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