“What I am doing here?” was the question that clicked into my mind on landing at Hargeisa airport. I had been looking out of the aeroplane window to see if it was a big town, and was astonished to find that I could hardly see the runway and was in for a bumpy landing.
It was 5 December 2011 when I joined Médecins Sans Frontières (MSF) in Somaliland as an expat laboratory scientist. Before that I had worked for MSF as national staff in Pakistan for six years.
MSF started providing humanitarian assistance in Somaliland to fill critical gaps in the healthcare system, beginning two projects in the middle of 2010: one in the capital, Hargeisa, to support nutrition and basic healthcare; another in Ceerigabo town to support the regional hospital in providing secondary healthcare.
I joined Ceerigabo regional hospital, in Sanaag region, in the north of the country, where local control is disputed between the Somaliland government and Puntland, an autonomous region of Somalia.
The security situation was good, with sporadic incidents involving gunshots fired in the air or personal disputes. Being a clan-based society, the influence of the clans was felt in most areas, from hiring and firing to renting cars, and it was of the utmost importance to keep a fine balance – not only to save our skins but to stick to MSF’s principles of neutrality and impartiality.
Personnel from the government’s Special Police Unit (SPU) were around all the time to accompany us from hospital to compound and vice versa, and on occasions to go to nearby downtown. This is one of the few missions with an armed escort, contrary to MSF’s policy of unarmed guards. Most of my expat colleagues found them completely moody and, being paid a very nominal US$40 per month salary, they were always asking for a few dollars to buy khat (green leaves chewed as a stimulant) or cups of tea and recharge their mobile credit.
While I was there, MSF activities were scaling down, as the central management team had already decided to close down the Ceerigabo project by June 2012. The Hargeisa project had already been closed in the middle of 2011. Major need assessments were carried out in the second half of 2011 in Sanaag region and in southeast region of Sool (a disputed area between Somaliland and Puntland, where local political and militia groups aim for autonomy). But all the needs, including Ceerigabo hospital, were found to be developmental rather than emergency, which did not fulfill the intervention criteria of MSF OCA’s strategic plan.
The expat team consisted of a project coordinator (PC), administrator (Log admin), nurse, midwife, plus myself as laboratory technician cum medical focal point. Along with the national staff, we were committed to do capacity building, in terms of rigorous training and planning, while scaling down activities. At the same time, the central management team was looking into finding a better handover partner.
We all enjoyed good teamwork, from the capital to the field, whether in the hospital or in the expat house. Finally we were able to find a local doctor and surgeon to act as a consultant to manage the hospital. But, as always, MSF – being an emergency organisation – was not very good in exit. We all had mixed feelings about the handover and closing down of MSF OCA in Somaliland, as we had done a great deal, whether building infrastructure and supply, training national staff, or putting systems in place. So it was a bit sad, but also happy in the sense that the handover went very smoothly, without major concerns over human resources, thefts or other security issues.