John Bunnell, a resident of Bali for nine years, was ravaged by war in Syria as a logistician for two and a half months working in a Doctors Without Borders hospital infiltration field (Doctors Without Borders). Here, he shares his experiences of the first line.
Our field hospitals in Syria were "infiltration". First, we ran a hospital in a cave, then he was moved to a farm operation not a better place and we could adapt it to reduce the risk of shell or mortar shrapnel. When I arrived, the field hospital was already operational, although a rough manner. There were still things that needed improvement and a constant threat throughout the hospital could be moved to another location within a short time. The look of the inside hospital is quite normal, but it was obvious it had to be made operational quickly. The same old inflatable operating theater of the cave was used for sanitary and privacy issues. It also has emergency rooms, inpatient and outpatient, a busy maternity service, which we expanded and even a component of mental health.
Helicopter drums and bombings were quite continues in the "free" area in which we were working. That said, the hospital has never been targeted, but you could hear the explosions at any time of day or night; some being worse than others. MSF has been very adamant that every future field agent to the project completely understood the situation they were getting into. It was a mission in a war context in its purest form. We had war wounded coming in quite regularly, and some big massive losses just before I arrived. That was our main goal to be prepared for.
I went as LAF (Log / Administration / End). I find the administrative part of the job to be cumbersome for the rest of my work. There were major changes in human resources (HR) had to be done that required a lot of attention. The decision was made to hire an HR expert to give me some relief; making it possible for me to focus on the pure logistics. Before the war, Syria was a developed country, and many of our national staff were trained to some degree. I was fortunate to have the help of an excellent national staff in my department towards the end of my mission.
The actual compound of the hospital is not very big, so it was easy to move. We also had two rental houses in the valley, an outpatient clinic, three mobile clinics and a first aid station that the necessary attention. My duties have led all aspects of the logistics of MSF regular, but was told to focus on communication as a priority when I arrived. Communication was very difficult and too much time was spent in pursuit of it. I think it was well treated while I was there.
Food, surprisingly enough, has worked quite well, relatively speaking. We could get very simple things of the community nails, cement, gravel, drums, and basic food products. The majority of medicines and other medical supplies were legitimately brought by legal border crossings; other more normal articles were regularly moved through the border to a variety of content using a variety of means. All the lots required good contacts and networks to ensure that we received the medicines and supplies quickly to the medical team to do their job. All these movements, including the passage of the staff were among the most amazing I've seen in my life. The movements and passages modified by day and sometimes by the minute. I am amazed at how our staff removed these situations on a regular basis!
In Syria, security was also on the top of the priority list. We had some unfortunate incidents where people came with weapons. No one was injured, but it is disturbing to say the least. This made us quickly look at how it should be corrected immediately. It is a basic rule of thumb for MSF projects around the world that we will treat anyone who needs medical assistance, including soldiers or rebels, but all weapons must be left outside the center MSF.
In the context of war, there were inevitable incidents that could compromise the safety of our staff and patients. Physical changes were made to the hospital at the end of my mission to help address these important issues. I am mainly involved in the practical side of security -Training watchmen, do physical systems from input to screen people who come to the hospital and into a weapons-free zone. We set up entrance where staff and patients alike are examined before they enter the vicinity of the hospital. There are "layers of barriers" or various stops before getting inside it is a mass for the victim, for the registration of patients and for staff.
daily safety meetings were a key part of our day. The field coordinator and I, as well as medical and focal point security adviser, held daily meetings in the morning followed by another that involved the whole team. On ordinary days, we met twice a day. On bad days we had a lot more! I've never experienced such complete security meetings in any other mission.
The safety meetings are not just for the safety of personnel, but also to prepare for what will happen next when we expect an influx of patients, what kind of injuries we wait, that might work and management of cases of patients, what is necessary, we have enough supplies, are there going to be massive losses or just a handful of people injured.
It was a very difficult task because we were in a war. Although she was one of my best mission ever, it was a very sad and horrible situation for Syria. I would go back if I was asked, however.
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