A business secondment at Medicine Sans Frontier, Sierra Leone

Magburaka, Sierra Leone, September 2017

All started on the Friday before CitS 2016. Mentally already in the snow, but physically in Paris for a pitch to do a supply chain project at Medicine Sans Frontier (MSF). Since I started my career, I always have had the ambition to apply some of my consulting and supply chain skills to an emergency situation in the developing world. During the project – which we won despite the distraction from the upcoming CitS – I decided to plan a business secondment at MSF to work as a supply chain manager in one of their missions.

MSF is a humanitarian organization, mainly focussed on providing medical care in emergencies. To maintain operational autonomy, missions are set-up as independent sub-branches. All have their own HR and finance department, as well as supply chain and logistics teams. Together this should ensure that a clinic or hospital full of doctors, nurses and medicine, is properly constructed, maintained and equipped, has water and electricity supply, internet, budget, supporting staff, and safety and security procedures.

In February 2017 I was off to Magburaka, Sierra Leone for a nine-month mission. As a supply chain manager I would be responsible for distribution of medical items, stock management, order management, purchasing and supplier relations. At the moment of writing I have four weeks to go, and without a doubt I can say that it was a truly remarkable time. Let me try to explain why, by giving three reasons:

1.       The satisfaction of bringing an idea to life

2.       The challenge of managing operational crises

3.       The opportunity to develop some new perspectives

1) The satisfaction of bringing an idea to life

The thing I love most about consulting – its strategic and conceptual nature – has one drawback: results are often visible only after a period of 1 to 3 years. Not here. Soon after my arrival, the project circumstances required to centralize all medical and logistical stock into a single location. To do so, we had to redesign and rehabilitate a newly rented property and turn it into a new warehouse including a 18 by 26 meter cool room. To manage something tangible like a construction project and see the idea being realized by a team of capable and motivated technicians and labourers, was truly an unforgettable experience. In this blog you can read and see how we did it. All war stories aside, the operational nature of this job gave instant satisfaction. And that has nothing to do with the somewhat sentimental idea of ‘doing good’ for people in need.

2) The challenge of dealing with operational crises

Over the course of nine months, there have been multiple small and larger crises that directly or indirectly affected our operations. Whether it is providing relief supplies after the deadly mud slide of August 2017 in Freetown; selecting daily workers without tribal-bias; resolving power cuts and water supply issues; interpreting the fear for ‘black magic’ practices; reducing the impact of a cold chain breach, all require to remain calm but be decisive, stay impartial and neutral and act with sensitivity for the local cultural context and customs. The challenge of dealing with these crises is certainly something that made me a better and more complete manager, equipped with a more diversified pallet of management styles.

3) The opportunity to develop some new perspectives

Sierra Leone is amongst the poorest countries in the world. During the nineties it has been suffering from a civil war and more recently it was fighting Ebola. At present, the country is very safe to live and move around. Its people are very cheerful, hard-working and resilient, and they live peacefully in a society that is proudly lifting itself up. Basically, the sort of stories that people return with after their secondment abroad or holiday in Iran, Mongolia or any other off-the-beaten-track destination. However, slightly different from the stigmas that are attached to many African countries. Sure, I had my own prejudices and some of them were reality. The point however is that an occasional get-away from our little bubble works refreshing. An example is the slaughtering of a goat for the evening’s BBQ, which made me more conscious of my own meat consumption. Or the comparison of the national staff’s weekly wage, which is equal to an expat’s per diem to spend on food, which again is equal to two billable minutes of a Deloitte manager (nothing romantic about the 60% unemployed btw, but the relative difference compared to zero is so hard to compute). And lastly, the incredible proudness my staff expressed when I announced the upcoming visit of my dad. They just couldn’t believe that their town would be worthwhile visiting for someone not being an NGO worker. All of these experiences made me reflect, laugh, cry, shiver, gave me Goosebumps, made me homesick, or wanting to stay longer…

Full of energy and new inspiration, I will resume at Deloitte Consulting per November 1^st. Let me know if you want to know more about a business secondment at Deloitte, MSF and its operations in general, or anything else more specific

Project Warehouse

Mid-March. Finally we receive the keys of a compound at the outskirts of Massoko, Magburaka. During Ebola times, it served as the nerve center for Ebola-response activities. Think of storage of protection suits, boots & hygienist supplies, administration of Ebola cases, deaths registration, and payment of the high-risk allowance to health and sanitation workers as well as logisticians. For one and a half year, many Sierra Leoneans and foreign aid workers, operated in or near areas with Ebola patients; so called high-risk zones. A lot of our staff - when in a comfortable setting - tell the most horrendous stories of colleagues and friends they lost, the stress they experienced while working near patients, the awkwardness of the no-touch policy, and the contact-tracing that happens after each diagnosed Ebola-case. Our IT officer even was a suspected case himself. As such, he spend two weeks in quarantine, fearing for his life.

MSF's plan was to refurbish the big building inside the compound, to create a cool-room warehouse for storage of medical supplies for the Magburaka governmental hospital and six outreach locations across Tonkolilli district. Cool means twenty-five degrees, so a couple of A/Cs and insulation material would do the job after the 18x45m big room had been partitioned by a wall and ceiling. The entire thingy had to be constructed and fully operational with electricity installed and stocks moved within five weeks. The only reason we made it, was the abundance of skilled and incredibly hard-working individuals that we were able to temporarily employ as flexible workforce. A sequence of events...

Before construction could start, we had to relocate its household. Amongst other things: 341 bicycles, 1 conference table, 23 conference chairs, a set of ladders, and a 16kVA generator. Other preparatory activities consisted of replacement of locks, cutting of grass and plantation as a preventive measure against snakes, and installation of water and hand-washing points

Then we made an attempt to re-paint the gate-wall...

After emptying and cleaning the room becomes clear why smart, urban hedonists were able to turn abandoned buildings of large European cities into cultural hot-spots. What a brilliant location to throw a party

To avoid artificial, cool air flowing-out, and natural mosquitoes flying-in, ventilation-windows were cemented or covered with thin metal 'mosquito-mesh'

Then, suddenly, from nowhere an angle arose who took a grinding machine to cut the lock off the large metal gate, to grant access to day-light

In the meantime, a welder was busy making a frame-sample from angle iron bars. Each frame (approx. 4.5m by 4.5m) would consists of four quadrants. At this stage, the importance of standard building-supply measures became clear. Considering standard measures (e.g. plywood, 4x8ft; timbers, 10ft; angle irons and PVC ceiling, 5.8m) while making the design, significantly reduces waste, hence costs. Yes. I understand. But its quite enoying if one needs to reconsider the entire design when 4 inch short on ply-board.

Positioning poles on a wobbling floor-surface in-between skewed walls. Arghhh.. Measuring. Marking. Measuring again. Marking again. Digging holes. Fixing the first pole with mortar and ball stones [..] Starting the forth pole. Measuring again. Wrong. Marking again. Removing the first pole. And on and on and on..

The 24 angle iron frames would be closed with each four sandwich-panels. A panel is constructed from a wooden frame with PVC ceiling at the bottom, plywood on top and insulation material in-between

Then a factory-line for wooden frames was set-up

Due to the building interior (gates, reinforced concrete beams, side-room with door) each metal frame and therefore wooden-panel got slightly different measurements. Before separating frame and panel, all were tagged

The first metal frame is lifted

Wooden panels are top-side closed, and the room gets its cover

At that moment someone found Styrofoam. Not really of course. It just sounds cool..

This was the start of a puzzling-exercise to finish the sandwich panels

There even was some left-over for the partitioning wall. A real energy saver. No joke. So true

 

The beauty of modular construction

And then there was light at the entrance of the tunnel

The welding company that delivered a good job of welding the frames and poles, was asked to construct a metal door with look-through

Meanwhile, a support team from Freetown was busy assembling the warehouse furniture from the same angle iron bars that formed the frames. Polishing, painting...

..labeling

To give the room a face, painting was one of the final sagas

To keep the room at 'cool' temperature, we estimated 4 to 6 ACs were needed, depending the time of the year, and how good of a job the insulation material would do. Electricity supply in these contexts is mostly established through diesel generators. These could function both as permanent solution as well as back-up, given the occasional city power shut-down. At this stage I realized how little I know about current, amps, poles, load-balance, breakers, change-overs, types of cables, related color-coding, and that common sense does not make a surge hurt less or a short-circuit have less impact. (Nothing terrible happened)

Then on Sunday-night, April 9 the job was done. Not really of course. The leaking roof still had to be repaired. Due to a lack of Styrofoam we could not finish all ceiling panels. Lighting was temporal. The small side-building that would serve as the supply office required some renovation. All in all not major show-stopper so the next morning we could occupy the room with ugly boxes again..

 

Honestly, my role was minor. My primary task was to design the warehouse layout and purchase the construction supplies. All credit goes to my technical colleague and the team of capable and motivated daily workers, who worked there asses off. Employment is so scarce here, so apart from being a medical organization, MSF is an employer and learning opportunity for carpenters, plumbers, electricians, masons, painters or general laborers. Their hard-working mentality - inspired by their appreciation for being offered this job - really makes Sierra Leone different from any other country I have worked so far.

All in all, the whole thing was a really cool and satisfying experience. To work on something tangible like a construction project, and together make it happen in such short time frame. That was truly an unforgettable journey.

A regular Saturday morning

Fortunately Saturdays are less unpredictable, less rush, less man-made 'emergencies'. It can easily happen though, that you need to operate the fuel station immediately after your pancake-Italian coffee breakfast (don't feel sorry for me;) because circumstances did not allow the drivers and guards to refuel vehicles and generators on Friday, just before the weekend. This time Easter was the cause, with Good Friday as public holiday.

Normally we use a regular fuel hose with proper flow rate to do the job quickly. As we had to prepare for maintenance to our steel fuel tank (small leakage on the discharge pipe) we emptied our tank completely. During the maintenance-period we are relying on a buffer tank and 20L jerrycans to do the weekly refueling process: today just over 580L, so 29 'yellow rubbers' only...

"Opotto"

Cycling across town feels much like Sri Lanka. A lot of smiling faces, people shouting for a little attention or just a simple answer to "Your name?" or "How are you?" The most heard catchphrase while cruising around is "Opotto, opotto" referring to the Portuguese discoverers that invaded Sierra Leone, more than five centuries ago. The attention from groups of children and strangers passing-by is pleasant, although at times I miss the 'escaping' in the crowd. The feeling you get when you go to a proper rave, making your way to the DJ booth or hidden stage. Speaking about going to a rave. That is probably one of the activities I miss the most. The nightlife is lively, with weekly shows of local performers, dancers, afro pop-artists and even comedians. The venues are very creatively set-up with small festival-like areas - sometimes aside a junction - being fenced and colourfully decorated. Inside there is a stage, of course a dancefloor, chairs for the elderly seeing their grandchildren rock, and a lot of little joints hosted by local business-seekers with cool boxes selling drinks and snacks. The music is what I define as afro-EDM: A beat above 130 BPM, rapping vocals which are sometimes a bit screamy, and high beeps and swinging drums. The whole cocktail creates a truly happy, ‘hands-in-the-air’, danceable sound and that is also what I do most of the time. However it is just not 'my' type of music, so mostly I do not make it through the next morning…

Then a thing that consumes my thoughts a lot these days: the positive discrimination that comes with being an "Opotto". Children are so much indoctrinated by the idea that white people are a 'special' kind, that walking around can be quite awkward and embarrassing. To me it creates a big despair on how to behave and respond to the continuous greeting and staring. Of course, all comes from good intensions, but actively saluting or responding nicely triggers more of the same anti-discriminating behaviour. On the other hand, who am I to think I can change a mind-set that has been around since the Golden Age, by walking around like an asshole and ignoring friendly greetings and eye-contact? And then lastly: How I dare, with all my privileges and conveniences that come with my place of birth, to be disturbed by such innocence. Let's say I have the next months to find my way...

The rest of the last weeks where occupied by the design and construction our new warehouse, preparing for the move of our medical stock to the new location, donating some of our overstock, and doing on-the-job training of the basics and intermediates of Excel. Some can already work with formulas, others never worked with a computer before: "This is the keyboard, it consists of all letters of the alphabet and numbers from zero to nine. These are the arrow keys to toggle through your worksheet. To activate a formula start with the is-equal sign." Leisure activities varied from playing football, watching a match between the local Kalidu F.C. and the next village’s squad. Going to the river for a weekly splash. Being fascinated by kids playing bare-hand tennis on the street. Schoolboys imitating the Fostbury-flop to jump over a wooden stock held up by two individuals. Visiting Burah beach for a relaxing weekend off-the-compound. Staring into the beautiful sun, creating a magnificent light over the fields that surround Magburaka.

4TP and crew...

Arrival in Freetown and Magburaka

My very first encounter on Sierra Leonean soil was in Dutch with a Belgium, grey, old man. His son had started a biological vegetable-farm in the capital of Sierra Leone. While speaking we were waiting on the speedboat that would take us from the airport to the Freetown ferry terminal, which would be five minutes drive from my temporal house.

Upon arrival in the compound, Bonno (also a Dutchman) and Lisa (my Australian boss) welcomed me and gave me a tour through the house as well as something to eat. What followed was a couple of days with a lot of meetings to 'brief' me on the current project status and context. I went to the beach to have a beer with Andreas, and we went out to listen on live music and dance on local afro-pophits. On Friday I took a stroll to discover the neighbourhood, I almost got lost but all people seemed to know where I had to go: "The MSF Holland house? Go straight and left at the junction."

On Saturday it was my turn to join the KISS-movement. A process where two cars with different origins drive towards the same KISS-point, where upon arrival they exchange passengers, luggage and cargo, and then return back to their origins. My destination was Magburaka, the capital of the Tonkolilli district. Here, for the coming nine months, I would take the role of Supply Logistician, a sort of Supply Chain Manager responsible for all the international and national supply of medical and non-medial goods. I would not do this alone, but together with my team of 6 national staff members.

As I arrived in the weekend I had time to: meet the team of expats; 15 in total, nationalities varying from Kiwi to German to Ugandese to Polish. Visit the local market in Makeni; a pretty chaotic but by all means peaceful place. Go clubbing in Paparazzi, a local dance-joint with speakers and a bar that sells STAR bottles. Play volleyball in our garden; lots of grass, plenty of space, a hammock and enough shade from trees. Walk along the Rokel River, take a dive and cross the passenger bridge; pretty scary.

On Monday it was time to work. First moment of semi-shock: That weekend I had forgotten to check the fridge temperature. Most medical items require a temperature controlled environment, the bulk is stored in an air-conditioned room to keep temperature between 25 and 30 degrees Celsius. Some medical drugs need to be stored in fridges at a temperature between 2 and 8 degrees. Daily temperature checks are part of the procedure. This is due to the high value and criticality of these drugs, as well as the possibility of incidents due to generator failure or, like this weekend, an overheated A/C resulting in a fuse that was blown. Fortunately, my colleague had discovered the issue early enough to avoid a cold chain breach (a situation where temperature is so much or so long off-spec that it expires the drugs.)

The following week was great. I met my team of six eager beavers. We completed the reception-puzzle: Making sense of tons of international cargo that arrives in containers with pallets and stacked boxes that contain smaller boxes, parcels and eventually jars with pills, sealed needles and surfical masks, and little tubes with power to make injection solution. Obviously, not the product description nor the product ID number is clearly indicated on each box. This makes the whole exercise a quite manual matching process where VLOOKUP cannot be applied. Also, I found myself trying to open a 40ft container with my consulting fingers. A 40 ft container is a 'unit of measure' I used a lot in my Excel sheets, with the exception that I never had to open one. Lastly, we signed a contract to rent a former World Food Program location; a huge courtyard with a squared warehouse of 20x45m, in which we will centralize all our medical, electrical, construction and water-sanitation inventories. These are now scattered across three locations and multiple physical places.

Apart from work I discovered that the team of national staff, 150-200 people varying from nurses, guards, drivers, health promotors, administrators, storekeepers etc. was quite active in organizing shows and various parties. My supply chain officer Claudius, organized a show on Valentine-Tuesday, bringing artists from Freetown (capital of Sierra Leone), and 4TP, the radio operator had his very own album launch last Saturday night...

All in all a great start in an even more facinating context of people, work, surroundings, culture and encounters. No Wahala.

Paulista

Grünau to Noordoewer - 138km

De langste etappe voor het laatst bewaard. Een tijdritje van 138 kneiters tot de laatste Namibische nederzetting vòòr de grens met Zuid Afrika. Na een uitgebreid ontbijt en inladen van toated sandwiches voor lunch neem ik afscheid van de Fransen, ze nemen de andere tar road naar ZA (direction Karasburg).

Kwart voor negen op de fiets. Het is niet super warm, wat sluierbewolking. De weg lijkt rustig. Als ik Grünau verlaat dringt al snel tot me door dat de laatste stretch totaan de grens echt leeg is, niet alleen qua bebouwing, maar vooral qua landschap. Het is leeg, zandig, enkel grasachtige begroeiing met af en toe een boom. In de leegte, turend naar een hoge duin schreeuw ik het uit: dit is de reden dat ik fietsend reis. Er staat een harde noordwesten wind (voor mij zijwind van rechts), door de kromming van de weg heb ik hem soms licht in de rug. Het grootste voordeel is echter dat het vandaag gemiddeld genomen dalen is: van 1050m hoogte naar 250m. Ik stop bij een picnickplaats voor water en snacks, er slaat ook net een auto de grindstrook op voor een break. Er springen een paar kinderen en ouderen uit de auto en we raken aan de praat en maken grappen (die pad is kak, foto's? No, do you have some food?). Ze gaan naar een concert van Mariah Carey in Kaapstad (eerste keer dat MC in Afrika optreedt). De twee vrouwen gaan erheen, de twee dudes gaan vooral drinken en op de kids passen. Uiteindelijk geven ze me een knijpkat (omdat ik moet overleven) en maken we foto's. Het is op ongeveer 70km dus nog de helft te gaan.

Na 100km krijg ik het zwaar. Het gaat ook opeens valsplat omhoog. Ik realiseer me dat ik geluk heb gehad met de omstandigheden (vaak tailwind en licht omlaag) en dat ik daardoor vaak rond 1-2 uur op plaats van bestemming kon aankomen. Boven aangekomen kijk ik neer op de grens met Zuid Afrika, een klif-achtig gebergte dat lager is gelegen dan waar ik me nu bevind. Ik realiseer me dat ik er bijna ben. Het geeft een machtig gevoel. Met gebalde vuist juich ik elk tegemoet komend voertuig toe. Het is een onweerstaanbaar uitzicht: ik kijk neer op een lager gelegen gebergte. Vanaf nu knalt de weg ook enkel naar beneden, ik denk dat ik de 50-55 wel aantik. Via de sloppenwijk van Noordoewer en de bottleshop/supermarket van Dina kom ik terecht bij Orange River Lodge. Ik trek de lycra uit en trek paarse adi short aan: zwembad en Tafel Lager. Het zit erop.

Canyon Roadhouse to Grünau - 73km

De weg terug is ingezet. Laatste ruk dirt road ook, vanaf morgen is de B1 weer m'n vriend en eventueel de N7 in Zuid Afrika, totdat Roel en Steffie met gevolg me opslokken.

Het stuk naar de C12 (dat ik met de Duitsers heb gelift op de heenweg) is geen topper. Het kost zo'n 75 minuten voor 18 kilometer. Daarna gaat het beter: vlakkere weg en aan het begin van de middag wind vol in de rug hetgeen me in staat stelt in de zwaarste versnelling te vlammen. Onderweg kom ik een soort bloem-achtige rotspartijen tegen. Ronde vormen van opeengestapeld rots, Lucky Luke zou weer niet misstaan. Voor lunch een broodje mozzarella, tomaat, pesto, meegenomen van het ontbijt (met toestemming): kneiter lekker.

Uiteindelijk draai ik iets voor 1 uur het terrein van Country Lodge op. Ik tuk in een soort stenen tent, verder niks te doen behalve beetje chillen met red-necks in de bar die hun verdiende geld stukslaan op brandewijn en wiskey met Cola. Ik eet met een Frans echtpaar, ze hebben in Jo'burg gewoond, later kom ik erachter dat de man eigenlijk Portugees is en uit Angola (Portugese kolonie) heeft moeten vluchten toen dat land onafhankelijk werd. Eten van het bufet is ok, het is best gezellig, maar ik ga morgen weer fietsen, niet een dag verdoen in dit gat.

Rondje Fish River Canyon - 48km

PDie pad is kak, zouden Afrikaners zeggen. Maar deze weg is echt kak, slechtste tot nu toe. Van dat golvende wegdek waarvan je het gevoel krijgt dat je je fiets en je lichaam totaal niet onder controle hebt.

De tocht naar Fish River Canyon duurt daarom langer dan geschat. De Canyon is schijnbaar het derde grootste door een rivier uitgeslepen gebergte ter wereld. Na Grand en nog een in Mexico. Omdat Namibië enorm uitgestrekt is, en ik met mijn actieradius van ongeveer 100km weinig flexibiliteit heb om 'even naar dat viewpoint te rijden', is Fish River mijn enige echte toeristische attractie. Dolle boel dus.

De weg gaat ligt omhoog (wat een kak weg, serieus) en opeens sta je aan de rand van een enorm gat met opzich best wel heel bijzonder uitzicht. Je kan kijken vanuit het dek of centraal gelegen uitzichtspunt, of naar een viewpoint lopen op 800m vanwaar je 'om het hoekje' kan kijken. Ik fiets erheen, niet te doen door al die rotsen. Vette stenen wel hier, blokkig, magma van origine, soms met pickles. Onderweg laat ik een foto maken met fiets. Het Poolse meisje dat met helpt met mijn triple-Laurens pano-foto wil ook naar AfrikaBurn, maar heeft nog geen kaartje. We praten even en nemen afscheid, ze moet de bus weer in van haar 6-weekse toer vanuit Tanzania naar Kaapstad. Later kom ik een ouder echtpaar tegen, het hadden m'n ouders kunnen zijn, nou iets jonger dan, de vrouw vraagt of ik ook naar het afrikaburn festival ga. Uhmm ja! Funky.