Flying pharmacist on the ground
The extreme heat and prevalence of dust, insects, and rodents make achieving optimal storage for all the medication that this busy hospital needs less than easy.
Not surprisingly, rats absolutely love the sachets of peanut-based therapeutic food that we give to malnourished children. They even devour oral rehydration salts if they can get into them. I’m usually working at the pharmacy from 7am to 4pm and one of our vital tasks at the end of each day in is to carefully rat-proof all attractive items.
It’s hard to believe that I’ve been here for four months already. Time goes so quickly and every day is a long one and packed full. I came here as a ‘flying pharmacist’ and my first job has been to provide short-term support to the pharmacy staff in Am Timan hospital.
When I arrived in May it was at the peak of the malnutrition season. With the arrival of the rains, the numbers of children presenting at the hospital with acute and severe malnutrition seems to have now reduced. Instead, the number of malaria cases has sky-rocketed, as stagnant pools of water left over after heavy rains are breeding grounds for mosquitoes.
Unfortunately, I do not think we have seen the peak of the malaria season yet, as the rains in Am Timan are late this year, so there are definitely more cases to come.
My three pharmacy staff colleagues — Abdel Aziz, Solange, and Hamat — are very patient with my sub-standard French and indeed have become my ‘professeurs’, so we manage to communicate quite well, even if it is not grammatically perfect. Communication in general is another challenge in a country with around 180 recognised languages. Furthermore, many of the patients coming to the hospital are illiterate and have to rely on verbal instructions on taking their medications. So, to best help our patients, instead of pharmacy labels as we understand them in Ireland, here we provide the medications with pictogram instructions.
As a pharmacy team, our goal is to improve the management of the pharmacy, its stock as well as the recording and analysis of consumption data — basically how much of each drug is being used. The whole issue of the consumption data is not super-exciting, but it is absolutely vital. Unlike your local pharmacy at home, we don’t get twice-daily deliveries. Instead, an international order for all our supplies is sent to our headquarters in Amsterdam twice a year and they are dispatched to us by sea. The quantities we order of each item are based on forecasted monthly consumption so we really need to know what we are actually using in order to get the forecasted consumption right. If we don’t, we run the risk of a dreaded “rupture” in stock — this is when we run out, and it really a disaster as it means a lot of hard work and expense to get something delivered by air in a short timeframe. Better data means more control over how and when we are using our supplies and so better service supply for our patients.
Hence, from 4pm to 7pm or 8pm, I’m usually working in the office back at the base, wrestling with my friend/foe — the Excel spreadsheet.
We often hold our meetings in the evenings as well, and with a large, diverse, and constantly changing team, it is essential to have good communication to keep our goals in focus and our plans to achieve them on track.
After work, I return to the compound for a couple of hours of downtime and chat with my fellow Médecins Sans Frontière colleagues. We come from all over the world and sometimes it seems a bit like the UN with several languages being spoken at once. Our social scene is limited, but occasionally we have movie nights or a volleyball game. Also, it is amazing how simple things, such as the arrival of the monthly food order, can create a party atmosphere — you have no idea how much the arrival of jam or cheese can make people happy.
* Louise Keane is a hospital pharmacist from Tralee, Co Kerry. She swapped her job in Kerry General Hospital to volunteer with Médecins Sans Frontières in Chad. She is mid-way through her first eight-month assignment.
Médecins Sans Frontières (Doctors Without Frontiers) is an independent medical humanitarian aid organisation working to save lives and alleviate suffering on the frontlines of wars, disasters and disease outbreaks. &
For more information on volunteering with or donating to Médecins Sans Frontières, see www.msf.ie
