© Beatrice LAU
In order to provide efficient and effective medical assistance, logistical support is always of the same importance as medical action in MSF, especially in medically complicated settings. As a non-medical volunteer in MSF, Yuan Pan who is now working in a multi-drug resistance tuberculosis (MDR-TB) project in Uzbekistan, is the best one to illustrate the significance of a logistician.
I come from mainland China. Several years ago, I worked with MSF as a national logistics staff member in a tuberculosis (TB) project in Nujiang valley, Yunnan province. During that period of time I learnt quite a lot about TB. In a TB project, if a patient failed to complete the whole treatment for months, he/she would probably develop MDR-TB.
As a non-medical person supporting the project, I had many questions about drug resistance in my mind and also why MSF could not try to treat patients with resistance there at that time.
Medical professionals told me that due to the cost and logistical-medical implications as well as geographical limit, treating MDR-TB in Nujiang valley was not feasible. Frankly, this answer was rather depressing. Doctors admitted that for those who had MDR-TB in Nujiang, it was like having a death sentence and there was no other way in sight. Since then, how MDR-TB patients could be treated remained deep in my mind.
Then I worked with MSF as an overseas volunteer in Bangladesh. I had been longing to work in MSF's pilot MDR-TB project in Uzbekistan, since I still worked in Bangladesh and came to know the pilot project. Finally after some months of gap filling in Sierra Leone, I arrived here in June 2005.
I was so excited and happy when I heard about this pilot project as MSF is trying to gain some experience in treating MDR-TB in developing countries. I always hope that, patients like those who have MDR-TB in Nujiang valley will have the hope of a cure one day. At least this is a step forward¡KI am proud to be part of this new pilot in MSF.
Uzbekistan is a very mixed and colorful country, with the larger part of the country having very distinct seasons, cold winters and hot summers. It has a good mixture of many ethnic groups, from Russian (eastern Europeans), central Asian as well as quite some north-Korean descendants. So I blended in very well, being most of the time recognized as "local".
Complicated Treatment Demands Potent Logistics
© Beatrice LAU
The MSF MDR-TB project is located in the northwestern part of the country some 1000 km away from the capital Tashkent. Beginning in 2003, the project now has around 160 patients on treatment at different stages of their treatment.
The treatment of MDR patients is medically very complicated and demands potent logistical support. Owning to the nature of MDR-TB treatment which is so different from 'normal' MSF medical work, our logistic work is also unique in the kind of support provided. Here are some kinds of support that are normally not in a typical MSF program:
We have to cope with extreme temperatures ranging from +50°C in summer to -30°C in winter.
We have to handle infection control from air circulation, and use UV lighting for the immediate environment surrounding patients to proper disinfection of highly infectious waste.
We are supporting the allegedly most sophisticated Mycobacterium laboratory in Central Asian
We have to deal with complicated supply of second-line line TB medicines, which are not widely available in the international market compared with other medications. It is a rather demanding work for logisticians to closely follow up the monthly use of second-line drugs and to ensure no disruption of drug intake for our patients.
We have to know what we are doing medically deeper as non-medical to ensure the support.
Since I came here, I have read the treatment manual over and over again to understand how our logistical support can be more effectively executed as everything comes down at the end to the treatment of patients.
After a year being here, I think I have fully understood the correlation between our medical work and logistic work, especially in terms of supply administration of MDR-TB treatment which is the main part of the logistic support.
Greatest Challenge As Well As Achievement
© Beatrice LAU
For more than one month, I have been spending lots of energy concentrating on a computer programme that helps in calculation of the need for a second-line drug at any given time for the next 48 months. This is important as we need a reliable system which is less dependant of the computer literacy of an individual, but rather more dependent on the medical data in the past, as well as valuable medical input from our doctors.
This process of understanding the supply and need of drugs for this project so far has been the most challenging part of my work as well as the greatest achievement of my time here. After working here for over a year, I am leaving the mission in one month. I will surely keep in contact with the team and I am ready at any time to give support to any other MDR-TB programmes that MSF would be engaged in the future.
As the one of the few Mainland Chinese overseas volunteers with MSF, I could not have been more proud of having the opportunity to represent China in the MSF movement worldwide, besides the personal fulfillment of being able to help the needed in such a movement.
I have met many Chinese working overseas for different reasons. Most of them are very closely connected but do not really engage themselves within the local community or other people working outside. I do feel that there is a need for Chinese people to know others in other countries/cultures and to appreciate other cultures rather than only looking at our 5000-year-old culture and at the same time to let people know us better.
Opportunity to Appreciate Different Cultures
The most intriguing part of the life away from home is the opportunity to appreciate very-very different cultures, and to work on a day-to-day basis with people from vastly different cultural backgrounds, like working with your national counterpart and/or colleagues as well as your international colleagues from many different nationalities. I believe this experience is very personal and individualized and to me it's beyond my command of languages to express what it really means to me. Of course it makes you truly understand why MSF is still needed in so many places. I guess one will have to discover it by oneself.
But at the same time, this life makes you miss and appreciate your own culture from another angle in a way that otherwise you would never have appreciated if you had not taken this step. For me, I keep discovering how little I know of my own culture and history while talking to people from different cultural backgrounds on basic world issues.
To me, an indispensable part is the Oriental kitchen, which I always miss the most besides my family and friends. I am enjoying this type of life very much so far, though after sometime you do need a break back home and get "re-united".
PAN Yuan joined MSF in 1998 to provide logistic supports to several MSF projects in China. Since 2001, he participated in the missions in Sudan, Bangladesh and Sierra Leone as a logistician. Now, he is working in a multi-drug resistance tuberculosis (MDR-TB) project in Uzbekistan as logistic coordinator.