A recent resurgence of violence in Central African Republic (CAR) has placed a spotlight on one of the world's most challenging humanitarian contexts, but Doctors Without Borders/Médecins Sans Frontières (MSF) has been present in CAR since 1997, and scaled up our presence dramatically following the start of the current conflict in 2013.
Canadian project coordinator Will Plowright recently returned from MSF's medical project in the town of Bossangoa. In the article below, he shares the story of one of his closest friends and colleagues in CAR, and highlights the crucial role that MSF's locally hired national staff — who make up more than 80 per cent of the organization's employees worldwide — play in our ability to deliver lifesaving care.
By Will Plowright
Often when we talk about the work that MSF does in countries around the world, we focus on the international employees, or "expats." However, sometimes we forget that most professional humanitarians in MSF and other organizations are locals; "national staff" members, as they are known, are people working in their home countries and their home communities.
I worked for six months at the MSF project in Bossangoa, Central African Republic (CAR), as a project coordinator, which basically means I was responsible for overseeing MSF's program there. CAR is a country plagued by poverty, and is regularly ranked as one of the poorest in the world. It is suffering through a war that has lasted for years, and the government is struggling to retain control of anything outside the capital. Our project served a catchment area of 400,000 people, with more than 120,000 patient consultations a year. This was in an area with no other healthcare provider, meaning that the community of Bossangoa was almost completely reliant on MSF's presence.
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A close friend and colleague
In addition to the 15 to 20 expats in the project, we had a team of 130 national staff. Although I had many friends in the team, the person I worked with most closely was a national staff member named Saint-Fort Ndilbe Dakanga, or simply Saint-Fort. He was hired as a driver, and although young, his application to a position of higher responsibility was soon accepted. Technically he was my assistant, however it seems absurd to call him that, because he did much more than merely "assist." Saint-Fort helped me understand the team and the context more than anyone. He helped settle disagreements within the team, aided negotiations with representatives from the government, and helped me to ensure that we had stable relations with the armed groups that controlled the area.
Soon after I arrived in Bossangoa, I decided I wanted to do something to recognize our national staff. I couldn’t bring myself to call it “Employee of the Week,” since I work with MSF, not Wal-Mart – and because we wanted to emphasize teamwork and not hierarchy. We decided on the much nicer sounding “Exceptional Colleague of the Week.” Each week we picked one person, gave them a certificate of thanks, and then I would take them out to lunch to thank them. The first exceptional colleague was Henri, who worked in administration. He received recognition for managing to keep his department running when all of his coworkers in the department were away. After Henri, there were many others who received the weekly award, including doctors, nurses, drivers and guards. Saint-Fort, however, was never among them while I was there.
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Henri Akahet, right, an administrator at MSF's Bossangoa project in Central African Republic, receives the inaugural Exceptional Colleague of the Week award from Canadian project coordinator Will Plowright.
Fixtures in the community
Each week I would consider making Saint-Fort the Exceptional Colleague of the Week, since it was clear to everyone that he was hard-working and dedicated. However, I was too worried that people would think I chose Saint-Fort out of favouritism, since we worked closely together. I let my own insecurity and inexperience get in the way of what was a relatively straightforward decision to recognize the hard work of a friend.
Sometimes we forget about the national staff, and we only think about the expats. We forget that the national staff are fixtures in their communities, leaders in their workplaces, and life-savers to the people that they help. However sometimes we do the opposite, and those of us who have gone to work in places like Bossangoa remember our national staff colleagues as fixed in their communities; as permanent in their workplaces, as impenetrable to dangers faced in unstable areas. We forget that they have their own dreams, their own career trajectories and their own vulnerabilities. I remember Saint-Fort in Bossangoa as though he will always be there. And it is this mistake that I am guilty of.
The last conversation I had with Saint-Fort before I left was during his formal evaluation, which is a discussion between a person and their supervisor about career development. I asked Saint-Fort to be frank and to tell me what he really wanted for his future. Surely, he didn’t want to be doing the same job forever? He told me that his dream was to continue to improve in his current job so he could move to a management position in MSF, and then one day become and expat member of staff and work in another country where people needed MSF’s help.
Saint-Fort (in green shirt) leads a training session with his colleague Daniel Wiguele (in black shirt).
Sad news about an exceptional colleague
I had been back in Canada for two weeks when I received an email telling me that Saint-Fort was dead, a victim of a car crash. He had been travelling from the capital back to Bossangoa when he was trapped in an accident from which he did not escape.
It seems silly now, but one of the first things I thought in the days after I heard of Saint-Fort’s death was that I wish we had chosen him for Exceptional Colleague of the Week and that I had made it clear what he meant to me, to the team and to the people of Bossangoa. I also wish that he had had the chance to travel and be an expat like he dreamed of, and to help people in other countries the same way he had helped so many people in his own.
So, as an apology to Saint-Fort and as a chance to remember my friend, I present to you this week’s nomination for Exceptional Colleague: Saint-Fort Ndilbe Dakanga, for his dedicated work to his community and his colleagues, and for being a leader, a brother and a friend to so many, including me.
As I mentioned at the outset of this article, the Bossangoa project oversees more than 120,000 consultations a year in a region where there is no real option for healthcare other than that provided by MSF. Imagine a hospital in Vancouver, Seoul, or Amsterdam that sees that many patients, with a small fraction of the staff that the average developed-world hospital has. Now imagine that hospital is surrounded by endemic disease, poverty and armed conflict. Finally, try to picture the type of person you would need to help run that hospital.
That person you are picturing is Saint-Fort.
Will Plowright is a project coordinator with Doctors Without Borders/Médecins Sans Frontières (MSF). He lives in Vancouver, BC.