We’ve also got a clinic in Johannesburg next to a large Methodist Church in the centre of the city where there are between 2,000 - 3,000 Zimbabweans seeking refuge. The problem is that South Africa does not recognise these people as refugees and therefore they do not get any assistance – they are classified as voluntary economic migrants.

Those that do make the decision to leave have quite a hazardous journey. First, they must cross the Limpopo River which especially at this time of year after some rain is a big fast flowing river full of crocodiles. Then they have to cross a sort of no man's land which is full of robbers called Guma Gumas who say they will help the people get through the wire fences but attack them and take anything of any value. Next they have to cross the wire fences – several layers including electrified ones. Then they try to make their way into Musina, avoiding the South African police patrols. If caught they are immediately arrested, detained, and then sent back.

Once in Musina, they go to a car park to try and get papers to allow them to enter South Africa legally, so that they can go on further into the country to find work. This process though can take several weeks and so during this time they stay in the car park (about 100 metres x 175 metres) - about 3,500 of them with no facilities at all.

The car park in Musina where about 3,500 Zimbabwean migrants have gathered after fleeing their country.
Photo by Sara Hjalmarson

We are gradually improving things but slowly slowly as the municipality do not want it to become a "refugee camp". We have managed to get the municipality to provide toilets and we have erected tap stands, hand washing facilities, laundry areas and a drainage system. UNHCR, the United Nations Refugee Agency, has just recently managed to get permission to erect a large tent in the middle of the camp and have helped to sort out a system for registration. Apart from that there is nothing – some of them hang some plastic sheeting on the surrounding fence to shelter under to get some protection from the sun but also the rain - when it rains here it really throws it down!

My job here is water and sanitation – giving support to Musina but mostly to try and sort out and improve the situation in the Methodist Church in Jo’burg, where as I said there are between 2,000-3,000 people in a building about 30metres x 30metres and four stories high with a chapel in the middle (not used except for services), with a labyrinth of stairs, corridors and various small rooms all of which at night are occupied by all these people and with 10 toilets and four showers between them!! The reason all these people stay here is that the Bishop of this church has opened the doors to them and provides not only shelter but also safety – there has been quite a lot of xenophobic reaction from some South African locals and the police are constantly carrying out raids and deporting as many as they can.

MSF's main aim was initially to facilitate access to South Africa's existing health system, but we started to focus intensively on the prevention of cholera after the outbreak started in November.  For patients with cholera symptoms, the small clinic we have screens people who are ill and isolates them immediately, sending the worst cases to the hospitals and the not-so-bad to another building where we have a small isolation ward. We also screen for many other diseases, and treat everything from respiratory tract infections to HIV and tuberculosis.

The other intervention is to improve the sanitation in the church and to keep the toilets clean, for which we have four teams of four cleaners working round the clock, constantly cleaning. In addition, in conjunction with the municipality, we have established 30 basic chemical-type mobile toilets outside on the pavement, which as you can imagine has not impressed the local shop owners! You have to remember this is right in the middle of the city with posh high rise office bocks and shops all around – just a little different from the bush in Somalia or the desert of Darfur!!??

There are thirty toilets to share between 2,000 - 3,000 people at the church in Jonannesburg. Febuary 2009.
Photo by Garrod Cooper

Personally, give me the bush any day – I am not a city person and trying to get things done in amongst all these people and with no room to swing a cat is quite challenging.
The other day I got an early morning call from the guards we have looking after the outside toilets to say that the toilets are busted and that the effluent (my word – he said something else) is all over the street. I rushed down to find that the contractor providing the toilets had come to empty them but had not connected his hose correctly to the tanker and when he started pumping it came undone!

You can imagine the scene – muck all over the pavement and running down the street and people trying to step through it all on their way to work and the stink was wicked! Although not my responsibility, (it should lie with the municipality, who had organised this contractor),  I then spent the rest of the day having to get it all cleaned up and chasing various people to ensure we did not get a repeat performance – bearing in mind our main aim is the prevention of cholera – not the spread of it!

So all very different from my other missions, not only the work and the location but also the living conditions – 4 of us share quite a nice house in the suburbs which is a bit strange after the squalor in the church and a far cry from staying in a tent either in the freezing cold of Kashmir or the hot and steamy South Sudan.

Cheers for now.

Garry