We went to some of the most remote and isolated parts of eastern Chad, vaccinating children everywhere, from busy market villages to tiny nomadic settlements. The area was very unstable; with Chadian and Sudanese rebels, strong military presence and overlapping conflicts between different ethnic groups. MSF addressed the security risks by keeping close connections with all protagonists and by reducing the costs of equipment carried by the teams. Instead of land cruisers we had 1950’s trucks with holes in the floor. Instead of thuraya satellite phones, we had enormous mini-M’s, which were so old-school no one knew how to use them initially. The team leaders only carried enough money to buy a chicken for lunch. It was frustrating sometimes, but it worked. In almost three months of camping along the Chad-Sudan border we had no serious security incidents and the only items stolen were paracetamol and soap.  

I was responsible for security, communications, planning the day, managing the cold chain and keeping the team happy and motivated. This last responsibility was probably the toughest as the weeks drew on and the novelty wore off. Living conditions were rough, we were sleeping on the ground and food and water were strictly rationed. Quite often we were dirty, hungry and cross. We learnt to appreciate the basics; collecting wadi water for a luxurious shower became very exciting and market days were an ecstatic orgy of buying mangos, dates and treats.

Drawing water from a 'wadi' on the vaccination campaign trail in Chad. March 2009
Photo by Claire Grisaffi/MSF

The days were essentially all the same - get up, vaccinate, go to bed – and on a good day it was fantastic. You woke up to a beautiful dawn, with rice pudding for breakfast and enough water for a shower. You left promptly at 7am with a guide who knew exactly where he was going and a good route. You arrived to the open arms and beaming smile of the village chief and all the children from the area gathered under a shady tree, perfect for a vaccination site. Hundreds of children were vaccinated in record time and at the end the villagers bought you boule, spicy peanut sauce and a chicken to say thank you. Back at the base in time for a cheeky beer and then sleep under brilliant stars feeling happy and just a little bit smug.

A little girl is vaccinated by Afaf, an MSF doctor in Chad. March 2009 Photo by Claire Grisaffi/MSF

On the worst of days, it was miserable. You woke up freezing cold with your ears and eyes full of dust and a chicken crowing next to your head. You didn’t wash for the fourth day in a row. There was only stale bread for breakfast and no sugar for the tea. The truck had to be push started and the springs had broken through the seat. The guides did not turn up so you left two hours late with no idea where you were going. You picked someone up en route who knew only donkey paths through impassable undergrowth and across ravines. Three hours later you arrive already exhausted and shaken to pieces at the village. The locals have no idea who you are and run away from the truck as fast as possible. There are no trees, so you set up site in the baking sun and wait for curiosity to overcome fear. Eventually you start vaccinating, children scream, babies puke everywhere and a scowling village chief turns up to demand why you are torturing his infants. Needless to say, no chicken is proffered. You leave and get stuck in a wadi, the battery cuts out and you wait there for five hours until another truck arrives to jump start the engine. It is getting dark already and you race back to base using torches in place of the headlights and pushing the truck across every wadi.

But, whatever the day, it was an absolutely unforgettable experience and, as a water engineer, a chance to do something really excitingly different. Given all the security problems and the speed of mobilisation, I am proud to work for possibly the only organisation which could have completed such an ambitious campaign successfully.