When you are accustomed to living in closed compounds you develop a long-distance stare; a meditative gaze you adopt automatically when left to yourself. This abstracted state serves two purposes. It allows you to take a little break, to escape for a moment without physically leaving the property, and it helps you overlook the razor wire that charmingly adorns the walls of this and other Médecins Sans Frontières (MSF) compounds around the world. This time round though, my view is a little different. Beyond the wire, climbing roses and clumps of deep-green foliage adorn a backdrop of billowy hills.

Perhaps Congo is the closest thing there is to that romanticized image of Africa we have created in the west – tropical forests, gorillas (and guerillas, of course), exploitation, civil wars, dusty road, and lots of dancing. I have numerous preconceived notions of the Congo, all based on novels or historical accounts written by westerners who came here to conquer, enslave or make their name through ‘adventure journalism’.  Then there are those (such as King Leopold) whom we associate with the Congo but who never actually set foot here; and those (Conrad) who experienced the cruelties of the Belgian Congo so vividly that they could only write about what they witnessed in metaphorical terms.  I’m trying to be conscious of these preconceptions so I can let go of them at some point.

Here, for the first time, I will be leading a project. Although there is nothing inherently intimidating about this role, I find myself thinking wistfully about the solid simplicity of the medical roles I have taken on up until now.  We will be closing down Bon Marché, the flagship MSF hospital in Bunia, and transferring all activity to the regional Ministry of Health facility. This will involve a lot of negotiating, HR management, and security assessment – and yet I will still be heavily involved in the medical aspects of the programme, in terms of quality assurance before and after the transfer. The role is something of a poisoned chalice, as such changes – with all the HR implications – are inevitably demoralizing for the staff. The next 6 months will undoubtedly be taxing and stressful, but could nonetheless be satisfying. I think.

Thankfully my office is in the hospital grounds, and when I step into the hospital wards I breathe a (paradoxical) sigh of relief, as if somehow I am coming home.  Instead of slippers I put on my stethoscope, and suddenly everything feels familiar and logical. The children are thin and frightened, the mothers care-worn and tired, the nurses are eating their lunch….and all’s right with the world. But then a voice whispers in my ear that the budget revision is due tomorrow, and I reawaken rudely to the reality that I am now a bureaucrat, albeit in doctor’s clothing.

Kiran James Jobanputra has been working as a doctor with MSF in Somalia, Kenya and Niger since 2007. He is currently Project Coordinator of the MSF Hospital (Bon Marché) at Bunia, DRC. This blog also appears on the MSF website.