Volunteer story - Alicia Cook

Alicia Cook

A Communications Manager based in Australia, Alicia is currently on an assignment in Kenya, working with Amref Health Africa to develop and implement a fundraising strategy.

These fundraising activities will allow for the continuation, expansion, and sustainability of AMREF Flying Doctors’ outreach activities to reduce morbidity and mortality in certain areas without compromising AFD’s financial obligations towards Amref Health Africa.

October 2015

Part 2/2

Since accompanying the flying doctors on an evacuation last month, I have been captivated and intrigued by Mandera – a tiny, arid town that from the sky, barely seems to house any form of existence.

Tucked in the far corner of north-eastern Kenya, Mandera District is bordered by Ethiopia and Somalia. It is desolate, dry and all but forgotten.

The problems here are epic. Drought, clan conflict, cattle raids, lack of access to education and healthcare, near non-existent infrastructure, limited access to food and water… If there is ever a health or societal problem to have, Mandera is sure to have it.

Years of neglect and marginalisation have pushed this part of Kenya well past the boundaries of humanity.

For decades, the county has performed far below acceptable norms on development indicators. Literacy is less than 10%, malnutrition well below emergency levels and most shocking, maternal mortality rate (MMR) stands at 3,795 deaths per 100,000 live births. Comparatively, that’s more than double of the neighbouring county, Wajir where our CEO Andrew Witty visited two years ago when he announced the Save the Children partnership. This statistic means Mandera has the unwelcome honour one of being one of the worst places in the world to give birth.

Two years ago Kenya gave renewed hope to the forgotten corners of the country by devolving the power of 12 Government functions to 47 newly established county administrations. National ministry budgets were distributed to newly defined counties, those deemed the most marginalised including Mandera, receiving a greater portion.

Because of devolution, the flow of funding reaching Mandera in the past year – which incidentally, is more than they have received since Independence in 1967 – has meant the county has been able make some inroads in their development plan. Last year, street lights were installed for the first time and the first ever tarred road is due to be laid at some point this year.

These are early signs that devolution may well be the catalyst that will bring Mandera out from behind the shadows and into the national fold. But there is one thing the change in governance isn’t providing a solution for and that’s the increasing security issues facing the county’s 250k residents.

The Mandera Triangle, as the region is known, is home to a complex network of administrative and clan related disputes and more recently, terrorist activity from militant group al-Shabaab.

The rise in terror attacks in the area has led to a mass exodus of the very people Mandera needs if it is to have any hope of sustainable development.  Among them teachers and healthcare workers, even humanitarian agencies have been forced to reconsider having a physical presence.

As I sit and trawl through the dozens of articles, blogs and opinion pieces my thoughts go back to the gunshot patient we picked up. I start to think more deeply about his circumstances and what would have happened to him if we didn’t pick him up given the void of healthcare workers.

The more I read, the more heavy-hearted I become at the thought of a place being in such a vortex of deprivation. Like many places around the world, Mandera is plagued with misfortune. For every step forward there is a step back. How does it stop? Who will help the people who have no choice but to stay in Mandera when everyone else has gone?

AMREF Flying Doctors saved one man’s life but their impact on overall statistics is limited without economic and humanitarian help from others. Having seen the dedication and integrity of the team here, I have no doubt if there was any chance of making it happen they would try.

September 2015

Part 1/2

Last week after spending the day at GSK’s Nairobi offices, I received a call on my mobile just as I was going to bed. For my phone to ring at any time is an unusual occurrence given the only people who have my number are my work colleagues and the drivers I use. I figured neither would be calling for an idle chat at 10.30 at night.

It was Catherine, my manager.  A 19 year old man from Mandera County, North East Kenya, had been shot and was in need of evacuation. While most of the flights for AMREF Flying Doctors are for tourists or members who have paid annual insurance, there are a select number of occasions where evacuations are performed for free, typically when the patient concerned meets certain social, medical and financial criteria. This was one such occasion.  I was invited to join the flight so I could write about it in marketing and fundraising materials.

I confirmed my availability and called for a driver to pick me up so I could get to the airport in time for the 7am departure. Mandera is just over 1,100 kilometres from Nairobi but travelling in a Cessna Caravan, the trip takes us close to three hours.

Flying in the early hours of the morning evokes a certain stillness in mind and body. As a guest passenger I was left to sit back and watch the world float by. It was a hypnotic journey past the dusty bedlam of Nairobi, over Wajir County and into Mandera.

The landscape changed as we travelled north into the tiny far corner of Kenya, bordered closely by Somalia and Ethiopia. It reminded me a little of outback Australia. Red, barren and desolate.

I scratched around in my imagination trying to picture what life would be like living here. Gazing out the window, the odd isolated village captured my attention and snapped me back to reality. Poignant reminders that as distant and unbelievable as things may appear, for some people this is home.

There isn’t much to Mandera and even less to its airport. There is no check-in counter, no air traffic control. No building even. In fact, there is barely a runway. Mandera airport is nothing more than a concrete pivot circle and some bunkers.

Amidst hot, dusty wind, the flight nurse and doctor immediately set about assessing the state of the patient as I lingered awkwardly in the background and made small talk with one of the soldiers on duty. I tried to keep enough distance to give the patient privacy while still keeping an ear out for details that may indicate how he came to need our help.

But with the patient not speaking English or Swahili and none of the crew speaking his tribal language, the details never came. Given the history of the area it is likely this was a tribal dispute. I’d like to think it wasn’t something more sinister but in Mandera even the most extreme scenarios are a possibility.

August 2015

One of the things that most struck me most when I started working at GSK four and half years ago was the insane amount of brainpower that surrounded me. Big brains with bright ideas were everywhere. My contribution as a communications specialist playing with words paled in comparison to what these brains did. Chemists, scientists, doctors, engineers, health economists, regulatory boffins – there was a whole ecosystem of intellect churning within the company. I felt constantly awe-struck by the newness and magnitude of it all.

Reminiscent of the overeager grasshopper from The Karate Kid, I asked a lot and learned a lot in those early days. But, as with everything, the ‘wowness’ faded over time. The significance of the work being done never diminished, things just became… normal.

Now, nearly three weeks into my PULSE assignment with AMREF Flying Doctors, the moments for ‘wowness’ are back. Like most charitable organisations, the vision of AMREF and the Flying Doctors started with little more than heartfelt desire to help others and the will to do something about it.

In 1956 reconstructive surgeons Tom Rees, Michael Wood and Archibald McIndoe sat in the shadows of the mighty Kilimanjaro and decided to combine their specialist surgical and aviation skills to form Africa’s first aero-medical service.

AFD archives: Dental surgery in East Africa in the late 1950s

The archives are impressive. Cotton-soft and tattered, black and white photos and age-stained documents tell some remarkable stories of those early years. True pioneers who, despite the hurdles, made things happen because people needed what they had to give.

I was full of ‘wows’ musing through the visitors centre on my first day – so many testimonials of greatness and gratitude. The emotions of wonderment started to resurface. Oh the brains – not just doctors but pilots too, doing so much in the most difficult of circumstances. I took to Google to learn more and came across some sage parental encouragement Tom Rees received from his father:

I shall not mind what profession you choose but I do hope that whatever it is, sometime in your life at least, you will find a way to help other people.

Hidden in the simplicity of his request, was probably my biggest wow moment yet. Rees’ father wasn’t overly ambitious or forceful in his request. He was gentle and humble. His words spoke to me in volumes and reminded me that big brains is helpful to have, depending on the profession you choose, but it means little without the warm-heartedness of humanity and the determination to make a difference. This wasn’t a revelation. Of course I knew humanity mattered but, for some reason from where I am standing this had a different meaning.

Unlike Rees, Wood or McIndoe, my contribution won’t be medicine or aviation, for my brain is not big enough for anatomy or physics. Instead, my contribution to help others will be a less awe-inspiring but no less important set of skills – communications. Over the course of the next few months I will be helping AMREF Flying Doctors identify business development and fundraising opportunities - two aspects that are critical if they are to continue to provide charitable air evacuations and aero-medical transport for clinical outreach services alongside their commercial enterprise.

AFD archives: Dental surgery in East Africa in the late 1950s

This would be relatively straightforward if I was in Australia or perhaps even England where I understand more about the opportunities and challenges. But I’m not, I’m in Kenya and things are different.

AMREF Flying Doctors operate in a wonderfully contradictory way – uncomplicated service delivery in a very complicated environment. Conversations here are not about refining process and procedure. They’re about navigating inadequate runways and poor infrastructure, security clearances for inter-regional transfers and conflict zones, visas and passport checks, and of course, let’s not forget the ever-narrowing funding streams and increasing competition for money to keep things going (no pressure Alicia!).

I can’t pretend I am not still slightly girly about working with the big brains of pilots and medics (a leopard can’t change her spots), but if I am to take anything from the subliminal messages given by Rees’ father and my first few weeks working here it’s that the size of your brain is irrelevant. It’s what you do with it that really counts.

July 2015:

My ‘challenge and change’ journey began late last year. After an amazing four years at GSK as a Communications Manager in Australia I wanted something different. Something that will stretch me beyond where I am and what I do.

To quench my thirst I enrolled in a Masters of International Development with RMIT. Going back to university was exciting. I literally felt my brain stretching and yawning like it was awakening from a long sleep. This was the stimulation I needed. I loved it, but study was my plan B and something I was prepared to defer should my plan A – my PULSE application - be successful. It was.

So after only a few short weeks of getting my geek on, I closed my textbooks and started to wrap my head around my new offering – a six month secondment as a Business Development and Fundraising volunteer with AMREF Flying Doctors in Nairobi, Kenya.

I am familiar with the notion of starting a new chapter somewhere different. When I was 20 I represented Australia on a pan-Commonwealth volunteer program in Nova Scotia, Canada and Jamaica. I followed that by moving to Vancouver because put simply, I could. I have started new chapters in London not once but twice, and called Japan home after flipping a coin with my brother.

But this time it feels different. I am more considered. I feel like I have left the flippant whimsical 20s and moved into the more measured and conscientious 30s. Unlike before, I find myself accommodating a broader spectrum of emotions that I didn’t really think existed in me.

Of course there is the usual abundance of excitement and enthusiasm, but accompanying this adventure is a fresh set of anxieties. Ones I haven’t really experienced before. Perhaps it comes with being more appreciative of the investment and magnitude this opportunity brings – for me, GSK and AMREF. Can I deliver what they need? Will my contributions make a difference?

Like most little critters, my anxieties only come out in the stillness of night when I can’t sleep. The two most bothersome being a very sobering self-doubt and the ever-growing list of things to do before I leave – cancelling utilities, packing boxes, calling the bank, deciding what to take and what to leave, seeing friends, finalising my handover notes... the list goes on.

My apprehensions dissolve as day breaks. I’m another day closer to my adventure. After devouring a double shot latte, I manage to find my pragmatism and confidence and refocus my thoughts on what lies beyond the beginning–a once in a lifetime adventure to ‘be the change’. I can’t wait to get started.