Since August 2017 more than 700,000 people have fled violence in Myanmar's Rakhine state for camps in Cox's Bazar, Bangladesh. Since this latest crisis began, New Zealand Red Cross has been sending delegates to support the Red Cross Red Crescent response, including a number of health workers to work in the Red Cross Red Crescent Field Hospital that opened in October 2017. Fiona is one of them and this was her second deployment. She writes from the field.

3 December 2018

Hi All

I'm happy to say we made it to Kutupulong Field Hospital with no hitches this time.

The hospital has changed so much – for the better – since I left last January. The OPD (outpatients/ED) has been extended and covered, isolation has closed now the measles and diphtheria outbreaks have abated. The staff café, now dubbed 'starbucks,' is very well equipped with good quality food - there are hot showers and flush toilets!

This time around, our role is largely to teach and allow the local and national staff to lead the care. This is a challenge for those of us who thrive on hands-on clinical work. It is essential, however, if we wish to leave a legacy of quality care for this still highly vulnerable population of now nearly 1 million, who are living in the world’s largest camps directly across from the hospital.

I am delighted to be back in OPD and for our department to be very busy. The presentations are very variable. There is still a lot of trauma, fractures, lacerations and burns but other common presentations are major skin infections . Many require surgery – complicated obstetrics, lots of respiratory disease and a regular stream of 'all body pain' and gastric issues.

It was delightful to see many of my colleagues from a year ago still here and doing a great job.

Being among those whose first language is not English can be quite isolating but we are getting to know the crew of mostly Finnish and Icelandic staff. There is also an Irish person, someone from Malaysia, a couple of Norwegians, a Swiss, and five Kiwis!

Sleeping in a shared tent surrounded by a mosquito net is a bit challenging, but the jet lag is wearing off and busy days should bring restful nights.

Missing you all!

Four of the five Kiwis working at the Red Cross Red Crescent field hospital over Christmas 2018. L-R: Alix McGinity, Guru Dev Singh, Fiona Blair, Bronwyn McBain.

10 December 2018

Hi All,

It's hard to describe the atmosphere and direction of this mission. Although the conditions for the delegate team are much better this time, I find this produces in me a feeling of guilt for having so much: food, clothes, healthcare, possessions, access to education, job security.

Being on my feet all day in the busy, noisy, dirty OPD is super tiring, and I generally fall into my camp stretcher as early as possible. A great antidote is the early morning 5km run towards the Myanmar border. We pass through rubber and mango plantations, rice paddies, a crocodile farm and rural small holdings. The sunrise over the hills of Myanmar is stunning.

I’m off back up to OPD to check on the evening staff, then a quick meal and bed. Sleep, eat, work, repeat!

The greatest pleasure remains the one-on-one work with the lovely people who present at our door. This work remains a privilege and pleasure, and there are joyful moments every day to far outweigh any despondence.

Love to all

Fiona Blair and Dr Merle Weber use morning runs as a way of dealing with standing on their feet all day at the Red Cross Red Crescent field hospital in Cox's Bazar, Bangladesh.

23 December 2018

Hi dear family and friends.

The full moon is rising over rubber garden, the Muezzin is calling to prayer, and the foxes are crying across the valley. Disco music and political advertising have recently been added to the general cacophony of sound, day and night. Evenings are very cool and the leaves are falling from the rubber trees, mornings misty and pink with rising mists.

Personally I feel I've really hit my stride over the past week or two. Work days are tough, emotionally and physically. The work environment is noisy, dirty and quite chaotic, and sleep somewhat elusive, but I feel really driven; energetic and enthusiastic, and as though I'm really doing what I came for. I will throw myself in wholeheartedly till the end.

This week I carried a 25-year-old woman to an ambulance to take her home; light as a feather, with a massive tumour in her neck. We gave her paracetamol and ibuprofen. I really felt sick for her and her family and she haunts me still.

Children here are so silent and watchful. There was a wee girl with burns right around both arms who sat silent in her father’s arms, clutching my hand, never crying as we gently covered her burns ready for theatre.

I love visiting the paediatric ward. Here I see the silent and watchful become smiling and laughing children: the parents chatting with each other; the very small 4-year-old chasing a ball around the floor and cheekily kicking it to us; the previously quiet and pale 6-year-old lighting up with pain relief, new clothes and good food.

I had a walk in the camp today, 12 months after I was here last time. I'm glad to say it gave me hope. Children are generally better nourished and clothed, small business are thriving, there are more bridges and the tracks are better. More than this; people seem more open and interactive. There is bustle and purpose, and smiles as we pass.

Kiwi nurses Fiona Blair (left) and Bronwyn McBain teaching local staff at the Red Cross Red Crescent Field Hospital.

Christmas Eve, 24 December 2018

Christmas Day approaches fast and it is a moment to pause for reflection. This is the way to not ‘spend’ Christmas, but to ‘live’ Christmas. My festive season is a secular one, but the Christmas message of good-will to others, peace, grace and forgiveness are sentiments which cross religious and cultural boundaries.

Every day here brings its human dramas. Successes and lives saved thanks to our fantastic surgical team; tragedies and tears shed for those we cannot help or who die despite our best efforts. Before my eyes is the everyday human story of the triage gate: children – undernourished with large eyes in small faces, or in pain or fear; the adults with closed, haunted faces who are numb and unresponsive to the gentlest approach; and the elderly who move slowly and with resignation.

The young represent hope, and I hope for these young people that they have access to education, employment, regular food, and reliable shelter. Living here, however, they may rely on NGOs for many a year for these essentials of life.

Why are we here? Because disease, grief and trauma have brought the needy to our gate. We may or may not cure, but we can offer what we have, and be kind. Hope can be glimpsed through a hand held out to help someone get back up, or to sit and be present when fallen or in a dark hour; surely this will demonstrate that there is care in the world, and there is dignity in life, and it is still a gift to be human.

At times we feel inadequate and we despair, but if we cannot offer ‘things’ or ‘cure’ we can act with empathy, humanity and kindness; and also offer these to each other. We define ourselves as humanitarian workers, not nurse or doctor or cook or psychosocial support, but one who wishes to bring compassion and care to others.

We arrive here as delegates, but leave as family, having shared the true Christmas spirit.

He aha te mea nui o te ao What is the most important thing in the world? He tangata, he tangata, he tangata It is the people, it is the people, it is the people

Love from me.

Fiona Blair NZRGON