18

Saving the world, one email at a time

There was always a bit of tension between people in the field and people at headquarters. Concern was actually pretty good at listening to the ‘voice from the field’, but in the humanitarian industry generally, there was often a disconnect between the high-level planning and strategy, and the realities on the ground. I never wanted to be a ‘headquarters’ person, but the time had come. I needed to give my body a break and my relationship a proper go. Living out of a suitcase wasn’t good for me; I needed to put down some roots. This suited A— just fine.

It meant that I would need to look for a job in Geneva—the humanitarian capital of the world—but it had to be the right job. I loved working for Concern and I didn’t really want to leave, but I figured it would take a few months at least to find something interesting, so I would have time to ease into the idea. As it happened, I found something interesting about a week in: an advertisement for the Global Emergency Health Advisor with the International Federation of the Red Cross, the largest humanitarian organisation in the world. The role described was the perfect balance of technical advice and field support—the best of both worlds.

I expected a lengthy vetting and interview process. I had had three interviews and an exam before I joined Concern, and the Federation job seemed a much higher level to me, so I expected to jump through a few hoops before I knew what was happening. I didn’t think to let Richard at Concern know that I had applied.

Shortly after I sent in my résumé, I was in Rome to deliver a conference paper on the Concern mission in Uganda when I got a call to say that the Federation wanted to interview me. Over Skype, they asked four or five fairly easy questions. I actually thought I had blown the interview and they’d stopped before they got to the tricky ones, but the next morning when I woke up, they had emailed me an offer. They wanted me to be in Geneva within a couple of weeks to get started.

Leaving Concern was like breaking up with someone. I flew to Dublin and sat down with Richard over a cup of Earl Grey tea and told him, ‘It’s not you, it’s me.’ He completely understood that I needed a more stable life and said, ‘We can make it work!’ We discussed some possible scenarios where I worked out of Geneva for Concern, but ultimately it was just too hard. Heartbreaking, but too hard. I was headed back to the Red Cross.

A— had already been living in Geneva for six months and was all set up in a cosy one-bedroom apartment. Rent was exorbitant, particularly for such a small place. The studio would do for the time being, but you couldn’t swing a cat. I hadn’t paid rent since I lived in Alice Springs; literally every home I’d had when I was working had been provided as part of the job. I had hardly cleaned my own house in over eight years. I hardly even drove a car anymore. Now I was going to set up house, with a domestic partner and domestic responsibilities. There were moments of pure panic.

I had to buy new clothes. My uniform of jeans, Blundstone boots and polo shirts had served me well for years, but was not going to cut it at Federation headquarters. I was a working stiff now. On my first day of work, A— surprised me with a gift: a coffee cup, a photo frame and a ceramic scuba diving cow to put on my desk. Apparently people liked personnel knick-knacks to personalise their office space. Who knew?

I caught public transport to the Federation ‘house’ every morning and sat in what seemed to be an endless procession of meetings, and when I wasn’t doing that, I answered emails all day long. It wasn’t my natural environment and I struggled at first. The work was interesting, it was actually quite important, but it was an adjustment. I was saving the world one email at a time.

When I first started, I was responsible for providing technical support to all Red Cross health operations in Africa and the Asia-Pacific—a huge chunk of the globe to cover. In any one day, I could be providing support on multiple diseases or operations, from an earthquake in Asia to multiple disease outbreaks at different scales within Africa. Zika, yellow fever, cyclones, malaria, floods, malnutrition—it all crossed my desk.

Years of study had given me a strong theoretical and technical knowledge covering a wide variety of disasters and emergencies, but being able to put my field lens over things definitely helped. I had a good understanding of what was practical and doable in most emergency scenarios. If a team in the field called to say that they couldn’t move equipment because a road had disappeared, or that the ministry of health was blocking them, or that a community engagement strategy didn’t seem to be working, I knew what they meant. I’d been there, so it was easy for me to help them find solutions.

The program design was very different to Concern’s—large integrated programs like I had run in Niger were not really appropriate. The national Red Cross societies that were strong and robust didn’t need our support. For the most part, I worked with the national societies that didn’t have enough staff, or enough money, or enough technical knowledge. Their strength was that they had volunteers everywhere, all across any given country, which gave us a unique level of access into the community. The trick was to figure how to activate those volunteers in simple, effective ways.

This is assuming that the national societies were interested in my help. The running joke about my role was that while it was in my job description to provide technical support and advice, it wasn’t in anyone’s job description to accept it.

When people weren’t coming to me for assistance, I was looking for trouble. Data mining was a big part of my job with the Federation, which meant scanning the internet to look for signs of coming health emergencies around the world. There were key sites like FEWSNET and another one called ProMED, which collated data about infectious disease and sent out regular updates, but a lot of my research involved scanning daily news bulletins. From the BBC and CNN, I’d harvest information about political instability in Africa and the Asia-Pacific, which was one of the biggest risk factors when it came to public health. If a natural disaster or major accident struck unexpectedly, I often saw it on the news first.

I had a global overview with information from lots of different sources and it was my role to analyse the risks and communicate them down the chain. If I came across any red flags, I would call the teams in the field and ask if anything was on their radar. I’ve heard there’s some cholera here, have you followed up on it? More often than not, my call was the first time the local team had heard about it. My job was to have eyes everywhere, to communicate with the people who could respond, and to make sure they had the resources they needed as quickly as possible.

The other significant part of my role with the Federation was the least familiar to me when I started out: global representation, leadership and advocacy for the Red Cross. I was now part of a cohort of international aid agencies, researchers and technicians that worked together on global strategies to respond to public health emergencies—a group of 200–300 people responsible for the big picture, including representatives from the UN, WHO and MSF.

It was very cool to meet with people who had extraordinarily high-level information about public health and disease, and still have something to contribute, though I sometimes sat in full-day meetings where I hardly understood anything anyone was saying. Some of the experts I sat with were so specialised they could talk for hours not just on one disease, but on one small characteristic of one disease. I once spent a whole day in a meeting about the shortage of sterile chicken eggs in Russia, which were needed as part of the process to produce yellow fever vaccine. No eggs, no vaccine, it seemed, but it took about eight hours to say that. That there were people who sat around all day worrying about chicken eggs was quite the revelation.

My role was to be a translator, bringing information from the field into these high-level meetings, explaining the complexities and difficulties of actually implementing programs, and then interpreting the science or recommendations from these meetings back down to the field teams in a way that could be translated into action.

How am I going to explain this to the volunteers and how will they explain it to the community?

That’s great, but the community would never accept it.

That’s great, but we won’t be able to implement the program in that way.

We’re going to need to consider weather/culture/religious factors when rolling this out.

I added a social mobilisation and community aspect to global strategy discussions, and gradually was asked to bring that viewpoint to public health conferences around the world. My message was always the same: the community needs to be at the centre of all health emergency planning. It’s funny how often that commonsense advice came as a surprise.

I didn’t plan to end up where I was. Every step in my career had felt very natural, and each mission and position had built on the one before, carrying me forward until I found myself with this really fascinating global overview. It happened by accident rather than by design, but every step I took along the way prepared me for what was to come.

What I liked most about my job with the Federation was that I still had a connection to the field. I bridged the space between the high-level management side of humanitarian aid and the coalface of program delivery, and it was a nice position to be in. I felt like a useful cog in the machine that made the humanitarian system run.

I deployed to the field occasionally to support different Red Cross operations, including a cholera response in Sierra Leone in 2012 and the Typhoon Haiyan response in 2013. My field kit stayed packed and ready to go, always. Some habits were hard to break, but I also believed that staff at headquarters needed regular reality checks. Seeing how things were implemented on the ground allowed me to develop new tools and improve the guidance and advice I was doling out. It helped to understand where the bottlenecks were and what support we could provide to unblock the operations.

Besides, the Red Cross volunteers were like crack for me. They were the perfect antidote to the politics and the bureaucratic battles I came up against in Geneva. If I ever felt like I was losing perspective, the commitment and energy of the volunteers inspired me to work harder and do better. They believed in the Red Cross like it was a religion, and I believed in them.