Field Notes: Organizing Nepal Earthquake Relief from Uganda
By Eric Moffet
KAMPALA, UGANDA — The earthquake hit on a Saturday, the 25th of April, in the afternoon local time. For some weeks prior I had been working in Uganda; the plan had been to head home to the States for a few weeks and then depart for Nepal in late May. The work would include organization and oversight of a dairy farm social business that had been implemented by Global Orphan Prevention, an American NGO, some months prior. Now, all that changed.
Late in the evening on that Saturday I received a message from one of my Aunts, “Praying your friends in Nepal are OK.” Immediately I searched for news reports, and there it was: “Devastating.” “7.8 magnitude.” “Thousands feared dead.” “Kathmandu in ruins.” It was clear in just a moment that I must go early, that I must find something to do, somewhere to help. Without a plan, I bought a ticket to depart Uganda on the following Saturday.
Sometime the next day the reality of my commitment to this country and its people became apparent. It was as if I stood at the foot of a great mountain peak, without any idea how to take the first steps; only a passion to reach the top. The days prior I had felt exalted after successfully coordinating a free pediatric clinic campaign in rural Uganda between a local community based organization and a group of physicians from the U.S. The project had cared for over 1100 children in just five days – I recognized this as my greatest achievement. Days later it paled in comparison to the calling that now beset me.
That I was in Uganda seemed a blessing, they have liberal pharmacies. My idea was to export the vital medications needed in the wake of a disaster. With an unjust sense of urgency I purchased thousands of units of these items. The cost was minimal; the dollar strong; in this case nickels and dimes would save lives.
But as soon as I had the seven boxes and 300 pounds of meds back in my room – 20,000 tabs of tylenol, 5000 doses of oral rehydration salts, 11,000 antibiotic tabs and enough chlorine tablets to treat 6,000 gallons of water – the uncertainty of the task overwhelmed me. A voice inside insisted I was in over my head – this proved impossible to hide.
A friend that I met at the guest house some weeks before caught me and asked, “Eric, are you OK?” She was a Family Medicine resident physician from Maine, in country for service work. She stood with her hands on her hips, taken aback at the medications stacked high in my room.
“I keep telling myself naivety’s a great motivator.”
“You’ll be fine,” She said, and we proceeded to bounce ideas off one another as to how I ought to pack this boatload of medication in order to ease transport. I decided to leave the oral rehydration salts in their original packaging, and assumed it would make transport easier if I were to remove all of the tablet pop-out strips from their boxes. I then piled them into a large duffle bag, saving volume and weight.
After that I took a nap. Awoken I felt refreshed. Remotivated.
The doubts would not overwhelm me, I maintained. I must find a way to get these live-saving opportunities to the people who need them most, I pledged. Even if it costs me personally, the cost was small in comparison to the good that would come of it.
Soon I lugged the cargo towards a waiting taxi, to head for the port city of Entebbe, the location of the Ugandan airport. Entebbe sits on the northern shores of Lake Isabella, the source of the Nile River; an upscale city in a low-income country.
The morning of my intended departure, on the Saturday after the quake, the sky was gray with clouds and the air was misty. My spirits were high; sure of the uncertainty, excited for the trip ahead. At the airport, after I loaded the boxes and the large duffle bag of meds onto a roller cart, I followed signs to the cargo terminal. After looking into rates via a big time international carrier it had been decided that shipping freight directly from the airport would be the most economical option.
On my way towards the gate that marked the cargo terminal entrance a man with a checkered shirt stopped me.
“You must have paperwork for entrance – I am a cargo agent. My name is Bensen.” He smiled wide, his white teeth against his jet-black features.
We walked away from the gate, he asking of my plan. “To Nepal,” I told him, “these are medications for the earthquake survivors.”
It took a moment, but it dawned on him my mission. “For Nepal?” He reassured, pronouncing the last syllable of the country much like the first syllable of palace.
“I can help. When do you leave Uganda?”
“1230.” It was 0800.
“Oh-“ he responded, a sudden sense of urgency upon him. Our walk quickened, as did the rain, enough for Bensen to place his plastic document folder above his head.
First we left the cargo in a trusty location, among the cab drivers at the door for arriving passengers, then we headed to the Civil Aviation Authority office to procure a pass for me to enter the cargo terminal. In the warm rain, among the humid, non-air conditioned rooms, I began to sweat. The occasional muttering by Bensen of the words “Oh my god…” made clear that we were not on a usual path. The unease began to rise; pressed for time. We rushed.
In a cargo airline office we were given the necessary documents and quotes; we then ran by an office to make a handful of copies. Next we hurried back out of the gates towards where the medication had been left. I gave the babysitter a few dollars, wheeled the meds through the terminal gate and towards the bay labeled “Cargo Export” and felt as though things had turned in my favor. Although the rain swelled, the export seemed so close to completion. Soon I’d board a plane for Nepal – it was 1015.
“You need approval from the National Drug Authority of Uganda.” The young Ugandan woman said, sitting behind her screen that flashed the contents of the boxes in the x-ray machine. She was clear. I needed approval, no arguing: export rules.
Pulling the cargo from the backside of the machine was a kick to the gut. And rolling it back out of cargo, through the now pouring rain, was a kick to the head. Then I tried to roll the cart over wide grating, where the wheels caught up, throwing three boxes and their contents onto the pavement before me. And of course my airline would not provide a voucher or reschedule my flight, I had purchased it through a third-party agent. The numbness had overcome me at this point. Dejected, I returned to the guest house.
That evening I took a motorcycle taxi to the botanical gardens where I strolled, read a book, drank a beer and calmed myself. I’ll make the best of this, I consoled. I had no choice. I made plans to visit the Ugandan National Drug Authority (NDA) first thing Monday morning; my friend, a Ugandan physician and leader of the Ugandan organization I worked with, would accompany me.
After my export fiasco on Saturday, it seemed appropriate to investigate procedures for importing medication to Nepal. This is the point where my naivety and will became outweighed by a lack of procedural knowledge.
Turns out that import requires original packaging, which provides a variety of necessary information. When I ditched the packing boxes for the tylenol, antibiotics and water treatment I had unknowingly doomed my intent. This was not a complete loss, the medication could be donated to my Ugandan community based organization, however, it was a further hit to my self-confidence.
Everything seemed to be falling apart on me. It would no doubt provide invaluable lessons moving forward, yet, my mistakes were adding up. The only saving grace was that it would not cost Global Orphan Prevention and their donors, my beneficiaries – again, as with the missed flight the day before, this was a mistake I had to pay for.
On Sunday, I packed up and headed for Kampala from Entebbe, about an hour ride into the big city and location of the NDA. As I slid the boxes out from under my bed I writhed at their soppy wet exterior. They left puddles on the ground. And when I picked them up they sagged and crumpled like the paper they were. The hits just kept on coming.
That night I made friends with some German and Dutch folks, stayed out late, visited a number of night time establishments in a ritzy area of Kampala on top of a hill where the city lights lay below. The night was calm and I left the group early, under protest, at 0100 to hit the sack for my 0800 rendezvous with my doctor friend at the NDA.
I woke up late the next morning, rushed through a shower and breakfast, packed my bags and boxes, now dry after having basked in the sun upon arrival the afternoon prior, then departed in a cab just in time. I met my friend, Dr. Wadaya, just four minutes after 0800.
Uganda National Drug Authority Offices, Kampala.
As we waited in the lobby he laughed at my experience, his deep looping voice displaying the smile he wore at my misfortune. “People don’t usually take medicines out of Uganda.”
“Right,” I laughed, “and there isn’t a guidebook out there for this kind of thing.”
“And in Uganda they let you make mistakes.” Maybe it’s better that way.
We were invited to the second floor where Dr. Wadaya made my case, then I spoke for a moment of my work in Uganda and the plans for Nepal. The man behind the desk was solemn, hard to read and soft spoken. Through his glasses I couldn’t see his eyes, the glare of the office whited out the lenses. I wasn’t sure what to make of the situation, but Dr. Wadaya shot me a knowing nod and we were told a letter of approval would be provided. And further, that the typical license fee of $35 would be waived since the export was for donation.
After another hour and a half waiting and pacing in the front lobby we were again invited to the second floor where a letter was provided – success – and I hit the ground running. It was time to get back to Entebbe, back to the cargo terminal to get these boxes in the air.
From there things ran smoothly. Although the freight company I had intended to use was no longer flying into Kathmandu, the next one tried was, plus they charged $250 less. Once I left payment and received all of the necessary copies for retrieval I walked out of the building, Bensen guiding me. As we descended the iron steps to ground level he pointed to a just-landing white jet.
Bensen and freight airline representative.
“That’s yours.” He said. The cargo would arrive to Nepal before I would.
My flight followed the next night, about 28 hours later. Ahead towered a challenge just as significant as the one just met, I thought in anticipation. My first steps up this mountain had been wobbly. Weather the storm, I recited in my mind. With these intentions things fall together in the way intended; the right people encountered, the right places found. Just weather the storm.
UPDATE: Eric is currently on ground in Nepal assessing risk and need for earthquake survivors and victims. As time progresses, Eric will be trekking into the far reaches on Nepal, teaming up with local NGOs and bringing aid to underserved populations. Subscribe to our blog updates to hear more notes from the field. Also, consider a small donation to fund our necessary relief missions.