Health

All they want is my blood and stool. I make daily trips across Paris to deliver them, sometimes by taxi, otherwise by metro or on foot. My timing is way off: the first day I squirm in the cab, the second day I'm faint from not eating. The nurses joke with me and rattle plastic vials for my blood, the laboratory gives me instructions: no vegetables, fruit, or grains for three days. I settle into a diet of sugar and meat: Nutella crêpes and cheap Chinese food seem to fit the bill nicely.

I am in Paris from Chad because after a period of bad health and then two weeks of intense treatment for malaria — large quantities of quinine ingested and dumped directly into my veins — I'm still not well. I think of telling the stewardesses on the plane, if I pass out, it's a malaria coma, but I don't know what that will do, so I say nothing. At 1am I eat the lamb and green beans packed in a foil tray and drift off to sleep suspended somewhere over the Sahara.

I never though too much about health before moving to Chad, now I see the world as alive with potentially deadly germs and pitfalls. I watch as friends' kids succumb to malaria, funeral after funeral for people dead from AIDS, illness, or accidents. In Chad life expectancy is 44 and more than one in five children doesn't make it to their fifth birthday. Even beyond these life and death figures, almost half of all children are severely malnourished and almost no one lives in sanitary conditions. The figures go on and on, it's so hard to build a private sector with a foundation like this.

It's not only sickness, but it's instability that makes life hard. We're still at war, fighting in the east and too many guns in N'Djamena.

The whole of the capital has had little electricity for weeks now, people are exhausted from having tried to sleep outside in sweltering heat. Our house is falling apart, yet there's no real way to get things fixed reliably. A man who works security at the school down the street is attacked, fights back, and the police make him pay the hospital bills of his attacker. Life is a daily scramble to get by. We evaluate entrepreneurs and we ask for their financial statements and they say: "Which set of books do you want to see? The real ones or the ones we use to file our taxes?"

The days in Paris pass, I sleep mostly. I get diagnoses and treatments mixed in with stories like how my doctor was sick for months after coming back from Mali in the '70's and finally a bottle of opium cured him. I go to the US, recover some more, and soak up what feels like an easy life. To my delight I find that you can now buy sushi as a snack in corner markets. I'm with a Chadian friend who cannot grasp the concept, "Raw fish? You're crazy, that's your food" he says. "I'll stick to well done hamburgers," his newly discovered delight.

My friends and I joke maybe someday European dignitaries will fly to Africa for medical care, instead of the other way around. I see our job as helping to put in place the building blocks of stability. Last week we visited a recycling plant being built in Chad, the first of its kind, based on a long term waste management contract a local entrepreneur won with ExxonMobil with our help. Through building the private sector I hope that we are building a base, a future that will help ward off all this illness, this insecurity, this malaise. We picture Chirac or even Sarkozy boarding the plane in Paris, saying he must get to N'Djamena to see his doctor. Stranger things have happened. We'll await the new day.