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The public face of MSF is the delivery of care to populations in distress, but there is an enormous amount of behind-the-scenes work, from bean-counting to logistical coordination, which brings the medical staff and materials to a particular location.

This coordination function for MSF is generally run from the capital city in each project country. As the financial controller for Nigeria, I was based in Lagos (although Abuja is the official capital).

It's hard to imagine a city with a worse reputation. Mexico City gets a bad rap for its pollution. Johannesburg gets a bad rap for its crime and slums.

Well, Lagos has all of the aforementioned nasties in abundance and then Lagos some. It is a city in disrepair in every imaginable way- a clogged up, crime-ridden mass of humanity crammed into what could be some of the most pleasant ocean-side real estate imaginable. Beat-up yellow vans and over-sized buses ply the various motorways while belching black smoke into the sky. Gangs of jobless youths, known as "area boys," wait beneath the motorways for the inevitable car breakdown, which will provide them the opportunity to swarm in like vultures and strip the victims clean.

Electricity is practically non-existent. The police, underpaid and understaffed, often clash with the vigilante O'dua People's Congress (OPC). Unfortunately, the OPC, an ethnic militia group claiming to champion the political cause of the Yoruba tribe, are frequently accused of complicity with criminals. All of these factors added up seriously undermine the claim of Lagos to be the "Center of Excellence" (which is boldly displayed on all car number plates).

At the same time, it's hard to imagine a place that's more alive. The humid night air often sizzles with the infectious polyrhythms of Fela Anikulapo Kuti, the king of Afro-Beat and Nigeria's favorite son. At the infamous "Bar Beach," located on the south end of posh Victoria Island, young Nigerians get together to discuss, in loud, friendly banter, the latest in Nigerian parliamentary shenanigans or the latest in American presidential shenanigans.

Troops of local musicians, decked out in tunic-like local dress, beat out requests on various drums, one of which, dubbed the "talking drum," makes a warbling bass noise when squeezed. The smell of "suya", choice beef dipped in a powdered peanut and chili paste, fills the air and kickstarts the tastebuds.

And, fueling the festivities are extra-large bottles of Star and Gulder beer. There is even a Nigerian version of Guinness available, which, as many Nigerians point out proudly, is twice as potent, twice as bitter, and can be bought in a bottle twice the size of the original Irish version.
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