Students using the library

My Mapuordit Blues!

Making groundnut paste

Winnowing sorghum

Monday 24th October

Well we have one more week to go, it has gone so fast, always something happening that you have never come across before. Two patients this week with human bites – one a marital problem, the other a drunken escapade. I thought hyenas were bad enough!

A few witch doctor treatments gone wrong - charcoal in eyes, cutting between fingers (patient died).

Malaria continues to take its toll. 14 children died last month, the death toll I think will be higher this month, as it continues to rain, so the suffering continues. It tears me apart to go on the children’s ward, which I do daily, so many babies with the complications of malaria such as pneumonia, cerebral problems, anaemia, temperatures above 39C, on top of malnutrition and some with HIV.

The nurses are flat out just keeping up with the tepid sponges to reduce temperatures, and keeping cannulas patent to give them their quinine.

At the moment there are 32 children admitted and I think 30 would be in with malaria. Never seen it this busy, it seems a never ending stream. Please someone, work hard on finding that elusive cure!

I am sitting in the library tonight as it is open three nights a week. This task gives me great pleasure, as each year there are more and more books (thanks to many of you, particularly in the UK). In my first year here, there were 3 shelves, now about 20 with some great up-to-date books.

More and more of the students and staff are taking an interest and learning how to use a library. This is a big thing in their lives, as many would never have had a book in their hands, never mind being able to take one home. Some of the TALC books (Teaching Aids at Low Cost UK based) are so good, lots of pictures and very basic English - they are always being borrowed.

Just for interest, my final dressing list with the students included:
One osteomylitis case? waiting for a skin graft when a new Dr comes next week who thinks he might be able to help
One spear wound to the chest
One hyena bite to the leg
One little girl who developed an abscess on her abdomen and was taken to the witch doctor for treatment! She has been with us now for two weeks and will be here for at least another week on antibiotics ++
One head wound of a lady who was beaten with a panga by her co-wife
And 3 leprosy cases, who have all had surgery to their poor crippled feet.

Unfortunately all the lovely dressings I was given in Sydney are well over and we are back down to the basic - cotton wool and gauze - but it’s all they expect, and when they get a new bandage on top they are all very happy.

What did throw a few outpatients recently was when they returned to have their sutures removed after surgery, and there were no stitches to be found.
We had our Australian Dr working here in the operating theatre and he has a wonderful way of using dissolvable sutures. Never seen here before, so I think the patients were a bit worried that some magic had been played on them; some were even disappointed that they were not going to have to suffer the removal of stitches!!! They are strange people.

Last day at work today, so there was the usual farewells at the assembly. They are amazing speakers, when they get going. Lots of talk about Ian coming to reclaim his wife, and how good he is to have loaned me to them!

The best bit was when they said ‘I am an old woman but I still work very hard and set a good example’. It was meant as a compliment I am sure, but I could not stop laughing.

We are old here as the life expectancy in South Sudan is around 42yrs, so we are going well. Saying that, I really don’t know how the UN worked this fact out, as there is no registration of births or deaths here.

The two lots of students also gave us a nice send off, with lots of small gifts of flowers, a small pot and we even got to plant a tree. Felt a bit like the queen, but it was a dirty old spade not jewel encrusted.

I think the tree was a ploy to try to get us to come back next year to see if the tree is growing.

We leave tomorrow morning at 6am early, just in case the track is flooded or other problems like cows blocking the road.

P is coming too, which is a big sacrifice as it is a terrible journey and I know how busy she is as the main administrator, nurse, midwife, social worker, mediator, wages officer, clinical tutor, accountant, problem solver, and I could go on but she will kill me if I do.

We plan to have a stroll around the wonderful clean town of Rumbek, have lunch at a luxury resort, lots of tears and hugs, and leave on time, on our Lear jet for Nairobi.

My impression this year 2011 of South Sudan is that the people seem happier to be free of the North but apprehensive as to how the new country can survive.

Only a small minority have paid work, that work is usually connected to the UN, UNICEF, Combonis (who run the hospital), Our Lady of the Sacred Heart, Red Cross all those organisations. As they move out over the next few years I am not sure what or who is going to take their place.

The idea of taxes paid to a government out of their wages will be abhorrent to them, but of course taxes, like death, are inevitable!! Unfortunately, over the years they are used to hand outs, don’t pay for anything, everything is given. We koadjas (whites) all feel better by doing that, but I am sure in the long run for them, it is not the best.

Education is the only way forward and at least here at the hospital that is what is being achieved.

As I write this, the final year students are sitting their final exams to become certified nurses (these are the ones I helped to teach in 2009,) the first in South Sudan. So they don’t know what to expect, no past exam papers to study.

I do hope all 11 get through. It is a fantastic achievement for this hospital, in particular Dr R and P. They are the ones who pushed for it and found the sponsors (CISP an Italian organisation) & they had the vision for the hospital's future.

The plan is that the newly qualified nurses will come back and start taking up the more senior positions in the hospital and slowly replacing the Kenyan and Ugandan workers (and koadjas like me!).

One already is booked to work for a 6 months period in a Ugandan hospital in a radiology department to learn the ropes so that next year when we open this type of department in the hospital there will be a local there to take over the running.

This young man is very happy as he is being sponsored by two very good friends of ours, so all this can be achieved. Thank you so much, it's a huge gift to South Sudan. Slowly, slowly this country will grow if the people, men and women, are educated and the tribal fighting can be eventually eliminated.
Here endeth the last lesson! Hope to see you all very soon. Thank you for following the blog, put together with the help of Ian and the girls.