Lazy Sunday

Triplets doing well

The good news is that the babies were all still doing well this afternoon. Nurse Peter said he had a busy night. He took to feeding the three stooges every few hours, giving Mom a break. I fixed up a toomey syringe with lactated ringers and dextrose. Nurse Peter has named the three Michael, Ajak  and Khor Peter after the three attending men. Khor means lion and is nurse Peter's Dinka name.  He even put bracelets on to identify them. I don't think the Mom has had much to do with this. No girl, no Catherine.

Sitting in the back at church

Went to church this AM. It was great. This afternoon I went to Peter Kuchcorn's tukel. It was so cool inside. These Sudanese are on to something with their construction design. They are probably the same design since the time Christ walked this earth. We all spread out, put on music from Ajak's computer, read, visited, drank warm pop. Can't think of a better Sunday afternoon.

Peter Kuchcorn

Relaxing in Peter's tukel

Aaron chillin' at Peter's

This next week will be full. I think we will be discharging the burn guy - Malik is his name. I will be teaching his family how to do dressing changes. We will visit the leper colony probably on Wednesday. Dr. Mike has a connection to a Swiss group that takes care of lepers. We will go on a fact finding mission as well as hold a clinic, and then make a report to send to this group. We are also working on a list of medicines and inventory and what is needed immediately. There is also a  need for such basic things as gloves, gauze, 20g IV's. Somehow we will get by. Always seem to.

Happy Sunday to all.
C

I don't know nothin' bout birthin' no babies

OK, easy day. Few patients, some inpatients, and of course our burn patient. So an easy day. Spent the day going over solutions to get meds for the hospital. Working with Dr. Samuel of Bor State Hospital. He also is a Cuban Lost Boy and colleague of Dr. Ajak. Hopefully we will get some info soon and have a source of meds.

What a miracle

Dr. Mike with #3

This afternoon, after 3pm, a lady in labor came in. She delivered at home but was very obviously still pregnant. So we took her into the OR and watched as the labor progressed. Sure enough, baby number 2 came. He is really cute and appeared to be doing really well. So two boys. While waiting for the placenta, I said to Dr. Mike and Dr. Ajak "I think there is another baby, here is the head" and I was pointing to her upper abdomen. No its two placentas. Hmmmm. Anyways, placenta came out and baby boy number 3 came out. He was flaccid, not breathing and not a good heart beat. Dr. Mike went to town with compressions, I grabbed a mask and got the compressor on, we put a mask on and actually did some breaths into the little thing. He is probably a kilo (2.2 lbs), kilo and a half. No more than that. We did the stimulating and rubbing his back. And he had agonal breathing. Then he did better with the mask on. The compressor only goes to 5 liters, but it was enough. Thank God we had the generator on. Pretty soon he perked up, and started to breath on his own. After awhile he opened his eyes and tried sucking. We have tucked the kids in with their mom and grandma's and the traditional birthing lady who showed up to help. I am not sure they will all make it, but because of this hospital, they will have a good chance. Please keep them and their mother in your prayers. I guess I can help with this birthin' baby stuff.

Three little peanuts

God's peace to all
C

Friday Night Light

The moon is nearly full and the light it gives is unbelievable. Like a bright lamp up in the sky. I have to put something over the head-end of my mosquito net to keep the light out of my eyes so I can sleep. It is really beautiful.

I saw my first really big snake. I don't want to see another. It was going across the road. Dr. Mike and I were coming back from Werkok. Of course I am looking the other way and Mike stopped. I said "what" and he is just pointing. I was this close to expiring with the big grabber. Another exciting moment in Werkok, brought to you by Dirty Pants.

A group of people stopped by from Samaratin's Purse. It was fun to show them the hospital. They really liked it. I am so glad that I cleaned this morning. Gave a good impression. It is always nice to have visitors and to hear their stories. Last year on my way over here, I sat next to the mother of one of the girls who visited here today. Small world stories abound.                                                                                                  

Meeting friends on the road to town

Sign outside of the municipal office

Naomi's home

Kids can always find something to play with

We walked to Werkok for a cold pop early evening (see snake reference above). It is amazing how many people I now know. Felt a little bit like home when Dr. Mike said "do you know everyone?" I was crackin' up. It is fun, and hardly different from home - families trying to make ends meet, playing with their kids, loving their family, just trying to give them the best life possible. No, not too different from what any of us want.
C

Bor here, Bor there,

Dr. Cooper talking with Dr. Ajak

Ajak is in Bor at Bor Hospital attending an education seminar and getting CEU credits. He is working with Dr. Warren Cooper - who has worked with Dr. Chupp, Dr. Dan Stephen, Dr. Lim, etc. from Southwest Medical Clinic back home. Such a small world. He knows all those guys. Yesterday I took the burn patient to see him, for an opinion on how it is healing. He said that it looks really good and to keep up the same routine. I will continue to debride every day. A few more days ought to be all that is needed.

He is so sick, not much could be done

Then today John Makach, our mechanic/driver, took me to a neighboring village to find a boy with a heart condition. We were to take him to Bor Hospital so Dr. Cooper could do an echo cardiogram on him. They were suppose to be at the hospital on Monday but did not show. So John and I went looking for him. We found him in the hut of the traditional healer. She had made slices on his chest to bleed out all the bad. It was really sad. He is so pathetic. He is 10 years old, weighs about 40 pounds (maybe) and is skin and bone with large joints. His knees hurt so bad he has difficulty stepping up. His breathing is shallow and at a rate of about 36. I felt so bad for this little guy. We got him to the hospital and Dr. Cooper did the echo. It was very painful for the boy because of the burns on his chest. He was very brave though. Unfortunately, the bottom line is he needs a transplant. If it had been a mitral valve, Tenweck could have repaired it. But the ventricle was not moving. He has lots of problems with the heart. His name is Aluang Kuong, please keep him and his family in your prayers.

Traditional Healer's tukul

Our trip to Bor today was crazy! We got a little rain last pm. But closer to Bor, they got lots of rain. The roads are pure slippery mud. We might as well have been on ice. John did a great job, not getting stuck. It is easy to see why the road are impassable during the rainy season.

Hope all is well with everyone. Lot's of snow?
Love, C

Bats, Cats & other creatures of the night

My sleeping quarters. 

I sleep in the middle of the compound on a cot with mosquito netting over it.  It helps me catch any breeze that happens to go by. Usually I leave my mosquito net open on one end to get some air. Last night a bat flew in with me. Man, did I every move fast outta there. It is a very small space. And then a cat jumped into my bed and grabbed the bat and took off. You can't make this s*** up. Crazy man. So I was not sleeping well due to this and I keep hearing noise either in or behind the closest tukul (hut). I am just paranoid I thought to myself. Then there was a low flying prop airplane flying over, very slowly. It took forever to get over. I have never heard a prop job at night. Fifteen minutes later there was a lot of gunfire. It was in the distance, I was not frightened. It was just an odd night. In the morning one of the Sudanese who lives here asked if I saw the gazelle hanging out behind my place. I guess that explains the noise I was hearing. Also, John Makach, our driver, said he heard an antonov, a Russain made airplane that the North flies. Hmmmm. Such a strange night.

Dr. Mike challenging Mary

Mary learns American games

We have introduced "cornhole" to all the staff. Some stiff competition is going on here. It also explains the beanbags I was making last weekend. The beanbags work great. As usual, I am having a fun time in Werkok.

Wish me a good nights sleep - C

Melting Monday

Market T-shirts

In a great Ethiopian restaurant

As we enter our week, we continue with high heat, and a sweltering hospital. But let me catch you up on the weekend. Saturday night was a feast. The pineapple was nearly frozen - ahhhh. It was really great. Then on Sunday we feasted on Ethiopian food and hung out in the market at Bor Town. I am living the high life. It was a great weekend. Just lots of hangin' out.

Lots of stuff at Bor market

This year is so different in the amount of work to be done. I find I am working normal hours - 8:30 to 6:00 and only a few hours on Saturday and Sunday. There are so many people who have worked during the past few years to make it a little easier now. Thank you, you know who you are. We had a nice day today. Full patient load, some interesting cases. It is so dry that we are not seeing the malaria that we have seen in the past. Also, having the hospital here for the past few years allows the people health care and so many more people are using mosquito nets. All these factor into a healthier community.

Cool fruit drink on a hot day at the market

We have been having many visitors. Today a person from Samaritan's Purse came. He will be the foreman for the building of a new ward. This ward will be for women and children particularly maternal health. This is very exciting to see the growth. Also, KK from CMA came with two other guys. KK has been here the last two times I was here. He is part of an "eye" team. They do trachoma surgeries, saving many people's eyesight. It was really great seeing him again. He will be returning in April to start a full time clinic here for trachoma. The growth here is just amazing.

Well, signing off, hitting the hay. Have an incredible north wind blowing tonight. It is so refreshing. Maybe it will blow the Sahara down here. A phenomenon that I experienced two years ago. I will let you know tomorrow.
C

Lazy Sudan Day

Lazy day today. Only a few patients this AM. I was very busy making bean bags since we have a board for cornhole. Hot competition tonight!!! I cut off a pair of my scrubs. We ran out of rice to fill them, so I only made three. Mary, the cook, was a bit ticked off. I also cut up a pineapple and put it in the freezer that is used in the lab. It is a kerosene fridge/freezer. I am hoping for pineapple ice cubes. Then we are having a luau. A little limbo, some cornhole, Beatles music.....ahhh life is great.

My cut-off scrubs, they made great bean bags

Tomorrow we are having a roadtrip to Bor. Going for some Ethiopian food. Am looking forward to it. Hope all are having a great weekend.
C

Another week bites the dust

Can't believe we are to the weekend. Where is the time going? Here is some info on the work I am doing. I have been inventorying two containers of "stuff". I think I have mentioned this before. I am done now and actually have a nice supply room with supplies that are needed. I am sure it will be very helpful to the staff. Also been inventorying the med situation. We are out of lots of antibiotics. We will try next week to find some. A list has been made, now to find a supplier, hopefully at a cost we can afford.

We has a total of about 14 surgeries this week. Dr. Ajak is at a conference in Bor Town and won't be back until next Friday, though he showed up today with some of the other doctors from the conference to look at some cases here and to show them the hospital and the compound.

Happy at work

We received a burn patient last Sunday. I have been deriding his burn which is about 25% of his back, up onto his right shoulder. It is tedious work, as we don't even have a scrub brush to get the dead skin and ookie stuff (really it is a medical term) off. Just use cut up cloths and gauze. I sedate him with ketamine and every time I'm done and wake him to get back into the wheelchair he looks at me with wide eyes and says "mama". This just cracks Daniel, my assistant, up. He is coming along, but I think of all the healing he has. It was second and third degree. He went to another hospital first and they gave him penicillin but not much else. he was in terrible pain when he got here. I am so thankful for our running water. it makes it so much easier to keep things clean. We are low on ace wraps so I wash one and hang it to dry to use the next day on him. They get pretty stinky.

Gabriel & Peter - my Dinka teachers

Happy, just before I speak Dinka to her and she runs away screaming!

I have a bunch of friends teaching me Dinka. Today at my lesson, two little girls were walking by and I started saying phrases to them asking their names, saying hello, etc, and they both started screaming and ran away crying. You have never seen Dinka laugh so hard. They said it just frightened them to hear a kawaja (white person) speak dinka. It was hilarious. Well, must be on my way. This is a long blog. I apologize for my ramblings. I appreciate every one's thoughts and prayers. Back atcha
C

Where the goat and the antelope played

Pesky chickens

Mary going into the cook hut

I'm thinking that your thinking "what the heck is she eating" We eat antelope and goat for our meat. We did have chicken once. That pesky rooster was way too loud in the AM. There are no greens. We have some oranges and pineapple, but very little. One orange for 7 or 8 people. We do get some cabbage but it is usually cooked with carrots. Every meal does have some homemade bread. Either rolls or a flat bread. it is very good, cooked over an open fire. Mary is our cook. She has been at the compound for some years. We do have things prepared in the Sudanese style. It is OK, tolerable. As many of you may remember, last year there was very little food. The compound was somewhat dependent on a container arriving with supplies. It never came last year while I was here. Now all the food is bought by locals, that is a good thing. I did bring oatmeal packets for breakfast, but find it to be too heavy. So now, just a cup of joe, ahhh, instant Maxwell House really gets the blood pumping.

Most of the crew left today. It is me and Dr. Mike McMahon, Aaron and Matt the construction guys.

Have to go, the bugs are attacking the light
C

Another Manic Monday In Sudan

Medicating a burn victim

First I will let you know that my day yesterday was very nice. It was quiet around here. Then we received a patient who was burned one week ago. Probably a quarter of his upper back, his shoulder, ear and head. He fell into a fire at a cattle camp. He was given antibiotics. Now he is in terrible pain. It actually looked ok but will need debriding as the skin is getting hard. This could impede his range of motion of his shoulder. Slathered with silvadene cream after putting some clean cloths on it so soften and clean a little. We will look at it tomorrow in the OR to see if we can get some of the skin off. I did medicate him and he slept through the night. I then took a stroll over to north compound to visit with my friend Peter.

This week I am pushing to get finished with the inventory of two containers. With Dr. Junko here, I am not as needed in the medical end of things. A perfect opportunity to get this work done.

My friend, Lee, asked about what should be sent to the hospital. Good question. I am sure each project is unique. The number one question should be "what is needed for this specific project" then stick to that. Questions you may ask are: is there electricity, is there running water, who will this project service, what is the climate (I just came across winter clothes for kids today and it is 120 degrees here in Sudan!) Just be sure to ask alot of questions so that helpful and appropriate stuff can be sent.

Some friends I met on the road

Smiles all around

This evening several of us took a walk to downtown Werkok. It is a small village but is bustling with activity. So many kids and they all want their pictures taken. I really should experiment with my camera and downloading. Any advice from anyone would be great.

Well, this is all for now. I am having a great time and am enjoying Sudan so much. I just love the people here. Sweet and kind.
C

I heard it was Valentine's Day

Happy Valentine's Day to all. Did not realize it until I turned on my computer! Not a big holiday here. Yesterday Ajak, John the driver/mechanic, and I went to Bor. We stopped at the Deng clan compound and found Dr. Deng, grabbed him, and then went to Ajak's sister's home. She has 7 kids and no husband. Ajak supports her. I  gave her clothes for the kids last year and saw they still had them on.. So this year I gave cash so she can get clothes as needed. She is well as is Ajak's mother. I met all of them on my first trip here, in 2008, and have made a point of visiting several times during my stay.

Ajak's kin and me

Ajak's mom

Dr. Ajak conferring with his Mom

Dr. Deng with Ajak's nephews

Ahh, Sudanese bar-b-que

We also went to Freedom Hotel and restaurant and had some refreshments. It was fun. It was as if I had never left. Saw the people who worked there and they all greeted me by name.  Again, we picked up a table and sat behind the restaurant where the staff lives, just like last year. Then nobody watches us us. Sounds odd, but that's the way it is. Bor is growing. It is so Africa. Yikes, have to run, but will finish later.

OK, I am back. Had a dressing change to do. Yes, like at home, nurses work on Sunday! Everyone went to Bor, Ajak and I stayed. A few patients in the hospital. They will all have Ethiopian food in Bor. I am sure I will get my fill during my time here. The truck was full and I am looking forward to a quiet day - blogging and washing my underwear. Who could ask for a better life?! So Ajak and I go over things here in the hospital and figure out where there needs to be changes (a clean utility room) and how to dispose of unnecessary things. We make some progress even on Sunday. And I enjoy the quiet of the compound. Not much traffic on the road. Only some troop transport vehicles. Ajak said they are the disarming crew. They are headed for the Merle (not sure of spelling) another tribe that have caused a few problems in this area. The Dinka in this area have already been disarmed. I have not heard any gun fire this year.

Well, on that pleasant note, I will say hasta manana or wo be yook nhiak - see you tomorrow
C

The scorch of Africa

Missed yesterday. Busy at the clinic and with organizing the storage container. Taking inventory and getting rid of things that are not needed - for example the craniotomy drill. It's pretty amazing the things people send over here. I do get a little miffed each visit and see the 4000 self cath foleys. Hmmm, not one has been used, maybe I can ship them to another hospital that has urinary retention patients!! So please, if you are ever thinking of shipping "stuff" someplace, please make sure it is something that can be used. Ask if they have electricity.

Getting meds for patients

Listening to the BBC

Coming to visit Miss Catherine

Gabriel's children, Hok and Aya, catch my heart

Always there to help

Gabriel is one of the "nurses" here at the hospital. His picture is on the side. He has been here since I have started to come. He has a public health certification which is not too much more than education of a CNA - certified nurse assistant but does so much more. He also has been trained in trachoma surgery. This is a surgery on the eye lids to get out infection and scar tissue that has formed from the flies landing on eye lids. Gabriel is currently getting ready to start his senior year in high school. You see, because of the war, he was not able to go to school. There were no schools, they all closed.  Now he is much older.  I think in his 30's. He has been trying to finish up his secondary education since a school opened here two years ago. He goes to school during the day and works 8p to 8a at the hospital and takes care of his family. He would like to become a Clinical Officer. This is similar to a PA. They have a patient load but also oversee the daily running of a clinic. The education for this would take place in Kenya. There are several schools. He is familiar with Kenya as that is where he took his trachoma training. I told him to get information and to see what the requirements are to do this. He is a good person, loyal to a fault and so very hard working. He has a command of the English language. I do not think he has to finish high school to do this because of his only needing one year and his clinical experience. We will talk to Dr. Ajak later today to see if he thinks Gabriel can do this. I think he can and told him I would give whatever support possible.

Our beds in the middle of the compound, hoping to catch the breeze

It continues to be extremely hot. Never cooled down last night and most of us were outside under the stars begging for a little breeze to hit us. It is afternoon and is too hot (116 degrees) to be moving stuff from one container to another as I organize and inventory. I will go there soon though, to finish this project today. Hope all is well in Joe Town and places in between. Oh, by the way, I will not post pictures as it takes too many bytes (I think that is what happens) and will use up all my time. I will have a big posting of pictures when I get home.

Take care, C

Snow? Can't remember the cold

Hard to imagine a place in the world that is cold and full of snow. Think of it as an adventure. The day was spent going through meds and trying to continue the organizing that was started before I came (thanks Stephen). The work is never ending but is good work with lots of camaraderie going on. Junko did great hammering out cement from cement blocks that Aaron and team made. So great to see a Dr. working so hard.

As I promised last night, a little more on Ajak. He was sent to Cuba when he was 11. Around 600 kids were sent. He was housed, fed and educated there. Cuba was the only country to take these kids who were caught in the crossfires of war. General John Garang, who made the arrangements, gave a commission to these kids "get educated, you will be the ones to return and save South Sudan". So many of what I call the Cuban Sudanese have returned. They are all educated and they are all professionals. The Minister of Defense wants to interview them about their military service to see if they are exempt from further time in the service. Off he went to Juba with two other Cuban Sudanese doctors.

The kids are just grabbing my heart. They are so cute and they dress up to come to the clinic.

The road outside of the hospital is very busy. This is now the main road to Bor. We are almost not in the bush anymore with the traffic. At least 10 vehicles went by today. Even mutatu's go by - they are the taxi's. Ahh, progress, sometimes it is not all that it is cracked up to be.

My thoughts are with everyone in the snow.
C

Back in the swing of things

Tom & Tim working on the veranda





Back in the OR with Dr. Ajak

 Day consisted of 6 surgeries and also clinic. I helped Dr. Ajak in surgery while Junko worked the clinic. The construction team, I have only mentioned 2 - Tim and Tom who flew in with me - has been very busy working on the veranda. This is so great since I pushed for one for the past 2 years. It will give shade, keep direct sunlight out and keep the rain out. Patients can sit outside on the veranda and be in a relatively clean area. This is good. Aaron, a young kid (maybe 21) is kind of in charge. He has been here since November and has done so much with the compound. He was here last year while I was here. One of the best things is that he is buying local. That can mean as far away as Uganda. But it is African and it is employing people. Many of the same workers are around from before - John, Blind Daniel, and alot more I recognize but don't know their names. Rounding out the team is Matt.  Matt is from around Grand Rapids and will be going to Michigan State University next year.  He, along with Aaron, are here long term.

Neighbors of the compound

Junko and I took a walk to downtown Werkok this evening. Lots of kids. Also met a lost boy from Atlanta. This is his third trip back to see his family since finding them. He is having a good visit but recognizes how hard life is here. He does not want to move here permanently. The kids we saw are cute as can be. Of course lots of dirt and head fungus, eyes are swollen with the fly bites. But they are very happy and kind. Also very shy.

Ajak has left this evening for Juba. He has an interview with the Defense Minister who is interviewing all the Cuban boys. I'll explain that whole connection tomorrow. I think he is being interviewed on his past military service. Hope they don't make him reenlist. That would be terrible.

This is all for now. Hope all is well. We are HOT HOT, HOT. Thanks for reading.
C

Back Home in Werkok



Flying In



Arrived about 2pm. Many at the airstrip to greet the plan. So many friends here! A film crew got on the plane to head out. They were filming Dr. Ajak and a professor, who also is a Dr., from George Washington U. He is filming some of Ajak's life as a repatriated "Lost Boy" as well as a study in peace. They have been working with clinics and doctors from the Merle and Nuer tribes. Werkok and the surrounding area are Dinka. So this is a great thing.

HOME

Let me introduce you to some of the players. The people who flew in with me from Nairobi are Junko (wrote about her last night) Tim Williams - he is a board member of Partners in Compassionate Care, the umbrella group I come under. Tom - he is Mr. Construction and has already fixed the front end loader and other stuff.

At the hospital is, of course, Dr. Ajak. There is a new hospital administrater, Jacob. Nurse Gabriel is still here, also James (2 syllables Jay mus), Daniel, and a new nurse Peter. They are all Sudanese. There is a medical officer who is like a Physician Assistant John Jok, and Simon the new lab tech. Again they are all Sudanese and are making a go of running a hospital. This is good and what is suppose to be done.

My Mama's who take care of me

Many of the mama's are still here. They are the staff that cooks, cleans, keeps us running. Truly ol' home week seeing them. They are beautiful, loving and have horrifically tragic war stories. But they have perservered.

That is enough to keep things straight. The three I flew in with today will leave a week from Wednesday. Another Dr. will arrive on the plane that comes to pick them up. I will write more tomorrow on how the compound has changed and how the hospital has grown. I may even try to get a picture up of everyone.

God's peace to you all
C