Wednesday, Thursday, Friday

Gabriel, Mary and the kids

We got up early on Wednesday and headed to the airport.  Before going, Gabriel and his family visited.  They all look well and the kids are darling.  They have grown so much.  Hok is in school.  Aya starts next year and Lual is such an outgoing little imp.  Mary and the baby came a little later.  The baby looks healthy except that Gabriel said he recently spent three weeks in the hospital with diarrhea.  I am glad he is well.  Mary looked beautiful as always.

We headed through the neighborhood back to the main road with Gabriel carrying my too big suitcase.  Over the stick bridge again.  We got to the road and about three minutes later Makach picked us up.  He took us to Bor Airport, which is noting to write home about.  Thank goodness the man who took my money for the flight was there, checking in passengers.  He announced that there would be only one flight that day.  Boy did negotiations start.  By 9:30 we were in the air and I said goodbye to the Bor/Werkok area.  I had a long delay in Juba, I sat in a covered seating area that has some snacks and cold drinks.  This is new and it was quite comfortable.   Ajak and Mary went on their way.  We said goodbye - sad- as they had to get Mary's yellow fever shot and Ajak had to pick up his passport from the Canadian Embassy.  He is traveling to USA the same day I am but will be on another flight.  I am hoping to see him while he is in Grand Rapids.

I flew to Nairobi in the late afternoon.  During the flight I started with a sore throat.   It has progresses to a whopping full blown cold/upper respiratory infection.  Yes, I have been miserable and really have no idea how this happened.  I arrived at Joy Phillips house.  It is beautiful and is right down the street from Karen Blixin's house.   "I had a farm in Africa".  Anyways, I did get a good night's sleep and in the morning we headed to Tenwek Hospital in the Rift Valley.  The drive was beautiful.  The mountains are layered with different fields and pastures. It was a three and a half hour drive. 

Tenwek Hospital is amazing.  It is quite modern with many specialties.  Currently there is a cardiac team that is there.  The first week they did adults and the second week pediatrics.  I think there was a total of 35 people on the team, including cardiac nurses and the docs.  They brought all their own equipment.  Quite an undertaking and they have had amazing results.  I met with docs and clinical officers who would like to come work in Sudan, holding clinics as well as doing surgeries.  I am very excited.  It was good that I had just come out of South Sudan and could talk first hand to them about the facilities and the needs.  This was a very good trip.  I saw Dr. Chupp and Dr. Spreigle.  They both look well and were so surprised to see me.  It was fun seeing where they work and where so many of the team from Southwest Med Clinic come to work.

I am now back at Joy's home.  I leave later tonight and am very concerned about my ears.  My cold has progressed from bad to worse.  We will go to a pharmacy and get some drugs.  You can buy most things over the counter.  The day is beautiful, sunny and her gardens are amazing.  She does have to keep windows closed or the monkeys get into her house!  Imagine.

I have had yet another wonderful adventure in South Sudan and now in Kenya.  I am blessed for all I have and all I have  been exposed to.  We truly live in a global community.  Until my next adventure.  God's peace to all.

This is About Tuesday

I woke up early and finished with packing.  My suitcase is too heavy.  The clouds are coming.   Around 7:45 it started to rain, and it rained, and it rained.  I guess I will wear my gum boots to Palabach.  We called Ajak and let him know about the rain.  He said Bor was clear.  That is good.  We finally left around 10:15.  The ground is very wet and muddy.  It is slippery.  It was not too long before the guys were way ahead of me.  Mawiel has my red suitcase on his shoulder, my porter, walking fast with his ultra long legs through the bush.  Quikcorn stays with me.  We talk about problems in South Sudan as we walk.  So much is so good and so much is so bad.

We made it to Palabach around 11:45.  No car waiting.  Hmmm.  About 15 minutes later Makach and Ajak drive up.  Dr. Moses is also with them.  It was a hard drive they said.  I said goodbye to my friends.  This is always the hardest part.  Quickcorn and Rachel drove to Bor with us.  They had business there.  It was a crazy ride.  The mud is the same as ice.  We slid all over the road and at one point came very close to a truck that was traveling in the other direction.  Makach is the best driver I know.  I love him. 

We got some lunch in Bor town, Ethiopian.  It was excellent.  Then Ajak and I went and paid for our ticket.  The man said he was sorry, no receipt and no paper ticket but he would be at the airport in the morning with the list of who paid.  Ahhh, South Sudan.  We ran into a people from Handicap International.  They said they have lots of equipment and they could assess the lady in Werkok with the Rheumatoid arthritis. Check that off the list.  I am so glad. I will email Deng when I get to Nairobi and let him know to make arrangements.  I am so glad about this.  Check that off the list.  We went into the market to a beauty salon and met Ajak’s wife.  She was getting a wig made.  She is beautiful and was very shy of me.  I could tell she and Ajak are very happy together.  I am glad for him.  We met Gabriel and James.  I gave money to Gabriel to purchase some IV catheters and give them to Rachel to take back to the hospital.  Check that off the list.

We went back to Dr. Moses’ place, where we were storing my stuff.  The doctors from Bor Hospital came and we had a wonderful feast.  We talked about opportunities and working for South Sudan.  It is a baby nation and someone with money could get so much stuff going.  It was a great gathering.  I wish all of these hard working people the best.  They are brave and courageous.

Off to Ajak’s house.  We were dropped off on the road with our suitcases.  We walked, in the dark, through “neighborhoods” over a bridge made of sticks lying across two pieces of wood.  I had visions of landing in the stream below.  Up a small hill, slippery, down the other side, winding on the path finally to a clearing.  It is Ajak’s family compound.  It is good to see his mother and sisters.  His wife is there, she greets me when I go into the tukel – “Ah, Mother” and gives me a hug.  Their home is a modest square tukel, the inside is roomy and it is comfortable.  There are two beds and a small square table in the middle of the room.  There is a bouquet of plastic flowers on it.  I know Mary Aman worked to make it look good for me.  The walls are covered with fabric, giving it the feeling of a childhood fort.  It is charming and I feel so welcome.  Ajak and I sit outside.  Of course the mosquitoes are terrible.  I spray and it is more tolerable.  His sister comes over, her youngest on her hip.  She is very frightened of me.  She wiggles down and hits Ajak on the knee.  She is saying to him “why did you bring that kawaja here?”  Ajak is laughing, telling me what she is saying.  It is so funny.  Eventually she calms down and shakes my hand, the sign of hospitality in South Sudan.  She is precious.  We soon go in the tukel, get ready for bed and very soon the entire area is quiet.  I hear Ajak and Mary’s soft breathing with an occasional word being said.  I am content, I am comfortable and I have been honored to be invited into their home for the night.  I pinch my arm, am I dreaming?  It is one adventure after another.  I must keep reminding myself is to live in the moment and be glad in where I am.  Yes, I am very glad.

Last Day Blues

He was so happy with me!

Today is my last full day in Werkok.  I am so sad.  Up and checking on patients.  Mama a little better.  Deng and I went to Werkok this morning to meet again with the Chief and Elders.  We drove the blue land rover.  It is up and running.  Battery charged but the windows won't go down.  A little warm inside. While waiting to get started, I walked around and talked to kids and held a baby who was crying and the Dad seemed perplexed as to what to do.

Snuck this photo during meeting

The meeting was good.  Just talked about the future and a bit about the past and history of the area.  It was great.  Everyone seems to know me. Some guy walks up to me, hand out saying "Casrun, Casrun, you return"  and all sorts of other things.  I said "it is so good to see you again!"  Clueless as to who he is.  Even the kids know my name. 

Whole family to see doc

After returning to the compound, I helped with patients.  More diarrhea people coming in.  It seems to be going around.  The Mama was sitting up in bed.  Her daughter took her out and washed her, I helped with the wheelchair.  She is getting better.  Quickcorn had to go to a meeting in Bor and is bringing back some meds.  I think once she gets these meds in her, she will really turn the corner.  But she was up and talking and that is a huge improvement.  Other patients I saw had problems with vericose veins, malaria, diarrhea, wound recheck, baby with cough, young adult with bloody diarrhea.  And the list goes on.

I finally had a chance to clean up my room and get my things ready.   Ahhh, so many scorpions in my things.  Catherine 4 - Mr Scorpion 0. I hope I don't bring any of them home!

I got him

I don't seem to have too many things to bring back.  One suitcase and then my backpack.  But still, we have about an hour and a half walk to the junction.  Ajak and Dr. Deng will be there waiting for me.  I hope.

Beautiful sky

I am going to miss this place.  Hard to believe my time is over.  It always goes so fast.  The sunset tonight was particulary beautiful.  I sure will miss it.  Every evening is a treat.  I am sure I will have some adventures in Bor Town tomorrow.  Then off to Juba on Wednesday.  I still have a long journey home.  And I get home Thanksgiving week.  I certainly have an awful lot to be thankful for.  Life is so good. 

Another Week

Time is passing too fast.  I am in a tizzy trying to make lists, see things that need to be done, organize some of the hospital things, etc.  Yes, I do like 5-6 weeks better than three.  Church this morning.  The priest was not there, some big gathering west of here.  Afterwards I checked on patients.  All are okay.  Our poor Mama is just not   bouncing back and we are out of med.  I did don the space suit and went into the white container to see if there was any metrondizole tucked away somewhere.  No luck and no stings.

Gabriel came by.  We talked about his education.  I went on line looking for places and costs.  He has his list and now must travel to places to see where it is best for him to go.  We then walked to town, visited with many.  I took tons of kids pictures.  It was so fun to see them.  They are really not any different from kids anywhere.  And they are so beautiful, even with their dirty faces.  One boy was making mud cattle.  Even as young kids understand the wealth is noted by the number of cattle you have.  That is your importance.  I will add pictures later that I took of these little mud figures.  They were really cute.

Our guard is back.  He has been here for several years. When I arrived this year, there were no guards.  Now he is back.  Apparently he had to go to Juba for work.  He is military.  A nice guy and he was so surprised to see me.  I always felt safe knowing he was walking around at night, especially when I would sleep outside.  None of that this trip, due to rain.  And it is cooler.  I think the temps have been in the 90's during the day but down to the 70's at night.  Good sleeping.

Short report tonight.  Life is good.  Back at the grind tomorrow, seeing patients and trying to get meds here.  We have the money, just not the means to get them.  I am sure we will get things this week.  At least I hope.

Saturday's All Right For Fighting Bees

Much Better

How do you like my new picture?  See, isn't it different with green.  Today was somewhat lazy.  Saw patients in the morning. Am still concerned about the Old Mama.  She is just not bouncing back very well.  We are almost out of medicine for her.  The young girl with malaria is much better today. Cleaned some wounds and bandaged a young boys leg.  He had three round sores on this lower legs.  I think he fell over a stake that is used to tie the cattle to.  I told him to leave the bandage on for two days and then he had to wash them with water each day.  The cattle camps are just filthy. 

Bee hive on veranda

After lunch I did some wash and then set up a chair in the sun and studied.  I have stuff due on Tuesday after I get back.  It was a perfect afternoon.  A beautiful breeze.  I was in the sun about an hour then the shade of the porch covered me.  I keep thinking that I have to take advantage of the sun - I may not see it until next April.  People were coming and going.  Visitors sitting with me or with the staff, one man came and brought his sheep herd while he visited.  I think we have premium grass here.  When they were going to an area he did not want them to go to, he would sing to them and they would go to another area.  It was really something. 

The bees have started creating a hive on the corner of the veranda.  By noon it was the size of a basketball.  I tried to get into the container with the medicines but got stung.  So that was the end of that task.  We talked a lot about what we should do.  I found a surgical suit that completely covers you and has a plastic bubble hood.  I thought they should get the hive into a bucket and take it far away.  They just told me to "stay here" in the dining hall.  Off they went.  Ten minutes later I hear running and laughing.  I came out and Mawiel and Abraham had stings all over their arms.  I ran and got my tweezers and benadryl.  The hive fell down and spread all over.  We are really in trouble now.  I have no idea where it went or where all the bees are.  But I bet they are mad. 

I am going to try to put some pictures up.  I will see if it takes too much power to do.  So bear with me.

Friday - (I know it's Saturday)

I was too tired and lazy last night to write.  The day was actually low keyed.  Checked patients.  After insisting on stool sample (sorry) it turns out our Old Mama has giardia.  Boy can I sympathize with her.  Appropriate meds started, fluids continuing.  We also received a young girl (maybe 14) who has a bad case of malaria.  Started meds.  Will keep her for several days to make sure she recovers okay.  Clinic not too busy.

I finally got into the container.  It is a grueling job but had to be done.  I did inventory, cleaned, combined, threw out.  I put things in the clinic, pharmacy and operating theater that could be used now.  I think the operating theater is now ready to service patients.  It will be great if doctors from Tenwek come to do surgeries.  A real boost to the community.  I even held my temper when I came across boxes of dialysis equipment and venous graft kits.  Better living by chemicals, I say.

My time here is winding down.  I have a few chores to do over the weekend, but I think my list is mostly checked off.  It has been a whirlwind of activity.  Still have to figure out how to get IV catheters.  We are down to two.

I made plans to leave.  I will go to Bor on Tuesday. Yes, another trek through the bush, this time with my suitcase. If everything goes as planned, Dr. Deng and Ajak will meet me at the junction with a vehicle. Or maybe bota bota again. I will purchase a ticket from Bor to Juba.  On Wednesday I leave.  I fly from Juba to Nairobi in the afternoon.  I will stay with Joy Phillips.  The two of us will go to Tenwek Hospital on Thursday and Friday.  I am hoping to talk to some of the doctors about doing some work here at MCH.  That is my goal.  And Joy said we even have a party to go to on Thursday night.  We will return to Nairobi on Friday.  I fly out on Saturday night.

The bees have decided to move.  They are on the corner of the northwest corner of the hospital!  In one day their hive is huge!  I am just not sure what to do about them.  We may end up having to close the hospital for about 4 days, get them removed and then clean the area.  This is just terrible.  People are getting stung.  I am still waiting for some suggestions.

Saying Bye to the teachers

Deng and I walked to the teacher's compound in the evening.  They live in containers that have been converted.  They are really nice.  I took some pics.  They just finished up exams today.  They will all leave tomorrow.  I have enjoyed them.  They are mostly Sudanese and then a couple of Kenyans.  They have a two month vacation and then they return for the next term.  They have three terms per year.  I know Deng will miss their company.

It was dusk when we started back.  The path is small and I stayed close to Deng, not being able to see in that kind of light very well.  We crossed through the school ground, looking at the new buildings.  They are very nice and will service the student very well.  The path narrowed and we were into the tall grass, winding our way through the village, going through peoples "yards" greeting them while they were making their dinners.  There was a gentle breeze that made the grass sway ever so slightly and kept us cool.  To the east, I could see a glow on the horizon.  I pointed it out to Deng.  He said maybe a fire.  In the next few minutes we were treated to one of God's glorious wonders - a red glowing full moon was rising out of the grasses in the distance.  There were a few clouds that reflected the light.  We both stopped, watching in awe at this magnificent sight.  To the west, the sun had fallen below the horizon but the dusk was still evident.  How beautiful the land is!  These moments are part of why I keep returning.  This simple yet complex world of South Sudan.

Bota Bota Bor

Deng leading the way

Got up and got ready to go to Bor.  It was sprinkling.  First checked the patients and was happy to see that they were better.  The old mama was able to talk and had not vomited all night.  The little girl was also sitting up and drinking rehydration salts. I left instructions and then Deng and I started walking to the junction.

It is still wet

I had a backpack and I had on my gum boots.  The first half hour path was small with 6' grass on either side, but then it widened.  The road was hardly a road and I could not imagine driving a vehicle through it.  At the Chief and Elders meeting on Monday, there was much discussion about getting this grated so it will be passable.  It was a nice morning, cloud cover and a pleasant temperature.  Most of the walk was really nice but certainly all terrain.  We did come across some cattle carcasses and saw one laying down but could not get up.  This east coast fever is really having an effect.

We made it to Palabach in about an hour and a half.  This is the junction to the main road.  We walked a short way when a bota bota came by.  This is a motorcycle taxi.  We both got on and the three of us headed to Bor Town.  It was a crazy ride.  The road is just awful and I found I closed my eyes a good portion of the time.  I would make a terrible motocross competitor.  At one point, by a cattle camp, we got stuck in the middle of a huge herd of cattle and they had really bit horns.  I had visions of  being skewered onto a horn.  I admit I was letting out little screams.  One big old steer kicked me in the leg as we drove by! And Deng kicked the cattle back.  All I kept thinking was "you can't make this s#*t up".  It was so totally crazy.  We went through deep mud holes, through grass, around goats and cattle.  But finally, just before noon we arrived in Bor.

Ajak, me, and Makach - together again

Paul, Dr. Deng, me, Gabriel, and Ateny

We met up with Gabriel and went to the bank.  Took care of some banking for his schooling and then went to do errands and see people.  I saw James and Paul, met up with Dr. Ajak, went to the Dr.'s compound at Bor Hospital.  There I saw Dr. Samuel.  He is now the Director of the hospital.  He has his work cut out for him.  I saw many people I have met at the hospital over the past few years.  It was nice to see them again.  I ran into Peter Kuchcon (we call him Quickcorn).  It was so good to see dear sweet Peter.  He has been in Bor because his brother died.  He will be back in Werkok tonight.  I am glad for that.  I have missed him and going to North Compound.  Ajak and I went to check on flights that leave Bor for Juba.  The place was closed.  We ran into Dr. Moses and grabbed a quick bite to eat. Then it was time to get back to meet Deng and Gabriel.  We were hoping to get IV catheters.  We are down to 2 or 3.  Bor hospital is out of them also.  We bought a few in the market.  They were very expensive. This is just terrible, especially with the issue of vomiting and diarrhea that is going on.  Then Dr. Deng showed up.  He is great.  So good to see my old friend.  He was the first doctor I met here.  He looks great and seems to be doing well.  Work is busy for him.  He is the director of Sudan Medical Clinic.  He oversees about 12 clinics located all over South Sudan.  Then we all started walking (with a huge box of medicines) to look for transportation back to Werkok.  We kept running into people I know.  It was really fun and I was able to get some pictures.

So we made arrangements to get back.  We again got bota bota to take us back.  Oh my goodness.  This was a really crazy trip.  Deng was on the motorcycle with the med box and I was on another one with our backpacks.  I must be out of my mind doing some of this stuff.  Again we went through cattle.  It was just as scary but I did not get kicked.  We ended up taking the bota bota all the way to Werkok so we did not have to walk with the medicine box.  It was so crazy going through the bush.  Yikes.  As I said, I must be out of my mind.  My muscles are so sore from being clenched.  I was very happy when I could see the water tower at the compound. 

The teachers from the secondary school were here.  They laughed so hard at my stories.  I let Maweil, Simon and John Garang know that I saw Peter, Mabil, James, Dr. Deng and Dr. Ajak and they all say hello to them.  And I told them that Peter will be here tonight.  Tomorrow I will go over to the school and take some pictures and see the students.  I made the arrangements with the teachers.  I now need to eat some din, shower and hit the bed.  I am sunburned and I am tired.  It is hard work being in a constant state of being scared s#*/less.  Night night.

Big Fat Hump Day

Got up and got ready to go to Bor.  Motor cycles never arrived.  Maker called us around 10:00 and said he could not find anyone who would come out here.  I spent the day writing reports, checking the hospital, trying to do homework and attempting a quiz.  Am sure it was operator error, but it did not work.

I am amazed by all the birds, lizards, dragonflies, spiders, scorpions, bees, bats that are just hanging around the place.  Really amazing.  And really beautiful - well most of it - Catherine 1, Mr. Scorpion 0.  I am not nearly as timid in the grass as I was when I came.  What a difference a week makes.  I even walked through the bees to get some supplies. Amazing the things you do when you have to.

This evening, a family brought in an old mama.  She was barely alive, hypovolemic shock.  Cool extremities, well I won't go into all the details.  But basically vomiting and diarrhea for 13 hours.  She is old and I am not sure she will last the night.  The other thing is we have only 4 IV's left.  So back to the bees, I had to get more IV fluids from the container, yes the very one that is full of bees.  I did the zen thing, put a pillowcase on my head and was one with the bees while I grabbed, gently, the needed supplies.  Pretty scary stuff.

We sat with the mama for awhile.  Made sure she was somewhat stable and made our way back to the dining hall to eat dinner before going back.  No sooner did we get there than another patient was brought in.  A little girl with nausea and diarrhea.  We did not start an IV, but I did give her meds to stop vomiting which also put her to sleep.  I am having her mom give her sips of rehydration salts.  We will see how long she can keep things down. Sat with her for awhile then got everyone tucked into their beds with mosquito nets. Headed back to the dining hall.  None of us ate much.  It is late.  One more trip to the hospital to check on the patients, shower, and hit the hay.

We will walk to the main road tomorrow early and then catch a mutatu into Bor.  We need IV's, syringes and some other supplies.  I hope no more patients come tonight.  We are here for them but it is frustrating to always have to make due.  I guess that is life in the bush.

A Day In The Life

Up and moving to rain.  Only a small amount.  I finished the operating theater.  It is nice, if I must say so myself.  Saw several patients.  Did one small I&D to a little ones thigh.  Oh, I felt so bad.  She screamed.  Mom fainted.  I left her on the floor.  It really was an easy one and the toddler was more mad at being held down.  On antibiotics, cleaned up and out the door.  Saw a woman with a mass to her right mid-abdomen.  No weight loss. I could move it around, and gave her a little pain.  Off I sent her for an ultrasound.  We hopefully have a team of surgeons coming in the near future.  And the bees keep buzzing.

Spoke with guy who is working on east coast fever meds.  He called here, in response to the emails I sent out. He was sorry he did not know I was coming over, he would have sent some of the stuff with me to try out on the cattle.  It is in clinical trials, but the only option we have here is to let them die.  It's better to do something. Someone is going to bring a few vials of the vaccine, but it won't be for about three weeks.

Had a great dinner.  Mary made a fresh pumpkin/peanut dish.  And we had rice with spinach in it.  Or it looked like spinach.  So nice to have some greens and it was from our garden.  I wish the bananas were ripe.  Another few weeks, I think.  They are all over.  I don't know why they don't grow them.  You don't do anything but plant them.  Ahhhh, so many easy things people could do to make a tough life just a bit easier.

Just after dinner, someone came and said there was a patient.  Abraham went over to see.  He came back to the dining hall and said that the baby is not alive.  I ran over there, along with Deng and John Garang, and yes, she had passed away.  She looked about 2 years old.  Her Mom brought her to the clinic this AM, she had a cough and low fever.  We gave antibiotics and paracetamol - a fever reducer.  Mom said this afternoon, evening she started vomiting, then started seizing. and it sounds like it was for awhile.  It does not sound like she was alive when they arrived here.  So very sad.  Abraham feels just awful, he is the one who saw her.  She was walking around and has a healthy history.  I do feel we should get some cipro and give a dose to the family - meningitis is common here.  Deng and I are planning to trek to Bor tomorrow and we will get some.  Gosh what a shame.  I feel just terrible. That poor mom.  There is really not much else to say.....

Busy Monday

Up and at 'em.  Good night sleep with it being somewhat cool.  Great dreams.  Oh wait, I am living my dream.  The Chief of the village came to see me this morning.  He said the area is being infested with East Coast Fever.  Whoa.  He asked if I could help.  I said I would see what I could do.  He also said he would see me this evening at the "council meeting".  I guess that is what it is.

So off to my computer to learn everything possible about east coast fever.  Here goes, it is transmitted by ticks that carry a parasite.  Usually it takes 48 to 72 hours to be transmitted, but not in the heat.  It can become deadly in 4 to 12 hours.  No cure, but there is a vaccination.  It costs too much - $35 per injection.  So sad, cattle is their wealth.

I started to clean up the operating theater.  It really is a mess.  I worked hard and it was hot hot hot.  I am not done, but will finish in the morning and then Naomi and Roda will bleach all the surfaces.  I am hoping that it will stay organized and clean so that if the docs from Tenwek Hospital in Kenya come, they won't be mortified.  I could not open the door to the OR because of the bees.  Yes, they are in the hospital also.  If anyone has any ideas, please send them to me.  I can't get into two containers to do inventory and organize because the bees have taken over.

Around 4:30, Deng and I walked to the village.  We met the Chief.  He chose the place we were to sit.  Then all the other chiefs and all the VIP's of Werkok, including the County Councilman, gathered.  The Chief started.  There were a lot of questions about the hospital and about Dr. Ajak, who has given his resignation.  Then there were questions about the cost of meds and the cost of exams.  Then I gave my presentation on what I found out about east coast fever.  I told them I have contacted a couple of organizations to see if they could offer some help.  I hope to hear back from them.  They all spoke well of the Hospital and being part of the community.  That makes me happy.  There are a few future projects that should help things along.

Simon showed back up with the tractor and more food.  USAID gave it to us so we can feed the patients.  That is a great idea.  Some travel very far and have no food with them.  I think this will work well.  Yeah, Simon!

I still want to go to Bor Town.  No rain today. If there is no rain tomorrow, then I think I will go on Wednesday.  I think I will have to go on a motorbike, though.  If only a tractor could get through, then I know the land cruiser won't make it.  I would like to contact Handicap International about that lady with the rheumatoid arthritis.  I think they will be able to help her.  Also, I want to see Gabriel and his family.

Well, I am up to my ears in projects.  I wish I could stay longer!  Off to bed, big day tomorrow.  Thanks for reading.
PS - My butt cheek is a little better.  Not as red and no longer burning, just sore.

Sunday - The Day of Rest

Something I forgot to tell you about yesterday is that Gabriel's wife sent me a sheep.  I asked him why she did that, knowing how difficult it is to make ends meet.  He got so mad at me.  He said "why do you ask this?  Why can you not just accept a gift"  Ooops.  Okay, I get it.

Last night when I was getting ready for bed, something stung/bit me on my left upper leg just below my butt cheek.  It was red and burning.  Is still sore today.  I took some benadryl and it still took me awhile to get to sleep.  So I ended up oversleeping for church.  I got up, ran around getting ready and headed off to church.  I go there late and there was quite a stir when I walked in.  All the kids were saying kawaja, kawaja, which means white person.  They were so loud that a man had to come by me and yell at the kids.  No one could hear the priest.  There was a prayer and then the closing hymn.  Oh well, better late than never.  Some of the secondary school teachers came here this afternoon and they have bee stings.  So I gave them some benadryl and I told them to be careful, it might make them tired.  I said that I overslept for church and came in late.  Two of the guys said "yes, we noticed.  You really created an uproar".  Oh my goodness.  I was cracking up.

So I told you about the sheep.  We had meat for lunch and dinner.  It was pretty good, as good as mutton can be.  It is good to get protein.  Remember that I sent Simon and Abraham to Bor to get medical supplies?  Around 1:30 pm Simon came walking up, all full of mud.  He came to get tools and people because the tractor that was bringing him back with food got stuck.  So off they went, all but Maker who was seeing some patients.  I sat with the teachers and we really had a good time.  One is Kenyan and the rest are Sudanese.  They, like us, are having a problem with bees.  So they decided to spend the afternoon here since they could not stay around their place due to the bees.  Then around 3pm Mawiel shows up and get a big chain.  Whoa, this is not good.  Off he goes.

At about 6:00 I hear an engine.  I go out on the road but do not see anything.  Then finally, about a half hour later I see the tractor emerge from the grass down the road.  Finally they are here.  They are all covered with mud and the tractor wheels are mud caked all around.  There is a trailer attached to the tractor and it is full of sacks of food.  They are all labeled USAID and WFP (World Food Program).  They all have American flags on them and it says "From the American people".  Ha, I looked at the driver and said "from me to you"  he started laughing.  We really have had very little food so this is a welcome gift.  Simon said they just gave it to us.  Now we have bags and bags of sorgum and yellow split peas.  Woowoo.  Then I said to Simon "where are the medical supplies?"  We don't have any.  I am not sure I will be able to make it to Bor.  Abraham is not here yet,  maybe he will have med supplies.

One of the Bor County councilman, who represents Werkok, stopped by.  His name is John Atany.  We are going to have a meeting tomorrow with the Chiefs of the area.  Mr. Atany and I were able to have a nice conversation about things.  His thing is agriculture.  Hmmmm, do wonder what he has been doing.  And then before he left, he said he may bring his Mother here to see me.  She is very old and has pain.  Of course I smiled and said I would be honored to see here.  I hope she is not on her last leg and I have to tell him that.  We will see what tomorrow brings.

Not only are the teachers having difficulty with bees, so are we.  I have not been able to finish my inventory because of them.  I have not been able to get into the white pharmacy container because of them.  And now, it has been reported to me that there are bees in the ward.  If anyone has an idea about how to get rid of them, please let us know.  I am not interested in pesticides, I think they just leave then come back.  In the reading I have done, it says to move the nest.  Yeah, right.  I am looking for any help here.

I hope everyone is well and that there has not been too much crazy weather.  Please remember to keep all of us in Werkok in your prayers.

PS - my leg, butt cheek is killing me.  Oh, and we had a snake in our dining hall.  The mama was going crazy.  It was little.  I am concerned where the mom snake is.


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Ahhh, Sudan in the Rainy Season

It rained last night.  Was great sleeping.  Did have to move my cot as it was under a leak.  Oh well.  It actually was a pleasant temperature for sleeping.  I started the day doing the inventory in one of the containers that has medical equipment.  What a chore.  I hope to finish up tomorrow.  I hate to repeat myself, but the amount of stuff that is sent here that is unusable is incredible.  I am amazed.  No we do not do open heart surgery, please do not sent cardiac cath kits to a developing countries clinics and hospitals.  I read a phrase written by an organization that assesses the needs of clinics and hospitals in developing countries.  They use the phrase "Junk for Jesus".  And that describes exactly what 70% of the stuff sent here.  So I will now climb down off my soapbox.

I did find a padded 6 inch wide strap with velcroe on each end.  I cut it in half and then put it on the knees of the young lady I spoke about yesterday who can not walk.  She was very grateful and then demonstrated how much easier it is to get around on her knees with the straps protecting her knees.  Also, I found some hydrocortisone and  gave her an injection yesterday and this morning.  Maybe it will take some of the inflammation out of her swollen joints

It was a humid day.  I quit for lunch around 1pm and was very surprised when my friend, Gabriel, walked up.  He looks good and said his family is well.  They are all now in Bor Town since Gabriel moved there for work and he did not have any close family member to help watch out for his family here in Werkok.  So in June, he moved them all to Bor.  I have missed seeing them, especially the kids.  He said his youngest, who was born when I was here in February, has been quite sick.  He is doing better, though.  I gave him the bag of clothes that I had bought for them.  I guess I went overboard as my suitcase is now pretty empty.  I walked with him to see him off.  We went towards the village.  About half way there, Naomi came out of the bush and greeted Gabriel.  She then started scolding me and telling me to turn around and go back to the compound.  The weather was very threatening with a storm coming from the southeast.  It really was dark.  I had my boots on and my umbrella.  She just laughed at me and told me to go.  So I said my good-bye to Gabriel.  I hope to be able to get to Bor next week and to buy a plane ticket from Bor Town to Juba.  I can get a ticket from Juba to Nairobi on line.  If things continue, I will have to walk to the main road with my luggage!  Yeeesh.  I keep hoping it will dry up.

The afternoon was low key.  I did some homework, yes I am in school. I checked patients and I took some pictures that will be sent to some of the docs at Tenwek Hospital in Kenya.  I am hoping that they will come here and do some surgeries.  Joy Phillips, who flew in with me, is going to talk to them.  This is the place where so many of the Southwest Medical Clinic docs go.  It would be so cool to have some of them here for a week to do surgeries.

I have found out that since becoming an independent country, food prices have soared.  Not very much is produced here in the south.  Most of the food stuff was shipped down the Nile River.  All of that has stopped.  I did tell Gabriel he should go into agriculture.  It will be interesting to see where things go.  So far I have seen no evidence of unrest.  But of course, people are not getting around very well. 

I will say good night to all. Please keep all the people here in your prayers.  Life is very hard and I am just glad that I can make it a tiny bit easier for a few.

And We Are Off

Now that I am over the amazement of the green tall grass, I can get to some real stuff.  I have already used my pink rain boots to go to the airstrip to see WGM staff off.  I want to see Mr. Snake just try to penetrate my pink super boots!!  I am now here alone with the Sudanese.  Clinic this morning was interesting and, of course, my favorite thing.  There are three inpatients with malaria and one little one with diarrhea and vomiting.  The Mom of this little one has many problems.  From what I can tell, she has an extreme case of juvenile rheumatoid arthritis. Suddenly at the age of 14 she started having severe joint pain and swelling. It is very sad.  She walks on her knees because they no longer straighten.  Her toe joints are swollen and crooked as well as her fingers.  Her left elbow is deformed and she is unable to straighten it.  She has never been to a doctor for it.  She walks on her knees with some flip flops under them.  She has a little cart that she pedals with here hands.  It is incredible.  And she has two children.  I am sure she is not married to the father, I think she has no say in this world due to being "crippled".  It allows people to use and abuse her.  I found her to be so pleasant and so humble - just caring and loving her two children.  I am determined to find something to put on her knees to make it easier for her to get around.  I thought of a small cart (think Eddie Murphy in Trading Places) but the ground is way to bumpy and now with the rains, would be impossible to maneuver.  Let me know if anyone has any ideas.

The staff that is here seems very adequate.  Dr. Ajak is no longer here but did come by yesterday evening after hearing that I was here.  It was good to see him.  I think the people in the community really miss him.  John Maker is the clinical officer and Abraham is the nurse.  They seem to work well together.  Rachel is still here and she registers the patients and collects the money.  John Garang still works in the pharmacy.  Simon is the lab tech.  He came here when I was here in February.   Deng is the new site administrator.  He has been here for a few months.  I am sure it is a big adjustment since he spent so many years as a "Lost Boy" in the States.  He has a masters in Public Health Administration.  He seems to get along well with everyone and is doing a good job getting things organized.

I will be back later, reporting as my day unfolds.
Here I am. It was brought to my attention that we are completely out of pediatric IV's and syringes.  I sent Abraham and Simon to Bor town to get some. They have to walk the 9 kilometers to another road that is passable.  They can not get too much stuff that would be heavy to carry.  The path to the main road is difficult, full of ruts and mud.  I do worry about getting out.  Will worry more next week. 

This evening Deng and I were listening to the BBC and I looked back at the garden and it was full of goats.  I grabbed a broom to shoo them away.  They were eating our lettuce.  Deng jumped up to help.  So here were two "Americans" who live in towns (Deng from Grand Rapids) trying to heard goats.  We did not do very well.  It really was funny.  Then we were looking at the banana tree.  There is a huge branch full of them.  I asked Deng if he thought we should cut the branch down, if they looked ripe enough (Hey Mister tally man, tally me banana) and he looked at me and said "I don't know, I am from the north, no bananas in GR".  Well he has a point.  I was crackin' up.

The weather is warm - of course, but the main difference is that it is humid.  Makes a big difference.  The mosquitoes are pretty heavy.  I guess I should get on something.  Will do that tomorrow.  Deep Woods Off is my best friend.  Am glad I remembered to bring it.

This is all for now.  Will be back tomorrow.

The Green Green Grass of Home

Finally made it to Werkok.  It was a long day with lots of African hurry up and wait.We had to go to Juba to have our passports stamped.  How crazy is that.  We made it to Werkok around 3 pm.  It is so different here with the green grass!!  The roads are impassable and flying up from Juba I could see the road the entire way.  I only saw 8 or 10 vehicles the entire way from Juba to Bor.  The roads are very bad.

It has been so good to see everyone.  I just can't get over how different everything looks with all the grass and all the green.  We walked to the town and I could not recognize things.  Instead of brown open space, everything has 5 foot green grass.  There are small paths to the tukels and you can not see them from the road. 

I am with a group from Tenwek and from World Gospel Mission.  They are looking at the compound and maybe there will be a future with them.  That would be nice.  We need help here and they have shown some interest.  Two of the people in the group, Carolyn and Francis, will be going to Tonj for 4 weeks to set up a lab.  I know the couple who started the clinic there and am glad to hear they are doing well and that their clinic is growing.   They are all leaving tomorrow and I will be the only kawaja here.  That is ok.  I would like to go to Bor to see Gabriel and his family, but I do not think the roads are open.  I hope they will be open when it is time for me to leave.

I am going to sign off now.  I am tired, everyone is. It is nice to be here.

The Subtleties of Life

Very rarely in our fast paced American life do we have time to sit and just be.  This morning I am able to sit in the garden at Mayfield, listen to the kids play games, and enjoy the harmonies of the choir rehearsing at the church next door.  My friend, Joe Kadenge, will pick me up at 2:00 pm to do some errands.  I have had him drive me around the last three years.  He is a very famous futbol player, playing for Kenya in the 50's, 60's & 70's.  Off course back then they did not have the big money that they have now.  He drives a cab to make ends meet.  He must be in his 70's.

I was surprised when I entered the dining room.  It was almost completely full.  I sat at a table, recognizing a man I had met the last time I came through Mayfield.  There are many families here.  I believe they are here for a conference.  They are from the mission field, various places.  That is why there are so many children playing in the gardens.  Two of the moms are playing games with the older kids. Also with them are a few Kenyan women who help with the babies.  They carry the babies around on their hips, obviously doing this for a lifetime. I notice when others come near, the babies cling to their "mama" enjoying the softness of their large breasts and soft bodies.  They love each other.  It is very sweet.  Will be back later to finish my day.

I went to Yaya Center with Joe driving me.  He looks good, but I did find out that he has been sick.  His blook pressure is out of control and his diabetes has been giving him fits. It was raining hard today.  Does not bode well for South Sudan.  I can only hope that this is the only rain I will see.

On the way home from Yaya, we passed a car that the back wheel had gone into the ditch.  This was right on a curve.  Joe pulled past them just past the curve on the other side of the street and got out to help her.  It was hilarious.  Next thing I know there are 10 men trying to figure out how to lift the car out and all the time, because of how Joe parked, a huge traffic jam ensued.  I was cracking up.  Finally they got the car dislodged and directed traffic so things were back to normal in no time.  They are crazy drivers here in Africa.

Tomorrow I am off to Werkok.  I am glad I had today to rest.  I took a nap this morning and this afternoon!  What's up with that?  Maybe it was my work schedule before I left.  See you all from Werkok.

Back at Mayfield Guest House

George picked me up from the airport.  I made it through customs without any problem.  Unfortunatly my suitcase was 53 lbs.  I had to pay $75.  Gosh they get you any way they can.  Flights were fine.  Upgraded both, finally I was able to use some of my 100,000 plus miles for something.  KLM has a nice business class.  So I was able to keep my feet up and sleep most of the Amsterdam-Nairobi leg.

Tomorrow I will do some errands.  I hope to have everything done in the morning and that gives me the afternoon to sit in the garden and read.  I have reports to read that Deng, the site administrator at Memorial Christian Hospital, has worked on.  It will give a nice overview of what has been going on the past few months.  It is helpful to know the type of patients that have been seen and what their complaints/disease process is.  I think I will be doing a lot of administrative stuff, but am sure I will get my hands dirty in clinic each day.  I look forward to arriving in Werkok.  Am still trying to figure out how to get out.  Will work on that tomorrow.  Sleep tight, all.

Small World - A Blast From the Past

http://www.nytimes.com/2011/10/23/opinion/sunday/kristof-the-man-who-stayed-behind.html

Above is the link to an Opinion Page article in the NY Times.  Nick Kristof, who does lots of things in South Sudan, wrote about this guy, Ryan.  I knew who he was right away.  I have wondered about him these past few years and am glad that he is safe.

I got out my moleskin journal from my Sudan trip - 2008 - no satellite yet at the compound, so no blog - and went through looking for my encounter with Ryan and his friend, Chris.  Both from Samaritan's Purse living in the Nuba's.  They had several reasons for visiting the South - the Nuba's are at the border of North and South.  Well, I will let you read my entry......

23Feb2008:
When we were closing the clinic and Joy Mueller was closing the gate to the road, a white Toyota Land Cruiser pulled up to the gate.  There were two white guys in it.  Joy asked if she could help them and they said they were looking for Joy and Dave Mueller.  She said "I think you have come to the right place, that she was Joy Mueller and Dave was her husband".  It was too funny.  These guys are with Samaritan's Purse - a mission aid NGO and they really had no idea where they were.  They were just going to stop by and ask if anyone knew the Muellers.  No maps, no road signs, getting dark.  Samaritan's Purse is the sponsor of the program that Dr. Ajak and Dr. Deng went through.  Chris is from Indiana and Ryan is from Florida.  Crazy, huh.  They have been in the North - Nuba Mountain region.  And this area is Arab.  They have been there a long time.  One, 8 years and one 5 years.  They both speak Arabic - Chris really well and Ryan doing pretty good.

Ryan has a Sudanese girlfriend.  Both Ajak and Deng know her.  He let them know what she is up to these days.  It was such a nice surprise having khawaja visitors.  They were funny, nice, handsome, charming.  We debated a bit - them being Fundamentalist and me being Episcopalian.  All in good fun and lessons learned.   We must all be included in God's presence.

24Feb2008
......returned back to camp around 4 pm.  The guys (Ryan and Chris) were headed off to Juba.  I wished them God's Peace, safe travel.  What a crazy world we are in.

After reading  Mr. Kristof's info on Ryan, I felt a nice feeling of relief.  I can not even say how many times I have thought of those two boys up in those mountains.  It does not surprise me that Ryan stayed.  He seemed the type that would not just leave because someone told him to.  They both are courageous young men with a deep devotion to God.  My admiration for them abounds. As I prepare to return next week to Werkok and the hospital, I wonder if I will be able to find his wife and say hello.  Let her know I met her husband some years ago.
Here are some pictures I found of Ryan, Chris and me.

Juba Juba Juba

We finally left for Juba around 12:30.  The DG (Director General, Juba Hospital) came with us, which is why there was such a delay. He had work to do.  So Ajak missed his meeting with some people from Samaritan's Purse who were here regarding an anesthesia seminar.  I felt bad for him, he really wanted to meet with them.  John Makach came with us.  We saw him in Bor while we were waiting and he decided to come.

We went to check out a place to stay - shady at best but cheap and since I had a driver to pay for, I went cheap.  Then we went to another hotel where Ajak knows the Manager.  We had a snack, some cold pop and water and enjoyed the later afternoon.  We had arrived in Juba just after 4pm.  We were sitting on a patio overlooking the Nile. It was really great.  This is where I will stay tomorrow night, as I will be here alone.

Two of Ajak's sisters came.  They all look so much alike!!!  I told them if they were walking down the street and I saw them, I would know they were his sisters.  And they look so much like his other sister, in Bor, whom I met four years ago.  So it was fun seeing them and visiting.  What a great family - they are all sad that they are so far apart, and unlike the U.S., don't have good roads to travel very often to see each other.  We returned back to the place we were staying, I conked out.  John and Ajak were ready to go out and have dinner around 8 pm.  I was too tired.  I stayed in my room and read then slept.  Around 11 pm the electricity went off and there went the fan.  Hot Hot Hot Juba.   So that was my day in Juba.

When I left Werkok, I was crying.  All the patients were doing really well.  Bor Hospital sent a nurse, they knew I had leave.  We made a schedule for dressing changes, additional antibiotics and pain meds.  I think Jon Jok and Paul will do just fine.  Everyone is stable and the initial debridements and cleansing was all done.  All the patients were extremely sore, limbs tender.  The militia still keeping guard.  They had the hospital surrounded.  Lots of AK-47's, but the governor thought it was necessary.  So it must be.   Ahhhh, Jonglei State,  I hope you get your act together.

Sunday morning we returned to the hotel where I will be staying.  We had coffee and talked about stuff that needs to be done.  Ajak and John will head back at noon.  John has work in the morning and Ajak needs to get back to the hospital.  One of Ajak's sisters and her husband came to say good-bye to him.   Ajak's brother-in-law is a clinical officer and a high ranking military man.  He gave me much insight into some of the problems with Jonglei.  Then and friend of a friend of Bits came. Tom of Catholic Relief Services.  I called him this morning to say hi.  He and I went out to lunch.  But first, a heartfelt good-bye to Ajak.  Ahhhhhh, I hate this.  It was so hard.  He is my third child.  He will be coming stateside in May.  That is a saving grace.  I get to go home to relative luxury and civil peace.  He has to stay here  continuing to work in this country of Deng's.  Making a difference to so many people.  I don't envy him.

Tom and I went for Ethiopian food.  It was terrific.  Unfortunately it was at the hotel where we dropped off the DG.  Of course he made a beeline for me.  You see we dropped him off and took the driver and the car.  The DG is in Juba for a conference, we knew the driver would be taking Ajak and John back to Bor.  He greeted me kindly and then said "where is the car ?"  Rut Row.  "Does Ajak have the car?"  I thanked him for allowing us to use the car and driver and yes, Ajak was on his way back to Werkok, you know, because of "the troubles" he had to get back right away.  I told him how kind it was that he did that for us.  Then I introduced him to Tom.  Of course he could not say anything.  But he did say thank you for taking those patients.  Yeesh

I guess this is my closing.  Thank you all for your prayers and your support.  I do have a great life.

C