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

Saturday Morning

Up early to do rounds and grab some oatmeal and coffee.  We had eleven patients arrive around 6:30 pm.  All had gunshot wounds.  We assessed, irrigated, cleansed, dressed the wounds.  All of IV antibiotics to start with and will continue on oral.  Wounds ranged from through  and through calf wounds to one that entered to the left of the nose and then came out the mouth, taking care of the patients two front teeth.  I said he will now be very handsome with his Dinka mouth.  He started laughing so hard, I did not know he spoke English.  The Dinka often have teeth missing, it is a rite of passage to pull certain teeth, the look is revered by many.

We did a good job of organizing, prioritizing, and caring for the patients.  Team effort for sure.  All are stable and Ajak and I will go to Juba.  We are just waiting for a nurse to come from Bor.  It is Pastor Paul, I have known him since I started coming here.  He is a nurse at Bor Hospital and a Pastor for the Episcopal Church.  He will help Jon Jok, who is left here with the patients.  I think it will be fine.  All have their meds, wounds need to be redressed after they shower.

Crazy night.  All the military are still here.  They think they will be here for two weeks.  Even though the patients won't be here that long.  They are afraid of retaliation.  We saw a report in Sudan Tribune this morning about it.  They did say that one group went to Bor Hospital and that another group went to another clinic.  Thank goodness they did not name our hospital.  As most of you know, I have no trust in the media.  Here or at home. 

I will sign off now.  Again, I have another round of good-byes to do.  I did this yesterday, but will repeat it today.  This crazy country of Deng's. 

C

So, God, Exactly What Are You Saying?

Some days are just like this.  Was at hospital at 9 AM with a very young girl in labor.  States age as 18 - I put her more like 15.  Story is not straight forward.  After awhile I learn she has been laboring for 3 days.  We do an ultrasound.  All looks well.  Hear rate is about 150.  The mom is complaining of back pain.  I tell Ajak that the baby is probably turned wrong.  Head is down, but not correct presentation.  We watch her, she progresses.  Pains fairly constant.  Delivery is imminent.  Then in comes the Commissioner of Bor.  I have not seen him yet this year.  Was good to see him, but I was a little busy.  He said to me "we have a problem".  Rut Roe, goes through my mind.  There was an inserection north of here, quite a ways north between two Dinka tribes.  They are being flown to Bor by the UN.  The problem is Bor hospital is not all that big and there are many wounded.  And they are from these two fighting Dinka clans.  They don't want them in the hospital together.  So they will bring one clan here, if it is OK, and the other clan to Bor Hospital.  Of course I say yes, there is no other choice, no other hospital.  But I do tell the commissioner that I have a plane to catch on Monday morning.  Someone will have to drive me to Juba sometime on Sunday.  He said he would talk to the Minister of Health.  He said he would be coming this afternoon.  I walk back into the hospital to check the laboring pt.  Almost time, and then another vehicle pulls up.  It is people from the Indian Army via UN forces.  They picked up this patient who was being carried to our hospital some distance away.  He had a broken leg.  I got him onto a cot started an IV, gave morphine for pain and undid their splint.  Looks stable, probably just the fibula.  I told them they would have to wait awhile, we had a baby to help deliver.  So I left and Ajak and I went into the birthing room.  This child was not going to be born without help.  Ajak did an episiotomy and then he pulled to get the head out.  It presented the back of the head.  I don't know how long it was in the birth canal but she had one heck of a cone head.  All seems to be well.  Sewed up Mom and then went back to broken leg guy.  I found a splint that could go on - covered the foot and lower leg using velcro.  It was a hard splint.  Then I taught him how to use crutches.  They preferred to go back to the traditional healer.

In the meantime, Mary wanted me.  So I ran over to the cook house.  She wanted me to cook lunch.  Yikes.  I guess our intervention this morning did not do anything.   Started a chicken soup.  Pulled out some noodles to put in it just before serving and went back to the hospital.

About 3:00 the Minister of Health came.  He said it was possible there will be up to 40 patients, 18 casualties.  Lori, Jina, Thais and EEEEffa where are you?????  We only have 12 beds.  We got the cot mattresses that the people use when they are visiting here and put them on the porch.  We still only have 20.  Some will have to double up. Besides, Sudanese have a habit of exaggerating. Thanks Aaron for making the porch last year.  Naomi and Roda were great.  They made all the beds, got more supplies, cleaned off all the IV poles.  I came up with a system for triage and assigning and ESI number.  See I really do pay attention in all those classes.

We came for lunch around 3 pm.  Mary had put an entire bag (large, Sam's club size) of macaroni noodles in the soup.   Lunch was a bust.  All Ajak and I could do was laugh.  I worked on it to doctor it up, but it was a disaster.

Around 5pm and truck comes racing up the road.  I said "I think they are here".  But no, it was the army, a militia here to guard us.  The "Big Guy" comes up to me and says "Insurection, we are here to protect you".  Yeah, OK.  So, I take it that means he patients will be coming in the near future.  I have been busy making sure that all is ready.  I requested that IV cannulas be brought from Bor Hospital.  We have about 10  24guage and maybe 6 22guage IV catheters.  They will send them with the patients.

Obviously I am not going to Bor for the night with a barbeque turkey at Liberty Hotel - we had put in a request.  Nor will we make it to Juba by noon to meet some people who are there from Samaritan's Purse.  Dr. Deng is also there.  Ajak and I will remove bullets, cleanse and suture wounds, make sure everyone is stable.  Then maybe we can go.  Jon Jok is here also.  No matter what, I have to leave by Sunday afternoon,  I will do that.  My flight is 10 am on Monday.  I have to be at the airport by 8 am.  Funny how things turn out.  We will see.  Hope to write later and give an update.

Last Thursday Here

Well today is my last full day in Werkok at the hospital.  I woke up with this sick feeling in me.  The time has passed so quickly.  I am not sure if it did so much at home, but it sure does here.  I have a long journey home that will be filled with new adventures, so leaving is not quite as final as when a plane picks me up and sweeps me away.  I have started to make piles - things to give away, things to pack.  My large suitcase, empty, went back to Nairobi.  I will get it there.  My small suitcase will fit into my medium suitcase for the trip to Nairobi, I hope.

This morning I went to the secondary school and gave away soccer balls.  I spoke to each class and said how wonderful it was to see all the students here.  I am glad it is underway.  The primary schools have not started yet as there is a dispute in the teacher contracts on receiving cost for housing.  You see, the teachers register with the government and then are assigned a school.  It can be anywhere in Southern Sudan.  Therefore, the teachers have to live at the school, as they may be from another state or another region of South Sudan.  Crazy system.  I don't really see it working very well. I will give the soccer balls to Ajak to deliver once the primary school opens.  If you think there is too much government involvement in America, just come to Sudan.  This is one of the reasons why we (PCC) do not want the government involved in the hospital.  They may very well send Dr. Ajak to another area and just place any doctor who has no connection with the mission of PCC or any connection with Bor Dinka placed in the hospital.  A real problem.

After working in in the clinic, I went into Bor.  John Makua drove me, a she got the blue land cruiser running.  Hurray!  When we arrived in Bor he called Gabriel but his phone was off.  We were at the bank.  I jumped out of the car and ran to where Gabriel worked.  I had to run through the market.  I think Makua had a heart attack.  An unaccompanied Khawaja running through the market. The bank closes at three and is was 2:20. I got Gabriel and we opened a bank account at Kenya Commercial Bank.  The only bank in Bor. The only bank in 5 states.  It has been opened for 10 months.  It is really a new way of thinking for the Sudanese, who live in a cattle trading society.  I explained each step of the way to Gabriel and the very kind Kenyan who was helping us found it all very charming.  It took much patience and it was a big learning curve for Gabriel, but I believe he understands the concept.  I will now be able to wire money for his schooling, which I will be continuing to do fundraising for when I return home.  I am thinking he will go to Uganda for his schooling.  It is cheaper and there are several schools to chose from.  As I have said before, there is only one school in all of South Sudan for Clinical Officer training and it is very expensive, even for U.S. dollar standards.

The way home was hilarious.  John Makua drove, I shifted for him, and we picked up some people going to Werkok.  We also picked up some supplies for the compound. At one point we had 6 people, 2 sheep and various sacks of goods (rice, flour, soap)   When we were going down the main road towards Werkok, I saw a truck going along the side of the road on the wrong side.  There seemed to be a lot of things piled in the back of the truck (a pick-up) and on the top was a khawaja (white man) sitting in a chair.  Beverly Hillbillies visit Sudan.  It was crazy.  He waved to me as we passed.  Very odd.  Then we hit the junction for the cross over to Werkok.  I was thinking that if we had a car following us to go to the hospital, I am sure they would think we were  crazy.  We go through a very small village at the junction (where we picked up Rebecca who works for us) and then it is a very pitted, hardly a path drive for 30 minutes.  Sometimes I am not even sure if we are on a road or just going through the bush.  There is yellow grass and sharp thistle all around.  Acacia trees are most common.  There are also very thorny trees with red trunks that have no leaves during this time of the year.  They are green and bushy during the rainy season according to those I have asked.  Soon we come across a tukel, then a few more.  James lives in one, I wave to his wife (#1) and kids,  Roda is down the path aways, then we stop and let the old man who rode with us, out at his tukel.  Pretty soon we are in the outskirts of Werkok, the Pentecostal Church, there is Hok, waving, Lual is naked standing by the fence, laughing and waving.  It is late afternoon,  The village is alive with sounds of any town, laughter, goats bleating, metal spoons clanking on cooking pots as dinner is started.  Yes, this is a comfortable place for me.  Away from the hub bub of the city, Bor. Quiet and small town.  Lots of gossip, everyone knows everyone's business.  Not too much different from home.

The guys and I walk to town.  A good game of dominoes, except that all the MCH guys lose rapidly.  We blame it on the pop I bought and gave out to the guys.  Simon said he could not concentrate on the dominoes, he was just thinking about the cold pop.  OK, never before or during a game, just after.  We wander to North Compound and sit and visit with Peter.  One of the teachers stops by and thanks me for the soccer balls.  I told him they were from the Sunday School class at my church.  He is very grateful.

Dinner, beans and bread.  I will talk to Mary tomorrow regarding the menu.  Consists of beans, lentils, potato soup and bread or rice.  I think an intervention is in order.  Everyone agrees.

Off to bed, reading, listening to the sounds of the night.  Owls, bats flapping around my net, crickets.  Yes, this is good.  This is a good life I have.
Night night
C

Bota Bota Bor

Went to Bor this afternoon.  Caught a ride with a patient who brought his Mom to the hospital.  We made it to the junction going into Bor and then caught botas to get downtown.  Once again on the motorcycles.  Ajak, Jacob and I.  What a threesome.  Bor was good, went to Bor Hospital.  Saw a bunch of doctors in the doctor compound.  Held a little baby for awhile.  He is so cute.  I have pics.  About 6 weeks old.  They call him Freedom as he was born on the last day of the voting.  Saw Gabriel and Michael..  They both seem well.  Are working in Bor.

This morning Tim, Thom, Aaron and Tanner left.  My little buddy - I will miss Aaron.  Gosh we had some adventures.  It was fun.  He was a sport putting up with this old lady.  I will miss him.  So I am the only khawaja left in the compound.  It will only be for a few days.  We, Ajak and I, leave early on Saturday for Juba.  We will leave from Bor so that means we have to spend Friday night in Bor.  I hope I get done all that I need to.  It sure is more convenient to have a plane pick you up where you are, but there was no one else headed to Loki or Nairobi and the charter cost is too much for just me to pay for.  So we will hit the road for more adventures in Sudan.

Driving back this evening I was struck by how familiar everything was.  I remember a point in time not really knowing where I was.  But now, after four years, recognizing landmarks, tukels that were familiar and the family is familiar.  The same kids waving when you go by.  The trees that I recognize, certain curves in the road.  Not too much different than at home, just different landmarks - the fence that is crooked, the tree with the broken limb, the tukel that has a design on the side of it.  Even in Bor Town, though it is not too big, I know where shops are in the market.  I know the streets and how to get places.  I know where to get some good juice or a cold pop.  And I always run into people I know.  So many people.  Today in Bor I met a young man.  We got talking and he had been in Atlanta and then Grand Rapids.  He went to school in GR - Grand Valley.  Then after we were talking, he said to me that I was very familiar to him.  Turns out I met him in GR.  When Ajak was in SJ we went to GR and met with a bunch of Sudanese, including the Governor of Junglei State.   Yes, I was there, and he said he was there and that is where he knows me from.  Crazy small world.  He has been here for 7 months but will return to the states so that he can get a masters.

Well, that is all for now.  Fun day, but a little sad saying bye to those who left today.  Travel safe my friends.
C

Happy Tuesday

Guess what? What. I made my plans to get out of Sudan.  So I guess I am coming home.  Trip to Juba with Ajak, he does have to leave on Sunday and then I will fly to Nairobi on Monday morning.  Mayfield will pick me up and take me Mayfield House.  OK, enough talk about leaving.  I have another week.

It has been hot.  We are suffering.  Today I did some more organizing.  Tomorrow I will finish - whether I am done or not.  Time to get back to patient care.  Actually I have plans to go to Bor tomorrow.  Looking forward to it.  Got some business to do.

The days have a rhythm and a routine.  That is always nice.   The mama's come, a true indication to get my butt out of bed.  Up and moving, two cups of joe (instant) and then of to the hospital.  I have seen so many people this year that I know from other years.  Sometimes I bring my computer with me and show them pictures I have taken of them in the past.  They always get a big kick out of it.  Ajak was seeing a patient the other day and I walked in to ask him something.  I saw this lady and said to Ajak that I knew her, that she was here last year with one of her kids.  And she has a hundred kids and they are all is such bad shape.  She actually has the features of a fetal alcohol syndrome baby.  That is how I remembered her.  So I showed her pictures I took of her and her baby (she has had two since) and she said that it wasn't her.  Ajak and I were crackin' up. 

We had lots of visitors this evening.  Many of the secondary school teachers came by.  They often come in the evening and visit.  Most of them speak english.  I gave them a soccer ball that I found in the container.  They were so happy.  Then Rebecca came by.  It was so good to see her.  She was the receptionist at the hospital and would get everyone registered and would interpret when I had a problem.  Just a sweet kid.  She is now working at a primary school in Bor.  She is a teacher.  She just did not look happy.  But she would not confide in me.  It was so good to see her.  I will post pictures of her smiling face from last year and the ones I took this evening.  There is an AIM pilot here.  He flew in this evening.  He will take Thom, Tanner, Tim and Aaron out tomorrow.  Boy will it ever be quiet here.  I hope we don't get into trouble.  You know how things can get if you get bored.

Well, that's about it for me today.  Night night
C