Another Lazy Sunday

Church this morning. Went to the Pentacostal Church since the Episcopal church was having a joint service in another area. Did not really want to travel. Many of the hospital staff go to this church. It was fine. Preaching about the word of God, then some prayers and then music. Drums primarily. Lots of jumping up and down and dancing around. Lots of fun. The Pastor, while preaching, made some comment like "even the old kawaja mama..." pointing to me. He backpedalled and said "with the very young face". Hmmmm, nice recovery. Everyone was crackin' up. The mama's from the compound were howling. After the service everyone came up to me calling me Kawaja Mama Dinka??? It was crazy. I was laughing.

Listening to the Word of God

Hok dancing

Mary & Lual playing drums

Came back to the compound and did rounds. Everyone is doing really well. Hopefully the diarrhea siege is starting to wane. Also, the triplets held their own. One had a weight gain and the other two held at their same number. While weighing them the Commissioner of Bor stopped by with his wife. He is a great guy - he said they were driving by (with a little bit of an entourage) and pulled in the "see the kids". I think his wife really likes the kids. She is amazed by their size. They have about five grown kids - one set of twins. He did see us when we were headed to the leper colony. He ask me if I saw him waving at me. I said "of course, didn't you see me waving back" I think he likes me.

It was so hot this afternoon. I went hunting in one of the containers and came across a hose and sprinkler. So we set it up. We were running through the sprinkler. All the Dinka were watching us. Very strange behavior seemed to be what there thoughts were. They just shook their heads. But it was really refreshing. It made our afternoon. Otherwise, lazy day. Reading Sookie Stackhouse books. My Kindle is workable - I dropped it (serves me right after coveting it so much) and now I have a blank spot on the top line. But I seem to manage in understanding the story ok.

Dr. Mike and Aaron cooling off in the sprinkler

This is heaven

Aaron all cooled down

Well, off to the shower. I enter my last week. It is sad for me.
God's peace
C

Ahh, The Weekend

Saturday, the day of rest. Oh wait, that is tomorrow. Confused for a moment. We were praising God this morning as all three babies gained weight!! This is the first. They weigh 2.7, 2.8 & 3.2 lbs. They are all looking good. Mom is feeling good and moving around alot more. Dad is handling the babies and helping - very undinka like. I made bracelets for them to tell them apart. Khor, which means lion and is Peter the nurse's given name, is yellow, Ajak is blue, and Michael is orange. I also put these colors on their bottles so we can measure how much each is eating. Then into the ward. Sick babies all resting - at least for now.

They are growing

Oops spoke too soon. Baby Khor(not one of the triplets) screaming. Gave ORS and he immediately started the routine of poopin' but he is so thirsty. Has had an IV going and is not dehydrated. I walked around holding him, massaging his belly for about 40 minutes until he calmed down. This is so frustrating.

Baby Khor did recover after several days

In the afternoon, Ajak, John Makech and I went to Bor. I bought stuff for the mama's who work on the compound. A thank you for all they do for me. I have also found out that Monday is "Women's Day" sounds similar to our Mother's day. So it will be perfect to present the goodies I got for them on Monday.

We met with Dr. Deng. Had a lot of fun just talkin' and visiting. Deng is director of SMC - Sudan Medical Corp. He heads up about 12 clinics. We talked about the leper colony. He also has visited them and has some proposals in to the government. We talked about their needs - a fence that outlines their property, currently there is a secondary school encroaching on their land. The school has already built a fence right over the road used to get to the leper colony. That is why we had to hike through the jungle to get to them. There is also a need for new shelter. Their homes are really falling down. And it would be a great project for someone to go in and evaluate and teach agriculture. It is right along the Nile so there is plenty of water. It would be nice for them to be able to grow food for their consumption and some for providing an income.

Gathering together, lots to talk about in Sudan

Dr. Deng making a point about the clinics he runs

Taking some time to relax

We also had long conversations on different projects for South Sudan that would generate jobs and revenue. The people lost so much during the war. The main thing they lost was their knowledge. They spent 25 years moving around and trying to avoid the conflict. They lost their knowledge of commerce, of agriculture and there were no schools during that time. That is why Gabriel is 37 years old and just finishing up high school. He started his senior year last week. Lots of people stopped by our table and joined in the conversation. It was interesting to hear their views. Nobody has the illusion of another country or an NGO saving them. They know they must do it on their own.

The time passed quickly and before I knew it, John was pulling my arm saying we must be on our way. It was rapidly becoming dark and it is not safe to travel in the dark. I said my good-byes to all, knowing I would not see them again this trip. It is a really hard thing to think about - leaving.

John Makech, the best driver in Sudan, navigated the dirt roads as easily as I navigate the bumps on Ridgeway. He knows them all. Most of the time we are on the wrong side of the road, it is smoother. The sky quickly turned black, the wind picked up and in the distance we could see lightening flashing over the bush. It truly was a beautiful and awesome sight. We passed the villages and before I knew it, went around that last curve and saw the lights of the hospital - the generator is on. Once again, delivered safely back to my home in Sudan.

John getting me back safely

Thanks be to God,
C

I Can't Believe This Day

Early to hospital, couple of trips there during the night. Still have a problem child with this diarrhea. I am so concerned. He is the son of someone I know. Dr. Samuel, Administrator of Bor State Hospital, said they have also seen this increase in little ones with diarrhea. One symptom is intense abdominal pain and watery poop every 10 minutes. Hope you are not reading this during a meal!! Any suggestions from anyone?

James and his sick son

In the afternoon, we went to the leper colony. It was incredible. But let me back up to the trip there. We were on the road to Juba, sounds like a great opening line for a novel. We turned into the village of Malek and drove through towards the river Nile. We then had to park the car and walk the rest of the way. We really were in a jungle! Waiting for Tarzan to swoop down. AhhhhAhhhhAhhhhAh. We were on a small path and a herd of sheep came running towards us, yikes a stampede. They were being chased by a HUGE baboon. One little sheep in the front had a mangled face. It was crazy, you can't make this s*** up! Then Ajak grabbed a huge stick with thorns in it and John Makech grabbed rocks - they were going to protect us. This was so hilarious. The baboon saw us and hit the brakes and the guys chased him away.

Stampeding sheep, baboon off in the distance

So on with the lepers. As we all know, leprosy is an ancient disease. Not much has changed here. They are ostracized from society. Their village is really very beautiful along the Nile, but their conditions are just horrid. The tukels are falling down, not really shelter from rain. The clinic, that used to be used and has not seen any medical staff since 2003, is now used to house chickens. The age of the people there was odd. There were young children and old people. No one above about 25. I think that they leave to work, they do not have the disease at this point, and they leave their children there with the old folks.

The older folks all had missing fingers and toes. They did not seem too sick. The children were really quite healthy looking. I believe this is in part to their being sequestered from society and not being exposed to the everyday ills. Very curious. It was a really incredible experience.

Beautiful children

Dr. Ajak and a new friend

We all gathered around the chief as he told his people's story

New friends

Living with a terrible disease

Beautiful smile

I had promised to keep these shorter. I have not done a very good job. Sorry about that. So I will sign off now.
C

What a Difference A Day Makes

OK, I know I was wordy on the last two posts. Will try to keep it down. Very busy morning. I spend a couple of hours teaching mama's how to feed with a bottle. When I put the baby on my shoulder to burp him, their eyes went wide and an old mama started cursing me. Or at least that is what it seemed like. So I belched to let them know the baby needed to do this or have a tummy ache. Right on cue, baby Khor let one rip. All the ladies laughed and Khor snuggled into my shoulder to sleep. He was a great prop.

Feeding every two hours then a good burp

The Minister of Health paid us a visit

The triplets are losing weight. Of course it is to be expected, but they really can not afford to lose any. We are trying to figure out a schedule of feeding and seeing if the mama needs help. She is tired. Her husband, contrary to Dinka custom, has been at her side and is now even holding the little guys. But you can tell he is terrified.

Too tiny, losing weight

The good news is that the Minister of Health and the Director General paid us a visit today. They have gotten support from the Governor and other agencies and will provide money to the hospital to then purchase formula. Sounds like they are talking for a year to a year and a half. Also, they are insisting that they live near here in case there are medical problems. Once the kids hit 2 kilos, I think we will move them to the building we use for family members. No one really uses it, so it will be perfect. I think we will start raising kids here! Yup, the new poster children for South Sudan social services. I figured. They also gave some sorgum and sugar.

Gifts of formula and food for the family

Then the Minister for Bor County came by with his wife. They also are willing to help on the county level. The couple were just speechless. They are simple folks. They are beside themselves and overwhelmed. It has been a very good day. Quite happy after the tragedy of yesterday. Ahhh, God is good.
C

Uphill then Downhill

Wednesday. I am tired. Several trips to the hospital during the night. One of the diarrhea kids is not doing well. Not too much sleep, but when I did it was heavy. Early to the hospital. When I was leaving after rounding, Gabriel, the night nurse, and I stepped outside and he paused, grabbed my arm and said "don't step there, it is a snake" and yes it was. Not too big and with a design. Gabriel threw rocks at it, hitting it several times, but is slinked under the storage container. He told me it is very bad, a viper. Yikes. I just hate snakes!

Went to Bor today to plead our case with the Minister of Health and the Director General to get the state to provide formula for the triplet family. They really have nothing, not in the sense of having nothing in the USA, but in the sense of having nothing in the Sudanese sense. Nothing is nothing. No cows, goats, no land. They had to borrow money to buy a chicken - as I mentioned the other day.

Minister of Health

We were greeted cordially and when we told our stories, and showed pics I had on my camera, they were amazed. They seemed really receptive to the government needing to provide social services (is there such a thing in South Sudan?) for them. I am hopeful. We did get formula to take back to the diarrhea kids. That will be helpful. I also purchased baby bottles. The second thing we spoke of was the leper colony. I think we will go on Friday. Both the Minister and the Director General were not informed of this group. Dr. Ajak has made a report to the government on this colony, but since these two are relatively new, they had not come across the report yet. We discussed things that they could provide. We will get back to them after our visit with a new report. I did invite both of them to come visit our hospital and see the work we are doing.

Then back to the hospital. About 5 minutes after we arrived one of the diarrhea kids (such a terrible thing to call them) passed away. I was shocked. I was actually preparing some of the formula we got in Bor. I am so sad. I am so sad for his mother who tried so hard to keep breast milk down and ORS (oral rehydration salts). We did everything by the book and with our resources. I believe he developed some aspiration pneumonia. We had started him on Rocephin. But his pulse ox was down. We did put him on oxygen but the generator must be on for this. The generator was on most of the day and had been turned off to cool down. It was overheating. A half hour was all that was needed. This is when the child died, during this half hour. Diarrhea is the number one killer of children worldwide. I am just heartsick over this. This beautiful baby boy with huge brown eyes. We have no anti emetics, limited antibiotics and only ringers lactate - which I guess is ok for someone losing their electrolytes.

He looked so good just three days earlier

I ran over to the hospital and the little guy was wrapped in a cloth. Nobody was around. When I unwrapped the cloth to get one last look at his sweet little face, They had bound his face with gauze wrap. They also bound this hands together and his feet, as is their tradition. Rebecca, one of the mama's that does the wash, and young Mary, one of the cooks, came in and placed him into one of the carrying holders that they use for babies. Then Rebecca put it over her shoulder and Mary wrapped the cloth around them, in their tradition. They then went to the mother and accompanied her to the land cruiser that John, our driver, had ready to take them home. It was horrendous to witness. They were all very stoic. I think I was the only one crying openly. Please keep them in your prayers.
C

Routine

Tuesdays are often routine days. Over the rush of Monday, not yet hump day, too far away to look towards the weekend. So our Tuesday was just "normal", as normal as can be in the bush in Southern Sudan. Continue with sick kids, dehydration primarily.

Life on the compound is routine. Each morning I wake to the sounds of chickens and a rooster crowing. The last rooster that kept waking us was eaten. I am not sure how long this one is going to last. But there seems to be other roosters that are growing, so I am afraid we are stuck with the alarm clock.

Mary & Mary  start the day

Daruka arriving to work

Mary arrives and I hear the clinking of her putting the charcoal into a tin pan. I know water will be heated for coffee in about 20 minutes. Time to think of moving. Up, dressed, meet with Ajak and Dr. Mike while we drink our coffee and talk about the day. Slowly the compound comes to life. The staff wanders in for their coffee, tea, breakfast. I see patients walking over to the hospital to get registered and get their names on the list.

Then hours of hospital stuff. I have gone over this nearly each posting.

Later afternoon brings us to a lull. We are usually done with patient care and are now focused on settling the inpatients, doing vitals, giving meds. The guys wander to the big tree in front of the hospital next to the road. A big chess tournament starts. There is yelling, dancing, chiding moves and lots of laughing. Many matatu's come by, all honking and waving and some even stopping. Hardly different from any small town.

Ajak contemplates a chess move

John & friend dancing after work

Watching John dance while waiting for a matatu

                         The mama's on the compound are winding down their day. The two Mary's (both cooks) are usually the last to leave. Roda and Daruka, the wash ladies, bundle up their things. Rebecca and Naomi take one last sweep of our tukels, making sure the floor dust has been cleaned up. Often they are humming a Dinka song, and often the others will join in from around the compound. It is soothing and a sign of friendship amongst these hard working women. It is a sign that our day is winding down. I say wo be yook miak to each - see you tomorrow. They love my attempts at Dinka and giggle as I try to say phrases to them. They are beautiful people.  

Mary leaving for the day

Checking the patients before calling it a night

Our nights consist of gathering for dinner, and visiting. Then we often get on line, I write on my blog, others do their email. We often end our nights with some songs, Aaron plays guitar. I am trying to talk him into some Led Zepplin, Jimmie Hendrix so far no go, but he is entertaining the idea. Few chords of Layla this evening. He's learnin'. Great kid. So is Matt.

The night ends with reading in my mosquito net cot on my kindle - thanks Dave. It is a great thing. And I wind down listening to the sounds of the night, the compound settling down. People wandering to their cots and tukels, saying good night as they pass. It is peaceful, an oxymoron for Southern Sudan.
God's peace,
C

Just another Manic Monday

Started with a bang. Lots of patients waiting by the time we arrived between 8 and 8:30. Many sick kids. So the day was spent starting IV's, rehydrating little ones and cleaning up poop and diarrhea. I love my job! They are all so darn cute I could just squeeze them to death. We also have one adult, a woman, who is pretty depleted of all fluids. So we are pretty full up.

Waiting in line

So beautiful but sick

Mama worried

The three stooges are doing great. They have even been a little bit boisterous when they don't get their food right away. Mom seems to be doing ok, moving around fairly well. Did I mention that these three are number 6,7 and 8 in her household. She only has one girl. I think Dad is shell shocked.

Mom, Dad and the three

It is late, have just come back from the hospital. Just a short note for tonight. We will have to go to Bor to see the Minister of Health to get some formula for this family. There is no way they can afford formula for three kids .I found out they had to take out a loan to buy a chicken so Mom could have some protein. We insisted on this. I hope we are able to convince the Minister of the need for this family. Ahhh, the needs of everyone here are so great.
C