First Reactions to Working with Doctors Without Borders in the middle of Africa

Juba to Aweil 9/27

Once again I slept very little last night.  I just tossed and turned all night under my barely adequate mosquito net.  I went out to dinner last night at Juba Bridge Hotel right on the Nile river.  The frogs were very loud and the bugs tolerable at best.  I packed and repacked just trying to get all my stuff close to a total of 15 kg to comply with weight regulations for my series of domestic flights in Southern Sudan.

My final attempt this morning weighed in at about 21 kg.  I was prepared to pay extra or if necessary have the MSF driver take something back with me.  Karto was my driver and he was kind enough to wait in line with me at the airport.  The doors were still locked upon arrival and there was a horde of people organizing lines with their suitcases.  Once the doors were opened people pushed their way everywhere.  What was the point of making the lines in the first place?  It seems like a simple little thing, just trying to organize a queue but there was a complete lack of organization.

Once I got through, my stuff indeed weighed in at 22 kg but they said no problem.  I went back to the door and told Karto that I was fine.

I’m flying first to a town called Wau and then Aweil on the world food program planes operated by the UN.  Now I’m sitting in a basic waiting room with a hundred other people.

There were 3 flights actually: first to Rongbuk, then to Wau, with a 3 hour wait in the heat in Wau, then to Aweil on a tiny 20 person plane.

Landing in Aweil was one of the most bizarre and nerve-wracking experiences of my life.  I did not see a runway, just dirt and one small straw hut.  I thought to myself “are we actually going to land there?”   An MSF man was waiting for me and drove me to the home base in the small town of Aweil.  I was exhausted after nearly a week of travel from NYC.  I sat down for literally 2 minutes and Nancy the hospital manager asked me to come to the OR.  Man, this is crazy.  No time for any rest.

I met Nicola in the OT (operating Theatre) and we had a nice chat while he and Joe, the internist from Minnesota were finishing a small procedure on a young girl.

Nancy took me for a tour of the hospital and it was insane.  I have never seen anything like this in my life.  Saw neonatal tetanus, a few cases of malaria, a few cases of TB, a case of pertusis, and glaucoma, and brucelosis.

Aweil 9/28

Just absolutely insane. So much to say that I don’t even know where to start.  It’s hot as hell.  It’s filthy and basic and as remote as it gets.

Had dinner with the team last night.  A pretty cool team of 20 expats.  We had chicken curry and rice.

Got called in around 1130 pm last night and went and did a c-section.  Let Nicola try a few times for the spinal and then I did it. Took me a few tries.  Was not deep at all.

Horrible night last night.  Very hot and there was a hole in my mosquito net.  Living just minute to minute here is hard.

Did a bunch of Pedi cases in the am.  Mostly ketamine sedations and halothane mask only.  Did a wound debridement myself and helped Joe cast a kid with a forearm fracture.

Walked through the market to go back to base for lunch and it was insane.  It’s surreal.  I couldn’t even know how to describe it to my friends but it’s a feeling that you are the furtherest away from home as possible.

It’s dirt roads and basically just dirt everywhere.  There are donkeys pulling little carts and the markets have typical cheap Chinese knock off goods such as clothes and cheap electronics.  Even though it’s dirt poor here, people still have cell phones.

Did a c-section at 6 pm and nicola got the spinal but it was an incomplete block.  Jane the ob started the case and patient did not scream but was moving legs.  We had to put her to sleep. It took a while for nicola to get stuff organized but he did the induction with pentathol and sux.  When the sux wore off he rebolused with sux which I told him was not good and that vec was safer.

We came home and ate dinner.  Enjoyed talking with Rupa from Colorado and Marie-Amie from Bordeaux, France.  Terry is from NZ and does mechanical stuff.  Nancy is the hospital coordinator and is from Seattle.  I like the group very much and it’s cool when everyone chills out after dinner and has a beer.  I could not because we had to go do a c-section at 9.  I tried not to call in nicola but had to because I could not find the sux.  It was in the fridge (cold chain) outside the or.  Came back and asked the generators to be left one extra hour to use the fans and it helped so much.  Plus I have my new mosquito net so no bites.

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