Local tukuls


Saturday 26th June

Finished work a little earlier today at 4pm, so three of us decided to take a short stroll through the bush as it was such a lovely evening. There are three main tracks leading to different villages. Each track is about the width of two bicycles. The only means of transport to these places in the past has been by foot, now there are a few bikes and one or two small motor bikes. It’s hard to imagine that every single thing in and out of these places has been carried, mostly on the head, by the women who usually have a small baby in a goat skin over their shoulder too.

It is good to get out of the hospital and appreciate what sort of lives some of our local community lead. It helps to understand how hard it must be for them to come to a hospital like ours.

It is like stepping back in time, as though we should not really be there. I saw nothing from my century, no plastic bottles, no rubbish, the kids play in the dirt, and enjoy splashing in the puddles. I would like to have been invisible so the locals did not feel as though they were being studied.

They seem to be in small family groups with their goats and chickens. The tukuls (huts) are well maintained and the hard-packed earth outside is well swept. They all have a hollow log outside with a large stick like pestle, where they grind the grain to make flour for their porridge. Also there were piles of Lulu fruit laid out to dry. Some have sorghum growing, which, in a few weeks time, will be well above our heads; it is just so green and fertile. The ground nuts are also now showing their heads (peanuts).

It is hard to understand why more people are not trying to grow their own food, as there is so much poverty in this area and nothing to purchase in the market. Saying all this, they greeted us warmly and always shake your hand. They say something, we say something back, neither of us understands but all smile, and laugh and then get on with their job at hand.

All the children look quite healthy, mostly naked apart from some beads around their tummies and their necks. I wonder if these children will ever know a different life, although they are happy at the moment. Will they ever see a tall building, an aeroplane, the ocean, and all these things that we can't even grasp that there are people who don't know about them. Does it matter? That is our world not theirs.

Sunday 27th June

Mapuordit, the village where the hospital is situated, is just so different from these other areas, only a few kilometres apart. Here, the children are in western torn rags, very dirty, a bit cheeky, wanting pens, money, not as healthy looking, rubbish everywhere, green stagnant water surrounding the market. Their huts are not as well kept. Animals roam the area. Children are drinking Coca Cola, Pepsi, Fanta, sucking lollies if they are ever given any money. Is this what we are doing to them? It could be the Northern Territory with our Aboriginal population.

Sorry, it is Sunday, perhaps it is a day for thinking. There was a prayer rally today in the market which involved a band of hallelujah dancers, drummers and Church of Christ, or perhaps Pentecostal, groups (not sure), leading a procession around the area through the hospital grounds, drumming up the locals to come and join them in prayer. By 2-30pm there would have been around 100 adults and perhaps the same number of children. Lots of singing in Dinka and clapping - all seemed to get something out of it, whether it was for the faith or the spectacle it was hard to say.

Well, our long awaited chicken lunch in the market which I had already given the restaurant cook 20 pounds ($10) to purchase a chicken with, turned out to be very tough beef!! You win some you lose some, but the gravy was delicious + 3 bread rolls. Desperate for some veg - I dream of green.

HIV baby

The cow with the crumpled horn....










Friday 25th June

Woke early this am as the cocks were all crowing just outside my bedroom window. I could hear the water pump clanking away, out under the old mahogany tree, so the children were all collecting water to take back to their villages for their porridge (if they are lucky).

Unfortunately, we had no water from our taps at all; different system, and since it has rained for a long time, there was no power left in the solar batteries. Hope fully the sun will get up soon and we will be in business again.

Luckily there was a little hot water in the thermos from yesterday which was enough to make tea with but I was really hoping to wash my hair today, after a week it gets pretty bad!!

A slight lull in the malaria cases, but another week and they will be back up again after the heavy rain - just enough time for the mosquito larvae to breed.

Good news, the little girl who was so sick with cerebral malaria (her sister died on the way here) might be going home tomorrow. She is just starting to walk and say a few words, not sure if she will ever be back where she was, but her parents are just so happy she is alive.

We are still unpacking all the ‘goodies’ that have arrived - it is just so good to see the equipment, thank you everyone again!!

The student nurses will have their first taste of the wards in a couple of weeks so it has all come at a good time.

E--- (Italian volunteer nurse) and I were in the market after work today. We are getting low on onions - this is the only veg you can get in the market - so we lashed out and bought 6 for 3 pounds ($1.50 aussie) and made two ladies very happy (three from each - it was all they had to sell). We also re-stocked up on beans and tomato paste; this diet is not quite what you would call interesting, but we did have one small tin of tuna, I think it was 100gms for 4 of us tonight, bulked up with onions, rice and pasta.

It must have been cow day today, as there were many roaming around, some beautiful horns on them.

Smiles are free!!

Wed 23rd June

I am sitting in my room, it’s about 9-30 pm, and I still have some power in the solar system for lights. In the distance, I can hear the African drums beating - the locals must be practicing for some function next week. The frogs are croaking really loudly as there has been lots more rain, and the odd mosquito drones by.

Only a few hours ago, I was listening to the beautiful African kingfisher that was up in the tree, preening its bright blue feathers. There goes another big bang on the roof - sounds like gun shots, but it is only the fruit of the Lulu tree that hangs over the roof and regularly drops its bounty. It’s a wonderful shade tree, the locals collect the fruit and eat it, and the seeds they make the sweetest smelling cosmetic butter for face and hand products. Look out for it - it's divine.

You need a few good smells around here.....

The stars are out again, and a bright full moon shines. No torch required tonight. Drums still going. ....went on till 12MN

E--- (the Italian volunteer) had a terrible fright this afternoon. I was busy washing my uniform in my bucket when I heard her shouting ‘Anne, Anne' getting closer, ‘Quick, quick’. I opened my door and found her clutching her leg and her hand saying 'I have been bitten, very painful'.

She had been in the terrible latrine I wrote about last year, and suddenly felt all these bites, about 5, within about 5 seconds, some sort of bee or wasp had attacked her. She came flying out of there shouting, hardly time to pull up her shorts.

After a bit of first-aid of hydrocortisone cream and Stop Itch, things settled but she is left with 5 raised red areas on her leg, arm, hand and fingers. The problem here is you never quite know what got you....

This morning her hand was swollen and red, same as her finger, other area not as bad. She says ‘I am fine’ as we all tend to do - we are fine compared to others.

Today, Thursday, I had a busy day teaching in the classroom, 11am-1.30pm, 10min break. This was with the students in the school.

I was looking very smart with my theatre scrubs, rain coat and wellington boots on (all day). The rain has not stopped for about 10hrs - it's almost up to the top of my boots in places walking to the class room!! Topic today was The Importance of Fluids and Electrolyte Balance. Also had to cover fluid balance charts and IV drip calculation.........very appropriate!!

It might sound easy, but when the students have not had too many years of schooling, it can prove to be quite a challenge....there are always the few at the front who have it worked out in a flash, and the ones at the back who are lost. The problem is they are so proud they would not like to admit they had not got a clue. Slowly slowly!

Then at 2.30-3.30pm teaching the greens - bed-making, positioning and pressure sore prevention. Nice easy topics. This is all good in a classroom situation when you have a set of nice sheets, a bed cradle, etc. (my favourite place to be!!). However, I am a bit of a coward because it is very different on the ward. For example, it has rained all day today, so there will be no linen available tomorrow for bed-making (the laundry will not be dry), and the bucket with the rag to wash the bed will have gone to some other worthy cause.

So the hunting starts, it can take up to an hour to get equipment together for demonstration, and by then the nurses have gone for tea break and the moment has passed. As they say here ‘calas’ - 'enough'!!

Italy did not deserve to win. We did wander up to the cathedral to watch the game. A lot of sad faces from the Italian group, until the last quarter. The kids were having a great time playing in the mud and water outside, rather than watching the game. There are so many broken footballs laid around just now, every child is dreaming of being a football star!!

Looking around the adult spectators (all male apart from us), the ones that have a tee-shirt on are all ‘freebee types’ with slogans saying ‘We want a peaceful election’ ‘Peace in Sport’ ‘Join the HIV learning program’ ‘Fight Malaria’ 'I am a devoted Christian’ - they probably all think all clothes come with writing on. Most of the kids are in very dirty rags which I suppose have been passed down from the big brother or sister, as none of them fit. These kids have no possessions, but still have big smiles to make your heart ache!!

Delivery time!









Tuesday 22nd June

A small drama on Sunday morning in our dining room (a grass roofed hut). One of the small cats in our compound had somehow climbed up into the roof which is lined with a yellow plastic to stop the rain and dust falling on to the diners. It was trapped between the roof and the plastic.

At 7am it was mewing, but by 10am there was no sound. We all thought it was dead and were wondering what the smell would be like as it started to decompose. But, a miracle! We saw a slight movement of the plastic, and, with the help of a long bamboo pole and a very tall Dinka, she was rescued. Drama over, they say a cat has nine lives!!

Three of us went to see the Italy v NZ game - still very well supported with lots of children down at the front. Will try and send photo.

They seem to like the ads as much as the game. There is a small cartoon African boy that appears and they love him as he gets lots of cheers. Visa and the insurance company in the ads don’t rate very highly - sorry, Ian!! The kids have not got a clue what the ads are about. They don’t own anything, so it’s not a good idea to set up a branch of an insurance co here!!

Great news! The lorries have arrived with half the load and the rest is to follow. It broke down in the mud, so another lorry went to rescue it, but it is very stuck, so the goods were transferred, although it was a smaller truck.

I am sure the rest will arrive soon. It was very exciting unpacking today, all the equipment which was ordered by many of you from the Sisters' website arrived, bed screens, a wheel chair, pillows, mattresses, trolley, urinals, bed pans, scales, it was very exciting, and to think you all made it possible.

Tomorrow, we will get them all labelled with the hospital name, then they will be on the wards in full use. The nurses have been having a sticky beak and can’t wait to use them, they love new things. The new beds have even got a back rest and wheels.

I think there is also some food arrived, but have not seen that yet. Perhaps ‘happy days are here again’ with tins of green beans and peas. I have not eaten one green thing since I left Australia, you start to miss them. Until now, it's been beans beans and more beans, wind wind and more wind............Mapuordit is called 'windy city' here!

Today P and I started teaching a crash nursing course with the green nurses. We have 7 weeks to get them up to scratch, and one will be picked out of 6 candidates to be a blue nurse (green is the lowest grade, blue the next) as we have a vacancy.

So, every morning for 1 hour in the classroom, then onto the wards for practice. It is always so much easier in the classroom as you have all the equipment, but once you hit the wards, to find a bucket and a rag to wash someone with, and a towel to dry them, is very hard.

It was the same last year; most of what I bought then has gone. That is quite understandable, as no one has anything, so if a co-patient sees a bucket, and it is not in use, they will take it as they have not got one. It’s not stealing, it’s just using.

Meanwhile, at the hospital another HIV patient has died and two small babies, new admissions, died last night both with cerebral malaria. It sometimes takes people so long to get to the hospital, it is just too late to help.

The child whose sister died last week on the way here is slowly improving; I think she seems to recognise her mother and father, but is very week and mentally not sure how she will be. The child with the snake bite has gone home OK, but into that bed came a child with a scorpion bite to the little finger. And so it goes on, the chain of misery for these people.

Sunday 20th June

This is for the blog - it is not much as I am giving lots of in-services now most mornings and some evenings, so run out of time after preparing lessons.

Well, we had the chicken last night for dinner and it was delicious. But nothing is easy, as our cook went up to the Sisters' compound to pick up the lovely white chook, but it had escaped out of the chook house, so she had to catch one of the Sister’s birds to replace it.

Problem was, it was one of the Sister’s favourites - Whoops! She put an onion in the pot with it and a small tin of tomato paste for flavour - not a lot of meat for 6 but enough. How these cooks manage to cook on one little kerosene burner I will never know, a chook, beans, and rice.

The best thing was the bottle of red wine I opened. I bought from Wilson Airport duty free in NBI - it was the only red wine they had so it had to taste good!! It was a South African Drostdy-Hof claret from Stellenbosch. I think it was the Bakelite cups we drank it in that helped with the aroma. Good night was had by all, including P------ who was our special guest.

Boy patient

Saturday 19th June

At the moment we have a visiting Italian nurse from Y--ol, about a 2 hr car trip away. She brought some patients for treatment and thinks our hospital is wonderful. We have bed sheets and pillows and covered mattresses, not just rolls of sponge you can’t wash.

We have a Dr. and medications, an oxygen separator machine. We even have nurses that turn up for duty. Apparently, it is a government hospital, so the nurses just turn up for work on pay day, collect and go home. It sounds terrible.

She has been there since March and has a contract until August. She does not think she will be able to stay under those conditions. Her return trip is on Monday.

Our surgeon should be back in full swing tomorrow after his scorpion bite, so lots of new admissions today ready for the theatre list.

There is one little boy I would like to tell you about. He has been in the hospital for 2 months and has what the medical staff think is a Kaposi's sarcoma (Google to get full description), a form of cancer of the lymph nodes in the neck and inside his mouth. Poor lad, he is now having trouble eating, the growth is so big inside and out. He has had some chemotherapy here but very basic, it seemed to go down a little but has grown again.

Now, to all the people who so generously donated funds into my UK account for all those books and teaching DVDs, well, there was $550 USD left, so I withdrew it and brought it over with me.

So I hope that you will all be willing to let us use some of this money to send Pantar with one parent to Uganda, to a large town called Gulu, where there is a chemotherapy unit who think they might be able to save him. The money would cover his and one parent's return bus fare and food for the full time he is there. The treatment will be free.

His father is also going to sell a cow to pay for his wife to go too. That is a huge thing, to sell a cow. So hope you all agree. He is such a lovely boy and well loved by his parents.

Walking wounded

Happy baby

Boy who was attacked by hyena






Friday 18th June

Well I will give you a bit of a run-down on the hospital and a bit about the type of patients we have in just now. Some of these may be too much information so stop reading now!!

Two gunshot wounds both lucky - bullets went straight through, one arm, one thigh.

One little girl who was bitten on the toe by a snake, not sure what type, was very sick. We have no antivenene as yet - trying to get it to keep at the hospital with no refrigeration is hard. She has had a very high temp and a swollen leg, but slowly improving.

This might distress some people. A boy of about 6 years old was riding his bike along a track one morning about 8am, when a hyena jumped out and attacked him. He tried to fight it off with his hands but it was biting into his head; hyenas have enormous jaws and a terrible grip. Lucky for him a cattle man was coming on the track and frightened it off. He brought him to the hospital with a very bad head wound and his hands were badly bitten. He has dressings done every day and is improving slowly but what a shock! It was on the track that we use to go to Rumbek...

About 8 HIV patients, one father and child both positive, the mother has already died. As we are the local centre for giving Antiretroviral therapy (ART), we will be seeing more and more. There is also a mother and child, again both positive, the child suffering from malnutrition too. When you look down the ward, it looks as if they have all been in a concentration camp, all so thin and wasted, they just seem to stare into space, so bad.

One case of typhoid, two children with cerebral malaria, the one I spoke about before remains the worse, not sure if she will make it. The mother has joined the father now, as she had to return to her village to bury her other child.

We had a young girl of about 16 yrs come in today with a bad wound to the leg, very deep and a strange dry green colour. Apparently she had been a patient some months ago and the wound was healing, then she was discharged to come in for twice weekly dressings, but she was lost to follow up.

Her father had taken her to the local magician or witch doctor who had treated it with ground-up cow dung or goat dung rather then bring her to the hospital. This often happens. They sometimes, I am told, put a piece of cow bone into a wound, or ground up root of something, bleeding is also practised with these very anaemic patients....

It all seems so strange to us Westerners arriving in this country, but these things have been practised for hundreds of years, and sometimes they may get good results - I have not seen any, but there again I've only been here a short time.

Who's to say we are right giving them all our antibiotics, so that by the time they join the third or second world countries they already will have no immunity to most of our super bugs? Perhaps it is we who are wrong. Sorry, a bit down today; it is never-ending the misery for these poor people.

On a lighter note, I am now the proud owner of a chicken. Done the goat! A present from David. David, who was in charge last year on the children’s ward, brilliant with the kids, could get a cannula into the smallest dehydrated babies, is now in training in the school of nursing. He said he was so pleased to see me back, so sweet. I just hope he goes well, he has got all the practical skills but he only had a few years at school, so is struggling when it comes to classroom work.

The Sisters are giving him extra lessons to help him through.

At the moment, the chicken is wandering around the Sisters' hen-run; until we cook it, there is nowhere else to keep it here. After discussing with the rest of the volunteers in the compound, it has been decided to have it tomorrow night. So, I then had to explain to Martha the cook what was happening. I have no Dinka, she no English, so after lots of chuck, chuck, chucks and neck pulling and pointing towards the Sisters' compound I just hope she understands. Or we may find something completely different in the pot!!

Mother & baby clinic


Tuesday 15th June

The Brothers and Fathers are all happy as Italy drew and did better than Australia (they are mostly Italian)!

The little girl with malaria is still alive, temp down but mentally not with us yet.

The lorry bringing all the supplies has still not arrived. On it are all the antibiotics, IV panadol, and quinine - stocks now very low.

Another hard day with children, I can’t get over it - so many, so sick, much worse than last year, mosquitoes everywhere.

We are now full, and are overflowing into the surgical ward, perhaps it’s a good job the theatre list was cancelled, at least they have a few empty beds.

One of the children needed oxygen today which we don’t have, only an oxygen separator machine which pulls in room air and removes the carbon dioxide, so giving oxygen. The problem is that it depends on the quality of the air in the room.

We had the child on the couch in the treatment room - very small and two adults plus all the others who want to come in to see what is going on. Not a lot of oxygen to extract.... My fear also is that tonight I don’t think the machine will be able to be used as there will be no lights in the hospital at all. Each ward has a small light on but combined they will drain the battery. No one has torches - impossible to see anything.

Just trying to find equipment is very hard. I found some nasal prongs (for oxygen) but they had perished as they have been cleaned too many times; I found an adult mask which I had to use on the child until P came to the rescue with a child’s mask. That may be something I might have to ask Ian to bring over for me in his already over-weight bag.

This child had a Hb of only 3, so we quickly checked the mothers blood, same group, free of HIV and Hep B, so I went ahead and removed about 300 mls from Mum who kept saying ‘calas', ‘calas' (enough, enough). They get very worried when they see all this blood coming out of them.

After a cup of tea and a week’s supply of iron tabs given she will be OK.

The child continues to fight for his life - time now 6pm.

The silly thing is, today I had to teach Oxygen therapy in the class room to the blue nurses (nurses who run the hospital). I always hear myself saying "Well, unfortunately at this hospital I can’t show you one, but if you ever go to another big hospital you may see this in use".

My feet are quite swollen just now from all the mozzie bites - they seem to like RID!! Just hope that my Doxycyclin will keep on working. One of the students was admitted today with malaria - very sick.

Every one was too busy today to think about cleaning.

Co-patients at Mapuordit

Volunteers' compound


Monday 14th June

Our one and only surgeon was bitten on the hand by a scorpion in the hospital yesterday so is now unable to operate for a while; it is very painful and swollen, so we just have to hope there are no emergencies. He has cancelled the theatre list for Wednesday, let’s hope he recovers quickly.

It is just so busy right now, we had five admissions to the children’s ward in 30mins - all malaria, two cerebral. Temp up to 40c, so sick.

One family were bringing their two children to the hospital, a 5 and a 3 yr old. They had seen the local witch doctor who had given them some sort of ground root, no good.

On their way, the little 3 yr old died at the side of the road.

From what I can gather, the mother took her back to the village and the father continued on to us with her sister. She is so sick, I don’t know if she will make it. Her little heart is just racing. We gave all we could in drugs to reduce her temp and pressure in the brain, and of course the quinine for the malaria, plus tepid sponging. Now we have to wait and see, the poor father is beside himself.

The patient who is the paraplegic (the one that gave me the goat) was in the dressing room today. His wounds have improved so much since last year, all the very hard work of one nurse who has persevered all this time changing them 4 times a week. The only dressing material we have here is cotton wool hand rolled and gauze hand cut into squares. Lotions are savlon, iodine and hydrogen peroxide.

So he (the nurse) has done so well. Last year, this patient had the biggest pressure sores I have ever seen across both buttocks. He lives in the hospital and spends all day in an old wheelchair with a very thin cushion. Just the idea that they would heal at all is a wonder. I was given a few special fancy dressings from my hospital in Sydney which I am trying now. It would be great if we could get it completely healed before they run out. Fingers crossed.

They went thataway....


Viewing Sudan-style



Sunday 13th June

Only went up to the hospital for the internet today, but have just heard that another of our patients has died of HIV. That is two in 5 days, people are really starting to believe it now, and it is touching every one. At the hospital, now that we have the HIV clinic, it is a dawn of realisation for them, but the feeling here amongst the medical staff is that it is too late for this generation. Perhaps with more education in the schools, the next generation may be more prepared, let’s hope so.

Great excitement today in the market near Mapuordit, one of the Dr’s had found some apples for sale, one pound each (50c), and we bought 10 - what luxury!! I think they are Granny Smiths. The entire compound was on the move to the market. When you all think of a market you think lots of fresh fruit and vegetables. Forget it. In the food line, they sell beans, coffee beans, rice, salt, sorghum, flour, powdered okra, tins of tomato paste, small packets of plain biscuits, onions & garlic. Last year I did see fresh tomatoes once.

The rest of the things for sale are washing powder, long sticks of soap, material for wrapping around you, woven mats, plastic buckets and bowls. That sort of thing, so not a lot of variety.

Four of us decided to go into one of the ‘restaurants’ for lunch yesterday; it is called ‘the free and easy’. For 2 pounds (A$1) we got 3 bread rolls and a bowl of beans in some very nice gravy. If we had booked (!!), we could have had chicken with beans and 3 bread rolls. That will have to be next Sunday. Our cook has a day off on Sundays, so we have to fend for ourselves on the Sabbath.

The problem with all these beans....... well you can imagine (not looking forward to Ian coming!!!), but there is another problem. The cook is only given 5 lts of kerosene a week and she has been using too much, as the beans take so long to cook; to resolve this, I have to remember to soak them over night so reducing fuel usage.

It has been a very late night - I decided to go back to the cathedral to watch Australia play Germany - wish I hadn’t, what happened 4-0 and 10 players only???

The screen tonight was 2 mosquito nets fastened to the back-drop of the alter; the problem was it was very pixillated, so you could not make out the faces of the players - all looked a bit dull. Then, when the insects started settling on the screen, it looked like the teams had gained extra players!!

The bats were quite active too, as there is a colony that hangs in the roof of the cathedral so they were busy flying in and out (bit like watching the antics of the seagulls at the cricket at the SCG!). All in a nights viewing in Sudan.

Best seats in the house...


The goat that was...



Sat 12th June

Dr P left today to go back to Italy for 4 weeks. We will miss her, not only at the hospital, but also here in the compound, as she is always the life and soul of the place!!
.......but it does mean I have two rooms now to move around in, I feel a bit guilty really compared to what the others have.

Things are still getting cleaned on the ward, long may it last. I have spent most of the day today ‘damp dusting’, scrubbing lockers and trying to encourage by example. The hospital already is looking so much better with everyone’s hard work.

The rain is still coming down and the compound is flooded again. Hard to keep the fire wood dry. Well the goat is no longer with us, I am goat-less. Little did I know, but it was with kid, but very young if that helps. The gatekeeper did what he had to do, then one of the compound cooks prepared all the meat. The main pieces were put on a big barbeque (with wet wood) and all the ‘other bits’ in a big pot to make a thick soup-type thing. I was hungry but not that hungry. The thought of the kid put me off somewhat.....

Every one brought food, so we had rice, beans, assida (porridge with ground millet) all washed down with a beer. What a feast - there were about 12 of us, teachers, Drs, nurses, everyone in the compound and P of course. Have saved a plate of food for Juma who gave me the goat - hope he will not be offended.

Time now 9-30pm the crowd had gone, when there was a knock on the door - one of the teachers and the Italian nurse to say there was a match on. Rid repellent quickly applied, gum boots on as it was still raining, and we set off up the road, only about 500meters away.

The track by now was a mud bath. I was fine, but most of the others going were in bare feet. As there are no lights apart from the odd torch it is very hard to see where you are going, just follow the crowd.

The church (but the locals call it the ‘cathedral’, as Rumbek has one so they want one too!) is a giant sort of yurt with no windows. So a roof and pillars supporting it and between two pillars there is a framework that is the alter type area. There are rows of thin strips (about 5inches across} of very rough mahogany wood nailed onto posts to make the seating. It is so uncomfortable, but it’s a seat.

The screen tonight is a large plasma television screen, a little low but most Dinkas are very tall. The TV was given to the school by a benefactor and is used for viewing DVDs etc (no TV in South Sudan). The loaned satellite dish is up, the generator is on, and the tension rises. So does the steam, as there are so many of us all in there and we are all wet, with the temperature probably around 30c - you can see and breathe the rest I am sure. At times the condensation misted up the screen!!

When Gerrard scored that first goal for England the place went mad, it was great to be there.

By now the rain had stopped and the stars were out in their full glory. It was hard to believe I was in South Sudan watching a World Cup game in a Cathedral with this group of people, most of whom would never have seen a TV in their lives!! Surreal!

I am sure Father was so relieved he had got all the equipment working for the locals, after the game it all had to be loaded into a truck and taken back to the brother’s compound – what a worker.

Big disappointment - the satellite dish did not work for the next game and apparently they all hung around hoping, but eventually left very disappointed. Poor Father - he had worked so hard and had a man from Rumbek working on it but no go. It is a problem as very few people know anything about such technology, as they've never seen them before. Whereas we take it for granted, and people easily at hand to fix things!

I know Father will not give up, so I am sure it will be OK for the next match.

Friday 11th June
"Let the cleaning commence....."

You will be pleased to know that the lady who died is at last on her way back to her village.

On Thursday, Pauline and I were discussing how we could get the hospital a little cleaner and came up with the idea “Clean Up For The Cup”.

So, we have divided the hospital up in to teams, given them colours and goals they need to achieve, to wash walls, beds, lockers, trolleys, equipment etc. So they have 4 weeks to clean up in, taking us up to the World Cup Final. We will be scoring at the end of every week. At the end, we will have a final inspection by one of the sisters, perhaps Sister Mary who all the nurses love (she has been the principal of the local school for the past perhaps 15 years or more, she is now over 80 years, a great lady with lots of good stories to tell). One of the Comboni Fathers (who run the hospital) will help her in this task. Not quite sure how we can make a cup, perhaps a cardboard cut-out, if I can find one on the net.

We then have to find some prizes for the wards. Just hope we have enough digital thermometers and scissors for the winners. My order had not arrived when I left and it will all be over by the time Ian gets here with them.

We announced it in assembly this AM and it seemed to go down well. We talked about how millions of people all over the world would be watching the games and how there would be a lot of educational material being screened between matches about AIDS/HIV and malaria - spreading the message of health and hygiene.

This led on to multiple use of antibiotics and super bugs, and people were going back to the idea of cleaning and sunlight, as Florence Nightingale had done all those years ago. So our main goal for the World Cup is to reduce infections and have a clean environment (well the best you can have in South Sudan!!)

Pauline had been up half the night making signs for each ward with their colour and team number; they all had streamers hanging down. Looked great.

As the cleaning staff do not speak or understand English, we met them separately with an interpreter to explain the game plan. They were very happy to join their teams especially when the nurses were going to be doing cleaning too.

Within an hour lockers were being scrubbed and left out in the sun to dry, walls were being washed, it was remarkable. I tried to say you don’t have to do it all in one day, you have 4 weeks, but it’s hard to dampen their enthusiasm. Will send photos.

Again, I think it will be quite a challenge to keep it going.

We think we will end with a big party and show them all the photos I am taking like we did last year. They love to see themselves ‘in lights'.

Not sure what film to show - Invictor would be good, but how to get it is a problem we might just have to have 'The Chicken Run‘

One of the fathers has been very busy these last few days arranging a large satellite dish to show the World Cup, not quite sure which group has sponsored it but it is a first for this area. It has been placed in the open air church near the market. Apart from the Cup, as I said above lots of educational stuff which is a wonderful idea, will be shown all over Africa. A great opportunity not to be missed. The dish will all be removed after the Cup Final.

The school pupils have been playing soccer every day after work - they had a competition going with the hospital soccer team. The other thing that the sisters (OLSH) have arranged is a big quiz at the junior and senior school. The questions are all on all the countries taking part in the World Cup. So they are learning heaps.

Tension is rising - 2hrs to kick off - South Africa v Mexico!!

10th June Thursday

Well I am now the proud owner of a goat!! Quite a large goat. I was busy on the ward doing some teaching when one of the nurses came looking for me; she was very excited saying there is someone to see you. I went outside and there was a little boy with a goat who said it was for me (in Dinka).

When I got a nurse to translate, it was a present to me, from Juma, the paraplegic former soldier who lives in the hospital. He wanted to say 'thank you' for all the gifts he has received from everyone in Australia, Joan the bootees you gave for his pressure sores on his heels, the dressings, tee shirt, Vitamin pills and a few other things. It was so kind of him as he is the one that needs the meat not me, but it was a gift and I could not say no. So we have a few pics to show you.

I did not know what to do with it, so I left the hospital with my goat and the little boy and went down the road to the compound. Luckily we found the gate man and tied it up near the kitchen under a tree with lots of nice green grass.

I headed back to work after giving the boy Majak some coloured pencils. It was strange being the owner of a goat - I have only had rabbits and guinea pigs before!!

After work Dr P wanted to meet ‘Felicity’, but as we were approaching her, she got scared and broke her rope. She headed off across the compound past some of the men sitting having tea. I was shouting to them to catch the goat but they just sat and laughed, as P and I ran after it. My concern was the gate was open and if she got out she would go back home.

I called to the gate keeper who made a dive for her; he missed and Dr P did the same - all the time I was running for the gate. I made it 1 second before Felicity did. We had her. My poor knees - I have never run like that for years. I guess you had to be there. All the children who collect water at the pump just outside the compound were all laughing; they thought it was so funny to see two white women running after a goat.

Poor thing it cried all night, so it was decided her number is up and she is for the pot on Saturday.

Wed 9th June

Attended the first ward round today to see what other cases there are in the wards and where I can start doing some ‘hands on’ with the very new nurses (called 'greens' as they wear a green uniform). Found lots to do, so tomorrow we will start.

But we do have a problem just now. A women of about 30 died today She came alone from a village the other side of Rumbek and was being supported with food from the hospital shipping container supply, and a co-patient of another patient was trying to look after and cook for her (the hospital doesn't provide cooked food for patients, rather 'co-patients', usually relatives, cook). She appeared to have no family who were willing to look after her when she was alive, now the poor lady has passed away and she is laid out in our little mortuary. The temp today must be about 35C - I hope we will be able to find someone soon to take her home to be buried....

Will keep you posted on that...

Today day was food distribution day (three times a week). For those of you who did not read last year’s blog it is a large shipping container with large sacks of milk powder, sorghum, Egyptian beans, rice, drums of cooking oil and boxes of biscuits. Small quantities are distributed to the co-patients of the very poor, or of patients with HIV and leprosy patients in the hospital. They then cook it for them.

Inside the shipping container it is just so hot, and the people are stretching out their hands with old tin cans or bags for us to put their rations in. It is heart-breaking. Ian helped in this role last year so ask him what it was like. This time I noticed the container is nearly empty, I just hope that the supply lorry arrives soon.

The "Liberty Loo" (new latrine block) progresses (part paid for by a generous donation from Liberty Mutual, a company Ian works for).
It is almost finished, it has taken a long time as the builders went back to Uganda during the recent election in Sudan as they thought there might be problems - fighting, so have just returned this week.
Don’t forget they first have to make the bricks. Thank you Liberty!! Will send more pics as and when.



Tuesday 8th June
The compound was just so flooded this AM, I could not go up to the hospital until later as I had no gumboots. It’s a good job I flew in yesterday; they would not have been able to get through from Rumbek today.

I had a good morning sorting out all my bags. Things for the hospital, things for teaching, things for dressings.

I then set about my list of things to get in the market. Beer top of list for the fridge, fly swatter - don’t think I will be able to get that but we will see. An orange powder which helps make the water taste a little better. I will keep adding.

Handed over the phenobarbitone into the pharmacy so let’s hope it will last a little while, as it is only for the patients that are fitting with cerebral malaria.

I wander around to catch up with the nurses and met three patients who were still in hospital from last year. I think two had been discharged but returned. The other is soldier who is a paraplegic with the terrible pressure sores. He lives at the hospital. Not seen his wounds yet......

A lady who had her leg amputated last year after osteomyelitis (a result of bone infection) - she had a fall and damaged her stump, so has returned. She was so pleased to see me, and just wanted me to take her photo. Usual reaction.

The last one I will see tomorrow, a boy about 10 years old who fell out of a tree about July 2009: a small cut originally on upper right arm developed into osteomyelitis. Now very bad large wound with large sinuses despite lots of visits to theatre to clean it out... I thought perhaps some of the silver dressings I have with me may help these mix of wounds, we will see.

P and I sat down and worked out my teaching sessions for the next 6 weeks or so. Only about 4-5 hours a week face to face so it will give me time to do lots of practical teaching on the wards.

This year there are a few more volunteers, two Slovakian Drs over for 3 months and a young Italian nurse who has only been here a few weeks, so is still feeling a little shell-shocked as it is her first visit to Africa. It’s great for the hospital having all this extra help.

Click on image to enlarge

Monday June 7th

Arrived safely in Rumbek after heavy rain in NB and throughout the flight; it was an 18-seater with two propellers and still has signs inside which read “do not smoke while oxygen is in use”. A bit unfair as they did announce that it was a non-smoking flight.

We had one stop at Lokichoggio (just inside Kenya) where I was presented with 5kgs of medications for the hospital which had come through by road that far; because of the rains, progress by road had been slow, so at least this way they got to where they were needed a little faster. By now my extra luggage was about 14kgs. I forgot to say a sister in NB give me 2kg of pork sausages to give to the sisters here at Mapuordit, and all the mail (no post in Sudan so always a pile waiting in NB). What with the drugs, talk about the bag lady!!

The landing was fine, the dirt runway was clear of cows, so without too many bumps.
Pauline’s smiling face was there to meet me. After frantic shopping in the market, we went up to the Rumbek hospital to see the students we had taught last year. They were just starting their second year in Rumbek.

They greeted us both as long lost friends, and wanted us both to come to Rumbek and teach them there. The student who had a baby just after I left was there with a healthy baby boy. Her mum sits under the tree with him all day while she is in classes. No Emma, Rachel will not do that for you.....

The road was not too bad, will send some pics, not too many road blocks or soldiers with guns.

The 4x4 was packed high inside and out. Full petrol cans, a water barrel, 3 large boxes of goods for the malaria/leprosy programs, plus my bags and shopping.
Apparently, the food supplies from Kenya for the volunteers' compound I am staying in have not yet come: they should have arrived in April, so supplies are low, very few tinned goods, so it will be more rice, lentils and beans.

But we will still be eating better than the people outside the compound.

I am sharing a small house this time with Dr P----, so quite spoilt. She has given up her room and has a bed in the sitting room which is very kind of her. She heads off home to Italy for a month on Friday.

Let me explain the set up. It has a front and back door. A small bed room with a bed and a large cupboard. A little sitting room with bed and table and - guess what - a small fridge. I can’t believe it, I will be able to have a cold beer and drink cold water: blooming luxury!!

There is then a store room which has all the solar system things in, batteries, pumps and all the food storage area for all the volunteers in the compound. We are 5 at the moment, but by the end of the month down to three I think. Best of all, if I go out of the back door there are two tin huts. A shower and a flush toilet. Looks good but just a few problems, although I am sure I will get used to it. The shower is a trickle so if I want to wash my hair, better to go to the one I was using last year, which works really well - as long as someone else has not turned a tap on!

Now the toilet - it is 100% better, but there is no seat and it does not seem to flush. So, I am informed, if we catch the drips over night from the shower then we can use that water to pour down the toilet after use. Nothing is a problem here!

Perhaps I will take a photo, then Ian might be able to do some running repairs when he comes over. I think it only needs a new ball and washers. You can see we badly need a plumber and parts to teach the Sudanese a bit about plumbing, all new to them as they have not had it before.

As soon as Pauline and I got back we went up to the hospital to get the drugs into the pharmacy and some into the kerosene fridge. Of course, we met some of the nurses from last year - all very happy to see me again, but all asked after Ian and could not understand how he had given me permission to come again on my own.....

I was invited to dinner at the sisters' compound where a very noisy cockerel had been slaughtered. He made a delicious soup, followed by a very nice casserole and even a birthday cake for me, well, not quite, but they improvised and made nice pear custard - just so good. It was lovely to see everyone again and they all made me feel very welcome.

Dr P---- and I went back up to the hospital around 9pm as there was a couple of new admissions, so I thought I'd better see what is happening and get used to the place again.

We first went to the children’s ward to see a little girl who had been checked out earlier with a diagnosis of malaria with an Hb of 30!!! (should be around 100-130). One of the other volunteer Dr’s was just being bled to give her a transfusion. She is still alive this AM, but very very weak.

Another child earlier in the day had died with the same condition but her HB was 40. The mother had donated blood, but as they were getting the cannula in, she died. So it is going to be a bad year again, I think the ward is full.

We were heading off out of the gate with Dr P---- when in came a little boy, screaming this time - it was a scorpion bite on his toe. Poor little thing he would not let me near him to bathe it as it was bleeding too. Often children are frightened of white skinned people as they have never seen them before. After some pain relief, he settled and was sent home. By now it was around 11 pm.

I slept well despite an amazing thunderstorm and just so much rain.

6th June 2010 (posted 8th June)

Well it has been less than a year since my last adventure in South Sudan. Many things have happened. The web site for OLSH has been set up http://www.olshoverseasaid.org and approximately A$25,000 has been raised in less than a year by many good people who gave their time and energy to achieve this. And it's a remarkable achievement. Money has been sent from far and wide. From the UK alone 2685 GBP has been raised.

The money has been put towards a huge range of good and needed things:

A new latrine block of which I will send a photo when I arrive.

Two nurses have been able to be sent to Juba to do further training. We hope they will become medical officers (step up from a nurse), then they will return to the hospital to work alongside the Dr and run the outpatient clinics etc.

One young girl has been sent for heart surgery to Khartoum and has returned looking extremely well I am told.

Equipment has been purchased, which I know is all in use. Some of the towels may have gone walkabout but that is OK - I can soon help to replace those.

Pauline’s emergency bottom drawer is ‘afloat’ again for when the very urgent, desperate situations arise and funds have to be found.

The money from the UK has purchased 100 GBP worth of nurses scissors and stethoscopes, and over A$2500 worth of medical books and DVDs for teaching purposes from a company called TALC (Teaching Aids at Low Cost). One box has arrived safely still awaiting the other two to come through, I have every confidence(you have to...)

So thank you to everyone who has supported this project, with time, funds and lots of energy; I am sure you all realise it has all gone to a very needy hospital in South Sudan. Who would have thought just a short trip by me to South Sudan would have generated so much interest, its great. Even Dick Smith (Aussie philanthropist) got on board with a donation.

This year my bag is packed again with the full 20kg allowance for the last leg of my trip - and the rest. Most of it for the hospital. A few pairs of knickers for me!!

Not quite sure how I will go writing the blog, as I saw everything for the first time last year and was just so blown away by how people barely survive and live under such difficult conditions. I wanted to share it all with you to help you visualise these conditions. This year I know it will be different but Ian tells me I have to try and keep you all enlightened!!!

I have had a hectic two weeks getting everything ready. I was thrown somewhat when I had an urgent request to see if I could bring any phenobarbitone over with me, as the malaria season had started early and many of the children with malaria were having convulsions, and the drug that the hospital has was not helping them. Unfortunately, it could not be purchased in Kenya or Italy, so they were desperate. Perhaps Ian may have told you all this.

For those of you who don’t know, this drug is a schedule 4 drug so is not available over the counter and a Dr would only be able to write a script for it if it was for your own use. So somewhat of a dilemma. Anyway, to cut a very long story short, I managed to get a small quantity. With lots of help from the Department of Health for an export licence, a very generous drug company and a very helpful pharmacist and hospital who let it all happen.

The next problem was, I can get it out of Australia, but what will happen when I go in and out of South Africa and Kenya. I warned my girls they may hear of a 63 year old grandmother being thrown in to jail for drug running. They said ‘well last year it was smuggling a skeleton into the country’, so they'll be expecting something odd from you! If you remember I look a small skeleton over for the student nurses' anatomy classes. It was made of plastic but the soldiers at Nairobi airport took a lot of convincing.

Well my journey has begun and I am once again in Nairobi awaiting my flight into Rumbek, Sudan, tomorrow.

The flight was packed from Sydney to Johannesburg, full of soccer fans heading for the World Cup. There was great excitement as everyone seemed to be discussing what tickets they had and which the best teams were. All a bit worried about the Ghana vs Australia match ‘will be a tough game’. That's what they said.. what would I know? More concerned about carrying the pheno! The arrival hall decorated with posters and a giant soccer ball was hanging from the ceiling.

The roads to and from the airport are lined with flags from every nation, everywhere is clear of the rubbish we saw last year, the roads are all marked well. A new rail line has been put in to move fans around. There is even a park and ride service with new buses. A first for JB as there has been no public transport to talk of before!!

They seem to be ready for the games - it all had a good feel to it, many people have been given work, not for long but at least they will earn a little. I even was driven past the stadium where the opening game will be played, very impressive.

The best thing, I got through with the drugs no problem, they were more interested to see if I had any food in my bags not drugs.

JB to Nairobi was fine, again no issue with the drugs so I only have to leave Kenya for Sudan now. There is something about going through customs - I always feel guilty even when I am not carrying anything I shouldn’t (which is almost all the time!).

The diocesan driver was also there to meet me this time at Jomo Kenyatta Airport in NBI, so all going well so far.

For all followers of the family drug mule, this was received from Nairobi early on Monday morning (7th June).

"Hi Ian Have arrived safely with all the drugs. Just going to have some icecream with Jennifer (housekeeper). No time to write as on land line - sorry will contact soon love
Anne"

Hmmm! With all the scanning of emails that goes on by CIA, DEA, USA, ICA and all the other 'A's', maybe Anne's choice of words could have been better............

Last Customs hurdle will be at Rumbek, Sudan, later today, but P and the Bishop should sort them!

Anne arrived in Jo'Burg en route to Sudan and duly declared the Pheno. The Customs official was more interested in the Tim Tams (chocolate biscuits) that Anne was taking to Mapuordit for the Australian sisters, and duly confiscated them, allowing the Pheno through!
There must be a joke or comment to make about that, but I can't think of one......

Only two more Customs hurdles to go - Nairobi on Sunday (her birthday) and Sudan on Monday. Fingers crossed!

Note from Ian

Anne has now left for her second "tour of duty" in South Sudan, but her journey there commenced before she left Sydney!

A week before she left, an email came through from Dr R------ to advise that the malaria season has started early in Mapuordit, as the rains are earlier than last year. Young children are the most affected, and many were suffering convulsions when brought into the hospital, as the malaria had already progressed to the cerebral stage.

Existing drugs to control the convulsions were proving ineffective, so R------ asked Anne if she could obtain some phenobarbitone and bring it with her. You know, the scheduled drug, mildly addictive, the kind of stuff that is strictly controlled in most countries......no problem!

Frantic calls to NSW Health & Health Dept in Canberra established that a licence was needed to carry & export scheduled drugs – a permit for Anne was duly obtained with the help of a helpful Canberra official. More calls to a pharmacist friend for assistance, and calls made to a drug company, elicited, quite legally, a donation of a small amount of Pheno.

Yet more calls to a helpful official at the South African embassy in Canberra who provided the fax number of SA Customs at Jo’Burg airport, as Anne was routed through there, with an overnight stop, on her way to Sudan. She wanted to establish her chances of getting the Pheno through SA Customs. Same issue with Kenyan Customs, but no response from either, so - take the Pheno as hand luggage along with the permit and chance that they would let her transit it through each country.

Watch this space for news of the family drug mule.....