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!!