Tailor Made: Week 17

I would like to introduce one of my favorite people in Aweil: M'Barak, the tailor. He is personally responsible for keeping me in high Congolese style. Aweil doesn't have much for style so we have to look west to Brazzaville in order to keep up with true African fashion.

If neocolonialism weren't already rampant in central Africa with all our cooks, watchmen and drivers, the concept of having your clothes tailor made for you is completely foreign and old fashioned in the Western world. Despite the fact that is not only cheaper than buying Chinese mass manufactured garments in the market and widely accepted as the way most people purchase clothing it still feels a bit strange and extravagant. Well, when in Rome....err Aweil.

Totes Adorbs

Some days the kids are the only thing that keeps me going. It's a good thing they're so cute.

That's Officer Nurse to you.

So my job: Nurse Specialist or Clinical Supervisor or whatever the French want to call it this week is a lot like being chief asshole. Part of my work is following what is written in the patients' charts and the practices of the nurses caring for them and looking for aspects of patient care that could be improved and more importantly to intervene when patient safety could be violated. Which, sadly, is pretty often. Wash your hands! Did you just wear those gloves into the latrine? How much is in that syringe? Are those patients sharing a bed? That one has a rash. Do you want the other one to get the rash, too? Remember what we said last time, of you think the patient has polio, put them in a separate room.
It sucks. It's not fun and most days I don't like being the hand washing police. But it is what it is. I can't in good conscience allow Marko to wear his gloves to and from the latrine and then back to mix up medications. That's just not allowed. I'm sorry, Marko, but I'm going to have to write you a ticket for this one. You can make your case in court.
Maybe I can ask them to change my title?

Saving Money Builds Economic Stability: Week 16

Ok. I've talked about ironic t-shirts. Let's talk about the next level: Ironic messages on t-shirts that were never meant to be ironic.
Various aid organizations often distribute t-shirts to people with messages on them as a way to get a message to a nation without any steady news source. It's usually some sort of development campaign type slogan or public health announcement. Sadly the verbiage is often unwieldy and way beyond the average person's comprehension. Not to mention that the primary targets are usually unable to read English. So, the result is a brand of irony that makes me chuckle and want to cry at the same time.

It's not uncommon to see a shirt that says:
"Washing Hands Saves Lives"
"Nations Who Educate Girls Are Among the Top Economic Performers"
"Sleep Under a Mosquito Net at Night and Reduce Your Malaria Risk"
"Exclusively Breastfeed Your Baby for the First Six Months of Life"
and possibly the saddest one, "Saving Money Builds Economic Stability"

Too sad. Maybe if there was less corruption, girls (and boys) actually could go to school instead of having to work or farm the land for food just to survive, and there were fewer superstitious beliefs at work undermining the propagation of public health agendas then and only then could things really improve as the t-shirts suggest. Until then, my patients will be poor, uneducated, and forced by social mores to consult a sorcerer before they can come to the hospital. I'm okay with it. I'm not trying to force my agenda on anyone. I just want them to wash their hands a little more often. Small changes. 

Mmmm Coffee

Every morning I make a cup of coffee. Which isn't nearly as simple as it sounds. Right now because the stove is broken, it means that I have to use our well worn Italian coffee pot over the coal fire. Usually the cooks make the fire which is helpful and incredibly time saving, but I know how to do it if I have to. The water in the coffee pot takes about 10 minute to come to a boil. After I brave the thick, clearly carcinogenic smoke and potential for disfiguring burns to grab the handle with a piece of newspaper (we have nothing resembling towels or potholders here), I have hot espresso at the start of my day. It's the most amazing luxury that I have taken for granted all these years. Especially living in Portland where for a couple bucks you can get a really amazing cup of coffee MADE for you. Here I expected to go off caffeine cold turkey when faced with the prospect of only drinking Nescafe. This coffee pot has saved my life and my mornings. I think I'm in love.

Star Bar

Some nights, just any other thirty-somethings living in the big city, we go around the corner to have a beer at the local pub. Except our "pub" is a little courtyard fenced in with grass mats and flanked by a small grass hut housing a generator and a deep freezer. It's called the Star Bar because well, being outside, it has a great view of the stars. With only diesel generator fed electricity for the rich and no city power, few people can afford to power outdoor lights, especially those big enough to cause light pollution. The result is that you can see the stars here in Aweil very, very well.
The Star Bar has a pretty decent variety of beers (4) including the most disgusting Chinese made 13.8% alcohol malt beverage they simple refer to as "13" and it's Russian counterpart called "9" for the same reasons. They also offer french fries with the most fluorescent, vinegar flavored version of ketchup I've ever seen, greasy India style chapati bread, and their famous "half pizza" which is neither a pizza nor half of anything. It's a Spanish tortilla and it's pretty good when it's available which isn't often.
 The best part of Star Bar is the entertainment. Other than being owned by one of the hospital employees and getting to chat to his wife and play with his kid, there is also a generator powered TELEVISION!!! On which there is often and Arabic over-dubbed American movie or WWF fight DVD playing LOUDLY. Love it. My culture as interpreted by the Arab world and then in turn sold to developing sub-Saharan African nations. There's nothing like drinking really bad, warm beer and watching Predator on a trinitron surrounded by a crowd of displaced Eritreans and Darfurians.

.

Arts & Crafts: Week 15

So, I'm sure many of you are wondering what to do with your next baby's umbilical cord stump after it falls off. Don't worry. It's a completely normal thing to be concerned about. I'm sure you're not alone. In fact, I know you're not.
Luckily, there's a solution to your problem!!
And even better, it's just a simple Saturday afternoon project. You take the leftover umbilical cord stump that some wasteful people over concerned with hygiene and smell would throw away and you place it gently into an empty and not necessarily clean Coca-Cola or other used soda bottle. Then fill bottle carefully with a handful of pebbles. Screw the cap back on tightly and Voila! You have just made you baby's first rattle. Now the next step is to shake the rattle rhythmically albeit violently and sing loudly anytime the baby is crying especially times when others are sleeping and the baby is crying. This improves the effectiveness of the "rattle."

Heal the World

Every Saturday night we have a party. Unfortunately, lately it's been approaching the level of forced fun. Hey kids, enjoy a fun night of obligatory drunkenness!
I agree that it's good to let off some steam every once in a while, but when you only get one day off a week, you tend to feel more pressure to get completely wasted on your Saturday night. Which, of course, we try very hard to do. Of course.
At any rate, the night always ends with someone putting on USA for Africa's "We are the World." Then as children of the 80's, we stand and sway together belting out the lyrics we know loudly and often slightly slurred. This song permeated many of our childhoods. Oh the irony that we find ourselves here now doing the work that we do. But enough about that, we're not out of beer yet. Keep drinking and singing.

We are the world, we are the children
We are the ones who make a brighter day
So let's start giving
There's a choice we're making
We're saving our own lives
It's true we'll make a better day
Just you and me

Ironic T-shirts

Remember when all the hipsters were obsessed with wearing t-shirts with the ultimate ironic logo or phrase? Even better: Remember that time your local Christian Organization asked you to donate your (gently) used clothing to the starving children of Africa?
Well, it's all here. All those t-shirts you donated in 2005 after you ran that stupid 5k. BUT it's for sale. Yep. What the well intentioned "aid" organizations didn't realize is that someone takes those shirts and then sells them back to the very people who need clothing. Sure it's cheap, but it was supposed to be a donation, asshole. So, as a result, those that can afford shirts without holes have ones that say things such as:

Miller High Life, the Champagne of Beers
This is My Fucking Costume
My Sister is a Witch
Sam Houston High Seniors, Class of 2007
and my all time favorite:
Get Rich or Die Tryin'

Horrible. Absolutely horrible. I'm sorry South Sudan. I wish Americans had better taste in the the t-shirts they choose to donate. And I wish the African aid pipeline was less corrupt and the people who really needed clothes could get them for free.

The Death Flour: Week 14

 

Something died in the flour. I'm sure of it. If I wanted to go carb-free, now is a good time. It's been about 6 weeks since I stopped eating anything containing flour because the taste of death was just getting to be too strong. Every now and then I forget and take a bite of something or other only to be instantly nauseated by the taste of moldy dead mouse or rat. At least I assume that the vomit inducing flavor I'm experiencing is what could only taste like long dead rat or mouse. It has to be, right?

Well at any rate quitting flour-based foods which is nearly everything we eat here in South Sudan has been fabulous for my figure. I'm slimming down, err, wasting away quite quickly and with very little effort on my part. Anywhere else in the world I would have to work for these kinds of results. AND as an added bonus (because I'm really concerned) I'm finally detoxing from all the processed flour and refined sugar I used to eat as a part of my American diet. Atkins diet all the way. Love me some red meat. I hear it's good for you. You know, protein and such. Besides, the skin and bones look is really in right now. Right? Right.

Kuac

I want to tell you about one of my favorite patients. There's a little boy in the ICU that we've been taking care of for two years. His name is Kuac. Like Crotch pronounced with a lisp.
He has pretty pronounced lung disease and is nearly oxygen dependent. He can only go a few hours without it on before he gets breathless and tired. He requires constant medical monitoring, daily medications, and unless South Sudan gets some sort of home health care system and Aweil installs city wide electricity or Kuac's family gets a generator to run his oxygen machine and suction machine, he will never be able to be discharged in good conscience. So with us he remains. He's almost 3 years old and he's spent nearly 2 of those years in Aweil Civil Hospital under the care of MSF nurses and doctors. Before you start to feel sorry for him you should know that he doesn't seem to mind all the attention. Neither do his parents who have 24-7 day care for both him and his 8 year old sister that takes care of him and doesn't seem to go to school ever. They're fed, looked after, and we're even working on potty training Kuac. It doesn't get much better than that in Aweil. He is pretty cute though. Can you blame us for wanting him around all the time?

Spitting and Nose Picking

It's okay to pick your nose in South Sudan. In fact, it's not unusual to be having a conversation with someone WHILE they are picking their nose. It happens at least once a day. A least. They talk to you, pull something out of their nose, look at it, and flick it away. Not in your general direction thank goodness, but nearly. Eeek.
Then there's the spitting. Dinka people spit A LOT. And not whimpy little spits. No, it's a huge wad of flem summoned from the depths of their throat. Inside. Outside. It doesn't matter. We recently moved patients out of our corridor ward into a nice new tent to promote hygiene. The walls of the corridor: covered in spit stains. Absolutely covered from waist height down. Gross.

Halfway Point: Week 13

So I've reached the halfway mark of my 6 month tour in South Sudan. To be honest, it's both exciting and daunting. The first 3 months felt insanely long. I imagine living them over in mirror image and I'm not sure if I can do it again. Endure 3 more months of bad food, horrible smells, and endless frustration? No thank you.
BUT then I think about all the good things that have come from the last 3 months. I've met some amazing people. I've had an impact on their lives and they have made a tremendous impression on mine. I've learned more about Africa than I ever imagined possible (and it's just the tip of the iceberg). I have seen and experienced so much in such a short amount of time. I feel like I have lived several life times in just a few months. The world is a big place and I'm getting a very close view of a small part of it that is so incredibly different from where I come from. It's been unforgettable for sure. So today, I'm looking forward to the next 3 months and all the challenges and opportunity they will bring.