Womb with a View: Week 3

A funny story that has nothing to do with me: the other afternoon, an emergency hysterectomy was done. The midwife kept the uterus to show to the maternity staff so they would know what a uterus looks like. Cool. Except then she left it on the windowsill in the department. The obstetrician called it a "womb with a view." Funny, right? Sick. We are all sick in medicine, but I think working in humanitarian environments makes you a little more sick.
This week has been exquisitely difficult for me. I have had more frustration with the system than I ever expected possible when I got into this mess. The hierarchy that makes up this organization's chain of command is unbelievable.We have to have a meeting to discuss the meeting that we will have about the next meeting. It's painful and when the meetings are done, the higher ups go back to the office while I and the other workers in the field must put all these grand plans into place.I am beyond frustrated with NGOs and the business of operation at this point. I understand why it has to be this way, but it doesn't stop me from feeling annoyed.
I guess what I come back to always, even when I am frustrated in the US, is the patients. They are why I come to work each day, why I work 12, 13, 14, 15, 16 hour days, and what I think about when I go home. The patients and the people are why we are here, not to satisfy some paper pusher's need for statistics or to fill a line in some annual report. We provide a service goddammit! I provide a service and my patients matter. I try to remember above all else that my job is to help those that cannot speak for themselves be heard. To give them a voice, lend them my hands, and be their advocate for change and justice. I will try to remember that when I am angry and frustrated with the system. It's the patients that matter, not the paper.

Bitten by the Thunder

Today the most amazing thing happened.
Yesterday there was a terrible thunder storm and during the storm, a man was struck and killed by lightening. He was coaching a group of boys playing soccer at the time and was struck dead on the field in front of his team. The local culture believes that if you are struck by lightening and killed, you must be buried where you were struck. So this morning, a whole funeral procession came and got the body from our hospital morgue and took him in what I can only describe as grand New Orleans style, singing and dancing, to the field. Once there, they first proceeded to dig a hole with shovels and when that failed due to shallow bedrock, they brought in a modern excavator to do the work. The juxtaposition of a large group of Dinka people dancing and singing in traditional dress next to the huge backhoe digging a hole to bury this man in was such a fabulous contrast.

One of the other expats and I went to check out the progress of the hole. The locals were very welcoming despite my concerns they wouldn't want the Kawaja's there. One guy told us the story of the man and then another and another. It seems he was very well loved in the community and an amazing soccer player. They told us he was "bitten by the thunder." I think that is the most beautiful use of words to describe what happened. And I think the farewell they gave him was equally beautiful. I hope when I go someone will hold a funeral half as amazing as the one I witnessed this morning.

Swarms of Flying Ants and Other Signs of the Apocalypse: Week 2

The screaming usually starts around 10 pm. That's when the noise of the street outside has died down and then out of nowhere bloodcurdling screams suddenly puncture the inky darkness and send chills down my spine. What could make someone scream like that? And why does this deranged  someone seem to be screaming like that most nights? What kind of bizarre world have I found myself in? 

Yesterday morning after yet another night of fitful sleep, I crept up close to one of the other expats and whispered "how long had you been here before the nightmares started?" She replied, "not long, but maybe it's just the Larium (her antimalarial)." I'm not sure if I should feel better or worse.
Every night I dream of terrible things. Blood. Blood everywhere, people with red eyes and bodies wrapped in blankets. I can't explain it. I'm not on Larium. I'm not particularly prone to nightmares. But this place is different. Maybe my mind senses it? This is a land where so much killing has taken place. Not far from where I sleep in my tukal, whole families were slaughtered a little less than a decade ago. That has to change the energy of the earth somehow. Maybe my subconscious senses it?

However, it's not the heat, the smells, the nightmares, or the screaming that gets to me. It's the unholy amounts of insects I do battle with on a nightly basis. Flying ants. That's what I hate most. There are many insects here in South Sudan, but flying ants that sting are just wrong. They wait until dark, then they attack.They get caught in your mouth, eyes, hair, the sweat that clings to your body long after the sun has gone down. Ugh. Just wrong.
There are so many things that signal the end of days here. The red, dry dust that covers the land. The hollow expressions of the people walking the streets. The skinny, hungry, rabid dogs that circle as I walk by. Bugs, insects in droves. And most of all the endless human suffering. It's all so surreal. Like I've wandered into a Mad Max film.
Maybe as time passes, my perception of normal will adapt to include this strange new world.

Dumb Luck

There are so many things in this world you cannot control. Weather. People. 
But also all the sorrow, all the pain. I know it is impossible to really live and not experience true sadness at least a few times. Some days are really good. Many days are good.
Others can knock you down hard. 
I don't understand why some people experience extreme poverty while others live lives of complete luxury. Or why some people, some incredible people are forced to die young. It's not fair. The deep loss of the plans gone unrealized. All the hopes and dreams that will never be fulfilled. The anguish of the living. Why should we live while others do not? It's just not fucking fair.

Ooooo that Smell: Week 1

The overwhelming smell of humanity hits me as soon as I enter the ward. Combined with the heat of several hundred unwashed bodies huddled together in a small space overnight with all the doors and windows closed, the sensation could kill a person on impact. The smell of the hospital is nauseating. Every morning. It's hard to stand it the first 20-30 minutes of every day. Some mornings are worse than others. Today was definitely a record breaking bad smell day. It seemed every department had its own brand of funk and as I was working in all departments this morning, I had the glorious chance to experience each thoroughly.
 It's a well known fact that I have a sensitive nose. I come by it honestly. I was born this way. My father could always smell cigarette smoke on my clothes when I came home from going out in high school, even if I hadn't been that close to people smoking. I'm okay with it and usually can tough out bad smells. I'm a nurse after all. I've been smelling disgusting things for years.
I can certainly appreciate how every place has its own smell. Unfortunately South Sudan has a stronger smell than most places. I won't go into too much detail, but it's stronger than any place I've ever been to.
I can only hope my senses are desensitized as time goes on.

"Welcome to Aweil"

Today was my first day in the hospital. I'm using the term "day" very loosely. I made it about an hour and a half. I vomited the first time about 20 minutes in and was sent home the second time when I casually mentioned that I was feeling a bit faint. Turns out being pale and puky doesn't instill confidence in your ability to finish rounds. I can't understand why that would be.
My best guess is that I just succumbed to the oppressive heat, smells, and strange food. It's rare that I am ever physically ill. Especially as violently and suddenly as I was. At least the maintenance guy enjoyed watching me throw up in the latrine. He laughed as I ran in and then when I came out, explained to me with hand gestures that I am supposed to point the other end at the hole. Very funny.
So here I am back at base (what we call our compound). Slowly sipping Emergen-C in water and trying not to over do it. They don't know that Over-do-it is my middle name here yet. Shhhh.
I'm going to hydrate, gather my strength, and head in again after lunch. I have nothing better to do. Might as well get back on the horse.
So in the last 72 hours, I have navigated the familiar wall of heat and sound that is NYC in the summer, gotten drunk in Heathrow with my best British (and one American transplant) mates, fought my way through the Visa line and luggage check in Juba (with a little help), and been briefed and and debriefed and briefed again. Normally I would be tired after all this motion, but I'm running on some sort of epic adrenaline high. I keep waiting for the inevitable exhaustion to set in. I know it's coming.
Until then, it's back to work...