Friday 7 November 2008

Cows, Birthdays etc.

Hello again everybody,

Apologies for the lack of blogging but time is rapidly running out and we are working around the clock in a bid to make all the good things we have achieved continue in our absence. We have 39 days left and are trying to achieve the following:

  1. Organising trainers to continue teaching
  2. Re-opening a new Medical Emergency Ward, stocked with drugs and well trained nurses
  3. Training people to implement triage
  4. Organising ceremonies for all nurses who have received certificates with us (should be around 200)
  5. Travel to another hospital 500 km away to conduct a fact finding visit for another potential link
  6. Practice medicine

It is safe to say that we have never been busier...

Yesterday I celebrated my 30th birthday in Juba. The morning routine began much the same as any day; on arrival at the main entrance, there is the exchange of many greetings which involve more than a modicum of vigorous hand-shaking, shoulder patting, and hand-holding (I can now say I am used to holding a man’s hand).

However, my birthday also started on a bit of a low. The evening before, I admitted a 25 year old woman with acute diarrhoes who was very unwell on arrival. This is potentially a nasty illness but thoroughly treatable - they just need good rehydration and close monitoring with hourly checks of vital signs (pulse BP, respiratory rate).

Sister Anna teaching nurses

Sadly, there were no nurses on duty that day and there would be none in the night either. There is a high level of absenteeism amongst the profession - a salary of £50 a month is not enough to feed their families and they need to do other jobs to supplement their income. I did the best for my patient- I gave her 2 litres of fluid and hoped. Sadly it was not enough. She passed away in the small hours of the night, leaving behind a two and a half month old baby whom she was breast-feeding. I don’t hold out much hope for the child; the family will not be able to afford the formula feeds. God bless the NHS - I swear I will never complain about it again.

However, as is typical in Southern Sudan, there were many highs; two drugs cupboards have been completed for our new Emergency Ward. This is the first time a ward in Juba Teaching Hospital will stock life-saving medications and fluids and in a land where minutes literally count, this will save untold lives. The Ward will be re-opened on Tuesday and all the nurses staffing it will have received training on managing medical emergencies. I am holding out high hopes.

I will be working on this ward with sister Anna, one of the brightest ward sisters in this hospital and she also does the nurses training with me. I mentioned to her that I was getting married next year and she asked “How much is the wedding?” I went on to tell her that a typical British wedding costed £15,000.

“Ah but this is not much though,” She replied.
“Not much?” I asked, slightly bemused. This is a massive amount in the Southern Sudan.
“My bridal price will be 200 cows. This is about 1,000 Sudanese pounds a cow so that is about... 200,000 Sudanese pounds (£50,000).”

I asked what made her so expensive as a bride and she told me. “It is because I am tall and I have black gums and white teeth. This means I will give birth to tall, strong, fighting men!”
I asked her how much my future wife would be worth in cows.
“What colour are her teeth?” I answered they were white.
“What colour are her gums?”
“Pink.” She tutted at this.
“And how tall is she?” I judged that my fiancĂ© came upto my shoulders.
Anna shook her head. “She is not tall so all your children will not be strong. She is worth one... maybe two cows at the most. And a few goats.”

At 5pm we enjoyed a beer with some friends we have made in the NGO (non-government organisation) community, whereupon I was handed a selection of fine cheeses, including a particularly strong smelling stilton - you can’t even begin to imagine what a luxury this is out here.

Dave's second party of the night at Comboni

The evening ended on a high in Comboni, where we drank and feasted on various Italian delights that had been prepared by the priests for my birthday which was very kind of them.
On days such as these, I think of previous birthdays I spent with family, friends, and fiancé that are left behind in England. I smile when I think of these times gone by because I would never have guessed back then that I would be celebrating my 30th in a monastery.

Anyway, I had better go. I shall see you all before the new year is out. Take care everyone,

David

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