Tuesday June 25^th 2013

Impressions week two.

Has it really only been two weeks ? Feels like much longer, thanks in part to how lovely all my work colleagues are, and how completely at home they have made me feel. The days are certainly long, and the patients sick, but it is interesting and I’m learning lots very quickly. I’m challenged again, which is a nice feeling.

Juba itself, what I have seen of it, is truly a funny old place. There are a hundred stories, every day, from people who have been here since before the war.

 “ I remember when there were 2 motorbikes and one car here “.

Difficult to picture when you’re stuck on a lawless asphalt road struggling to turn right amongst the UN armoured cars, the local battered cars, and the poor little “Boda Bodas” (motorbike taxis). Every now and again you see a shiny white uniformed traffic guy, standing in the middle of the road, literally taking his life into his hands, desperately trying to restore some order. I really hope they’re being paid something.

The town itself, from what I have seen (which is not much) is quite grim. As you drive along the few paved roads, you can see little collections of “Tukuls” (mud and thatched conical huts), completely dwarfed by buildings, all partly under construction. You can clearly see where once there was a tiny village, now totally overtaken by “progress”. And my, the progress is surely happening at the speed of light. I swear that where there was no building yesterday, today was two stories high and had the beginnings of a roof on it . I’m not kidding.

It’s happening so fast, that the more enterprising folk have even been seen to set up shops in the partly completed buildings, while building is going on around them. I was chatting with a fellow blogger (The Guerilla Researcher – link on the right) about how it would not be unusual to see a business man, on the second floor of a half finished building with no walls and no roof, sitting at a desk with a mobile phone

“ Come over to my office – the air conditioning is great and I have a wonderful view”

There are over 300 tribes in Sudan, and over 100 different dialects. Down here in the south, the most predominant tribe are the Dinka – characterised by their size – they are extremely tall and statuesque. A lady who came to the clinic today must have been 6 feet tall, in a wonderful dress, and was quite awe inspiring .Our beds are WAY too small for them, their feet are at least a foot over the edge – I really must try and find some bigger beds!  

Then there are the African foreigners, here to find work – the Ethiopians who are also VERY tall, but unlike the Dinka, very very thin. The women are beautiful. The Westerners, the Indians, business men here to invest in a new city and make a quick buck .The NGOs, trying to help in some way whilst putting themselves right on the front line of violence and disease, people like me who provide a service for all the above. The EU army (yes, there is one!) here to try to improve aviation security. The pilots, here to teach the South Sudanese to fly, the Italian chefs, here to capitalise on the lack of good food here ( I had the best cheesecake I have EVER had tonight). The miners (there is gold here) – the UN, the Embassies.

None of this was here 3 years ago. None of it. Except the little mud Tukuls, and the families and communities that existed around them.

While ugly buildings rise out of the dust, violence erupts. Where once there were only cattle to fight about (and frankly those fights got very nasty), now there is the ever shining dollar. Suddenly there are people on the street with cash in their pockets. There are mobile phones that access the internet, there are laptops, watches, iPods, opportunity. And these people very recently were fighting a bloody war of independence. And they have guns.

We here in our compound are well respected thanks to the hard work that my predecessor put in over 5 long years. We are protected by our clients, some of whom are officials in the government, and to whom we have given the best service over many years. It is an education, and a bizarre privilege to be here.

Living in Juba I am privy to watching a capital city being born from a village, on a time-lapse camera. 

Tuesday June 18^th 2013

I just thought I would post my impressions after a week here in Juba, if only to have something to compare it to in 6 months time, when I’m sure my impressions will be very different.

 Work here in the clinic is quite punishing, more so than I thought. It’s not the crazy busy of my last job, where I hardly knew my name from night to bonkers night, where I was frustrated at the lack of autonomy (except where it suited), where I ran from one crisis to the next. It is a steady trickle of really very unwell people, coming to us as we are honestly, and I’m not biased, I’ve seen the competition, the best in town.

There are those who have been out in “the field” ( I intend to go into that in a later post), for months, and return to “civilisation” (Juba) , dry, exhausted, mentally and physically burnt out, and as a consequence of all the above, usually with Malaria, Typhoid, Giardia, or a combination of all three. They come to us as their company pays for them to, for a bit of sanity, a bit of a chat, and of course, for us to make them better. We have the drugs – mainly – we’ve been waiting for vaccinations to arrive from Nairobi for 2 weeks now, all to do with the paperwork of getting liquids that require a cold chain through customs, we have the knowledge (well at least the others do, I’m still learning) , and we have friendly faces. Sometimes I think it’s the friendly face they come to see...

There are those who are local staff, whose company pays for them to have treatment, and who shyly come in, looking a bit embarrassed, with the most raging Malaria, and are so grateful that it almost hurts.

Those who expect to be treated like royalty because they are paying – the most hilarious Indian man today who was “100 per cent!!!” insured ! (he had more exclamation marks than that, honest)

Those that are so tired of being ill they become angry – my best advice to a young Dutch girl this morning who had been ill for 3 months was to go home for a bit – she came in this evening for a check-up and told me she had booked 2 weeks at home leaving Friday – she just needs her Mum.

I love it.

The schedule is tiring itself – everyone works a 6 day week, plus we at the clinic do 2 on calls a week. Last night was my first one on my own. The clinic closes at 5, and after that it is only emergencies that come in. The last few nights there had been a few phone calls and nothing else. I had the poor Dutch girl in at 11pm, till 0100. I probably would have kept her later, but after 0100 she would not have been able to get home – she works for Oxfam and their curfew is 0100 – after that you’d be pressed to find a driver that will negotiate the road blocks (and the bribes that have to be paid to get through..). I got to bed about 2. At 0430 I was woken by a young girl from an NGO who thought she had appendicitis. I asked a few questions, advised painkillers, told her to call me in an hour if she didn’t feel better. At 0630 the Dutch girl came back, weeping, fed up, and no better. I then worked a full shift, and just as I was closing the clinic at 5, got a chap in with a temp of 41 – proper Malaria. Although I was not on call, my colleague who was on call, was busy with the Dutch girl (who had gone home and come back again), so I stayed with him until 2000, when he finally felt well enough to go home.Nothing compared to a 12 hour crazy shift in a busy acute hospital, but steady, 2 hours sleep at a time, and tiring nonetheless. That is pretty much the reality of it, for everyone in this town. It’s no wonder the rotas are usually 8-10 weeks on, 3 weeks off. You’d go mad otherwise.

I love it.

To end today, I got a fit of the giggles. We have the lovliest lab technician, who is South Sudanese. His grasp of English, when asked a technical question, is superb – he gave me a lesson on which bloods I could safely store without being haemolysed today, with all the appropriate jargon. When challenged with social English however, he struggles a bit. As I was asking him if he minded working Sundays, as our other lab guy is a Pastor and needs Sundays off,  we got a bit confused over the issue of him needing to take a day off during the week to compensate.

“Which day off during the week would you like off ? it doesn’t need to be the same day every week, you just need to tell me a bit in advance”

He nodded and smiled. Good.

“So, this week, it being Tuesday, which day would you like off?”

Long pause.

“Monday please “.

Long pause.

“But it’s Tuesday, you need to take a day off you haven’t already worked....”

Long pause.

“OK. I’ll have Tuesday off”

I think I have convinced him to have tomorrow  off, but I will not be at all surprised to see him in the morning. 

Wednesday June 12^th 2013

Arrived in Juba yesterday, after a perfectly acceptable flight to Nairobi, a very nice flight to Juba, and a scrum at the airport to be allowed in. I had been warned, and thank goodness for that, because if I had no clue as to what I had to do, it would have been bewildering to say the least. Juba airport is the perfect example of the “tin shack” that travellers beguile listeners with when telling  their intrepid tales. It is hot, dusty, noisy, and sits next to a part completed much larger stone building that, apparently, is to be the new airport, when it is ever decided who hasn’t run off with the cash (again). There is no indication of what it is you need to do to be allowed through the wooden archway that leads to Juba itself. There is a dusty glass fronted box, in which 4 uniformed officials sit, and in front of which there are 6 or seven “queues” of passport waving nationals, and confused looking non-nationals. The idea is you give your passport, entry permit, and a crisp $100 bill (no marks, no earlier than 2006, it is carefully examined)to the guard on the left, who nods curtly at you, and mutters something that could be “move to the right hand window”. After fighting your way to the right hand window, you then wait an hour or so for your passport, and carefully handwritten receipt for your  $100, to be examined by the official on the right, who fills in another piece of paper, and hands it to the official on his left. Once it gets to the top of HIS pile, your name is called out (I usually have to listen really carefully at this point as no-one can ever pronounce my surname – it is usually something like “AAW-ES”), you are fingerprinted, and granted entry for a month. Phew. After having your bags opened, checked for goodness knows what, and marked with a bit of chalk, you are finally allowed through the hallowed wooden archway into Juba itself.

I have to say I was so tired that I hardly noticed the streets as we passed through, just a haze of dustiness. What I did notice, however, and which made my poor co-worker sigh in a resigned fashion, was that the sign on the clinic door read “closed Sunday’s”. Ooh that will have to be painted out ! I was shown to my little stone cottage on the compound where everyone who works here lives, which contains a double bed, air con, internet (patchy, but OK during the day), and a hot water shower in the bathroom – frankly a lot more than I was expecting....

First day at work today, and everyone has been so friendly and welcoming I feel completely at home already. Just getting to know the staff, and how everything and everyone fits together is going to take a few days, but so far I feel confident that it is all possible.....

Am off to bed now as I’m shattered, and was just about to pop my night shirt on, when I couldn’t find it.  I have been warned that the cleaning ladies will wash everything they can lay their hands on if you leave it lying about, and certainly my clothes from yesterday disappeared today, but I thought my shirt was safe, on the bed, by the pillow. Clearly not. I shall have to hide my second one somewhere safe in the morning , or I shall be sleeping in my uniform – I wonder if you lie in late, if they physically disrobe you from last night’s clothes.....

Thursday 6th June 2013
I am finally off. Have my scary looking permit to Juba in my bag, along with my flight leaving on Monday.My permit looks like a "Wanted" poster, with a very bad photo of me, stapled to the top right hand corner. I have been advised that it will take anything from 20 minutes to 2 hours for my visa to travel from "the left hand window to the right" at the airport, and I should stay calm, dress smartly, and visit the toilet on the plane before landing. All good advice.
I have spent the last few weeks being very anxious about being "in between jobs" - while having 3 weeks to organise myself has been useful, it has also given me a lot of time to worry about, well, everything, really. What happens if I get run over now? Eek ! Finally yesterday I settled down and started to get excited - I'm off on an adventure, and it's going to be brilliant. I hope...
I'm doing my final run to storage tomorrow, so from tomorrow evening I will not have a kettle, a toaster, or a TV. My lovely handsome cat went to his new home yesterday, and I am properly, finally, on my own. I have tenants for my flat, so on paper, everything is going to plan....
I am not quite sure how everything I have left in the flat is going to fit in my suitcase (get me - suitcase ! I've never had a suitcase! My faithful rucksack has been usurped!), but I'm going to give it a good try, 8 bottles of mossie repellant and 2 big bottles of hair conditioner are weighing me down a little...still, sure it will be fine.....
So. Lovely leaving BBQ with friends on Saturday, recover Sunday, then trip to the airport on Monday with good friends to see me off.
Here I go..........

Oh and I know some people are having trouble leaving comments - I have enabled comments for everyone, although they come to me for moderation first. Strangely, if you go to the bottom of any post, where it says "no comments", if you click on that it will allow you to comment (although it will take a while for me to accept them ). Always welcome comments people :)