Monday 15th July 2013

My lovely, larger than life, funny, practical and very competent boss, Patsy,  left today. After 5 years here, from working with an NGO, living in Tukals, dodging snakes (both the animal and human kind), bullets, malaria, Nairobi fly (they are REALLY evil - go on, Google the pictures), to taking on this clinic when it was a single room with the odd pot of paracetamol, and turning it into what is the safest place to be in Juba if you're sick, she has finally moved on to new adventures. Leaving  Andrew and me  to carry on  - scared? us? OF COURSE WE ARE !!!. Crikey, what a name to live up to. She knew everyone in this town, from the entire cabinet it seems, to every local cleaner/driver/groundsman - and treated everyone with the same respect and consideration. I only hope we do her legacy justice.

We had a great weekend - out with the EU army on Friday, which turned out to be a slightly more, shall we say, lengthy, evening than I had planned, to partying on Saturday night in the infamous "Bedouin's" - the local meat-market/dance hall/shisha bar.

Everywhere you looked there was a character, from the 7 foot Dinkas ( I know, they're getting taller every week - but they are!), to the middle-aged ex-pats, eyeing up the local talent ( I use the word "talent" loosely), to the usual crowd of NGO's letting their ruined hair down and having a laugh. It was hilarious. At one point, some of the local "ladies" decided to have a bit of a scrap ( a nightly affair apparently), and no-one even noticed the wigs flying about and the screeches as the hair extensions were yanked . My boss told us a story of a similar night in there, where one lady's hair extension had come flying over the bar and landed in her friends drink. He calmly pulled it out and continued on with his conversation

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The music ranged from Madonna, to dance-hall, to rave, completely WITH seams, and by the time we left everyone was having a great old dance (especially the local "ladies", who were really showing off their wares by now). Being slightly broken from the festivities the night before, I was off at 1130, only to sit in the yard of the compound 'till 0230, giggling to yet more "you wouldn't believe it if was in a book" stories from Patsy. Hilarious. Poor Andrew was a bit startled by the whole experience, and has sworn never to enter "Bedlam's" ever again. Very apt.

With Andrew safely retrieved from Nairobi, we are really going to crack on with the things that need to be done in the Clinic. The logistics of getting the things you need are mind boggling, and we really have to sort a system out that will work for us, and the clinic. Lots of hours ahead of us, with the realisation that we're on our own now, and we have to learn even more quickly than we have had to so far.

All this positive thinking was a little dampened when I put my request for leave in today, happily thinking to myself that I would be off on a plane to catch up with friends in 5 weeks, only to actually COUNT the weeks, and discover that August seems to have lots more days in it than is strictly polite, ( I know it's only 31, but WEEKS wise...), and recalculate to 7 and a half weeks. I'm not wishing my life away ( my Mother cautioned me against that at every given opportunity), but here, in this funny old place, you have to have a glimpse of another world every now and again. I was going to say the real world, but it's no more real than here. Here is  definitely real.

I'm not sure I've mentioned it enough, but I am very glad indeed that Andrew is back and I can share this experience with someone who gets what is going through my head - I got overly excited at the arrival of some Typhoid reagents from Nairobi today, all cold chained properly, and only a few hours late. 

My world has got a lot smaller,despite living in a vast continent. 

 Funnily enough, it's all OK.

Thursday July 11 2013

Bureaucracy. You’ve got to love it, just for its sheer pointlessness. Yesterday I had to go to the Immigration department, to renew my monthly visa (It can take anything up to a year to get a work visa processed). So we trotted off round the corner, my trusty Filipina receptionist/finance officer and I, armed with a sheaf of papers and $80. The Immigration building is housed in a compound not 100 metres from us – a selection of darkened rooms, in a dusty square, with lots of people in important uniforms, standing about, being important. So important, that it was tricky to work out exactly which important job they were doing, but it may have been top secret. I certainly couldn’t quite work it out.

We queued for about an hour to get into one dark, heavily curtained room, behind other assorted ex-pats and NGO’s from all over the world, grasping similar sheaves of paper, and all looking a bit hot, but resigned. Most of them did this every month, so were quite used to it. I am mustering up that  look of resignation for next month.

A man of imposing stature, seated behind a wooden desk, studiously read my papers, closely examined my passport, studiously examined me, and laboriously signed my papers and handed them back to me, gesturing me out of the room with a flick of his large, gold ringed, fingers.

We then headed to the army green container, which housed the finance chap. My trusty Filipina friend had already got in line for me (she’s done this before), so I slipped in halfway down the line. To find all my fellow queuers ( who had been behind me in the previous queue) had had the same plan and were actually in front of me. I paid my $80 dollars, received my handwritten receipt, and moved on.

We then travelled to the next room, on the other side of the compound, to wait in another queue, behind the same people as before. By now we were all on first name terms – I met a very nice boy from Dublin who I chatted to for a while. This room had 3 desks in it, behind which  were sitting  3 people to a desk. It appeared to be training day. Oh good. The lady on my left seemed to be picking it up very quickly, and beneath her rather fetching hat, was very beautiful. I was not so lucky. In the time it took her to process 3 of my fellow visa-hunters, my chap was still typing my name into the computer, letter by painful letter. He really did have his tongue poking out in concentration. To be fair to him, his “helpers” were making it worse by knocking his hands out of the way and typing over him, then deleting what they had just typed so he could do it himself. On my right one of the “obviously top secret” (or presence without a purpose) workers, scraped a table back and forth across a dusty floor for no apparent reason. Teeth on edge, I consoled myself with the obvious top secret-ness of the operation. Honestly – he spent at least 15 minutes repositioning that wretched table , only to put it back exactly where he found it. As you can probably tell, my bonhomie was beginning to wear a little thin. And I had forgotten to bring water. Schoolgirl error.

After what seemed like an hour (but was probably only 20 minutes) I received the same sheaf of papers back, after being fingerprinted, and still trying to smile

.

It wasn’t over yet. THEN, we got in another line, this time being ordered into  line with an imperious “STAMP!” command. Finally I was admitted into the same room as the first one, this time to a desk on the opposite side, where, after careful consideration, my visa was pasted into my passport, and we were allowed to leave. We had actually, geographically and metaphorically, gone full circle.

The whole thing took about 2 hours, which is nothing in the great scheme of visa appropriation, but it felt like half my life had passed by...Possibly the most wearing thing was trying not to look fed up, smile nicely at the officials, and just resign myself to it. Next time I will definitely bring water.

Not that the visa is foolproof. Oh no. My poor friend and colleague, the deputy head, was coming back from leave today, but wasn’t allowed on the plane to Juba. He is currently residing in a hotel in Nairobi until we can get him back. Although the visa is single entry, so, on paper, if you are given it in the country, you are allowed back in once, the rules appeared to have changed since yesterday and we have to start all over again with him. Still, he’s having a nice stay in a hotel, and off to see some Elephants tomorrow.

South Sudan had its 3^rd Independence Day celebration on Tuesday. Now for all our local staff, that meant a day off,but, with Andrew on leave, left me as the only person to run the clinic. Although we were closed, there is always the possibility of an emergency. That said – no cars were allowed in Juba, and the phone lines were cut for several hours, so mercifully it was all peaceful. For security reasons, we did not leave the compound – I had been out the day before with Okello, and every few yards there were roadblocks being set up, by huge groups of soldiers with very big guns indeed.

It’s very tricky politically here at the moment, as someone said the other day “a toddler country, bashing into things and getting hurt”, so security was high. It all passed without a hitch however, and we could hear the sounds of celebration drifting over our barbed wire, late into the night. We consoled ourselves with eating all day – a fantastic brunch cooked by our German manager, and roast chicken, roast potatoes and gravy, cooked by my N Irish boss, and me.

So it’s my birthday tomorrow. I’ve spent many a birthday abroad, but definitely nowhere as odd as this. I am planning on spending this one, my 44^th, working and going to yoga, then on Saturday, after work we are all going out for a meal, then onto a restaurant by the Nile called “Bedouin’s” for a few drinks. This is also my boss’ last hurrah, as she leaves on Monday. Thank goodness I am not on call on Sunday – it promises to be a late one.

After a small sense of humour failure on Saturday, and a tiny burst of homesickness – entirely due to burning the midnight oil and working hard, I have pulled myself back together, and will face my 45^th year (good grief!) with a song in my heart !...well, a little ditty, anyway.

Happy Birthday me !

Monday 1st July 2013

I’m gradually settling into life here. Daily I meet the widest range of people I would ever hope to meet – the slightly mad Australian  psychiatrist professor with the self confessed anxiety, who insists on calling me “Alexander”, the 7 foot tall South Sudanese minister for something important, with the most beautiful voice, the hard working and hard playing South African miners who are our neighbours, and are to a man, polite, funny, and ever so slightly crazy. There is a theme here....

Last week I went to a leaving party for the miners, who are all going home as it’s coming into rainy season, and they can’t work. They’ll all be back in 2 months, but for now they were singing, cooking the most wonderful BBQ’d meat, and inviting me into their free bar. They live on the compound next door, and welcomed me with open arms, kindness and gin. (There is also a theme here don’t you think???)

So much so that one of their number, who has only one leg due to a landmine incident, professed undying love for me (bearing in mind that there were only 2 women there, my boss, and me ), then promptly fell over. Few too many whiskeys....we “nursed” him into a low chair that he couldn’t get out of, and left them all singing along to Culture Club and Bronski Beat .....really....

Work-wise, it’s certainly a steep learning curve. Being Head of Clinic, and managing staff is not such a jump from my previous job, but I’m currently buried under purchasing/ordering/stocking..... There were several “fillers in “ before I got here, each with their different systems, some with none, and I spent Sunday’s on-call (mercifully no patients) unceremoniously “filing “ 2 years worth of stuff into a plastic bag and starting again. I’m consoling myself with the thought that at least I will know what I’m doing. The poor deputy head, on his return from leave in the UK, will, however, not have a clue where anything is – I fear I’m making a rod for my own back...

One of my jobs is the “Pharmacy Run”. This involves getting my patient Kenyan driver, Okello, to drive me round all the pharmacies in town to try and find drugs that we have run out of. Now this is a perilous endeavour, not for personal safety reasons (I’m getting to know them all, so It’s actually quite good fun), but simply because you have to check every drug to see where it’s made (China – don’t buy, Arabic – be deeply suspicious, Kenya – probably OK ). This is to do with the vast amount of counterfeit drugs for sale. Pretty pointless to get a drug cheaply, and then find out it’s chalk. Occasionally you have to ask them to show you a pill, then crush it, to see how easily it disintegrates. A lot of the drugs are near to expiry, hence being sold on in bulk, so you have to check every expiry date – if you’re not going to use it quickly, no point in buying. All of this is new to me, along with exactly how much we use of everything and the fact that I only find out that something has run out when it’s gone (bit like putting an empty carton of milk back in the fridge). Why don’t we have a system ?  We do, but again, it’s not perfect and I’m still wrapping my brain round it.  The nice thing about these “runs” is you get to talk to local people, have a bit of a laugh, and in one pharmacy, watch the most awful Nigerian soap opera (in English) on the ubiquitous TV that sits in the corner of every shop that has walls. It’s over the top, over-acted, and very funny. I’m sure it’s not meant to be....

You do get to see some odd sights on these runs though – today I saw a “Boda Boda” driver (motorbike taxis, who are constantly being run over) driving down the road with his motorbike encased in bubble wrap. He, of course, was not even wearing a helmet. A sign for “Big Boyz” (that one for Brighton folk) and an old lady, her face shrunken like a little old prune, wearing a baby’s cap on her head to ward off the sun – made of wool.

Tonight I went to Yoga. I’m not a stranger to yoga, having practised a few times on and off over the years, but this is YOGA. 2 hours of contortions, standing on one leg, twisting yourself inside out , and it’s really tricky. Last week we were in the very posh EU compound, in a little air conditioned hall, but tonight we were on a rooftop. A flat one, obviously – heaven knows it doesn’t need to be any more difficult that it is . On the rooftop was what appeared to be the whole staff of Marie Stopes International, The International Red Cross, and several assorted other NGO’s, all stretching the fatigue and the stress away under a clear night sky.  As we lay down for a particularly tricky pose, (it was dark by now), I saw a shooting star – honestly the first one I have ever seen. Down below the streets had become alive with music, tooting horns, laughter. I could see the fledgling city stretching out to the foothills of the Jebel Kujur ( the hills in the distance), half built buildings silhouetted against the clear, starry sky, and for the first time since I arrived, I appreciated that I was part of a  living, breathing,entity. Hidden behind rolls of barbed wire and travelling by car everywhere you miss it.

 But there it was, and I liked it.

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 :)