Feb 27. That is not far from the truth. Today I have seen and admitted six cases. The tally would have been seven, but the family of a young patient lived just a bit too far away, and he died from measles complications before I got to the hospital this morning.
(Lizard in my tent. In fact, there are several. I can hear them rustle in the straw when I am in bed.)
The miserabled are exceeding our capacity to hold them, certainly to isolate them. Until yesterday, they occupied the veranda of one hospital ward. Yesterday, they started spilling onto the lawn. They ignore the tent we have set up for them because it magnifies an already aggressive sun. Yesterday I baked a cake in the tent. I made it from nutella. It was delicious.
Sporadic measles cases have popped up in other inpatients. Families mix freely in the hospital and it is not uncommon to have the patient share his bed with three relatives, sometimes more.
I am often asked why I ended up choosing MSF from an armada of medical NGO’s with whom I could work. For many reasons, but none more compelling than this one. At our morning meeting, I wondered aloud to the rest of the team about our space problem. A decision was made to do something about it. By 2 pm, there were six men in the corner of the hospital compound, and by 5, they had built a shelter that would house 20 patients. We also decided to find a nurse, hire one if necessary, and devote him or her to measles care. Within the day, the will was found, the money, and the hands. We did not need to add it to the agenda of another meeting, nor to a paper pile of requests on an administrative desk. Within hours, it was hammers and nails.
(Bilal call to prayer. Five times per day, I think. The first is at 6 in the morning. I think there are two competing mosques. They battle with volume. It wakes me, but somehow, it is not so bad.)
Unfortunately, as much as we like hammering things into place, sometimes nails are tough to come by. In this case, it is vaccines. My head of mission is in the next tukul with my updated measles register, trying to convince Khartoum that there is an epidemic. The curves certainly suggests it. And we have mobilized a dozen people, three cars, , bought bullhorns, hired translators, pored over maps, made site visits to places even closer to the middle of nowhere than abyei, been refused by broken bridges, and turned back by soldiers. Vaccines. Release the vaccines. Abyei has learned all that measles has to teach. Me too. Neither of us need to learn more hard lessons about life, death, and preventable disease. We get that one.
[More Info : Basic Guide to Measles and MSF vaccination programs]
My radio crackles beside me. I am on call to the hospital tonight, and am responsible for it all nights. And all days. I thought I left this call business well behind me, that I could just carry it around as a kernel of pride. “oh yeah. 30 hour shifts, I’ve done that. It’s not so bad.” It was bad, OK? I admit it. Didn’t like it at all. Uncool.
But, speaking of uncool, and its opposite, the coolest…..here is the real reason I work for MSF. Radios. The coolest. I really, really get to say almost every day: “Roger. Good Copy. Over and out.” It’s amazing.
Pictures. By Friday evening.
It is inspiring to follow your mission chronicals. As a fourth year medical student on the precipice of taking the leap into the CARMS abyss a MSF mission still seems a long way off. Your situation in Abeyi (really enjoyed the "no X where") feels even more far off since I am above the treeline in Churchill on an elective. I always enjoy the Canadian perspective and your descriptiions allow me to recreate the scences of my own East African adventures. Last night I reread some of my own travel musings. I remember the sounds of the call to prayer from the darkness of my room in Kigali and how once accustomed the wake up call became a welcome morning ritual.
I wish you all the best. Until I am in the position to join myself, I will live vicariously through your blog.
Ah, they named the falcon well – a portent of your coming. Thank you for being there and giving of your skills. What I like best about Doctors without Borders is that they help everyone they can, regardless of the politics, because they are wise enough to know that people are more important than ideology and rhetoric.
You are suffering from the heat and we are finally coming out of a long cold spell with temperatures of -31 with the windchill factor in the Maritimes. I think I’d much rather have the cold than the heat….do you dream of snow storms and huge snowflakes like doilies? Keep up the good work you are doing, James.
And people like you are why I chose MSF as my main charity. Thank you for everything you do to make this world a better place. :)
what no orthapedic bed for you? straw! ek my god, my bones are screaming from Toronto. I do hope you shared your nutella cake with "Lizzy the lizzard", and "falcon James"
Hopefully you are gaining ground with the measels. Terrible for the little ones, and the elder to suffer so.
keep fighting the good fight.
L.
Mary P.
From a fellow U of C alumnus (’05 M.Ed. TESL), thank you for being there. Many of my students are from Sudan. You help them there. I help them here. It seems that we have found our reason for being . My students have started keeping blogs (which are subsumed under my blog for computer literacy reasons). We invite you to check it out.
Yesterday, at the office, I argued with yet another parent over the need to vaccinate her one-year-old for measles, mumps, and rubella. I failed. My assistant had already drawn up the vaccine. I had to throw it out. I wish I could have sent it to you. My PhD thesis is on immunization policy and I am going to work harder on it.
Please take care of yourself. Oh, and here’s a tip. According to the Oxford Companion to Food, the author of a 14th century French cookbook once stated that "the meat of a spayed goat of six or seven years is reckoned the best; being generally very sweet and fat. This makes an excellent pasty."
Hi James,
I can’t beleive I can actually leave you a message. It seems incredulous, even as I work for a high tech company. Sitting here working at my pc this morning I received an email from MSF with links. I looked at the haitian information, since I am waiting for a child I am adopting from there. Then I see the links for blogs. What would be more compelling to read than what is really going on in these places where we get little to no news on. Every day I feel myself more drawn to doing work that means something, that helps someone. Reading your blog is amazing. I have so much respect for the work you are doing. You will be in my thoughts and I will check back often to see what else you experience and see. Meanwhile I am bracing for the next snowstorm, but right now the sun is shining and I will take a walk with my dogs thinking about what I read. Hats off to you!
Georgina