September 11th, 2009 by MSF Field Blog

Wow, so it turns out I’m a pretty important person for MSF in North Kivu today. So remember how I couldn’t believe I was medically in charge of a 140 bed hospital in the Congo, well today not only am I that, but the expat Nursing Manager of the project has left, the Project Coordinator is being split between two sites and is currently at Kitchanga my old home, and the Logistician is stuck in Goma the project capital for the next week. So amusingly I am now also the person responsible for the hospital pharmacy, thirty nurses, all the logistics involved in the project from making sure there’s enough drugs in the pharmacy to sorting out the problem of the fact we are going to run out of food to serve the patients as of Sunday, as well as my actual job of trying to oversee the medical management of 140 patients including the ITU and supervise six doctors. Yesterday evening I carried every bunch of keys involved in the project – about 20 key rings. Oh and I have a radio.

Which, like my old bleep, is going off every five minutes.

Am feeling very important and not at all bitter. ;)

Although I am feeling surprisingly calm and almost vaguely cheerful. I think you may as well smile whilst you try to swim and not sink. Also am bemused and excited by the fact that I seem to understand most of what’s being said to me these days, which means my French is thankfully improving, although I have a sneaking suspicion that I still sound a little stupid when I speak it.

This morning, I chanced upon a cold dead child in the ITU. I think perhaps the first dead child I have ever seen. Sadly, I suspect, not the last.

Hello from Mweso

September 8th, 2009 by MSF Field Blog
Dr. Pavithra Natarajan

Dr. Pavithra Natarajan

Hey all, am writing this from my garden in Mweso, my new home in the Congo. It’s been a hectic couple of weeks but to cut a long story short, the doctor working at the hospital up the road left and I’ve been asked to leave Kitchanga to take his place. Gone are my lovely team of five Congolese nurses and crazy treks through beautiful jungle over rivers to get to remote clinics, instead I have a 140 bed hospital filled mainly with paediatrics and pregnant women to manage, which is frankly terrifying having never worked in Obstretic &gynaecologic or Paediatrics. I’ll be working alongside a team of Congolese Ministry of Health Doctors; it’s all part of MSF’s policy of supporting the local health infrastructure rather than replacing it with foreign doctors, which I whole heartedly believe in. It’s just that I get the feeling it’s going to take a little negotiation skills… in French. Not sure what I’m going to do or how I’m going to do it, but I guess I’ll give it my best.

The pathology is fascinating, although the lack of diagnostic tests blows my minds. No X-rays, of course, but not even culture facilities. We have a FBC machine, a microscope to examine stool and urine and can test for Hepatitis B and C, syphilis and HIV. Lots of tuberculosis, malaria, malnutrition, pneumonias, gastroenteritis and the occasional cardiopath or fascinating adult with massive lymph nodes or gross ascites or interesting murmurs, who I enjoy mulling over and scratching my head at and then realise there’s no way to confirm a diagnosis anyway. I am also responsible for managing the lab, which has delighted me so much that I am rapidly filling my camera’s memory stick with photos of acid-fast bacilli and video footage of wriggling Strongyloides down the microscope.

Mweso is a little village with one high street. The other expats think its hysterical that I refer to it as a high street since it’s just a mud road with mud houses and thatched roofing on both sides, and goats on the road, and not much else, but I think its gives it a sense of normality for me. The hospital here is massive by comparison and people come from all over the nearby and not so nearby villages. Some come from the village in the mountains where we used to do our mobile clinics, they’ve usually walked six hours to get here. My view out of my bedroom window in Kitchanga was of green mountains and spectacular sunsets, here my room is next door to the office and my view is of a grey stone wall and the IDP camp on the hill (Internally Displaced People –people who have had to flee their homes like refugees but they haven’t crossed an international border). Nevertheless being a little village, we see a lot more of the stunning countryside. Hopefully, in time, I’ll settle in…

About Pav

September 1st, 2009 by MSF Field Blog
Dr. Pavithra Natarajan

Dr. Pavithra Natarajan

Pavithra Natarajan, originally from Kerala, has lived in London most of her life. Having graduated in Medicine at the University of Nottingham, she specialised in Adult Internal Medicine and General Practice in London. She is currently working at Mweso Hospital in North Kivu, Democratric Republic of Congo where she is responsible for the Medicine, Maternity and Paediatrics department and the Laboratory. This is her first mission with MSF.