abyei is underwater. well, much of it. the cracked fields that stretched from its sides are filled. in the middle of these lakes sit poorly placed tukuls from which women walk, balancing buckets on their heads, lifting their dresses to keep dry. trucks lie stranded, their wheels spinning. it seems that either none of us were prepared, or we were waiting for the beginning to begin. our compound of dust is now one of mud, and we are watching for the first signs that cholera has found abyei’s thousands of returnees in their new, wet land.
I mentioned that one of our plans is to draw the hospital, to imagine it differently. I have been here too long, and can only see it as it is, immutable. once we draw it, I will post it. as it is, one enters through a common gate into the chaos of our outpatient department. people lie on floors or fan themselves with their registration card until they are seen. emergent cases, if recognized as such, are seen more quickly and passed to me or the other MD. if admitted, the patient is loosely placed near one of our wards. pediatric (consumed entirely be the TFC), the male ward (full), a the female ward (full), measles (empty and leaking), tuberculosis (full). earlier this year, in january, the hospital held twenty patients. we now have 20 in our TFC alone, 50 in total. malaria season is yet to come.
I am not sure if you can glean an idea of the hospital structure from the short video I posted. likely not. there is brief shot of the feeding centre. because of our increasing numbers, we made it on the open ground between two buildings. we covered the space above with shadow net, and on top of that, heavy grass. it has been one of the greater challenges here to convince women to stay in the hospital to allow their children to complete treatment. they often have four others at home, equally as deserving and, for all I know, just as hungry. we look for solutions, reason, beg, compromise, do anything to make it possible, or easier. the shadow net provided some respite from the sun, and was working well.
with the rains, of course, it is not. water leaks through and when I looked at last night, the wet grass was causing the shadow net to sag. a quick image of thin, broken needles in a wet haystack, and we knew a change was necessary. the only space we have to use is the emergency tent we have been reserving for mass casualties. the most common mode of transport in and around abyei is to ride standing in an open convoy with 20 other passengers and watch the landscape pass by, or if you are unlucky and the truck turns over, watch it hurtle toward you.
(wait ... I heard something rustle... there has been a frog in my tukul for two days... he is very small, very fast, and somehow, smarter than I am... i am going to try and catch him ……………………………………………………… and, finally, no.)
so, anyway, ground hurtling, hurting, 20-people tent, now a proposed home for starving children and their reluctant families. some of the women agreed, others refused. the rains have continued all day, and they have been heavy. the tent leaks at its seams. when I went to the hospital this evening, only three families had made the transition. the others sit, crowded, on top of each other, in two small hospital rooms. I will see how many remain in the morning.
some follow up. the woman with the rash, no response to antifungal treatment, and I have asked her to come back for a biopsy. the lab technician returned today on what may be the last flight to land on the dirt strip in agok. from now on, we drive 12 hours to the nearest tarmac. I will ask him if he can look for filiria.