feb 19. i arrived in khartoum two days ago. the air temperature when i stepped outside was 30 Celcius. i have been told that we are about to be entering the "hot" season, where temperatures in khartoum climb to 50 C during the day, and cool off to 30 at night.
i haven't seen much of khartoum. the MSF office is not far from the guesthouse, about a ten minute walk. well, ten minutes unless you assure the head of mission of your impeccable sense of direction and insist that you can find your way without using a driver. in that case, the walk is approximately one hour.
my day has been full of details. i have received a more refined account of the social and political environment of abyei, discussed security procedures in the field, and today, am receiving a more specific medical briefing.
in brief. well, depending on one's definition of it. abyei sits in a political vacuum. it is mentioned in the comprehensive peace agreement, but its final division, between north and south, is yet to be determined. at present, it is home to primarily two populations: the masseria from the north, and the dinka from the south.
the town itself has increased in population from 5,000 to 25,000 in the past ten months or so, mostly dinka. with cessation of conflict has come an opportunity for people to return home. the influx of people is less than anticipated thus far, but it is expected to continue. and with it, an increased need for medical care and a potential for outbreaks.
i have been told that there is a measles outbreak in the abyei area, and that we need to mobilize a vaccination campaign. further, we are anticipating that the meningitis outbreak [More Info: Meningitis Definition & Treatment] in the south will soon find its way north. i am asked to be vigilant with case finding, for there may be a need to organize mobile meningitis vaccinations. there is also a problem with the water supply in town, and for the hospital. there is enough, but it is not clean. we are hoping to get a water and sanitation expert to visit the town next month. some here are surprised that we have avoided a cholera outbreak thus far [More Info: Cholera Definition & Treatment].
much of my work will take place in the small hospital. jean, the medical coordinator with whom i just met, says of it: "it's what you would expect of a rural, remote hospital in africa. not much. but still pretty good." no x-rays, a small lab, direct blood transfusion (from family to the patient), about 30 beds.
there are two referral hospitals three hours away that have a surgeon. one is built by the oil companies in the area, and the other is managed by an NGO. if i receive a woman with obstructed labour, and can't manage her in abyei, we transfer her to one of these centres. similarly if i receive any gun wounded, or traffic accidents, that need an operation and can survive a three hour ride. for those that cannot, or need more sophisticated operations on their head or their chest, there is nothing that can be done.
it is dusty here. and windy. not a cloud. i am having trouble sleeping. not just from the heat, but because my head is full and my mind too active. i wonder about things i cannot know, like how i am going to recognize my first case of kala-azar, or how i am going to arrange transfer for half a dozen injured patients that i may never see. i have gone from not thinking about the future to completely inhabiting it.
i leave on wednesday, on a world food program plane. i am told that i can bring 15 kg of luggage, including carry on. i think i have 15 kg of peanut butter. i might have to leave my bowflex in khartoum. crap.
off to lunch. i need to winnow down my peanut butter stock.