Well it’s Sunday again. I arrived in Gambella just after 1pm and was met by a very distraught driver. The road was so bad he had broken some part under the nearly new minivan that he was responsible for. Poor bloke. I reassured him I would tell our logistician not to send that car again to the airport. Anyway half way to Gambella the road was blocked by a mass bogging of around 15 UN, UNHCR and World Food Programme cars. A huge truck was also bogged and a bus had slid off the road into the bushes! Mmmm welcome back! I have quite a collection of bogged photos!
The team has changed with the arrival of our new German PC. She’s very experienced and can tell shit from clay, so here’s hoping a change is in the wind! The staff have been told we will close the project in July 2013 and so the response has been to push the boundaries and give a “who cares” attitude, which is one thing with the staff but not ok when it comes to the patients. This has resulted in a few dismissals and increase in tension between all.
The weather has been hot, not horrifically in the 40s, but in the high 30s combined with high humidity, torrential rain, slippery, sucking, squelching mud and a barrage of insects so ferocious that you can’t eat a meal, speak or even breathe without inhaling them. The nights around the table after dinner last about an hour before everyone flees for the sanctuary of the mosquito net in their rooms or tukuls. Honestly, the bugs actually fly straight at you hitting you with quite a force and some of them bite or sting. Luckily for me so far I’m not having too much of a reaction to them but some of us are covered in bites, painted from head to toe in calamine lotion. The mosquitoes are so vicious they will bite through denim jeans, and the snakes are out in force with several killed in the compounds. We're seeing an average of five snake bite patients a week!
We’d just attempted to rescue a kid, a beautiful, chubby two year old girl brought in, in shock from malaria. Unable to get a line in, she got two intraosseous [injections into the bone marrow] and urgently needed a transfusion as her hemoglobin was 3.5. The mum refused to come into the room, the father proved a positive match but when told he may feel a little tired for a maximum of 24hrs, he changed his mind and refused.
Honestly, one really needs to come for a field visit to actually understand what we have or for that matter don’t have here! Sometimes we just need something to think about, to look forward to, to hope for, something far removed from our current reality.
The activity of the mobile clinic has hit record attendances with 2337 patients consulted last month and heading towards higher numbers this month. The main morbidities are malaria and chest infections.
We’ve lost quite a few kids this week with cerebral malaria and malnutrition. We had two fatal rabies too, something new for me as I’d never seen a live case before. Pretty horrific way to die, especially for the family. Thrashing and writhing, frothing and convulsing in an engulfing world of pain. I didn’t realize that it could lie dormant for so long before striking. One kid had been bitten six weeks before and the other two months, but apparently it can show no signs or symptoms for up to a year, but once it converts there’s no stopping or treating it. As we have very limited vaccine, we have to be very certain before we start the treatment, not an easy task with a very non-compliant population.
Anyway today the village is having a dog cull. The population in Mattar has been asked to push all the dogs out and keep the kids in. They are herding the dogs into corners and throwing poisoned meat to them. I wonder how many dog bites we will get from this little operation. I also hope we will be able to find out what poison they are using exactly as we may have poisoned people on our hands later today.