Bad mosquitoes

Well it’s Sunday again and we are in September! Hard to believe on one hand and on the other I feel like I’ve been here for three years.

Well it’s Sunday again and we are in September! Hard to believe on one hand and on the other I feel like I’ve been here for three years.

The dawn drummers have been making a racket since 6am, interrupting the only possible sleep-in for the week. Since the start of the big wet, the animals such as impala, white eared cob and warthogs are more prominent, and as a result easily hunted by our neighbours.

This means more meat but also more skins or hides so of course MORE DRUMS!!! The constant pounding of tanned leather strung over hollow wood or cut down metal drums has almost become as natural a sound as the insects. Between the night-time howling sessions of the rouge dogs, the barrage of frogs and electrified symphony of wing-whistling insects and the occasional low humming growls of an unidentified large animal that is able to scale our six foot fence, my best sleep comes between 4 and 6am.

The team members are off doing their Sunday thing; getting hair plaited, sleeping, playing guitar and singing, working on the computer…It’s been a pretty good week as far as the clinic goes. We had the highest ever number of consultations in July of 2337 patients and for August we broke that reaching 2538!

The week didn’t start off too nicely though, with a 17-year-old pregnant girl transferred at dawn Monday to Nasir with the dead baby’s legs dangling from between hers. The crew was pretty distressed by this especially as it was the first of twins. An hour after she left, we got a call saying the boat had broken down and we had to send the other one out to rescue them. As it was they got it going again and arrived in Nasir in time to save both the second baby and the mum. Really a miracle we didn’t think could happen. The sight of the baby hanging from the mum really disturbed some of the staff but the outcome has relieved some of the bewilderment.

On Thursday we took both boats to Jikow. At the clinic we had four bite patients from a rabid dog, three snake bite injuries, a two year old with about four litres of excess fluid in his abdomen and two gun shot patients. At the end we packed all the patients in one boat but alas ours wouldn’t start! We ended up leaving the dog bite patients who really needed to start their rabies prophylaxis and headed off home with one boat loaded to capacity and the other breaking down six times on the way home. I think there’s a problem with the fuel as it was a new mix last Monday and we’ve stuffed two motors since then.

I could go back to Jikow to pick up the rest of the patients on Friday but now we can’t go anywhere further than town as we only have one motor left. That means no transfers to Nasir and no Mobile Clinic. This puts a huge amount of pressure on the medical team as we’ve lost our lifeline. After a week there have been three car movements to Gambella and the broken motors are still here in the shed.

The river is nearly at the top of the bank and has the aroma of dead dogs and people faeces when a boat stirs up the water. The big Baro is still a muddy brown but flowing quickly from the Blue Nile. It has broken the banks in many places and created estuaries and off shoots that enable us to take short cuts through last months inhabited villages. The weaver birds have made thousands of nests, hanging precariously from the reeds or branches, swinging madly with the passing of the wake. They truly are an amazing sight, their yellow and black bodies littering the banks, the whole length of the river. Now most of the people have removed the roofs from the tukuls and moved to higher ground. It’s amazing passing totally flooded tukuls in the boat. The mosquitoes are at an all-time feeding frenzy high, biting through our clothes, oblivious to the layers of deet, without a deterrent, making the river banks a malaria-ridden, inhabitable zone. Children under five tested positive in 64% of cases, with cerebral malaria being a dreadful killer.

Anyway, a funny happened this week. An old fellow was waiting for me while I was consulting. When I was finished with the patient I asked him “Yes what can I do for you”. He asked for a mosquito net, as do at least five patients a day. My usual response is “Oh are you pregnant?” he laughed and then went on to say how bad the mosquitoes are where he’s living. I empathized with him but explained they are only for first presentation antenatal care patients. He continued to tell me how he will certainly get malaria, how they are really big ones and very vicious. I apologized and told him I couldn’t even give my staff one but he could get one in town for 25birr or to ask the local authorities or the UNHCR who supply nets to the public.

He told me he had no money and was too old to walk to town. I continued working and some 10 minutes later he returned and again waited for me to finish with my patient. “Yes?” I asked now exasperated, hot tired and covered in bright green caterpillar poo that was constantly dropping on me from the tree we were under. He went on to explain that actually the mosquitoes in his tukul were so big and so bad and so ferocious, that they came in the night and stole his teeth! With this he gave me a huge toothless grin. He was missing about six top teeth and four bottom ones. Well I told him that was the best story I had ever heard to get a net and I’d heard a few! Anyway I took a photo of him without his teeth and he seemed to be happy with that! Still brings a smile to my lips.