So we're off to Jikow, the furthest and busiest clinic, which MSF visits twice a week.
We set off at 7am and stopped at a village called Nib Nib to meet the Kebele Chief. He is the chief of 17 villages and resides in a Tukul complete with gold cup! I was introduced to him and given permission to work in his Kebele, the smallest administrative unit of Ethiopia. I am to meet with him before each clinic in Jikow to hear any issues, discuss our activities, and to be informed of any security concerns as it’s literally right on the border with South-Sudan. Actually the Lou Nuer tribe is classed as Sudanese despite moving with their cattle and residing on either side of the border, depending on feed and rival tribe conflicts.
We drove for a further hour across a broad expanse of nothing until we arrived at Jikow. The village is on the banks of the Bora River, with South Sudan on one bank and Ethiopia on the other. The village comprised of a series of grass-fenced lots of 4 or 5 Tukles, with the cattle kept in the center to protect them from the rustlers. There have been many raids and many deaths over cattle in the past few months, the change being that the last few times the cattle were stolen women and children were taken or killed. This is a new element to the conflict and quite disturbing.
We set up the clinic under a beautiful, huge Mango tree where over 100 people waited for us. While the team unpacked, Moctar (whom I’m replacing) and I did a quick triage, walking through the crowds and picking out the sickest. We pulled out around 12 sick babies, all under one, and set to work assessing and treating them.
I learnt a lot and got to put the clinical aspects of my nutrition course to work. Most of our malnourished had marasmus*, luckily without edemas (swelling). I also learnt and did lab tests for malaria, syphilis, pregnancy, etc, under the shade of the Coola bar tree.
The antenatal examinations and wound suturing were done in the back of the car, as that was the most private and clean environment. Five hours later we packed our equipment onto the roof, and six patients/caretakers into the car and took them back to be admitted at the health center. After three hours of data entry I ate tea, pasta and tomato sauce, showered in the dark and fell into bed totally exhausted.
*Marasmus: Chronic wasting of body tissues, especially in young children, commonly due to prolonged dietary deficiency of protein and calories.