Patients have asked me a few times “do you know what it feels like to be a patient?” I usually answer “no” and focused back onto my academic knowledge of health. In some instances victims of a problem are the least appropriate to empathize with the variety of patient needs. But at the same time lacking the experience can dismiss seemingly insignificant issues – I’d be an awful hospital patient.
I have just returned from a 2 night in Seleia – the first sleep over since December. Though I was very excited to return to my humanitarian home, I had to keep in mined that I was returning to a very different Seleia. We hiked into town on foot with material for a clinic, some material for cooking, and other basic requirements. Our previous living compound did not offer any living support. Broken glass, needles, and other biohazards requested vigilance with every footstep. The buildings remained, but were polluted with the same hazards of the outside. The gate to the compound was missing and the doors of the tukuls and were nonexistent. The residents who returned to Seleia were still gravitated around the military base for safety leaving the town vacant. The location and condition of the compound made it feel like a death trap.
The health center was in a similar state as the living compound, but we gave it some good points because some doors could close, and there was a gate that surrounded it. Resembling an IDP family the MSF team set up their living area on the porch of the health center. We cleaned out one room, then I.C. and Eric immediately started to see patients. David the field coordinator and the liaison officer set off to rekindle the community relationships and get an update on the security situation. Aaahhh, we are back in Seleia again but this time living, working, cooking and sleeping in the same room.
As the medical consultations commenced I set off into the community. People were still living huddled around the military base. It seemed impossible to count families because life seemed so chaotic. The community was almost all made up of women and small children. Groups of 5 to 10 women lived together with their children in temporary grass dwellings. I was surprised to see one group with chickens, goats and donkeys brought to and from Chad. I found a group of kids and I chatted with them for a little bit. They did not have any complaints, a few of them made some toys from medical material left behind from the looting. Some of the kids later came to the clinic complaining of “Wadga Botton” – belly pain. Perhaps their diet was not diverse enough, or maybe they were upset. I hope they can return to a time of their old life of going to school, playing football, living in a complete family unit and wandering around with their friends in safety.
Later I went to fetch water. I was the only man at the well; the other 10 people were woman and children. I think it was strange for them seeing me the foreigner-male pumping water. I exhausted myself caring the 10 litres back to the clinic, it’s hard to believe that the women do the same several times a day while carrying children. Actually I have to confess that some charitable local women helped with the work.
When I returned to the clinic I found a very pleasant surprise: A friendly dog looking at my team members without the usual growling and barking expected from a typical Seleia dog. David stated that is was Clemens our puppy whom we adopted before the evacuation three months ago. “Clemens?!” I could not believe it. He acted the same way, but I could not believe he survived, let a lone was able to grow into a healthy dog! I then confirmed his identity with his unique tail markings and then we played for a little bit.
At dinnertime we were out of sugar. So my Sudanese friend and I set off to look for some sugar in the chaotic settlement with no market. I know, buying food from people in their most vulnerable state is ethically questionable. But I think the food supplied from the World Food Program was one of the few safely marketable items. Was I taking food from the poor, or contributing to their economy? You decide.
I slept very well that night knowing my animal friend (Clemens) was protecting or at least to warn me of any danger. Lying on the ground, I learnt to appreciate suffering the IDP population experienced. The nights do get very cold in Sudan, there are huge bugs all over the place, and without a bed there are no boundaries for people to sleep undisturbed.
I slept next to a patient who had suffered a gun shot wound entering in the chest and exiting in the back next to the spine. He also had a broken collarbone making his sleep very interrupted. I hooked him up to an oxygen monitor to ensure he was getting enough oxygen despite his pneumothorax (sucking-chest-wound). Mind up I gave him enough pain control to affect his breathing in hope he would get some sleep so I could get some sleep. As I laid awake listening for snakes I was debating calling Clemens over for protection – but that would threaten my clean patient care – /sleep/cooking/office environment; so I left Clemens in charge of possible bandit attacks. Then I heard some hissing…was it a snake? No, it sounded more like my brother’s whistle nose that earned him his own room. But it wasn't the patient’s nose it was air being exchanged through his lung cavity and the environment! He was breathing through his wound- but it was nothing a 3-sided dressing couldn't fix.
The patient was sent to El Genena with a military convoy and we headed back by helicopter. The “camping trip” was fun but exhausting, but I don't think I could have taken another day in the insecure environment with scanty food and missing infrastructure. I image the Seleia population wonders what the next day holds every night they sleep – It is hard to believe that my 2 night pretend taste of IDP life is an eternal reality for many people… and even then I was lucky when it came to resources and status.