Medevac (Medical Evacuation)

Day 90

And then it was Christmas.

Day 90

And then it was Christmas.

We had a wonderful Christmas Eve party with other NGO's (Non-Governmental Organizations) that included presents, turkey, stuffing, lots of dancing and getting to relax curfew and stay over. Slept on the balcony in my mosquito net tent and woke up Christmas morning feeling all was ok with me, if not with the world. It almost made it acceptable to be so far from family and friends on this special day. But not quite. I was looking forward to a Skype call to my family on Dec 28, when my whole family would be gathered together for their Christmas dinner. But a peaceful Christmas was not to be.

We received a disturbing phone call late Christmas morning, while we were enjoying our day off and the camaraderie of our fellow volunteers. We were advised to expect a large number of wounded civilians with GSWs (Gun Shot Wounds), some extremely serious (I would have thought any gunshot wound was serious). They were being transported for hours in a boat down the Nile to our hospital from an area where we had an outreach clinic and local MSF staff who ran the clinic. I had never seen a gunshot wound before. We don't have many of them where I live in Canada. We were informed that the injuries had occurred the previous evening, in a church, on Christmas Eve. People were gathered for the service, and then, there was shooting.

We solemnly gathered up our mattresses and our leftover turkey and our Christmas gifts that we received in our Secret Santa festivities on Christmas Eve. We climbed into the Land Rover and headed back to our compound. On the way we passed so many families, out dressed in their Christmas best, on their way to church, or off to visit their friends and families on this special day. The little girls had their hair plaited and bows to decorate their beautiful hairstyles, and wore gorgeous satiny sparkling dresses in pink and blue and lavender. The boys were outfitted in serious suits, pants and ties and polished shoes. Their mothers were dressed in the stunning colourful outfits that African women wear with such statuesque style. And the men, looking serious, chaperoning their families, dressed to the nines in their dark suits in the midday sun.

There were parades and drums and musical instruments and dancing. Everyone looked so happy and the contrast between watching all the families, looking so wonderful and enjoying the holiday, and us, missing our families, and heading back to the hospital to deal with unspeakable horror, was so difficult for all of us. We were very quiet on the drive back. We were wondering what the rest of Christmas Day would bring us and how we would cope.

Christmas afternoon, we waited. And waited some more. We sat in the shade of the building that houses the Operating Theatre, and we talked. Some smoked. I'm still not smoking. Yet. We talked about why we were so far from home on Christmas, and how bad things happen for no good reason everywhere, not just in South Sudan, and what exactly we were expecting, thinking about and afraid of.

Finally, at suppertime, Dec, 25, they arrived. The boat pulled up to the harbour on the Nile, and the badly wounded were lying in the bottom of the boat. The rest had been sitting, leaning on each other for support, in the sun for hours, with little water or food. Our National Staff worker, an amazing Clinical Officer (akin to a Dr. in Africa) had assessed and bandaged and given antibiotics to prevent infection already. He had not slept all night. He is amazing.

We triaged. We took the most seriously wounded patients to the OT (Operating Theatre) on Christmas night. And then we went home and collapsed into bed and I got up the next morning and went back to the OT and we operated all day long.

The next day I finally rested. I really rested. And I wondered about guns and violence and war and innocent civilians and children caught in the crossfire and the reasons MSF is where it is and the reasons why I am where I am. It really was a good day for me I felt, not contented, but accepting in some way, and felt that I had managed to do a good job in a very difficult situation. We all did. We were a good team.

And then....that very night, hours after I fell asleep well, I woke up in severe pain, so suddenly, violently ill. Not able to walk, I had a fever, nausea, vomiting, diarrhea and an abdomen that was acting like it wanted to have its appendix out There are no high tech investigation here, no xray, no CT, no ultrasound. And so my MSF colleagues, the wonderful doctors and nurses that I had been working with, looked after me, started antibiotics, an intravenous, gave me pain medication and my PC (Project Coordinator) arranged a plane, which picked me up four hours later and took me for investigation and medical treatment far far away from where I was, and where I knew no-one. There was no Christmas Skype call to my family.

At the very moment I should have been chatting with my kids, I was, instead, writhing with pain inside the CT (CATScan/Computerized Axial Tomography) machine in Nairobi Hospital. I would much rather have been Skyping.

It was a very lonely time; in a strange city, with no team to support me, very ill and so sad to be so alone during the Christmas season. But here, (MSF really does teach you, simply by observation, to always look on the bright side, to realize that things could always be different, could always be worse), I would receive excellent treatment and recover from my illness, catch my breath and, once fully restored to good health, eventually go on my much desired and needed vacation. I relaxed on the beach, I ate food not out of tins, I had salad(!), I ordered a mixed drink, and I had time to think and swim in the beautiful warm salty Indian Ocean, and rest some more and then I realized I had the time and the energy and the inclination to finalize the writing of these blogs

And then, recovered, on to my new job, in a place I passed through once already, on the way to the Kala Azar assessment. I liked it then and am excited to go back. I have been given the JP (Job Profile). It seems the previous doctor left abruptly. The job just wasn't right for him.

MSF asks if you are willing to take on a job and tries to be sure you know what you are agreeing to. There really is no pressure to accept a job you are not comfortable with. Although after a while, you realize that there is no job you will be completely comfortable with, ever. And sometimes, you think a job will be ok, but once you arrive, once you see the enormity of the need and the challenge, you may reconsider.

I had read the JP; asked many questions about the new responsibilities. I had spoken on the telephone to the MTL (Medical Team Leader) about whether my medical qualifications qualify me to do this new job (I was pretty sure the job profile was actually for three physicians). This job is not Kala Azar-related. This job is being the responsible physician for the medical ward, including the ICU (Intensive Care Unit) and ED (Emergency Department) of a huge MSF run hospital. I feel like I'm Dorothy, going on the Yellow Brick Road, not to Oz, but to Leer. I'm told there is a book to read, called 'Emma's War', that will help me better understand the history and politics of South Sudan, and that Emma is buried in Leer, so I think I will go shopping, before I go back to where there are no shopping possibilities. Except, perhaps, onions.

The Yellow Brick Leer and a brand new job