Fieldset
A doctor in DRC: Homesick

Ludvig has recently completed an assignment as part of MSF's emergency team in the Democratic Republic of the Congo. He's shared his diary with us. Today's post was written just before he left remote Bolomba, where the team have been fighting a measles outbreak, to begin the long journey home...

And so suddenly it's only three days left before I leave Bolomba for good. On Monday, I will get on the motorcycle again, travelling for 11 hours on a crazy journey towards Mbandaka. From there, I fly on Wednesday to Kinshasa - and then, in 10 days and counting, I fly to Brussels and then to Stockholm. A few months ago, I would have considered 16 hours Kinshasa-Stockholm to be a long trip, but I've got a new perspective on travelling here – like so much else in life... 

I spent last week in Itotela. It is probably the most isolated place I will ever visit. No mobile phone coverage. It was even hard to find coverage with the satellite phone. The main road is a narrow, muddy path. Thrifty with food. Apart from bananas, which for some reason were abundant. Let's say it will take some time before I eat one again ... the rainforest was our only neighbour, which in itself was pretty nice as it meant the temperature got a bit cooler at night. 
The hospital in Itotela is basically a small copy of the hospital here in Bolomba. The disease evaluation is also largely the same, except that the number of measles cases is smaller. This is partly due to the fact that PUC (that's the emergency team) mass-vaccinated children in the area in ​​2014, which means that in principle only children born later, or who weren't vaccinated at the time are susceptible. However, while the number of measles cases is lower, the prevalence of malnutrition is significantly higher.
The cases are more difficult here. Undernourished children are, firstly, extremely sensitive to infections and, secondly, much more difficult to assess clinically. They often don't develop fevers (because their bodies lack the means to mobilise an elevated body temperature) and they always look dehydrated (the eyes are always sunken, the skin is often relaxed, etc.) But at the same time babies are extremely sensitive (the heart, kidneys and liver are adapted to the minimum resources and overloaded easily). It is simply very difficult to distinguish a malnourished child who only needs nutrition from a child who one minute later may stop breathing. 
So there's only three days left here in Bolomba and my strongest feeling is - home sickness. As expected. Everyone says the same: when you approach the end of your assignment you only want to go home, whether it's been three, six or nine months. How long my stay back in Sweden will be is completely unclear at the time of writing.  
I pass Eldris on Monday. A quick coffee on the move to mobilise the last forces, then just carry on.