It is five o'clock in the morning but I was woken up extra early by les crieurs. They walk around the village with megaphones urging people to vaccinate their children and announcing where the MSF team will be today. They get up early in the morning...
I myself am preparing to travel to Itotela. In a way, it will be exciting. It is probably the most remote and isolated place I will ever visit. And it's probably the only week of my life that I will spend as a guest in Pygmy country.
The pace of work over the past week has been close to the limits of what I can handle. I have been the only MSF doctor here when Dr Mamie has been in Itotela, and not only have I been on my own, but there have been a lot of patients.
The reason for the large numbers of patients is that the vaccination campaign has been launched, with no less than 38 mobile MSF teams travelling around the area by boat, motorcycle and on foot, carrying big blue refrigerators. And following the old phrase 'seek and you will find', they discovered a lot of sick children whose parents have not been able to access our hospital themselves.
Yesterday we beat the record: I saw 42 patients, discharged 12 and admitted 16. I spent my lunch break doing cardiopulmonary resuscitation on a child who arrived in a very bad state during the night. Making chest compressions on a child suffering from malnutrition is a strange experience - the chest is so fragile that it is enough just to use your thumb. We actually got both heart and respiration started several times, which was almost a miracle, but eventually, with dilated pupils and the absence of corneal reflexes we stopped. Sadly the child became our fourth death from about 300 patients so far.
Today I'm going to try to do the morning rounds quite quickly, because at lunchtime I will travel on the motorcycle to Itotela. Now, however, it's time to pack up my tent and bed-buggy mattress.