Chad: Jumping Jack Flash

Sarah is a GP from the UK, on assignment with Médecins Sans Frontières/Doctors Without Borders (MSF) in Chad, Africa's fifth largest country. She blogs about camel road rage, boozy anecdotes and magic capsules...

Sarah Wookey discusses a patient with an MSF colleague

Last week I had a Jumping Jack Flash moment; not one to be recommended.

The moral of the tale is that if you're planning to use the squat toilet, it's wise to check beforehand that your USB flash containing all your MSF protocols, pictures of your children and a suspiciously grainy version of Love, Actually (yes, we really are that desperate) has not been stashed in the shallow pocket of your trousers.
Could I have..?
Don't even go there.

Goats < Cyclists

My daily commute to work involves a bike ride of about a kilometre.  The road is shared with occasional 4x4s but is mainly populated by pedestrians, cyclists and livestock.
Camel trains pass through the town daily, groups of donkeys congregate on street corners or else convey ladies to and from the market, and goats roam around freely.
There's an unwritten Highway Code here to which everyone seems to adhere: goats<cyclists<donkeys<pedestrians<motorbikes<cars.
Everyone has accepted that obviously no self-respecting camel would ever dream of giving way to anything, ever.
Everyone has accepted that obviously no self-respecting camel would ever dream of giving way to anything, ever. I'm rather hoping for a camel-on-camel showdown, just to see what will happen.
I've discovered, belatedly, that when cycling through a herd of goats, it's a good idea to try to ensure that the nannies and kids are on the same side, or else to be certain that your reflexes and brakes are in good working order.
And, of course, to remember that goats often have twins.

Beer gathered around our mosquito coil

In the evenings our intrepid band of MSFers likes nothing more than to gather round our mosquito coil, sink a few beers and reminisce about some of the things we did before joining up.
I thought I'd won first prize for the worst job (being an air hostess for Saudi Arabian Airlines in 1978 to earn my medical school fees), but was pipped to the post by Aileen, our medical team leader.
Aileen used to work in a call centre (I can't type this without tears running down my face) where she cold called dentists to ask them if they'd removed any gold teeth or fillings recently, and if so, would they be interested in selling them?

Another ignorant Westerner

Cultural differences appear where you don't expect them.
We recently had a maternity patient who we thought might need blood urgently.
The usual practice here is for the family to donate blood. They readily agreed and we went ahead and took the blood.
As it happened, the patient ended up not needing the transfusion. We were approached by the family as soon as they heard this, enquiring whether the unused blood could be returned to them.
"Please tell me they don't want us to transfuse it back into the donors!" I whispered sotto voce to Emilie, our senior local midwife.
"No, you idiot, but it's a part of the body and still belongs to the family" she replied, sighing patiently at the thought of having to deal with yet another ignorant Westerner.

A taste of home

Every six weeks or so we get a weekend off to stay in N'djamena, the capital.  
There are shops which cater for the expatriate community where we can stock up on whichever imported luxuries are most important to us, to last us through the next six weeks; Vegemite for the Aussies, pesto for the Italians etc.
The range of goods available isn't huge and gives an insight into what things people miss most about home.
I wasn't surprised by stocks of tampons, moisturiser and conditioner, but, er, fish food?

Hair-pulling and telephoning

Sometimes, doing something that takes two minutes at home can take a week here. I spent all day last week trying to upload a picture of an ultrasound scan for an international opinion. 
We had a child in the hospital with a severe skin infection. She didn't respond to the usual antibiotics so we asked for the second line ones, as we suspected she had a resistant bug.
Sarah with a young patient and their mother.

Sarah with a young patient and their mother. Photo: Sarah Wookey/MSF.

At home in the U.K. a couple of computer clicks would have the pharmacy downstairs packing the medication up before the patient had left my room. Here - we requested the clindamycin.
No problem.
Fantastic result, skin lesions heal miraculously. Can we change to oral treatment? 
Not in stock.
Back-up stock?
Possibly. Might take a few days.
Hmm, sort of need it now so that Clindo Kid can go home before she picks up another infection from the sick children around her...
After much hair-pulling and telephoning and passing of messages up and down chains of hierarchy, the magic capsules arrived just in time.
Pass the beer.