Friday 6th March 2015

The team have just arrived home after leaving Wau on Thursday morning. We took the decision to leave two days early because of security problems in Wau following repercussions and reactions due to delays in payment of wages to the local police. Although we left early we had accomplished most of our objectives and achieved about 52 hours teaching, formal and informal, to student nurses and midwives, doctors, medical students, anaesthetists and other staff. In addition we have had invaluable networking with senior hospital  management and the ministry of health and other friends. It’s been another interesting and fulfilling visit despite having to leave earlier than planned and we will continue to keep in close touch with our friends in Wau.

Tuesday 3rd March 2015

Great afternoon teaching at Sister Gracy’s. Sally and Hilary A taught shoulder dystocia and breech and ran rather an amusing midwifery quiz. We had a great reward at the end of the afternoon when we were entertained by the students doing tribal dancing and singing to us. As well as giving us gifts there were many speeches.

Cleaner with baby at work

Girl with pot

Monday 2nd March 2015

James had a good time teaching at the university, meeting the vice chancellor and deputy vice chancellor. Sally and Hilary have set up the portable ultrasound machine bought by PAL in the doctors office in maternity and it’s being well used. We have set up an HDU area in the new maternity theatres but staffing it is the main challenge now.

Sunday 1st March 2015

Sunday being a day of rest we were up at 6.30am to attend the 8am English service at the Episcopal church. We spoke at both the English and Dinka services, the team introducing themselves and Hilary A and I giving messages of greeting from her church and Poole deanery and also one from the Bishop of Salisbury to the people of Wau.
We had the rest of the day for a bit of R&R with the female members of the team going to Amarula Lodge, the nicest hotel in Wau, to relax and swim, while James decided to remain at our hotel to prepare for his talk at the university tomorrow and escape our female chatter. He seemed quite refreshed on our return!

Hilary

At the Dinka service

At the English service

Saturday 28th February 2015

We had a record turnout of over 90 staff at our ‘Shock’ morning today. About a third doctors and medical  students, and the rest nurses and midwives. – plus one cleaner and one “down and out”! 20 people had to stand outside. General shock and obstetric shock was covered, and the morning went well.

We then went to visit the family of our loyal driver, Justin, with some gifts for his girls. then on to Dr Majok’s house. Here we had a lovely lunch and a warm welcome from his wife Alec Bol, children and extended family, about 20 in all.

Hilary

 

James getting broody with Baby Majok

 

South Sudanese selfie

 

 

 

 

 

 

 

 

Some of our 90 students today

 

 

 

 

 

 

 

 

At the home of our driver Justin

 

In the home of our driver Justin

 

 

 

 

Friday 27th February 2015

It’s the hottest it’s been on my Wau trips, and working eleven hours each day at the hospital, then teaching students from 3 till 5.30, and then preparation for next day is hard for us all..

Today I’ve been mending and sorting kit again and teaching resuscitation at Sister Gracy’s with James. I had a lovely welcome from Bishop Moses at Wau cathedral when I went to arrange a lift to church on Sunday. Sally and Hilary A have caused great amusement for staff and visitors walking around the hospital with a black doll for resuscitation. They have managed to set up the portable ultrasound scanner bought by Poole Africa Link in the maternity unit, although I  had to go to the market for a new extension lead. James has had a good day working with the anaesthetists on drugs and equipment to produce safe modern anaesethesia.

Air con and Internet at hotel now not working… Surprise!

Hilary

James and Hilary teaching resus at sr gracys

 

New born baby at Comboni hospital weighed 1.1kg and abandoned by its mother

 

With sr Maria at Comboni hospital

 

 

Portable ultrasound machine bought by Poole Africa link set up in maternity

 

Thursday 26th February 2015

Another very hot day…
James has worked with the two newly trained anaesthetists, and was very impressed with their knowledge and skills which vastly outstrip the equipment and drugs available here, which is frustrating for everyone. James assisted them with the ketamine anaesethetic  for a laparotomy patient, without the usual control of airways we have in the UK, in the superb new maternity theatre which we are delighted to find has the best toilets in the hospital!

Sally and Hilary, following yesterday’s tragedy, decided to strike while the iron was hot and invited all maternity staff to update their skills in resuscitation of the newborn. Unfortunately, some staff still refused to engage in developing modern safe skills. They are in the process of setting up an HDU in maternity and have moved the portable scanner bought by PAL into that area.

James and I met with IMC (International Medical Corps)  who have been chosen to manage the  £ 2.2 million grant from the Health Pooled Fund (a consortium of international donors including DFID, UK) for the development of WTH. They have asked to have more discussions with us, which is encouraging.
I’ve been locating and mending broken kit and also met with the Matron. Nurse:   ‘management’ here is nothing like the UK!
We moved hotels today so now have Internet (of sorts).and air con

Hilary

Wednesday 25th February 2015

It’s now Wednesday afternoon and with no internet at our hotel or the hospital communication has been difficult. The state minister of health who I met with this morning has kindly let me use an office in the ministry this afternoon…it not only has wifi but a fan, which is great relief in the 45deg heat!

We arrived in Wau quite early on Monday morning having been ably assisted with transport and flights and access to the VIP lounge in Juba by Dr Kediende from the MOH who has looked after us well. Unfortunately the ministry can no longer support our internal flights so all the funding is down to the link now.

We had out usual tour of the hospital and Sally and I, having been here several times were very encouraged by the improvements, not only in the buildings but in the number of medical officers and the improved skills of the student nurses.

For the last couple of days Sally and Hilary have been concentrating on maternity and starting to set up a small high dependence area there. Along with James they were in theatre this morning for a Caesarian section and the baby proved difficulty to resuscitate. Early this afternoon the baby deteriorated and despite the best attempts of our team he sadly died. Sadly this is the third baby who has died in maternity since our arrival. James has been working with the new anaesthetists mostly in the lovely new maternity theatre.

This morning I met with the state minister of health Dr Isaac Cleto and we had a very useful discussion. There will soon be a big investment in the hospital which will be carried out by IMC so we will see more changes.

Our teaching programme at Sr Gracy’s Mary Help Nursing school has started with James and I teaching resuscitation, and the midwives obstetric emergencies. We received an amazing welcome from the students who sang a welcome to us and Sr Gracy who made us cake! The skeleton we took them caused great hilarity. We went with Sr. Gracy to see the progress on the new hospital she’s building out of town. 

It’s great to be back in Wau despite the extreme heat which is exhausting but we have had lots of very warm welcomes from old friends and new.

 Hilary

 

 

Monday 23rd February 2015

The team had great assistance from South Sudanese friends at Juba, and were able to fly to Wau this morning, Monday 23rd February – with all their kit and personal luggage.  More details to follow when they obtain access to the internet.

Sunday 22nd February 2015

Safely arrived in Juba 40 deg, all tired but now enjoying a beer by the Nile before a busy day tomorrow. Unsure yet when we will get flights to Wau…usual mystery tour !!