I think that this is probably the most difficult blog that I have written so far. We arrived back from Uganda the night before last, having had a lovely break. David went back to JTH yesterday to continue his work on the Emergency Medical Ward, whilst I stayed at home to enjoy what is left of my week off. However, as I found out when he arrived home late last night, David did not spend yesterday seeing medical patients. He spent yesterday managing casualties from tribal conflicts that have broken out in Jonglei State in the North. He spent yesterday working in a hospital surrounded by armed guards, in order to prevent the patients and their relatives trying to kill each other (again). Part of his medical ward is now a trauma ward for one tribe, the other tribe being based in the surgical ward.
But, before I get into this, I’ll write briefly about our lovely break in Ziwa Rhino Sanctuary in Uganda. The 3 days of rest that we had were worth the two days of travel. Given our limited budget, we traveled on a coach there and back. This was hot, sweaty, dusty and not good when battling gastroenteritis! I managed to dehydrate myself sufficiently to not need to pee for 12 hours! It was certainly a new experience. The road between Juba and Nakitoma is mostly without tarmac. The drivers want to get to their destination in daylight hours and they drive fast. The roads are bumpy and the whole coach was frequently airborne during the trip (no exaggeration)! After the first hour or so, your body acclimatises to the sensation, the adrenaline rush subsides and you begin to realise that this is a normal journey and that freaking out is not helping! The unpaved roads are also incredibly dusty and at times it was difficult to see (or breathe) inside the coach due to the dust clouds. It is then that you decide to close the windows and accept that you are traveling within a spine-jolting, portable oven and try to enjoy the experience! I must admit that I did enjoy some parts of it too. Not the part when we realised that we had left our South Sudanese visas back in Juba, but the parts when you see daily life going on as it has for centuries. Life that goes on without electricity and communities made up entirely of “tukkles”, built using centuries old techniques. Seeing families clustered around water pumps, with the children bouncing up and down on the handle like a see-saw is also a brilliant sight to behold. Seeing the amazingly lush Ugandan countryside and local people clustering around the bus to sell their wares were things that we would have missed out on if we had have flown. And yes, there were of course the obligatory live chickens on board!
Anyway, after 11 hours of travel, we finally arrived. Ziwa is not just a sanctuary for rhinos, it was a sanctuary for us too. We were shown to our very clean and basic room. We were fed very good food (neither of us had eaten en route due to tummy concerns and were both feeling a bit “hypo”) and good red wine. We sat and chatted to the owners of the sanctuary and, quite frankly, were inspired by them. Originally from Namibia and South Africa, fate had led to them moving to Uganda and taking over the rhino sanctuary. What had happened next was inspiring. Angie, the manager of the sanctuary used her work at the rhino sanctuary to enrich the lives of the local community. She expanded the business, providing jobs for the locals, she allowed the staff to bring their families to live on site, she opened and staffed a school for the local children and she employed the elderly men who would otherwise have starved. Angie has even given each employee and their family member additional money for healthcare and ensures that her HIV positive employees have frequent health-checks and access to anti-retrovirals. In short, Angie and her family have changed the lives of all members of the community for the better. Oh, and we mustn’t forget that they are also single-handedly saving a species from extinction! What is most impressive is that they have only been there for 3 years!
So, Angie’s story got us thinking…. What if we were to replicate this model when we return to sub-Saharan Africa after we have completed our training? We have friends in the hospitality industry who have already expressed a desire to come out here with us. Tourism is an up-and-coming industry in this corner of the world. What if we set up a tourist venture and used the profits to develop a health-care facility; starting small, but reinvesting and expanding as we were able? In partnership with the government and training local staff, but retaining some autonomy too; something that we have discovered is very difficult when working within a government run hospital. It’s just an idea, but it’s one that has got us very excited!
Whilst at Ziwa, we read books, lounged in the sun (the temperatures are so much nicer in Uganda – 28 degrees compared to 38 degrees in Juba), admired wildlife (including rhinos that wandered onto the accommodation area at night) and went on bike rides. We spent more time outdoors than we have in the whole of the past 4 months. We “Skyped” family members and wished them a Merry Christmas; something that our Juban internet connection is in no way up to doing! It was lovely, we both “switched off” and didn’t do any of the work that we had brought with us. We ate plenty, drank sufficiently and chatted to a lot of very interesting people. Sadly, after 3 days of bliss, we had to get back on the coach and head back to Juba. The coach journey was just like the way there; hot, sweaty, dusty, smelly and long, but ultimately very interesting!
Now, back to reality. The Nuer and Murle tribes have been fighting in Jonglei state. They have clashed for years over cattle raiding, but now the Nuer tribe has decided that they need to “eliminate the entire Murle tribe from the face of the earth”. Internet forums make fascinating but difficult reading. Thousands of Nuer youths are armed and ready for further conflict. People openly discuss the “need” for “ethnic cleansing” due to atrocities that the Murle have previously committed. The SPLA (South Sudan’s army) are reluctant to take sides, as many of them are Nuer themselves. It seems that further conflict is inevitable, which means that hundreds or thousands more innocent lives will be lost. Victims that survive will be headed towards Juba for further treatment.
The patients admitted to JTH yesterday were mostly admitted with “minor” gunshot trauma, as patients with serious injuries invariably died before making it the hundreds of kilometres south to Juba. I am sitting in our shed, feeling incredibly guilty, writing this blog. I am still technically on holiday, most of the surgery will have taken place yesterday (before I even knew about this) and there will be enough anaesthetists at work today to allow surgery to proceed. However, that is not the reason that I am here and not there. I am too scared to go to Juba Teaching Hospital. I am scared of being in a hospital where the patients want to kill each other, their relatives are able to kill each other and there are (supposed to be) armed guards on every ward. Although David admitted that he wasn’t keen on me coming to work, there was no way that he was not going in. He still has sick medical patients to look after and a ward that doesn’t function if he is not there. We decided that I would stay at home and that he would call me if there was another influx of casualties. He promised that he would leave the hospital if he felt that the situation was unsafe. Maybe if I had have been there yesterday, I would have seen the situation at the hospital and would have not been so scared. Maybe then I would have gone to Juba Teaching Hospital and would not be feeling so guilty right now, waiting for David to return.