Thurs 19th April
Sight and Sights in Juba
Claire and I have now been here a week since the rest of the team deserted us. It has been very productive for both of us in Juba Teaching hospital. I have been able to carry out clinical teaching for doctors on interesting patients and taught fundal examination techniques. Patients were referred to me for diagnosis and advice by the local doctors. As expected in Africa, many patients have advanced disease. Some examples include corneal scarring, advanced glaucoma, optic neuropathy, retinoblastoma, ocular tumours, onchocerciasis, trachoma and xerophthalmia. The most upsetting are babies and children with serious disease, some life threatening, with inadequate treatment available locally.
On a more positive note, the eye unit works extremely well within limited resources. There is a free walk-in service for everyone with immediate treatment when possible. There are no waiting lists and those who qualify for surgery (i.e. are blind) have surgery the following day. Since I have been here, 16 patients have had their sight restored by the local surgeons.
Wednesday saw national demonstrations in support of the Government leaving fewer Doctors and patients in the hospital. Most departments closed at lunchtime so Claire and I organised a trip to the market for the afternoon. As we left the hotel a monsoon-like rainstorm developed which closed all markets, and the driver took us for a tour round Juba instead. He drove into the outskirts to his house where we met his wife and daughter on dirt roads which by now had become mud tracks and gushing water. It rapidly felt like a 4×4 adrenaline ride in the outback with Bear Grylls. Most buildings there were traditional wood frame and mud with a straw roof. In many we could see school children amazingly still dressed in immaculate starched uniform surrounded by muddy streams.
The highlight was driving into a large puddle which turned out to be so deep that water covered the bonnet. Our driver was completely relaxed about this, and throttled hard to pull out the other side before the engine cut out!
Claire and I are now packed and ready for an early start on our trip to join the rest of the team in Wau.