Tuesday 24th April
This evening Dr Alex invited us to dine out with a few friends. Unfortunately despite directions from Alex our driver dropped us off at the wrong place. The Tiger hotel seemed an unlikely place for dinner but we had a beer whilst awaiting rescue by Drs Alex and Peter. They took us to the Rockstar hotel and restaurant to meet the Minister for Health [western Bahr el Ghazl] and a Dr Sood from the UN. We had a delicious dinner of Sudanese food with good conversation and great company in the cool evening air under the light of the stars. Prem made everyone laugh by falling backwards out of her chair Graham Norton style [soft sand not alcohol].
Wednesday 25th April
Prem and Claire started the day in referral clinic, which is like an outpatient clinic in theUK. Prem was delighted to meet an 86 year old man and she supervised the medical house officer seeing patients in the clinic. Unlike theUKthere is no appointment system; first come first seen and only one room in which several doctors sit to see the patients. One corner was screened off for Claire and the ultrasound machine, another for an examination couch. Claire managed to scan 4 patients before the electricity went off completely. One patient had a large superficial mass above and lateral to his nipple. We weren’t sure if it was breast cancer but he also had lesions in his liver so wherever the primary, prognosis is bad. Meanwhile Ben was in eye theatre doing more surgery, at moments by torch light when the electricity cut out.
At 11am Frankie and Prem went to a meeting at the University with the Vice Chancellor and the Academic Secretary. The university is short of teachers and we have agreed to look the possibility of providing lectures for medical students on future visits. At 12.30 Rebecca was born delivered by our very own Rebecca, a lovely normal delivery to very proud parents. Kate spent her day setting up oxygen therapy and training the staff in paediatrics. She also painted blackboard squares above the beds to use as drug charts. Rebecca was delighted to see her blackboard squares from the day before being used and individualised by the Drs and nurses in maternity. Ben finished his day teaching first the doctors at the hospital and then the nurses at CHTI; Prem suggested he teach on management of hypertension but he insisted on teaching eyes!
After another busy day we were very excited to be invited by Dr Garang to have dinner at his home and meet his family. We had a lovely evening and his wife cooked us a feast of Sudanese food. We were all on our best behaviour when Kate snorted very loudly. It turned out she had inhaled a fly and was trying to expel it from inside her nostril!
Thursday 26th April
Our day started with a visit to the level one medical facility at the UN base. Most of us forgot ID so we very nearly got turned back at the gate but we managed to blag our way in [well actually our host persuaded the guards we were trustworthy].
For Claire and Kate it was work as usual except there was no electricity for most of the morning so Clare now has a waiting list for ultrasound. Instead she spent her morning looking at x-rays and helping the surgical doctors diagnose fractures. Ben spent the morning with his VIP patients; who can beat 1 minister and 3 Bishops? Frankie and Prem had a very positive and constructive feedback session with the junior doctors who have been a joy to teach over the past couple of weeks. Becca spent part of the morning with the community midwives and TBAs (traditional birth attendants) at the antenatal clinic before saying good bye to the midwives, women and babies on the delivery suite. Kate taught more nurses how to use the oxygen saturation meter and the concentrator, she also taught Prem and the medical officers how to use the glucometer to check BMs. Kate was very pleased to see the blackboards already in use. A fitting child also gave an opportunity to teach the nursing students about seizures.
For Prem, Frankie, Becca and Ben it was our last day at Wau teaching hospital. It has been hot, dusty, at times frustrating but most of all a very rewarding experience. We have all learnt new things about ourselves and it has challenged us to think how we would do our job under these conditions. Prem has realised [at last] how much the nurses do without being asked. Ben has always taken for granted that his instruments will be sharp and the lights will work. Frankie will be very happy to return to continuous monitoring and her ODP. And Becca has a renewed appreciation for documentation!
Team profile number 4
Becca is our team counsellor and peace maker. With three consultants on the team you can image the clash of egos. The battle of the oxygen concentrators [paediatrics or outpatients] took very careful mediation to resolve. Becca also named our team cocktail the woo wau and had the ingenious idea of painting blackboard squares above the beds in maternity to solve the documentation problem. Becca’s infectious laugh and morning greeting will be sadly missed by Kate and Claire her roomies.
Love the super seven