And to Tanzania...

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‘I really like England’ one of my students told me, as I sat down for hot sugar with a bit of tea (the SouthSudan way) before class today. “Oh really, why’s that?’ “it is where my favourite scientist is from… Dr Darwin” he replied as if I should have guessed. It wasn’t the answer I was expecting. I was anticipating having to fake an interest in David Beckham or Arsenal’s place in the football league to be able to ‘connect’ with a South Sudanese male whose life so far I could only imagine. John lost a leg in a land-mine explosion when he was ten. He apologized for not turning up to class one day because his stump had become swollen it wouldn’t fit his prosthesis (that old excuse again). But as I sat there in the heat talking science and medicine, it struck me that while I cannot understand what it is like to live in a war-torn country, to lose limbs, homes, brothers and parents, to be shifted about the place with little clue of what the future holds, medicine had become a common language.

The Introduction to Medicine course is coming to an end and I am about to move to Tanzania to start a bit of studying myself. Having never heard of an OSCE (clinical exam) before, the students will sit their first tomorrow. I’m hoping that after a month of me nagging them to wash their hands before they touch and stop asking their patients if they are ‘alcoholic’, that some might pass.

Over all it has been an incredibly rewarding and fun month, but with various rumours flying around about what might happen to the medical students, and some resistance to us teaching from the university faculty there have definitely been some frustrations. The future for the Harvard teaching group is pretty much as unclear as it is for the students. The difficulty of setting up a simple service in Juba – treating patients and teaching students for free, has been confusing. We have been told one thing, then another, been welcomed then ignored, found locked doors and unexpected bills, come across disagreements, suspicion and confrontation. As well as being a bit depressing, this has made me consider how hard it can be to give and receive ‘help’. While I find it hard to understand why anyone would turn down a free service, especially with the name ‘Harvard’ attached to it, how would I feel if my country was full of hundreds of NGOs and charity do-gooders, if every piece of equipment in my hospital declared it had been ‘donated’ by some government other than my own, and if my workplace and community was the target of various ‘projects’ and ‘programs’. Although it doesn’t justify some of the encounters we’ve had, it does me good to put myself on the other side and realize that I have just as much if not more pride and resistance to being helped.

Any negative responses have by far been exceeded by the incredible graciousness of the students, who have gone the extra mile to make us welcome and let us know how much our efforts are appreciated. Whether or not we can carry on working with them, their wide-eyed attention in lectures, their insistence on paying for our lunches and their elaborate and earnest words of gratitude, have made it all worthwhile. (but no, don’t get them extra OSCE points).