10 weeks and 4 days

I must admit that while expressing outrage at having to fly across the world to deal with a minor stationery issue, I am secretly feeling a little relieved at my excuse to have a break from Juba. Maybe it’s the heat, dust, and burning piles of rubbish that make Juba a less than endearing place to live or maybe it’s just my intolerance. But as one colleague put it, ‘Juba seems to have all the problems of Africa, without any of the charm’. Saying this, I know that I have glimpsed some charm in the sights, the people and the querks that I have come across during the 10 weeks and 4 days I’ve now lived and worked in Juba but right now I’m feeling an acute need for some time and distance away to be able to recollect them.

Moments I enjoy are walking through the hospital grounds first thing in the mornings. Every day I take the same route, picking my way among the camped out ‘co-patients’, recovering wounded and recent amputees. They sleep on mats outside the wards, cooking their breakfasts on coal fires and brushing their teeth with bits of wood. Many of them have been there for weeks, waiting for relatives to recuperate or their bones to heal and so they greet the strange kawaga doctor: the young guy with one-leg and the huge smile, the angry woman who tells me which patients I should be operating on and the little bare-chested kids with their round bellies and dinka beads who say ‘moning, moning’ (which I like to believe means ‘good morning’ and not ‘give me money’).

Life on the wards, although tough, also has its moments. I like to make the tired, demoralized nurses smile with my pigeon Arabic (‘Waja? (pain) and point to head, tummy, chest etc.. is my general approach). I like the super keen Clinical Officer students who put the doctors to shame, coming to the ward early, rounding in groups of 10, asking hundred of questions. These guys know how to learn, and they have to learn a lot, quick. After 2 years of training most of them will be the only medical professional covering a majority of health facilities in South Sudan. I like the ward ‘mascot’, Marco who is technically not a patient but seems to like living in hospital and I guess has nowhere else to go so the nurses let him stay. I also like seeing community like I never see at home. Sickness bring people together – huge families gather around bedsides, village meetings are held on the ward to decide if they can pay for patient’s treatments, people travel for miles to donate blood for distant relatives. Although infuriating when attempting to do a ward round among this throng of people, it is pretty humbling to see the meaning of family in this country.

Life is hard in South Sudan. People are so poor they come to hospital without spare clothes, never mind the money they need for tests, drip sets, drugs, and even the ‘public’ toilet. People get sick a lot and come to hospital so late in their disease we don’t get a chance to make a diagnosis before they pass. And sadly people die a lot whether due to lack of awareness, money, expertise, treatments, resources or a simple system failure. My frustrations though are nothing compared to what is felt by my South-Sudanese colleagues. They are the ones seeing their own family suffer (I’ve already attended one of their funerals), who don’t get allotted any leave, who don’t get enough salary to pay the rent and hadn’t been paid since December until they went on strike for 3 weeks. They are the ones who I will leave with the long-term burden of working for better health care in South Sudan. So once I have replenished my stock of cadburys chocolate, earl grey tea-bags and waitrose muesli and have regained a positive frame of mind, I hope I return an encouraging trainer instead of the nagging Kawaga that left them.

Clinical Officer students soaking up every word...

My lovely walk to work

Another burning pile of 'trash'

A rare moment of relaxation