I am awake around 6...the night has again been busy, with vivid dreams. It is cool, almost cold, but I don't add another layer, just wear the same combination of clothes, I have been wearing for months, a T-shirt and scub pants. Brush my teeth at the outdoor sink facing the lightening sky to the East, overlooking the Dura river. Daily the level is dropping. I can see the vague outline of a woman who has come to get water. No other activity right now, but later today the river will be teeming with children swimming and playing, people bathing, washing clothes and fishing. It is still passable by cargo boat, but only just barely. We have moved our boats down to Otum, the confluence with the Baro and if we need to transfer a patient to Nasir we will drive them to Otum.
I head to the kitchen, to start the hot water for tea and coffee, open the offices, and then go to the Health Center to open up the locked rooms. It is a short walk to the HC, passing mostly quiet tukals, with sleeping dogs curled up in the ashes of last nights fires. Cattle are tethered to their sticks in the ground, and there is a young boy spreading cow dung on the ground to dry. I enter the compound, greet the guard and make a quick walk through all the wards, and check in with the oncoming nurses, restocking any medication they might need. Back to our compound for tea and our early morning meeting. A roundtable of brief plans for the day by the members of the team. A mix, British, French, Nigerian, Rwandan and American A good mix a good team.
Then back to the HC at 8 am to make sure all the staff has arrived and the clinic has started registering and seeing the morning patients. The staff are all so polite, greeting me with enthusiasm and always a handshake, a nice way to start the day.I work closely with the nurse supervisor who positions the staff. The roster has been made up for the entire month, so most people know what they should be doing, and most are but there are often last minute alterations to be made, people are sick or they just don't show up. Mystifying in one sense, but I am used to it by now and so we are pretty good at juggling staff. The clinic sees 150-250 people a day and we work 6 days a week. Mondays and Friday are busiest,and right now the majority of the patients coming have malaria. The numbers have been increasing week after week. Making sure we have adequate supplies to deal with this is one of my jobs.
My days vary, meetings, security issues,staff issues...requests for leave, or sick, or complaining, or diciplinary actions, patient referals to Gambella or Nasir, reports, pharmacy orders, stuff like that. These fill my days in varying degrees. We work till noon then a two hour break, resuming at 2pm to continue until 6pm. By now the heat is oppressive, like being stuck in a room right in front of heater on full blast, no escape. I lock up at 6pm and head to take a long awaited shower, passing the families gathering around their outdoor fires. Dinner follows, prepared by our cook, predictably, pasta and sauce, tomato salad, lentils, fried potatoes, sometimes a meat dish and if lucky a fruit salad (bananas,papaya). Usually we watch some TV (satellite dish of course). We don't have internet or cell phone access but we can watch Master Chef and The Doctors...go figure.
Still hot and now the bugs are out. Not something I can explain, just how significant the bugs are, attracted by the lights....in clouds. They find their way into my hair, on my face, down my shirt,up my pants...truly disturbing. If they are too bad I just go to my room to read, encased in my mostquito netted bed. Brushing my teeth at the sink, I try not to dodge the bats that swoop around my head, and watch the lightening bug show in the darkened sky. I usually am able to fall asleep once it starts to cool down around 11pm.
It doesn't sound very exciting....and it isn't...but it is unique, interesting and challenging and we do good and important work. It feels right.