Anne Goes to Africa

Last year I published several newsletters from my classmate Anne, then a medical volunteer in Afghanistan. In September she left Afghanistan after an ugly incident, spent some time in India until our class reunion in early November (when she promised her classmates not to do anything else crazy), then went home to Scotland. Now she’s off again…

January 16, 2005

I am about to go off to south Sudan to work with Medair. I have enjoyed just over 2 months here but I am ready for the next adventure! I leave on the 25th of January for two years although I will be back for a holiday during that time.

Medair has been working in south Sudan since the early 1990s and is well established there. Some of the major bonuses are that the south is predominantly Christian and there are therefore fewer restrictions in terms of dress and being a woman, and that it is hot all the time! There is a lot of malaria though and probably lots of other interesting aspects to life.

I will be a part of the mobile response team which does medical and water and sanitation work. Obviously I will be part of the medical part! From what I understand, the medical bit goes to certain locations at regular intervals to run primary health care clinics. It also responds to outbreaks of disease and I think planning is not exactly straightforward. I will spend half of my time in Lokichoggio which is in Kenya near the Sudan border. It is a place that has grown up around aid organisations which all use it as a base for Sudan. The other half of my time will be in Sudan. Living conditions are very basic and we fly in small planes to the places where we hold clinics. It is not secure enough to stay for longer than a few days and I guess you can treat more people over a larger area when you flit around. I will be doing a lot more clinical work than I did in Afghanistan which will be a challenge as I have never done tropical medicine before. Everything is pretty basic and limited in terms of what you can do so I guess I will manage! However, the work in Sudan is being reviewed and will probably be changed in terms of how things are structured and run so by the time I get there it may all be different. I will let you know!

Medair’s main base is in Nairobi. Due to the hard living conditions and the hours worked, we get a week off every 6-8 weeks in Nairobi where there is a team house and lots of civilisation. I will be able to receive and send post from there and letters are delivered to the team every week while in Sudan.

Feb 27, 2006

Dear All,

Some news is overdue – sorry!! It was good to catch up with some of you when I was home for a month recently.

I have been back for a month and it has been hectic. We are in the middle of responding to a cholera outbreak. As of Friday there have been 4207 cases and 80 deaths in the 3 week old outbreak. [Our organization] has set up emergency water treatment centres in Yei and Bor. The health team has gone to Juba and set up a treatment centre in a camp for IDPs (internally displaced people). We have not seen so many cases as it has been possible to contain the disease as the camp is 7km outside of Juba. In Juba town itself there have been a lot of cases and deaths. We are currently looking at moving on to another place to start there as the disease is spreading. Quick action is vital with cholera and we managed to get everyone to Juba in less than 48 hours which was quite a feat given that the team were all over south Sudan.

We have had quite a lot of issues with security already this year. We have had to evacuate teams from 2 places – one because of community issues and the other because there were lots of soldiers and shooting going on. People are being disarmed at the moment which is not going down well. There are also issues about people being appointed to positions of power who are from the north and not acceptable to the local people.

We are also facing problems with health workers wanting so much more than we can give. In one place they are all threatening to strike unless we give them the 300% wage rise they think they should get. We are currently talking to officials in the Ministry of Health to get advice. In the meantime they are working as normal but refusing to be paid. I cannot quite follow the logic but never mind….!!!

We had plans to hand over 2 of our 4 sites as we did not get enough funding to support all of them. Unfortunately the 2 NGOs who were interested did not get funding either. One of them has applied to 2 different funding bodies and there is still a chance for them. It puts us in a difficult position as we do not have enough funding or staff to do everything.

We have had plans to do a mass yellow fever vaccination campaign since the end of November. There was an outbreak in north Sudan very close to the border with the south in which over 150 people died. We were involved in the task force set up to deal with it and are planning to vaccinate in Twic county. We have been fighting bureaucracy since December to get vaccines and still have not succeeded!!! However I have just heard that they have confirmed cases of yellow fever in Malakal where MSF work and they are looking for vaccines. It is obviously much more important for them to get the vaccines as they have confirmed cases and I think we may not get any as there is a shortage of vaccines. We will see….. We are all packed and have done all the preparation for it. However most of the team are now involved with cholera so…..

Over the last few months we have closed the therapeutic feeding centre and transferred the management of malnutrition to the medical assistants. There are nutritional surveys going on just now though and we are expecting to find high levels of malnutrition again so may need to open another centre. The TB clinic in Ayod is going well and we have now had 16 people who have completed the 6 months of treatment and been cured. We have between 45 and 50 in-patients at a time generally.

Recently I have been stuck in Loki a lot as there has no one to cover for things here. I am hoping to get to Sudan more soon!! Loki is a strange place and not the easiest place to live. The generator in the camp has been broken for 2 weeks now and we only have a small one. For 3 days we only had power for 4 hours a day. In the office it has been up to 42C and I have found it difficult to be productive! It was over 50C outside so I guess I should be grateful for small mercies! Hopefully we will get our big generator back and be able to put on the air conditioners in the office again. It is hard to get a good nights sleep when it is so hot.

Hope you are all well. Thanks to those who keep in touch – it means a lot.

With love,
Anne

anne's adventures in afghanistan