Sunday, May 25, 2014

Out in the Bush

On the "path" to Gongoli Village
For the past 9 months, I've considered myself to be living in "the bush" of Africa--middle of nowhere, a good 45 minute walk from the nearest "town" aka bigger village, rural Africa.  But on Saturday, I was introduced to the real bush.  Sister Meriline and I went for mobile clinic in a place called Gongoli village.  It was a full, busy, exhausting nine hours, but one of the most rewarding days I've had since I've been in South Sudan. 

Washing and fetching water at the multipurpose water hole
The day started by walking just under 2 hours through the bush.  I spent the whole time trekking on a narrow path, pushing grass that is taller than me out of my face.  We had to carry the medicines and all our supplies because there was no way of taking a vehicle or motorbike on the path.  It was so beautiful though, peaceful and serene.  We finally reached the thatched roof church where we set up our clinic.  Before we began I walked to the water hole where the people get their water just to check it out.  And it was just that--a hole that collected rainwater.  The water was extremely dirty and kids were bathing right where the other people were collecting water for drinking.  No wonder so many people there are suffering from water-borne diseases!  I made my way back to the church area, and some kids started kicking around the football.  So naturally I had to jump in and play for a few minutes before we started the clinic.  It caused quite the scene.  A white girl who actually knows how to play football--unheard of!  

Some patients waiting in line
Then we started the clinic.  I played doctor for the day and recorded the patient's symptoms, assessed, diagnosed, and prescribed medications.  The supplies we had were very limited because we had to carry everything, but we made due.  We had just over 90 patients come, a pretty good turnout for 4 hours of seeing patients.  The most common illnesses that I saw were intestinal worms (no surprise there), malaria, fungal infections, anemia, and musculoskeletal pain from working in the fields all day.  Sister and I took a break about half way through and gave a health awareness talk about the water they are using (after I saw the hole where they were fetching from and the quality of water) and how to properly filter or boil it to prevent sicknesses.  Then we started to ask about the demographics of the area and what access they have to resources.  There are over 200 families in the village--making well over 1,000 people, the  majority of whom are children.  These people have no access to healthcare, no schools in the area, and no support from the county.  If the kids want to go to school, they have to walk 2 hours each way to our school which is the closest to their village.  So the vast majority of kids there were just running around all day not attending school.  It was interesting to see because most of the places I go here, usually a few people speak English, but here nobody spoke a word of English., obviously from a lack of exposure and formal education.  The same issue occurs for healthcare.  They would have to walk to our health center to get any medical attention at all.  And when you are sick, a walk 2 hours each way just isn't feasible.  I was speaking to the chief, through a local translator who came with us, and he was telling me that they are petitioning the Ministry of Education and the Ministry of Health to get these services in Gongoli village; however, the county has yet to respond or provide any kind of support.  It was interesting to hear about their problems and struggles, but then to see how they are coming together as a community to try to fix them and improve their quality of living.  

Many people we saw were small kiddos
The clinic ran smoothly, but it wouldn't be an African day without heavy afternoon rains.  We had to take cover under the leaky, thatched roof Church.  We finished the last few patients and waited for the rain to stop.  This made for an interesting walk back to "civilization."  We moved back through the bush in the mud and with wet grass hitting us the whole time.  I was so dirty, but it was a fun adventure.  That is the mobile clinic that I want to do…those are the type of people I want to work with--those with absolutely no access to healthcare.  Although I was only with these villagers for a short day, I learned so much from them about living a simple and happy life.  They make due with what they have, and they have next to nothing.  Sister and I are already talking about making this a more regular mobile clinic site, maybe once a month or every other month.  Hopefully we can build a relationship with these people and at least make a small impact on their health.  It was a long, but incredibly fulfilling day.  The whole day I just felt in my element and so happy, and it is then that I knew this is what I am truly called to do.  One successful day in the bush complete and hopefully many more to come!
Getting lost in the bush!

Thursday, May 15, 2014

A Year of Nursing

This past week was National Nurse's week, and it also happened to be one year since I graduated from nursing school.  It made me reflect and think back on my first year as a registered nurse, and I quickly saw all the joys, struggles, rewards, and challenges that came along with my first year of nursing.

Around April of last year, I couldn't even count how many times I heard, "Do you have a job?" "Where will you be working?" "What unit will you be working on?"  My answer for all these questions was a bit different from the typical graduate nurse's response-- "Actually I'm moving to South Sudan to work at a clinic for a year."  This decision was not an easy one.  I felt as if I wasn't qualified enough (or at all) to go abroad.  I thought maybe I should get experience for a year or two in the states and then go do global nursing.  I went back and forth so many times, made many pros and cons lists, and said countless prayers for guidance and wisdom.  Ultimately, I couldn't ignore God's call and knew that I had to do what I was passionate about in a place that I always dreamed of working- Africa.

Waiting to get their wounds cleaned.
This past year of nursing has taught me many things about myself and also has reassured me of the reasons I studied nursing in the first place.  The clinic here has very basic services as I've mentioned before.  It is not the busiest of clinics- usually 30-50 patients a day.  And the resources and supplies we have are very, very minimal.  I spend 5 hours a day in the clinic where I bandage wounds, give medications and injections, and occasionally sit in for the doctor when he is on leave.  I don't call physicians, give blood transfusions, spend hours charting in the computer, or many of the other tasks and skills that I learned in nursing school.  But I didn't enter nursing just so I could do those tasks.  I started nursing for the relationship that nurses have with their patients.  They are the ones who get to know the patients, who spend all day in and out of their rooms, who really get to see each patient progress day after day.

A "balloon" can brighten any day!
This nurse-patient relationship is so much different here.  First, because I work at a clinic instead of a hospital, patients come one day and I rarely see them again.  I don't get to follow them to see if they get better or if the medicine works.  Secondly, it's hard to form a relationship with somebody when you can't verbally communicate with them.  However, it's not impossible.  I've realized, more than ever, that this relationship is the very reason I love nursing.  Even at a clinic.  Even in South Sudan.  I make do with my broken Arabic, my patients' broken English, and plenty of motions.  Even though I only see each person for a couple of hours in a day before they leave, it's still plenty of time to let them know that they are loved and to try to provide them with the best care that I can give.  I get to snuggle with sick babies while they wait to see the doctor and blow up gloves to make balloons to give to the kiddos.  Every time I'm at the school and a child comes to find me to show me their wound or to tell me what part of their body is paining, I can't help but smile.  That's when I know that they trust me enough to share their concerns and know that I will help them.  It might not be the nurse-patient relationship I learned about in nursing school, but it's just as rewarding and fulfilling. 

Snatching babies to play with every possible chance I get!
Reflecting back on my first year as a nurse, I am so thankful to be in such a rewarding and loving profession.  I probably couldn't list off the pathophysiology and signs and symptoms of Cushing's Syndrome or Glomerulonephritis like I could in nursing school, but ask me about tropical diseases and I could talk for hours!  I don't think any amount of post graduate nursing experience could have prepared me for the types of diseases and conditions that I find here.  It definitely has been on-the-job training, but the same core aspects of nursing and the purpose of nursing are still present.  I am so grateful for all the things I have learned and for the opportunity to do what I love for the past year.  I can't wait to see what experiences this amazing profession has in store for me in the future!