Three weeks in Doroji!

I arrived at my home in Doroji three weeks ago today. I am half way though orientation and have made friends of the other 14 missionaries on the Doro team. Life is very much like camping here. I take showers under the stars with a bucket fashioned with a nozzle like thing allowing me to open and close it to let out the water. I'll cook over a coal fire and sleep under a mosquito net in a building made of wood, mud and grasses. I have at least 10 itchy mosquito bites at any given time. Frogs, crickets and other unknown critters sing me to sleep and occasionally wake me during the night. Water comes from a borehole pumped by hand by a gentleman who uses a donkey cart to bring it to us. It is stored in barrels where we dip out what is needed to wash with, cook with, and drink (after it goes through a Katadine filter).

My main mode of transport is my feet, but I will be purchasing a bicycle in the near future for destinations further than 30 minutes away. My roommate and I have a solar system in our tukul that allows us to use a light bulb at night and has a converter to charge our laptops and cell phones. It is kind of funny that we have those electronic connections with the rest of the world when the remainder of our lives is very low tech.

Four or five days a week I work in the Memorial Heath Care Clinic and one day a week at the Nutrition Program for malnourished children. The clinic is a busy place where seven graduates from our Community Healthcare Worker training school do the patient check-in, initial assessment and make a potential diagnosis and treatment plans. Then one of the nurses reviews the patient history, physical exam and helps confirm the correct diagnosis and treatment plan. The interns are still in the learning process and need guidance, teaching and reminders. Critical thinking skills are not developed as a general rule in the primary school system in Sudan and an 8^th grade education is as far as most of these men were able to go before getting in the Community Healthcare worker program. The goal is to have them prepared to diagnose and treat the people independantly. We want to equip them to help their people and work ourselves out of a job.

Nurses currently do all the injections, IV medications, deliveries and invasive procedures. There is no doctor stationed on site so when we are stumped on a diagnosis or when the patient is not responding to treatment, we consult via telephone the SIM physician based in Kenya. I have much more to learn about conditions specific to Tropical Medicine and malnutrition. Please pray for retention of it.

The Maaban people often wait until they are really sick to seek treatment and having malaria makes them miserable enough to come and get help for that and the other conditions they often just endure. Others might not be that sick when they begin the trip to the clinic—but when it takes them 2-3 days to walk there or be carried there—they are very sick when they arrive. The average patient gets treatment for malaria in addition to another acute illness.

I have seen many conditions here that I have never seen in the US. Malaria, Leprosy,
Onchocerciasis, Lymphatic Filariasis (formerly called Elephantiasis--caused by a bite from a particular mosquito carrying a worm larva), malnutrition, amoeba, giardia, scabies, infestations of various intestinal worms, and dysentery. Most of these are caused by coming in contact with or ingesting contaminated water and from lack of sanitation and overcrowding. In our nutrition program we have children with some of these conditions and complicated by their malnourished state, they do not have the ability to compensate the way an adult does. The mortality rate for children under five is tragic. We seek to decrease unneccesary deaths by education for the adults and treatment of the children. I will write more about the Nutrition Program in another post. It is separate from the clinic and has a pace and personality of its own.

On weekends I've been visiting people in their homes, shopping in the nearby market, eating Maaban food and doing a bit of exploring with some of the other missionaries. Weekends have a very different pace than then clinic days. I'm thoroughly enjoying getting to know some women and children and learning the culture while forming friendships. As I am becoming more comfortable with the bush life and medical work-- I find I'm relaxing more and beginning to get the rhythm of the village. It is lovely.

Transplanted into this different world I've learned much about myself. I feel like my life back in the States is a lifetime and world away. I'm excited about how God will grow me and shape me to be more life Himself as I'm stretched by challenges and influenced the the acceptance and hospitality of the poorest of the poor in the Sudan bush.

"Even (our) most original thoughts or imaginative creations are indelibly shaped by a lifetime of encounters with artists, theologians, family and community. We do not interpret the world alone nor do we live without influencing one another profoundly." --unknown