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My typical day - I walk to work about 7.30 in the morning, which takes about 20 minutes and I see all the kids heading off to school in their bright coloured uniforms, the market opening for the day, people brushing their teeth on the roadside, donkeys pulling the water carts from the Nile and people going about their morning routines.
I arrive at the hospital and start up the generator for the office, then I usually spend half an hour checking emails and waiting for the field officer/interpreter I work with to arrive. His name is Andrew and he is a lovely man from Malakal who worked with MSF for a long time during the war. He has some great stories and provides insight for me about the culture, tribes and general life of the local people.
Andrew and I usually spend the morning in the wards - we look after four of the surgical wards and help the local staff to manage these patients. We do a ward round to see all the patients, stopping to see how everyone is, offering pain relief, helping with wound dressings, checking vital signs and offering bedside teaching and advice to the local nursing staff. Most of the patients have a family member who stays with them and will help with toileting, washing and feeding the patients. It’s not unusual for these caregivers to tell me through Andrew that they have headaches, fevers, sore backs - the list goes on, and the ward round takes even longer. If there are new patients then I let our surgeon know so he can review them and decide if they require surgery or not.
Although the majority of our patients are from Malakal, many come from villages many miles away and have spent days walking to get to the hospital. Some patients arrive with wounds that are badly infected that are days old, and have caused terrible swelling and infection. The smells and sights on the wards at times are not pleasant and with the heat, flies and lack of electricity, these are often compounded.
After our rounds I update my list, often keeping track of 60-70 patients each day so I need to write everything new from the rounds down to remember what I have to do. On a Monday and Thursday we have a big round with the surgeon so this usually means lots for me to do afterwards. In the afternoons I am usually busy getting the post-operative patients from the day organised and administering antibiotics, fluids and pain relief and through Andrew showing the local nurses what needs to be done for them.
There are many challenges in the day. Often lack of equipment is a problem, for example having no x-ray films, and the hospital running out of many essential supplies, but we seem to tick on and find creative ways to manage. One of the biggest challenges is dealing with the heat and my own tiredness. We tend to work 10-hour days Monday to Friday and at least a half day on Saturday, and it’s not unusual to also go in on a Sunday to check on sick patients or be called in for emergency surgery.
I work with a great international expat team from all over the world. At the moment the surgical team consists of a surgeon from the Philippines, an anaesthetist from Italy, an OT nurse from Kenya and myself. There are also other members of the team who assist with managing the project, hospital administration and water and sanitation - it’s a busy little place.
So another walk home at the end of the day, a much appreciated and needed long shower then a cold beer on the deck with whoever is around, watching the Malakal sun set over the local mosque.
Three months in and three to go, I am enjoying my time here, learning lots about the local life, traditions and language. This week I had a lovely moment when one of my patients’ caregivers named her new baby “Erin” in my honour. I was really delighted and it’s moments like this that make being a long way from home so worthwhile.
Erin O'Connor is working in Malakal, South Sudan as part of the New Zealand Red Cross delegate programme which has been running since 1960. The programme is currently supported by funding from New Zealand Aid Programme through the Ministry of Foreign Affairs and Trade.