Writhing and screaming, the toddler recoiled in fear from the needle that the “khawaja” (white foreigner) held. He couldn’t know that the medication would relieve the pain radiating from the infection in his hand. He was too young to understand what would happen while the anesthetic was in effect. The child’s mother sat beside the procedure bed, her hands knotted in her lap. An interpreter conveyed to her that Dr Rob would make a cut to drain the pus, and I hoped my smile offered some reassurance. As the Ketamine took effect and the boy’s cries subsided, my mind drifted twenty-four hours earlier. Could it be that I had only been here for a day?
One-hundred degree heat enveloped me as I stepped off the plane onto the red dirt of Doro’s airstrip. A group of local people had gathered to witness the arrival of the aircraft; their broad smiles, hand-shakes, and evening greetings helped me feel like I was among old friends. SIM missionaries showed me around the compound that I would call home for the next six months. After an evening meal shared with everyone on the base, I settled into my tukul (hut with mud walls and grass roof) that I shared with another nurse. My first night in Doro was spent mostly awake; the lizards rustling the grass roof, the humidity, and the mosquito net all were new distractions. It was excitement, however, that made every sense electric; the excitement to finally be in Sudan.
May 28 dawned overcast with rumbles of thunder. The plane that had carried me from Nairobi left early that morning, and as I watched it angle South, I felt very small in an alien land. I wanted to get acquainted with the people and customs in this new world as soon as possible. A wise nurse instructed that “to truly know a people, one must speak their language”. Back at the compound, I pulled up a chair to Tabitha, a Mabaan lady who was making lunch, and asked her how to say things in the local language. Our laughter at my pronunciations brought some attention, and a missionary gave me a book on learning Mabaan. I was relieved to have a foundation for learning the language, and a new friend.
I joined my tukul-mate, Amy, for a visit to the nutrition village later in the morning. She had nine malnourished children living there with their mothers, and they remained in the village as long as they required care. Amy’s responsibility was to ensure the health of the children. She oversaw the diets, medications, and daily weights of the children. We communicated with the mothers and children with the aid of Community Health Workers, (Mabaan men who went through health education training). As we were evaluating a mother with twins, one of the kwashiorkor toddlers walked up to us and held up a pitcher for his milk. Doman’s swollen face and large brown eyes gave him the appearance of a Cabbage Patch Doll, and he was adorable.
After lunch on the compound, I was eager to see the clinic where I would be working. I followed the path there with the SIM nurses that ran the clinic: Amy, Sandy, and Christiane. We passed the church, the nutrition village, and groups of tukuls along the way. Pigs, goats, dogs, and chickens wandered as they pleased and grazed in the open spaces between palm plants and wide Baobab trees.
The clinic consisted of a one-room building with a door on each end; the room was divided into five examining areas with one procedure bed, or “Emergency Area”. The room was alive with activity. Community Health Workers (CHWs) were seeing patients in all the stations; the nurses oversaw the CHWs, diagnosed, evaluated treatments and administered medications. Dr Rob examined more critical cases and taught the staff about how to diagnose certain conditions. Meanwhile, a crowd of people rested in the shade of trees as they waited patiently to be called to the clinic. There were over a hundred Mabaan and Falatta people to be seen that day.
I listened, asked questions, and absorbed as much as possible. Observing the assessment and diagnosis process was facilitated by the Mabaan language-learning book and a manual on tropical disease. One family in particular touched my heart. Sahdia was a skeleton curled up in one of the examining stations; she was too weak to lift her head or speak. Her malnourished daughter, Mary, sat listlessly beside her. Sahdia’s sister had journeyed to their village and brought them ten miles to the clinic. Sahdia was ill likely with tuberculosis, so she had seen the village witch doctor, Yaya. Yaya told her patients not to eat, so the emaciated people eventually came to the clinic with complications. Sahdia and her daughter were admitted to the nutrition village as inpatients for care. I reminded myself to check on the pair’s progress in the morning as a commotion from the emergency area drew my attention.
Dr Rob was evaluating the toddler’s hand that had swollen with infection after being poked by a wire. I held the toddler still as he received an antibiotic injection, Tetanus Toxoid, and the Ketamine. The boy drifted to sleep swiftly and Dr Rob, my uncle, made a small incision in the palm. As the doctor explored the wound and drained the infection, he explained how to avoid cutting nerves. I was fascinated by the process, and so thankful that the clinic had a fresh supply of Tetanus prophylaxis, which was not usually available. The procedure was over in a few minutes and the boy awoke soon thereafter. With the child in his mother’s arms, the family was prayed with, and my prayer was that they would know the love of Jesus. The body only lasts for so long, but the spirit is forever.
What a joy nursing is, and how wonderful to care for people with no other opportunity for medicine. But what a tragedy it would be if that’s where the care stopped! The greatest joy of all is a relationship with Jesus, and I left my first day at the clinic determined to keep His saving love as my priority. A physical cure is temporary, but only Jesus saves the soul and gives eternal life.
Pictured is a brother of a child being treated at the nutrition village. After seeing the picture of himself, the little boy laughed and laughed.
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