First trip to the Field

I am just finishing my first field tour, so I have a better idea of the work we are doing here in Darfur.

In Zalingei, our main work is with the local hospital, alongside the government’s hospital staff. We work mainly in the services that see the most IDP (internally displaced population – this means refugees inside their own country) camp patients: emergency room, pediatrics and a therapeutic feeding center for undernourished kids. We also have home visitors who go into the camps to refer patients who need help to the hospital and get a general feeling about the number and condition of arrivals in the camp.

For the moment, the number of undernourished kids is increasing rapidly, so we have just opened an outpatient therapeutic feeding program (OTP) in one of the camps. This program provides therapeutic ready-to-use food to undernourished kids who don’t have any associated pathologies, to be taken at home rather than in the hospital. This kind of program allows us to treat more kids with fewer resources during this peak period. They are followed on a weekly basis until their weight comes back to normal. Of course, the kids with pathologies enter into our therapeutic feeding center at the hospital so that they can be followed medically.

We feared an outbreak of cholera here. A treatment center has been set up, but fortunately, there is no need for the moment.

The staff in Zalingei is great. Some of the high level national staff live in the same house as the expats, and the atmosphere is really good. We spent some late nights talking, singing, and watching old Tom and Jerry cartoons.

Niertiti is a very small town with two very big IDP camps. It is closer to the fighting zones; we heard some heavy artillery fire Saturday night. We run our own 42 bed hospital (emergency room, maternity, pediatrics, therapeutic feeding center, women’s ward, and men’s ward), which currently has about 70 beds. It’s a bit crowded, but activity is decreasing here. In cooperation with the government’s health care service, we also work in an outpatient clinic which includes a women’s health program. Both of these operations were set up for the IDP camps, but we get people from the town as well. We also have a big home visitor set up as in Zalingei.

We usually transfer surgery to the Zalingei hospital, but sometimes there are situations that call for small surgical interventions to save lives. This includes primarily cesareans. Some women walk several hours to get to our clinics and are pretty far along when they arrive. Zalingei is about 1 ½ hours away when the security is good and when we can arrange for transportation. We have doctors who are capable of performing these operations here in Niertiti if necessary. So we are preparing a surgical annex with the basic equipment necessary for these emergencies.

We also have two outlying clinics: Thur and Kutrum. I got to visit Thur yesterday. It is a small outpatient clinic much like the one in Niertiti. We have 600 consultations a week, and the medical team goes from Niertiti on Tuesdays and Thursdays only, joining local employees on site. People come from quite far away, because this is the only clinic around.

Kutrum is in the Jebel Marra area, an area with a lot of fighting. In fact, we have been prohibited since the middle of August from going there because the security of our people cannot be guaranteed. It seems that this travel restriction may be lifted so that we can return this Saturday. The team from Niertiti leaves on Saturday mornings to join the local employees in Kutrum, and they return the following Thursday evening. This clinic is again along the same lines as the outpatient clinic in Niertiti and they also get about 600 consultations a week.

In Niertiti, the office, expat compound and national staff compound (for Sudanese employees who work in Niertiti but were recruited in other cities) all touch, but are sort of divided. It makes for a lot of intermixing, but allows some privacy, too. Niertiti is a lot colder than our other locations, being at an altitude of about 1200 meters. They say that Kutrum is a paradise. It is higher up the mountain and is known for its delicious oranges. Unfortunately, with the travel ban, I didn’t get to see it this time.

Tomorrow, it’s back to El Geneina where I have to finalize the August accounting by the 15th. We have a big coordination meeting the 17th to decide on actions up until the end of the year. And based on this, I have to complete a budget which must be in Paris on the 20th. I don’t think I will sleep much until the 21st. Then I need to go back to Niertiti to help them prepare the pay for their staff at the end of the month. It’s good to be needed.