Have you seen this monkey?

Muddles is on the lam. It is alleged that he bit a lady as she crossed the road outside the hospital, though some say he was going in for a kiss but she moved. He has not been seen since and there has been the suggestion that mob justice punished him, and thus he fears to return to the area. Sightings of the furry fellow have been made in St. Josephs catholic church, where he was seen crouched by the alter trying to pronounce the words ‘Hail Mary’ without success.

Heidi, however, still carries ‘Monkey Stone’ wherever she goes. The smooth orb lies on the car seat overnight, and remains in her hand at all times outside of the confines of the concrete walls of the wards or offices. The staff now ask if she has it with her, and even suggest inviting Muddles for peace talks overseen by the Medical Director. Heidi has declined the offer up until now. Even when Heidi fainted after a long and hot ward round in the long stay ward, I came to find her lying on a hospital bed to which she had been carried, smiling, and with Monkey Stone placed carefully by her side, clearly rescued from the ground where she fell by the nurses.

Medical officers at their teaching

But what else has been happening? We had a meeting with the Head of the hospital to discuss the doctors’ attendance and reassuringly it has improved after some form of order was sent out from the top. The wards have now been divided between me and the other consultant so I look after the men, and he the women. This is working very well as you get to know the patients well, which speeds up the ward round and improves their care. The juniors have also divided themselves into two teams and this is allowing them to see the patients improve, providing them with some reward to their work along with seeing when treatments don’t work as well and getting a chance to ask why.

Some clinical medical students have started to arrive on the ward of their own accord. As we have previously mentioned, during the war the medical schools were moved to Khartoum in the North and now they are moving them back. However, all the lecturers are Northern and thus have not returned with them. As a result the 5^th years have had no teaching for 4 months and some have emerged from the four corners of Juba city hungry for some education. We have started teaching from our office one afternoon per week to these few keen students and with great results which is really uplifting, and have offered our services to the university so we will see what happens.

The junior doctors have gradually been appearing at teaching with increasing numbers and have started to do presentations themselves with us overseeing it all giving them feedback on their presentation skills which again has so far been a real success, and will hopefully continue. Bedside teaching has started as well as we are starting to teach examination skills and this is slowly taking off.

Heidi is working hard in theatres, focussing on getting the right drugs to provide a sustainable service there, rather than one that will cease as soon as we leave. Theatres are currently being tiled so little work is happening inside and Heidi is acting as the ultimate all-rounder, seeing medical admissions and the surgical patients.

A boat of returnees

Relaxation has largely focussed around the camp, with a few beers and Tangawizi’s on the water front. On a few of the evenings we have been greeted by the amazing sight of huge barges slowly cruising upstream to the port just upriver from our camp. The boats are crammed with people, on the bows, on the roofs, down below deck, in every available inch all cheering and ululating as the boat sounds its bellowing horn. These people are returnees from the North; Southern Sudanese who are finally returning home to help rebuild their shattered country and you can hear their excitement at coming home in their shouts, having spent many days on the river. These boats are followed by other barges, creeping through the pink haze of the evening sky, crammed with their belongings, including chairs, tables, donkeys; basically their entire lives piled onto a deck.

If you look closely you can see the little shop (next to the people walking) outside our camp

This is a view from the village looking at our camp (the green sign in the distance)

A picture of James enjoying a coffee - in the background is a flattened
patch of ground where a market was just a week before.

A common sight in Juba is small fires scattered along the streets
where people burn their rubbish, including many plastic bottles.