Submitted by sherron on Sun, 2010-09-26 00:00

The morning starts at different times for each person. There are a few alarm clocks one can choose from, from the soft sounds of crickets and frogs, the cock crows as the sun starts to go up, or drum beats from someone making music in the village. Usually the final wake up call comes when the Clinic’s facilities manager fires up the generator, which runs a submerged well pump and pumps water up into the storage tank in the Clinic and is used to clean the Clinic in the morning. It takes about an hour to fill the tank, which lasts the whole day. After that it’s the sweet sound of nothing, as an array of solar panels, donated by several groups and individuals in the United States, powers most of the Clinic’s other needs, such as laboratory equipment, satellite Internet, and nighttime lights.

The sounds penetrate easily through the tents where most of the staff lives. Staff who have homes in the village make their way to the Clinic by about 8am, where they take a light breakfast of tea and maybe bread from the night before. This morning it’s mandazi, a sort of fried dough, from last night’s dinner. Living together in the same place, the staff becomes very close and communal, sharing meals, jokes, and just about everything else, including the occasional hardship, and especially the successes.

Newton, one of the Clinic’s lab technicians and a skilled farmer, goes out to the garden to pull some tomatoes off the vine before they can be spotted by birds and eaten. The staff spends their weekends and some afternoons tending the garden, which is now booming and an example for the community in an area that could be the breadbasket for Africa. Mothers are taken through the garden when they come to the Clinic to learn about improved nutrition and farming methods.

 There’s already a group of patients, some who set off hours ago or even the previous night, through knee-deep flood water making their way to the Clinic. Walking is the only option now with much of the entire region covered by standing water from intense rains the past month. It’s hoped that the rains have peaked now and the waters will begin to recede by November or December.

 The staff spends the first half of the day with patients. The two Clinical Officers, equivalent to a Physician’s Assistant in the United States, will see 30 or more patients each in a day. Today is a Monday, so it’s vaccination day for mothers and children. Women in the area dutifully bring in their children’s health cards, a big step when record-keeping is so rudimentary compared with the West, though just as important. The midwife weighs each child and marks it on a growth chart on the child’s card. JDF is hoping to launch a nutrition program in the coming months to better manage children who are identified as being malnourished.

 The reasons for visiting run a broad spectrum, from malaria to HIV counseling to an older woman with a big cut on her hand. By the afternoon, the Clinic has received 80 patients, which is generally considered a slow day. A dozen patients come for their daily treatment for tuberculosis, the only place for more than a two or three days’ walk that can treat the disease.

 The staff goes for a lunch of rice and beans, a staple, since the cost of food is so high in the area. The expansion of the garden provides some diversity, including kale, tomatoes, corn, and in a month’s time and with careful tending, watermelon and pumpkin, amongst other seeds brought from the United States.

 After lunch, it was a haircut day around the Clinic. The Clinic’s pharmacist, Victor, gave cuts to several of the guys under a tree outside. The staff is in and out of the Clinic tending to patients as they come in. The Clinic has never closed in its history, after more than three years and 35,000 patient visits.

 Some afternoon storm clouds roll in and everyone braces for rain. The flood waters have already displaced more than 1,500 people in the village and thousands more throughout the county and region. Thankfully, there haven’t been any deaths reported, but the Clinic is on alert and monitoring the situation, responding to an increase in certain illnesses. The rain came for just 15 minutes and was gone, making way for a beautiful sunset.

 It was a special dinner, with a simple but tasty beef stew and bread. Earlier in the week someone in the village butchered a cow, a rarity since cows are usually only slaughtered on special occasions. With the remaining solar power, some of the staff watched TV as they ate, usually American or African movies brought from the United States or Nairobi. Some of the staff, several of them who come from Kenya, checked e-mails from home before turning in for the night, prepared for what the night might bring—a late night delivery, which would call out of bed the midwife, clinical officer, pharmacist, and perhaps a lab technician for blood typing or disease screening. 

In a place where health care is still so limited, the Duk Lost Boys Clinic is an example for what can be done throughout the region and South Sudan. It’s how day in and day out, the Clinic is transforming healthcare in South Sudan.