In the coming days and weeks, I want to lead the discussion in the area of AIDS, fighting the deadly virus that is threatening us in South Sudan.
For today, listen to this report on IRIN Radio from Nimule, to get the taste of things to come. You will need Real Player in order to listen.
A long time ago, I came across this quotation attributed to Sir Humphrey Davy Rolleston, a physician to King George V: “Medicine is a noble profession but a damned bad business.” I am not sure about the context he said that, but at least it rings true for the doctors in Sudan, if at the whole of Africa! Let me explain.
Doctors are poorly paid in Sudan. It has been like that for ages. When I started my work as a junior in early 2000, man we were paid pittance! Our colleagues in the other fields used to laugh at us. And we felt real bad. After spending more than six ears in the university, no one appreciates your work!
You know what, they always say medicine is a humanitarian service, noble etc. However, they forget hat even doctors need to eat, dress, rent houses, feed dependents, transport themselves and get married! How can one be in the same society and be excluded from other basic needs? Another wrong concept is that you can supplement that by opening a clinic! When other people are resting and talking to with their families, you are runing back to the private clinic!
The attitude of our guys in the ministry of health these days is still the same. They forget that the doctor need to be cared for like they care for other professionals. I know now why many decide to serve outside government service just to survive.
The government need to re-structure the salaries of doctors, support them in all ways possible. When he is not cared for, it will definitely affect his professional work, when he becomes divided between looking after his patients and running around in the market in search of money! This is suppose to be secondary. Our patients come first.
It may not be true for many doctors, who have abandoned government service, gone “full” private in their big clinics to make big money. The little ones hanging around in the hospital OPD are the losers . . . It certainly makes medicine bad for business.
I will tell you next time why I decide to go “private” . . .
Sometime ago you will find a very famous little poster hanging in many offices in Juba. I used to have one in my little shack too. It is the one about alcohol drinking. It is called “I am call alcohol” or something like that. The little posters say “I” kill and do all sorts of things: breaking up families, destroying jobs, etc. It is no longer to be found in Juba, or the ones that are present, probably hidden somewhere collecting dust.
Just afew days back my next door neighbour was found dead in his house. Friends say he had been drinking all the hight before. And the diagnosis: “ketuk”! Last week another guy was brought into my clinic, very sick, with signs of liver failure. He had a very long history of drinking.
There are many stories in Juba in the past, with very similar endings, like people being found dead under trees. Now the phenomenon has gone up several scales for the worse. Many people are talikg about the epidemic of drinking in Juba, but nobody cares to do anything about it. The unfortunate thing is that people continue to drink during working hours, in the offices.
Moderation is the key. When alcohol consumption begins to interfere with your life, know that you are on the way down. With bars springing up in every corner of town, regulating it will be a tough job. I believe we have other pressing matters to deal with, but it is clear that the effects are being stored for a life time of troubles. A public health disater.
I think I will look for that poster again and hang it on the wall in my clinic. It will be a small step, but I know my patients will read it.
Just the other day . . . (sorry folks, will tell you later!)
There is a great sense of mistrust about anything coming from Khartoum, from the bottled water to salt and pepper. The citizens of Juba, especially those who came in after the peace don’t buy “Jalaba” things. They are turning to anything East African, prefering “Rowenzori” water to “Crystal” or Safia” from Khartoum! This paranoi is something that is quite evident. But what has that got to do with medicine? It is getting into drugs now . . .
In all my life, I have never seen a real life Masaai warrior from Kenya, but I was shocked to see one in Juba the other day. Just outside my clinic in Konyokonyo market, there was this tall guy, wearing only a red blanket wrapped around his body, carrying a small bag and peddling some things in his hands. It turned out this guy is selling some traditional Masaai medicine, wrapped up nicely and labled too! It reminds me of the Chinese coming all the way from China to sell small boxes of “vics” or whatever in the streets of Khartoum!
However, it got me thinking: if the Masaai man can get into Juba, set up a stall and start selling drugs, what is the bigger picture like? The world is amassed with counterfeit drugs, sold cheaply, but could threaten lives. With the new porous borders of south Sudan, lacking any controls, let alone regulation of medical imports, we are in for a big trouble. You can now find drugs in Juba that are said to “be stronger” than the ones brought from Khartoum! Just go to custom market!
We need to set up that body, like the “Central Drug Stores” that be our own FDA to control sale of drugs, license pharmacies and drug stores, analyse new drug imports for quality, etc. By the way, FDA is the American Food and Drug Administration.
It will be a disaster if my patients use my prescriptions to get fake drugs and die. Am I not implicated, by proxy? Think about it.
I have just seen my last patient and I think I will tell you what is bothering me. You see, I have only this lttle clinic that caters for simple problems. If patients have bigger problems that need further care and hospitalization, I refer them. However, I am planning to have my own “little” hospital some day.
Anyway, my problem is that, when I refer patients to the hospital, they don’t get the necessary investigations and other things as expected. The hospitals are lacking in basic equipments. But this is true: some months back, a judge in Juba died because there is no nebulizer in the hospital! He had an acute attack of asthma and died, with the doctors watching helplessly!
Imagine that! What a disaster. I wonder where our ministers go when they get sick. True, we heard some these days fly to South Africa or Uganda, scrambling a plane at short notice. But what will happen between the time of preparation and actual flying out? Acute illnesses are acute and you may quit the earth before you call your grand mother’s name. Equiping Juba hospital makes good sense, not only for the honourable ministers, but also for the common citizen.
We may lack the cadres to man most equipments, but with proper planning, we could get them into trainings, etc. There should be a budget somewhere for capacity building in the medical service.
As for my little clinic, it will continue to serve as best as it could. Who knows, maybe the dream of the bigger hospital may come true one day
Last weekend, I closed my clinic early, for lack of patients and since I had enough time to kill, I thought I should go for “cold one”, just for the road. I don’t like those young people who are killing themselves drinking (that is a topic for another day, anyway). I went to Bros, which is much nearer my clinic in Konyokonyo. Before the bar ladies came around, my jolly old colleagues came in, laughing and talking loudly.
And to my surprised, one of them ordered free drinks for everyone. Being the old guy in the company of young doctors, I wanted to know the cause of their celebrations. Has someone decided to get married? One of them laughed, and said I maybe the only who didn’t know what happened. He said people in Juba are giving a sigh of relief, for something long over due: the removal of the GOSS Minister of Health!
He said this guy has never delivered a thing, apart from chain smoking and drinking himself to death. To make it worse the ministry has been riddled with scandals and schemings that line the pockets of those concern.
For example, being the capital of South Sudan, Juba Teaching Hospital should be first grade. But alas, it remains in shambles, despite the face lifts and paintings it is getting these days. The out patient is too small and run by paramedics, instead of doctors. If not for the Red Cross, the hospital would have run down long ago.
And the Minister is sleeping, he continued. He entered into dubious deals with the Normeca group to build hospitals at costs that can make your head spin. The hospitals are also prefab buildings, not permanent, for God’s sake.
You see, my friend seems greatly relieved that it has at last happened. And what of the new guy in his place? Well, he said the new guy seems to be tough, for he had gotten things moving from day one. Phew!
I guess if all goes well, I may go back to work in the ministry. Otherwise, the clinic in Konyokonyo will still receive patients. I will have a glass of juice for that instead. Good bye, Mr. Minister.
Have you ever entered a toilet and wished you had gone to the bush around the corner? Phew! I am not advocating that (as my previous post stated) but the state of our toilets leave a lot to be desired.
In most countries and in peoples’ homes, the toilet is the most private place for quiet thinking as you answer nature’s call. I have seen houses where they keep stacks of magazines and newspapers on the side for you to read. Splendid.
Unfortunately, in South Sudan, say we lack a lot. First we squad in what is called the pit latrine or the VIP – ventilated improved pit latrines. Secondly, we lack running water to use the modern flush ones. Unfortunately for us, we construct the modern ones and don’t care for it after that.
Have you passed through Juba International Airport and used the toilet at the waiting lounge? That is a shame, I tell you. With Juba Airport now the hub of South Sudan, receiving international direct flights from Dubai, Addis Ababa and Nairobi, and hundreds of international people passing through it, the state of the toilet is wanting. (Maybe the VIP section has better facilities).
Sitting in the airport the other day, Dr. K. K. answered nature’s call and found the shocking state of the airport’s toilet. It is the flush modern, seat toilet but you couldn’t recognize that. It is dirty, smelly and the seat is even off. Urine all over the floor. The worse thing is that the toilet is part of the lounge and its top is off, with the pungent smell of urine and what-have-you filling the waiting area. At least, they should keep it clean, employ someone to do it.
They say you know the man by the state of his toilet. Does that tell us anything about the state of our country? You reach your own diagnosis.
A long time ago there was this famous slogan: keep Juba clean. How I long for those days! Alas, with the new regime in the Ministries, and lots of people pouring into town in droves, keeping Juba clean is a dream from another world.
Juba has become an unhealthy place, even for the flies that reside in it. There is gabbage everywhere, especially around the markets, next to my clinic in Konyokonyo and custom. Children defecate wherever they want, behind tress, under the trees and in old buildings. I wonder where the guys from “Mejeles” are. They use to do a good job of keeping Juba clean.
Nobody seems to bother and the flies are having a feast everyday. When cholera strikes, people run like mad. Keep Juba clean, fellas.
