Sharing The ChAdventure

Rush hour

Its only been four weeks, but how quickly the intense heat and the all consuming dust fade into vague memories... surely it can't have been that bad!?! The people I've met, the many many experiences I've had and the love I now have for Chad and its people will however continue and will probably never truly leave me. The final week was a busy whirlwind of activity, packing up my house and bags, tying up loose ends, but in the busyness I was able to say goodbye to friends and even manage to enjoy for the last time the unique experience of the Chadian rush hour...

A post ward round celebration with the nurses
on my last day of work

A good bye party with the hospital staff, complete with cake
(I couldn't say it was a 100% sweat free cake, but near enough...)

Packing, while feeling the heat.....

This will be my last post and far from having anything particularly ground breaking or inspirational to write, I just want to say two simple words; Thank you.

Thank you for the interest, support and encouragement you have shown me over the past 5 years, in other words, thank you for sharing in my ChAdventure! (Sorry, but I'm chuffed with that word!) For those of you who would like to hear some more of my ChAdventure (you bored of it yet?), I have the upcoming speaking dates lined up and would love to see you there:

• Thurs 9^th July, 14.30, Rugby BC
• Sun 12 July, 9.30am and 11.15am, Guiseley BC
• Sun 19^th July, 10.45, Abbey Centre, Northampton
• Sat 25th July, pm, Budleigh Salterton BC
• Sun 26th July, 10.30am, Budleigh Salterton BC
• Fri 31st July, 19.00, Earl Shilton BC, Leicester
• Sun 2nd Aug, 10.30 and 18.30 Didcot BC

 Its been a strange mix of emotions coming home; excitement, apprehension, guilt and joy. But now its time for the next adventure, wherever and whatever that may be.....

Receiving a warm welcome back to the UK

What a ChAdventure!

I can’t quite believe it has arrived, but my time in Chad has come to an end! It has been an incredible four years with many highs and lows, surprises and challenges along the way. In a word, it’s been a ChAdventure! Here, in no particular order, are just some of my most memorable moments….

Guinebor II

Working at Guinebor hospital has been a real privilege. It’s been hard, challenging wonderful, frustrating, encouraging, sad, a joy… a whole mix of emotions and experiences. It’s been fantastic working alongside the Chadian staff, watching them develop in their skills and knowledge as nurses, but also to build up good relationships with them along the way. And at the same time, develop my own skills as a nurse too.

One of my little patients awaiting major
abdominal surgery

Neonatal resuscitation training with
 nurses and midwives

Due to the nature of the hospital, the clinical work has just been one part of everyday life here. Some of the more bizarre moments include finding myself giving gardening lessons to the guards who wanted to prune the trees, towing the ambulance out of the thick mud in which it got stuck while trying to pull out another vehicle, or chasing away various members of the animal kingdom from the wards, lizards, cats, spiders, birds, without a second thought. I also come away from this place, knowing far more about generators than I really think is necessary.

Rescuing the ambulance

Gardening lessons

Mariam vaccinating

It wasn’t something that I foresaw as being my role when I came to Chad, but other than working with the nurses, the majority of my time at Guinebor has been developing the malnutrition and child services the hospital offers. All children under the age of 5 are now measured and weighed to assess their nutritional status, there is new clinic, run by Mariam, devoted to following up malnourished children, providing health promotion, free nutritious food and vaccinations for all. While the inpatient treatment and care for children admitted with severe acute malnutrition has improved. This project has been a huge learning curve for me, but working with these children, their parents and especially Mariam has been my greatest joy here in Chad. To see such sick children become well is just incredible.
Here are just some of the children treated and helped through the malnutrition project....

Khadidja                                      Youssef                                          Moustapha
\Baby Rebecca                                                    Twins, Zakira and Zena

Friends and Family
The hardest thing for me to leave behind in the UK when I came to Chad were my family and friends. And yet, in coming here I have found my Chadian family and friends (cheesy but true!).

With Mama

In my first few weeks in Chad, living on my own in a noisy neighbourhood in town, I was determined not to be trapped within the four walls of my flat. So, each evening at 4pm, I forced myself to go for a walk around the block, and I hated it. It was hot and dusty, I fought with my newly acquired head scarf, trying to keep it in place, I passed men who hissed and whistled at me, all in the desperate hope that someone would speak to me and not just eye me with suspicion before turning away. Eventually I heard the words I’d been longing to hear “Bonsoir, ma fille”. That was all the encouragement I needed; off I went traversing the dusty rutted track, negotiating the thick green slime of the open sewer, to sit down with the round and kind faced old woman with swollen painful and immobile knees, who I now call “Mama”. Her daughter in law, Felicity and her three granddaughters, Mya, Joanna and Paulette are now my Chadian family.

Visiting Felicity, Mya, Jo and Paulette

During my time in Chad I've also met many people from around the world and have made some very close friendships. Just one of these friendships was with Claire who ended up sharing my house while she worked for 9 months as a Pharmacist in the hospital. Games nights, singing 90’s classics in the kitchen, doing gardening (well, a form of) in “sack” dresses and flip flops, escaping into town for ice-cream when it all became too much are just some of our memorable moments.

Creating culinary delights with Claire

But there have also been some incredibly significant and precious visits from the UK: my Mum and friend Louise. I didn’t realise until they came, Mum in my first year and Louise in my second, how much I missed having people who knew me so well and their presence highlighted to me how different my life had become, how what was now ‘normal’ to me, hadn’t always been. Both of their visits were highlights for me and I still can’t believe they actually came!

Fun with Louise

With Mum at Elephant Rock

Getting creative

Celebrating Thanksgiving with
American friends

With very little available here to offer any kind of distraction, to survive, it is essential to make your own entertainment. This may come in the form of the greatly exciting “Guess the 10 fruits in the 10 fruit cocktail juice” game that Claire and myself developed on one particularly exhilarating Saturday breakfast, or temporarily taking on another’s cultural identity for a few hours to celebrate their national holiday, such as Thanksgiving. Basically, recreating, or creating, any celebration with a Chadian twist, usually revolving around food where the hard work in searching and the excitement in finding or creating an alternative adds to the air of anticipation! Having said that, one of my best Christmas celebrations here didn’t involve food at all, but certainly did offer a very Chadian twist- camel riding on Christmas Eve! Across the dry, dusty golf course…. Like you do…..

Camel riding across the golf course

Celebrating Chad style

Celebrating with the staff wearing the hospital's official
fete materiel

One of the highlights of being in any different culture is to be a part of the fêtes, and with the Chadian tendency to take even the slightest excuse to celebrate, there have been many to be a part of here. Of course there have been the obvious celebrations; weddings, baby naming ceremonies, engagement parties, where bargaining in high spirits for the bride price provides great hollers of laughter and fun. But there have also been the ones that, at least to me initially, seemed a little more bizarre, such as the shipping container opening ceremonies.

While less jovial, being a part of funerals and offering condolences to people have offered a precious insight into the Chadian culture and provided a great opportunity to come alongside and identify with those I have lived and worked with.

Rose receiving her wedding presents

Time to Explore

Walking in the footsteps of elephants

Having said there is a limit on what is on offer in ways of distraction and tourist attractions, I have taken two holidays in Chad, which were fantastic. The first was flying across Chad to the far east side to a national park called Zakouma, which has to be the least visited national park in Africa. It was beautiful with most of the cast of the Lion King appearing, and yet, due to the lack of tourists and rules, frequent stops and going for a walk alongside crocodile infested waters, and lion roaming country added to the excitement!

At Zakouma Park

My second holiday was also to the east of Chad, but rather than a couple of hours flight I took the 12 hour bus option! Not nearly as comfortable or easy, but certainly more interesting! I went to visit some close friends and enjoyed a fantastic week of relaxation, visiting neighbours, going for walks and picnics along a dried wadi and excursions to the market.

       

Am Timan market

What’s in a name?

In the UK, I go by a number of different names; Rebecca, Becky, Becca, Bex. But here, I can add a few more to that list:

Nasara- It took me all of a day having arrived in Chad to realise that local children were pointing at me while shouting “Nasara, nasara”. This term meaning ‘white person’ in Arabic I didn’t particularly relish at first but was soon reassured that it was not meant as an insult, more one of recognition and description.

Rebecca Jolie- This is the latest one I can add having seen it just this week on Felicity’s phone. Very sweet, if a little generous!

La mere des enfants- The Mother of the children. This was a name I was frequently given by the relatives of patients when I worked on the paediatric ward, especially with the malnourished children. Because many of these children would spend a long time on the ward, they often got over their initial terror of a white woman as I spent time helping the mothers give the milk and the other cares they needed. It was an honour as well as humbling to be given such a name.

But my favourite? Madam Guinebor- As I get out of my car at various places around town, this is frequently shouted to me, along with a greeting and questions on how the hospital was going, often from people I don’t recognise at all. I assumed this was simply in response to me driving a car with the hospital’s name on it, but there have been a few times when I’ve been in town in a plain car and the same thing has happened, “Madame Guinebor, Madame Guinebor”!!

Random acts of kindness- from free truck rides when stranded, assistance changing tyres or being pushed off the middle of a chaotic roundabout when the car has decided once again that this would be the perfect time and place to breakdown, invitations to join patients and relative in drinking tea on their mat, towing me out of mud when stuck (after standing laughing and pointing for a while first!), receiving a gift, I could go on… These are just example of some of the random acts of kindness that I have received here that have come at the least expected time and have brought me great pleasure.

Culinary delights- Grasshoppers, goat, camel, undistinguishable meat, gombo sauce (slimy boiled okra), boule (flour and water mixed to form a solid paste), quisa (big spongey pancakes), kakanje (flower used to make a sweet juice or I cooking), capitane (white fish), mangoes…. Just some of the delights I’ve eaten here, some more desirable than others!

Grasshoppers, a local delicacy(?)

              

Everyday life
With climbing temperatures, unpredictable driving, thick dust or oozing mud, or overheating fridges, the list could go on and on. But suffice to say, these are just a few of my highlights and significant aspects of life over the past four years, in what can only be called, a ChAdventure!

D.U.S.T

Dust is an inescapable and prominent feature of life in Chad, and its presence has been especially felt over the last couple of months. Now, before I go any further, let me just say that there is no dust like Chadian dust. It is not the light covering that settles in the lounge and can be ignored for a few days (!) but a fine powder, like talcum powder, that invades every space, every nook and cranny, it crosses barriers such as rubber seals around the cooker, and pays no heed to any vain attempts to flick it away with a duster. No, it’s a flighty, invasive being that, while at times may lull you into a sense of its innocence by being ever present, irremovable, irritating, yet gentle, every so often, it exerts its full force of chest rattling, mouth crunching, air choking power.

Many mornings, on waking, the sun is to be found shining strongly without a cloud to be seen in the bright blue sky. And yet, recently on waking, a thick fog seems to have descended overnight, covering everything with a dull sickly grey casing the landscape to take on a monotone muteness. The full force of the dust has arrived….

The dust fills the atmosphere

If, for some reason, you should you ever find yourself in such a dusty place as the Sahara desert, here are some of my tips for survival and warnings as to what to expect in the D.U.S.T:

D- Deep Breath.

Breathing. An activity that for much of the times takes very little effort or thought for the majority of people. And yet, when the air so thick with the dust, that as you go about your day you find yourself crunching it in your mouth, feel it coating your eye lashes and can see tracks as the sweat pours down your face (sorry, not the most attractive picture!), it’s not heard to imagine why so many people at this time of year have problems with their breathing. But for some reason, this year has been particularly bad which is very obvious to see here at the hospital with the high number of children hospitalised with severe breathing problems.

The one available oxygen concentrator, run by a small generator, has been working almost full time to help these children in the first day or two of their treatment. But one concentrator and many children? Yes, it’s been time to be creative once more! Out with plastic ‘Y’ pieces (no idea what they are actually meant to be used for but they’re helpful here!), oxygen extension tubing, chopped up oxygen tubing usually placed into nostrils to provide two way oxygen supply, sticky tape to hold it all together, upturned plastic kidney dishes to mark the tubing criss-crossing the floor, secured in place with a well-placed rock and hey presto, you have oxygen supply for a maximum of four children!

The battered and well-worn concentrator has worked hard, but it has literally been a life saver!

Our hard working oxygen concentrator supplying oxygen
to 3 children

U- Undercover.

As the dust invades there truly is no escape, there is nowhere to hide. So the best way to avoid the unpleasantness of continual fruitless cleaning is to go undercover. Close all doors, shut all windows, draw all curtains. Forget the sweltering heat and the lack of ventilation this has now caused, close up and keep shut up until the dust has relented.

These efforts you understand of course will not prevent the dust entering, merely reduce it. You will still find that on opening a cupboard, your food inside has a cover of dust and the inside of the cooker you can write your name in. 

In fact, I’ve come up with a new game recently. It’s based on Kim’s game where you put things out on a tray, memorise them, hide the tray and see how many you can remember. The Chad version is to leave a selection of items on your table at the start of the day. Go to work come back, lift off each item and then based by the outlines in the dust, identify the items!

Kim's game, Chad style!

Sadly, while the house can be shut up, work and life still call for attention and so for myself, I appreciate another role the required head scarf has- reduction of dust in ears and hair. Sunglasses are worn despite the lack of sun and as for the rest of me, a regular dust down is required to keep from myself taking on the monotone grey of my surroundings. 

But it’s the Arab men that are really sorted for this weather with their white turbans wrapped around their faces, exposing their eyes only. While a new fashion statement is seen all around town- eye covers usually used to aid sleep are seen sported over the mouth and nose, acting as a filter.

Talking of questionable fashion statements, attractive 'tan lines' are not uncommon:

The 'tan line' on my friend Claire's legs at the end of a meeting
that took place inside, while a sand storm raged outside!

S- Shut down.

The disruption brought by the dust is not restricted to the individual alone. The airport experienced shut down as several flights to Chad were diverted or cancelled completely, some for several days, due to the poor visibility and potential risk to planes.

T- Top Tips.

Despite all your best efforts, the dust has won. The house looks grey, as you walk through the lounge you can see puffs of dust rise around each of your footsteps, you wash the dust off your face with water pouring from the dusty tap and after you dry your dusty face on a dusty towel. You pour yourself a cup of water in a dusty cup and as you set the dusty cup down on the dusty table you here the subtle but distinctive crunch of the cup displacing the dust. 

What now? Take as a deep a breath as you can without setting off into a coughing fit and reach for the duster. And at this point, here is my top tip following a dust storm: the temptation is to give everything a good clean and wash with water. Mistake. All that fine dust then turns to mud, which streaks and smears. Dry dust, then wash with water. 

Then watch the dust resettle and carry on with your day.

At the end of the day, the clean up begins...

Dignity

Sunday, 8th March, was International Women’s Day. Despite the word “International”, I have to confess, that until coming to Chad I had never heard of the day, never mind spent the 8^th of March, along with hundreds of other women, celebrating by marching, eating, dancing and singing together. All the time bedecked in hurriedly made clothes in the official material, decorated with slogans broadcasting the rights and importance of women!

Celebrating this years International Women's day with hospital staff

Here, in a country where a women’s status is largely found in her social circumstances, where her voice is rarely heard, and in a country listed as having the top five worse maternal mortality rates, acknowledging and promoting women is not only an excuse for celebrating, but is essential to offer women protection, value and a sense of dignity.

Esther dancing with friends

Since being in Chad, I have meet some truly inspiring women, ladies who have persevered through some incredibly difficult circumstances. Women such as Esther, a colleague of mine at the hospital, who, having married at a young age and had several children, watched as her alcoholic husband spent all of her earnings leaving her and her children without food. Eventually her husband left Esther for his mistress, leaving her with no provision, but 4 children to bring up and get through school on her own. With hard work and determination she has done so, and yet the challenges continue for her as she is now takes care of her daughter- in- laws child who she has abandoned. And yet Esther is frequently found to be working away singing at the top of her voice, or on her day off, teaching local women how to knit.

Or there is Yvette. A young very bright lady who was able to get a good education and has worked incredibly hard resisting much criticism at her desire to further herself. But now finds herself unemployed, despite a degree in management and having had many job interviews, because she will not sleep with the potential employer.

A friend, Naomi, works here in the capital with vulnerable women. She tells me a story of two sisters, Natalie and Angela, who come from the south of Chad:

Following the death of her father, Natalie was taken out of school at the age of 14 and married to an older man she did not know, to provide for her family. Before long, it was evident that the marriage was a disaster. Her husband drank, leaving frequently to visit his mistress and violence on both sides, was common. Two children were born and died. Eventually Natalie could take no more and ran away to the city to seek out a new life. Having no education or training, earning money for her rent was difficult and she quickly turned to the crowded bars. Here, in the midst of laughter, activity and music, Natalie was introduced to a completely new world; one where she was not ordered to cook, clean and await for a long absent husband who beat her on his return. Here she was called beautiful, promised protection and security. Her rent was covered, clothes were bought for her and she had food to eat. For a few months it was by one man and when he disappeared, it didn’t take long for another to step in.

Despite her lack of education, Natalie was not stupid and was aware of the risks her new lifestyle brought. Every three months she would get herself tested for HIV and every time got a negative result. So far her risky lifestyle was paying off and although the pain of losing her children never left her, she found her place in this new world.

Some years on, her younger sister Angela came to stay during her school holidays. Her eyes were wide at the initial sights of the bustling city, a world away for a 15 year old from a small village, where her mother’s home and the church were her everything. Angela’s visit offered Natalie and her friends a new diversion. One night they dressed Angela up and took her out to the bars.

The next day, Naomi went to visit Natalie and greet her sister, but Angela was lying motionless on the bed. Her black eye, the only outward sign of her innocent body having been wrenched apart.

In the small dark room, Naomi listened in horror as Natalie and her friends urged Angela to find the man and apologise to him. To say nothing, make no fuss, “c’est normale”. But Angela could barely move. Some days later, having recovered, Angela returned to her village, a “shell”.

Following Angela’s visit, Natalie’s interest in the bars and the men began to dwindle and yet, without them, how could she survive? Without them, who was she?

Natalie tried to set up a business selling tomatoes. Having saved enough money to buy an initial stock, she sat on the roadside, waiting. She sold a few, but of course, within a matter of days, her stock had literally rotted away and the little money she had earned was taken by her latest man.

In the quiet, dark times, Natalie prayed, but she felt, deep down, she was not good enough for God.

One day Natalie found herself feeling so sick and weak, she could hardly get out of bed. Her latest HIV test was positive. Although she had started taking treatment, her main focus now was to get strong enough for the return journey to her Mother’s home in the village, confess her sins and then die.

Looking back at that time in her life, Natalie says with confidence “God has spared my life”. It was like a new beginning for her. In society’s eyes, Natalie has lost everything; she no longer has a man and she has no children. Yet, Natalie now no longer looks to men for her worth, identity, or her financial means. She now knows her true worth is in God. With help from Naomi, Natalie is receiving training and works full time and last December she was baptised. Life is still a daily challenge for Natalie as she still lives in the same neighbourhood surrounded by the same bars and men, but she is determined to keep moving forward into her new life with a sense of dignity that she had long sought, but now experiences.

Such stories as these are not unique to Chad but are repeated globally. I could go on, but I will finish off by encouraging you to think of ways in which you can get involved in taking a stand for women like these in Chad, in the UK, world wide. BMS World Mission are committed to taking action and campaigning, specifically against Gender Based Violence, in their Dignity campaign. For ideas of how you can get involved, go to www.bmsworldmission.org/dignity

(All names have been changed to protect the ladies concerned and permission sought to share these stories with you.) 

Yousef

For those of you who have already heard some of the story of Yousef, let me update you on this incredible little boy. But first, for those of you who have yet to hear his story, let me fill you in:

Yousef is a 5 year old boy who lives in a village several kilometres away from here. He came to the hospital emaciated, severely malnourished, with signs of tuberculosis of the spine. He weighed 6kg and has never walked. He was frequently found to be bundled up in a nest of coats and blankets, supporting his upper body, while his legs laid limply on the bed, his head perpetually covered by an old dirty white towel. He looked like a bag of bones, listless and disinterested in everything around him. That was of course, unless you took the old towel away from his head; that always brought around a reaction! Having started treating his malnutrition and giving him several blood transfusions, he began his treatment for TB. Within a week a huge change had taken place, Yousef had put on 1 kg of weight, a change that was evident as soon as you looked at him.

A kilo heavier, its time to start playing

Having got past the critical stage of illness, it was now time to try and reclaim some of his childhood. And so, with a little red plastic ball in hand, I set to trying to play with him. The first few attempts of rolling the ball to him, tickling him with it was met with an apathetic stare and I began to wonder if it was really worth continuing, conscious of the curious stares of the Chadians watching me. However, I decided to give him a bit longer and eventually a long skinny arm emerged to push the ball away. That was all the encouragement I needed. I kept rolling the ball and then risked throwing it at him (gently of course, there was no evidence to suggest he would defend himself against a flying object coming at his face!). This provoked a giggle! It was an incredible sound to hear! Yousef then tried to get the ball himself to hand back to me, and eventually he even pushed himself up into a sitting position to reach the ball and to be able to put more power behind, what had now become throws. This was the first time I had seen him reposition himself at will, let alone hear him laugh!

My next activity for him, again was met with trepidation and downright terror. Following a trip to a local market, I had brought with me a child’s blue plastic chair. As I and Mariam lifted him into it, his initial shock was shortly replaced with screaming terror as he kept pointing to the mat and his bundle of coats. Mariam explained to me that he was scared of falling and it struck me that this was probably the first time in his life that he had sat on his own in a chair. Several attempts of distracting him were employed to try and gain his confidence in the chair but the last attempt of singing to him I think just brought about enough confusion to divert him!

Casually leaning on his frame, showing off his
standing skills

Since this day, Yousef has continued to improve putting weight on daily, interacting and chatting. One day, after a long and fruitless morning with Yousef and his Grandmother in town searching for a child sized wheelchair for him to help with his future mobility, I was feeling despondent. But on the journey back to the hospital, I felt some insistent tapping on my shoulder, to turn around to see Yousef standing on his Grandmother’s lap!

This all happened about 3 weeks ago and he now has a walking frame with which he can stand for several minutes at a time. I was bowled over 2 weeks ago, when at the start of the day, I walked onto the ward to see him cruising up and down the length of the bed! My clapping and exclamations of joy were met by a rather disinterested stare from Yousef, but that was broken down into squeals of delight as we then had a tickling fight.

Up until this point, I had not quite let myself believe that Yousef would one day walk again. It just seemed too fantastical, having seen where he had come from. But, as always, Yousef had yet another surprise up his sleeve and last week, each day he was found to be talking little walks around the ward with his grandmother and frame!

Having made such a remarkable recovery from such a critical state, and surpassed all our expectation, Yousef has now gone to stay with relatives nearby as he continues his treatment with regular check-ups with us.

The last thing I did with Yousef before he was discharged from hospital? Play a (very tame) game of football!

'First' Impressions

I recently returned to Chad after a couple of months in the UK and though it was not a very long break, I was surprised at how strong some of my returning “first” impressions of Chad were. I say “first” impressions, because my true ‘first’ impressions happened over 3 years ago as I stepped off the plane for the first time. But elements of Chadian life that I have recently been sharing with friends and family at home, are easily dulled when not experiencing them everyday. Yet, on return, they hit me once more. And so here we go, my “first” impressions:

Dry

The green countryside that I left behind at the end of the wet season, has now returned to the parched, brown landscape that features throughout the majority of the year. Being on the edge of the Sahara desert, this really shouldn’t surprise me, but it is the rapidity of the change that strikes me each year. Just over 2 weeks into my return and the dryness has already led to dry, cracking and bleeding skin. However, I am well prepared and I have returned armed with moisturiser by the bucket load!

Lush and green for 3 months of the year...

... soon turns to a dry, dusty and barren landscape

Warm welcome

During much of the year, this phrase would take a double meaning, referring not only to the people, but to the sweaty, hot climate awaiting to embrace and envelope every person in its thick suffocating presence. However, I timed my return perfectly and found in contrast, the air to be cool and positively cold in the evenings. With the temperatures dipping to the low teens at night, I kept some of my jumpers and jeans to hand.

However, it was the warm welcome I received from friends and colleagues that was really encouraging and made the transition back into life here, away from family, much easier. I have found the Chadians to be quite reserved people and so it means even more to me when I am shown such an enthusiastic reception with hugs, hand slapping and cries of “Welcome back, how is the family? How is the cold weather?”

Dust

I find it oddly ironic that when I was younger, while other children would find the prospect of a picnic on the beach exciting, I found it a reasonably stressful experience; fighting against the encroaching sand on my towel, fruitlessly trying to flick sand out of my sandwiches, only for it to be replaced by yet more from my sandy fingers and the next gust of sand laden wind. This aversion to dust has not gone with age, but has been reinforced by the necessity to do my least favourite household chore. Yes, you’ve guessed it, dusting. And so here I am, in the Sahara desert where sand and dust permeate, quite literally, the everyday.

Having said all of this, from what I am hearing, I’ve managed to avoid a couple of highly unpleasant weeks, during which the dust was so thick, it hung in the air like a thick cloud, causing planes to be diverted and people to take on a distinctly orange/ grey complexion.

Time to celebrate

While in the UK, I visited and spoke with many people across the UK supporting the work here at Guinebor hospital through BMS. I always find meeting people for the first time telling me they’ve been following mine and the hospital’s progress a humbling and encouraging experience. It is also a good excuse for me to spend time looking back on what has been going on here on the ground over the past year or so. Very often the days and weeks pass in a blur of activity of hospital life and I find it easy to forget or not see when something good happens. On my return though, it suddenly struck me that January 2015 marks the first anniversary of the Vaccination clinic! In the first year around 1,150 children have been vaccinated against preventable childhood diseases. As I have previously written about, having seen children die of some of these diseases it’s a great joy to know that these children are protected.

Needing very little excuse or encouragement, I took this milestone as a reason to party and made 60 cupcakes to celebrate with the staff! In all honesty, I’m not sure what the Chadian staff thought of me, I think I confuse them at times. But they all humoured me singing along to “Joyeux anniversaire”, while Mariam, who works in the clinic, took her role of receiving the cakes and blowing out the candle very seriously! After, myself and Mariam went onto the Paediatric ward and used the occasion as an opportunity to promote vaccines and gave out some cakes to each inpatient child and their carer. The cakes certainly did not hang around long!

Mariam taking her role very seriously!

Now a few weeks in, it feels like I’ve never been away. My ‘first’ impressions of dust have become part of daily life, the warm welcome I received from the people has, in the last week, been caught up by the warmth of the climate, it is great to be working alongside the nurses again, and as I try to keep my eyes open for causes of celebration, I will continue to share some of these with you in the coming weeks and months.

Missie enjoying her cake!

Two different worlds

How quickly things can change. Just over a week ago, I was frantically banging the Chadian dust that seems to invade every nook and cranny from my stowed away suitcases, working my way through a long ‘To Do’ list to ensure I had handed over the right piece of information or piece of paper to the relevant person, while ignoring the high humidity that the end of wet season brings, all the while thinking ahead to cooler climes and endless cheese.

And now, here I am. Wearing several layers, listening to the rain outside having eaten a delicious roast dinner, enjoying the fast internet connection and looking forward to the prospect of seeing friends this week.

It really does feel like I’ve stepped out of one world and into another. As I left Chad the wet season was at last drawing to a close. Not that it had been a long wet season, but it had started late and brought with it some incredibly heavy storms. This inevitably brought with it high numbers of malaria and in the last month of working, the hospital was incredibly busy with many people being admitted with severe malaria. September saw 501 people treated as outpatients with malaria and 39 people hospitalised with severe malaria. (October’s numbers looked set to be even more). And of course, malaria also hit the staff, which provided more challenges as we ensured shifts were covered as we sought to meet the ever increasing demand. Children are particularly vulnerable to malaria and while we sadly saw some not making it, we also saw some incredible recoveries.

For example, one little 2 year old girl arrived at the hospital unconscious and fitting. She had a high fever and her test for malaria was positive. She had cerebral malaria. We started her on the treatment immediately and she was admitted onto the children’s ward for ongoing care. Usually, people will start to make some sort of noticeable recovery within a couple of days. But a week later this little girl was still unconscious and having high fevers that we could not get down. This is usually not a good sign for the future, so it was a great surprise and joy when a few more days later she started to

respond to stimuli. A couple more days and she was sitting up, drinking and eating. Having been unconscious for so long, she had lost weight and was very weak, so we started giving her the enriched milk we usually give to children with acute malnutrition. After nearly 4 weeks of treatment, and on one of my last days at work, she left the hospital to go back home.

Although it does feel like another world, many of you in the UK are a part of the work in Chad through your support of the hospital. In the coming weeks, (other than eating cheese), I will be speaking a various places to share more of the work that is going on in Guinebor. If you would like to hear more, please come along to any of the following locations:

·         9^th Nov.         11.00am Connect, Hollybush School, Bramley, Leeds

·                               18.30pm SENT, South Parade BC, Headingley, Leeds

·         16th Nov.      10.30am Tottlebank BC, Cumbria

·         22nd Nov.     16.00pm Rugby BC

·         23rd Nov.      10.30am Fuller BC. Kettering

·         30th Nov.      10.30am Folkstone BC, Kent

·         7th Dec.        10.30am Mansfield BC, Nottingham

·                               18.30pm Mansfield Road BC, Nottingham

·         14th Dec.      10.30am Brentwood BC, Essex

·         21st Dec.      10.30am Camrose BC, Edgware, Middlesex