there is no news from here, except that the doctor’s office called and want me to come in for more bloodwork Monday morning…and instructed me to go to the Emergency Room if i have any significant pain.

fair enough.

no one ever died of just the sheer misery of waiting, did they? funny.  i could swear this limbo is harder than just coping, but all my swearing – and oh, it has been copious…so pious am i in these times of frustration that the name of the lord is never far from my blaspheming lips – seems to make little dent in the state of things, as they are.

bloodwork, though. i hung up the phone with the doctor’s office and came and opened the email copied below.  the backstory: one of my most beloved friends, whom i lived with in college and who is this amazing, endearing, gawky redhead whom people can’t help but like, so charming and self-effacing is she, became an ER doctor.  two years ago, she took a leave of absence from her practice and spent six months in Darfur with Medecins Sans Frontiers (Doctors without Borders), living in a tent in a refugee camp and eating a lot of goat meat.  she came out with stories that curled my hair, and made me realize that for all i’ve travelled and lived hard and known sorrow with my joy, dude, i’ve not seen shit.

Susie gave up her practice in Ottawa this fall. she’s back in Africa with MSF, a one-woman doctor team in another camp for displaced persons, doing ALL the bloodwork for her patients.  in addition to treating them.  24/7, so far as i can tell.  and while i understand that comparisons is a silly game to play at…sometimes, when one is feeling all too beaten down by luck and wondering when one is going to catch a break, an email like this offers amazing perspective and a picture of a world that re-paints one’s own picture in different colours, a little less dramatic than one thought.  and the distraction of trying to imagine that life, that alternate universe?  fascinating.

i give you my (unwitting) guest blogger, live from Dogdore, Chad…my friend Susie.

I’m in the small town of Dogdore, which is in the very bottom, right hand
corner of a map of Chad (or Tchad, as it is written in French…not sure
where the T comes from, but I kinda like it and might start adding it to
more words: tchicken, tchilly, tchorkle, etc.).  Dogdore was just a little
sleepy town of 2000 or so residents, in the middle of nowhere, and 30km from
the border with Darfur.  Then about a year and a half ago ago, the fighting
between the rebels and government troops in nearby towns forced large groups
of people to move.  Roughly 30,000 of them settled in and around Dogdore.
In general, they arrived with the clothes on their backs, and maybe a
cooking pot or, if they were very lucky, a goat or donkey.  So I am working
with the same type of population here that I was in Darfur – IDP’s, or
Internally Displaced People, who are essentially refugees within their own
country.

MSF came here in June 2006, and we are the only source of health care for
the population. This past spring, the security situation was very unstable,
with lots of fighting between rebel groups and looting of NGO cars, etc, and
so most NGO’s, including MSF evacuated.  MSF returned in May, and since
then, things have ben much calmer (ie, don’t worry, mum!), and some other
NGO’s have returned as well.  But we are the only providers of health care,
and I am the only doctor.  Well, that is not exactly true…my Field
Coordinator is trained as a doctor, but his resposibilities are mostly to
run the program, meet with local sheiks, do admin stuff, and so in effect, I
am on call 24/7 for the hospital and clinic.

The good thing about this is that the work I am doing is very clinical -
seeing patients all day (and sometimes all night) long.  In Darfur, I was
doing a lot more supervision and administrative work, and I like the
actually taking care of patients part much better.  But it does get a bit
exhausting.  And we are currently in the middle of malaria season, with lots
of very sick kids.  We have done 7 blood transfusions so far [for children
with malaria, sometimes the infection is so severe that all of the red blood
cells get destroyed and they are left severely anemic and in shock, with
hemoblobin levels as low as 16 - normal levels are almost 10 times that].  I
have to say that I have a newfound respect for bloodbanks and the labs in
hospitals….Here in middle-of-nowhere eastern Chad, in our little hospital,
I am the nurse/lab tech/bloodbank all in one.  I start by taking a sample of
blood from the patient and testing for blood type, then asking permission
from the parents to test their blood, or other relatives’ blood to see if it
is a match.  Sometimes the parents say no, and refuse to allow their child
to be transfused….there are very strong beliefs here about the taking of
blood, and as much as you try to explain about how important it is,
sometimes you aren’t successful.  I have had one child whose parents
refused, who ended up dying a few hours later – very frustrating and very
sad.  So if the parents accept, I test them for blood type and if they are a match,
I do tests for malaria, syphilis, HIV, hepatitis B, and hepatitis C.  If all is
negative, then we take the blood from the donor/parent and give it directly
to the child.  The whole processs to get to the transfusion can take about
an hour or so, more if we have to test multiple family members. Once, the
parents were not matches, and there were no other family members, so I
donated my blood (good ole B Negative, comes in handy sometimes…), after
the parents agreed (with some reluctance, it must be said).  Luckily the
little girl ended up doing very well, which is lucky, because if not, you
wonder whether the parents will blame you and your bad blood.  So next time
I’m in a hospital at home and order a transfusion, and the bag of blood
miraculously appears a little while later, I will not be taking it for
granted!!

The team here is pretty small:  a French nurse, the Field Coordinator from
Burundi, a logistician from France, a Watsan (water-sanitation guy) from
Congo, and me.  The hospital is great – it was just built, and is tiny, but
very well organized.  We have 35 beds, which are mostly pediatric, and a
little emergency room.  We have all sorts of luxuries, like electricity from
10 am to 10 pm, oxygen for the patients, nurses who know how to take a blood
pressure, and fridges that actually work, in which to keep vaccines, etc.
We also have a toad infestation at the moment, so as I sit at night suturing
wounds in the little ER, I can also watch the humongous toads hopping all
over the floor.  At least the toads eat the insects, so there are less of
them to land in the wound I am currently suturing.

We even have an ambulance….of sorts.  His name is Martin, and he is a
donkey.  He pulls a little wagon with a mattress in it and is actually very
useful.  Sometimes the cars can’t make it across the wadi (river) to pick up
patients, but Martin always does.

The living compound is just across the street, so when I’m called in the
middle of the night I can just stumble across to the hospital.  We have a
lovely little compound, with the usual MSF squat toilets and bucket-showers,
but with 2 glorious fridges for cool water to drink (and the occasional
pepsi..).  We each have our own little room, and the food is much better
than I had been expecting – it is still very limited in variety, but we have
more chicken and less goat, the occasional carrot and tomato, and a
surprisingly large supply of  ’La Vache Qui Rit’ cheese.  Apparently, of all
the MSF sections (Dutch, Swiss, Spanish, Belgian), the French always have
the best food – and I have to admire their priorities.

They are pretty strict here with how much we can email, so I haven’t sent
that many, but I have been wondering how everyone is back home.  I hope this
letter finds you all heaalthy and happy…and probably about to start all
sorts of frenzied Holiday/Christmas preparations.  I’ll be here in Dogdore
for Christmas, the first time I’m not at home, but it should be fun…maybe
we can go on a little sleigh ride with Martin-the-ambulance, or decorate the
outhouses with wreaths, or go caroling next door to the Red Cross compound,
or the Save the Children compound.  Anyway, I’m sure we will think of
something.

In the meantime, I am keeping busy… and despite being a little tired, it
has been a good mission so far – I am learning a lot and meeting all sorts
of very interesting people.  It seems to me that the situation here in Chad
is not as horribly desperate as it is in Darfur, but it is still pretty
terrible for all the people who have been forced from their homes and
attacked again and again; living in little shelters and lining up for hours
for water and walking for days to access health care.  Once again makes me
realize how damn lucky I have been in my life. 

love, Susie