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Letters from Ann Evans, Old Fangak.Letter # 5 The few days in Nairobi were both R & R, and a LOT of work, mostly for Jill, who was on-task as soon as she could be upright! While I accepted delegated shopping duties and made sure that Jill ate and drank (until she fired me as her nurse…), Jill organized the shopping for other needed supplies, arranged for printing materials, scheduled flights and shipments, and communicated with various individuals, groups and agencies about the work in Old Fangak. As the tasks to be done were getting ticked off the list, we both felt a strong draw to be back in the village. The twin jet-engine East Africa Air flight to Lokiochoggio, Kenya was smooth. Barcari met us and took us shopping for additional supplies for the charter flight into Sudan. The allowable weight limit was at odds with our perceived need—could we more afford to leave a bag of sugar or a bale of blankets? Jill designated the sugar. On take-off the plane seemed to groan with the load and to reach altitude slowly; I hoped we weren’t catastrophically over-loaded. Later we learned the sugar wasn’t held back; we really were at maximum load. Except for a few hills early on, the terrain between Loki and Old Fangak was flat and mostly dry. About two hours after take off a swirled ribbon of green appeared; soon we were landing at the Old Fangak International Airport…well, we had just come from Kenya! Two large plane carcasses ominously define the breadth of the dirt and dry grass runway, warning that some plans (and planes) go awry and are not so easy to repair. To one side of the airstrip stands a hauntingly lovely red acacia tree, leafless with a red trunk and many branches; behind it cows are grazing on a green field bordering the Zeraf River. Tukels are scattered about, usually with a fenced area around them. Beyond the tukels lurks a red acacia forest, home to the sand fly that infects the local population with kala-azar—life, with beauty and danger intertwined. Arriving early afternoon means it is HOT; but that doesn’t deter the children who stream toward us. We unload the plane and stack things nearby so the plane can leave. After take-off the plane turns and comes back as though it might land, which doesn’t make sense since it is now very far down the runway. Then Jill drops to the ground as the Kenyan pilot playfully and dangerously buzzes her. The national staff greeted us like we had been gone for a year, happy that we were now ‘home’. During the week-long absence three patients died; another died shortly after our return--he was Jill’s ‘little sweetie’ and was waiting for heart surgery. Although Jill had carefully checked him and given him medications in her few hours of energy before we left the village, the mother had doubled the medication while we were gone. Jill lamented that these patients wouldn’t have died if she had stayed. She was probably right, of course; but the bigger truth is that people are dying all over Sudan, most parts of Africa and other parts of the developing world because there is so little access to care. The distribution of physicians and other trained medical workers favors the developed countries. Few from these developing countries enter and complete medical school, and when they do, the developed countries, particularly the US, siphon them off, usually within a year or two. Meanwhile, the debate on US healthcare lumbers on, with insurance companies gaining an increasingly solid footing and a REAL public option slipping away. In Nairobi I read “Best Care Anywhere: Why VA Healthcare is Better than Yours”-- by Longman and Noah. It should be required leading for congressman and senators. How can it be that the VA continues-- in study after study-- to come out on top in multiple measures of quality and, at the same time, to stabilize costs, while the reverse is true for the private sector??? I close the book with sadness and frustration, then reach for Jeffrey Sachs’ latest: “Common Wealth: Economics for a Crowded Planet” --on how we can do better at sharing the bounty enjoyed by the wealthy with the ‘bottom billion’ of the world. Hmm…I wonder if we can manage this in my lifetime? Our children’s lifetime? Ever? Well, so much for restful reading in Nairobi…. We are now into the third month of the kala-azar epidemic, with about 80 admissions a week, and around 350 receiving daily treatment. Today we admitted the 1000th patient into treatment. And most importantly, a very high percentage is being cured of this deadly disease. A slightly quieter past few days hints that the numbers may be starting to decrease. We hope this is due to MSF opening a site in Pagil, where some of our sickest and most distant patients live, often arriving too late for a successful intervention. The sense of a holiday season escapes me right now, not that I miss the gaudy commercialism that spans Halloween and beyond. Someone said the heavy drums and indistinguishable singing in the distance is Christmas music; but it isn’t familiar music to these ears. At home many are planning travel to be with friends and family; last minute shoppers are still searching for that special gift; some have chosen our work. We are so very grateful for the contributions that continue to flow into the project, contributions that are saving lives, feeding very sick babies, providing blankets against the winter nights’ chill, the essential supplies, medicine—it takes so many resources to run this expanded project! We use contributions in the most efficient manner that one can imagine, and without overhead since 100% goes to program expenses; still, the need is great and we would welcome more contributions as we struggle daily with the balance between needed supplies and available finances. Checks can be sent to: Crosscurrents International Institute On-line banking provides a wonderful option for continuing support; please consider this for the gift that keeps on giving. Visit sudanmedicalrelief.org or crosscurrentsinstitute.org for more information about our work here in Sudan. Namaste and God bless our many friends--both old and new who are partners with us in this wonderful lifesaving work. Wishing each of you a very happy Hanukkah, Christmas, and a joyous holiday season. As Jill has said, the people in Old Fangak ‘only hope to live’—not such a big wish for most of us; but tremendous for the people here. Peace and good cheer, dear friends! ann |
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