E-newsletter Issue 48 | August 2006
Letter Home, Damien Brown – Mavinga, Angola – August 2006
| Damien Brown is a doctor from Eltham in Victoria, who is currently on his first mission in southern Angola. Damien writes about the challenges and reality of working in Mavinga, an extremely resource-scarce town in Cuando Cubango Province - traumatised by decades of civil war and once dubbed ‘"o fin do mundo" (‘the end of the world’) by the Portuguese. |
It’s the end of my second month here in Mavinga, a small town of
about 30,000 in the south-east of Angola. With our team of four expatriate
staff and over 100 Angolan staff, MSF run the local hospital and a water
project that provides clean chlorinated water to the town each day. It’s
a truly remote place, and as a consequence of the landmines (a constant
reminder of the almost 30 years of civil war that wracked this place),
everything has to be airlifted in.
But it’s a great place to be, and if you ever met an Angolan, you
would never believe the hardships they have faced as a people. Just so
many smiles!
The following is an extract from my diary…it’s not all been like this. In fact last week was very quiet, almost routine. I’ll describe the last 24 hours.
So it’s Thursday evening. I am back in the hospital for the evening round. What a frail young thing… a two-month old baby really fighting hard to breathe and starting to look very tired. We’ve given really everything we can, she came far too late though I suspect. Fingers crossed. Next - an eight-month old, weighing 3kg... is it even possible, are the dates right?! She is coming along OK though. Good, now the malaria wards and they’re all doing OK.
Adults… my two ‘heartbreak’ patients are in here. A great 20-year old guy who has gone totally blind in just a few days and I have no idea why. I have been in contact with an opthalmologist who concedes they have no idea either. And there’s that beautiful, frail ghost of a woman who just smiles at me in between moans, as her kids play on her bed and her cancer plays havoc inside her. Again, she came so late, too late for surgery. But we treat her pain and try to control her symptoms, and her husband is grateful.
Back to the compound for a game of cards and then, not half an hour later, ‘Doctor, it’s very urgent’. A quick dash over the road, straight to where our two-month old patient is and everyone stands back from the kid when I walk in and looks at me. She’s clearly dead. So I go through the motions of resuscitation, we do our best, as I wrestle with my conscience – is it cruel to give the parents another 15 minutes of hope than to just call it like it is? Or will they sleep better knowing that they got their baby to a hospital in time where a doctor could try and save its life? Or is death, like I have heard so many times before my arrival in Africa, ‘just a part of life’ here?
No, clearly not. For the second time this week I witness the distraught frenzy of family members mourning the loss of a child, wailing and beating themselves - so I stand like a deer caught in headlights, just watching, not sure whether to apologise or attempt to console a sea of waving and pounding arms. They take the body and go.
They go to wail on through the night. I can hear them. I go to finish my game of cards. I forget about it. And then I go to bed and I remember. And the questions start.
A day to remember
Friday morning. Cold again, 7.30am ward round and same old, but good team on today. The round is enjoyable, and once again we have a few successes with patients turning the corner overnight.
Fast forward to lunch. The four of us expatriates once again ponder our reflections in a bowl of oil garnished with a little pasta, as prepared by our (truly delightful) cook, Dominga.
And then…THUMP!!!!!!!! Dust and debris fall from the roof, and the plastic windows almost fall out of their panes. The walkie-talkies and radios go insane. Clearly not a planned blast (there is a de-mining team working in town). People are screaming. I grab the landmine medical kit and we all run down the road, but before we get 50 metres there’s a crowd of people running towards us, some with injured slung over their shoulders.
I run to the hospital. They pour in, and people just dump wounded in the first room. There must be 50 people within two minutes… medics, injured, family, police and so on. There’s blood all over the floor. Everyone is yelling. It’s full scale chaos. So I join in on the act. I start yelling too. We clear two wards quickly. We pick up patients and put them on beds. Who is severely injured, who can wait a bit, and who can wait? OK, good, only two severely injured… a bad facial injury, and a penetrating skull wound. That’s not bad out of over a dozen.
We get through the afternoon and no one dies. The ‘expat’ team rises to the occasion, and the Angolan staff perform fantastically well - everyone pitches in. Fortunately the governor of this state is visiting town today with the press, so he offers his plane to transfer our two most severely injured patients tomorrow. The others will be fine.
And in an absurd irony, our surgeon-nurse here, who fought for over 20
years in the civil war, sustained his first ever injury today! It’s
minor and he thinks it’s hilarious.