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FROM UGANDA Marg Ward is a 61-year-old grandmother from Ballina in Northern NSW who is working as a nurse in Soroti, in the Northeast of Uganda. Médecins Sans Frontières offers basic health-care in four sites for displaced people in Soroti town and a team works in the paediatric ward of the district hospital. Since the early nineties the northern regions of Uganda have been terrorised by rebels of the Lord’s Resistance Army (LRA). The rebels have no clear political agenda. They say they want to install a rule in Uganda based on the biblical Ten Commandments. The LRA have operated from bases in Sudan, Uganda’s northern neighbour, for years. The rebel incursions, accompanied by plundering, looting, murder and many abductions of children, have displaced around 1.2 million people from rural areas. The phenomena of ‘night commuters’ – children who leave their villages in the evenings for fear of attacks and abductions has manifested over the last 12 months. Some of them spend the nights with relatives but most sleep in the streets of the district capitals. Since August 2003, as the rebels activities have increased Médecins Sans Frontières has responded by setting up new programmes to deal with the increasing number of people displaced by the violence. Today is the 9th January and it is hard to believe that 2004 is up and running!!! This is the first chance that I have had to sit and write as I have had two days off in 5 weeks. The number of patients and the severity of their condition demanded more hands than we could manage. I worked long hours and still managed to have time to cook the turkey. I spent my Xmas day between the small gas stove and the intensive care unit. We enjoyed a team dinner with visitors from Veterinarians sans Frontieres - 13 in all! The improvement in the ward over the last few weeks has been reflected in the reduction of deaths, the staff are ensuring that the children receive their treatment regimes and the atmosphere has changed to one of learning and interest. I have been amazed to see so many Internally Displaced People (IDPs) sleeping on the verandahs of the shop fronts, the local authorities are trying to move them from the schools, the new term commences soon and many thousand remain in the school buildings. Two of my team members Khalil and Francois and I have changed our walk to the hospital in the mornings. We now navigate the main streets - seeing people cleaning the gutters of the rubbish and the shop fronts preparing for their day. We duck under lines of fabric on show for people to choose from, mattresses piled high, Singer sewing machines by the dozen with colourful fabrics, purple, yellow, pink blue and red, being turned into school uniforms. There are some Indian shopkeepers; supermarkets that are basic; a town which has looked tired and worn, is beginning to show pride with new paint being splashed onto its shop fronts. Across the park where more of the IDPs sleep in their groups, there is no grass now, only dust and the beautiful old trees shading their few scant belongings, wrapped in recycled plastic. The central fountain has seen better days, no water, plastic bags caught on the stalks of grass and weeds. The children are happy in their world of play, mothers bathing them with a dish in the dusty open space. We cross the road to walk past the market sellers, steamed sweet potato, maize on the charcoal fire, small sachets of Omo, pineapples and sugar cane. The scene resembles a shantytown. Always the busy bells of the bicycles. We enter the gates of the main hospital entrance, gardeners sweeping, we shield our faces from the dust and the guard welcomes us. The best part is the canopy of jacaranda and flame trees, as we pass all the different departments and wards. Many people milling around. Outside the theatre people are queuing for attention, some elderly - with a piece of strapping above one eye. There are soldiers with guns who are visiting wounded young men, some in wheelchairs or on crutches. It concerned me that these men would often walk through the ward with their guns. Now they have accepted my request to enter without their guns. Last week the admissions decreased, but this week we had another increase. Yesterday 71 patients - with 18 admissions before lunch. I am into my 6th week, and there is a difference in the programme, the challenges remain but the day will come when we have to let go, as the real emergency is over now. I know that when the time comes to withdraw the Médecins Sans Frontieres support from the hospital, it will be so difficult - just taking a day off is emotional. With love, Marg
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