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Anna Dicker – Australian Nurse in Niertiti, West Darfur
Anna Dicker is a nurse from Lennox Head in northern NSW. She is currently on her first mission with Médecins Sans Frontières (MSF). I have been in Niertiti for 2 months now and am in the routine of managing the Inpatient Department and pharmacy. I have gotten used to the dust, heat, flies, lack of hygiene and have just shaken off the diarrhoea that has plagued me for the last two months. I have lost eight kilograms since I arrived here so I have spent a lot of time taking in my waistbands. MSF provides medical services to 30,000 residents and internally displaced people (IDPs) in Niertiti, West Darfur. Two clinics are also operating outside Niertiti: one in Kutrum which is in Jebbel Marra controlled by the Sudan Liberation Army and the other is in Thur, a town at the border of South and West Darfur where there have been no medical facilities for almost a year due to insecurity. We are currently unable to access our clinic in the Jebbel Marra for security reasons so local staff are running the clinic without direct supervision. However, contact with them is possible by VHF radio. We can’t send patients back there by road so they have to go back via a very roundabout route making the last of the journey on donkey. We have heard gunshots nearly every night, which rips you from your sleep. I lie there hearing my own heart, waiting for more shots or screams but there is only silence and eventually I drift off back to sleep. Drunken soldiers we think but we never know as we are tucked up in our compound with a 7pm curfew. This week I saw the result of a Kalishnakov bullet. A woman was brought in from south west of Niertiti –a victim of a deliberate attack. She didn’t get to us until a day later and it is a testimony to her toughness that she survived. The entry wound in the shoulder was innocent enough but when we turned her over the awful truth was revealed. The exit wound was huge and had gone right through her lung. We could hear the air moving in and out (that fact probably saved her life). Her ribs were smashed; she had lost a lot of blood and had a raging fever. We couldn’t transfer her to Zalingei hospital, which has a surgeon, as it was late afternoon when the roads become unsafe and she wasn’t stable enough. We plugged the hole in the most rudimentary way, took resuscitative measures and transferred her the next day (in the back of a taxi as it is unsafe for MSF vehicles to be used as ambulances). It’s pouring with rain and very tempting to stay in bed all day – which I would if the bed was a bit more comfortable! I check my garden of Australia French beans and despite being planted in a mini flooded zone they still exist and have started to grow beans, which are now about 2cm long. They will bring a welcome change to the limited range of local food that we have access to. We had some good news yesterday with the arrival of blankets, which we had run out of, our food order and a new stove – no more struggling with the charcoal stove. Yesterday, a young couple arrived with a 2 year old who was severely burned on both arms from boiling milk. They had taken a couple of days to reach us and the child had a high temperature and the state of the burns was pitiful. They made it to us by donkey and with fluids, antibiotics, tetanus cover and dressings etc she will be OK. I had to help with ‘nurse-type’ things as we were resuscitating. It was quite a chaotic day yesterday. The burnt child had never seen a white person before and screamed with terror every time she saw me. I will have to work on that in the next few days with little gifts and smiles. The kids get used to me after awhile but they not only have never seen white skin before but two toned blonde hair is beyond their comprehension. The other child we were resuscitating was two days old with neonatal tetanus we don’t think she will make it as she is in very poor condition. The therapeutic feeding centre is in full swing with the malnutrition season at its peak. These children are in very poor condition but with good care and the use of Plumpy’Nut, a high calorie peanut-based paste, most of them survive. Once they are stabilised, we maintain them on an outpatient basis until they are gaining weight well and are out of danger. Kwashiorkor and Marasmus are words that roll off my tongue now, both terrible conditions seen in infants as a result of prolonged starvation. Mothers can’t sustain their breast milk supply and there are few foods suitable for weaning available. On a happier note the rainy season has been a good one and people are planting crops in the areas that it is safe to access. Once these ripen the pressure of living on food aid will ease and the nutritional status will rise. The people of the area are blessed with a sunny optimistic nature and try hard to maintain their lifestyle under trying conditions. There is always a smile and a greeting (the first thing we need to learn is the complicated and somewhat formal greeting process) when we walk down to the hospital.
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