Akot Medical Mission

In medicine, there are many times when the patient feels as though he has lost control. That is true in the US as well as Sudan. Even in our sophisticated society with medical exposures on TV and magazines continually, when you are the patient, there is the feeling of getting swept downstream and having no options but to go with the flow. Those feelings are exaggerated in a population that is in transition from traditional care (witch doctors) to modern medicine, read more…

We had a woman come to us at what we judged was approaching term (around 36 weeks) with abdominal pain and some bleeding. She was from Paloc, a village almost directly north of us that is a short distance but a long drive away. The road is rough during the dry season and virtually impassable during the rainy season. After a couple of days, the bleeding stopped, but her pain persisted. Now abdominal pain during pregnancy is ubiquitous, but this lady’s pain read more…

One of our patients on the wards is a 7 day old with meningitis. We have had a fair amount of meningitis lately, and I have reported several cases, but this one tells much about the Dinka culture. This child was brought to us at 4 days of age, but with a history of being sick for three days. The three days prior to coming to us were spent seeking “traditional cures.” They took the child to the witch doctor. Fortunately, this time the witch doctor was merely ineffective. read more…

Rose keeps a child, Mary Abyea, who is Paul’s niece. She has recently reached a milestone: she started her menstruation, thus making her, in the Dinka mindset, eligible for marriage. She has lived with Paul and Rose for about 4 years and is much closer to both of them than either of her parents, but her father, who mainly played the role of sperm donor (he is the kinsman redeemer, the brother of Paul’s sister’s husband who died, but he has had virtually read more…

Yesterday Gordon Mayom came to warn me about some unrest in the area. I am not wild about the currently in vogue definition of insanity, but it does seem to me that after years of repeating the same stupid mistakes, people would catch on to its futility. Yet two nights ago, really in the morning hours of yesterday, some Dinka Agaar from Paloc and Pecam (actually a long way NW from Akot) raided some Dinka Atuot in Pandit (east of Akot), killing two men read more…

Mary Agum pressed me again to help her get her sorghum and millet for planting. There is no question that it is time. Indeed, there are many of us who think the slow growing sorghum will not mature before the rains end. I had put her off a couple of times, but it was time to help, and I had no conflicts, so I agreed. We have a visiting team from America who are fun and adventurous, so I invited them to come. All but one took up the offer. So we first drove to read more…

“Etu Brute? Then die Caesar” (Julius Caesar, William Shakespeare). I understand the pressure the guys who are close to the kawajas feel all the time. People in the community see the kawajas as having all things at their fingertips: unlimited money, power, fuel, vehicles, resources. So they are constantly being pressured to get us to do things for them. Johnson, one of the executive chiefs of the area, has been pressuring my friend to get me to drive him to Pacong read more…

A three month child was brought to us a few days ago, and it did not take a master clinician to see that this child was very ill. He had a fever 39.5 C (103F), had wheezes and crackles throughout the chest, and had a large spleen (6 cm). I did not think him more irritable than the fever should cause and he followed my keys, so I did not think he had meningitis. I diagnosed him with malaria, asthma, and pneumonia and started him on ACT (artemisin combination read more…

I saw a patient in follow-up from an abortion (miscarriage) last week. She has two children at home, but lost the third child early in the pregnancy. Hers is a common problem in Sudan, probably for a number of reasons. First of all, miscarriages are relatively common anyway. One benefit of the legalization of abortion has been that we recognize the pain associated with the loss of a child, whether the abortion is spontaneous (as it invariably is in South Sudan) or read more…

Sexually transmitted diseases (STD) are common and often amusing. Whether in the US or Sudan, it is common to find the patient somewhat evasive about symptoms, origin, and often about the real reason they are seeing us. Today we had a follow-up for a meningitis case, though he was about 2 weeks late in his appointment. We had been a bit uncertain if this 31 year old man had suffered from Typhoid fever or meningitis, though we thought the latter and his read more…