Apparently, the new winner of American Idol (Phillip Phillips) was crowned a few nights ago. I'm generally aloof pretty much everything around in life - including pop culture -- so I had no idea this happened. However, Stefani has been on-top of her stuff, and after becoming a fan of Phillip over time, she happened to start playing his music in our room.
When his song started playing, I wasn't really listening -- I was expecting something random and poppy to come blaring out from her Mac speakers. But, when I heard the opening lines of his winning song "Home", something clicked in my head:
Hold on, to me as we go
As we roll down this unfamiliar road
And although this wave is stringing us along
Just know you’re not alone
Cause I’m going to make this place your home
At any other moment, these glossy lyrics wouldn't have caught my attention in the slightest bit. But, of course, this moment was different.
Ever since South Sudan gained independence, life became tense for hundreds of thousands of Southerners living in the North. Didn't matter if they had spent their entire livelihood in Khartoum or surrounding regions -- in a flash, they became foreigners in their own home. This week, their story took another dramatic turn. Over the past few days, more than 6,000 South Sudanese living in the North have been airlifted to a makeshift refugee camp outside Juba. Most of them already spent the past year in settlement camps in cities of Kosti and Khartoum, treated as outcasts from a society that deemed their existence unwanted.
For some, this return marks a jubilant homecoming -- a time to finally return to their culture, their land, and their people after decades of instability. For others, the move brings only more uncertainty and angst -- a detachment from a world where many have lived for nearly two decades or longer. Yet, even though each of them may have a unique path that brought them to the dusty streets and sweltering heat of Juba, they all share one thing in common: this place is now home.
Yesterday, I had the chance to spend a day at the returnee camp assisting the International Medical Corps in providing basic, primary care for those coming back. Makeshift tents set up in days by the International Organization for Migration (IOM) and USAID served as a hospital, prepared to treat a wide array of incoming cases with a stock of essential medicines, bandages, and a few beds. Three international physicians and a handful of local doctors were tasked with the challenge of managing health for the thousands of returnees, and had little capacity to treat serious illness -- yet, when you think about it, this physician-patient ratio was probably one of the best (if not the best) in the country. I was impressed as the two docs I had a chance to really meet -- Adam and Pranav -- came together to supervise the clinic, creating a form of organized chaos that helped address the needs of a constant onslaught of patients.
My job throughout the day was simple: help register folks as they came into the clinic. The only issue? Virtually no patients spoke English. I always knew there would be a day when the errant cries of my Arabic professors ("Yaa Sanjee, stop sleeping through class!", "Yaa Sanjee, stop staring at the girl in the book!", "Yaa Sanjee, READ!") would come back to haunt me. Yesterday was that day.
Thankfully, I spent most of my time working with Alice -- a wonderful local staff member who did the lion's share of translating patient information. But, as the day progressed, I started to registering folks on my own -- and here's where it got fun. I used my three semesters of Arabic knowledge to extract the patient's name and age....and then I was out. We then proceeded to stare awkwardly at each other for about 15 seconds, until we acknowledged that no other verbal magic was going to happen. From there on out, we entered one massive game of charades that become quite comical for everyone else (except for me) involved. As we tried to figure out their chief medical complaint, I got the hang of (an admittedly pretty crappy) system:
Repeated thumping of chest and rubbing of throat = cough, a signal to look for respiratory tract infections
Putting my hand on their forehead and yelling "SAHANA!" (hot!!) = fever
Pointing to head and making flash-like motions with both hands = headache
Pointing to stomach area and making *whoosh* noises = diarrhea
I'm not even sure if this exercise was useful for the doctors, who would interview patients more thoroughly once they saw them and use their diagnostic prowess to figure out what the deal was. Eventually, we saw all kinds of cases -- from clinical malaria to moderate trauma to skin diseases/infections to even a suspected case of TB. But, in any case, it was quite the experience. No matter the barriers in communication, I relished the chance to get a glimpse into the lives of over 165 people I never would have met before, even if only for a minute or two.
There were all kinds of patients, from 2 month old babies to elderly women who couldn't even recall how old they were. But, the interactions that struck the deepest were the ones with people my own age. It was a surreal experience, watching a 20-25 year man or woman enter the tent and take a seat next to me, wearing a hardened expression that cracked at times to reveal a sense of resilient hope. Many times, they carried 1-2 year old children battling fatigue and cough, seeming to know that finding a way to "cure" an extension of themselves in this camp represented the first of many challenges to overcome in this foreign land called home.
Whenever we see footage of refugee camps on CNN (and in the 30 seconds before we forget about them), we automatically associate them with a sense of despair and depression. It's a reflexive connotation that seems pretty logical -- living in temporary quarters that lack access to food, sanitation, and personal space is definitely not ideal. But, at least for now, that's not the vibe permeating the camp in Juba. There's an undercurrent of energy, of vitality -- there's simply a buzz. Maybe it's just the novelty of the whole experience; the camp has only been open for a week, after all. Or maybe, just maybe, it's the fact that no matter how transient or fluid their life seems right now, there's one constant hope guiding their outlook: they can finally make this place their home.
When his song started playing, I wasn't really listening -- I was expecting something random and poppy to come blaring out from her Mac speakers. But, when I heard the opening lines of his winning song "Home", something clicked in my head:
Hold on, to me as we go
As we roll down this unfamiliar road
And although this wave is stringing us along
Just know you’re not alone
Cause I’m going to make this place your home
At any other moment, these glossy lyrics wouldn't have caught my attention in the slightest bit. But, of course, this moment was different.
Ever since South Sudan gained independence, life became tense for hundreds of thousands of Southerners living in the North. Didn't matter if they had spent their entire livelihood in Khartoum or surrounding regions -- in a flash, they became foreigners in their own home. This week, their story took another dramatic turn. Over the past few days, more than 6,000 South Sudanese living in the North have been airlifted to a makeshift refugee camp outside Juba. Most of them already spent the past year in settlement camps in cities of Kosti and Khartoum, treated as outcasts from a society that deemed their existence unwanted.
For some, this return marks a jubilant homecoming -- a time to finally return to their culture, their land, and their people after decades of instability. For others, the move brings only more uncertainty and angst -- a detachment from a world where many have lived for nearly two decades or longer. Yet, even though each of them may have a unique path that brought them to the dusty streets and sweltering heat of Juba, they all share one thing in common: this place is now home.
 | ||
| Rows of tents were set up pretty quickly for returnees in Juba |
Yesterday, I had the chance to spend a day at the returnee camp assisting the International Medical Corps in providing basic, primary care for those coming back. Makeshift tents set up in days by the International Organization for Migration (IOM) and USAID served as a hospital, prepared to treat a wide array of incoming cases with a stock of essential medicines, bandages, and a few beds. Three international physicians and a handful of local doctors were tasked with the challenge of managing health for the thousands of returnees, and had little capacity to treat serious illness -- yet, when you think about it, this physician-patient ratio was probably one of the best (if not the best) in the country. I was impressed as the two docs I had a chance to really meet -- Adam and Pranav -- came together to supervise the clinic, creating a form of organized chaos that helped address the needs of a constant onslaught of patients.
My job throughout the day was simple: help register folks as they came into the clinic. The only issue? Virtually no patients spoke English. I always knew there would be a day when the errant cries of my Arabic professors ("Yaa Sanjee, stop sleeping through class!", "Yaa Sanjee, stop staring at the girl in the book!", "Yaa Sanjee, READ!") would come back to haunt me. Yesterday was that day.
Thankfully, I spent most of my time working with Alice -- a wonderful local staff member who did the lion's share of translating patient information. But, as the day progressed, I started to registering folks on my own -- and here's where it got fun. I used my three semesters of Arabic knowledge to extract the patient's name and age....and then I was out. We then proceeded to stare awkwardly at each other for about 15 seconds, until we acknowledged that no other verbal magic was going to happen. From there on out, we entered one massive game of charades that become quite comical for everyone else (except for me) involved. As we tried to figure out their chief medical complaint, I got the hang of (an admittedly pretty crappy) system:
Repeated thumping of chest and rubbing of throat = cough, a signal to look for respiratory tract infections
Putting my hand on their forehead and yelling "SAHANA!" (hot!!) = fever
Pointing to head and making flash-like motions with both hands = headache
Pointing to stomach area and making *whoosh* noises = diarrhea
 | ||
| View of the clinic from the registration desk |
 |
| Chilling with the registration log! |
There were all kinds of patients, from 2 month old babies to elderly women who couldn't even recall how old they were. But, the interactions that struck the deepest were the ones with people my own age. It was a surreal experience, watching a 20-25 year man or woman enter the tent and take a seat next to me, wearing a hardened expression that cracked at times to reveal a sense of resilient hope. Many times, they carried 1-2 year old children battling fatigue and cough, seeming to know that finding a way to "cure" an extension of themselves in this camp represented the first of many challenges to overcome in this foreign land called home.
Whenever we see footage of refugee camps on CNN (and in the 30 seconds before we forget about them), we automatically associate them with a sense of despair and depression. It's a reflexive connotation that seems pretty logical -- living in temporary quarters that lack access to food, sanitation, and personal space is definitely not ideal. But, at least for now, that's not the vibe permeating the camp in Juba. There's an undercurrent of energy, of vitality -- there's simply a buzz. Maybe it's just the novelty of the whole experience; the camp has only been open for a week, after all. Or maybe, just maybe, it's the fact that no matter how transient or fluid their life seems right now, there's one constant hope guiding their outlook: they can finally make this place their home.
 |
| A flag stands proudly outside the entrance to the campsite |
Thank you for shedding light, Sanjay, and for exerting yourself to coexist and understand under conditions where the communicative medium is almost too thick to do anything more than "stare for 15 seconds." On a medical note, have you asked Adam and Pranav whether your initial screening is clinically productive? I think it creates greater capacity to find the sickest of the sick first and provide attention faster, but perhaps there's a practical reason beyond that. In any case, impressive as always and looking forward to the next post...
ReplyDelete-Jordan
Amazing to hear about your work Sanjay. I'm writing from Kampala, Uganda now. At the Hostel, a veteran missionary worker on his way into Juba who shared some grievances on the aid-system into South Sudan. One, he lamented that organizations "sit in Juba" doing assessment work. When asked which orgs are getting into the field, he listed several mission groups like Mercy Corps or Billy Grahams' service. I was skeptical. From what you're seeing, who delivers services? Who gets out of major cities? Best of luck in continuing your work. -Ben
DeleteIt probably could be way more clinically productive as a method of triage. But, aside from quick glances at severity of a patient's condition, it was tough to really glean in-depth information quickly. What we did is make it easy for the real triage folks -- South Sudanese med students -- to take vital signs quickly b/c they didn't have to deal with personal info. So, as soon as they saw us, they went -- folks with fever got a quick temp., babies got checked for malnutrition, BP was read, etc. and then they sent most severe cases to docs first. Our primary role was epidemiological record-keeping -- we registered folks, and once they got a diagnosis, they had to come check-in back with us and get our signature before pharmacy could give them drugs, b/c we needed to note their condition for the WHO and other surveillance agencies. (Sidenote: there's a very fluid measure of how many people are actually in the camp, somewhere between 2500 - 5000, so calculating any reliable epi measures is pretty tough)
DeleteBen --
DeleteI wish I could answer that with more insight -- but given the fact that I've stayed in Juba for the past 10 days, I can't really tell you who's doing serious work in the rural areas. Faith-based organizations, especially the Catholic Church, are widely-recognized for providing a lot of value in health and education not just recently, but for the past 5 decades in S. Sudan, though. Not sure about Mercy Corps and Billy Graham -- I've seen some flyers around, but don't know much more than that.
Civil society is huge, though. For health, government support has been very tiny -- and given funding crises, will continue to be very small for a while. Domestic and international NGOs have stepped up to fill the void, providing care and community education with a lot of donor money from UN, USAID, etc. The one problem that we keep hearing about isn't the fact that they're sitting around doing assessments -- it's the constraints on coordination. In order to respond to pretty shitty situations, NGOs have adopted "vertical" models -- where they autonomously figure out how to solve problems in local areas. That's probably preferable when you have to rapidly address humanitarian crises, but doesn't lend itself well to developing systems that partner public/private sector for long-term change. One example: there is no standardized surveillance form for disease monitoring that the government and civil society share, meaning there is no reliable way to actually monitor progress in health over time. Many more examples like this.
I want the world to know that Sanjay has now listened to that song by Phil Phillips 40+ times in our room, often on repeat.
ReplyDeletethis is true.
ReplyDelete