Starting the Conversation

Monday morning I decide to walk to work. It is early and cool and I want to get to work before the morning meeting. I was told on Sunday that I would be presenting Monday. We had already had that tentatively planned but nothing had been finalized. Sunday I got word that I would be educating the CMMB staff on mental health. I planned on doing a series of short discussions on mental health, in different areas.

Monday I walked in and got to work extra early so after dropping off my bag I headed to a local vendor and grabbed some fresh “doughnuts.” I don’t know what they are actually called. They are a fried dough ball. But they are not sweet. They taste good though.

Monday morning is always the meeting first thing in the morning. This time I understood a little more about what was being discussed. I am slowly picking up on some things. Other things still confuse me. People also talk very fast at times and I cannot catch everything. I suppose it is the same for others as well.

After the meeting Monday I met with a few of my teammates to discuss my proposed project for the clinic in Nzara hospital. While parts of this were already planned and underway there were a few components that we needed to address further. I won’t get into too many details as realistically, even to me, they are relatively boring. The important bit was that the training is going to happen starting next Tuesday in Nzara.

After the meeting, and sensing my frustration with being in the office all the time, Veronica (a PM), suggested I head with Taban, a midwife, to the clinic to start observing and hopefully to find some people to work with. Taban and I walked the approximate quarter mile to the clinic.

 I spent the rest of the day shadowing and nearly fainted when I watched a delivery. That was a first for me. Even during my clinical rotations in the operating room and other times I have witnessed traumatic or graphic procedures I have never felt like fainting.

I blame it on the heat and the fact that I forgot to eat lunch that day. I excused myself from the delivery room and headed out to the main maternity ward. After sitting in a chair for a while and grabbing some water I started to feel better. One of the other clinicians (in training) chatted for me for a while with me, talking about deliveries he has attended. That distracted me.

I think Taban felt bad for me. When he walked out of the delivery room after taking care of the mother and the new baby he came to check on me. I told him what happened. I was also very clearly sweating a lot. It’s hot here. Everyday is in the high 90s. I assured him I was fine.

I spent the remainder of the day observing in the ward. I didn’t want to risk actually fainting. They have enough work to do without having to worry about me. That evening I caught a ride back to the compound and felt fine. I wanted to go back to the clinic. It was the first time I felt more at ease about work since coming here. Clinical settings are what I am used to, not offices.

Tuesday turned out to be a frustrating day. There was no work for me in the morning so I asked to go to the clinic. I was told I needed to stay at the office so I could go out and go to one of the Child-Friendly Safe spaces to see some children who have suffered trauma. We just had to wait on a vehicle to be available. Even when there was a vehicle we did not go. I could not go on my own because I didn’t know where it was.

I stayed in my office. I was also told there was a patient that the community was trying to get to come see me. One of my co-workers told me of her the week prior and wanted me to speak with her. However, she refused to come to the office. So I never saw her. I spent the day reading. I like to read but it is not why I am here.

My frustration with the lack of work that I am actually doing here now led to a new plan Wednesday. I come to the office in the mornings and see if there are meetings or other things going on, check for patients to see, and address any other needs that have been identified for me to work on. If there is no work at the office or no plans for me to go to one of the community centers to see patients I go to the clinic.

I want this. I can spend time in the maternity clinic. There I have been able to learn a lot about how things work here. I have learned a lot about the culture and about medical care. I am also learning a lot about mental health care, or lack of care. One thing I learned was that when a person attempts suicide the case must be investigated before that person receives medical care. This is certainly not how we do things in New York so it was very surprising to me.

On Wednesday I attended two more deliveries. Neither time did I feel like I was going to faint so that was good. I enjoy being in the maternity ward, trying to talk with the women, and seeing the babies. I am learning so much. I am also learning about some of the trauma and mental health struggles in the area. I hope the more time I spend there the more I will learn and the better I will be able to start talking with both staff and community about their mental health.

On Thursday I only spent an hour in the clinic at the end of the day. The morning was spent going to the Child-Friendly space. There I played with 3 small boys who are displaced with their mother and will hopefully go back to their country someday. I listened and talked with the man who runs that area. I will be doing more work there in the future.

We also attended a community meeting on Child Protection and Gender Based Violence. Both groups work together as their work often overlaps. It was very, very long meeting and meant I missed the second meeting I was supposed to go to. I hope to attend to that one Monday.

After my meeting finally ended I got back to the office to find that Sarah, Martin, and their kids have arrived in Yambio. Sarah is a Nurse Midwife who will be working at Nzara’s hospital. She is another volunteer. I met her in New York in December. She and her husband have been here 2 times before now. Martin does project management in Nzara.

This was my first-time meeting Martin and their two children. It is really nice to have more familiar, friendly faces from the US closer to me. We had lunch at the UN compound. We also had to do the rounds to some of the community leaders with them. After this we adventured to the market. The women loved seeing a white toddler. It was fun to watch. Then it was time to say goodbye to them. I should see them in Nzara next week.

My work certainly is not what I expected of it. And everything is moving slowly. But doing anything clinical and starting to see people open up and talk to me is a good thing. It is a slow process but we are starting conversations with locals and starting to make more plans and work towards more progress. I will keep pushing where I can and do what I can to work to try and do more.