News

Live Blog from Member Mission Trip to South Sudan

March 17, 2010

13. More Patient Updates

If you would like to learn more about the continuing treatment of the patients featured in this blog, please e-mail mduffie@shandonpres.org. We will be happy to send you the latest information, as it is quite lengthy.

12. Patient Update from Sunday, March 14, 2010

I received the patient update (read below) from Dr. Lori on Sunday. I've done some small editing, and even so, it is long, but very much worth your while to read. You may be interested to know that South Carolinian J. Marion Sims was the first person to successfully repair vaginal fistulas back in the 1850's. The hospital in Addis Ababa even has a plaque in his honor.

Dr. Carrie is back home, so that just leaves Dr. Lori and Dr. Richard absent. Please continue your prayers for them until they are safely home.

Notes for the "Patient Update":

Hakim is our Murle translator from Pibor, and SPLM is the Sudan Peoples Liberation Movement (the civilian arm of the SPLA- Sudan Peoples Liberation Army, which fought against the Government of Sudan). The activity below is taking place in Nairobi, Kenya.

Patient Update from Dr. Lori:

March 14, 2010

Greetings from Addis Ababa, Ethiopia!

Hakim and I arrived to Ethiopia yesterday morning with Adosh, our Vesicovaginal Fistula patient. It was quite a journey and not without its struggles but God is good and faithful.

The last update I sent on Thursday, I had asked you all to pray that Ethiopian embassy would give us her visa. Thursday night, we had Adosh's passport, National Identity Card and Birth Certificate in hand thanks to the Sudanese embassy and SPLM. Coffee and ice cream that night was wonderful and it just touched my heart to see the personal efforts that the ambassador and SPLM took to help Adosh.

We set out early Friday morning after breakfast (Adosh LOVES breakfast at guesthouse with the eggs, jelly and toast!). Much to our dismay AGAIN, the Ethiopian embassy could NOT grant us a visa due to strict regulations with Sudanese in Kenya. We were told we must go to Juba to obtain a visa from there or go to Kenyan Embassy/Immigration office and obtain a Re-Entry Visa stamped in her passport. We opted to go to Kenyan embassy where we were denied a Re-Entry Visa because she has no workers permit or study permit and does not have residence in Kenya.

We then went to SPLM for help and one of the government officials left the office, got into our taxi and we all headed back to the Sudanese Ambassador's office to see if he could talk directly to Ethiopian Ambassador for assistance in this matter.

He made a phone call and typed a letter and we were directed back to the Ethiopian embassy with the letter. At the same time, Adosh is in the back of the cab with us and she is praying and praying.

We arrived at the Ethiopian embassy and were sitting in the Counselor's office. He made a few phone calls to the Ambassador and told us there was just no way that we could get a visa for her due to the strict regulations.

The Counselor could see that she was very sick. We brought her back out into the cab (where our driver, Bobby, waited with her). Before Hakim and I went back into the Counselor's office, we all held hands and prayed together for God to change the hearts of those in charge to make a medical exception if it was His will. We praised God for getting us this far and remembered the promises in scripture that God will meet all of our needs according to our riches in Christ Jesus (Phil 4:19). We sang "Jesus Loves Me" with Adosh and she raised her hands in the air ( a gesture of giving it to God).

Hakim and I went back into the Counselor's office with the SPLM government official and then the counselor told us he would grant her a visa for a month! He said the ambassador warned him that if there were problems with Adosh, it would cost him his job. He said he didnt mind because he could see how Adosh was suffering (a total change of heart).

Visas were granted to Hakim and Adosh for one month. We left the office with the Ethiopian Counselor hugging us and thanking us for helping people and for giving him the opportunity to help Adosh.

We made a quick 4 hour total trip to Kijabe Hospital to see patients and then went directly to airport after midnight for flight. Adosh was so cute…when asked about her thoughts of this busy day, she said "Americans don't eat or sleep, when we eat it's in moving vehicles, and the mall is a "dangerous place with boxes that move up and down (elevators) and she cannot understand why some cars (which are small) never grow up to be big ones (like trucks). Adosh used headphones on the flight and enjoyed watching TV for the first time in her life!

We arrived to Fistula Hospital on Friday morning and Adosh saw many girls sitting on the ground outside who were suffering from the same problem as her. She grabbed my hand and Hakim's hand and raised them into the air, and we all thanked God that we finally arrived here and that God gave us the strength to persevere. Hakim and I sang together "Rejoice in the Lord Always and Again I Say Rejoice!"

We were immediately greeted by the nurses and medical doctor. The doctor examined Adosh and feels as though she has a good chance at having a successful repair. He commented that she has two holes in the bladder and its circumfrential and she will be there for about 2 months. She may need antibiotics for infection. He feels as though Kenya docs in Loki may have done a hysterectomy so she will have an ultrasound to confirm that. No longer being able to have children will be hard for Adosh, so pray that she will accept this news if that is the case. She will get nutritional support and also physiotherapy for her foot drop (also due to her prolonged labor). She will also have spiritual and emotional counseling. We are hoping that some of the Southern Sudanese doctors/nurses that are studying there will speak her language. After saying goodbye, Adosh happily went into the hospital to bathe, get changed, and make new friends.

Dr Hamlin, Founder of the Fistula Hospital, had called the nurses station and asked to speak with me. She thanked VIMM/Trinity Presbytery for bringing Adosh and wants to meet on Monday for tea! She was asking me questions about the journey from Sudan and is interested in building ties with Southern Sudan. I was so delighted for this opportunity and hopefully we can talk about bringing more girls out of the Sudan (which is essentially unreached for VVF girls) into Ethiopia for repair. What a ministry this is. Spending one day with my dress smelling of urine made me experience what they go through in such a real way, yet still I could never understand the amount of shame, physical hardship and social isolation which they face.

Update for Kijabe...

Wuno - child with osteomyelitis - was operated on for tibial sequestrectomy and is now in external fixation. She is in pain but has pain meds and antibiotics. Will be there for about 14 days after the date of her next surgery which is still to be determined.

Thaduvach - third degree burn - needed debridement again and multiple skin graft surgery along with contracture release is moved to Monday. Doing well. She will be there for 14 days after grafts. Baby Oleyo still smiling and being held by almost everyone in the ward!

Lilcho - on Tb meds and antibiotics. Breathing is still difficult. But he is on oxygen and continues to improve. Tolerating small amounts of feeds via NG and hydration is slowly improving.. After seeing the way he is, I think if he would have stayed in Sudan even a week more, he would have died.. Please continue to pray that mama falls more in love with her son each day. He will stay for about 4 months longer.

Hakim is doing wonderful!! He connected our patients with a Sudanese husband and wife who are studying at the Bible College in Kijabe. They are Dinka and speak Arabic. Grandma of Wuno speaks Arabic and while Hakim and I are in Ethiopia, Grandma and the couple are translating! God has provided for even the slightest details.

love you all

Dr Lori

Cheers,

R. Cely

15 March 2010

11. Wednesday Morning, Columbia, SC

I'm back home, but a part of me is still in Africa. For me, the trip will not be finished until our four patients taken to Kenya or Ethiopia are back in Pibor, and our final three team members are back home.

Dr. Lori is staying in Africa to make sure that our patients are in good hands. She will probably come home next week. Read below for her update on our four patients that we transported from the Sudan. Dr. Carrie is going to visit a hospital in Kenya, where she plans to work after her residency. Dr. Richard is taking a short holiday to see wildlife in the Masai Mara.

Patient Update:

Wuno - 6 ½-year-old female with exposed tibia. X-ray revealed severe osteomyelitis. I spoke with the Orthopedic surgeon this morning (Tuesday a.m.) and she will be having surgery on Wednesday. They will remove the damaged bone and will clean in there as well. She will need tissue graft but this will be later on. Her expected stay is 10 days after all the surgeries are completed. Her osteomyelitis is chronic so there is alot of bone damage. The surgeon thinks she will do fine and will not need to amputate and she should be able to walk again without needing her tree branch in the future. Thank God we brought her out because she could have eventually lost her leg if infection continued to progress. Poor little girl suffered with this for 9 months.

Lilcho – 7-month-old with malnutrition, choking episodes and cough and dehydration, malaria, and Giardia (anything else?!) He has 2 central lines in for TB medications and TPN. No scheduled tests on him except for HIV which is pending.

Thaduvach – 26-year-old female w/ third degree burn to right arm was debrided last night, and I spoke to the plastic surgeon. She is scheduled for multiple skin grafts on Thursday or Friday and will need 10 days post op at Kijabe prior to returning to Pibor. Plastic surgeon said it was good we brought her because given his medical knowledge, she would have had multiple infections in Pibor and contractures as well which would have prevented her from using her arm normally again.

Adosh – 26-year-old female with Vesicovaginal Fistula was examined by doctors at Kijabe yesterday. She had a dye test this morning to see the extent of damage. Apparently there are two holes in her bladder (anterior and posterior) and her bladder and vaginal area need extensive repair. They are unsure of condition of urethra at this point. I have prayed alot about this because we were not sure if we should keep her at Kijabe or proceed with going to Ethiopia. The doctors are wonderful at Kijabe and she may be able to be repaired there with success. The difference, however, is that she may need an ileal conduit. She may have complications, and then I would have to take her to Ethiopia anyways. Also she has nerve damage to the right leg after her obstructed labor and this happens with Fistulas, and the Addis Hospital has a physiotherapy room just for this problem and they also have spiritual and nutritional and emotional support just dedicated to address the problems that Fistula girls face.

I talked to our translator and Adosh today, and Adosh said she wants to go to Ethiopia to be with other girls with the same problem. She said she has essentially been alone for the last 3 years and wants to be with others like her. She wants to return back to her village and let all know that God has healed her. Adosh is so beautiful and I just want to bring her to where she desires to go and will be happiest. I feel, given her opinion (which most Sudanese women are not strong enough to state out loud), that we will proceed with traveling to Ethiopia on Thursday a.m.

Please keep Dr. Lori and these patients in your prayers. I hope to give a couple more updates as I learn the status of the patients.

I thank everyone who has been praying for us while we have been away.

Yours in Christ's Service,
R. Cely
Columbia, SC
10 March 2010

10. Tuesday Morning, Amsterdam, Holland

My last update was from Thursday of last week. Friday, our last night in Pibor, Sudan, we lost our Internet access. Saturday, I was busy until 1:30 a.m. (Sunday morning) with the patients that we transported to Kijabe Hospital in Kenya. Sunday morning, I took time off for a short safari in Nairobi Game Park (worst safari ever), and then there was no Internet access at Mennonite Guest House. Monday, it was back to Kijabe to check on our patients, back to Nairobi in time to catch the 11:00 p.m. flight home.

So to update from Thursday night, when a woman went into a difficult labor, I'm going to plagiarize from one of our doctors:

"... and attended two deliveries in the middle of the night with women who were in labor but the baby was not progressing well. In the USA, both of these women would have had a C/Section but here in Pibor, that was not an option. Dr Fry and myself left one of the huts and Dr Fry tried to use satellite phone to see if any flight was available to emergency evacuate a mom who was in labor for a long time and baby was having decelerations in heart rate. There were no planes able to fly into Sudan at night as there is no airstrip or electricity for planes to land. There is no hospital in Pibor. There are no doctors other than MSF who does specific things in the community and C/Sections are not one of them. This was the reality that night...that both mom and baby might die, just because a higher level of care were not available. We prayed as a team and individually that night and a few hours later a baby was delivered and was intially not breathing but after resuscitation and stimulation, did well. Apgars were like 4, 8. There was thick Meconium as well. Mom did well. The second mom came to the church's ground outside where we were attending the first delivery, and she was in labor. They laid her on a sheet on the ground and the OBGYNs quickly assessed mom and noted she was in obstructed labor. We knew about Vesicovaginal Fistula complications and high infant and maternal mortality due to obstructed labor in this area and our team had to act fast. Mom was not pushing properly and baby required a forceps delivery. Mom was bleeding a lot and lost about 1000 cc of blood immediately post delivery due to uterine atony. Baby was resuscitated and did well, and mom eventually was stable. God was in control as The Great Physician through that whole night as all of this happened outdoors with no electricity and only flashlights held by several team members to allow us to deliver the babies, placentas, control bleeding, resuscitate, etc. God provided for these women and their babies."

Of the eleven members on the medical team, counting two laymen, ten were in attendance for the two births above. I'll let you guess who it was that did not attend.

We've seen almost 1,200 patients for the week. Friday was the hardest day yet for me. The heat and dehydration took their toll on me. We transported four patients to Kijabe on Saturday. Thanks again to AIM Air and their wonderful work. Three of the patients would have surely died, and one may still die, if we had not transported them to Kenya. The fourth, a vaginal fistula patient, while not life threatening, will be life changing.

In the next couple of days, I will give an update on the patients at Kijabe, but my very expensive Internet minutes are about to expire here in the airport.

Cheers,
R. Cely
9 March 2010

9. Thursday, Southern Sudan, March 4, 2010

The day started out very hot, but cooled off somewhat when it became overcast. We are working outside, so the wind that came along blew sand in and over everything, including our suitcases where the meds are kept. When in the Sudan, you soon give up any meaningful attempt at cleanliness. Maybe this is why about one half of our translators have been sick this week. I would like to mention how well they have worked, and obviously, we could not do anything here without them. Thank the Lord, and the congregation, that is providing them and paying them.

Tonight, the stars are magnificent, and the Milky Way is very visible.

We have now seen over 1,000 patients and given out (using a basic eye chart for reading) about 80 pairs of reading glasses. This part of our ministry is very well received.

We have been fortunate to find an Arab in the village who has opened shop, and performs diagnostic testing for common diseases in the Sudan. Most of our critically ill patients have hepatitis B/C and/or malaria. As I understand it, the hepatitis patients are not good candidates to evacuate.

Tomorrow should be interesting. There is a woman who is going through a very difficult labor, and our team leader may have to perform a c-section without anesthesia (meaning without anything to dull the pain). We are currently trying to contact the Wildlife Service to see if they can make an emergency flight to Kenya with this woman. Who on our team should go? We have two ob/gyn and one pediatrician, and without any one of them, a lot of patients will not be seen tomorrow, our last day.

Hard decisions always seem to come up on these trips, but all of the team members are very devout, and know that God is near, and in control. It is my prayer that the decisions that we make are to His Glory!

Cheers,
R. Cely
4 March 2010
South Sudan

8. Wednesday Night, Southern Sudan, 3 March 2010

Well, the temp got to 106 in the shade and 116 in the sun. I spend about one fourth of my time in the sun, so I feel a little better that I feel so tired.

We saw over 200 patients today, and gave away about 30 pairs of reading glasses. At one time, there was a near riot where the very basic eye exams were going on. One woman came for glasses because she was blind and wanted to see. Obviously, she was disappointed.

We now have 14 patients in our hospital, and 6 outpatients, one of whom has Vesicovaginal Fistula (VVF), and we would like to transport to Ethiopia Fistula Hospital. It would quite a journey, and if successful, would change a life, for these women are usually confined to their huts the rest of their life. We also have two VVF patients in Akobo that may be transported out with us.

In all, there are six to 12 patients that we may want to transport back with us. The VVF patients would go to Ethiopia, and the others would go Kijabe Hospital in Kenya. We will also need one or two translators as the village language is rarely heard outside of our area.

Please pray for a 5-month-old baby with Tracheoesophagea Fistula, who keeps losing his IV access. He is very dehydrated because he can't swallow milk. I believe that the operation is a challenge, even in the U.S.

I've been given notice that the generator is going off.

Cheers,
R. Cely
3 March 2010
South Sudan

7. Tuesday Night, Southern Sudan, 2 March 2010

Another hot and dry day. The high was about 99, and we didn't have the cloud cover that we had the previous days. The night is glorious with all the stars so bright, for the moon has not yet risen. Truly, the heavens declare the glory of God!

We saw about 200 patients today with multiple of them having swollen spleens and/or livers. All of these came from a village about 30 miles away, and the locals, of our village, do not have it.

Tomorrow (Wednesday) and Thursday start perhaps the most difficult part of our trip. With the financial resources that we have, we can take a limited number of patients back with us to Kenya. This means that, in all likelihood, we will leave patients behind to die because we can't pay for their care in Kenya.

The discussions that we have on who we take, and who we leave is fascinating, and can reveal a lot about yourself. Kind of like the movie "Sophie's Choice". For example, right now we have six patients with enlarged (or as one doctor put it "huge") livers or spleens and extremely malnourished (think "holocaust" after WWII) with three of them under the age of 8. They will surely die without intervention that we cannot offer here. An estimate is that it will cost about $800/patient to be treated at Kijabe Hospital in Kenya. God will provide!

R. Cely
South Sudan
2 March 2010

6. Monday Night, Southern Sudan, 1 March 2010

It was another hot and busy day. We saw about 225 patients today, so that gives us around 350 since we arrived. I'm drinking more, and so I have a little better hydration. I'm up around day break, and to bed around 11:00 p.m. or so.

We have another great team. Everyone is so willing to pitch in and help where there is a need.

Our "hospital" is a hut on the church compound where we put those who are most ill. We have about eight in the hospital tonight. Most of them start to improve once we start IV fluids or drugs, but there is one boy who looks like he may not survive more than a couple of days. The doctors have no tests, and are not sure what his problem(s) is(are). Dr. House, where are you?

One of the first patients we admitted Sunday was a baby boy. His mother walked more than 30 miles to our site when she heard about the medical team coming, and did so without any food. Such love, determination, and strength. When we found out she had been over 24 hours without eating, we offered her a high calorie paste type food, and she immediately gave it to her baby. This morning, we gave her one of our MRE's which she appreciated.

The doctors are frustrated that we can offer only Tylenol for so many of the aches and pains. We are seeing a lot of syphilis, as we did last year.

Signing off since the generator will be going off shortly.

Cheers,
R. Cely
1 March 2010
South Sudan

5. Sunday Evening - February 28, 2010

Saturday night/Sunday morning was a repeat of last year. We had winds and a small amount of rain (very unusual in February). The women, on the team, who started the night outside, soon moved their beds back inside. I stayed outside, but was a little damp at times. For Sunday, the high was 95 and the low was 83. Very nice for this time of year, since at times it gets to 120 degrees.

I am dehydrated, but I expected that. Drink more is the answer!

We started the morning by dividing the team into two groups. Each group went to a different congregation and participated in wonderful church services. The Gospel of Jesus Christ is alive and well in South Sudan.

After lunch, we opened the clinic for about 4 hours, and saw almost 150 patients. I am sure that we will get better as the week progresses. We have three patients that will certainly die if they do not get transported to Kenya for treatment. It is really fascinating to listen to the five doctors discussing what they think the illnesses are. It's like watching the TV show "House", my wife's favorite.

Cheers,
R. Cely

4. Thursday through Saturday, February 25-27, 2010

Not much was going on Thursday until the team arrived at 7:50 p.m., 30 minutes ahead of schedule. We didn't get away from the airport until after 10:00 p.m. because the team was missing six pieces of luggage. This was going to make for a VERY busy Friday. On Friday, one trip to the airport to pick up two pieces of lost luggage, one trip to pick up the last remaining member of the team, and another trip at 10:00 p.m. to pick up the remaining four pieces of lost luggage. We now have all 11 members of the Trinity/VIMM medical team:

Dr. Rich- ob/gyn, team leader, 4th trip to South Sudan
Dr. Lori- pediatrician, 3rd trip to South Sudan
Nurse Mary- 3rd trip to South Sudan
Dr. Carrie- ob/gyn, 2nd trip to South Sudan
Nurse Leigha- 2nd trip to South Sudan
Dr. Richard- internal med., 1st trip to South Sudan
Dr. Bill- ER, 1st trip to South Sudan
Nurse Amy- ER, 1st trip to South Sudan
Nurse Jan- Flight nurse, 1st trip to South Sudan
Andy- college student, 1st trip to South Sudan
Robert- 5th trip to South Sudan

Chairman Bill- not a member of the VIMM team, but chair of Trinity's Sudan Comm., and traveling with us. Bill is, without a doubt, the best friend that the Southern Sudanese have in America.

I needed two passport-type photos for five of the team members, so off to Nakumatt Friday morning (that department was closed on Thursday night). The visas normally take two days, but we had less than eight hours, since their embassy in Nairobi closes at 4:00 p.m. We also had to pick up the meds, and back-out the money that I had over spent. The traffic was sooo bad! Twice it took over 1.5 hours to go no further than two miles.

God is good! We got all necessary visas, switched medicine, and collected all missing bags of luggage. My thanks for all who are praying for this trip. I got to bed around midnight on Friday after collecting the last of the missing luggage.

Saturday started with a 4:45 a.m. wake-up knock on my door. We needed to leave the Mennonite Guest House at 5:30 a.m. to be at Wilson Airport (in town Nairobi airport) at 6:30 a.m. We had 12 people and nearly 30 bags of luggage. Even with that, the DC 3 (made around 1945) had room to transport the families of our pilot and co-pilot to Loki, where we re-fuel. They just wanted to go to Loki to see what it's like. It's the most desolate boring place that I have ever been to.

Dr. Rich had quite a discussion with customs at Wilson because they wanted money for all the meds we were transporting. If finally ended when Rich agreed to pay them around $100, and we were off.

The trip to Loki was the most fun that I've had on that segment. It was nice having the families with children on-board. AIM Air, our charter flight, are such a great group of people. Kurt, our pilot, allowed everyone a turn at being co-pilot. I could imagine what it was like for my father as he flew combat missions is WWII (without anyone shooting at you).

We arrived at our destination in South Sudan, with everyone pretty healthy (me - a cold, Leigha - slight nausea), all of our luggage plus an additional bag that somehow got loaded when we were re-fueling in Loki. First order of business was to get the water filtering cooler working. With Jan's help, they are working, and we have safe water to drink. Now, I just need to drink enough.

Tomorrow, Sunday, we go to church services (very lively), and then start the clinic Sunday afternoon. My guess is that we will see over 1,200 patients this week.

By the way, Dr. Lori just returned from Haiti, and she said that the people of South Sudan have it much worse than do the people of Haiti, even with the earthquake.

Cheers,
R. Cely
27 Feb. 2010

3. Wednesday Evening - February 24, 2010

I went to Kenya MEDS this morning to purchase medicines to compliment what the team is bringing from the U.S. I had a budget of $1,000, and I only over spent it by $1,000. No, not a typo. I spent double what I had been given money for. Dr. Rich, our team leader will get the good news when I pick him up at the airport Thursday night. Maybe he'll be too tired to notice :) The malaria meds (malarone) is a real budget buster. Treatment for 21 adults and 10 children was over $1,500. Still cheaper than what it costs in the U.S. We will be bringing over 3,000 treated mosquito nets into the Sudan at a cost of less than $10 each (paid for by the PC(USA)). This is a lot cheaper than treating malaria. The other meds are really inexpensive. For example, a bottle of 100 tablets of Cipro only costs $5.00.

First bump in the road- the S. Sudan visas were not processed because they needed two passport type photos for each person. I only brought one of each. When I pick-up the team members Thursday night, we will have to go by a Nakumatt and get pictures for anyone who doesn't have them. I'll take the pictures by PRDA first thing Friday morning.

Cheers,
R. Cely
24 Feb. 2010
Nairobi, Kenya

2. Tuesday Evening - February 23, 2010

I am amazed at how smoothly things went today in Nairobi. Bill and I (Bill is the chair of Trinity's Sudan Committee) accomplished all I could have hoped for, and I give full credit to the Holy Spirit heeding the prayers of those at home, and those awaiting us in South Sudan. There are so many things that can prevent us from accomplishing our work. Some small, some big. Two years ago violence in Kenya delayed our trip to the Sudan by a couple of months.

We started off by buying supplies at Nakumatt ( Kenya's equivalent to Walmart). We purchased water coolers with ceramic filters. The water that we will drink in the Sudan will come from a bore hole (a well), but VIMM requires that it be boiled and then filtered. Seems to me like overkill, but, on the three previous trips, no one got sick while in the Sudan. We got sick before going, and afterwards, but not in the field. For me, that's an answered prayer, because I don't want to come this far, and then be too sick to work- even for a day. We also purchased baby bottles at the request of our pediatrian Dr. Lori. If we don't bring what we need with us, we won't have it.

We next met with officials at PRDA (Presbyterian Relief and Development Agency- part of the Presbyterian Church of Sudan (PCOS)). Bill met with Rev. James, head of PRDA, and Rev. Peter Ret Riek, former moderator of the southern branch of PCOS. I met with the business manager and office secretary to arrange for South Sudan visas for the team.

Our final visit was with AIM Air. We had a great conversation with three of their pilots(Amanda who flew us in last year, John, who is Harriet McMaster's nephew (and one of our pilots last year), and Dan. They know so much about what's happening in the Sudan because of their frequent flights into the country. Dan told us about a small hospital in Werkok, Sudan that I didn't know about. This is important because we may be able to use it, rather than transporting seriously ill patients back to Kenya for treatment. Some of the patients we have transported in the past, with AIM's generous help, have been bullet wounds (with gangrene) and vaginal fistulas.

Tomorrow my goal is to purchase medicine needed for our trip. Most meds come from the U.S., but we purchase some, here in Nairobi. Malarone for malaria is one of them- very expensive.

Cheers,
R. Cely
23 Feb. 2010
Nairobi, Kenya

1. Background Information - February 23, 2010

This is the fourth year that Trinity Presbytery and Volunteers in Medical Missions (VIMM) have worked together to provide basic medical care to the people of South Sudan. The short term medical trips (one week in length) provide care to an average of over 1,000 people each trip. Medical care ranges anywhere from headaches to bullet wounds to sexually transmitted diseases. So far, we have seen very little AIDS in South Sudan.

This year, as in the past, our host will be the local Presbyterian pastor/congregation. I am currently in Nairobi buying supplies for our trip, and getting the necessary visas. The rest of the medical team will arrive Thursday evening and Friday afternoon. The team will consist of five doctors, four nurses, and two non-medical people who will serve as pharmacists.

When we fly into the Sudan this Saturday, it will be a charter flight with AIM Air. What a blessing that organization has been to anyone wanting to travel to the Sudan. Road travel is not safe because of bandits, land mines, tribal fighting, and just poor roads.

Internet access is very slow from the Mennonite Guest House ( Nairobi). I'll be curious to see how well the Internet connects in rural Sudan.

Cheers,
R. Cely
23 Feb. 2010
Nairobi, Kenya