Everyone,
I sit here in my small 8x10 foot room on a pillow against the wall. There are no chairs. There is a small night stand in one corner and a foam mattress that is caved in with a too big makeshift goldenrod sheet on it. A mosquito net hangs from the ceiling. The cement floors are swept clean (yesterday). It's hot. I have a fever as well...Malaria...again. A Fanta bottle half filled with water sits by the door. The closet is filled with all my possessions.
I try to sleep. It's too hot...I drench the sheets. I think of what I face...if it was just the patients, the medicine, the surgeries, it would be enough. But it's so much more than that.
I need to build a wall around the hospital to keep out the pigs which have taken over and to provide security for the patients and hospital staff. I can't afford the $20,000 price that is by far the cheapest we've come across with four different entrepeneurs.
I just got a letter from the auditors saying that the hospital owes them ~$35,000. No one here has any idea what that's for and we certainly can't afford it. I just got an email saying it was mailed out Feb 2 and why haven't I answered. If I want they can just fax it too me and I can fax it back. Do they have any idea where I am? Do they think I have a fax out here? In Béré? In the middle of nowhere with no telephones and no electricity much less faxes.
This email I'm sending over the satellite phone...the government wants me to pay $2400/year to have it here. Then they "nicely" agreed to lower it to $400/year...I refused...and I didn't have the money anyway. They said come back when you've calmed down and we'll work things out.
There's a team coming in June to build us much needed lodging. I'm supposed to get the foundation laid and all the materials on hand so they can come in and build it in a two-week period. That's great...but it's a lot of work for me...
The government is supposed to provide us with medications each year. We haven't gotten 2003's supply yet, but supposedly 2004 should be here. I had to decide what medicines and supplies we would need for a whole year so we can be well stocked without having to waste medicines like the last few years when we've burned thousands of dollars of expired, unused meds. Meanwhile, we are running out and I have to buy a little here and a little there to keep us functioning without buying so much that when the year supply comes we'll be overstocked.
I'm working on a program to include the village health care workers and village clinics in a program to treat tuberculosis adequately through Directly Observed Therapy. I'm supposed to organize all this so that the patients can get treated at home and just go daily to see a clinic worker or village health care worker.
I'm working on a program to try and test pregnant women for HIV and treat them during labor to prevent transmission to the child as part of the Ministry of Health's agreement with us. They have allocated $16,000 to us for research and the fight against HIV/AIDS that we will lose if we don't use it.
There is a volunteer here filming a film of the hospital which is fantastic but just adds a little stress. Likewise for a medical student who just arrived to spend a month. We have not adequate housing for them. They are both staying in Sarah's place while she sleeps in the same room with 3 Tchadian girls across the way. We all have to eat too...we are trying to find someone to cook and clean for us.
People also come to me daily looking for work. The pastor wonders when we'll be able to pay him to be the Chaplain as well so he doesn't have to earn his living by cutting reeds to make mats with. His salary would be only $50-75 per month.
I'm trying to get a proposal done to get a solar panel system for the hospital so we can have electricity during the day for light and especially for the lab to do their work...also to cut down on the wear and tear and expense of the generator. People hear I'm in the market (somehow) and came to me today to offer to sell me some panels.
Another man comes today asking if Sarah's still interested in renting a horse from him and also if he can catch a ride with us next time we go to N'Djaména.
The lab wants me to get the light fixed in there so they can work at night for emergencies without having to use a lantern or flashlight.
It's now black in the room...the generator is off for the night. The kids are singing outside. The TV is blaring a soccer match in French as Dr. Claver runs it off his battery. The sweat drips off my face and into my lap. I feel the weight of it all. Can it really be done? Is it too much? Somehow, despite it all, the thought of leaving never enters my head. I think I'm just too stubborn.
A day in the office means seeing patients, having people walk in with lab results, nurses telling me they're sick, people asking for work, an emergency case, this problem with that hospitalized patient, this meeting we need to arrange...
Which reminds me...there's the Management Committee to plan and run, the next AHI Tchad committee to organize and chair, the budget to work on with André...
Oh, and there's the water tower that is leaking and needs to be welded, the latrines and showers for the patients that need to be built, the chauffeur that I had to sit down with a talk to after giving him a formal letter stating why we are not pleased with the job he's doing, and then there's the nurse who just can't seem to get things done and is aggressive to the patients (one night the night watchmen had to come to his rescue so that the patients didn't beat him up)...we need to send him back to the district (he's lent to us by the government)...
So, now that I've got all that off my chest...let me just lie down in my sweat, put my earplugs in so the dogs, pigs, kids and roosters don't keep me awake, and sleep peacefully away wondering what tomorrow will bring and not knowing how it'll all get done but knowing that somehow it will and somehow I'll enjoy it and wonder how I got so lucky to be here doing things that I could never have dreamed up or invented and experiencing life...
I just wish I'd stop sweating and yes, Mom, I'll start taking Malaria prophylaxis again...
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