Second Week Stuff

Hi there. So here we are again – I’ll give some updates from the last week. A couple of amusing anecdotes and some other issues.
 

We always liked this old truck. It’s a nice feature in the hospital.

We’re doing pretty well in general and are settling into the hospital routine nicely. Matt and I agreed that it’s best not to rush headlong into any programmes or modifications, so we’ve been working hard in more a ‘shadowing’ (with participation) role in the medical department and elsewhere to get a feel for the hospital system. Obviously I have 4 months of experience last year but things aren’t always the same and time spent understanding and observing in the early stages is never wasted. So we’ve been working in and understanding outpatients, the emergency medical ward, chronic wards, pharmacy etc. We’re making progress, and seeing a lot of really interesting pathology.

Some interesting pathology...

In a lot of ways the last couple of weeks have been quite atypical in the life of JTH for a couple of reasons. Firstly the junior doctor’s strikes: this is certainly public information in Juba so I’m sure stating a few of my observations will be ok. I know there’s been some rumours, circular emails and anxieties back home about the current situation, so I thought I’d comment:

Since Monday last week (our first day!) a number of the house officers and medical officers (F1/HO and SHO equivalent in the UK) have been on strike in protest to not having been paid their incentives by the MoH for the past few months (a sum of several thousand US dollars each). In the very early stages there was apparently some nurse participation but this seems to have resolved. This has lead to the hospital being run by skeleton staff which is not ideal for patient care, but it’s still generally functioning. However, news/rumours of the situation have permeated Juba and is generally leading to fewer admissions as patients aren’t bothering to present to the hospital at all. I was looking at some admissions figures from the Emergency Medical Ward (EMW) today and a couple of weeks ago admissions were 30-50 per day, whereas for the past few days it’s been only a handful, and the chronic wards are virtually empty.

Some nice weaver birds in the hospital (to break up all that text).

There have been several negotiations between the Ministry and the Junior Docs but as yet I still don’t believe the situation to be fully resolved. This was further complicated by an unfortunate one-off episode last Thursday afternoon when some policemen turned up at the Doctor’s Mess (where we live although we weren’t there) and allegedly beat some of the doctors that weren’t working. Now I haven’t actually met any eye witnesses/victims so I don’t know the full details, but it seems to have been a relatively minor affair, although all the doctors clearly felt the threat of any violence completely unacceptable, which didn’t generally help matters in general. There have been more negotiations since and it’s unclear where the edict to the police came from, but everyone seems to condemn the actions and there’s certainly been no more trouble of that nature on the ground that we’ve been aware of. In general the senior directors in JTH are doing exceptionally well at holding the hospital together and still managing to provide emergency care to patients under these difficult circumstances.

Matt enjoying a fine lunch at the Sister’s excellent (cheap) restaurant.

A separate issue that’s been registering more on the NGO radar over last week but has less implications for us was a GoSS curfew (one day only) and military operation searching households and compounds seizing illegal firearms from civilians in Juba. Most of the hospital staff approve of the operation and it seems to have been conducted professionally.

From one report:

"Thousands of illegally and privately owned weapons including RPGs, PKMs, Kalashnikovs and pistols were retrieved in the town’s residential areas. Among them also included 12.7 anti-aircraft weapons privately owned by individuals.

The minister of Internal Affairs, Gier chuang Aluong, said the operation was aimed at freeing the town from armed criminal activities. Speaking to Sudan Tribune by phone, Majak Kuol, a resident of Juba in Atlabara B, said they started a cordon and search operation in the town early this morning. He added the joint operation by the SSPS and SPLA was a peaceful exercise acknowledging having been restricted movement."

Also anecdotally it seems to have worked. Chatting with some of the surgeons they tell me that they haven’t admitted a single gun-shot wound so far since the operation, so it seems to have been effective, which can be no bad thing. (Last year I was certainly seeing a few gun-shots per week.)

So on the lighter side of things, we’re making the most of the place. Our accommodation basically backs onto the Tearfund compound (with whom Dave and I made many friends last year) so we’ve been hanging out there a bit in the evenings playing badminton with a couple of their guys. Also they’ve kindly agreed to provide our evening meals which is just a real blessing, as the hospital is willing to pay and it’s good value all round. Recently we also tried our hand at some vetinary medicine...

Jasper the friendly dog.

So they have a puppy (rescued from marauding monkeys apparently) who’s a lovely little dog. Anyway, he needed an urgent blood test doing for quarantine regulations one day, and the vet couldn’t come (due to the aforementioned curfew.) Not afraid to try new things, we agreed to have a stab at it, so to speak. We didn’t have any knowledge of how best to go about it, so consulted the AQA text service, which astoundingly works here in Southern Sudan. They recommended the jugular approach, but we rejected this on the grounds of a) complete ignorance of the relevant anatomy and b) proximity of his teeth. A bit of exploration revealed a decent looking leg vein and with two assistance on restraining duties (which Jasper thought was a great game) I manned up and got 10mls without too much trouble at all. So there’s a first for us, but I always like learning new skills.

The tempting veins...

I generally like animals but I had a bit of a shock the other night when bedding down I felt something exceedingly strange scurry up my leg. Turned out a lizard had crept up there into my sleeping bag earlier and was probably just as indignant as I was at having it’s sleep disturbed. Anyway, we chased that out and now I’m more careful about tucking my mossie-net in firmly in the day time as well as night.

That darn lizard.

That’ll do for now. This week’s going pretty well and we’ve achieved most of our planned objectives for the week already, and some ideas and strategies are germinating so we’re feeling pretty good. More to come soon...

James & Matt

A Little Bit More...

Ok so you’ve made it through or skipped the boring previous preamble post. Well done. Now our internet access has been rather unreliable so far and I apologise. This means we have a little catching up to do over the past week, much of which relates to journeys and introductions, hence I fear this post may be slightly longer than I will usually aim for. However, once we get this orientation one out of the way then it should be much easier for us all. Right, on we go...

The journey was generally smooth – we (I) had some hassles at Heathrow regarding baggage allowances but that all turned out remarkably well. Addis was straightforward and actually rather pleasant as airports go and all luggage arrived ok. Juba airport can be a bit chaotic to the uninitiated but Dr Dario (Consultant Surgeon and Director of JTH) was there to meet us, chatting amongst the immigration officials no less (a well connected man), and hence we were warmly greeted.

The weekend was largely concerned with settling into the place. Our accommodation is in the Doctor’s Mess (the local junior doc’s accommodation) which is right opposite the hospital so location-wise it couldn’t be better. There’re still a few issues to iron out at this stage but we’re getting there. The main issues are security (it’s an open compound on the main road – no walls or gates or guards) and food. Our room locks though and everyone’s very friendly. Recently an armed guard has appeared at night. It’s a functional if not beautiful site with a hand pump for extra water if the mains is off. It’s a more authentic and culturally immersive experience than last year. The room itself is clean and perfectly adequate (although clearly a single room with two beds in) with a shower. Power is not working there yet, but we have a lovely air-conditioned office in the hospital which is a real added bonus. Food-wise the general consensus amongst the Sudanese it that we won’t get on well with the food they eat so we’re trying to come to a suitable arrangement on that one. So far we’ve been eating in restaurants which is not financially sustainable long term. The hospital will pay for our food but clearly we don’t want to abuse their generosity so we’re coming up with some creative (cheap) solutions.

 

 Our pump for washing clothes

 

Our Residence

It’s been a very tough week for the hospital with a lot of staff off on strikes over pay disputes and the atmosphere has been tense at times. There was a big police presence around yesterday which I think unsettled people. Also there was a city-curfew the other day with the army doing house searches and seizing illegal weapons. Generally this is considered a good thing, but it was quite disruptive to life in Juba. Throughout though, we have felt very safe and well looked after by all at the hospital and treated with incredible warmth and hospitality.

 

Matt and I on the Emergency Medical Ward. That's one of the nurse's kids

We’re using the time to refamiliarise ourselves with the hospital. It’s difficult to assess what’s ‘normal’ at this stage though with the strikes, however this has given us a chance to sort out some of the logistics in our accommodation. Yesterday Sister Anna took us to the market where we bought some bowls for washing our clothes, and also some more bed sheets. Matt chose us some nice floral numbers. I managed to acquire some bamboo canes today so I can erect my mossie net tonight (hitherto unused - I took a few bites last night and woke up itching at 0230). Our health has been good thus far.

 

 

I guess we’re still trying to work out what our main trip objectives are going to be, but we plan to start with some shadowing and working within the system to see how things are rather than going in all guns blazing. Certainly everyone’s extremely welcoming and happy to see us, and it feels more like a genuine reunion of friends than anything superficial. In a sense I don’t feel like I left at all – it’s a wonderful family here amongst the hospital staff. The respect and friendship took us quite a long time to earn and develop last year and it’s nice that it seems as strong as ever and should help us to get on and do things more quickly than last time. Patience is key here and not letting yourself feel frustrated at an apparent lack of progress. Generally most of the really good stuff happens when you least expect maybe after a couple of hours of general chit-chat. Certainly some of the best stuff that David and I did last year weren’t planned, they just grew organically. That’s just the way things happen over here, and never being much of meticulous planner myself, frankly I rather like it.

Anyway, I hope that wasn’t too unbearable. We should be able to get on to the good stuff now. If the above was too wordy (Nick) to summarise:

• Arrival safe
• People friendly
• Having fun.

Bye for now

James & Matt

New Blog

Hello and welcome. I’m James, this is my new personal blog. This will be largely a continuation of last year’s St Mary’s Juba Link Travel Blog (http://stmarysjubalink.blogspot.com) which some readers may be familiar with.

Matt and I

First some rather dry but necessary housekeeping (You can skip this bit...): The switch from an institutional blog title (i.e. St Mary’s Juba Link) to a personal one is largely one of logistics: Firstly I no longer work for St Mary’s hospital and although I remain in very close contact with and supported by the Link Core team at St Mary’s, the current trip to Juba Teaching Hospital has largely been privately rather than corporately arranged. Secondly I hope that this blog will continue in the future as I undertake further adventures in medical travels and an unmodified domain name would be rather confusing. Obviously the St Mary’s Juba Link is entirely relevant to our current trip to Juba Teaching Hospital which I’m sure will be reflected in future posts. In particular we’re looking forward to working a delegation from St Mary’s in December undertaking some fistula repair work, though more of that in due course. Incidentally, the blog title was inspired by a friend I made in India in 2004 and I always rather liked his blog.

In terms of my personal career progress since returning to the UK from Juba in 2008, (if you care) I worked as an SHO for 6 months in ITU and Acute Medicine until August, and secured a training job in Anaesthetics in Wessex, which commences in April 2010. Gaps in medical careers like this are somewhat rare gifts, and hence I was keen to grab the opportunity to do some more overseas work in Southern Sudan. Incidentally David, my partner-in-crime from Juba 2008, also obtained his first choice job and is currently doing core medical training in Exeter, though I’m convinced he’ll also be back in Juba at the earliest opportunity....

A fine specimen I found on our (outside) house wall

My current Juba buddy for 2009 is Matt Dennison, a doctor at the same level as me. We trained together in Southampton and worked together as House Officers in SMH. He’s subsequently been all round the place, latterly working in New Zealand. I’m sure he’ll be guest posting. The blog title in no way is meant to diminish his contribution to this current project, and is merely a reflection of the fact that I’ll be personally taking the blog further in the future.

Right, sorry to bore you with the above, as I’m sure you’re more interested in the good solid life-in-Africa-saving-lives(!) stuff. I strongly believe in keeping blog posts little-and-often and hence I’m gonna put that in a separate post to follow very shortly, with some photos if all goes to plan.

James

There and back again

It will be strange working in a hospital without goats roaming free...

It is 8.10 pm in Addis Ababa Airport and we are waiting for our flight to England which leaves at 00.25 am. In twelve hours time, we will land in London Heathrow and this whole tale will seem like a dream. Already our old lives in Juba seem to be shrinking into the shadows as we dwell in the limbo that is Addis. It is now time to write the epilogue of this most glorious little adventure.

Some of our EMW nurses with new uniforms plus Sister Anna

On Friday myself and James did the last clinical work we would do in JTH. Rather fittingly it ended when one of our nurses alerted me to a sick patient who was really sick - they had to go urgently for an operation for necrotising pancreatitis. The rest of the day was spent doing a formal handover to the folk at JTH. They will have a busy life ahead of them instituting triage, setting up structured medical teaching, continuing nurses training and continuing with the restructuring of the acute care services. However, from working with these people I have faith that they will do it- they are wise beyond their years and hard-working.

Part of Dario's House. It was a beautiful summer's evening

That evening the Hospital Director, Dario, invited us to his house along with all of our friends in JTH to say goodbye to us. About 30 people were present and Dario’s family laid on a fine feast with wine in the aftermath. Although Dario lived in Juba city, it felt more like we were in a close-knit village. There were about 25 people living in 6 tookalls (the huts they live in) within a fenced compound, all of whom were Dario’s relatives. The courtyard was everyone’s “lounge” with tables and seats outside. They all take their meals together, chat together and the kids play together. It was a really lovely, friendly set up, which made for a relaxing experience. A perfect end for us, marred only by the rancidity of having to say goodbye to all of our close friends. James summarised the event quite poetically, “I am glad saying goodbye has been so hard. It is a sign that we have made some strong, true friendships. It's a price worth paying.”

Hanging out with some of the JTH crew at Dario's

The next round of goodbyes came when we had to bid a fond farewell to the Comboni’s. Valentino gave us a big hug and they all said that we would be welcome back any time.

As I sit here in the internet cafe in Addis, I cannot help but reflect on the times I have had with these people and all the smiling and hand-shaking that went with them. The trust and friendship that we had traversed our cultures and brought us closer.

We had some awesome conversations that I would never have in the UK. The most memorable one had to be with the Ward Sister of the Emergency Medical Ward, Anna, when I jokingly told her she had the memory of a goldfish:

“What is a goldfish?”
“It is a small orange fish that we keep in a tank.”
“Do you eat them?”
“No!” I laughed
“Well what do you do?”
“We watch them swimming.”
“Why?”
“Because it’s what we do. It’s fun.”
“How can this be fun?”

I realised how stupid the whole thing must have seemed to her and when I thought about it, it is. It’s little things like this that make you chuckle.

Oddly enough, it is being here with these people, immersing yourself in their way of life that makes you realise some of the imperfections in our own society. Allow me to elaborate.
I spoke to Martin, the Obs and Gynae Consultant about English Society. “Do you speak to strangers when you wait at a bus stop, Martin?” “All the time.” He answered.“At home,” I continued, “We do not speak to strangers. If I was to speak to a stranger, the first thing that would go through their mind is ‘What does he want?’”

James and I have often talked with the Comboni’s and we find it interesting that we started out as Westerners thinking that African society was not as good as Western Society. Many people want to “help” Africa by making it more Westernised. Although in some respects this is good, is it all good? Probably not when you consider that 25% of the British population have been registered as depressed at some point in their lives.

I believe that all of us, whether we be African or English, have profited emotionally and spiritually from this experience. For us, we have developed a new found humility and respect for Southern Sudanese values and their way of life. These guys know what they want and they will achieve their goals irrespective of the St Mary’s Juba Link, NOT because of it. However, they really appreciate the helping hand.

Anna and Magdy often said that they were guilty of not thinking ahead and this is true. I often used to say to them that the only thing I would want to export from my culture was a sense of planning ahead - here people wait until something runs out before they replenish stock, which causes a truck load of chaos. I think this has been exported, our drugs cupboards have never run out of supplies.

However, there is something that I am going to import from these people - their humility and gratitude for the good things (such as oxygen that flows out of the walls of hospitals, drinking water from a tap etc.), their kindness and hospitality to strangers, and their sense of family and community. Our anonymous and fragmented society, hopelessly lost in the relentless worship of consumerism, would do well to learn from them.

Dave and James

PS: We both got back safely to the UK. It's going to be tough for us both I think to readjust. If you've enjoyed following our journey then do comment on the blog or email us. We'd appreciate it.

Performance = (Knowledge x Motivation) / Obstacles

“Look to the east, on the morning of the fifth day” Gandalf said to Aragorn. Aragorn was to go on and assist commanding the defence of Helm’s Deep whilst Gandalf went off in search of Eomer’s army to relieve the defenders from the evil armies of Isengard. This ended the battle of Helm’s Deep but the battle for Middle Earth was far from over.

One of the Nurses expressing her thanks for the training

Today the armies of Isengard, represented in Juba as the evil forces of apathy, hopelessness and low self esteem were delivered a long overdue, crushing blow. We have often talked about the plight of the nurses, the down-trodden profession of Southern Sudan. Their self-esteem is low, morale is non-existent and their pay amounts to £50 a month, which is hopelessly inadequate to feed a family of 6 or 7. The only way out for these people is promotion and this comes from training and good patient care. As a result their thirst for knowledge is insatiable.

Dr Dario adressing the audience.
With him is Jo who was covering the event for the news

You will also recall that we have helped develop the New Medical Emergency Ward, staffed by nurses that we had trained and had volunteered to work in the ward. It’s much busier than all the other wards, and they weren’t expecting anything in return. On November the 13th the ward opened. We had well trained nurses. We had the life-saving medicines and equipment. The question was “could they deliver good patient care?”

Dr Yatta, Director General for Curative Services, MOH/GOSS

To answer this question, we compared the mortality levels in July with the levels since our ward opened and the results are, quite simply, breath-taking. The mortality reduction was immediate and absolute. Although the number of admissions had actually increased since the wet season, we measured a 40% reduction in 24 hour mortality and a relative reduction of 18% in overall medical mortality (For the medical folk amongst you absolute difference is 1% hence our NNT is 100). We had shown that these nurses had delivered staggering patient care and had training. The stage was now set for the grand finale - the empowering of the nursing profession - in short a massive reward.


We asked the senior medical and nursing staff in JTH about the best way, culturally, to employ these nurses as an example to motivate and empower others. The glorious thing about the people here is they know exactly what gets their people excited. A few high level meetings were held, a modicum of strings were pulled, and the results, you see below:



Nurses (and indeed everyone) here love ceremonies. So the JTH staff held a ceremony for the 120 nurses who graduated in the courses we had ran over our stay here. Present at the ceremony were two key players in the Ministry of Health, Janet Michael (Director General of Midwifery and Nursing) and Dr Yatta Lugor (Director General of Curative Services - i.e. secondary care).

There was lots of singing and dancing as well which was thoroughly enjoyable

During the ceremony, the Medical Emergency Ward received modern, new, blue uniforms to replace the old 1950’s white uniforms that they usually sport. But life just kept getting sweeter. Following a personal recommendation from our Hospital Director, Janet and Yatta vowed to promote all of the Emergency Medical Ward nurses.

Janet Micheal, Director General for Nursing and Midwifery, MOH GOSS

“I want to send one clear message to all my nurses.” Janet said. “There is only one way to get more money and that is through promotion. This comes from training and through good patient care.” She had empowered the nursing profession by offering them hope and a way out of poverty. Furthermore, the uniforms that our Emergency Medical Ward nurses wear will serve as a constant testimony to all nurses that if you work hard, there will always be a reward. This is some powerful motivation, which is vital in the long term strategy for capacity building. And who better to build Southern Sudan’s capacity than it’s own people?


At the end of the ceremony, we were surprised and very touched when we received three sets of presents from three parties, the Juba Core Team, the Ward Sisters and the nurses on the Medical Emergency Ward, who had all clubbed together.


The greatest present, however, was a wooden plaque in the shape of Sudan that read:

"The entire community of JTH will always remember you and miss you. Thank you for the services you offered in Juba Teaching Hospital. We wish you all the best in your profession and your service to God's people."

It is gifts such as these that are the most generous and greatest gifts of all because these are the gifts that people have given up their time to make. In a land where days off are still a luxury, the time and efforted invested in hand-crafting this is, quite simply, priceless. and we were rendered speechless (and a little tearful, I may add) with gratitude. We know the people here very well and even after four months, they will still surprise and amaze us.

Tomorrow we are going to Dario's house for our leaving party. He has promised to slaughter us a goat...

...the next time we write will be from Addis on our way home.

D & J

Endings

I’m sorry we haven’t written much for a few days; life is tremendously busy for us at the moment. A well written story has a strong beginning, middle and end, and we feel it’s important to arrange a good strong ‘ending’ to our work here, which has been occupying a lot of our thoughts and activities for the past couple of weeks.

Dave teaching our nurses the finer points of the glucometer

The Emergency Medical Ward continues to be a success – the doctors and nurses are very happy with it. In a world of evidence based medicine and clinical governance, we need more than anecdotal evidence however, and we’ve been involved in both clinical audit and research into mortality rates and distribution to prove its efficacy. The results from both are very encouraging and we’re arranging a final big presentation for the hospital and the Ministry of Health to present the results. This will also be combined with a big public reward ceremony in JTH for the nurses we’ve trained to acknowledge and commend them for their dedication and hard work. They are the real heroes and it’s largely been the nursing staff (with a little training and guidance from us) that are responsible for the improvements. Nursing here has traditionally been a profession which is rather downtrodden, and so it’s important to actively continue to take steps to change that culture.

Louis' family and house

Louis & Dario: two key players in JTH. (Dario's our boss)

One of the greatest privileges we had during our time in Juba has been the opportunity to get to know and forge real friendships with the Southern Sudanese doctors and nurses we’ve been working with. They really don’t see us as outsiders anymore. The folks here are always very polite to foreigners, especially ‘kawajas’ (white people) but beneath this there are some very definite suspicions of their motives. (And in some cases rightly so...)

Louis and Baby Danga. A proud father.

William, the hospital administrator. William's a huge Sudanese man who has a handshake that could break your wrist, but a big heart.
He also has 4 wives and 21 children!

On Sunday afternoon we were invited to Dr Louis’ (Paediatric Registrar) house to eat with him and meet his family. It was wonderful to share in his hospitality. We had a great time actually. I think we would both agree that it was far better to eat there in his home than a pizza in an air-conditioned restaurant full of kawajas. Dave and I have also recently been enjoying our after-work beers in an African ‘local’ pub rather than the posher hotels for the similar reasons. For one thing, it’s cheaper(!) and for another, what’s the point of coming to Africa and spending as much of your free time as possible trying recreate the western world you’ve just left? Peer support and relaxation is important in often demanding circumstances, but I think it’s also easy to get too sucked into that world.

Some of the key players in Comboni.

We’ve learnt a lot of this philosophy from (other than Bruce Parry) the examples we see in the Comboni Missionaries we live with. We have the utmost respect for their unrelenting identification with and love of the people here. They didn’t even leave Sudan during the civil war. “Well the Sudanese people can’t leave for safety so why should we? It wouldn’t be right!” Brother Valentino once told me in the context of a story about how their village was being shelled. Incredible.

Jubalicious...

Endings

I’m sorry we haven’t written much for a few days; life is tremendously busy for us at the moment. A well written story has a strong beginning, middle and end, and we feel it’s important to arrange a good strong ‘ending’ to our work here, which has been occupying a lot of our thoughts and activities for the past couple of weeks.

Dave teaching our nurses the finer points of the glucometer

The Emergency Medical Ward continues to be a success – the doctors and nurses are very happy with it. In a world of evidence based medicine and clinical governance, we need more than anecdotal evidence however, and we’ve been involved in both clinical audit and research into mortality rates and distribution to prove its efficacy. The results from both are very encouraging and we’re arranging a final big presentation for the hospital and the Ministry of Health to present the results. This will also be combined with a big public reward ceremony in JTH for the nurses we’ve trained to acknowledge and commend them for their dedication and hard work. They are the real heroes and it’s largely been the nursing staff (with a little training and guidance from us) that are responsible for the improvements. Nursing here has traditionally been a profession which is rather downtrodden, and so it’s important to actively continue to take steps to change that culture.

Louis' family and house

Louis & Dario: two key players in JTH. (Dario's our boss)

One of the greatest privileges we had during our time in Juba has been the opportunity to get to know and forge real friendships with the Southern Sudanese doctors and nurses we’ve been working with. They really don’t see us as outsiders anymore. The folks here are always very polite to foreigners, especially ‘kawajas’ (white people) but beneath this there are some very definite suspicions of their motives. (And in some cases rightly so...)

Louis and Baby Danga. A proud father.

William, the hospital administrator. William's a huge Sudanese man who has a handshake that could break your wrist, but a big heart.
He also has 4 wives and 21 children!

On Sunday afternoon we were invited to Dr Louis’ (Paediatric Registrar) house to eat with him and meet his family. It was wonderful to share in his hospitality. We had a great time actually. I think we would both agree that it was far better to eat there in his home than a pizza in an air-conditioned restaurant full of kawajas. Dave and I have also recently been enjoying our after-work beers in an African ‘local’ pub rather than the posher hotels for the similar reasons. For one thing, it’s cheaper(!) and for another, what’s the point of coming to Africa and spending as much of your free time as possible trying recreate the western world you’ve just left? Peer support and relaxation is important in often demanding circumstances, but I think it’s also easy to get too sucked into that world.

Some of the key players in Comboni.

We’ve learnt a lot of this philosophy from (other than Bruce Parry) the examples we see in the Comboni Missionaries we live with. We have the utmost respect for their unrelenting identification with and love of the people here. They didn’t even leave Sudan during the civil war. “Well the Sudanese people can’t leave for safety so why should we? It wouldn’t be right!” Brother Valentino once told me in the context of a story about how their village was being shelled. Incredible.

Jubalicious...