Nurse from Alice Springs working in Ethiopia

Nurse Colin Watson, when he was working in Gaza.
© Isabelle Merny/MSF

Colin Watson is a nurse from Alice Springs. He writes to us from Mathar in Ethiopia, where he has been working since March 2010. This is Colin's third field placement with Médecins Sans Frontières, having previously worked with the organisation in South Sudan and the Palestinian Territories.

I am reminded of Joseph Conrad’s novel Heart of Darkness as the boat makes its way upstream. I am on the Dhure River in western Ethiopia and our destination is a village called Lol Kuach where we will conduct a mobile clinic. I have been in Ethiopia for three months and I am based in the small town of Mathar about eight kilometres from the Sudanese border. This part of Ethiopia is very remote and is home to the Nuer, a predominantly cattle herding people.

Médecins Sans Frontières opened its project in Mathar in November 2009 in response to conflict which had displaced many people. The main objective of the project is to provide health care to vulnerable populations and respond to emergencies. In conjunction with local health authorities, Médecins Sans Frontières is managing the health centre in Mathar. This health centre provides both outpatient and inpatient care. The project also conducts mobile clinics. As a nurse, my role in this mission is two-fold; I manage the pharmacy and supervise mobile clinic activities. The mobile clinic team consists of 12 national staff and includes nurses, health officers, logistic assistants, translators and drivers.

During the dry season, getting to Lol Kuach is a fairly straight forward matter. Now that the rains have arrived and road travel is no longer possible, our journey is a little more complicated. We travel upstream until our passage is blocked by water hyacinth which completely chokes the river. We unload the boat and wade through ankle deep water for 20 minutes to reach dry land. We carry all our equipment. But the river is not quite finished with us – after a further 20 minute walk we again reach the river bank where we load our equipment and ourselves into a dugout canoe for the final leg of our journey.

We arrive in Lol Kuach and are greeted by the excited cries of children calling ‘Kawayi Kawiyi’ (white person). Lol Kuach has become home to people displaced by conflict in Akobo, a region south of Mathar. When people are forced to flee their homes suddenly and in large numbers, the impact on health can be great. Displacement can cause food insecurity, poor water and sanitation and inadequate maternal and child care. Other consequences are more subtle and less obvious.  For the people of Lol Kuach, the primary concern is one of access to health care – flooding and tensions limit their access to our clinic in Mathar.

Our clinic is conducted under a large tree in the centre of the village. People are registered, screened and consultations provided. We see a diverse range of clinical conditions. Today we see a person with leprosy and many people with malaria. Now that the weather is cooler, we see many children with lower respiratory tract infections. The health care needs here are great – the mobile clinic team is constantly challenged to triage the most severely ill people. Before our clinic is completed, we have identified three people who will return with us to Mathar for inpatient treatment.   

Through mobile clinics I have been given unique access to Nuer culture. The Nuer are very mobile, moving with the seasons in search of pasture and water for their cattle. This mobility has implications for our service – particularly for people who are being treated on an outpatient basis. One of the more interesting exercises I have undertaken is to map these seasonal population movements. This will hopefully give us some idea where to find people at various times during the year.  

This is my third field placement with Médecins Sans Frontières but in many ways it feels like my first. This is Médecins Sans Frontières at its best – bringing health care to people who are affected by both conflict and a lack of health services. While our working day is often long and our living conditions basic, our activities here are valuable and I feel privileged to be a part of this project.