So after 11 years of feeling called, 7 years of medical training, 6 years of marriage, 2 years of support raising, and 4 months of packing up our house, we made it!

So what we are doing with our lives now that we’re off the plane?

Not shown: the 16 pieces of luggage we’d been hauling for 3 days

Well besides keeping the ol’ home fires burning (literally), we’re mostly working in the hospital and doing language lessons. Our goals for the first two years are pretty simple: learn how to capably practice medicine and nursing in the hospital, gain a basic proficiency in Juba Arabic, and build relationships with our co-workers, neighbors, and friends. Not as easy as it sounds when you can’t just run out to the store for groceries any time you feel like it and you’re on a multi-cultural team working in a very different culture.

Maggie is working one day a week in the hospital, learning how to do anesthesia for c-sections (hooray for ketamine!) and manage a growing staff of nurses and nurse-midwives from all over East Africa. The rest of the time, she’s at home with the kids trying to figure out what she can cook from our very limited pantry on the charcoal stove in our yard while I work at the hospital. I watch the kids while she works and so far have had one other day off per week to rest; I’m on call 2-3 nights a week depending on how many physicians are around.

I’m also learning how to manage obstetric emergencies and perform c-sections since I didn’t get to do much of either during my residency. Thus, I’ll often be on backup call to get experience in these things (and some other procedures). We expect that it’ll take about 6 months or so before I’m able to work independently (which will give the long-term doctors here a little relief and help us all balance the day-to-day clinical responsibilities with administrative work, family time, and other projects like research).

I make up for my lack of knowledge with my fundal-pressing skills.

There are technically 42 beds in the hospital split between maternity and pediatric patients, though oftentimes our capacity is exceeded and patients sleep on the floor or in the procedure room. We’ve been blessed recently to have lots of Clinical Officers (roughly the equivalent of Physician Assistants in the U.S.) who see patients with us and assist in procedures, so most days I’m supervising a team of 2-3 clinicians that sees 20-25 inpatients or 40-50 outpatients together. We also have antenatal clinic twice a week where one of the physicians reviews another 40-60 pregnant patients in addition to managing one of the wards. At any time, though, rounds or outpatient visits might be interrupted by the need to perform an urgent c-section, cast a fracture, or attend to a much sicker child who has come in.

Lots of Clinical Officers (as well as a growing roster of nurses) means lots of opportunities for education! In addition to weekly lectures (which have been going on for some time), we are now doing case conferences and grand rounds where we all discuss patients together. Advancing South Sudanese medical education is a big part of what we came here to do, so I’m excited to be doing it every day I’m in the hospital!

Ward rounds with the clinical officers, nurses, and students.

This is our work and these are our days. I miss the deep conversations I had with my patients in Baltimore and the half-hour block Healthcare for the Homeless gave me to have those conversations. I miss being able to order advanced diagnostic tests for my sickest patients when here I have to say, “If you have enough money, you could go to Uganda and they might be able to figure out what’s going on.” I miss being able to eat a Deluxe Spicy Chicken Sandwich when I had a bad day at work (not as much as the other things, of course). Still, it’s good to be here and we are glad to be figuring out what God has for us here day by day.