We had a nice meeting with a group of physicians and public health clinicians from University of Alberta, in Edmonton. They have a lot of international experience and are hoping to expand their work into Juba. There are plenty of opportunities to get involved.
Aid is such a tricky thing. What is the best formula for bringing the developing world out of poverty? The big opposing camps are: 1. We're on the right path, what countries like South Sudan need is more money and more help from multinational donors and NGOs, 2. Our current approach for aid isn't working, and is actually making things worse, so it's better to pull out completely and let the countries take control and run things themselves. I go back and forth between these. As I'm writing this from Juba, clearly I'm currently a believer that aid can make lasting changes, especially when it comes as education. But there are certainly days I feel that we should all pack up and get out, let the situation get so bad that there is an internal revolution of sorts, and that changes are made from within that equal the playing field a bit between the haves and have-nots.
Just received a call from the house officer (intern). A patient with heart failure has low blood pressure and a fast heart rate, as well as signs of fluid overload and clammy skin. This would be a difficult patient to treat in California. Let's try some gentle fluid boluses and antibiotics and see how she responds.
Frisbee, a twice weekly bright spot in the schedule, lies ahead. I have just about a week and a half left in Juba for this trip. I'm looking forward to giving a few lectures before I leave, evaluation of chest pain and HIV opportunistic infections. Then, a chance to step away for a few months to bring some needed perspective.
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