Thoughts of a Coffee Drinker

Powdered milk makes tea taste of cheese, which somewhat limits the enjoyment of drinking it. However, it is possible to get decent coffee in Juba. I was going to conduct a rigorous scientific survey to identify the best coffee here, but it turns out that there is so much variation within each establishment that I couldn't afford enough coffee in order to have a large enough sample size. I have tried though.

While sat in a very pleasant cafe the other day, for coffee research purposes, I had a bit of time to reflect on my last few weeks and to take in my surroundings. The week or so following my last post was incredibly frustrating, I think a lot of little things about working here got to me. I was very frustrated with the system, and many of my colleagues who didn't seem to care about patients or improving the systems they work within. I got to the point that I was dreading going in to work. I don't know if I was fed up of telling people we couldn't do anything for their illness, or if doing the ward round and finding that my colleagues hadn't done anything for any of the patients since I last saw them.

I have realised that there are huge cultural differences between myself and the local doctors, partly stemming from the fact that they have to make do with what they have here; I get frustrated when I see people prescribing completely random medications for people (ranging from the ubiquitous multivitamins to anti-hepatitis B drugs in people with any kind of liver problem), they are just trying to do something for the patient. As medicine here improves (and it is, if you have money at least) the old attitudes are hard to let go of, and evidence-based medicine is having a tough fight to break through. I imagine if I had always worked in a limited-resource setting such as this, I wouldn't be so emotionally involved with my patients, as there are so many of them that you can't do anything for. Even if you can't cure someone back home, there are almost always things you can do to help their symptoms and to ensure their emotional wellbeing.

Part-way through my second pot of coffee, I realised that I had almost written up a report on an audit that I started last week. I found myself looking forward to my shift at work, and my trips over to the government hospital. Some of the things they do still drive me completely mad, but I think I've learnt some tolerance and understanding about what makes my colleagues tick. I was determined that I wasn't going to be the guy who came out and told everyone that they're doing it wrong; it's a tricky balance to strike, because people do ask how we would do something in the UK, but I need to remember where I am and the limited resources that we have here. I think my week or so of giving up is over, but with less than 3 weeks left here, I have a lot still left to do.