A Day in the Field

I’ve had a few people ask about what a typical day is like in the field, so for one day during the Gogrial East Campaign I wrote down all of our activities. I would say it was a pretty average day. I apologize in advance if this entry gets a bit long or overly detailed- I’m new to this whole blog thing!

A day in the field.

My day begins abruptly at 6:30 am with a car starting and Dinka music blaring about 5 meters from my head. I lay in the mozzi dome for another few minutes listening to the roosters crow and a loud donkey braying in the nearby field. We all choose to sleep in our mozzi domes, because the tents are too hot. The mozzi dome is basically a pop-up mosquito net, it allows for air movement so it’s much more comfortable. I unzip my dome and reach for my shoes. Before putting them on, I check for scorpions- all clear. I’ve been lucky so far, but yesterday someone got stung by one, so today I’m even extra cautious. As I get up, I notice other Medair staff doing the same. I look around, since the rains began, the landscape has changed drastically- seemingly overnight. Where before the view was gold and brown, now there is the lush green of new growth. We pack up our mozzi domes and move them back to the inside rooms where we store our belongings. On an average day the room is shared with 15 bats, and smells like it. Inside is stiflingly hot, and within minutes I am sweating while carefully avoiding the bats. Next I head back outside and walk to the neighborhood borehole (hand-pump well). It’s a public facility, but fortunately for us, it is very close to our base. There is already a small group of women and children gathered around the pump.

Taryn trying out the borehole.

They are surprised to see me, and quickly begin chattering amongst themselves and giggling when they realize I’m there to collect water too- white people very rare in Lietnhom. I greet them all, one-by-one, in Dinka. This sets them over the edge with laughter and questions. Once I’d learned everyone’s names and shaken everyone’s hands I reached the extent of my Dinka knowledge. I’ve learned that in South Sudan it is very important to greet everyone with a handshake and “how are you.” That’s about the minimum, and had I not just exhausted all of my Dinka phrases, I would’ve also asked about their families, cattles, crops, etc. It took me a while to get used to these long introductions, but now I’ve come to really appreciate the interpersonal culture of South Sudan. As we pump water, people trade out frequently at the pump because it is a labor-intensive job. Since I don’t have to carry my water far, I help pump for some of the other ladies too. Many of them will carry these large jerry cans a kilometer or more. Pretty soon they insist it’s my turn and I carry the filled bucket back into the compound- not gracefully balanced on my head like the other ladies, but awkwardly at my side and spilling a little as I walk.

Now ready for the day, I go and sit outside by the tukul. A few of the team members are already there enjoying tea and mandazi (fried bread). I stir up a cup of instant, Nescafe coffee- which isn’t ever what I’m hoping it will be, but is better than no coffee at all. The hot water and mandazi were prepared by a local lady we hired to help us cook. She comes early every morning to light the fire, start boiling water and pounding out the mandazi dough.

Soon the rest of the team arrives, and the drivers show up after finishing their own tea in the market. We grab our backpacks, pack our supplies, and head out to the field. Today I hop in the car with Simon. Our first stop is the clinic in Lietnhom. I check in with the in-charge of the facility. Only one new measles case since yesterday. Sitting outside the facility are two enumerators for our LQAS coverage assessment. Even though vaccination is ongoing in some payams, my task for today is starting the coverage assessments in the areas where vaccination is finished. While we keep track of every child vaccinated, the true indicator of the success of a vaccination campaign is a good coverage, or the percentage of the population that has been vaccinated. For measles, it has to be 95% or higher. A few days ago Moses and I held a training for the 24 independent enumerators that would be conducting the coverage survey. The goal is to have as much independence from Medair as possible, so we don’t sway the survey results.

After greeting the enumerators, I give them the list of villages that have been randomly selected for assessment. In total across the 6 payams (like a township) 114 villages were randomly selected. From each of these villages, on household will be randomly selected. From that household, on child will be randomly selected. And from all this randomization, our goal is for 95% of the children to have been vaccinated in the campaign. We map out the villages and pick one to start. We decide to go to the farthest location first since we have the car. We hop in the car and take off. The village is across the river, and unfortunately there are only small community built roads to access it. But it didn't rain last night so we are able to make it through the semi-dried mud and through the river whose waters have not yet risen. As we continue down the road, occasionally losing it and having to ask passersby where to find it again, we are the only car around. The only others using this road are the people going on foot to buy or sell in the market and the pastoralists with their cattle.

The cattle herders use the same river crossing as we do.

I am fascinated by the pastoralists. When the season changes they pick up their settlements and move based on the availability of water and food for their cattle. Hundreds of cattle are moving along the road as we are trying to get by. Out in front, there is a young boy walking and rhythmically beating a drum. The cattle know that they should continue walking while the drum is beating, they stay together and don’t stop to graze. Scattered among the herd are women carrying rolled up woven mats on their heads, and hollowed out Kalabashes in nets across their shoulders. Some have babies on their hips, or in baskets on their heads. Everything they have they carry. There are also men, most carrying sticks or spears and herding the cattle forward. Some men are carrying small children on their shoulders, and an equal number are carrying small calves. They walk, remarkably quickly, over immense distances. As I’m watching them pass, Simon says, “even in the rain, they will not slow at all.”

This herd of cattle is moving along the road near Lietnhom. They have been traveling from areas in the north of Gogrial East, and are going as far as Luonyaker.

Once at the village, we walk to a nearby tree. There in the shade is a large group of men playing a game similar to mancala. After a quick Dinka conversation between one of the enumerators and one of the men, we are directed to an older gentleman sitting on the other side of the tree. He is the chief of this village, and many others here are village elders or community leaders. We introduce ourselves and explain why we have come. He tells us that he was thankful that vaccination came to his people, and that he would allow us to continue the survey.

After thanking him, we set of to the village center. Here the enumerators spin a pen, and begin walking in the direction is it pointing. As we walk they number off all the houses until they reach the edge of the village. Then, they write the numbers on scraps of paper, and randomly draw one number (on household) for the survey. We turn back and walk to the selected household. There is a child of about 6-7 years holding a baby outside. On our approach she calls inside the tukul and a woman comes out with another child of about 3 years trailing behind her. After another short conversation in Dinka (of which I only recognized the word Kung-kung  which means measles) she ducked back in the house. Just as I’m about to ask the enumerators to translate for me, she reappears, this time holding 2 yellow vaccination cards. This is good news, the mother took her children to the center, and both children in the target age group were vaccinated. For the sake of random selection, the enumerators draw numbers again, and select one of the children to complete the survey.

Even though this is just one household, it’s incredibly validating to see that this random household, in this remote area, was reached by our programs. But I don’t have time to revel in the success, because we have to go to another village to continue the survey. Along the way, I receive a call from the payam supervisor for one of the vaccination areas, one of the teams is running low on vaccine. So change of plans, we drop of the enumerators at their next village to continue the survey (more independence), and head back to Lietnhom health clinic to pick up some vaccine carriers and then continue on to the cold-chain facility nearby. This recently completed facility has a few refrigerators and 2 deep freezers, as well as a recently installed generator supplied by UNICEF. We pick up some ice-packs from our cold boxes, and some vaccines from our arkteks (arkteks can safely store vaccine for about 3 weeks without losing temperature). Even though the cold-chain facility is working, we prefer relying on the cold-boxes and arkteks. At any point the generator could run out of fuel and we could lose our vaccines if we can’t find more quickly. And fuel availability in Lietnhom is risky. Or as was the case last week, the county commandeered the cold-chain fuel to supply the ambulance to take a patient to Kuajok. We didn’t find out about it for a few hours, then we had to rush to distribute vaccines to the solar powered refrigerators in the villages (they are smaller so the vaccine won’t all fit in one).

Vaccine collected- we set out to find the vaccination team. They are working about 20 minutes away. This area was supposed to finish vaccination 2 days ago, but due to seasonal population movements, there were a lot more people than they expected, so we had to add extra vaccination days. We found the team quickly. They were set up under a large tree in the center of the village. The team was working well, but only had vaccinated about 20 kids so far today. This tells me that vaccination is finishing and we’ve achieved good coverage, otherwise the numbers would still be high. After handing over supplies, seeing if they had any problems, and watching them vaccinate for a little while, we began to leave. As we are getting back in the car, they stop us, and ask if it is possible for us to increase their pay, or buy them lunch, or provide transportation incentives so they can use bicycles to come to work. This is not the first time I’ve heard these requests. We get asked by almost every team, every day. We explain that their salary will come at the agreed rate as soon as the campaign is finished. Fortunately, they’ve heard this before and accept the answer, but not before reminding us that they are “truly suffering for this program” because they can’t buy tea. This is the other major thing I’ve learned about South Sudan, taking tea is very important, and if anything interrupts tea taking, it is a problem. We again assure them that we appreciate their work and that the payment will be at the end. And then we leave and they jump back into the work. As frustrating as it can be constantly negotiating and having to say no to requests from teams, I do see the hard work they are doing, and understand that for many, this is the only work they’ve had in a while so they may not have any funds to buy tea or lunch themselves.

Next we head to find another team of enumerators. We like to supervise each team at least once to make sure they understand how to randomly select the survey respondents. Luckily I have network, so I can call them and find out where to meet them. We set out again. Everywhere we look, we see people digging and planting crops. The most common farming tool I see is the shape of a hoe, but instead of turning at the end, it is straight like a spade. They kneel in the soil and swing in from left to right to till the soil. Occasionally, we pass someone very fortunate that is steering a plow yoked to two cows. One interesting thing about roads in South Sudan is that most of them are seasonal. They are only available certain times of year, but not just because of flooding and mud, but also because South Sudan has a very short growing season. There is a limited time between when the rains start and when the entire area floods and there is no land to cultivate. So when it comes time for cultivation, everywhere is fair game. As we are driving we find blocked roads and fields obscuring our path. If we can’t find a way around, we have to stop and convince the landowner to allow us to pass, driving through their garden. They often agree, because it’s still planting season, and most crops haven’t started growing yet. Usually we find a way, but sometimes the car stops and we foot the last bit of the journey.

After meeting the enumerators, and going with them for a few surveys (3/3 vaccinated!! YAY!),  we returned to Lietnhom. It was already almost 4pm which meant that the single ‘restaurant’ in the market would be out of food. While hot food can be nice, there is only so much goat a person can eat, so I’m not super disappointed that we will find food elsewhere. We stop by the one stall in the market that has a refrigerator and each buy a cold-ish soda to tide us over until dinner. It amazing that we can find a cold soda in the market here, where so little is available. Actually, when the health facility has problems with their refrigerator, they pay the shop-owner to store the vaccine and medications in this one.

Back at base, we again head for the borehole- we need water for a bucket bath to wash of all the dust and sweat from the day. Then we just hang out in the shade of the mango tree until the rest of the team is back. Once everyone is on base and had a chance to settle in, we have our evening team meeting. Depending on the challenges of the day, it could be 30 minutes or 2 hours. At the end of the meeting we plan out the next days movements. Who is going where, which car had problems today, which team needs extra support, who is needs to be paid because their work is done…. Finally finished, and it’s dark out. We use our headlamps to dish out our dinner. For me, it still feels like a luxury to have someone hired to cook for us. But with a large team, and the difficulties of cooking everything over a fire, from scratch, there is no way we would have time. The cook works the whole day, finding the ingredients in the market, negotiating prices. For some local foods they would literally grind their own flour from sorghum. Tonight’s dinner is Ugali, beans, and Chicken. Another team member, Oyay, saw the chickens when they were driving and purchased them through the open car window. All in all, a pretty good meal.

After dinner we sit around and swap stories until one by one we disappear into our mozzi domes. I fall asleep looking up through the mesh net of my mozzi dome at the stars, and usually listening to some Dinka music coming from a neighboring tukul. I sleep soundly, until in the night I notice raindrops hitting my face. I hear someone nearby call out "rain!" and everyone hurries to carry their mozzi dome to the semi-protected area under the awning at the entrance to the building- still nicer sleeping outside than inside with the bats!