At 6.30am I am awoken by a startling high-pitched screaming noise and a rustling from beneath my head. My initial confusion as to where I am is resolved - I'm in Darfur, western Sudan, working as a doctor with Médecins Sans Frontières.

The screaming is Ernie the hedgehog, who lives underneath my bed, chasing a smaller hedgehog around the room with apparent glee. It could equally be annoyance; my understanding of hedgehog is only slightly worse than my understanding of Arabic. The mosquito net is brushed aside and it's time for a shower. The bucket on the roof feeds through a pipe to a filter head; a real luxury, as previously it was splash-washing from a bucket.

Today I'm travelling to Deleig, a town which is a 30 to 45-minute drive north of our base in Garsila. It is home to between 20,000 and 25,000 internally displaced persons, or IDPs. I am responsible for running an outpatient clinic there and travel with a nurse who runs a feeding centre located in the same compound. Breakfast is a quick cup of tea and some local bread smeared with jam.

Then it's off to the office to load up the mighty land cruisers -how my respect has grown for this beast since our arrival in Darfur! Medicines and medicinal food are loaded into the vehicles and we set off in convoy with local translators accompanying us. We always travel in convoys of two or more trucks, as the rainy season has arrived and there is a reasonable chance one will be needed to pull the other from a muddy hole at least once on a trip.

Today the initial part of the journey passes without incident, thanks to some machismo driving from our driver, Azari. Our arrival at the clinic is reminiscent of Charles de Gaulle's entry to Paris, as crowds of small children emerge, smiling and yelling "Kawaja" ("foreigner").

The clinic itself is a fence of roughly-cut sticks enclosing two large white MSF tents, which serve as outpatient department and feeding centre. I greet the medical assistant, Abdul Ghasson, who works with the ministry of health here and who operates the clinic six days a week, with a hearty good morning in my best Arabic. This is met with a smile of appreciation at the attempt to use his native tongue combined with some amusement at such a strange and intriguing twist on what the words should sound like.

He guides me quickly across to see a man who was brought to the clinic this morning by donkey cart. He has been unwell for seven days and is currently surrounded by family members attempting to hold him down as the delirium he is suffering from makes him combative. It is clear that his family are unable to manage him in this state at home.

The patient had a rapid malaria test, which came up negative. He is markedly jaundiced, with bright yellow eyes, and my working diagnosis is liver failure, brought on by one of the viral strains of hepatitis that has broken out here recently due to the poor living conditions. His confusion is one of the symptoms. As I sit quietly, bemoaning how difficult and stressful my life has become, the figure of a Sudanese woman emerges out of the grey curtain of rain, walking along the side of the road with a massive jug on her head, smiling and waving.

The decision to transfer him to the nearest hospital, which is also supported by MSF, is not a totally straightforward one as we have had patients removed from our cars before. We load him quickly into the car and transfer back across the rugged road. A translator and I struggle to control him as I am not carrying a sedative.

The journey to the hospital seems to take a decade, but we arrive safely and are able to settle him down. Then it's back on the road again. This time our voyage is interrupted by a torrential tropical downpour that reduces visibility to a metre or two. The road becomes increasingly difficult and I begin to curse the decision to travel with one car.

As I sit quietly, bemoaning how difficult and stressful my life has become, the figure of a Sudanese woman emerges out of the grey curtain of rain, walking along the side of the road with a massive jug on her head, smiling and waving. We make it to the clinic in time to wait in a crowded tent for the worst of the storm to abate, seeing the sickest patients quickly. The first is a pregnant woman with a severe kidney infection, for which she would be hospitalised in my home in New Zealand.

Here, antibiotics into the arm and the care of her family will have to suffice. Then a malnourished eight-year-old boy, whom I have treated for malaria and who now has diarrhoea and dehydration. As I'm attempting to see an old man with fever and blood poisoning, the nurse physically pulls me away. We have to leave in order to make it back in the good weather and in accordance with our security plan. On the way home we manage to cross all of the wadis - river beds that are dry except during the rainy season - bar one.

The last wadi on the outskirts of Garsila has risen into a massive river. So, despite our frantic dash to leave before we got stuck, we now have to wait patiently for two hours for the waves to go down. The locals surround the truck, cheering. One cannot help but thank them for their amazing efforts to extract a group of strangers from a muddy river, that have left them soaked to the skin and covered with mud. After sitting it out for a while, surrounded by villagers doing the same, we decide to cross on foot, scouting out a path through the waist-deep water.

We enlist the aid of another truck from our base that waits on the other side and are able to connect a tow cable across the water. With a flourish of water, mud and gusto, the first truck makes it across to the cheers of the crowd. My truck is next and debate rages between drivers as to the best path to follow. We follow that of the truck before and, after initially looking hopeful, get stuck.

The water seeps rapidly into the cabin, which fills to knee-height in the passenger seat. Cables are adjusted, trucks linked in series and the massive push power of the local crowd is put to use. Amid wailing women and roaring diesel engines, we mount a final successful bid and tear free from the mud, just as the first drops of the next rain shower begin to fall. The locals surround the truck, cheering.

One cannot help but thank them for their amazing efforts to extract a group of strangers from a muddy river, that have left them soaked to the skin and covered with mud. Finally we arrive back at the house to smiles from the rest of a large multinational team of colleagues. Our plight was known to them and they are happy that everyone is able to sit down together to our dinner of goat meat in peanut sauce, rice and water.

Another day looms to a close with a succession of meetings where our medical activities for the days ahead are planned and security issues are discussed. Then there is a brief chance to check some emails from home and write to loved ones, before the generator splutters to an end and power is lost. Gradually we make our way back to our netted beds amid the sounds of the wildlife that inhabit the house with us.