Posts tagged sudan

Photo: David Bude examines a patient at the MSF clinic in Pibor. South Sudan 2012 © Robin Meldrum/MSF

Voice From the Field: A Clinic Deep in the Bush

The Clinic under the Tree

I chose a big tree, a good one with plenty of shade, and I cleared the brush underneath it. I had a plastic sheet and I gave it to my wife to make a sort of rough shelter. She cut some branches and made a frame, like a manyatta house, and we put the plastic sheeting over it. And then I made a wooden platform, like a rough bed, to keep the medicines off the ground. This was my pharmacy.

We cut some poles to make benches, so there was a waiting area for people to sit. And with poles and mud I made a sort of consultation room, so when a patient needed treatment I would see them in this “room.”

We got a message through to the MSF base team in Pibor town about where we were, and they sent some drugs by boat to the closest place a boat could get to—medicines for antenatal care, for diarrhea, for malnourished children, antibiotics, dressings, malaria drugs, even registration cards and a register for keeping proper records.

Spreading the Word

I found two of the health promoters from MSF’s Lekwongole team. They went around passing the message that if your child is sick with anything—diarrhea, eye infections, respiratory diseases, fever, or any injuries—they could come and see us.

And they came. A lot of people. Sometimes I saw 50 patients in one day. Malaria was common, and [so was] pneumonia. Children that were malnourished—we admitted 16 for malnutrition—cases of diarrhea because there was no clean water, and even a tuberculosis patient who needed a follow-up. I kept working until the supply of medicines ran out.

Photo: Sleeping Sickness in South Sudan 2012 © John Stanmeyer/VII

Fatal Neglect
Sleeping Sickness: The Long Road

For centuries, sleeping sickness, or Human African Trypanosomiasis (HAT), caused havoc in isolated reaches of Africa, preying on people with no access to medical care or those unaware of the biological dangers they faced when wading into a foreign land.

Sleeping sickness is endemic in 36 African countries and around 60 million people are at risk of being infected. Spread by the bite of a tsetse fly, the disease was signaled by the onset of fever, headaches, and joint pain, followed by disorientation and profound fatigue that makes it difficult to stay awake—hence the name sleeping sickness.

Between 1986 and 2010, MSF teams in several countries screened nearly 3 million people and treated more than 51,000 for the disease. At present, MSF has sleeping sickness programs in several other African countries as well. Collectively, this experience has made clear the need not only for ongoing vigilance, but also for new and easier diagnostic tests and shorter, more adaptable treatment regimens for patients.

VII Photo’s John Stanmeyer joined one of MSF’s mobile HAT teams, which was designed to augment fixed-site screening and treatment activities in Central Africa, allowing him a firsthand look at the modern-day effort to battle this age-old scourge.

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Photo: Residents of Gumuruk village in Jonglei State return to their homes after spending a month fleeing violence in the bush. South Sudan 2012 © Robin Meldrum/MSF

South Sudan: Displacement and Destruction of Health Facilities in Jonglei State

Ongoing violence in South Sudan’s Jonglei state has had a devastating impact on tens of thousands of people, with many forcibly displaced and further cut off from health care due to the destruction of medical facilities.

While Jonglei state has a long history of intercommunal cattle-raiding, thousands of civilians, including women, and children as young as four months old, have been caught up in violent attacks since 2009, which usually occur during the dry season. A disarmament campaign begun in mid-2012 led to widespread insecurity and was accompanied by abuses against civilians. Further fighting in Jonglei between a militia group and South Sudan’s armed forces has compounded the violence, causing new displacements at the height of malaria season. Health care is threatened as medical facilities are targeted and destroyed.

“Patients arriving in MSF clinics seeking treatment for injuries describe how they have been forced to make devastating decisions about which children to flee with and which children to leave behind,” said Chris Lockyear, MSF operational manager. “What we are seeing is an emergency; the lives and health of Jonglei’s population are hanging by a thread. The dry season is now upon us, making movement around the area possible again, and we fear a further spike in violence, injury, and displacement.”

ALERT: Fall 2012

The latest issue of our Alert newsletter highlights the devastating crises in South Sudan and Syria, conflict-related emergencies that are causing mass casualties and extensive displacement. In both places, our medical teams are doing as much as they can to ease suffering and save lives.

Photo: MSF staff measures a child’s height and weight, seeking to determine his level of nutrition.  South Sudan 2012 © John Stanmyer/VII Photo

Eyewitnesses to an Emergency
Report from South Sudan

Though it hasn’t gotten much attention, an immense refugee emergency continues to unfold in South Sudan. In the young country’s Unity and Upper Nile states, roughly 170,000 Sudanese refugees are living in camps that were, for much of the summer, sprawling, muddy tracts of hardship and sickness. The refugees had escaped state-sponsored aerial bombardments in their homelands, but MSF’s epidemiological teams documented mortality rates in some of the camps well above, and in some cases double, the World Health Organization’s emergency threshold for refugee situations.

MSF, which had been working among the refugees in Yida, in Unity state, and in Upper Nile state’s Maban County, rapidly scaled up its response, adding scores of international and national staff , taking on tasks—drilling boreholes for water, for instance—normally outside its purview, and working around huge logistical challenges posed by both South Sudan’s war-torn history and the onset of the rainy season.

“It was the most challenging ten weeks of my life. It’s a tragedy, and it was devastating to be there. We saw such high mortality, so many people dying. But also, being there and seeing MSF’s ability to respond quickly and make changes—to really bring about an improvement in the health and lives of the people in Yida—was really incredible. It was an honor to be there,” says MSF nurse John Johnson.

Photo: Francis Gatluak, one-time MSF patient, now the manager of the tuberculosis program at MSF’s hospital in Leer, South Sudan. South Sudan 2012 © John Stanmyer/VII Photo

The Patient Becomes the Healer

Three decades ago, when Francis Gatluak was a boy, civil war forced his family to flee their small village in Unity State, in the northern reaches of what is now South Sudan. He was diagnosed with kala azar, a disease that thrives in poor, unstable areas with limited health care.  

Francis endured the difficult SSG treatment at MSF’s nearby camp, and recovered. Since he spoke some English, the staff asked him if he would stay and work with them as a translator. He did this for a few months, developing a desire to do more. “I started to learn about how I can help the patient,” he says. “If there are people who can give medication, I can also help to do the job, and help the community.”

Today, he is a nurse in his twenty-third year working with MSF. He has gone on MSF assignments in other African countries and recently returned to the Leer hospital, where he is now in charge of the tuberculosis ward. And he recently traveled to Washington, DC, to speak on the organization’s behalf when MSF was awarded the highly-esteemed 2012 J. William Fulbright Award for International Understanding.

MSF Field Report: Decreasing Child Mortality in South Sudan
“How Did You Know We Were Here?”

The refugees wanted to know Dr. Jacoby’s story. They wanted to know where she was from, why MSF had come, and how did MSF even know they were there? 

Dr. Jacoby showed them the video that convinced her to go to Batil. It mad a major impact on them to realize that we were documenting their situation, and sharing it—“and that this information was enough to get people like me to come to Batil,” says Dr. Jacoby.

“I think that is really powerful. I think that knowing someone on the other side of the world saw what they’re up against, and cares enough to come, really helps people.“

Photo:Women gather at a water tap in T3, the temporary transit site for new arrivals near Jamam. South Sudan 2012 © Shannon Jensen

When the Tap Runs Dry

On Thursday, the pumps at the Bamtiko borehole—the main source of water for Jamam refugee camp—had failed. Imran, MSF’s water and sanitation specialist, led his team in a quick emergency response to replenish and treat the water supply. 

“By the time evening came around that first wet day, I was covered in mud, exhausted, hungry, my clothes bleached by spilled chlorine — a day well-lived. I’m looking forward to doing it again,” says Imran. Read more from his blog on ensuring water treatment in South Sudan.

Photo: Malnourished children often became unable to swallow and nasogastric intubation is required to feed them with enriched therapeutic milk. Ethiopia 2012 © Yann Libessart

MSF Assists Aid-Deprived Sudanese Refugees in Ethiopia

Nearly 40,000 Sudanese refugees fleeing conflict have sought refuge in Ethiopia. View this slideshow of our work in the area to aid the most vulnerable until the situation stabilizes.