Fieldset
Ethiopia: “She named her baby Nyamire. It means decision”

Christine Tasnier is a midwife from the UK, currently working in Ethiopia’s Kule Refugee Camp – home to around 54,000 people fleeing conflict in neighbouring South Sudan.

For almost a year now, I have been working in the middle of a large refugee camp in Ethiopia on the border with South Sudan. Here, MSF operates a health centre with 120 beds.

I see a lot of suffering and needs here. But, I also see a lot of joy… because I am a midwife. When children are born, it is always a special moment. Anywhere in the world.

My name is Christine Tasnier and this is my first assignment with MSF. I will be here until November 2018 and I would like to share my experiences and impressions with you.

54,000 refugees

The refugee camp in Kule is home to 54,000 people – most of them living here for almost four years now – who fled because of the civil war in South Sudan.

People have built simple huts made of wood, plastic sheeting and loam soil. They are often a maximum of four square meters inside and most refugees do not have more than a few mats to sleep on.

There are always existential dilemmas for the people here in the camp, which I, as a British person, have never experienced.

There are also places with water pumps that have to be shared by hundreds of people. Unfortunately, it happens from time to time that the water stops running. Then people have to fetch their water from puddles or an adjacent swamp. Our health advisors tell people that they cannot drink this water, or at least have to boil it. But firewood is precious.

When you walk through the muddy, holey streets of the camp, you notice little shacks of corrugated iron at the side which reflect the sun. If you open the door, you find a floor plate with two footprints and hole – a very simple outhouse.

MSF219974.jpg

A row of shelters inside Kule refugee camp in Ethiopia
A row of shelters inside Kule refugee camp in Ethiopia

There are always existential dilemmas for the people here in the camp, which I, as a British person, have never experienced.

A colleague from the mobile team recently told me that she met a woman at the fence of her hut. The woman had an inflamed wound and asked if she should come to our health centre.

"Definitely," said my colleague.

But, the woman hesitated. This was also food distribution day, which she must not miss.

This food is virtually the only way for refugees to survive. So, she didn't want to come to the health centre until the following day, despite being in great pain.

She still had one concern: would she be moved to the larger hospital outside the camp? Because then her children would be left alone. My colleague could not promise her that, but we hoped the woman had the courage to still come for treatment.

Nights of hope for peace

There is also a church in the camp where I have often gone with my translator colleagues, who themselves live as refugees here.

The services were always very long. Once I asked why that is:

"We pray for peace in South Sudan. That's why we have to pray for a long time," said the women.

Without medical help, Nyadak and her daughter, whom she called Nyamire, would have been fighting for their lives…

At night, when I am lying in my bed, I have often heard loud songs and cheers when news spreads that there is a new peace agreement in South Sudan. People are so keen to return home, but so far, their hopes have been disappointed each time.

On such nights of hope, a baby is sometimes called "Hope" or "Peace". Because that is a custom in South Sudan, that one calls their child after the circumstances of the birth.

One of our translators is called Mosquito because there were a lot of mosquitoes flying around during the night of her birth. I like her very much, she is an incredibly happy, warm person.

Some time ago she told me proudly that her niece, Nyadak, was pregnant, and it was clear that she would give birth with us at the health centre.

A birth and a good decision

Recently, Nyadak came to us in labour. At first, everything went well, but then we noticed that her labour was not progressing. I checked her belly and felt that the baby had not turned properly.

We tried different birth positions, which unfortunately did not work. Finally, we decided to move Nyadak to the hospital in Gambella which is also supported by MSF. There, our colleagues could perform an emergency caesarean section.

The drive to Gambella took one and a half hours over a bumpy road. Luckily, everything went well, and the hospital team were able to deliver Nyadak’s a healthy baby.

On such nights of hope, a baby is sometimes called "Peace"

Nyadak came back to our maternity ward a day later. Mosquito and I greeted her warmly and the joy of reunion was great. In my joy, however, I quietly wondered for myself what would have happened if MSF were not here?

Without medical help, Nyadak and her daughter, whom she called Nyamire, would have been fighting for their lives… It was a good decision to transfer her to the hospital in time.

By the way, Nyamire means "decision". Her mother said that despite all the difficulties, the baby decided to live. A really fitting name, in my opinion.

“The relatives and neighbours began to pray and sing”

The life here in Kule is full of existential dilemmas for people. At the same time, I experience a lot of warmth and humanity.

No one is left alone, as during a recent birth that I can’t get out of my head.

Relatives and neighbours began to pray and sing. And, after what felt like an eternity, the bleeding finally stopped.

Unfortunately, it was a stillbirth. The baby's heart had already stopped beating in the womb. However, the mother still had to give birth to the dead child and was bleeding heavily. The atmosphere in the maternity ward was very tense. Everyone sensed it was about life and death.

I had recently carried out training with my Ethiopian midwife team on how to stop this kind of bleeding. The team took all the measures they learned: draining the bladder with a catheter, administering drugs to contract the uterus, and finally I was compressing the uterus.

Relatives and neighbours began to pray and sing. And, after what felt like an eternity, the bleeding finally stopped.

I was physically exhausted from the straining posture but at the same time happy and boisterous. My team and I did it together. We happily hugged each other.

MSF247204.jpg

An MSF midwife performs an ultrasound scan on pregnant patient at Kule health centre
An MSF midwife performs an ultrasound scan on pregnant patient at Kule health centre

In general, I'm always impressed by how much happiness and positive energy there is from the people that live here in all this hardship. The Nuer – as the ethnic group from South Sudan is called in the camp – are very optimistic in my view. Their basic attitude is always: "Come what may, it's okay."

I'm determined to cut a slice off this when I'm back home. There are so many things that stress you out in everyday life, although it is completely unnecessary.

We all share the desire to provide emergency medical care for the most vulnerable, who would otherwise not receive treatment. It is important to us that MSF does not ask about origin, religion or political beliefs.

I'll see if I can take more serenity into my everyday life. The work here is very fulfilling for me.

It is enriching to work together with people from so many different countries. I have come to appreciate not only my colleagues from the refugee camp, but also all Ethiopian and incentive staff and my international team.

We all share the desire to provide emergency medical care for the most vulnerable, who would otherwise not receive treatment. It is important to us that MSF does not ask about origin, religion or political beliefs.

Not forgetting them

The people here, again and again, thank me for being with them and not forgetting them. Life in the camp depends on humanitarian aid.

As soon as possible, people will return to South Sudan and take their lives back into their own hands. This applies here as much as it does in other crisis regions worldwide.

For example, the Central African Republic, where hundreds of thousands of people have fled instability and are now displaced within their own country or living as refugees in neighbouring countries. Or, the largest refugee camp in the world, Kutupalong in Bangladesh, home to over 900,000 Rohingya refugees and another place where MSF operates.

In many places, our teams are working where people would otherwise be without medical help – just like here in Kule.