South Sudan: "We are seeing a steady increase in cases of moderate and severe malnutrition"

21 February 2017

Amy is a nurse from Canada. She blogs about packing up her life at home to join the 300 people working at the MSF hospital in Lankien, in the north of South Sudan...

The weeks since my last post have been really full, getting to know the various teams, routines (and paperwork, I can't escape the paperwork) of the Lankien project.

For wildlife updates, I was nearly run over by a donkey, saw my first South Sudanese snake (he wasn't interested in me, he seemed to be making tracks for the logistical stores) and found a cow trying to enter the out-patient department - perhaps for a consultation? Felix the compound cat (not at all terrifying it turns out) has been sitting on the chair outside my door a few mornings. I'm probably reading too much into it, but I'd like to think that he's taken a shine to me.  

At the moment I'm sitting with my feet in a bucket of water (did I mention that trick in my last post?) on the stoop of my tukul. We spent the afternoon as a team preparing for a possible arrival of a mass casualty but at the moment it looks like that's not going to happen tonight. If it does, we're as ready as we can be.

There is a terrific combination of strong leadership and deep experience in the international and national staff groups, which certainly makes challenges like this easier to face. 

The light is fading now and I can hear the children playing on the airstrip which is just beyond our compound.

The airstrip doubles as a soccer field, community centre and general meeting place when there aren't planes or helicopters landing. When there are planes or helicopters, ensuring that no cattle or goats are wandering around is an important consideration.

We actually walked out there last afternoon and the Watsan (water and sanitation specialist) caused a moderate sensation by pulling out a frisbee. Within about thirty seconds there was a mass of children screeching up and down in the dust, pursuing the fluorescent, plastic disc.

We were eventually escorted back to the compound by a gang of small, cheerful, brave little souls who kept high-giving us, or holding our hands and then checking their own to see if the white was rubbing off on them.  

I'm starting to get a better understanding of the different hospital departments, and seeing where I can share some ideas, and also where I can learn a lot.

I'm getting a crash course in all sorts of things! 

As predicted by the national staff, we are seeing a steady increase in cases of moderate and severe malnutrition, starting with infants. This time of year is known as the "hunger gap". It is also incredibly dry, and finding clean water is an impossible task for many.

We see a lot of cases of diarrhea in both outpatient and inpatient areas, as well as some extraordinary skin conditions. I'm convinced that all this has plenty to do with lack of clean water access.

Put it together with malnutrition and you've got a terrible equation to solve. Then layer on malaria, TB, HIV, kala azar (visceral leishmaniasis), parasites and acute respiratory infection... and you'll start to get a small glimpse into what many people are coping with here. 

Facing all this, and helping me to find my place to contribute, are a very wonderful group of staff. Their dignity, resilience and sense of humour lift me up and break my heart all at once. Even in the short time that I've been here they've shared extraordinary stories about their lives and their families, what they've suffered and what they hope for. 

Now I'm going to sleep. Tomorrow I'm first on call for the hospital and it's both very interesting (as there's so much to learn about) and very terrifying (as there's so much to learn about!) but that's life, isn't it?



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