Fieldset
South Sudan: COVID-19 confirmed

As the first cases of COVID-19 are confirmed in South Sudan, doctor Ayla Emmink shares her concerns for communities and patients in an area where many preventative measures are a luxury

Despite all the preventive measures taken by the government to lock in the population and shut out the virus, expectations are bleak.

Many people are malnourished and / or burdened with other conditions such as HIV and tuberculosis. That will make them defenceless if exposed to the virus. And, although the country is fortunately not densely populated, people live close together. Often in camps and usually with whole families together in a mud hut where ventilation is extremely limited.

The luxury of handwashing

Crowds in markets, soccer fields, funerals and churches continue despite the ban on social gatherings. People will not stay at home with "only" mild symptoms like fever and cough if they know that this can also be malaria.

Much worse is the fact that many people have hardly any drinking water at their disposal, let alone water to wash their hands several times a day

And, to make matters worse, washing hands, the most important protective measure that should be available to every person, is not an obvious luxury for the people here.

Infection prevention training

I endured dust, sweat, more dust and flat tires to help train all of our health workers and educators. Their job will be to spread the how and what of preventive measures in communities.

Their enthusiastic participation is promising and makes a rewarding job. At the same time, the concerns and questions they come up with make me sad.

Large parts of the population have no soap available, so they suggested giving instructions on how to wash their hands with water and ashes. Not ideal, but certainly a pragmatic and realistic alternative.

One jerry can

Much worse is the fact that many people have hardly any drinking water at their disposal, let alone water to wash their hands several times a day.

They have to walk for hours, queuing with jerry cans, often in the blazing sun without shade. When it is finally their turn, the water pressure turns out to be so low that it takes hours to fill a jerry can. Imagine yourself as a ten-year-old, with the burden of a filled jerry can on your head or shoulders, on the miles of dusty and shadowless road home, to your thirsty family.

There won't be a lot of water left after everyone has had a drink, your mother has finished washing, has started cooking and you have washed yourself. Which water should you still use to wash your hands?

We are preparing ourselves mentally and practically for the storm that is now inevitably coming

How must it sound when I ask health professionals to explain to people that regular hand washing will protect them from coronavirus and other infectious diseases?

COVID-19 confirmed

Just a few days later, several people in South Sudan are tested positive for COVID-19. We are preparing ourselves mentally and practically for the storm that is now inevitably coming.

We do not know on what scale this outbreak will take place, or whether the plans we are making will make sense once the first potentially infected individuals reach our clinics.

We do not know how long we will receive new supplies and how long we will be allowed to fly in new people and transfer patients.

We only know that this is what we signed up for.

After all, MSF provides emergency medical care. Maybe this is not the emergency we expected. Perhaps it is not what we came to South Sudan for, and it is not the crisis we were prepared for.

But, now we're here, and we need to make the most of it together.

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