South Sudan: "With COVID-19, it's a case of 'when' not 'if'"

In her previous post, MSF doctor Ayla shared the story of a late-night emergency call to treat a young patient who sadly could not be saved. In this latest piece, she looks back at that night…

Sunset over Mundri in South Sudan

Read Ayla's previous blog, here

I've been thinking a lot about the girl with the pneumonia, who I wrote about in my last post.

In some ways, she was representative of the sad cases I regularly experience in this area of South Sudan – treating children whose growth and development have been held back by a thick web of related factors, wrapped around them from birth.

There are many strands in this web: a sub-optimal diet (too little food, and what there is lacks essential nutrients), mothers who were also malnourished during pregnancy, limited attention from caregivers because the caregivers themselves have responsibilities like working or collecting food.


That night, as I started the girl's CPR with the team, my head was spinning. My thoughts went in all directions.

It's little things, but I have to believe that someday it will make a difference. Even if only one life would be saved.

This was not the first time since I arrived here, nor will it be the last time, that I've been in a situation like that. Every time I feel torn: so many different emotions and thoughts.

It is frustrating to think of all the chances the girl would have had if she had been born elsewhere. Better nutrition, hygiene and protection that would make her healthier. She could have been treated with medical resources and equipment that are not available here.

It is frustrating to think of the treatment I could have given that could have saved the lives I have felt slipping through my hands during my assignment here.

Emergency box

But, focusing on what is missing will not help us forward. In the current situation, it seems unlikely that anything will change in the near future.

So, I try to keep my head above water by focusing on training goals for the team – helping our South Sudanese staff grow in their CPR skills; helping them to recognise, analyze and treat medical emergencies in a structured way.

As part of this we'll create an "emergency box" in which the resources we do have are immediately available when needed.

It's a little thing, but I have to believe that someday it will make a difference. Even if it saves only one life.

Pandemic on the horizon

When I think about our little girl with pneumonia, she was "only" one patient whose condition was too bad to be saved with our limited resources. 

It does not seem to be a question of if, but when the virus will reach us…

But, with the worldwide COVID-19 pandemic, it seems likely that we will soon be overloaded with patients we cannot treat.

We only have two oxygen concentrators here and no mechanical ventilation option.

Although, as of April, there is currently no confirmed COVID-19 patients in South Sudan itself, all neighbouring countries have now been affected.

It does not seem to be a question of if, but when the virus will reach us…


Read more: Moving stories from South Sudan

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