Having only been in Mayom a matter of weeks I don’t feel suitably placed to offer my perspective on what’s what here.
I have seen, learnt and experienced a great deal already but I know I haven’t been here nearly long enough to have a considered, holistic view of the entire project.
For that reason I’d like to introduce you to Peter. Peter is the Logistic Assistant here and will be the star of the show when it comes to introducing the project and explaining what MSF means not only to himself but also to the wider community.
An openly honest perspective through South Sudanese eyes.
Peter at his desk. © Dan Acheson
I was born in 1987 in a small village in South Sudan. My parents had seven children. I do not remember what my birth place was like as my family were displaced by fighting a year after I was born.
Growing up in a civil war was not easy. My education suffered. I began school in 1991 but in 1997 my family were displaced again due to further conflict. For five years I had no access to any schooling.
My opportunity to study again came in 2002 whilst living in a Kenyan refugee camp. Aged 20 I completed my Certificate of Primary Education. I then sat my Certificate of Secondary Education and my scores gave me the opportunity to join university. Financially, however, I could not.
In search of work I moved to Juba, the capital of South Sudan, where I volunteered as a teacher in a primary school.
A year later my dear father passed away so I returned home to my village to attend his funeral. After that sorrowful period I chose to remain closer to my home and found work with a civil society organisation as a programme manager.
In April 2015 I started working for Médecins Sans Frontières (MSF) as a Technical Logistics Assistant in Mayom.
We have a population of close to forty thousand people. Most here speak Nuer, a tribal language. The population varies with the season as the community are mostly cattle keepers and farmers who follow grasslands. I have friends with small-scale businesses who have skills to run bigger businesses but lack the capital and systems to start larger-scale trading. Opportunities are limited.
The market town has two primary schools, one secondary school, two churches and one mosque. A beautiful, slow moving river named Chuoolpik, meaning 'black water river', that never dries up divides the town in half.
Since beginning activities in Mayom, MSF has helped people here in a way that shows real concern for the well-being of humanity.
Although a new project, thousands of patients have already been treated.
MSF arrived at a time when my people were in great need of medical aid.
Warring was the priority. With ongoing conflict little attention was given to medical treatment. No one seemed to care for the human suffering we saw.
Providing essential medical aid has provided a lifeline to my entire region. Importantly MSF’s involvement also means people here – including my loved ones – are all treated with same dignity and respect regardless of background.
Primary Healthcare Centre and compound. © Dan Acheson
Still more needs to be done though as many people from isolated communities have to walk long distances to get here for treatment. Some arrive so weak it is difficult for the medical team to treat them. For others the journey sadly can prove too much.
More plans for a community outreach programme to visit villages and provide remote medical treatment will help. This will be a vital aid to young children, mothers, the elderly and disabled people who are all made vulnerable by not being able to reach medical facilities.
The Primary Healthcare Centre (PHC)
In March 2015 the PHC was a skeleton of broken windows, dirty floors and a destroyed roof resulting from the war. This damage meant we only had access to a basic, limited medical service for the community.
Through intense renovation MSF transformed this. Now Mayom PHC treats patients with infections and diseases, offers support with pregnancy and frequently cares for malnutrition, burns and gunshot injuries.
Since starting in April the PHC has treated over 27,000 people, with a third of these being under five. The majority of these patients were diagnosed with malaria. It is certain that without the access to the malaria treatment MSF offers many of these people would have died.
This doesn’t take into account the lives saved through our malaria prevention campaigns either. The community talks about all of this. We celebrate this progress. I have seen with my own eyes, felt through my own experience, the improvement. A year ago none of this was possible.
Personally, when I had malaria, it was easy for me to receive treatment. The PHC is close to my home, treatment is free and I received excellent care. This reflects the benefits for thousands of the local community.
MSF being in Mayom means the people do not have to travel as far, there is no charge for treatment meaning everyone can benefit and the PHC offers medical professionals trained using modern-day equipment and medication.
MSF goes further still by transferring people with severe needs that cannot be treated in the health centre to our Agok project for hospitalisation and surgery. The transport resources we have here means this can happen all year, even during the worst road conditions, saving further lives.
MSF’s project here has other benefits. We are a large employer in a town with not much stable employment. We employ around one hundred permanent, contracted staff in many roles – nurse assistants, drivers, guards – and we also recruit many more casual daily workers for medical campaigns or construction works.
Our employment rights, benefits and regular income offer us MSF staff stability and opportunity in a time where many South Sudanese struggle day in, day out.
With this employment also comes a social, family feel to the MSF community. National and international staff enjoy time in the market together and, we partake in regular volleyball and football “friendly” games.
Logistics is about organising, and for me, it is making sure MSF’s resources are used well. Here it means planning projects that allow the medical work to develop and run problem free.
This includes building improvements for and maintenance of the current facilities, vehicle transfers for patients, receiving and sending stock and security processes like radio comms and guards.
Peter with vehicles. © Dan Acheson
Mayom’s logistic team is made up of a large number of people to organise these including drivers, security guards, maintenance agents, radio operators and store keepers.
In their own way, by carrying out their duties, each person helps to ensure the whole project runs well.
I face many, many challenges in my role managing a large team with a lot of different factors that can upset our work.
Transport is my first challenge. As there aren’t many vehicles in South Sudan we don’t have many roads.
The roads we do have are mostly made of dirt and are scarcely maintained. Because of the heavy rains during wet season the roads become very muddy, often impassable. This makes everything slower, including emergency patient transfers.
The hospital in Agok is only 80km away. In the dry season this takes around three hours but in the wet it can take up to nine hours. To ensure the project has essential supplies we use costly helicopters and planes to fly in medication and food but often my logistics needs are too heavy for this cargo.
Vehicle and aeroplane. © Dan Acheson
Even in the dry season Mayom is a long way from other towns. Because we are so remote it is hard to search for quality resources. The local market sells basic supplies but for building materials we have to wait months for deliveries. With suppliers so far away we also risk unreliable qualities and face high transport costs.
A lot of the local workforce has limited skills because of lack of opportunity with education and training here. This makes it difficult when delegating work and often my time becomes consumed over simple things. Where some skills are essential MSF uses relocated staff who have the needed skills but live in other parts of the country.
Many of our staff have at some point been displaced and lived in temporary structures that are often shared. These conditions, along with the high levels of malaria, mean staff sickness is regular.
Fortunately for me I have many enthusiastic members of the community looking for work and willing to help us out as daily workers.
The communities around Mayom really appreciate the presence of MSF. There’s no doubt about the medical intervention being felt as a good thing.
We are very thankful and we want MSF to remain here for years to come.