Fieldset
The Maridi fuel tanker: a story with three beginnings

Many of the patients who were first brought to the hospital had sustained burns to over 90 percent of their bodies...

I was asked to come to Maridi for a month following an accident that happened here.

There are rumours and variations on the story, but, in essence, a fuel tanker overturned on the road that passes from Maridi, in the southwest of the country, to Juba the capital. When the tanker overturned, the driver fled, fearing that people desperate for the contents of the vehicle would overpower him.

Fuel prices in South Sudan are escalating dramatically. I heard on the radio that a few weeks ago that a litre of fuel cost 8SSP; it now costs 14SSP. Fuel is a precious commodity that can be sold and, with conflict having recently absorbed the Maridi area, incomes are unreliable.

People flocked to the tanker. Details of the incident are unconfirmed but I have already heard three versions of the story.

The first version is that someone threw a lit cigarette; the second is that a policeman shot in the air to stop people looting the vehicle; and the third is that someone tried to hammer into the tanker to gain greater access.

Whatever happened, a spark caused the vehicle to ignite and explode. At the scene, 203 people died and 160 were injured. I can’t even begin to imagine the pain and the chaos that ensued.

The less severely wounded patients were flown to the main hospital in Juba, the capital, but the most serious cases were taken to the local hospital, 22 km away in Maridi, to be treated.

Maridi is a small town in the southwest of the country with a population of 20,000. The town is usually relatively stable, but in August this year a small, local conflict broke out and escalated quickly. In the space of a day, the residents of this junction town fled to the bush when random shooting took place, looting of the market and buildings began, and several houses were burnt to the ground.

Maridi hospital was looted of everything: medical supplies, mattresses – anything that wasn’t nailed down. When the fuel tanker accident happened, the hospital was abandoned, with the majority of its staff hiding in fear in the bush. The poor timing of the accident created even more challenges for the medical teams trying to keep the surviving patients alive.

Many of the patients who were first brought to the hospital had sustained burns to over 90 percent of their bodies. Several patients died in the hours following the accident after having reached the hospital. There were no medical staff to treat the patients, and ICRC and MSF flew in emergency teams – an action that saved a huge number of lives.

I arrived here one month after the accident. As the hospital had been abandoned in August, the water infrastructure was poorly maintained. In addition, the hospital was suddenly met with an influx of nearly 200 patients, and an equal number, if not more, of relatives and caretakers.

There are still 67 patients in the hospital, who are slowly, gradually recovering. Concerning the recovery of these patients, it really is a team effort – more so than I have seen for any other type of mission.

Several of the patients are waiting to undergo reconstructive surgery, entering the operating theatre twice, sometimes three times a week to have their dressings changed and their wounds tended. There are nurses, medical officers, physiotherapists, medical team leaders and hygiene staff trying to prevent infection – a serious threat to burns patients, all contributing to give the best care possible to the patients.

The road to recovery is slow and difficult; several of these patients are utterly traumatised by what has happened. They are in extreme pain without access to the type of pain relief available in a more developed setting. They are still suffering from the shock of sustaining burns to the majority of their bodies, which will lead to permanent scarring and lifelong disability.

This accident has been incredibly difficult for the whole community. Given this, it is no wonder that when we see a patient beginning their rehabilitation and physiotherapy, pushing through the pain to take steps around the hospital every day and smiling when relatives and patients get together to sing and listen to music, it feels like a big success.

The saddest thing I heard was when I was being briefed on the situation, and a local doctor said to me that the truth of it was, that if a fuel tanker overturned in the road again tomorrow, the same thing would happen – people would flock to the tanker in desperation to find any source of income.

The economic volatility and unreliability that South Sudan is undergoing is causing people to turn to extreme measures every day just to provide for their families.

For now, this accident has pulled the community together and there is calm. It is a team effort that we are all a part of, helping the surviving patients to return to full health, but no one is certain how long it will be until violence erupts again in Maridi.