I was actually asleep (or possibly unconscious) when called at 9:30pm. There had been some shooting and victims were brought to the health centre. I staggered into the nearest set of clothes, adorned rubber boots and coat as it was raining, and trekked deliriously through the mud to the health centre. Two gunshot patients, one shot in the back, left flank, the exit wound lower left chest, the other through his right hip/buttocks with the exit right groin.
The second was OK, at least stable but the first had probably nicked his spleen or kidney. He had lost a lot of blood, the inner eyelid glowing a deathly white, which is a sign of anemia. Anyway, we worked on him for a couple of hours and were just about to leave when more shots rang out in the night. We moved everyone and stayed behind the buildings as the last shot was close. It was funny, some of the staff were really panicking, really worried, but after the adventures of the day, to be sitting behind a wall, shots ringing through the night, having a smoke and a coffee, I really just wanted to go to bed. And like I said, we may get another influx so I figured let’s sleep while we can!
We got back to bed at around 2am and were awoken again by the staff at 5.30am.
"What’s wrong?" I asked.
“The patient has five litres of blood in his stomach”
“Really? How do you know”
Considering we have no ultra sound, x-ray or anything more technical that a thermometer, I was surprised. Anyway, we all got up and prepared for the boat transfer to MSF in Nasir, South Sudan, knowing that we would have to wait for dawn before heading down river. It was raining heavily and had been all night. At 7:15am the administrator and I headed into town to check on security with the local authorities. It was tough going as the mud was treacherously slippery and over a foot deep in places. It was still pouring which didn’t help visibility and it wasn’t long before my boots were full of water and I was drenched through to the skin and covered in mud.
We reached the place half-an-hour later. Of course there was no-one there because it was raining! I needed a coffee so we walked to a nearby restaurant, for want of a better word but they do sell breakfast under a UNICEF tarp. As we came around the corner we ran into a large group of heavily armed soldiers. I wanted to call out but didn’t want to attract attention so just smiled, nodded and passed across to the restaurant. Not long after a very tall, solidly built guy, in brown/green gear came over to speak to us. He introduced himself as the head of security. “Great just the man I need to see” I said in a friendly hand-outstretched manner.
“I need to ask you about security because there was some shootings last night and one patient is critical so we are taking him to MSF surgical program in South Sudan, I need to know if it’s safe to travel”
“Yes I know we shot them” he replied coolly, “he is a prisoner and not to go over the border”.
Mmmm whoops, he was possibly already on his way…
So I smiled, looked up to his huge 6’4'' frame, dressed in camouflage clothes, a machine gun slung over each shoulder, the fellow behind him at ease with gun in hands, looked directly into his coal black eyes and said as nicely as I could:
“The patient is critical, his only chance is to have emergency surgery in Nasir, we are taking him there. We are MSF and we are only interested in the medical aspects of this case. We are neutral and will treat everybody the same no matter what their religion, race or political agenda, that is MSF” Mmmm, yep that’s our MSF charter, the one I believe in and is true to my heart!
He stood taller and with puffed chest asked me “do you know what he has done?”
“It’s none of my business what he’s done, I’m only concerned about his medical condition, we will take him to Nasir, he will have Emergency surgery and when he is stable he will be transferred back to Mattar. When he is released it is none of my business what you do with him, but now he is under MSF care and we will do the best we can to save his life.”
“I will speak to my superior “ was his solemn response.
Five minutes later he returned, informed me his chief agrees with MSF and the patient can go, there would be no problem with security, but he required us to bring the patient to jail when he returned from Nasir. I told him we would transfer him back to the health center and once he was released they could then do what they needed to. We shook hands and I headed back to the compound feeling a little relieved and a little like I’d been pushing my luck!