I’d arrived in Juba January 2nd with two whirlwind days of being briefed on my new role as Medical Referent (Specialist) in Yida refugee camp, at the north edge of South Sudan. On Sunday, my rest day before flying north, I was asked to help arrange care for a young boy arriving by MSF plane from a project not far from my own.
You can’t imagine how proud I felt to be part of this, my new team. It was such a thrill to pull on my emblematic MSF tee-shirt, grab my stethoscope and clamber into the MSF ambulance along with our Head of Mission and two team members. We negotiated our way onto the tarmac of the airport, bursting into activity as the small white MSF plane landed.
The nurse from Old Fangak had provided exemplary care and the young patient was stable and comfortable. She turned to assist out the boy’s mother, a thin barefoot woman clutching a rough cloth bag, even as the team loaded the boy into the ambulance, taking the time to offer comfort to this woman who’d never before been out of the bush.
As we drove to the awaiting private hospital, Jillian outlined the boy’s history. He was gored by a bull three days ago and his family carried him for two days to arrive at our center in Old Fangak. Jillian was woken at 6:30 in the morning with a call for help and found the boy near death from sepsis, dehydration and pain. The medical team worked to stabilize him with intravenous fluids, antibiotics and analgesics. He pulled through but a plane couldn’t be arranged until Sunday, the next day. She finished the details as we pulled up to the private hospital in Juba that had offered to take him.
The surgeon met us and as Jillian left to catch up on sleep, I reported to the theater staff. He gently pried back the bandage, revealing partially necrotic bowel extruded through the stab wound. The surgeon could not manage this case but would help us arrange for another surgeon to assess the boy, if we could transport him to the Central Teaching Hospital. We loaded the boy and his mother into our jeep and were back on the road.
Emergency at the teaching hospital was a sea of confusion, twenty patients in a room, one woman getting casted, two live bodies on the floor. We placed our patient on the only bed in the room and began the nightmare of trying to get things moving.
First we had to have blood before going to the operating theater. The young doctor in charge of casualties guided us to the lab where mom’s blood was screened for malaria and other blood disease. Her blood was not infected and she was a match with her son’s blood type, but before the lab would take blood, she had to eat.
No problem, I thought, as I had noticed a small store with buns, fruit and water nearby. I bought food for Mom, and she ate it quickly, hovering near her son. The sun crawled slowly westward as we went back to the lab, only for me to have four lab technicians argue with me that she hadn’t eaten the right sort of food. One must eat meat before donating blood in South Sudan. The senior lab technician then led me across the road to a restaurant where five dollars bought a bowl of chicken, the proper food.
Back to the lab to have the mother donate a pint of blood, then find the young casualty doctor to announce that the blood was ready. By now the sun was dipping to the horizon. “What is the holdup?” I asked.
“The staff surgeon is not here. He is coming from far away.” The young doctor shifted his gaze, understanding the urgency of the case but unable to proceed.
We passed over the rest of the IV antibiotics and analgesics, reluctant to leave yet with nothing further that we could do.
I received the news on arrival in in Yida. The Head of Mission had kindly informed our project coordinator that the young boy had come through surgery and was doing well. I could start my six month mission with a lighter heart.