Fieldset
"I will leave this project with wonderful memories": Reflections of a first-time fieldworker

For seven months, US mental health specialist Margaret has been providing support to people living in Bentiu, a Protection of Civilians site in South Sudan. The camp offers protection to those fleeing violent conflict in the region and is home to more than 100,000 people, as well as an MSF hospital. Margaret reflects on her first field assignment with MSF. 

I have enjoyed my time here at the project and I am grateful for the wonderful learning experiences afforded to me by the patients and my team of counsellors, medical doctors, nurses, nurse aides, surgeonsanaesthetists, and everyone I encountered on my journey through MSF's hospital in Bentiu.

As a first assignment, it was an eye-popping, heart-wrenching and heart-warming experience

I was amazed by the resilience shown by the patients and caregivers dealing with complex trauma due to prolonged conflict and internal displacement.  

Yet, they had smiles on their faces every day we interacted with them in the hospital.  

The joys and challenges

One of the challenges of this project was translation. Mental health counsellors would translate critical sessions, however, sometimes they had to work hard not to lose the substance of the sessions in translation.

There is another case that sticks out. There was a young patient who had been involved in a serious car accident and was brought to the MSF hospital with a leg injury.

His parents were ambivalent about whether to keep him in hospital or to discharge him and take him to a traditional healer to treat the broken bone. They became very anxious and the father wanted to put the burden of the decision onto his son.

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Children play in the Bentiu Protection of Civilians site, December 2018
Children play in the Bentiu Protection of Civilians site, December 2018

When the mental health time arrived to review the case, the family seemed quiet and withdrawn. Suddenly, everyone, including the nurses, started discussing how the leg should be treated without the young patient's own input. 

After unsuccessfully trying to review the case with the counsellor translating, I decided to set some therapeutic boundaries.

I asked everyone not to respond to questions being asked of the young patient or make any comments. These boundaries helped him to understand the treatment options and become more comfortable with the process and expressing his feelings. 

Strengthening the team 

In my role as the mental health activity manager, I have continued to develop and strengthen the activities of the mental health department within the hospital. 

We do morning rounds, enrol new patients and provide counselling to in- and outpatients, as well as psychosocial education about mental health.

We also facilitate music and movement therapy, clinical groups, psychosocial activities, and Friday movie nights

Since joining the Bentiu hospital, the mental health department has become much more active and collaborative, working with the entire medical team during interdisciplinary team consultations on psychiatric, sexual and gender-based violence, and treatment adherence cases, and helping patients and caregivers deal with loss. 

A final farewell

I will be leaving this project with wonderful memories of the beautiful people of South Sudan and the smiling faces, both young and old, who greeted me in the hospital hallway every morning.

They have taught me everything I know about the culture. 

A great many thanks to the people of Bentiu Protection of Civilians site and international MSF staff, who come from all different backgrounds and have given me the chance to learn and grow every day.

May you continue to touch people's lives through the phenomenal work you do.

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