South Sudan Part 3

Hellow,

Again a week has passed by and not without any stories to tell….

Let me give you some updates:

Our refugee camp has been growing and growing and if I take a look outside, indeed more and more tents are showing up. Last week I was visiting a woman, who makes nice baskets for shopping. Just to support the women but her residence existed only of a tent (well, just some plastics put up in the shape of a tent) and a big box with all the clothes of her and her children in…. I can tell you that the nights are getting colder. Oké, cold is perhaps relative but if you have 40 degrees during day and only 25 degrees in the night, well then it can feel cold. But I felt terrible for this family. Really this is what their place was existing off and this with 6 children. What a life. Some people are already here for a couple of months.

El Fuj is a town (60 km from our camp Jamam) on the border with North Soudan and so a perfect entrance for military between South/ North Soudan and a target point. Last Friday we saw a lot of military tanks passing by, going direction El Fuj. Apparently something was going on. And indeed 2 days later, last weekend, El Fuj has been bombed, 12 bombs has been dropped with a plane. We were ready to evacuate but this was not necessary, luckily. This feels really strange as El Fuj is only 60 km away from our camp.

Water situation: well our WATSAN person is still busy with pumping and chlorinating the water.

Still didn’t had a lot of people to pass by until this morning. Like I told you before, it’s Oxfam who

distributes the water in the camp. This morning one of the Oxfam trucks had an accident on the road.

This happened just in front of our MSF compound and I can tell you, not nice. A child got killed and not in a nice way. On a short time a lot of people were gathering around the truck and starting to scream and cry. It was a goosebumps moment. Because of this situation our WATSAN person had a lot of work today. All the people were coming to the MSF water point, I think Oxfam was having a terrible day. But honestly, we were thinking already why we didn’t had quicker an accident. Cars and trucks are driving so fast on the road. Apparently the driver thought it was a dog…. Well, not so….

Food: well I have to tell you, incredible. Sometimes I think our MSF compound is not positioned on a good location but anyway. Well we had last Friday and Saturday a food distribution of UNHCR. During the last week we saw a lot of trucks passing by, driving to Doro (the other refugee camp, 60 km from Jamam, were we have another MSF camp). So UNHCR was getting food based for in total 80.000 people. The problem is that they don’t have a good stock place in Jamam and so the food had to pass by first for coming back after… But the organization was incredible. Once they arrived, they unloaded all the food (beans, rice, sorgum and oil for 40.000 people) next to our compound. And it was so funny to see. They organized 3 mountains of rice and only one man was sitting on each mountain. Not a single person out of the camp was thinking of attacking the food, not one. The people here are very disciplined. Starving outside and knowing that this amount of food is just in front of you? You could easily attack it with a big group…

But Jamam has been classified into 4 tribes and every day 2 tribes can come and have their food. I saw the food card of my translator person and this was so small. Can you imagine that you lose this important paper? When people arrive in the camp, they have to register them with every child. All this is standing on that little, important paper…. It is the Umla’s (the chef of every tribe) who takes care of the organized distribution. What a power this man has, but what a work he is doing.

Honestly I like the Umla’s. I also have a good contact with them because they bring the TBA’s to me every Saturday. As you know I have every Saturday the TBA meeting and it is getting a huge success.

Even the chefs are bringing the TBA’s to me personally. Like this, they know that they have been presented…. As I said, what a power and organization this man has. Anyway last weekend was again a big success. From 30, to 50, to 80 TBA’s. Every week the amount is growing and they are really interested to come and learn. It is so much fun to do. It asks a lot of energy and preparation but what an energy I’m getting out of it. Last weekend I learned them about danger signs and when definitely to come to our clinic. It was with some performing because they don’t understand English. We laughed a lot and after we sang. But they got the message because my weekend was busy busy.

So we come to the stories of last week in delivery ward….

Last week the number of deliveries was getting up and I’m really glad with it. The only thing

is that this means that we also have more complicated deliveries. Like I said before I have 2

regional midwifes who are helping me and I’m so happy with this. On the other hand I’m still final responsibility and so for every complication they still come to get me. What is good but exhaustive and until now, every night there was already a complication.

I had one car delivery last week… The woman came in, bleeding and premature. Diagnose; placenta preavia and a breech (means with the bottom down). So that means referral for Doro (where they have an operation room). I decided to go with the car (1,5h driving on a bumpy road and you never know when she gets into labour) but that means that one of the man expats had to come with me.

So Sebatian, our log supply, joined me. Of course she got in labour in the car. Luckily I had gloves with me and other materials. We were not far away from MSF Doro Clinic and that was good because with this placenta preavia she could easily bleed a lot and the baby was 7 months. The woman was doing fine and because the baby was so small she delivered in no time, in the car. It was fantastic to see how Sebastian (who never saw a delivery before) panicked a bit and started to scream on the radio to inform the doctor about it (well of course all the people of Doro heard about it). The baby was not breathing and I was glad when we entered the clinic. I started the reanimation and it took some time to get this baby breathing, eventually he cried. Sebastian was so impressed about this that some tears emerged with him.

Last Sunday I had the most terrible night ever. A pregnant woman, already pale because of blood loss, came in delivery ward. I had the most strange feeling about this woman and knew this was not going good. Unfortunate I couldn’t referral here anymore to Doro (too late and too dangerous for the militaries on the road). I had to fix it in Jamam. Diagnose: rupture retro (=behind) placentair and premature (7 months pregnancy/ not a life). She delivered a death baby but the biggest problem is that the uterus didn’t contracted and so she kept on bleeding and bleeding, with big amounts. And she was already pale from before. The thing is, I have NO MEDICATION at all in my structure.

Apparently we have problems with supply in everything, including medication. I had nothing to give. So I was 2 hours busy with contracting the uterus, all what I learned and experienced before. But I never had a mission with NO medications… Honestly, yes I was afraid to lose this mother. The doctor came to help me with the 2 regional midwifes. It was a nice cooperation and everybody follow-up my instructions with no discussion and this was nice. In the 2 hours the woman failed away…. I really wanted to referral this woman and on this moment I was so pissed with my chef. He clearly preferred to lose this woman then taking the risk that something happened with me. It is good in this situation that you have a chef who thinks likes this but I was so angry on that moment. After 2 sweaty hours and doing the bimanual compression of the uterus I was able to contract the uterus. The woman lost more than 3,5 L of blood but she stayed a life. The whole night I checked (and I was not on call) and at 6am I referred her to Doro. After 3 days I can tell you that she is still a life….

After wards I had a huge discussion with my chef… hehe…

Last weekend my SRH (sexual reproductive health) responsible from Brussels came for a visit to

see how things are going. It was nice to hear that she never saw this result before, in any project.

Apparently I had build up a great delivery ward and everything that I could put up in place was in place. Also all the paper work, hygiene, trainings, contact with the TBA’s,…. she was completely surprised. This was really nice to hear because typically I was thinking that I didn’t do enough.

Also from the team it is nice to hear that they find me a great midwife. Certainly because a lot of

people saw me working in this condition. Our doctor is really happy that I’m here in this project, if not she was sure that this woman hadn’t survive it. It is nice to get this appreciation, really it is hard working but it gives me also a lot of energy but after writing this, I cracked.. On this point I realized that I’m tired…

My last week in South Soudan started…. My replacer should arrive in a couple of days…

Big kiss X