Expecting the unexpected: My story from South Sudan

Located next to a camp with a population of over 120,000 internally displaced South Sudanese people, MSF’s hospital in Bentiu is one of only two secondary healthcare providers in the area.

Ruth and the twins had arrived after a journey of four days overland from the capital city, Juba. Travelling via an army truck, in the back of a lorry and on foot across the country would have been a difficult feat for anyone, let alone a mother with a severe leg injury and her two young boys.

The floodwaters in the areas surrounding Bentiu – which have not subsided since the area was flooded last year – pose an immense obstacle for anyone attempting to travel overland, sitting at around a metre and a half deep. Many roads are almost impassable as a result.
 

She said that her husband had abandoned her and the boys in the capital. Now, here she was, alone in an unfamiliar country, unable to speak the local language and in need of urgent medical attention. She and the boys had arrived at the hospital with just the clothes on their backs.

From looking at Ruth, you wouldn’t know what a hazardous journey the family had endured. When I talked with her, the overwhelming feeling she expressed was relief. Relief that she was receiving care in an MSF hospital and relief that her children were being looked after.
 

They had arrived in the morning and Ruth was in surgery later that afternoon. She was in surgery for about three hours and soon after I met the twins, she was back on the surgical ward.

I’m not sure how precisely Ruth acquired the wound on her leg, but it had deteriorated during the course of her journey overland and she had developed a large blood clot underneath. At one point, the team thought the lower part of her leg might need to be amputated altogether: the wound was so deep and there was a concern that infection might reach the bone.

The surgical team cleaned and debrided the wound – a procedure to remove the damaged tissue. This showed she had further blood clots – increasing the risks. Ruth ended up requiring repeat surgeries on her leg to treat it fully, but thankfully the team were able to avoid amputation.
 

After these operations, Ruth was clinically discharged from the surgical team. But she still needed lots of care, rehabilitation and time for the leg to heal before she could even attempt to walk on it.

Altogether, she remained in our care for over three months, receiving input from the multi-disciplinary team including nurses, counsellors, caretakers and doctors, as well as clinical-administrative support to arrange a safe discharge.

At first, she was hobbling a little bit, but you could see her progress with every day that went by. After a few weeks Ruth was able to walk entirely on her own without a walking-frame or stick.

The Nurse Supervisor managed to find a local group who looked after them during the weekdays and kept them occupied with various activities and games. At the weekend, the hospital became their playground and all the staff came to know them.

I’d often go up and see them playing in the wards: they would have managed to find an empty box and one would be pulling the other around in it. On other occasions, they’d be found with a bucket of water outside, in their element, washing and splashing. We loved them, they were just so funny.

Once Ruth had recovered fully and after lots of logistical planning, we helped her and the boys get back to their family at a camp near the border with Sudan. We were all so glad that Ruth had made a good recovery, but after they’d left, we felt the family’s absence on the wards sorely.

Over those months we had been providing holistic medical care, but in the sometimes stressful and challenging environment of the hospital, they had given us something important too.