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South Sudan: The mosquito is potentially fatal in this part of the world

18 Aug 2016

My home in Australia boasts some of the most dangerous animals in the world. 

Sharks for instance are particularly spectacular. Their massive teeth capture the imagination of the bravest ocean goers, inducing mild states of panic as the soundtrack from “Jaws” plays over in their head. We have saltwater crocodiles made famous by the television celebrity the Crocodile Hunter. The animal that Steve Irwin loved and called “beeeeautiful”, terrifies the vast majority of the population and isn’t a sight many of us a care to see in the wild. We host five of the twelve most lethal snakes in the world. Our funnel web spider has fangs that can pierce through a toe nail. And the mesmerising box jellyfish has uninitiated swimmers reaching for their underwater cameras when they should be mounting a swift retreat. 

Yet here in South Sudan I haven’t seen the spectacular African animals that attract international travellers. I’m told by locals that decades of war have scared off the lions, hyenas and many others that were once native to this region. But there is one animal that is far more common and much more sinister – the mosquito. The animal that is nothing more than an unwelcomed guest at an afternoon barbeque in Australia is potentially fatal in this part of the world. You see these mosquitos commonly carry P.falciparium, just one of the many species of malaria. Although malaria is a common diagnosis year-round at the Aweil State Hospital, we have seen a sudden spike in presentations to our paediatric and maternity service. 

"The animal that is nothing more than an unwelcomed guest at an afternoon barbeque in Australia is potentially fatal in this part of the world"

Children and pregnant women are particularly vulnerable to the disease. They commonly present to us with a history of seizures, difficulty breathing, extreme fatigue, vomiting or in a semi-conscious state. These life threatening symptoms require a complex range of interventions including oxygen therapy, medication management and blood transfusions. All of which we can provide here with Médecins Sans Frontières. However the sheer number of patients is becoming overwhelming. In the past month alone we have doubled our number of daily paediatric admissions. And although the team of clinical officers and nurses are well versed in malaria diagnosis and treatment, without additional resources we are struggling to keep up with demand.

In this setting these additional resources are complex to coordinate. We are heavily reliant on our logisticians who are erecting large tents to house our additional patients. Another group is scouring the local market seeking beds and mattresses. Our pharmacist is busy ensuring we have enough rapid diagnostics tests and medication to diagnose and treat malaria in the coming months. And less obvious supplies like mosquito nets, water points for hand washing and biomedical equipment such as thermometers, are quickly being sourced from a range of creative locations. Our administration team is also straining with this increase. Recruitment of appropriately trained health care staff is particularly challenging in this region. We need an increased number of skilled staff to provide care to our patients; and there is also a demand to find staff that can cover the shifts of those on sick leave because many of our medical staff have themselves been diagnosed with malaria. 

Our administration team is also responsible for the payroll of what is now approximately 400 staff. This complex challenge is undertaken in a country with no electronic banking systems and the recent closure of banks across the country because of active fighting in the country’s capital, Juba. And all of these challenges can be attributed to the humble mosquito. What this animal lacks in size it certainly makes up in the havoc it wreaks for the population in South Sudan. 

 

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