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South Sudan: Part 1 - “When you treat malaria early and well, kids have good outcomes”

15 Mar 2017

Katherine Franklin is a medical doctor from Melbourne who recently returned from her second placement with Médecins Sans Frontières, where she spent four months in Wau, South Sudan. Katherine describes working in an overcrowded displaced persons camp.  

“Due to the fighting in Wau in June and July last year, the population in the UN Protection of Civilians (POC) camp increased from 3,000 people before the conflict to 29,000 people at the time of my departure. It is a complicated situation and the camp has become completely overcrowded. We saw a lot of cases of diarrhoea, upper and lower respiratory tract infections and meningitis. We also had lots of neonatal cases such as neonatal sepsis, due to babies being born without proper hygiene. Despite the food distribution in the camp, we had many children coming in with malnutrition, often complicated by other illness such as tuberculosis. Médecins Sans Frontières has about 86 national staff and seven international staff working in Wau. Our teams are running an outreach program to support four primary healthcare centres in the south-west of Wau, and a 20-bed paediatric hospital located in the POC, with a 10-bed inpatient department and a 10-bed inpatient therapeutic feeding centre. 

"The main focus of my mission became dealing with a measles outbreak which, due to the overcrowding, was a major concern."

The main focus of my mission became dealing with a measles outbreak which, due to the overcrowding, was a major concern. There was a high mortality rate and I found it very difficult dealing with children who were so sick. It kept us very busy and we were the only facility who could admit children who required inpatient treatment. We saw about 170 measles patients but I think there were over 300 cases throughout the camp. In response, a mass measles vaccination campaign was organised in the camp and Wau town. The case numbers did drop and when I left there was only one inpatient with measles compared to the seven or eight we had each day at the height of the outbreak.

Fortunately, the measles outbreak came at a time where malaria was tailing off due to the dry season, however we were still receiving patients with malaria, including cerebral malaria. The kids could become really sick, quickly, needing blood transfusions, oxygen or seizure treatment, which is something only Médecins Sans Frontières could provide. Our intensive care unit could also provide blood transfusions, if we managed to find donors. Some kids would come in having seizures and the team would spend two or three hours trying to stop the seizures. Then we would put them in a bed in the intensive care unit, hoping they would get better. Lots of kids unfortunately died from malaria, but there were times when I would come back later in the day and they would be sitting up, breastfeeding. When you treat malaria early and well, kids can have good outcomes. It was really great to see that. It was awesome.”

 

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