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Australian nurse Victoria Mowat writes from South Sudan

Sudan / 17.03.10

Australian nurse Victoria Mowat in South Sudan.

Victoria Mowat, a nurse from Brisbane, has just returned from working with Médecins Sans Frontières in southern Sudan. As supervisor of the therapeutic feeding centre, Victoria's focus was on providing care for malnourished patients. Having previously worked in Ethiopia, this was Victoria’s second placement with Médecins Sans Frontières.

I recently returned from a nine month placement with Médecins Sans Frontières in southern Sudan. My role was to supervise the therapeutic feeding centre at Leer Hospital. Leer is a small town in the Western Upper Nile region of southern Sudan.

During the 1990s many people were cleared from this area to make way for the oil companies. Since the comprehensive peace agreement was signed in 2005 people have gradually been returning from refuge to resettle their land. Access to healthcare is generally very poor. People often have to travel long distances to reach a health facility, many of which would be incapable of delivering adequate care.

Médecins Sans Frontières is running a large hospital in Leer. There are currently 150 national staff (including outreach staff), although this number changes regularly. During my placement there were eight expatriate staff and three regional staff.

The hospital in Leer consists of an outpatient department, a medical and surgical inpatient department, an operating theatre, a maternity and antenatal care unit, a therapeutic feeding centre, a tuberculosis (TB) program and a laboratory.  

Médecins Sans Frontières is currently concentrating on improving the quality of the facilities and services it is providing in Leer. During my time in Leer, I saw significant improvements in the structure and functioning of the hospital. A new building for the therapeutic feeding centre was completed which hugely improved the standard of living conditions for the children and their mothers.  A new building was also added to the TB village to accommodate for the increasing number of TB patients.

A more formal and structured triage system was implemented in the outpatient department in order to improve the quality of the consultations and make sure the sickest and most vulnerable patients are given priority.  An emergency room was established which greatly improved the quality of after hours services.

A number of national staff midwives were recruited in order to ensure that there was a midwife at the hospital 24 hours a day. The expatriate midwife was working on ways to increase the number of antenatal consultations and the number of hospital deliveries. She started having monthly meetings with the traditional birth attendants in order to form a better understanding of their customs and perspectives.

My role as the supervisor of the therapeutic feeding centre was extremely rewarding. In most cases the children improved quickly once they were given appropriate treatment. I remember Mayom*, a two year old boy who was in a critical condition when his mother brought him to the centre. He was severely emaciated and anaemic and he had lost his appetite completely.

At the hospital we were able to give Mayom a blood transfusion and feed him essential nutrients via a nasogastric tube. Gradually he regained his strength and we were able to remove the tube. One of the last memories I have from my time in Leer is seeing this little boy running towards me with a smile on his face to say goodbye.

A significant part of my job was also to provide training for the national staff which was a role a really enjoyed.  I found the staff enthusiastic to learn and they were always grateful for any guidance I could give them.

When I reflect back on my nine months in Leer I also remember the most difficult and challenging times. Hearing a mother’s wails as she realised her child had died. The tragedy of losing a child, knowing that if we had reached her a day earlier the outcome could have been different. Having to choose which child should be given priority for oxygen therapy when limited resources made it impossible to administer it to all who would benefit from it.

It was also heartbreaking to leave Leer knowing that it is not going to be a happily ever after story for many of the children who are treated at the hospital. A lot of them have chronic underlying conditions that require ongoing medical attention.  Médecins Sans Frontières is playing an important role in cooperating with the Ministry of Health and other NGOs who are working towards improving access to healthcare in the region.

Overall my experience in Leer was rewarding and also enlightening. I had the opportunity to experience life in southern Sudan and I’m sure I learnt something new every day I was there.  The intense teamwork that is part of life in the field has given me friendships that I will treasure for the rest of my life.

* names changed to protect identity


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