Elizabeth also remembers a recent patient that survived but lost her baby. "The hardest thing is that many women miscarry because they have malaria, sexually transmitted infections or other curable diseases. Yesterday, a pregnant woman came to us too late. She was a new patient and sick with malaria. We could not save the baby."
Malaria is endemic in Southern Sudan. It is one of the major causes of miscarriage in this region. Women and children die because they do not have access to the simple treatment needed to cure malaria.
Both Elizabeth and Rebecca realise there is a great challenge in encouraging women to come for regular ante-natal check-ups. "Many people live so far from here, they have to walk for seven days or more to reach us. And they do not want to leave their other children behind. They are afraid no one will be able to look after them if they are away," Elizabeth explains.
Across the road from Leer Hospital is the Médecins Sans Frontières tuberculosis Treatment village. Patients live here, and receive treatment in a village setting. Here Elizabeth Nyalok Diu is a community health worker for Médecins Sans Frontières. She takes care of the patients and gives sessions on health promotion and hygiene.
Tuberculosis is a major cause of morbidity and mortality in Southern Sudan and many people are unable to access health services like those offered by Médecins Sans Frontières. The treatment is long and requires six months of solid adherence to a variety of drugs, making it difficult for patients to follow.
"Some patients start to feel better quickly and want to leave," says Elizabeth Nyalok Diu. "But they must be encouraged to stay, because if they stop their treatment, they will not be cured."
Elizabeth believes that the success of the Médecins Sans Frontières’ tuberculosis programmes lie in their village approach. "We have children laughing and playing here and women and men are chatting. It is like a village, which makes it more comfortable and easier for our patients. They don’t feel like they are confined to a hospital bed," she says.
Elizabeth Nyalok began working for Médecins Sans Frontières in 1989. She and her family were also severely affected by the war. "The soldiers were very harsh with people," she recalls. "They took our food. We were constantly on the run and had to eat leaves from the trees and lily flowers from the water. We were on the move for many years."
Elizabeth truly understands what it means to be caught in a conflict without access to healthcare. "I gave birth to my third child in the bush", she says. We had no food. We could not wait for me to recover, the fighting was too close. I gave birth, tied a cloth around me and ran and ran for two, three days. I kept the baby close to my heart, until we found food. My children all suffered. My three year old daughter died of malaria. We had nowhere to take her."
Elizabeth Nyalok’s story resonates throughout Southern Sudan. Like Rebecca and Elizabeth Nyapini, she represents many women who, past and present, struggle to survive and provide for their families.
"We are the lucky ones," says Elizabeth Nyalok. "We have work, we are trained and we can continue to look after our children. Perhaps one day my children will go to university and then I will be the happiest woman alive."
"I love my work," says Rebecca. "Even if I was free to do anything now, I would choose to be here. I just want to be able to continue to work and help my community, this is my aim. I am a very strong woman. I never give up. I will still be here in this hospital long after Médecins Sans Frontières leaves."
"I think what I do is important," concludes Elizabeth Nyapini. "I am happy to have been trained by Médecins Sans Frontières, I can use my skills to help others. People know me in town, they know I work at the hospital. I am very happy to be here!"
All three women like to sing. "I am a very good singer," Rebecca says, with a big smile. Elizabeth Nyapini blushes: "My singing is not as good, but my friends know I like to talk!" Elizabeth Nyalok says singing and praying help her to hold onto all that is good and forget any negative thoughts.
"I have had many bad things happen in my life," she reflects. "But I see the good in things. This is how we can all stay proud and look to a better future," Elizabeth Nyapini smiles. "Let us sing a song for all the women," she says. "Oh sister, sister, keep me safe – don’t forget me sister – until we meet again."
