South Sudan 2011: November 2011

There has been a long hiatus between the last blog and this, partly due to a lack of internet access for 5 weeks combined with the fact that the original version of this failed to publish when I wrote it some time back. Here is round two in a briefer form, you will probably be relieved to hear.

The painted sign on the bus bumper read ‘Relax, Jesus is in control’. This seemed like a good thing since the grinning glazed-eyed gentleman behind the steering wheel did not inspire confidence. However just a few miles into the trip it dawned on me that Jesus is probably usually chauffeured around and that would certainly explain the erratic driving on the wet potholed road to Torit.

That’s right, we were on a road trip in South Sudan; the first of a couple to see the other health facilities outside of the capital to get a feeling for the different facilities available in the various states and to see the differences between a state-run and government-run hospital.

Road-trip 1

Torit is in the South East of South Sudan, a small town en-route to North Western Kenya. The town was quiet and friendly and it was easy to pass days with our American colleagues in the roadside tea houses. The hospital was a state-run place and surprisingly quiet. There are no tarmac roads here so road trauma is sparse and the busiest ward was male medical filled with liver disease. The paediatric ward had the obligatory ‘child fallen out of mango tree’: the mango season contributes hugely to child trauma as when stones fail to knock down the succulent fruit the rascals head up the tree themselves, often with friends still firing up rocks! The only female patient had been chopped by her husband with a knife.

Road-trip 2

Yei is in the South West on the road to the Democratic Republic of Congo. Two of my junior doctors had left Juba hospital to work down there as they felt they were treated better in this busy State-run unit. Yei is the second largest city in South Sudan and often described as the most beautiful. It certainly was a stunning place to see; the rough dirt road that took us there became a deeper shade of red the closer we came and palm-nut trees started to rise up from the bush as the scenery became more Central-African. Describing it as the second city is a big claim as it is tiny in comparison with the rest of East Africa and would constitute an average-sized town elsewhere. There are a couple of tarred roads in the city centre which are always a pleasure to see. The hospital was very busy and we were toured round by Joseph who worked with us in Juba. Here the junior doctors do everything- medicine, surgery, obstetrics and gynaecology and paediatrics. The accommodation was good in private houses a short walk from the hospital and free use of a 4x4 motor!

Road trip 3

Not exactly a road trip as a plane trip. After calling in some favours we landed ourselves a flight to Malakal in the north of South Sudan where up until recently there has been heavy fighting. This is the 4th largest city and is the base of one of the three medical schools. We climbed off the plane and fell directly into a swamp. After wading to one side we soon realised that the whole place was a swamp- and we arrived after a dry couple of days! First problem: accommodation. The recommended hotel was a simple one storey structure habituated by a large force of the SPLA (army) and in the reception was a crowd of grenade launcher-wielding troops waiting for their Commander. The rather steep $325 USD price tag for a room for the night saw us quickly vacate the premises.

Then began the long trudge in the blazing sun looking for a roof to cover us for less than the price of a kidney sold on the black market. This was to prove impossible until we stumbled across the International Red Cross who have established a trauma unit in the hospital. We were hoping to meet them to discuss the state of the hospital and they were aware of our arrival having been warned by our ICRC friends in Juba. Immediately we were accommodated, fed and toured round the hospital. Their kindness was amazing, and a huge relief after our wanderings in the sun, stumbling across drunk soldiers at check points and obstructive security guards in some of the very few cars in the town.

The hospital was basic and not particularly busy- generally a bad sign in a place with so many people, though you could see how hard it might be just to get to the hospital with no roads. They did, however, have doctors, which is at least something.

All in all an interesting time, and a great opportunity to see what is outside of the bubble of Juba. You very quickly realise just how well served the people of Juba are compared to some of the surrounding states.

Sorry the pictures are out of order.. starts with Malakal:

The view of the Sudd on our way to Malakal