‘We have come to restore hope’: Action Against Hunger’s emergency team in South Sudan provides last mile health care in hard-to-reach communities – South Sudan
By: Susan Martinez
In Pibor County, South Sudan, there isn’t enough data to officially declare a famine – but some experts believe it’s likely happening. Conflict, climate shocks and COVID-19 have all contributed to the worsening hunger crisis here. By the time a famine is declared here, it will be too late – many will already have starved to death.
Maruwo is an isolated area in Pibor County, currently home to around 17,000 people who have fled their communities to seek shelter from the conflict. In the hills below Mount Maruwo, the Action Against Hunger emergency team has been deployed for several months to respond to urgent health and nutrition needs.
Our multisectoral emergency team – dubbed the “MET” – is dispatched to assist communities facing urgent humanitarian needs. This small team reaches some of the most difficult to reach areas and, often, they are the only aid workers to travel for miles. Their role is to reach communities in need as quickly as possible and provide life-saving assistance until more permanent assistance programs can be developed or until a short-term crisis subsides. Sometimes they only stay for a few weeks and other times for several months.
Witnessing suffering seven days a week, working tirelessly to help those in desperate need and living in a tent for over a year – this is humanitarian life at its toughest. A year ago, a team of six people landed in Maruwo for the first time: Patrick, Moses, Michael, Umary, Queen and their team leader, Noel.
“Maruwo is an area where access is really a problem. We arrived with a plane because there is no road network ”, explains Noel. The arrival of the team came as a shock to the residents of Maruwo, who had never had access to any health services.
“It was quite difficult for the community to understand what we had come to do,” says Noel, who contacted community leaders immediately after the team’s small plane landed. “We explained to the leaders what we were coming to do here, and the services that we are going to provide to the people. After that, they welcomed us.”
Maruwo presented their first challenges early on, as the MET struggled to clear the land so they could pitch their tents and dig a pit for their latrines. That first night, the team only slept very late, under a starry sky and the laughter of hyenas nearby.
A MIDNIGHT EMERGENCY
A year later, the team is still there. While the team is typically only deployed for weeks or months in one location, the COVID-19 pandemic has kept them in Maruwo for much longer due to movement restrictions.
As a red moon rises over the horizon, a guard alerts the team that a medical emergency is upon them. These midnight emergencies have become the norm.
A group of women and men rush into the campsite carrying an unconscious woman on their shoulders. Noel and Patrick quickly put a mat on the floor and set up an IV stand for their patient. Carefully, the group puts the woman on the mat and sits next to her as the team begins their exam.
Asus Alami, 23, was sleeping with his family on the bare floor that night. They had traveled to the other side of the hill and were planning to go to the mobile health center in the morning. They had barely eaten in days. Asus had suffered from headaches and muscle aches for quite some time.
But then, in the middle of the night, Asus went into labor and passed out. Her family brought her to the mobile clinic as quickly as possible.
Noel and Patrick immediately stabilized Asus by stopping the bleeding and plugging her into an IV. As she slowly regained consciousness, they focused on the premature baby. “At least five months premature”, they estimated. The mother, still weak, had no milk. Patrick diagnosed him with severe malaria. The baby, against all odds, was active and touching.
“He’s fighting,” Noel says. Inspiration struck and he asked the family if any of the women had recently had a baby. Asus’ sister had and produced “very little” milk. Noel explained that at this age, the newborn could not breastfeed but could take her aunt’s milk with a syringe without a needle. The women were skeptical that only breast milk could be given to the baby. But Noel convinced them, and the baby eagerly drank the milk.
DEPLOYED IN A PANDEMIC
For over a year, MET members have camped in Maruwo, providing humanitarian aid to the community. No member of the team has taken time off to visit family due to the COVID-19 pandemic. Restrictions on movement in South Sudan have stranded many teams in the field, keeping them away from their loved ones for months. In addition to the pandemic, Maruwo is so remote that the MET is currently the only source of assistance for the community.
“There is no partner who can help this community at the moment, and we can’t just walk away. On a humanitarian basis, we can’t do this. Let people go back to the same suffering, we can’t do this. would make no difference, ”says Noel.
Living in a tent for so long and working in such an intense environment presents challenges unlike any other.
“The first time we arrived, one of our team was sleeping with a snake in the tent. In the morning we found out, and most of the snakes in these areas are poisonous, but luckily nothing happened. ‘is over,’ says Noel. “Bug problems are common. You often find scorpions inside the tent and at least every two months one of the team members gets malaria.”
Every day, Noel and Moses, the MET nurse, come to the small health center to provide life-saving care for children under five. Early in the morning, the health center is already full and the two are working tirelessly. Just outside the tent, Patrick looks after the adults who seek medical attention.
Meanwhile, Michael, the team’s water, sanitation and hygiene (WASH) specialist, travels around the community to provide hygiene and sanitation training and ensure that the community has access to drinking water from the borehole.
Queen sits under a tree in a private space where she can talk to people from the community. Slowly, they are showing up in greater numbers for the mental health support and youth health education it provides in a safe space.
Back at base, Umary, the team logistician, makes sure all humanitarian supplies are in order and properly organized for distribution. Supplies include everything from malaria tests to gardening tools, soap to nutritional treatment.
This is the MET, which works in a region where there are catastrophic levels of food insecurity and disease and extremely limited access to health, nutrition and water. Unwavering, they continue to offer their services.
“Never in their life have these people received these services,” says Noel. survival, we have come to restore hope, and that makes me very grateful. “