Saving Lives With Community Outreach in South Sudan

Matthias Steinbach

The Doctors Without Borders/Médecins Sans Frontières (MSF) duty surgeon in Yambio received a distress call from the maternity ward on a rainy Friday afternoon. Twenty-six-year-old Stella had been admitted with severe abdominal pains and profuse vaginal bleeding. Accompanied by a few of her kinsmen, she had managed to traverse the 30 kilometers [around 19 miles] of muddy, near-impassable, roads between Nzara and Yambio. The heavy rains had taken a toll on all of them.

Stella’s abdomen had a palpable, painful mass on the left side. An operation revealed that her abdomen was full of blood from a ruptured ectopic pregnancy. The doctors were able to stop the bleeding and stabilize her. Unfortunately, however, the left ovary and tube were already destroyed.

After regaining consciousness, Stella told the medical team she had been in that condition for two weeks. After the first week of pain and suffering she had sought the help of a traditional healer, who was unable to treat her. Her condition continued to deteriorate: the bleeding and the pains continued, and Stella almost gave up. Fortunately, her husband had heard from MSF information, education, and communication (IEC) teams about their services at Yambio hospital and decided to ask relatives to accompany him and Stella to the hospital.

Stella was discharged two days later, and after four days she returned to have her stitches removed. After that, a talk with the psychosocial team revealed that, at 26 years old, she had seven children, and this was her eighth pregnancy. She explained that she did not want any more children and wanted to know if there were any measures she could take.

She was referred to the family planning service, where several options were explained to her. Of those, she settled for a contraceptive implant, a small tube inserted into her upper left arm. She was to come for a follow-up visit after five years. Since she lives far away from a health center, she was very satisfied with this option. “This thing will help me live a normal life with my husband and children, and avoid a repeat of this terrible experience,” she says.

In their outreach activities, MSF's IEC teams try to visit as many villages as possible to spread health information, so it is no wonder that Stella’s husband had heard of the MSF facility in Yambio. “The IEC team has a way with patients that makes them open up and enables medical personnel to act accordingly,” says Hemmed Lukonge, MSF’s medical coordinator in Juba. “It is because of the IEC team that Stella and other people get to know of and access our medical services."

MSF doctors and midwives conduct regular medical check-ups in the pre- and post- natal wards to respond timely to any medical needs.
Matthias Steinbach