“Hunger, malnutrition and pain is the norm”
"What did you think?" I'm asked by Isaac Ibrahim, a CARE-employed nurse, as our truck pulls away from his workplace of Pariang Hospital in South Sudan.
"Umm... it's hard. Very hard. You're obviously all under a lot of pressure," I respond, weakly.
Isaac's simple question has thrown me. I feel like any response will be woefully inadequate to the pressures, challenges and horrors that Isaac and the 25 other staff at Pariang Hospital, in the far north of South Sudan, are now dealing with every single day.
The hospital, located in South Sudan's Unity State, in an area home to thousands of refugees from Sudan, is meant to support around 80,000 people from 100 kilometres in each direction. Syringes, equipment and medicines, including antibiotics and anti-malarials, are in short supply. With roads impassable, hospitals like this rely on infrequent and expensive air deliveries for the necessities. Staff are clearly exhausted.
It's a fight against time
But what struck me most is the all-consuming feeling that time is ticking. That every minute, hour and day that goes by is a minute, hour or day lost fighting an extraordinary battle. A battle where well over 10,000 men, women and children have already died, where around 3.5 million people are now facing urgent food shortages. A battle where hunger, malnutrition, physical and mental pain is the norm.
As our truck rolls along the long, straight dusty road back to Yida, where CARE's operations in this part of Unity State are based, I begin to feel ashamed by my inadequate response. I distract myself by rifling through some of my notes from the visit while Isaac looks on with interest. He points out a small figure in the background of one of my photos.
What did you think of the little girl? About what was happening with her?
Even without looking at the photo, I know the girl he's talking about. No more than four or five years old, she was the first person my eyes were drawn to when we arrived at the hospital, sitting quietly on the waiting chair outside the clinic next to her father, a local policeman who had the same exhausted look of so many people here. The little girl was clearly very, very ill.
"Does she have malaria?" I ask Isaac.
"Yes. But it's more than that," he replies. "Even for a little girl like her, whose father has a paying job, there isn't enough food for her to eat.
"We're seeing many children like her. Some have malaria, many have diarrhoea from the malnutrition.
Some are so badly malnourished that we have to send them straight to the emergency feeding centres. It's very common now.
I ask Isaac about the 'now'. Since December last year, this country – just three years into its life – has been racked by violence, fear and hunger. And even before the outbreak of violence, South Sudan was one of the poorest countries in the world.
"Before the war, things were better," Isaac tells me. "But once this war happened, people have just run away from their homes out of fear. They've lost their properties, they are living in very bad situations in the bush or in camps. There's no healthy food like they used to eat."
He tells me many sick and injured were facing frightening journeys just to get to hospitals like Pariang.
"Patients are coming in from far, far distances away – they're just coming on foot, having walked for days. Or they're arriving with transport like donkeys, or four people will be carrying a patient in on foot."
He pauses and looks down at his hands. Isaac's clearly seen a lot worse than just people coming in exhausted.
There is still fear. Fear is still there. Even though there is talk of peace agreements, there are no real signs of peace.
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