From refugee to aid worker: Reflections from the frontline

Joseph Ngamije
Patients at the CARE health clinic in Pariang © CARE / Josh Estey

Figures released for World Humanitarian Day show 2013 was the most dangerous year yet, with 155 deaths and 134 kidnappings. For World Humanitarian Day 2014, frontline aid worker Joseph Ngamije, CARE's Area Manager for Rubkhona-Bentiu, writes about responding to the current crisis with CARE South Sudan.

Conflict broke out in South Sudan in December 2013. Since then, 1.5 million people have fled their homes, leaving everything behind. Due to this massive displacement, people could not plant their fields and many are cut off from any kind of assistance.

CARE International has assisted more than 150,000 people in South Sudan with medical support; water, hygiene and sanitation services; and longer term needs.

When I was 11 years old, I was forced to become a refugee in my own country, Rwanda. I could see how innocent children and mothers suffered from a conflict they have never started. People died including my own brother. Innocent children were massacred. From then on, I developed a spirit of giving justice to those who are helpless, giving a voice to the voiceless, giving protection to the most vulnerable.

There are so many people here in South Sudan who have not received any assistance. Who are surviving with very little to eat, who have no access to health care, who are scared and traumatised from many months of violence.

Up to now, we've only been able to help people inside the UN Protection of Civilian Area (PoC). Now that the fighting has stopped, our team decided to work outside the UN camp. So far, CARE is the only organisation assisting people outside the PoC.

There are too many people who need help

We have a small mobile clinic which drives to Bentiu town twice a week. However, after seeing the immense needs in the past days, we decided to use the mobile clinic daily. There are just too many people who need our help.

We'll be going to more locations for our vaccination campaign which will vaccinate people against measles, polio and will provide vitamin A. This will also be an opportunity for us to de-worm all children under five and to screen them for malnutrition. So in a nutshell: we are doing what we can to provide basic primary health care.

There are now more and more people coming to our mobile clinic because the word has spread quickly that we are there to support them. Some people walk three or five hours to receive our assistance. Some have to stay overnight in Bentiu. This is especially perilous for women who always face the danger of sexual assault or worse. It must be a very hard and desperate decision for them: receiving support yet risking walking for hours through a conflict area.

People have spent months without any medical support. They tell me that children have died, that their neighbours have died, that they lost friends. Many of them are extremely happy to see CARE again. We have been working here before the conflict started, and people know us, they trust us. Yet they have so many needs. They need medicine and food. They have not been able to plant and the market is not fully functioning again.

As we can provide only primary health care we bring the more serious cases to the MSF clinic in the PoC and we make sure the patient is treated. We also drive them home as soon as they feel better. Last week we had to refer three patients, one of them was a small boy with jaundice. He was still in hospital with his mother when I visited him last Sunday. I hope he can be released soon.

Constant insecurity

One of our main challenges is the constant insecurity. This morning I heard gunshots and shelling close by. It is not easy but the team and I feel we have to do it to support all these people who are on their own. People live with that constant insecurity day after day. I always try to put myself in their shoes.

The signs of violence and destruction are still clearly visible in Bentiu:  empty houses, destroyed buildings. No reconstruction has started yet. People are scared and traumatised. While they slowly open up to CARE staff, telling us their often dreadful stories, it's mainly the men who talk. I hope that now that we have a midwife joining our team we can find out more about women's particular needs, hear more of their voices.

Yet, compared to the previous weeks, the town of Bentiu is becoming more and more lively. A few shops have opened at the major market and we see more people on the streets. Women are walking by to collect firewood or sell items. The number of displaced people living in the PoC is decreasing, at the moment it stands at 35,000 people. I hope that it will become peaceful again and that people can go home to rebuild their lives.

This article first appeared in The Huffington Post 19/08/2014

Joseph Ngamije's picture

Joseph Ngamije is Area Manager for CARE South Sudan