SEPTEMBER 14 2019 LISTENER 33
us as we drove past in the boat,
signalling they had someone
who needed help. We would stop
and transport the patient back to
the hospital for clinical review.”
In Old Fangak, many
pregnant women arrive for
care at the hospital in advanced
labour or with birthing
complications. The normal
practice in the region is for
women to deliver their babies
at home with the assistance of
a traditional birth attendant,
with little or no antenatal care.
With no surgical facilities in Old
Fangak, and no health facilities
nearby where patients can be
referred quickly, Janet and her
team needed to be well equipped
to deal with emergencies.
“One case that sticks out in
my mind is that of a woman
who had already had two
obstructed labours, during
which both babies had died.
She arrived at the hospital with
a third pregnancy in obstructed
labour. With the support of one
of our doctors, I managed to
deliver her baby. Unfortunately,
however, the baby didn’t
survive,” says Janet.
“The woman sustained afistula [a tear between the
vagina and rectum]. It took
three days to refer her to
another health facility for
further care, and another five
days to negotiate consent from
her family for the surgery she
required. But, thankfully, she
was eventually able to get the
care she needed.”
As there is a low level of healthliteracy in the region, one of the
main challenges was gaining
the understanding and trust of
patients and families, says Janet.
“We had to work hard
to communicate about the
services we were providing. One
important part of my role was
establishing close relationshipswith traditional birth attendants
in the community, to explain
the need for women to seek
medical care. These partnerships
also helped to develop the
community’s understanding of
why MSF is there, and to build
confidence in our services.
“Women and children in this
part of South Sudan have such
high health needs comparedwith those in many other parts
of the world. MSF is providing
one of the only medical services
in the region; without the
hospital and outreach teams,
many people would have no
access to healthcare.
“The women in Old Fangak
are incredibly resilient, and it was
rewarding to be there for many
of them during their pregnancies
and feeling that we were making
a difference,” Janet says.
“This resilience was also
true of my South Sudanese
MSF colleagues. They live and
work in adverse conditions and
without them there would be no
hospital.”
Janet intends to return to work
in the field. “I love travelling and
experiencing different cultures.
Working with MSF has allowed
me to combine this with my
work. What could be better?”She’d already had two obstructed
labours, during which both babies died.- At night, in the emergency ward of
the Old Fangak clinic, a medical worker
prepares to treat a young girl with
malaria. 2. An MSF mobile clinic team
travels down the Phow River. 3. Janet
Coleman in Aweil, South Sudan, with
colleagues from a field placement in 2010. - Consultation in the antenatal ward of
the Old Fangak hospital.
3
2
4
(^) P
H
O
T
O
(^) C
R
E
D
IT
: (^) F
R
E
D
E
R
IC
(^) N
O
Y.