Zimbabwean born Melusi Mabhena, 34, recently returned from South Sudan where he spent seven months working in the Pibor Project as the Nursing Team Supervisor.
Melusi together with fellow Zimbabwean, Melt Ndlovu were evacuated following the looting of the MSF medical compound in Pibor on 23 February. The fighting between the rival groups left at least 35 people injured and forced some 1 000 others to seek shelter in a UN base.
Describing the looting, Melusi said there was nothing left in the compound except for empty shelves in the pharmacy, emptied bottles of medication and piles of papers strewn all over the compound. For Melt, it was a blessing in disguise because when the looting occurred, he was in Juba for a field visit. His job entailed travelling to the different MSF projects and giving support to the projects as a Flying Nurse Supervisor. Although he lost some of his clothes and belongings, his experience is different from Melusi’s who lost everything except for his bath scrub, a pair of socks and a mini brief.
“From refrigerators, hospital beds to clothes, everything was taken by the militia”. “I couldn’t believe my eyes when I rushed back to my room to find everything gone after spending almost four hours in a safe house with about 30 colleagues and patients after the attack. All I could salvage was a pair of socks, a mini brief and a bath scrub. I couldn’t throw away the scrub because it’s the only thing that will forever remind me of the incident at Pibor and the only thing I could salvage,” says Melusi.
“I am going back home empty-handed, but I am very proud to have played my part and saved lives in South Sudan”
Melusi is married and has two children. He joined MSF in 2008 where he worked as a national staff member in Beitbridge, Zimbabwe for five years. He has also worked as an Emergency Nursing Team Supervisor in Mozambique and Malawi following a recent outbreak of cholera outbreak and floods respectively. He has a Bachelor of Science Degree in Nursing Science attained from the University of Zimbabwe in 2005. Melusi is looking forward to doing a Master’s Degree in Public Health once he gets a gap from his busy schedule.
About the South Sudan assignment
Why is MSF in Pibor?
Pibor is probably one of the most isolated and least developed areas in South Sudan, so despite the lootings and insecurity in context, we have to be there to offer health care services to the neglected community. MSF is the only healthcare provider in the area and we have been there since 2005. Over the years, the health needs in Pibor keep growing on a daily basis. We have an 18-bed facility for admissions. We offer Outpatient, Inpatient, Sexual and Reproductive Health, Nutritional, Health Promotion, Infection Prevention and Vaccination services at the hospital.
What were some of your roles and responsibilities?
- I oversaw all medical activities in the Outpatient and Inpatient Departments at Pibor hospital
- Offer on the job training for staff
- Took part in the immunisation and nutritional campaigns
- Supervised about 23 staff members including; nurse assistants, hospital hygiene officers, dispensers, registrars, nutrition officers and nurse aides.
Can you describe your typical working day?
I normally woke up around 6 O’clock took a bath and prepared for work. I would then make a routine check on everyone in the Outpatient Department and attend to the different consultations. After 9am, I would go for a medical round to check on patients with the doctor and health promoters in the In-patient Department. After the medical round, I would then do some on the job training with the medical team and support other departments.
What were the main morbidities and how many patients did you attend to on a daily basis at the hospital?
Malaria, respiratory tract infection, diarrhoea and gun-shot wounds were the major morbidities. We attended to about 120 patients per day and almost 40% of the patients were children under 5 years old.
What was the most fulfilling moment for you?
Just seeing the patients recover from the various ailments made me realise how important my contribution was.
What are some of the challenges you faced?
I never imagined that some people would choose traditional instead of conventional medicine/treatment, but in Pibor this was normal. One day I attended to a man with an extremely bad gunshot wound, so we made arrangements for him to be flown to Juba for further treatment. After everything was set up, he completely refused to go and opted to seek traditional treatment. This was a bad experience for me because I could see this man needed more than traditional medicine, but he left the hospital. I think patients are scared they may be amputated if they are referred to Juba or worried about their safety once they leave the community.
The context was a bit insecure – when the tension escalated and the looting occurred, I had a serious debate on whether I should stay and make a difference to the community that so much depended on us or leave Pibor for my safety. This was a huge challenge for me because very few of us remained to continue with medical activities because most of the local staff stayed away from work when the fighting started. The team was quite lean – meaning more work to the remaining team.
Leaving Pibor abruptly was a huge challenge for me because I was hoping I would still offer my services to the community and make sure I fulfilled my objectives fully.
Has the looting incident affected you in any way or will it impact on you going for other MSF assignments in the future?
This experience has not shaken me in any way. It is good to experience both the normal or regular assignments and the unstable ones. If anything, this incident has taught me a few lessons and strengthened me because I now understand what it means to work in an unstable environment. The key is to understand the context and if anything happens I should know what to do.
What lessons can you draw from your experience?
- As a team leader, keeping the team motivated is always critical
- Patience pays off
- Diplomacy always works wonders
- We take issues of access to health for granted – until I got to South Sudan I just assumed and thought it was a given that people should have access to health, but what I saw in South Sudan opened my eyes, some people are really suffering. We have to try by all means to offer our support wherever possible to such communities no matter how small the contribution may be.
What kept you going despite the challenges you faced?
Seeing the difference we are making to a community with such a sea of needs motivated me a lot. I can’t imagine how the community can survive without MSF’s help. The patients’ smiles and the heartfelt gratitude from them gave me a surge of energy to keep me on my toes. Working alongside colleagues I have known for years was great because I always got support from them and they made my stay in Pibor memorable. Melt and Emily were my pillars of strength.
Who is the one patient who you will never forget or who touched your heart most?
There are so many stories to tell, but I will never forget a 7-year-old child who was brought into our hospital suffering from malaria and had a snake bite wound. Because during the rainy season most places are inaccessible in South Sudan due to poor roads, people walk long distances to access health care. When this child developed malaria, the family walked to our hospital at night, but while on the way, they decided to sleep in the bush before they could proceed with their long journey.
While sleeping their child was bitten by a snake. This meant dealing with two serious conditions, malaria and the snake bite wound. A decision had to be made whether to focus on malaria first or the wound. The wound was quite bad, we were even thinking of amputating the leg. In the end, we referred the child to Juba for further consultation. By the time I left the child was still in the hospital and was recovering well.
Another incident that broke my heart was spending hours in a safe house with an 8-year-old boy who was shot and his intestines were outside his stomach, but could not help him since we were so packed and had nothing to use to save his life in there. We waited until the shooting subsided and some colleagues took him to the hospital for treatment.
What motivates you to continue working for MSF?
I identify with MSF principles and what the organisation stands for. Working for MSF exposes me to the different environments and contexts and the field experience is great. This prepares you for any experiences that may be thrown at you in life.
What are your plans going forward?
For now, I am going home, rest a bit and recharge myself. Hopefully, I will take up another assignment soon.