Dispatch from Aweil 2, Southern Sudan

In her second letter home from working in Southern Sudan with Mdicins Sans Frontires, RN Janine Issa reports delivering a breech baby and her first set of twins.

I’m beginning to feel like part of the team. Last week I delivered my first live, full-term breech baby. It was a lovely birth with a woman who already had seven children. Later in the week I delivered my first set of twins. I was on call for four days this week, which is pretty stressful, and I have had to attend several emergency caesareans. It is great to know that these babies and mothers are alive and would surely have died without help.

Although life here is much the same from day to day, it is also changing constantly. A typical day goes like this: up about 7am, breakfast under the mango tree and then to the hospital about 8am. Maternity is usually crazy with women and families everywhere. All day there is a steady stream of women arriving in the adjacent gynaecological ward with many problems such as miscarriage, pre-term labour, fevers, and – increasingly as the rainy season approaches – watery diarrhoea. Apparently cholera is a fact of life here. It comes every year, so it’s just a matter of preparing adequately and isolating appropriately.

One of the curious problems is hysteria. Three women recently arrived within 10 minutes of each other, each having convulsions with an altered state of consciousness, unable to stand or talk, but with no other obvious problems. They usually recover after a little while and all is well. I think perhaps it is just their way of coping. If I had endless babies, many of whom died, and worked as hard as these women do, I too would need to have the odd hysterical attack to afford some time out!

If possible, we expats have a ‘tea meeting’ under the mango tree behind maternity at about 11am, and later we have lunch at about 1pm. We return and work until 5pm or 6pm, and then we go home. At that point, one of the midwives is on call till morning. Most nights there is at least one call to attend to through the night.

I have become accustomed to drinking warm water. It isn’t very thirst quenching, but even if the water comes out of our one small fridge it turns warm within 10 minutes. I also drink a couple of bottles of lemonade or something akin to Fanta each day, would you believe? I think it is the sugar that I crave, and of course they are cold because we buy them at a shop.

I had my first day away from the hospital this Sunday. What a treat – although there is not a lot to do here on a day off, except dwell on the intense heat. Even so, we midwives only get one Sunday off every three weeks, so it’s great to have a break. I washed my mosquito net, which was super dusty, and it is wonderful to go to bed now without breathing in dust. Aweil is a town of dust.

For more information on Médicins Sans Frontiéres, visit www.msf.org.au