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Precious Cargo

Cow jam on Juba bridgeIt was a hot and sunny day when we started out across the only bridge on the White Nile for over 1000km. The banks of the river were bustling with people bathing, washing their clothes, fishing, and offloading goods from small boats. After we crossed the river we headed down a dirt road toward our first destination: a Primary Health Care Center (PHCC) staffed by a trained community health worker (CHW). The old adage that “It’s the journey that matters and not the destination” held true as we hastily rushed down the dirt road narrowly dodging goats, long-horned cattle, and small children and women carrying water containers and bundled wood on their heads.

At one point in the road we noticed a traffic jam with an assortment of NGO land cruisers, minibuses, mototaxis, and curious onlookers piled around a beer truck stuck in a muddy crevasse in the road. Men with shovels surrounded the beer truck, desperately trying to dislodge the vehicle and its precious cargo. Apparently a church was being inaugurated in a village down the road and many dignitaries were attending, as it was the home village of a political bigwig. Eventually the combined testosterone, need for beer, and growing crowd of annoyed onlookers managed to push the beer truck to the side and we proceeded onward in our mach-5 fashion. Driving along the bumpy road we passed tiny village after tiny village, each surprisingly full of people. Two and half hours later we finally reached the PHCC.

PHCC, South SudanThe PHCC, newly upgraded and considered to be one of the best in South Sudan, was situated on the slopes of a hill surrounded by a village and a drinking well. As I was guided through the building, accompanied by two doctors, we met patients lined up on benches waiting to be seen by the community health worker (CHW). This CHW, like many of his colleagues, was a local South Sudanese resident who received his basic medical training in a refugee camp in Uganda.  After decades of civil war and turmoil in Sudan, highly skilled medical professionals fled north, leaving South Sudan without adequately trained health workers. CHWs play an essential role in the health of rural communities, filling a gap in coverage and providing essential care. However, they bear the burden of working with limited training and resources and attending to severely complicated medical cases. I was about to see first-hand what this really meant.

Drug storageThe CHW led us around room by room, to the room where he dressed wounds and sterilized instruments, the drug dispensary, the laboratory with only a microscope, some malaria test kits and urine testing strips, the delivery room, and the storage room, which at over 95F, cannot preserve the potency of most drugs and vaccines.

In one of the patient rooms a heavily pregnant woman lay listlessly on a bed. She had a rapid pulse, shallow breathing, and was severely anemic (malaria, a major cause of anemia in women, is endemic here) and potentially had hepatitis. We realized that she had to be transported rapidly to the referral hospital in distant Juba, and at this point, we were the only source of transport.

It seemed only seconds before we were given the OK to begin transporting our own precious cargo, the pregnant woman, barely holding on to her life. The road back to Juba was as unforgiving as it was on the way in, every bump and dip sent chills down my back. All I could think was how grateful I was that my two colleagues and I happened to be there. Without our car and the skills of my OBGYN colleagues on hand, this woman would die. Hours later and still holding on, we carefully delivered our precious cargo to the hospital. This is a moment I will remember forever because this is when I fully came to appreciate my job and the work of VSI. Our work is about getting life-saving solutions to the lowest level in rural communities throughout Africa and South Asia. This way, health care providers are equipped with essential tools to ensure that no woman dies while giving life, no matter where she lives.