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Earlier this year, I was offered a mission with New Zealand Red Cross in South Sudan. During those two months, I discovered that I have been of use far more than I ever anticipated. During one of my previous three missions to the same area (then known as The Sudan), I had been told that “once you have drunk the water from the Nile, you will always return,” and this appeared to be the situation for me.
It was a good feeling to return, firstly to see how the area had improved or not, but also to meet with local friends from the earlier days. My brief was for the position of Operating Theatre (OT) nurse for a mobile surgical team to deploy into the field as necessary to operate on victims of conflict. The brief stated the living and working conditions could be difficult, as we would be camping in the field during the hot dry season.
I was very lucky in that I managed to complete four field trips in my two month mission. Perhaps the most satisfying of these was one to support an expat doctor working in an area that was receiving an unexpected number of weapon wounded casualties.
The hospital I worked in had been built and operated for 25 years, with donations and support from abroad and is designed to meet the medical needs of the local population (with a few minor surgical procedures that the doctor there can manage). I felt it was quite an honour to support the doctor during this difficult time for the people of South Sudan.
As was usual with every field trip I did, I was greeted by smiling faces and many handshakes from the South Sudanese people. The respect the Red Cross Movement has in this country is enormous and I felt very proud to be part of the organisation.
We arrived by aircraft and then by river, yes a cruise, and set up our camp site and then set up all our operating instruments and supplies to create a little operating theatre in a room in the hospital.
As usual, there was no running water, but we could fill jerry cans for hand washing, instrument processing and general cleaning at a hand pump about a kilometre away. Also, again as usual, we had no electricity, but luckily for us, the doctor has a solar lighting system which meant we had ceiling lights when operating at night.
We were a team of four – a surgeon, an anaesthesist, an OT nurse and a ward nurse. It was a privilege to have my friend Jaquee Dixon-West from New Zealand in the team with me as the ward nurse. You can imagine the debriefings we had together at the end of each day, speaking our special English that only Kiwis can understand: “oh I have guts ache Jaquee”, “are you crook?” “no, just bunged up”!
Our daily routine was to awake with the sun, which was about 6.30am. By then the doctor, whom I likened to an ant because she works all day and night, had boiled up some water on her gas cooker for a delicious cup of tea. We all enjoyed a breakfast together under a tree, after inspecting it for snakes, and discussed the plans for the day.
I would head off to the wee operating theatre and set up all the instruments, which I had sterilized the evening before in a sterilizer run with kerosene. Jaquee would do a ward round with the surgeon, and begin the logistically difficult job of getting the immobile patients to the operating theatre. As we did not have nice patient trolleys with wheels, only stretchers, Jaquee had to arrange for family members or other patients’ relatives to stretcher carry each patient to and from the theatre. The people in South Sudan are very tall and they are heavy!
So our day would continue, operating on patient after patient until we had completed all the operations necessary for the day. Between cases I would clean and sterilize the instruments and even though Red Cross has a policy of having no weapons, I sometimes felt my sterilizer was very close to exploding!
At the end of the day, we were all very tired. You have to remember it is a challenging environment due to the heat, bugs, particularly mosquitoes and also the workload. Also we had the added challenges of basic living conditions and limited drinking water supplies. So the chance to relax, take a cool bucket shower and chat in the evening was a welcome one. At about 8pm we would all be in our tents ready for a night’s sleep.
I am an older nurse having just had my 35th anniversary of the start of my training and I suppose you could say I had come to that time in my nursing career when I would ask myself the following questions: “Just what have I done? Where am I going? Have I been of any use?” This mission was just the tonic as I was reminded of how much I know. For example, on returning to base, I was asked frequently by the younger OT nurses about the field environment, how to work the fickle sterilizers, what you would use for this and that, how do you tell when a wound is going to be infected - all sorts of questions!
The best part for me was when I met South Sudanese nurses whom I had trained nine years before when I had run an operating theatre in Kenya which had a teaching program for Sudanese nursing students. They all remembered me and I felt so humble in their presence to see they were still nursing and in some small way I had helped them and indirectly all their patients over all these years.
So there you are, no mention of the terrible loos, the dust and dirt, the endless meals of boiled rice, the 48 degree temperatures - you forget all that, and the only question you have is, “when can I go back and be of use”?