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IV fluid bags hang from trees and drain tubes are draped across the branches. Patients, many with gunshot wounds, are scattered under the jungle shade, resting beneath the leaves.
It might sound like something from a dramatic episode of Shortland Street, but this is a real, working hospital ward in rural South Sudan.
Kiwi Lucy Gallagher is one of the nurses tending to patients in the hospital beneath the trees. Lucy recently spent six months in the war-torn country with Red Cross, supporting local healthcare and hospitals.
Most of the time, she explains, patients are not outdoors between trees, but in special medical tents. Sometimes, however, temperatures in these tents, baking under the African sun, become too hot for effective treatment.
Lucy and her team then have to think outside the box to give their patients the best care possible.
“Sometimes, you do a bit of improvisation,” she says.
“My high dependency unit was once under the trees. Coming from hospitals in New Zealand, it was just crazy.”
It’s not just the hospitals that are different – getting around is a lot more difficult, too. There are few paved roads in South Sudan. Even in Juba, the capital city, roads are rough. Across the rest of the country, Lucy says, they are horrific.
Helicopters are a common form of transport for medical staff as they travel to rural field hospitals, but in the rainy season, even these aren’t reliable.
“You just didn’t know if things were going to show up. You are thinking, please don’t let it rain – I have two tonnes of medical supplies coming,” Lucy says.
Red Cross works in some very remote areas of the country. Out here, communities are formed by local tribes, cattle are often used as currency, and tribal law is still prevalent. Many also rely on traditional healers for medical care.
Part of the challenge for Lucy has been respecting these local medical traditions while also saving lives.
Most of the patients Lucy tends come in for gunshot wounds and emergency caesarean sections. However, as a nurse, she is prepared to deal with anything that comes her way.
In September, she was required to help treat patients with serious burns, after a fuel tanker exploded in Maridi, a town in the southeast of the country.
Despite the long working days, the mud and the horrific injuries she saw on a daily basis, the hardest part about working in South Sudan has been the food.
In New Zealand, Lucy eats a lot of fresh fruit in vegetables. In South Sudan, the field diet is predominantly beans and rice, with vegetables served cooked in oil.
“That was always the thing that everyone complained about – not that you’ve been working 20 hours that day, but the food.”
The International Committee of the Red Cross (ICRC) works with conflict-affected communities in South Sudan, supporting hospital and physical rehabilitation services, reuniting families dispersed by conflict and promoting respect for international humanitarian law.