Saving Lives By Torchlight

* Any views expressed in this article are those of the author and not of Thomson Reuters Foundation.

Kaluak knew he was sick, very sick. His baby boy was sick too. He knew the signs: without treatment they could die. Kala-azar. Countless families in Southern Sudan suffer because of kala-azar, a deadly parasitic disease carried by tiny sand flies. Kala-azar causes fever, weight loss, enlarged spleen, rash, anaemeia, diarrhoea, fatigue, and, left untreated, death.But Kaluak and his family lived a long way from the health centre at Old Fangak. He and his wife Nyaruach had to spend a full month of wages to hire a boat that carried them, their four children, and Nyaruach?s ailing sister on the three-day trek down the river Nile. When they arrived in Old Fangak, they witnessed a shocking sight. Hundreds upon hundreds of sick, lethargic people were gathered there, some so thin they were literally wasting away. Families with nowhere to live and nothing to do but wait in this tiny remote village to receive their daily treatments, sleeping outside in the open air, praying to survive.Death hung heavy over this tiny village. Despite starting treatments right away, Nyaruach?s sister succumbed to her illness shortly after they arrived. ?She received injections and blood transfusions, but nothing helped,? said Nyaruach. ?She kept bleeding until she bled to death.? Crisis in Old FangakAt the heart of the health centre in Old Fangak, Dr. Jill Seaman and her staff of local helpers worked day and night to save lives. But with more and more sick people arriving daily, Dr. Jill knew that too many people needed treatment, that the crisis was escalating out of control. ?What we have here with the kala-azar is clearly an epidemic, and it?s a disaster,? said Dr. Jill, an international expert on kala-azar from Alaska who has worked in Southern Sudan for the last 21 years with her NGO, Sudan Medical Relief.?The clinic here in Old Fangak should normally see around 30 to 40 patients a day,? she said. ?But right now, we are seeing 700 to 900 patients coming every morning and sitting under trees waiting to be seen.?Dr. Jill knows better than almost anyone else how deadly kala-azar can be. In 1989, she witnessed an outbreak that killed more than half the population in the area where she was working. ?There have been other outbreaks since, but this is as big as anything that?s happened in Southern Sudan in 20 years,? she said. ?And now the epidemic is moving slowly down to new areas.?Dr. Jill knew she needed help, and she needed it fast. So she called Medair. ?I?ve been familiar with Medair for a long time,? said Dr. Jill. ?Medair has expertise in emergencies, which many NGOs don?t. They can respond very quickly. They immediately came to Old Fangak to see where they could help.? Unbelievable ConditionsMedair?s Stella Chetham has seen her share of heartbreaking scenes in Southern Sudan, but even she was unprepared for what she saw in Old Fangak. ?The conditions we found on the ground were unbelievable,? Stella reported. ?The clinic is absolutely overwhelmed with patients, many of whom are desperately sick. Many of the patients are reduced to barely more than skeletons.?Walking into that clinic felt to me as if we were stepping back 50 or 100 years,? she continued. ?Yet the team are doing incredibly professional work with the few resources that they have. The staff work late into the night by torchlight in the barely lit, severely dilapidated and crumbling wards.?The Medair ERTOur ERT quickly got to work. We supported Dr. Jill in assessing and treating kala-azar patients, delivering much-needed medical supplies, treating malnourished patients, providing vaccinations, training people in health and hygiene, and distributing mosquito nets to protect people against the swarms of disease-carrying sand flies. ?Every day, the Medair team takes the new admissions and vaccinates them, which is absolutely wonderful,? said Dr. Jill. ?The Medair team have also taken over the distribution of mosquito nets so I don?t have to worry about it. And of course they are doing health education, explaining to people the importance of using the nets. We haven?t been able to do proper health education until now.??The hardest thing for me is seeing people who come in when the disease is already advanced,? said Medair?s Dr. Joy Lomole, as she worked side-by-side with Dr. Jill. ?It?s painful to see that something could have been done earlier if there had been more awareness.?Kala-azar and MalnutritionFor two days, Nyayiek walked through swamps to reach the health centre in Old Fangak, carrying her deathly ill six-year-old son Ruach. By the time she reached Dr. Jill and Dr. Joy, Ruach had become catatonic, weak, and uninterested in his surroundings. Nyayiek feared he would die.The doctors knew there was no time to lose. They treated Ruach for kala-azar, suspecting an additional infection such as tuberculosis. While he improved slowly with treatment, he remained severely malnourished.Kala-azar patients often suffer from related cases of malnutrition and require nutritional support in order to recover. Two weeks after Ruach started treatments for his malnutrition, he showed wonderful progress. ?He is now eating and his cheeks are noticeably rounder and less hollow,? said Stella. ?The staff are all delighted as they had doubts that he would make it.?The kala-azar outbreak hit Old Fangak particularly hard, but the sudden spike in cases was felt throughout northern Jonglei state. In response, Medair sent ERTs to Jiech and to Ayod to provide essential support to health care facilities to help save lives during the crisis.New Problems in Old FangakBack in Old Fangak, Kaluak and his son had begun to recover from their bouts with kala-azar. However, they now faced a different problem, one that hundreds of others were facing as well. ?How are we supposed to survive after this?? asked Kaluak. ?My money was all used up by the journey.? Indeed, with so many sick people and their families forced to stay near Old Fangak, nobody had been at home harvesting fields or earning wages. This in a region where many people were already struggling to provide for their families before the outbreak. And in Old Fangak, the swelling population of patients with no shelter and little money had created new problems for the community.?There are 2,000 to 3,000 extra people here with nowhere to stay,? said Dr. Jill. ?I don?t know what we are going to do. The latrines are full; they were built last year and only designed to be emergency latrines. And people are drinking river water. This is not a hospital designed to take care of patients full-time.?In response to the overflowing latrines, Medair?s ERT WASH (water, sanitation, and hygiene) travelled to Old Fangak and built 26 new latrines and trained 20 community members as hygiene promoters to help protect the vulnerable population against the spread of other deadly diseases. Making a Tangible Difference?I wish I could bring everyone I know to this place to see the situation with their own eyes, as I fear that?s the only way they would really believe it,? said Stella. ?It is shocking to me that there is so much wealth in some places while there is such desperate need as this in others. I think many people really don?t realise things can be this bad. ?At the level of this one clinic and this one project, every syringe, every vaccination, every extra pair of hands really makes a tangible difference to the number of lives that can be saved and helped. It?s that simple. And people really are deeply grateful to know that someone cares.? As kala-azar continues to devastate families in Southern Sudan. Medair?s ERTs are actively supporting health care facilities to combat the outbreak in both Jonglei and Upper Nile states.Do you want to make a difference for the people of Southern Sudan? Stand in solidarity with committed professionals like Dr. Jill, Stella, and Dr. Joy, people who are out there working tirelessly, saving lives by torchlight. Stand in compassion and support for those who suffer so much but still press on with courage, fathers like Kaluak, mothers like Nyayiek, children like little Ruach.Please make a donation to Medair today. Your donation will enable us to respond to emergencies wherever the need is greatest. ______________________________________________________________ Medair?s Southern Sudan programme is supported by the E.C. Directorate-General for Humanitarian Aid and Civil Protection, the Common Humanitarian Fund, the Multi-Donor Trust Fund, Swiss Solidarity, the Basic Services Fund, the Swiss Agency for Development and Cooperation, the Big Give (U.K.), and private donors. Since 1991, Medair has responded to the needs of highly vulnerable people in conflict-affected Southern Sudan?particularly women and children under five. We currently provide WASH (water, sanitation, and hygiene) and health services in Upper Nile State (Melut and Manyo counties), while our emergency response teams provide rapid, life-saving aid during crises within Southern Sudan's 10 states.This web feature was produced with resources gathered by Medair field and headquarters staff. The views expressed herein are those solely of Medair and should not be taken, in any way, to reflect the official opinion of any other organisation.