On a clinic bed in a site for displaced persons in Juba, South Sudan, rests Madi, a woman who simultaneously cries and smiles as she testifies about her troubles. She has come to the clinic with stomach pains and vomiting as a symptom of her new pregnancy. But she shows heartache more than anything.
Madi is a foreign national living in South Sudan. She fled her East Africa homeland because she suffered persecution at the hands of those hostile toward her practice of worship. Her government only accepts a few organized religions and Madi practices a minority religion which is not recognized. Many religions have been banned from worshipping within the country’s borders and parishioners risk their lives every time they meet illegally to pray. At one time, Madi was arrested for practicing her religion and spent six months in jail. By the end of 2012, it was estimated that 1,500 people had been imprisoned in this country for their beliefs. Many of Madi’s fellow countrymen suffered religious persecution, arrests and abuse by their own government for their religious preferences.
Madi and her husband were forced to flee the country and make the long, arduous journey to the Jonglei State capital of Bor, where she heard business was good and life could promise more for her and her future family. Madi established her own shop that sold “just everything,” while her husband managed his own business. They made enough to eat well most days and keep a roof over their head. For four years, Madi ran her business in Bor, enjoyed relative freedom from persecution and built a new life for her and her husband as foreigners in a strange land. A year and one-half ago, she gave birth to her first child, a son. Then, violence broke out in South Sudan and Bor burst into conflict, resulting in hundreds of civilian deaths. Jonglei state has experienced the majority of the worst fighting during this conflict. Once again, Madi and her husband feared for their lives and the life of their infant son and were forced to flee to the only refuge they knew in Juba. The 200 km from Bor to Juba is a 3 hour drive on a day with good weather and decent security. Some IDPs fled in busses, cars and taxis to Juba. However, if there were spontaneous checkpoints or risks of running into soldiers on the road, the journey could stretch to a number of days. Dangers IDPS faced during this journey included robbery, violence by armed group, vehicle trouble, or flooding. When Madi and her family finally arrived in Juba, she had no one to lean on with everyone she knew in the world living many miles away in another country.
“I worry about my husband. He is angry and he worries all the time. Before, we had some money, a social life. Now he just stays at home, doing nothing. He is always angry. What can I do?” Madi pleads.
Madi’s son, Yarit, is the pride of her life. He is curious and precocious, with a wink in his eyes like he’s reading your thoughts. Madi prays for him every day.
“I tell God, ‘do not see me, see my son,’” she says, with tiny tears continuously falling from her face.
Between fear for her life in the Internally Displaced Person (IDP) site, where foreign nationals often face harsh treatment from others, her fear of her husband’s mental illness, and uncertainty about her future, Madi willingly admits she has little hope. One million people have already been displaced by the fighting as the crisis begins its fifth month. Juba currently supports 100,000 displaced people and tensions are high in the UN camp where Madi lives because resources are scarce. There is competition for the limited food, water, health care and other basic needs amongst all the inhabitants of the camp, South Sudanese and foreign nationals alike. It is challenging to raise a family in this setting to say the least. Madi says there is little food, little soap and hardly a way to generate income. When she arrived in the camp, she received a tarp to build her shelter, water and food rations, blankets, soap and cooking utensils. Her family of three must share a very small space inside the very densely populated camp. Only a very few IDPs in the camp are able to set up shops, tiny restaurants, hookah bars, food markets or phone charging stations. Even skilled workers, like nurses, are able to find a way to make a living. If possible, life is about to get even more challenging for the IDPS with the approaching rainy season. The lack of infrastructure and paved roads forces the city to shut down during heavy rainfall. This makes it difficult for humanitarian organizations to get the necessary supplies and personnel into the IDP sites, meaning they could be facing a shortage of supplies if weather conditions are bad.
To add to her stresses, she came to the clinic with morning sickness. Her second child is on the way. Just like her mixed-emotion demeanor, the coming of this child is both joyful and sorrowful. She wonders what kind of world her child will be brought into. She would love either a boy or a girl, but lights up talking about a daughter. This too, she says with a smile and with tears.
“It’s nice in here, I like it,” she says about the hangar-inhabited clinic where International Medical Corps has established one of its reproductive health care points in the UNMISS compound. Were it not for her hearing of the International Medical Corps maternal care clinic in the camp, she would have been left severely dehydrated and on the verge of passing out from sickness. Since the start of this emergency, the public health clinic has conducted a total of 5,163 consultations. International Medical Corps staff have attended to 63 live births and 78 mothers received postnatal care within 72 hours of delivery. 36 minor surgeries have been performed in International Medical Corps’ operating theater in Juba. International Medical Corps is the only organization currently providing both primary and reproductive health care in UN House and the only organization providing reproductive health care in the camp in Tomping. Recently, the clinic started conducting women’s health and mother care classes to educate women about how to properly care for themselves and their families while living in the harsh conditions of the camp.
“She was not doing so well, very sick. But now she has stabilized,” says the International Medical Corps staff physician who managed Madi’s case. The midwives arranged for her husband to visit, as she’d been alone the entire night and morning.
For a displaced foreign national and mother of one with another on the way, Madi maintains a truly strong spirit. No doubt the past four years have worn on her, and this second forced uprooting has strained hopes for the future of her family. Where our doctors and nurses can, they will support patients with attentive health care. Yet International Medical Corps recognizes the most resilient strength comes from the community. We celebrate mothers like Madi and we are there to offer health services at every opportunity.