Within weeks of the conflict in South Sudan beginning, Nora Hellman, an Emergency Room Nurse in Montana, USA, was on her way to join the International Medical Corps team in Malakal. With our clinic set-up days after Malakal once again became accessible, Nora flew there in late-January. Last week, fighting broke out once again in Malakal and the clinic where Nora works saw nearly 300 people in the first days.
We asked her some questions when she had a spare moment about how her first month in Malakal has been.
When did you get to Malakal?
Around the end of January, 28th, which was a week after it became possible again to fly up to Malakal.
What’s the set-up in Malakal?
We’re working in the UN base here. Next to the hospitals which the UN have for their staff we’ve set up tents and have a few rooms in the hospital just for the displaced people living within the base. So displaced people can come to our clinic 6 days a week and we’re set-up to help with primary healthcare, nutrition, and reproductive health. That means we can and do deliver babies at any time of day or night!
What’s your role up there?
I’m an Emergency Nurse and Clinic Coordinator. I see patients and also help run the clinic and manage the staff, who are mostly drawn from the people living in the camp. It’s much better to train local South Sudanese people how to take care of their own health needs, instead of having lots of international staff like me.
What’s an average day like?
There is no such thing as an average day here! But I get up, have some instant coffee, walk to the clinic, lead a staff meeting and teaching session, and then we see patients from 9-4. While we’re open for patients, I support staff when they need extra help, help in pharmacy, help manage the queues and triage. At the end of the day I do a bit of data entry and report on drugs. Oh and I eat a few granola bars in between.
What was an average day last week during the conflict?
Hour by hour the situation changed but when we could, we opened the clinic. And I’m proud to say that we managed it every day, despite the fighting. The main difference was that we saw people with different injuries coming in – machete wounds and gunshots joined the usual malaria, diarrhoea, malnutrition, respiratory tract infections.
Nora and Sam, an IDP and clinical officer at the International Medical Corps clinic, discuss a patient’s symptoms.
What’s the best thing about working in Malakal?
Definitely the staff from the camp. They’re supposed to be in school so it’s cool to work with them and teach them and then see them performing well, asking good questions and getting better every day. They’re even correcting the doctors! After the most recent training that I ran with my colleague, Dr Berhane, on medication they are now catching things like whether we should be giving paracetamol and ibuprofen to the same person.
What’s the worst thing?
Well the last week has been pretty tough. Specifically not knowing what’s going on, constant fire-fighting, and access issues, with people unable to get to us because of the conflict. Seeing people come a week or more late because they just couldn’t find the time is very frustrating. It’s not just conflict either it might be food distributions, family obligations or just now knowing we’re there.
This is your first conflict how does it compare to natural disasters?
It doesn’t. There are way more challenges, it’s uglier, it’s much more emotional. It’s easier to get angry about it.
How does it compare to working back in the US?
In most ways it is so completely different that I can’t even begin to compare it. The level of care in the US is always reaching for the very best. A patient comes in for a bad back and you give an MRI scan just in case it finds something else that needs to be treated. In South Sudan we do the best we can with the resources we have, but it is never enough for the huge needs here.
But fundamentally the people you work alongside and the job they do is the same anywhere in the world. It’s about people caring about people and feeling a sense of duty and obligation and desire to help.
Has Malakal taught you anything?
It may sound a bit cheesy, but I have more respect than ever for my profession – being a nurse. You can see just how powerful it can be. I used to think of it as a job just like any other but now I’ve seen what happens when there are no nurses around. It makes me proud to be part of something so much bigger than just myself.