In a refugee camp of 120,000 in the South Sudan, a local doctor has been working for the last six months as a volunteer with Doctors without Borders.
Dr. Stefanie Dr. Falz, who has been working at the East Kootenay Regional Hospital for the last eight years, recently returned from South Sudan after working and volunteering at a Medecins Sans Frontieres (MSF) hospital.
South Sudan is the newest country in the world, gaining it’s independence from Sudan in 2011, however, it has been mired in conflict stemming from a civil war that erupted two years later between government and rebel military forces.
Dr. Falz went through the application process, including a week of training on security issues, managing stress in the field and managing personnel before she was accepted and sent to Bentiu in South Sudan.
“I’ve wanted to work with MSF for a long time, probably since I applied to go to medical school, which is a few years ago now,” said Dr. Falz. “It’s always been on my to-do list, but the timing has always been a bit challenging because I knew for their first mission, they expect you to commit to 6-12 months, and to take that kind of time out of your life is challenging.
“But last year felt like the right time to go.”
She’s been to Africa before as a med student years ago, spending 10 weeks in Tanzania, so the culture shock and the expectations of the conditions she’d be working in weren’t too unfamiliar.
However, as an emergency medicine specialist, she handled all kinds of medical situations, with the majority of her patients being children.
In fact, the camp, with a population of 120,000 within 2.2 square kilometres, included 40,000 children that were under the age of five years old.
“The greatest need is mostly children,” Dr. Falz said. “It’s another unimaginable number, but out of the 120,000 people living in this camp, 40,000 are children under five [years old] which is just mind-boggling.
“A large, large part of what we were doing is paediatrics. Children under five are the most vulnerable too, they tend to die from things like diarrhea and malaria more so than adults do, so just by default I kind of became a paediatrician.”
The hospital facilities, operated and managed by MSF, were just one part of services provided by roughly 40 Non-Government Organizations (NGO) that also included the likes of International Rescue Committee, World Relief and UNICEF under the protection of United Nations military forces.
Arriving in October, Dr. Falz hit the rainy season, which turned the ground into mud. Temperatures reached as high as 42-44 degrees Celsius, but dipped to 18 degrees in December and January, which was enough to be a factor in causing cases of pneumonia for the local population.
The hospital, spread out over a series of tents, had an operating room, an inpatient therapeutic feeding centre, 160 beds and a staff comprised of close to 500 local South Sudanese and 40 expats.
“It’s unfortunately, in it’s short life, this country has already experienced a lot of conflict and so there isn’t a lot of functioning infrastructure in the entire country,” Dr. Falz said. “MSF and other organizations basically constitute the health care system of South Sudan to speak of at this time, so it’s a place where MSF does a lot of work now.”
Much of Dr. Falz’s experience was based in the UN camp, however, she also managed to get out for a few mobile clinics and spent three weeks within the Bentiu townsite proper.
“A lot of it was destroyed, so when you drive around Bentiu town, you can tell it was a pretty nice town at one point, there were parks and a basketball court that was still standing and traffic lights,” she said. “It seemed like it was a pretty nice place, but now it was completely destroyed. There were overturned cars everywhere, the houses were mostly gone, so there were lots of empty space with cattle running around.”
Malaria, malnutrition, pneumonia and diarrheal illnesses were the most common medical situations that required treatment. Dr. Falz said that one of the most rewarding parts of her experience was being able to see patients with those kinds of medical issues because they are highly treatable.
However, there were times where Dr. Falz and the staff were heartbroken over seeing other patients—mostly children, die from any number of medical conditions.
In 14 years of practice in North America, Dr. Falz only recalls one of her child patients who passed away. In the first week at Bentiu, three had passed away.
“You ask yourself what you are doing wrong—this doesn’t just happen, this never happens in Canada where kids just die,” Dr. Falz said. “You’re trying to beat yourself up, looking for mistakes you made and how you can prevent it.
"Then you realize after a while that there are so many things at play there that you have no control over and so you actually see a lot of—not just kids—but a lot of people dying, but especially the children, that was really, really hard.
“We had three kids die of rabies which is absolutely horrible to watch and there’s nothing you can do to prevent that death. You can alleviate their suffering, but you cannot prevent their death because there’s no cure or treatment for it.”
However, amidst the misery and the suffering, there were good things to pull from the experience, such as bonding with the local staff and expat volunteers and providing vital health care services that South Sudanese people simply would not have access to if MSF wasn’t there.
The local staff were very keen on learning new things as well, and Dr. Falz and other medical experts would often hold sessions to teach them a new skill or medical concept.
“MSF hires people from all over the world so I really enjoyed working with people from countries all over the world,” Dr. Falz said. “We’d have a surgeon from Rwanda, a nurse from England, a logistician from Holland, so it was really, really interesting just working with people from such a broad background and now I feel like I have friends in almost every corner of the world, which is definitely pretty cool.”