Expecting the unexpected: My story from South Sudan

Working as head nurse at MSF’s hospital in Bentiu in South Sudan meant Sarah Cross frequently had to adapt fast to support the staff and patients. She became used to expecting the unexpected, until one shift took a particularly surprising turn…
Sarah Cross and her team
Sarah Cross and her team

It was around 4.45 in the afternoon and I’d gone to do a round of one of the surgical wards with the nurse supervisor. Then, out of nowhere, two young boys come bursting around the corner.

They couldn’t have been older than four and here they were, unphased by me or their surroundings and seemingly unaccompanied. I had no idea who they were or where their parents could be.

Once I was able to keep the boys in one place, I found out they were waiting for their mother, Ruth (name changed), who’d been taken into surgery when the three of them arrived at the hospital just hours earlier.

Journey to Bentiu

Located next to a camp with a population of over 120,000 internally displaced South Sudanese people, MSF’s hospital in Bentiu is one of only two secondary healthcare providers in the area.

Ruth and the twins had arrived after a journey of four days overland from the capital city, Juba. Travelling via an army truck, in the back of a lorry and on foot across the country would have been a difficult feat for anyone, let alone a mother with a severe leg injury and her two young boys.

The floodwaters in the areas surrounding Bentiu – which have not subsided since the area was flooded last year – pose an immense obstacle for anyone attempting to travel overland, sitting at around a metre and a half deep. Many roads are almost impassable as a result.

Sarah Cross

She only spoke Arabic, but through a translator I learnt that Ruth was of Sudanese origin, from a camp on the border of Sudan and South Sudan. 

She said that her husband had abandoned her and the boys in the capital. Now, here she was, alone in an unfamiliar country, unable to speak the local language and in need of urgent medical attention. She and the boys had arrived at the hospital with just the clothes on their backs.

From looking at Ruth, you wouldn’t know what a hazardous journey the family had endured. When I talked with her, the overwhelming feeling she expressed was relief. Relief that she was receiving care in an MSF hospital and relief that her children were being looked after.

Treating the wound

They had arrived in the morning and Ruth was in surgery later that afternoon. She was in surgery for about three hours and soon after I met the twins, she was back on the surgical ward.

I’m not sure how precisely Ruth acquired the wound on her leg, but it had deteriorated during the course of her journey overland and she had developed a large blood clot underneath. At one point, the team thought the lower part of her leg might need to be amputated altogether: the wound was so deep and there was a concern that infection might reach the bone.

The surgical team cleaned and debrided the wound – a procedure to remove the damaged tissue. This showed she had further blood clots – increasing the risks. Ruth ended up requiring repeat surgeries on her leg to treat it fully, but thankfully the team were able to avoid amputation.

Care and progress

After these operations, Ruth was clinically discharged from the surgical team. But she still needed lots of care, rehabilitation and time for the leg to heal before she could even attempt to walk on it.

Altogether, she remained in our care for over three months, receiving input from the multi-disciplinary team including nurses, counsellors, caretakers and doctors, as well as clinical-administrative support to arrange a safe discharge.

At first, she was hobbling a little bit, but you could see her progress with every day that went by. After a few weeks Ruth was able to walk entirely on her own without a walking-frame or stick.

Sarah Cross

During this long period of recovery, our team practically adopted the twins. 

The Nurse Supervisor managed to find a local group who looked after them during the weekdays and kept them occupied with various activities and games. At the weekend, the hospital became their playground and all the staff came to know them.

I’d often go up and see them playing in the wards: they would have managed to find an empty box and one would be pulling the other around in it. On other occasions, they’d be found with a bucket of water outside, in their element, washing and splashing. We loved them, they were just so funny.

Sarah Cross
Saying goodbye to Ruth and the boys

Once Ruth had recovered fully and after lots of logistical planning, we helped her and the boys get back to their family at a camp near the border with Sudan. We were all so glad that Ruth had made a good recovery, but after they’d left, we felt the family’s absence on the wards sorely.

Over those months we had been providing holistic medical care, but in the sometimes stressful and challenging environment of the hospital, they had given us something important too.