South Sudan: Improving maternal outcomes with community outreach (part 2)
The MSF duty surgeon in Yambio received a distress call from the maternity ward on a rainy Friday afternoon. 26-year-old Stella had been admitted with severe abdominal pains and profuse vaginal bleeding. Accompanied by a few of her kinsmen, she had managed to complete the 30km of impassable, muddy roads from Nzara to Yambio. The heavy rains had taken a toll on all of them.
Stella’s abdomen had a palpable, painful mass on the left side. An operation revealed that her abdomen was full of blood from a ruptured ectopic pregnancy. The doctors were able to stop the bleeding; however, unfortunately, the left ovary and tube were already destroyed. She had lost a lot of blood but they managed to stabilise her.
After regaining consciousness, Stella told the medical team she had been in that condition for two weeks. After the first week of pain and suffering she had sought the help of a traditional healer, who despite a willingness to help, her condition continued to deteriorate: the bleeding and the pains continued and Stella had almost given up. Fortunately, her husband had heard from MSF IEC teams about their services at Yambio hospital and decided to ask their relatives to accompany them to the hospital.
Stella was discharged two days later, and after four days she returned to have the stitches removed. After that, a talk with the psychosocial team revealed that at 26 years old, she had seven children, and this was her eighth pregnancy. She explained that she did not want any more children and wanted to know if there were any measures she could take, and if so, what they were.
She was referred to the family planning service, where several options were explained to her. Of those, she settled for an implant, which was inserted into her upper left arm. She was to come for a follow-up visit after five years. Since she lives far away from a health centre, she was very satisfied with this option. “This thin thing will help me live a normal life with my husband and children, and avoid a repeat of this terrible experience,” she says.
In their outreach activities, the IEC teams try to visit and spread health messages to as many villages as possible in the State, so it is no wonder that Stella’s husband had heard of the MSF facility in Yambio, 30km away. The combination of an IEC team that works outside and inside the hospital is what makes the Yambio case unique.
“The IEC team has a way with patients that makes them open up and enables medical personnel to act accordingly,” remarks Hemmed Lukonge, MSF’s medical coordinator in Juba. “It is because of the IEC team that Stella and other people get to know of and access our medical services,” he adds.
At Yambio State Hospital the team has initiated activities like the Kangaroo Mother Care especially meant for newborns; psychosocial activities meant for malnourished children but which take in other children from the paediatric ward, and a breastfeeding corner, that teaches on the importance of breastfeeding and positioning of babies while breastfeeding, among other things.