Saving Lives With Few Resources

Without ultrasound available there was just no way of telling. Mundari lacks many things patients in the developed world take for granted. And yet, the hospital in South Sudan’s Kajo-Keji County is a beacon of hope in a country recovering from decades of civil war under a young government that struggles to provide services. IMC began operating the hospital in September 2006, with support from the U.S. State Department’s Bureau of Population, Refugees, and Migration (BPRM).

Mundari – The IMC Flagship in
South Sudan

“More and more people come to us because we can help them. The demand is so high that we send mothers home sometimes only two hours after they delivered because we need the beds,” says Dr. Joseph Habimana, IMC’s Medical Coordinator in Kajo-Keji, while he checks on Mary. He asks the nurses to give her intravenous transfusions to better cope with her heavy loss of blood. Her three babies are tightly wrapped and - in lieu of cots - sleep next to each other on a small trolley normally used for medical instruments.

Jagoro, the smallest of the three, should be in an incubator, says Dr. Habimana. “That would protect her from infections and increase her chances of survival.” But there is no incubator at Mundari. The staff gets by with limited resources while providing excellent and passionate care for people who have nowhere else to go to. “Mundari hospital is the IMC flagship program in South Sudan. We foster strong relationships with local authorities, because our emphasis is on building capacities of Sudanese health staff and hence strengthening the overall health system,” says Simon O’Connell, IMC East Africa Regional Director.

Mentor and Partner

Patients who come to Mundari are diagnosed and cared for by trained staff. Treatment and drugs are free. The wards can get crowded but are clean, the beds have sheets and mosquito nets and the hospital even provides two meals a day, a rare service in most of the developing world. The hospital is the only major treatment center for 182,000 people in Kajo-Keji County, many of them returnees from exile in Uganda. IMC supports the local staff and provides two doctors, a laboratory technician, two nurses, and a nurse trainer who work closely with their Sudanese colleagues. “We see ourselves as mentors and partners to our Sudanese staff. We must help to establish a sustainable system that one day will be owned and operated by Sudanese authorities,” says Rachel Taylor, IMC Field Coordinator in Kajo-Keji.

Sparsely equipped by first world standards, Mundari hospital makes a big difference to the public health system in South Sudan. “Mundari is the heart of Kajo-Keji’s health service,” says Felix Leju Tito, the hospital’s administrator and IMC’s local management counterpart. The hospital is the main institution for referrals from primary health care facilities in Kajo-Keji. Patients travel for up to two days to reach the hospital when the primary health care clinics in their area cannot help, and sometimes refugees living in Uganda even travel to Mundari if the services available to them are lacking.

Making the Difference between Life and Death

While Mary gave birth to Longa, Jagoro, and Modong - named after her grandfather and his two wives - another woman was far advanced in labor. Standing just a few yards away, her forehead pressed against the wall, she struggled with the pain of frequent contractions. Grace Konga and her colleagues debated where to move Mary, the new three-time mother and her babies so that they could start helping with the next delivery. Because every bed was occupied they decided to transfer one patient into the nurses’ room and asked Cecilia, another expecting mother who had been hooked on a labor-inducing drip for hours, to wait on a chair for her contractions.

It was a busy day in the maternity ward, handled by Grace and her colleagues with an impressive mix of professionalism, pragmatism, and passion. When the heartbeat of Cecilia’s unborn baby began to slow down dramatically they alerted Dr. Joseph, who quickly performed an emergency cesarean section in the hospital’s operating theater - the only place in Kajo Keji County where such a surgery can be performed. For Cecilia and her new baby, Mundari Hospital made the difference between life and death.