|The Jahun Hospital Compound full of trees|
If you came to the Hospital and you weren’t pregnant you would have to be seen in the part of its that’s run by the Governments Ministry of Health. From what I am told, the facilities there are very limited, and the two doctors still working there are struggling to keep up, managing only to achieve a bare minimum of medical care. It sounds very much like the set-up I encountered in South Sudan, where the MOH run facility is almost non- functional, and people lie about and survive by good luck more than anything else.
|The Hosital Gate looking out|
And most of them are facing in the direction of the MSF part of the Compound, areas that can only accessed by passing through a strong gate manned by two friendly MSF Security guys. These women and family members are waiting to visit and look after family in the hospital but not many of the patients being waited for are in the MOH wing - most of the patients are women in the Maternity Annexe, which is more or less the entire MSF project in Jahun, and people are flooding into it from near and far, from all over the state and even from beyond. In Aweil, South Sudan where I was last year, the MSF projected also cared for neonates and children up to 5, and had a feeding program for malnourished children. This meant we had other MSF doctors there besides nurse anaesthetists and obstetricians and midwives – we had paediatricians and physiscians, but here in Jahun there are none. It is all Obstetrics. Crowd control is paramount.
|To avoid upsetting anyone I take my photos when there aren't too many people about...the place is rarely empty like this|
If you were pregnant, the security guard would let you through into a small room where your story is taken and some basic tests are done. Your Blood count is checked, you are tested for HIV and Malaria, your BP and temperature are taken and then a decision is made if you should come forward for further assessment, or be given some advice and simple treatment and sent home.
This all sounds quite tidy and orderly – in fact theres usually a constant stream of people pushing about, trying to squeeze through, shouting and clamouring and not so infrequently a small mass of people pushes in with a half collapsed woman in the middle of them, groans, or worse, silence from her lips, spots of blood, anxious shouts and panic and she gets hurried through to the “PreDelivery Ward, (PDW) maybe shes about to have a baby, maybe shes had one and lost half her blood volume afterwards, maybe shes been in labour for two days and is half dead with infection, the baby is dead and stuck inside, maybe shes been having convulsions…..