18 Jan 18 05 Jul 18

South Sudan: A Canadian nurse finds hope amid hunger in Bentiu

Malnutrition affects children displaced by war in South Sudan, but Edmonton nurse Samantha Hardeman saw first-hand the difference that medical care can make.

By Paulina Cias

When Samantha Hardeman, a nurse from Edmonton, went to South Sudan to help Doctors Without Borders/Médecins Sans Frontières (MSF) deliver urgently needed medical care in a camp for people displaced by conflict, she didn’t expect to meet a princess.

But not long after Hardeman arrived at MSF’s hospital in Bentiu, a tiny two-year old girl dressed in an extravagant pink gown was admitted to the malnutrition unit. The gown hung loosely on Hardeman’s patient, but she wore it proudly and often, earning her the nickname “Pink Princess.”

“She weighed only 3.9 kilograms when she came in,” says Hardeman. “She was really apathetic and she wasn’t smiling.” Pink Princess was quiet and reserved throughout the majority of her stay in the malnutrition unit, and was not initially responding to therapeutic feeding, so Hardeman and her colleagues tested her for tuberculosis (TB) and HIV. She was diagnosed with both illnesses, but after a month of accelerated treatment and new medications, she finally started to recover and gain weight.

Urgent medical needs

A brutal civil conflict has been taking place in South Sudan since late 2013. Extreme violence against civilians has forced many people to flee from their homes. Over 120,000 displaced people have sought refuge at a UN-run protection-of-civilian (PoC) site in Bentiu. Here, MSF runs an on-site hospital, which consists of 160 beds, an emergency room, an operating theatre, a pediatrics unit, a malnutrition unit, a TB and HIV isolation ward and a maternity unit. MSF provides secondary healthcare services such as outpatient treatment for TB and HIV patients, malaria treatment and an outreach team that conducts health promotion activities across the site. MSF’s primary concern is to address the urgent medical needs of people affected by violence and to provide essential healthcare.

Pink Princess is just one of many children Hardeman treated in MSF’s hospital in Bentiu. Food and water are extremely limited due to the conflict, and malnutrition in children under the age of five is prevalent.

MSF also offers obstetric care, and at one point a pair of premature twins became patients at the hospital. They were discharged after a safe and healthy delivery, but soon returned as patients of the malnutrition unit because their mother was not able to produce enough breast milk. While outpatient treatment is not part of the unit’s program, Hardeman’s team taught the twins’ mother how to properly administer milk used for malnutrition treatment. “We spent a lot of time teaching her,” says Hardeman. “It’s not something that we typically like to do because we don’t know if it is being done properly at home.” Throughout the five and a half months she was in Bentiu, Hardeman would see the mother come in on a weekly basis to collect her doses of milk and to have her children weighed. “I saw them just before I left,” says Hardeman with a smile. “We started cutting them off from the milk and they were still gaining weight and looking great.”

While the Bentiu PoC site serves as a place of refuge against the ongoing conflict in South Sudan, the risks of violence beyond the camp’s barriers remain high. Yet many women must leave the camp for upwards of four hours a day to collect firewood to sell in the marketplace.

Families at risk

One of these women was the mother of a young girl who was a diabetic patient in the hospital. “One of her biggest concerns was that she was not with her children for a large portion of the day,” says Hardeman. “She was worried that something would happen to her when she was outside. She often said she has nobody who understands her daughter’s illness and who can care for the girl later on.” However, with little to no other options for work within the camp, collecting firewood serves as the only way for many women to provide for their families.

Many of MSF’s own staff members have not seen their families for long periods of time. “My national staff supervisor hasn’t seen his family in two years because he can’t get to Juba,” says Hardeman. “He can’t get from the camp to somewhere where he feels it is safe to travel. It’s too much of a risk for him.”

Not long before Hardeman was herself due to leave Bentiu, she visited the hospital’s malnutrition unit, decorated with colourful balloons for child patients. When she saw Pink Princess, the child was no longer quiet, but had chubby cheeks, a huge grin and outstretched hands that were eager to play. “She got discharged the day before I left after over a month of being there,” says Hardeman. “She became a completely different child and her personality finally came out.”

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