South Sudan: The tragedy of being female

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The delivery room at Aweil State Hospital. Photo by Lisa Lepine

The delivery room at Aweil State Hospital. Photo by Lisa Lepine


“I am here to help. But I feel helpless.”

By Lisa Lepine, MSF OBGYN in Aweil State Hospital, South Sudan

I was on call for the maternity ward last night but it was a relatively quiet night, and so I got some sleep. I can’t imagine what this day would be like with no sleep on top of it.

After I rounded in the hospital wards this morning, I was called to the OT (operating theatre or operating room) to evaluate a young girl. Her mother said she had come home with blood running down her legs. On examining her, it was obvious to me that she had been repeatedly raped on a number of occasions based on new and old wounds. She had lacerations along both sides of the vagina all the way up to the cervix, as well as lacerations on the perineum down to the anus. It took a long time to repair them all.

The girl would not say what had happened. I am sure she is scared and might feel she needs to protect the identity of the perpetrator.

After the surgery I spoke to her mother, explaining what I saw and did and instructing her in post-op care. She told me through the translator “Thank you for saving my daughter’s life.” As I walked back from the hospital that morning I felt overwhelmed and started crying, knowing I didn’t save her life and I can’t save her life. I am sad that she will not have the kind of life I would like for her, the kind of life she deserves.

After lunch, the ex-pat midwife on call was summoned to the hospital for a dead breech baby. The mother was 18 years old, having her first baby, and she had been in labor for 5 days. It was difficult for the midwife get the head out.

Since this young woman is at risk for developing a fistula between her bladder and vagina due to the prolonged pressure from the long labor, a bladder catheter was inserted. The birth also resulted in a large vaginal laceration that I was asked to repair. I injected lidocaine before suturing, but she began to wail. I was informed by the translator that she was crying not from physical pain, but from grief. I understand. The baby was term—a full 3,400 grams—beautiful, perfect. It was obvious he had only died within the past 24 hours or so.

At the end of the day, a young pregnant woman was brought to the maternity ward, unresponsive with cerebral malaria. Her blood sugar level was undetectable. Her husband had been traveling with her in that state all day because they lived far from the hospital and transport is very difficult around here. She was extremely dehydrated. After IV fluids and sugar, as well as IV antimalarial drugs, she became only slightly responsive. I hope she pulls through tonight because right about now I can’t take more tragic outcomes.

Life in South Sudan is very hard. It is particularly difficult to be female in South Sudan. Girls are so vulnerable. Pregnancy is so dangerous. Childbirth, a life-giving event, is too often shadowed by death.

I am here to help. But I feel helpless.

Editor’s note: MSF international volunteers and employees experience situations that some people could not even imagine. It is not always easy. We do what we can to reduce the suffering of vulnerable people wherever we work, and we usually wish that we could do more. Although it is physically and mentally demanding, this work is also very rewarding on a personal level. The writer can be very proud of what she did on this day. Although it seems like small accomplishments to her, there are 3 young women who are still alive because of her efforts. This is what we do.

Learn more about Lisa and read more blog posts from MSF field staff.

  #tomorrowneedsher #womenshealth Because Tomorrow Needs Her focuses on some of the impediments to women’s health, exposing injustices that disproportionately affect women and girls around the world.