Hos­pi­tal cum fac­tory de­liv­ers limbs, new life in South Su­dan

Civil war dev­as­tates world’s youngest coun­try

Kuwait Times - - INTERNATIONAL -

Solomon was just seven years old when he woke up miss­ing a leg. And he was one of the lucky ones. For weeks later, Solomon was back on two feet with the aid of an ar­ti­fi­cial leg, fit­ted at a hec­tic hos­pi­tal cum limb-mak­ing fac­tory in the South Su­danese cap­i­tal of Juba. The hos­pi­tal is in hor­ri­bly high de­mand in a coun­try born of war that re­mains lit­tered with mines and ex­plo­sive de­vices, with civil war still rag­ing all around. Most of South Su­dan’s ap­prox­i­mately 60,000 am­putees have suf­fered war-re­lated in­juries, be it gun­shot or land­mine wounds. As civil war dev­as­tates the world’s youngest coun­try - it cel­e­brates its sixth an­niver­sary next month - it has be­come in­creas­ingly dif­fi­cult for am­putees to gain good treatment.

Solomon came to his first ar­ti­fi­cial limb af­ter an open frac­ture turned into a life-threat­en­ing in­fec­tion, which forced doc­tors to am­pu­tate. When he woke from surgery in a re­mote hos­pi­tal in South Su­dan’s Ben­tiu, he was far away from the cap­i­tal with lit­tle chance of re­ha­bil­i­ta­tion or help ad­just­ing to his new life. “I was put on a flight to Juba, where I am re­ceiv­ing a new, ar­ti­fi­cial leg,” he told the Thom­son Reuters Foun­da­tion from his cur­rent home at the Phys­i­cal Re­ha­bil­i­ta­tion Ref­er­ence Cen­tre. It is the coun­try’s big­gest hos­pi­tal for pros­thetic or­thotic treatment, treat­ing about 30 pa­tients a day. “Am­pu­ta­tions have gone up since the begin­ning of the civil war in 2013, but even with in­creased need, ac­cess to some ar­eas is im­pos­si­ble due to ac­tive fight­ing and many peo­ple who have lost limbs might never be able to get out and re­ceive help,” said Em­manuel Lo­bari, who as head of tech­ni­cians over­sees the pro­duc­tion of all the pros­thetic limbs. Both hos­pi­tal and fac­tory, the cen­tre pro­duces an av­er­age of 50 pros­the­ses each month - all hand-made and cus­tom fit.

“We use polypropy­lene to make the limbs, a ma­te­rial that has proved to be both durable and af­ford­able,” said phys­io­ther­a­pist Daniel Od­hi­ambo. A Kenyan, he is one of a hand­ful of ex­pa­tri­ate staff at the hos­pi­tal, em­ployed by the In­ter­na­tional Com­mit­tee of the Red Cross (ICRC). “The pros­the­ses last for an av­er­age of two years and it’s usu­ally the foot, made out of a softer ma­te­rial, that wears out the fastest. The leg it­self can last up to ten years.”

Mak­ing a limb - from melt­ing the plas­tic-like polypropy­lene to shap­ing it into a leg - is a quick process in the hos­pi­tal’s small, modern fac­tory and can all be done within a day. “It’s the fit­ting and the pa­tient’s adap­tion that take up to ten days,” said Lo­bari. Lo­bari is South Su­danese, like most of the hos­pi­tal’s 30 staff, all of whom re­ceived Red Cross train­ing. The or­ga­ni­za­tion first started treat­ing am­pu­ta­tions in 1979 dur­ing Ethiopia’s civil war, and de­vel­oped the polypropy­lene tech­nol­ogy that has since spread across all con­flict zones.

Od­hi­ambo has worked in many places, in­clud­ing Afghanistan, Ye­men and Iraq. He re­cently took up his sec­ond mis­sion in Juba. “Here in South Su­dan, I mainly see war wounds and they are very dif­fer­ent from civil­ian wounds,” he ex­plained. Nearly 250,000 mines and ex­plo­sive de­vices were found and de­stroyed in South Su­dan in 2017 alone, ac­cord­ing to the United Na­tions Mine Ac­tion Ser­vice (UNMAS). South Su­dan slipped into civil war in 2013, just two years af­ter be­com­ing in­de­pen­dent from Khar­toum, and some 4 mil­lion peo­ple - one third of the pop­u­la­tion - have fled to neigh­bor­ing coun­tries in its wake.

For those left be­hind, risk is part of daily life. The worst case Od­hi­ambo has seen is an 18year-old boy, who was brought to the clinic with both legs blown off by a land­mine, pieces of muscle hang­ing out of the wound and shrap­nel frag­ments stuck deep in his flesh. “He was in con­sis­tent pain and it took months to build the right pros­the­sis, but I stayed with him through the whole process. I told him not to give up. He had his whole life ahead of him still.”

A re­silient na­tion

Si­mon has been com­ing to the hos­pi­tal for sev­eral months and can still vividly re­call the day he was at­tacked, when sev­eral bul­lets were shot through his leg. “I thought I was go­ing to die, but my fam­ily took me to a small hos­pi­tal where my leg was am­pu­tated,” he said. Si­mon is from the north of the coun­try then moved to Juba to get bet­ter care. Three in four pa­tients at the cen­tre are male. The women and chil­dren at the hos­pi­tal un­der­went am­pu­ta­tions af­ter suf­fer­ing a range of trau­mas, such as war in­juries, croc­o­dile bites, road ac­ci­dents or in­fec­tions.

It helps pa­tients such as Solomon - just start­ing a new life with his first pros­the­sis - to meet older pa­tients like Si­mon. “The boy is still young, but he can see that he’s not alone with his in­jury,” said Od­hi­ambo. “The one difference I’ve noted working in South Su­dan is that peo­ple here ac­cept their fate eas­ier than any oth­ers. They are re­silient and want to go on with their lives. I even see it in Solomon,” said Od­hi­ambo. “Peo­ple have suf­fered, but they don’t lose their drive and mo­ti­va­tion.” — Reuters

ABUROC: El­iz­a­beth Ad­wok (left) an eth­nic Shilluk who ar­rived with her seven chil­dren in April af­ter hav­ing been force­fully dis­placed from her home three times since South Su­dan’s con­flict be­gan, cooks sorghum in her small hut in the vil­lage of Aburoc, South Su­dan where she lives with other dis­placed peo­ple. — AP

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