Beyond that line is a pediatric ward jammed to capacity, including new patients who received beds only because two children passed away during the night. Over in the surgical ward is a patient dying of AIDS and a soldier with a knife wound in the head, the result of a quarrel over drinks with a fellow army man. Across the way are ladies with complications from pregnancy, and on the far side of a rock outcropping at the back of this sprawling compound, at the end of a twisting trail through the underbrush, are the stark cinderblock buildings serving as the temporary dwellings of those suffering from tuberculosis and sleeping sickness.
Dr. Albert, as most everyone here calls him, will not admit to the apparent impossible situation before him. But his way, his demeanor, his dog-tired appearance at 10 a.m., tells volumes about the three-year struggle he has put into keeping open this 175-bed hospital that serves some 400,000 — one of war-torn southern Sudan’s only functioning hospitals.
“We are short of antibiotics,” Oliha said as he makes his rounds to the scattered wards full of sick and dying in this town in Sudan’s south, some 70 miles from the Ugandan border.
“But we lack most other medicines and supplies, too,” he said. “We don’t have any surgical gloves, the operating theater is broken and we don’t have enough staff or the money to pay them.”
Then there are the medical challenges this 30-year-old faces each day. They are all-too familiar in this part of Africa: malaria, anemia (associated with malaria), dog bites (the hospital has no rabies vaccine), tuberculosis, sleeping sickness (the ward may shut down because of a lack of sleeping-sickness drugs), diarrhea, a mysterious illness suspected to be a neurological disorder locally called “the nodding disease,” as well as a plethora of otherwise easily treatable cases of strangulated hernias. In Dr. Oliha’s world, they instead go untreated, which will lead to almost-certain death.
Rare is the provincial hospital in Africa that does not struggle to overcome shortages of medicine and manpower. Stories and data abound of many African states’ inability to serve basic health-care needs outside major cities.
Still, even by African standards, the level of suffering here can be stunning.
It could be and it was
As bad as it is, however, Dr. Oliha is quick to point out that things could have been much worse at this hospital about 100 miles west of Juba, south Sudan’s commercial and political capital.
Bad is what went on here when Sudan’s predominantly Arab and Muslim north was waging war on the mostly Christian and animist south of the country. That war, known as Sudan’s second civil war, lasted two decades and cost some 2 million lives and displaced an additional 4 million people.
The warring sides reached a shaky peace in 2005 that has more or less held since then, though Sudan watchers warn war may again break out given political tensions between the north and south over an upcoming election and a referendum on self-determination for the south scheduled for 2011.
Back then, Lui’s saving grace, says Peter Knight, the Sudanese administrator of the hospital, was Samaritan’s Purse, a North Carolina-based aid organization founded by Franklin Graham, son of evangelist Billy Graham.
Samaritan’s Purse is known in the business as the Marine Corps of aid agencies. It comes in when situations are at their worse, but as soon as the crisis has passed and the local community has gotten back on its feet, the group leaves.
Samaritan’s Purse was very active in Haiti after the earthquake, but no one expects it to stay there long term.
It was the same in Sudan during its civil war. The group provided medical personnel, training, medicines and funding for the hospital.
Originally, Knight says, Samaritan’s Purse committed to stay for six months when it first arrived in 1997. It remained for 10 years.
“We set the hospital up during the war,” wrote Jeremy Blume, a spokesman for Samaritan’s Purse. “... Once the war ended, there wasn’t anyone or the infrastructure for the government to come in and take it over, so we began a process of training medical staff. Once they were at the point they could run it on their own, we began to transition the leadership and operation of the hospital into competent local hands.”
Peace beget misery
For Dr. Albert and Peter Knight, peace for the Lui Hospital has brought even more misery to this place.
Although the Italian aid group CUAM has recently sent a doctor to help, little money or materials seems to be reaching the hospital.
The out-of-commission operating theater — the apparent result of budget priorities as well as political squabbling in Juba — is a particular concern for Knight.
“That hospital theater is really a terrible problem. Around here, we have many cases of hernias that become strangulated,” he said, describing a medical condition that occurs when blood to a portion of the intestine is constricted, which leads to gangrene and death.
“Frequently,” he said, “people will come to us seeking treatment for this condition. We take one look at them and tell them they must go to Juba, immediately, within 24 hours, or they will die.
“Then they say ask us for money for transport because you have to pay for the bus and you must take someone along to assist. You can’t make this journey by yourself. But I have to tell them, ‘We don’t have any money, we don’t have money to pay our staff.’ So they tell me, ‘Well, I will go back to the village and die, then.’ What can I do? What else can I do? I can’t do anything for them.”
The Lui Hospital is not a helpless place and it is not a hopeless place. Dr. Oliha and Peter Knight know that given a lasting peace and respectable building, as well as a reliable stream of funding, the hospital can go from barely functioning to addressing the needs of a huge population.
There is nothing they would rather see happen.
But both also know there is a possibility — even a probability— of war in the near future. And the only comfort they find in that is an aid group might again come to the rescue.
John Fleming is a former southern Africa correspondent for Reuters. E-mail: firstname.lastname@example.org.