Nyakuoch Keat’s nine-month-old son Bhan had been running a fever for days and was listless and unresponsive to his mother’s attempts to cheer him up. His condition worsened, to the point where he was not holding down any food and even seemed to lose consciousness at times.
There appeared to be very few options for Bhan and Nyakuoch, who live in South Sudan in a cluster of mud-and-thatch huts far removed from health services even when there is no war, which there is now. The nearest doctor was in the village of Kiech Kuon, a two hour walk away across flooded fields and swamps.
But since fighting broke out in December 2013, the clinic there has been closed, with staff fleeing the conflict and government supplies of medicines, equipment and salaries drying up.
But Bhan was lucky. Thomas Lyimo, a health specialist and doctor working for UNICEF, happened to be in Kiech Kuon these past 10 days as part of a multi-agency ‘rapid response’ mission to provide urgent help. This mission was part of a series of short United Nations operations into remote areas of South Sudan that have been beyond the reach of basic services for months.
Nyakuoch arrived at the Kiech Kuon health centre shortly before sunrise, after walking for two hours from home the night before, and sleeping in an abandoned hut. Thomas and the team were camped at the health centre for their mission.
“I was just heading for a shower when a colleague said that there was a sick baby who’d come in early that morning,” Thomas, 38, says. “He was already very febrile, had been vomiting almost everything that he ate, and was running a fever that I estimated at 39 or 40 degrees (Celsius), although we had no thermometer to confirm.”
In fact, there was no way Thomas could carry out anything more than the most basic diagnosis — and he suspected severe malaria.
“The problem is that since the conflict started, there’s no structure here to be able to provide care – there’re no health workers, no supplies and no equipment,” he says. “It’s very painful personally, especially when it comes to children, because to be able to make proper diagnoses you really have to be able to do some tests, but in these remote areas you don’t have any facilities. To be able to treat the child, you need the drugs, and they are not here.
“It just makes it very difficult to come to a decision on how, if at all, you can be able to help.”
But as a doctor, and as a UNICEF health worker, Thomas could not leave Bhan to his fate – which, he said, “could ultimately mean he would pass away”.
Although UNICEF does not routinely treat the sick, Thomas took the extra step to save the baby’s life. Thomas worked his was way around the joint UNICEF and World Food Programme (WFP) team in Kiech Kuon, asking for a particular type of anti-malarial that might help save Bhan’s life.
Eventually he found it – an adult dose, and therefore not ideal, but it was something.
“It was only because I knew these UN people were here that we came, otherwise I would have stayed at home because this clinic I know is closed,” Nyakuoch says. “There is nowhere to go usually, I would have stayed home and who knows what would have happened to the baby? I’m very, very happy that this doctor was here. We are just lucky, thanks to God.”
For Thomas, going an extra step – or an extra mile – is what marks out a true commitment to helping people who are suffering.
“I believe that being a United Nations employee is about humanitarian actions,” Thomas says. “It’s not only about sitting on the policy table doing advocacy, supporting the government or other partners to come up with evidence to improve policies, strategies, plans, guidelines, things like that.
“It is also about providing services, especially to the most disadvantaged, and especially in a context like this, of conflict, where people are displaced, they don’t have anything because the war has worsened their poverty.
“There is a lot to be done, and some of it needs to be done right here down at the ground, not only at the high policy level, and I feel like I can be a part of that.”
Mike Pflanz is a journalist reporting from South Sudan for UNICEF.