Johanna Thomson is a paediatrics doctor who recently returned from South Sudan.
Why did you decide to work with Médecins Sans Frontières?
Médecins Sans Frontières has been around for over 40 years and does purely medical aid work. It provides medical care on a needs basis without being affiliated with any political or religious motivations. Its ethical principles of independence, neutrality and impartiality are closely aligned with mine.
Could you describe the project in Aweil, South Sudan?
Since 2008, Médecins Sans Frontières has been running a maternal and child health programme in Aweil, providing free healthcare to pregnant women and children. The overall aim is to reduce paediatric and maternal mortality. As paediatric department manager, I was responsible for the medical care of the patients, but also for managing and training national staff. I was introduced to many diseases that I’d really only read about before – malaria in every form, malnutrition, tuberculosis, HIV, tetanus and other tropical diseases.
Did any patients make a particular impact on you?
One who comes to mind is an 8-year-old girl, Abuk, who had tetanus. She was bedridden and in very severe pain. She wasn’t able to eat or move and had severe muscle spasms. I didn’t think she would survive. Every day I’d go on ward rounds and hear her calling out in pain. We tried to give her as much pain relief and medication for muscle spasms as we could, but sometimes I’d just go in and hold her hand and stroke her head. This went on for weeks and was quite distressing. Then over a few weeks she started to smile and reach out when I came into the room. She would call out kawaja, which means white person. She’d ask for food and eventually she sat up in bed, then started walking again, and then walked out of hospital after about six weeks.
What work were you involved with in Sierra Leone?
The Gondama Referral Centre in Bo, Sierra Leone, provides obstetric and secondary level paediatric care. It’s a huge project -- the hospital has a capacity of over 200 beds. I was the paediatric team leader, so I was in charge of directing the international paediatric staff and national medical staff, as well as leading the medical activities in the hospital. It’s a hyper-endemic malaria zone, so much of our activities focused on management of malaria in children under five and other common diseases such as diarrhoea, pneumonia, sepsis and neonatal conditions. It’s also an area where Lassa fever (a viral haemorrhagic fever) is prevalent. In both Sierra Leone and South Sudan newborn care was a strong focus, but I also worked closely with the obstetric team to ensure the best outcomes for both mother and child.
"Working with Médecins Sans Frontières is a lot of things – it’s confronting and challenging, frustrating and rewarding, heartbreaking and inspiring. But it gives you the opportunity to make a real difference in the lives of people who are most in need."
What are you doing in Afghanistan?
I’m working in a maternity hospital in Khost, close to the border of Pakistan. They have 900 to 1000 births a month, so it’s huge. I’m responsible for managing the neonatal department and developing neonatal care protocols. The aim is to work closely with local staff to address the very high levels of maternal and neonatal mortality and introduce a standardised system of care to help train the national staff.
What’s the most rewarding aspect of working with Médecins Sans Frontières?
The feeling of having a direct impact on the lives of children every working day. Being able to provide simple, effective, lifesaving treatment to patients who you know would otherwise have nothing. And after being there a little while standing back and supervising national staff as they manage patients with skills that you’ve taught them.
Do you have any advice for other paediatric health professionals considering this kind of work?
Working with Médecins Sans Frontières is a lot of things – it’s confronting and challenging, frustrating and rewarding, heartbreaking and inspiring. But it gives you the opportunity to make a real difference in the lives of people who are most in need. My experience working in the developing world has given me an appreciation and perspective of medicine and life that is difficult to find elsewhere. It’s not for everyone – it does involve significant personal and financial sacrifice – but it can enrich your life and be immensely personally and professionally satisfying. Think carefully about your motivations and commitments back home, and if you feel that it’s right for you, then go for it.