23 March2021
Health Care South Sudan

Dr Alison Smithies fondly recalls how working in South Sudan led to her founding the charity

I had not really thought about the living conditions I was likely be committed to when I set out to South Sudan. At the age of 10 I had been to a Girl Guide camp in the UK and I thought that probably the conditions would be similar to those experienced on that occasion – a fairly thin straw palliasse, made at the camp, and a rug – although I did not expect the temperature in Africa to be cold at night.

We landed not far from the village of Kajo Keji, at a site which had obviously been used many times by the small planes run by the Anglican Church. On our journey the pilot pointed to the ground below where we could see a large herd of elephants, a magnificent sight, and actually the only time I have seen them during all my South Sudan visits. We eventually flew down to what looked like a flat space and the little plane came to a halt. There was very little evidence that this was an airport, in fact there was no evidence of facilities at all, but at least the ground was level and clear for landing. We were collected from the plane and taken to the nearby village.

I do not now remember how we were greeted but we were made to feel welcome and taken to the compound which did have a perimeter fence, inside which were the tukuls where we slept. My tukul was a circular hut built from branches of wood, with the sides made of stout branches interwoven by thin branches. The roof was also made from woven branches – as it did not rain I cannot say that it was waterproof, but somehow I think it was. The tukuls were of such a size that we could stand upright in them in the centre. We slept on a thin mattress on the packed mud floor. There was no other furniture except we had some coat hangers although I stored my clothes and possessions in my suitcase on the floor of the tukul.

At one end of the area where the huts were pitched were the showers and latrines. The showers were just spaces where you could wash in some privacy, having brought with you a bucket full of water from a holding tank nearby. How you managed to use the water you had brought to the shower area was up to you.

One of the particular pleasures we enjoyed whilst living in Kajo Keji was being catered for by the women who were living in the settlement and looking after us. I do not remember at any time having to do any cooking, and what we were given to eat was always good, mostly stewed meat and vegetables. When we had our meals we would be sitting near a fire.

We were shown the extent of the site and where people were accommodated. The most unacceptable facility for me was the space which had been allocated for patients who had come in to be treated by the skilled health workers. This was because the one accommodation provided was a building of cells with no windows, where the patients who were ill were lying in a small space which had a door but if shut in they would be in the dark as there were no windows. Throughout the whole settlement there were no windows, as there was no glass. The idea of being cooped up all day virtually in the dark when you were feeling ill was one that troubled me.

We saw between sixty and seventy patients each morning, some who had got themselves to the clinic, others who had got a neighbour to bring them on their bicycle, and some in the transport vehicle run by the clinic, these tended to be women in labour who had been picked up through telephone messages as needing help.

I lived in this settlement for three months, being taken each morning in a jeep to the clinic about ten miles away.  At one time I thought of bicycling to the clinic rather than going by car but decided that cycling in the heat after a hard day of sorting out patients would be probably more than I could reasonably do. Cycling would have been possible as there had not been any rain, but the midday sun would have made it hard going. I should say that most of the patients did not speak English, so interviews were not undertaken at speed.  At times it was possible to get help with interpretation, but not always.  On the whole the patients were, or seemed content with, what treatment they were given.

It was a great pleasure to get to know the people living and working in Kajo Keji, and I admired the staff who were determined to do the best they could with limited facilities. I remained troubled by the dark windowless cells where patients spent time, and I determined to do something to help. On my return to the UK, I launched an appeal to raise £22,000 to build a new clinic, with windows and washing facilities. This is how Health Care South Sudan came into being. I was very pleased indeed to return to Kajo Keji with my then 17-year-old granddaughter to see the opening of the clinic the following year.