Nansen Refugee Award laureate responds to COVID-19 in South Sudan

The Bunj hospital in South Sudan’s Upper Nile State is a hive of activity. Construction sounds fill the air as patients stream in and out of the facility. At the centre of it all is head surgeon and medical director, Dr. Evan Atar Adaha.

Even before the COVID-19 pandemic reached South Sudan’s borders, Dr. Atar was putting in place preventive measures at the only functional hospital with surgery capabilities in the area, some 600 kilometers from the capital, Juba.

“The health system in South Sudan is weak but we need to be prepared and that’s what we are doing,” says the 54-year-old.

Since the outbreak of the pandemic, new arrivals into the country are screened or placed in mandatory quarantine as per the Ministry of Health’s COVID-19 precautionary measures. This is particularly important for Upper Nile State, bordered by Ethiopia to the east and Sudan to the north – countries that have both recorded significant numbers of COVID-19 cases.

South Sudan has recorded more than 2,600 positive cases since April, but only a small number of those have been in Maban, where the hospital is located.

“We have been lucky to have no cases in Maban for quite some time, but the threat is always there so we have to do whatever we can to keep the disease from spreading,” adds Dr. Atar.

“Our main job...is to prevent the rapid spread of the disease and we have the capacity to do that.”

As he walks around the 140-bed facility, Dr. Atar checks on the progress of the construction. A fence now runs from the main gate, where a screening point is situated, separating it from an isolation centre with 20 beds. A water tank is being installed nearby and a kitchen is being repaired so families can cook meals for their loved ones.

“Our main job right now is to prevent the rapid spread of the disease and we have the capacity to do that,” he says.

Dr. Atar set up his first surgical theatre in Bunj in 2011 at an abandoned health-care centre, where Bunj hospital now stands. Since then, he has worked tirelessly to secure funding and to mentor young refugees and locals interested in becoming nurses and midwives.

In 2018, UNHCR, the UN Refugee Agency, recognized the doctor’s outstanding commitment and self-sacrifice in providing medical services to more than 200,000 people from Bunj and the surrounding area, including some 154,000 refugees from Sudan.

Dr. Atar used the Nansen Award prize money to procure maternity equipment and commission the construction of a maternity ward. Upgrading the hospital has strengthened its preparedness for a COVID-19 outbreak, but the facility still lacks ventilators and an ICU.

The hospital has just two ambulances and needs a third one to cater specifically for COVID-19 patients. Supplies of personal protective equipment (PPE) are also inadequate and the hospital’s staff already work 12-hour shifts with barely enough time to rest.

“We are working day and night to manage the usual emergencies from the camps and the local communities,” says Dr. Atar, adding that in case of a major outbreak, he will have to make some tough decisions about how to manage non-COVID-19 medical cases.

In the meantime, he says his staff have come up with creative ways to manage with the little resources they have.

“We face exposure, but we can’t stop providing services to the people,” he says. “People make their own masks and at the screening point, we have put up some plastic sheets to separate the testing staff from the patients.”

“We are on the frontline and we have to care for the patients.”

With support from UNHCR and partner agency, Samaritan’s Purse, the hospital has procured some supplies of PPE and plans to hire an additional doctor, clinical officers and nurses. Staff have also been trained on how to handle suspected cases while protecting themselves and other patients.

“It can be worrying to our families and friends, but this won’t be the first outbreak we are facing,” says Dr. Atar. “We have faced many outbreaks before, and we know what it means to work in such circumstances.”

He speaks from experience, as he is used to working in tough conditions – he routinely carries out as many as 10 operations a day, spending hours on his feet.

“We are on the frontline and we have to care for the patients. At the end of the day, our lives are in the hands of God.”

The Nansen Refugee Award is named in honour of Norwegian explorer and humanitarian Fridtjof Nansen, the first High Commissioner for Refugees and Nobel Prize winner, who was appointed by the League of Nations in 1921. It aims to showcase his values of perseverance and commitment in the face of adversity.

The winner of this year's award will be announced on 1 October.