Since 2013, Dr. Buwembo Kakande, a general surgeon from Uganda, with over a decade of experience in the operating room, has mentored and trained two South Sudanese physicians, Mabor Matuiery and Nixon Anthony, on a number of surgical procedures like amputations, appendectomies, and prostatectomies (the removal of the prostate gland). The surgical team works at one of the largest medical facilities in South Sudan, the Wau Teaching Hospital, located in northwestern part of the country.
Dr. Kakande explained during an interview to Lukan David, Radio Miraya’s host that initially his colleagues’ skills were very basic, and their surgical experience was very limited.
“But at this point,” a proud Dr. Kakande declared, “I’m their surgical assistant.”
During the interview, Dr. Kakande shared his first impressions upon arrival to the hospital. He thought surgeries were impossible due to the deteriorating conditions of the facilities and the regular lack of medical supplies.
But he found motivation in the eagerness and willingness of his colleagues to learn as much as possible given the difficult circumstances.
“I love surgeries. I want to learn everything,” said Mr. Anthony. “I’m grateful Dr. Kakande is here. He has taught us so much.”
Both, Mr. Matuiery and Mr. Anthony, who is the acting medical director of the Wau Teaching Hospital, are able to benefit from Dr. Kakande’s expertise thanks to the support of the governments of Ethiopia, Kenya, and Uganda through a capacity development initiative from the Intergovernmental Authority on Development (IGAD), an eight-country trade block in eastern Africa.
The objective of the IGAD Initiative is to strengthen the capacity of the South Sudanese civil service at a national and provincial levels by lending out seasoned civil servants from these three east African countries – known as civil service support officers (CSSOs) – and pairing them up with a South Sudanese counterpart, usually referred to as a “twin.”
The relationship is one of mentoring, coaching and close collaboration.
Since 2011, more than a hundred CSSOs, working mostly on two-year contracts, have come to South Sudan to support capacity efforts in different sectors like agriculture, aviation, finance, and public health. Their salaries are covered by their own countries while other expenses are paid by the government of Norway, the project’s only donor. The United Nations Development Program (UNDP) is responsible for the coordination and implementation of this initiative.
Working conditions in South Sudan are challenging. As the three physicians explained throughout the interview, they are keenly aware that people in great need and even greater pain desperately need them.
When asked about the biggest hurdles they face in their work, Mr. Matuiery, of a quiet and gentle demeanor, emphasized that, “We work on empty stomachs.” After two-and-a-half years of civil war, the South Sudanese economy is in a dire state. Three months have passed since the country’s civil servants were last paid.
“Our people need us. If we aren’t there for them, they die,” said Mr. Anthony. “But we have family responsibilities too and we sometimes can’t fulfil them because of money. But we have to work, or people lose their loved ones.”
“We have to improvise a lot because we have very basic conditions,” said Dr. Kakande. “We’ve been able to do many complex surgeries with very basic facilities.”
An example of their efforts is the case of Alexander Paulino. Speaking enthusiastically in Arabic during the interview, he explained how he was about to lose his life due to severe gangrene in his right leg - a consequence of years of smoking.
The surgeons saved his life by amputating it. There was no other option. Paulino also talked about how they assisted him in his physical rehabilitation, which helped him get back on track and continue with his life.
The three doctors agree that there's talent and skill and eagerness in South Sudan when it comes to studying and practicing medicine.
However, the critical shortage, if not downright absence of essential medical supplies and equipment constrains their work, which means, existing health conditions worsen by the day. In other words, as Dr. Kakande put it, “we are either condemning someone to die, or to have an unpleasant life.”
The three surgeons know that with the right equipment and the right drugs, they could save a lot of lives.
“All we can do is work with what we’ve got,” explained Dr. Anthony. “And we’ve done plenty.”
“I’m very happy with my twins,” says Dr. Kakande. “They can do all sorts of procedures and they’re good at it. They can stand on their own, even when I’m not there. That’s what matters."