By Tessa Bolton, CARE Canada
In the aftermath of the Darfur war in Sudan, the village of Gorlangbang was completely isolated for over ten years like most of South Jebel Marra. In late 2019-2020 following the Juba Peace Agreement, humanitarian agencies were able to visit the area for the first time. They found a huge amount of need, as the population hadn’t accessed health, nutrition, water, or education services for over a decade. But there were also massive challenges with access and security. The region of South Jebel Marra is still under the control of the Sudanese Liberation Army (SLA). There is no electricity, running water, and very little phone reception. With the ongoing conflict, there is no road up to Gorlangbang. The only way to access the village is by driving for about five hours (through many military checkpoints and across no man’s land), followed by a donkey or camel trek, taking over three hours. Nevertheless, CARE decided to respond and is still the only non-government organization operating in Gorlangbang and one of only three in the whole of South Jebel Marra. CARE works hard to build strong relationships with local leaders, government, military, and SLA groups to ensure we have safe access and can reach those most in need.
Over the last year and a half, supported by Global Affairs Canada, CARE built the health and nutrition clinic (rejuvenating the local brick-making industry in the process), trained and supported local health assistants, pharmacists, midwives, nutrition assistants, and community health volunteers, and brings equipment, supplies, and medicines up the mountain. CARE also recruited the only doctor in the clinic, Doctor Gisma Awad Hassan Rwah. We had the honour of sitting down with her and hearing about her and the lifesaving work she’s doing under such challenging circumstances.
Can you tell us a bit about yourself?
I am 34 years old and am originally from Nuba Mountain, in the South Kordofan state of Sudan, but now most of my family lives in Khartoum.
I am married but have no children, and my husband lives in the USA (South Dakota).
Currently, I work as the doctor at Gorlanbang clinic. I have been a doctor for seven years.
I chose to become a doctor because it’s such an important job. I have saved the lives of many people and can help people in emergencies. As a doctor I can help people who are in pain, have illnesses, and even experience psychological pain. It is beautiful work.
Why did you choose to come here, to Gorlanbang, a region that is far from your home and so difficult to access because of the war?
Because there is so much need here in this region. I wanted to help people and I was the first doctor to come here in over ten years. Now it has almost been a year and I feel like I have become part of the community. I am very safe here and they tell me they don’t want me to leave. It is very difficult to work and live here though. It takes a long time to get up the mountain, at least three hours of climbing. Most people use donkeys but the first two times I was too scared, I walked the whole way. After that, I became brave enough to take the donkey. Every six weeks I come down the mountain to stay in the CARE Nyala or Kass offices for two weeks, to work in the office and have some rest from the difficult conditions.
Do you think it’s important for women to be doctors, as well as men?
Yes, it’s important. Women are the same as men. They can and should be doctors too.
Not everyone in Sudan feels the same way, though. Many think there are differences between women and men and in some ways, there are. Women here are more likely to have no education. They are expected to be in the home, not work outside in jobs like being a doctor or a teacher and they are supposed to look after the children.
How did you come to think this way, about men and women?
My mother gave me strength. She’s so amazing. My father passed away, but my mother supported me to study medicine. I studied at El Fasher university, here in Darfur, far away from home. My mother supported me always. She trusted me everywhere I went. Like me, my mother thinks we need to help people everywhere.
Can you talk about about your typical day?
On a normal day, I wake up around 5 a.m. to pray and then go back to sleep. At 7 a.m. I wake up again to start the day. I eat some hot milk and maybe a few biscuits. At 8 a.m. I get to the clinic and start working. I treat all sorts of patients. Respiratory tract infections are very common here, due to the cool weather and the charcoal cooking fires. Diarrhea is probably the second most common illness. But I also deal with traumas, like lacerations from falling or from being kicked by a donkey.
At around noon, I go back to the CARE guesthouse [to eat], on a good day. On a busy day, I might not eat until 2 p.m. After I go back to the clinic and work until 3 or 4 p.m. when the clinic closes, depending on how busy the day is.
The clinic is open five days a week, being the only doctor, I am always on call. For any emergency at night or on my days off, I still go and help. Recently there have been some emergencies late at night or very early in the morning – such as complicated deliveries brought to the clinic, a case of severe malaria, and a child who fell from a donkey and needed his wound sutured with more than 7 stitches. I have also been called to deliver babies in peoples’ homes twice-both times the mother and baby were safe and well.
Tessa Bolton and Doctor Gisma Awad Hassan Rwah during their visit together. Tessa Bolton/CARE Canada
Tessa Bolton and Doctor Gisma Awad Hassan Rwah during their visit together. Tessa Bolton/CARE Canada
Besides respiratory infections and diarrhea which you mentioned earlier, what are some of the other reasons people come to see you at the health clinic?
I see some cases of Malaria, but not so often, especially at this time of year. I support pregnant women and deliveries. Most women choose to deliver at home with traditional midwives. But we encourage them to come here, as we have drugs and medical support.
We also have contraceptive pills at the clinic and encourage women to have gaps between pregnancies.
We provide immunizations to all children and treat trauma and injuries. Goiter (thyroid) issues are also very common up here, due to an iodine deficiency in the water. Even in children, we see this. Skin diseases are also common, from washing clothes in bad water or sharing clothes. Urinary tract infections (UTIs) are also common, particularly in women.
What are the main challenges of your work?
There is no electricity at the clinic. If there is an emergency at night, I have to hold a torch to treat them.
Note: CARE is planning to install solar electric lights in the clinic in the coming months
Do you have a hero that you look up to?
My mama. I can’t speak about her (I don’t have words). She is not educated herself, but she likes education for others. She wants to help people at any time.
What makes you happy?
The happiness of people. That makes me smile from my heart. When I feel the people are happy, all my tiredness is gone by knowing people are healthy.