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Dr Atar: Award winning ‘bush doctor’

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By FRED OLUOCH
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On October 1, South Sudanese surgeon Dr Evan Atar achieved a rare global recognition in Geneva.

The 52-year-old received the 2018 United Nations High Commissioner for Refugees Nansen Refugee Award for his outstanding 20-year work in providing medical services to the displaced people of South Sudan and Sudan.

In an interview with The EastAfrican in Nairobi a few days before the ceremony in Geneva, Dr Atar said the award, which comes with a $150,000 monetary prize, is not for himself but for his entire team back in Maban, Bunj County in Upper Nile State, South Sudan, and will go a long way in solving some of their urgent problems.

The Nansen Refugee Award recognises extraordinary humanitarian work on behalf of refugees, internally displaced or stateless people and is funded in partnership with the Swiss government, the Norwegian government, the State Council of the Republic and Canton of Geneva, the Administrative Council of the City of Geneva and the IKEA Foundation (Sweden).

Presenting the award in Geneva, UNHCR boss Filippo Grandi said that Dr Atar embodied not only solidarity with his refugee patients but courage, having lived as a displaced person himself.

Dr Atar — from Torit in eastern Equatoria — left his job in Alexandria, Egypt, where he was working as a doctor, to help refugees and the internally displaced in Kurmuk in Sudan’s Blue Nile State in 1997.

But in 2011, the war broke out in Blue Nile, forcing him to flee across the border to Bunj State in Upper Nile, along with thousands of other refugees.

Dr Atar and the refugees walked for one month from Kurmuk to Bunj County, carrying with them whatever medicine and medical equipment they could salvage amidst aerial bombardment by the Sudan Airforce.

Now, his Maban Hospital, which he established in 2011 with the help of donors, is the lifeline of about 200,000 people.

Being the only hospital in Upper Nile after the war that broke out in 2013 destroyed all the medical facilities in the region, Maban Hospital attends to 144,000 refugees from Sudan’s Blue Nile State, 17,000 internally displaced South Sudanese, and refugees from the Central African Republic, Democratic Republic of Congo and Ethiopia.

Nansen Medal

Filippo Grandi, right the United Nations High Commissioner for Refugees presents the Nansen Medal to Dr Evan Atar Adaha, in Geneva, on October 1, 2018. PHOTO | AFP

Good things and good people

Johann Siffointe, the UNHCR South Sudan country representative told The EastAfrican that despite the gloom and suffering brought about by the civil war, Dr Atar has proved that there are still good things going on in the country.

Dr Atar attended primary school in Juba and received his secondary education in Khartoum before getting a scholarship to study medicine in Egypt.

But while most qualified Sudanese were opting to stay away in the comfort of Western and regional capitals, Dr Atar, a Canada-trained surgeon, decided to offer his services to the suffering masses for little or no pay at all.

Having worked for 14 years in Kurmuk and seven years in Bunj, Dr Atar believes in making a difference in the lives of the displaced.

“Let us share the little we have and make a difference in the world that we live in because we are all human beings and anybody can become a refugee at any time,” he said.

His wife and four children live in Nairobi.

Dr Atar runs a 120-bed hospital that has no blood bank, has limited anaesthesia, the only x-ray machine is broken, the surgical theatre is lit by a single light, and electricity is provided by generators that often break down.

He operates with the help of three other doctors — two Kenyans and a Ugandan, a few midwives and administration staff mainly from Kenya and Uganda. Despite all the challenges, the hospital carries out an average of 58 operations in a week.

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The maternity ward has 30 beds, too few for the number of people it caters for, who include the local community in Maban and those who come from as far away as Malakal, Reng and Malut in central South Sudan.

“Sometimes we are forced to accommodate two pregnant women in one bed, but it becomes difficult if one mother delivers more than one child. We hope this award will help us expand the maternity ward as our first priority,” said Dr Atar.

When Dr Atar arrived in Kurmuk — before the partition of Sudan — it was a restricted area where the Khartoum government did not allow operations by humanitarian agencies and non-governmental organisation.

The region was outside the ambit of Operation Lifeline Sudan (OLS), an agency of the UN which was operating from Lokichoggio in northern Kenya, attending to those affected by the raging civil war between the North and the South.

However, Dr Atar was determined to come to the aid of the people in that region and reached out to an official of Médecins Sans Frontières he only recalls as Fabrice, who provided him with an autoclave.

He later received support from some British Members of Parliament who supplied him with medicine to start off his operations in Kurmuk.

“From 1997 to 2005, we depended entirely on good Samaritans; at that time, we were attending to various armed groups irrespective of their affiliation, tribe or religion. It was our duty to give medical services to those who needed them. But from 2005, after the signing of the Comprehensive Peace Agreement, things started improving and we started receiving equipment from the government in Juba and managed to put the hospital in chapel,” said Dr Atar.

But war broke out again in Blue Nile and Dr Atar and his refugee patients crossed the border southwards to Bunj County. The fighting in Blue Nile, which is still going on to date, is between the Khartoum government forces and local communities who are fighting alongside and are sympathetic to the SPLA.

Dr Evan Atar Adaha performing surgery

A file photo taken on October 10, 2011 of Dr Evan Atar Adaha performing surgery at a makeshift hospital in Kurmuk region of the Blue Nile state. PHOTO | AFP

After South Sudan’s Independence in 2011 and the partition of the country, these communities found themselves in Sudan where they are not trusted by the Khartoum government because of their sympathy for pro-South Sudan militia fighting on the side of anti-government rebels. The communities say Blue Nile people were not given a choice of which side of the two Sudans they wanted to belong to.

Dr Atar recalls how on arrival in Maban in November 21, 2011 after a month-longwalk, he immediately went to see the area commissioner, who took him to a dilapidated primary healthcare centre. But as they were still inspecting the facility, the residents who had heard about his arrival in the area brought in a young man who had been shot and was in critical condition.

“There was no way we were going to let the patient die despite the lack of equipment and medicine. The bullet was lodged in his intestines and we were not sure whether the few pieces of equipment we had brought with us were sterilised. However, with the help of the only nurse from Kenya, we took a broken door and turned it into an operating table,” he said.

They opened the young man’s abdomen, cut out the damaged section of the intestine and carried out an anastomosis— the process of stitching back an organ after it has been severed. The patient survived and he is currently working at the Maban Hospital where he is in charge of receiving patients at the gate and controlling the queues of patients.

Dr Atar says that the challenges facing his hospital will only ease up if peace comes to South Sudan, enabling more young people to go back to school and study medicine; refugees to go back home and the displaced to go back to their homes and more doctors from the region to work in South Sudan.

He is, however, grateful that despite Upper Nile being the theatre of continuous fighting between the government forces of President Salva Kiir and those of Dr Riek Machar, the hospital has not been attacked by armed militias.

“We have made the rule that nobody should come to the hospital with arms or army uniforms. If they come to the hospital with arms, we don’t treat them because we don’t want the political hatred brought into the facility,” said Dr Atar.

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Public officers above 58 years and with pre-existing conditions told to work from home: The Standard

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Head of Public Service Joseph Kinyua. [File, Standard]
In a document from Head of Public Service, Joseph Kinyua new measure have been outlined to curb the bulging spread of covid-19. Public officers with underlying health conditions and those who are over 58 years -a group that experts have classified as most vulnerable to the virus will be required to execute their duties from home.

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However, the new rule excluded personnel in the security sector and other critical and essential services.
“All State and public officers with pre-existing medical conditions and/or aged 58 years and above serving in CSG5 (job group ‘S’) and below or their equivalents should forthwith work from home,” read the document,” read the document.
To ensure that those working from home deliver, the Public Service directs that there be clear assignments and targets tasked for the period designated and a clear reporting line to monitor and review work done.
SEE ALSO: Thinking inside the cardboard box for post-lockdown work stations
Others measures outlined in the document include the provision of personal protective equipment to staff, provision of sanitizers and access to washing facilities fitted with soap and water, temperature checks for all staff and clients entering public offices regular fumigation of office premises and vehicles and minimizing of visitors except by prior appointments.
Officers who contract the virus and come back to work after quarantine or isolation period will be required to follow specific directives such as obtaining clearance from the isolation facility certified by the designated persons indicating that the public officer is free and safe from Covid-19. The officer will also be required to stay away from duty station for a period of seven days after the date of medical certification.
“The period a public officer spends in quarantine or isolation due to Covid-19, shall be treated as sick leave and shall be subject to the Provisions of the Human Resource Policy and procedures Manual for the Public Service(May,2016),” read the document.
The service has also made discrimination and stigmatization an offence and has guaranteed those affected with the virus to receive adequate access to mental health and psychosocial supported offered by the government.
The new directives targeting the Public Services come at a time when Kenyans have increasingly shown lack of strict observance of the issued guidelines even as the number of positive Covid-19 cases skyrocket to 13,771 and leaving 238 dead as of today.
SEE ALSO: Working from home could be blessing in disguise for persons with disabilities
Principal Secretaries/ Accounting Officers will be personally responsible for effective enforcement and compliance of the current guidelines and any future directives issued to mitigate the spread of Covid-19.

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Uhuru convenes summit to review rising Covid-19 cases: The Standard

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President Uhuru Kenyatta (pictured) will on Friday, July 24, meet governors following the ballooning Covid-19 infections in recent days.
The session will among other things review the efficacy of the containment measures in place and review the impact of the phased easing of the restrictions, State House said in a statement.
This story is being updated.
SEE ALSO: Sakaja resigns from Covid-19 Senate committee, in court tomorrow

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Drastic life changes affecting mental health

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Kenya has been ranked 6th among African countries with the highest cases of depression, this has triggered anxiety by the World Health Organization (WHO), with 1.9 million people suffering from a form of mental conditions such as depression, substance abuse.

KBC Radio_KICD Timetable

Globally, one in four people is affected by mental or neurological disorders at some point in their lives, this is according to the WHO.

Currently, around 450 million people suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.

The pandemic has also been known to cause significant distress, mostly affecting the state of one’s mental well-being.

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With the spread of the COVID-19 pandemic attributed to the novel Coronavirus disease, millions have been affected globally with over 14 million infections and half a million deaths as to date. This has brought about uncertainty coupled with difficult situations, including job loss and the risk of contracting the deadly virus.

In Kenya the first Coronavirus case was reported in Nairobi by the Ministry of Health on the 12th March 2020.  It was not until the government put in place precautionary measures including a curfew and lockdown (the latter having being lifted) due to an increase in the number of infections that people began feeling its effect both economically and socially.

A study by Dr. Habil Otanga,  a Lecturer at the University of Nairobi, Department of Psychology says  that such measures can in turn lead to surge in mental related illnesses including depression, feelings of confusion, anger and fear, and even substance abuse. It also brings with it a sense of boredom, loneliness, anger, isolation and frustration. In the post-quarantine/isolation period, loss of employment due to the depressed economy and the stigma around the disease are also likely to lead to mental health problems.

The Kenya National Bureau of Statistics (KNBS) states that at least 300,000 Kenyans have lost their jobs due to the Coronavirus pandemic between the period of January and March this year.

KNBC noted that the number of employed Kenyans plunged to 17.8 million as of March from 18.1 million people as compared to last year in December. The Report states that the unemployment rate in Kenya stands at 13.7 per cent as of March this year while it stood 12.4 per cent in December 2019.

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Mama T (not her real name) is among millions of Kenyans who have been affected by containment measures put in place to curb the spread of the virus, either by losing their source of income or having to work under tough guidelines put in place by the MOH.

As young mother and an event organizer, she has found it hard to explain to her children why they cannot go to school or socialize freely with their peers as before.

“Sometimes it gets difficult as they do not understand what is happening due to their age, this at times becomes hard on me as they often think I am punishing them,”

Her contract was put on hold as no event or public gatherings can take place due to the pandemic. This has brought other challenges along with it, as she has to find means of fending for her family expenditures that including rent and food.

“I often wake up in the middle of the night with worries about my next move as the pandemic does not exhibit any signs of easing up,” she says. She adds that she has been forced to sort for manual jobs to keep her family afloat.

Ms. Mary Wahome, a Counseling Psychologist and Programs Director at ‘The Reason to Hope,’ in Karen, Nairobi says that such kind of drastic life changes have an adverse effect on one’s mental status including their family members and if not addressed early can lead to depression among other issues.

“We have had cases of people indulging in substance abuse to deal with the uncertainty and stress brought about by the pandemic, this in turn leads to dependence and also domestic abuse,”

Sam Njoroge , a waiter at a local hotel in Kiambu, has found himself indulging in substance abuse due to challenges he is facing after the hotel he was working in was closed down as it has not yet met the standards required by the MOH to open.

“My day starts at 6am where I go to a local pub, here I can get a drink for as little as Sh30, It makes me suppress the frustration I feel.” he says.

Sam is among the many who have found themselves in the same predicament and resulted to substance abuse finding ways to beat strict measures put in place by the government on the sale of alcohol so as to cope.

Mary says, situations like Sam’s are dangerous and if not addressed early can lead to serious complications, including addiction and dependency, violent behavior and also early death due to health complications.

She has, however, lauded the government for encouraging mental wellness and also launching the Psychological First Aid (PFA) guide in the wake of the virus putting emphasis on the three action principal of look, listen and link. “When we follow this it will be easy to identify an individual in distress and also offer assistance”.

Mary has urged anyone feeling the weight of the virus taking a toll on them not to hesitate but look for someone to talk to.

“You should not only seek help from a specialist but also talk to a friend, let them know what you are undergoing and how you feel, this will help ease their emotional stress and also find ways of dealing with the situation they are facing,” She added

Mary continued to stress on the need to perform frequent body exercises as a form of stress relief, reading and also taking advantage of this unfortunate COVID-19 period to engage in hobbies and talent development.

“Let people take this as an opportunity to kip fit, get in touch with one’s inner self and  also engage in   reading that would  help expand their knowledge.

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