Performing timely lifesaving surgery is never easy, even in ideal circumstances, and any delay could mean losing a life. However, such cases can be addressed or mitigated by Mobile Surgical Teams. 

The mobile surgical team travel to hard-to-reach regions in Raja county to carry out emergency and life-saving surgery. The idea stems from an obvious need: Last year, from May to September, 15 critical cases were reported due to difficulties in medical access, delayed routine antenatal care from rigid cultural beliefs, absence of qualified medical personnel and the lack of well-equipped and functional operating theatres. 

This concept was an innovation of Western Bhar-El-Ghazel Raja County Hospital Coordinator Dr. Otien Ownar, a 52-year-old Obstetrician and Gynecologist with over seven years of experience that now leads a team of four health professionals handling complicated obstetric, gynecological, and surgical cases in inaccessible Raja County areas.   

In recounting his motivation for coming up with this idea, Dr. Ownar Otien pointed out that he used to receive many late-night phone calls from women and other patients in complex situations who needed urgent medical attention.

“About two years ago, I received a phone call at 2 AM from Deim Zebir Health Centre, requesting an ambulance to pick up a mother who was in obstructed labour for a long time. Deem Zebir is about a 5 hours’ drive and it was raining. I knew the mother might not make it here, so I called the anesthetist, nurse, and ambulance driver to get ready and we set off to Deim Zebir. Regardless of the road condition and other risks associated with the journey, we managed to reach her and did the operation successfully,” said Otien with a smile.  

After this experience, Dr. Otien and his team have done several rescue operations. He described his team as cohesive and collaborative when conducting surgeries. His crew consists of himself, an anesthetist assistant, a midwife and a medical assistant. For the team, providing essential and quality medical care services to those in need, whether at the facilities or outside their comfort zone, is the core of what medical professionalism means to them.   

The team performs such operations when needed, although often the health facilities they travel to are not ideal for surgery. When occasional necessities such as blood transfusion arise they do not have the required equipped laboratories for blood screening.

“All our primary health care units aren’t conducive for surgical procedures, but the team always tries its best to set up a theatre using the available resources and all operations we conduct are always successful,” said Dr. Otien.

Osman Kudos, the Anesthetist Assistant in the Mobile Surgical Team, narrates how difficult providing these needed services can be when traveling to remote areas. “The initiative is wonderful and unique but a mobile surgical team isn’t ideal for emergencies. It can be perfectly done for early-stage cases. Sometimes we do surgeries using torches and candles for lighting” said Osman Kudos.   

Dr. Diana David, the Raja County Hospital Medical Director who manages the facility’s day-to-day operations and other centres within Raja works closely with HealthNet TPO staff. Dr. Diana commended the mobile surgical team, describing it as “an essential move” to intervene in worst-case scenarios, adding that medical teams often must weigh options available between their lives or saving the patients.

“HealthNet TPO staff are so dedicated and creative. For instance, before the mobile surgical initiative, there was a radiology camp where the team moved to different areas to scan all expectant mothers who might have unnoticeable complications due to a lack of services outside Raja town for their cases to be handled before they worsened. They constantly come up with innovative approaches to save lives,” said Diana.

However, to save more lives, Dr. Diana recommends the establishment of comprehensive emergency, obstetric and newborn care centres, and the permanent presence of a medical doctor to deliver and handle more advanced services and complicated cases in Diem Zebir, Timsah and Buru Medina.  

HealthNet TPO manages 11 functional health facilities in Raja County, including one hospital, three primary healthcare centres and seven primary healthcare units, with support from the Health Pooled Fund. 

While noting the initiative, Dr. Charles Okidi, South Sudan Country Director, expressed gratitude to his team for always spearheading innovation, adding “This initiative came as a result of group observation on the ground on increasing deaths of pregnant mothers with obstetric and gynecological emergencies.”

Dr. Charles added, “they noticed that it would take 8-10 hours for the ambulance to come and pick up the surgeons to the health facility, which has no theatre or, worse still, drive the pregnant woman over 4 hours to the Raja Hospital to be operated on. By then, the unborn child might have died or, at worst, the mother”.  

Describing how impactful the initiative is, Dr. Charles stated that the initiative is not only lifesaving but also cost-effective in terms of fuel and time, “The organisation is in full support of this initiative and looks forward to expanding it in its other areas of operation,”.