The story of a surgeon who has dedicated his life to serving refugees in southern Sudan

Maban Province, Southern Sudan. © UNHCR / Will Swanson
The story of a surgeon who has dedicated his life to serving refugees in southern Sudan
Dr. Ivan Attar dedicated himself to providing health care to the most needy people in a tense and volatile region in southern Sudan.
Dr. Ivan Attar Adha is the Head of Surgery and Medical Director. He does not have an office and does not like to sit.
He performs up to 10 surgeries a day, spends hours standing on his feet, assists nurses in the treatment of patients and examines everyone, from gunshot wounds to malaria patients and newborn babies.
Often the first to enter the operating room, pushing the heavy metal surgery platform to the right place. It can also be seen in the new newborn ward, playing one of them. One of his colleagues recently found him standing barefoot on the operations platform late at night and singing while repairing a lamp in the ceiling.
"We are here to save lives, not to sit down," says Dr. Atar, known by his middle name. No time to laziness in the operating room. We are all equal and we all form a team. "
Dr. Atar, 52, is the only surgeon and surgeon at the 120-bed Maban referral hospital and two operation rooms in Pong, located in the south-eastern part of Upper Nile state in southern Sudan.
Located 600 km from the capital, Juba, the only surgical facility in Upper Nile, it has a section for newborns and a 20-bed TB ward.
The 24-hour hospital serves more than 200,000 people. Dr. Attar is very well known and many refer to the hospital as "Dr. Atar, "and patients travel for days to get treatment from it.
"This hospital is comprehensive. It is a service collector and is the last referral point "
"This hospital is comprehensive," says Dr. Kalisa Yasseru and Ababi, a doctor from Uganda who has been working at Mapan Hospital for more than two years. It is a service collector, the last point of reference, and the highest level of competence. " UNHCR finances the work of the hospital through several partners.
Dr. Attar and his team work in a difficult and dangerous environment. Southern Sudan suffers from a shortage of facilities and skilled workers in the health sector, and there is also a shortage of medicines and equipment.
When South Sudan gained independence in 2011, it had about 120 doctors and 100 nurses while its population was 120 million. Since the outbreak of civil war in December 2013, the displacement of more than 4 million people, health care has deteriorated.
In the past, medical facilities in southern Sudan have been looted or robbed, and their staff have been intimidated, detained, abducted and killed. Ambulances were shot and stolen. Since 2013, 103 humanitarian workers have been killed.
The situation in Maban province is volatile and has seen continuous periods of violence in recent years. After attacks on compounds and offices of international organizations, including UNHCR in July this year, Dr. Attar remained in hospital even when medical personnel were forced to leave.
Dr. Attar ignores the danger and says, "We treat everyone here regardless of their identity." He smiles, adding that all parties to the conflict seem to understand that they also benefit from good health care.
With his invincible optimism, his constant laughter and his sometimes obvious stubbornness, he did not give up on the health care of the people most in need, to focus on this issue.
Dr. Attar, from the town of Turit in southern southern Sudan, received a scholarship to study medicine in Khartoum and then moved to Egypt to undergo medical training.
In 1997, he moved to Kurmuk in the Blue Nile State of Sudan where he managed, during the 12 years of intense conflict, often under bombardment, a basic hospital where he treated wounded civilians as well as fighters from both sides
"The only thing left was an operational table"
"When I arrived, the hospital was in a mess and the only thing left was an operating table," recalls Dr. Attar. We used normal threads to cut wounds and bars to stop bleeding. " Dr. Attar says his most expensive possession is a set of amputation equipment and a small package of sterilizers previously given to him by a French doctor
In 2011, under a barrage of intense Sudanese shelling, he joined his entire team with tens of thousands of Sudanese who fled across the border to Maban province in southern Sudan. Equipment and medicines were started in a tractor and four vehicles. "It took us a month to travel. There was no passable road. It was during the rainy season, and the rivers were surplus "
In 2011, Bong, the main town in Maban province, was a small area with a shopkeeper. The hospital was a primary health care center and had no operating room. For the first operation, Dr. Attar prepared an operating room and made a high platform by stacking the doors above each other
Dr. Attar is conducting a process for a young Sudanese refugee at Bong Hospital in Maban Province, Southern Sudan
Dr. Attar is conducting a process for a young Sudanese refugee at Bong Hospital in Maban Province, Southern Sudan©
Today, in addition to the 53,000 residents of Maban, the surrounding area of ​​Pong also hosts 144,000 refugees from the Blue Nile State of Sudan, of whom 142,000 live in four refugee camps. In addition, there are 17,000 people from Southern Sudan internally displaced by the conflict in Maban province and surrounding areas. As cross-border fighting intensifies, UNHCR expects an additional 12,000 refugees this year.
Health care facilities are linked to the Maban hospital's refugee camps. The surgical team of four doctors performs 58 operations per week on average. In 2017, operations were Of which about 70% of all surgical operations were performed by refugees. The situation in Bong and surrounding areas is tense and volatile as communities grapple with limited resources such as firewood, farmland and pastures. Repeated conflicts between political parties have led to exchanges of fire. Relief agencies comply with the curfew, sheltering exchanges of fire in bullet-proof shelters, and their staff have been evacuated to Juba many times. However, Dr. Attar did not leave Pong. "I can now help my older son with homework in physics and chemistry." He admits that his choice of this work is difficult for his wife and four children, seeing only three times a year. The family lives in Nairobi and Dr. Attar is trying to stay in touch with her through Watsab and e-mail several times a week. "Now I can help my older son with homework in physics and chemistry. When I was in Karmak, the letters I wrote lasted a whole month to arrive. " Dr. Attar is not doing anything extraordinary. He lives in a cloth tent that has become soaked by weather and keeps a hand-sewing machine in the hallway used to make surgical wipes. He says he derives his energy from drinking milk. On Sundays you can relax by going to the church or taking a nap in the open air where you lie on an old bed without a mattress. "It's like sleeping in an air-conditioned room," he says. He likes to sing and sometimes works 24-hour shifts and likes to joke that his nurses call him a dictator. While joking, discussing family planning with a mother recovering from a third caesarean section, encouraging a man to amputate his left arm and fracture his right leg to learn to walk with one crutch. It is clear that his first source of happiness is not just surgery, but also communication with his patients. Dr. Atar, who is fluent in Arabic, prays with patients before anesthetizing them according to their religion, reads the Bible or the Koran. "What makes me feel happier is when I realize that what I have done has saved someone from suffering or saved his life, . Medicine can not be cured alone. You have to rest assured the patient. The moment you communicate with the patients, they will open their heart to you ... When a patient dies in my hand I feel very sad. " Improvisation is part of his work. If needed, especially during the rainy season with malaria, the number of patients in the family doubles and may add up to 60 patients. Power saving depends on two generators and solar panels. Dr. Attar requires all doctors to acquire basic mechanical skills. This has been useful in recent times when all systems have been disrupted at the beginning of surgery. There is no blood bank. Many people here think they will die if they donate blood. Dr. Attar does not hesitate to pressure the patient's relatives to donate. Dr. Attar says his retirement is unlikely. The hospital is what gives him hope and gives his life meaning. "The more good services you offer, the more people will come," he says with a faint laugh