South Sudan: Healing the wounds after Maridi fuel truck explosion

Since 17 September, the ICRC and the South Sudan Red Cross (SSRC) have been working tirelessly to help the victims of the fuel truck explosion in Maridi, which claimed the lives of over 180 people. A full ICRC surgical team and 20 members of the SSRC have been working alongside resident medical staff at Maridi hospital.

Life at Maridi hospital is filled with pain and anguish. All of the 91 patients and their family members are anxiously awaiting signs of improvement.

Of the 160 patients who survived the explosion and were admitted to Maridi Hospital, 55 were evacuated to the Teaching Hospital in Juba, South Sudan's capital, in the first 48 hours and another 14 last Monday. But the number of new patients seeking urgent medical care at Maridi hospital steadily increased to more than 90 over the weekend. Many of them had sustained severe burns over up to 90% of their bodies. Sixteen patients subsequently died.

Since 20 September, no new deaths have been reported. With the survival rate improving, the outlook has brightened considerably for the patients' families. Tents are being set up to provide greater comfort for the relatives, who have been in limbo, sleeping under the trees in the hospital yard.

Maridi, South Sudan. SSRC Action Teams were deployed from Yambio and Juba. A 20-member strong team, well trained in emergencies, spend their days gently applying medication to the burns, transferring patients between wards and preparing some patients for evacuation to Juba. CC BY-NC-ND / ICRC / Layal Horanieh

Keeping germs away is vital following Maridi explosion

"Keeping germs away from the patients is our top priority. It's their only chance of survival," said Jan Wynands, the ICRC's on-site surgeon.

To counter the threat of infection, family members have been encouraged to organize a laundry service at the hospital to ensure that clean linen is provided regularly. An off-site waste disposal service has also been organized, and visits have been limited to two hours a day. Additional hygiene protocols, including the systematic use of gloves, aprons and masks, and strict rules about contact with patients, have been put in place.

The ICRC in Maridi has provided more than two tonnes of medical supplies over the past few days, and 30 operations have been performed each day, on average. Supplies were rushed in by helicopter on 19 September, thanks to a temporary suspension of Juba airport's usual weekend closures. Two days later, more patients were airlifted to Juba teaching hospital, which is now at maximum capacity, with its resources stretched to the limit to meet the needs of the growing number of patients.

"What matters most is getting patients through the initial shock and keeping them alive beyond day one," said Wynands. He went on to list the remaining priorities: avoiding infections in the first five to six days, and a week later, closing the wounds, with continuous treatment and care in as sterile an environment as possible.

Sadly, permanent scarring and long-term disabilities await many of Maridi's survivors. Physiotherapy, rehabilitation and reconstructive surgery will be necessary for those whose lives have been deeply marred by the fuel tank explosion.

Maridi, South Sudan. The ICRC's mobile surgical team, which  is  composed of a surgeon, two nurses and an anaesthesist, do the best they can to ensure sterile conditions for the patients, running round-the-clock monitoring to attend to patients' most basic needs. CC BY-NC-ND / ICRC / Layal Horanieh