In South Sudan, where floods swallow the land and infrastructure is almost non-existent, accessing urgent medical care can be a life-or-death challenge. This became painfully clear when International Medical Corps Program Manager Bithou Gatkuoth faced a medical emergency while working in Nyal, a city in the central part of the country.
On Saturday, February 1, Bithou led a training session for community leaders in Nyal—a project that is generously funded by the UK’s Foreign, Commonwealth and Development Office. Though he had been experiencing abdominal discomfort, his dedication to the session never wavered. By 3:00 p.m., he had completed the training and hoped that rest would ease his pain. However, the situation quickly worsened. By Sunday, his pain had intensified to unbearable levels, prompting his colleagues to rush him to the nearest health facility, Nyal Primary Healthcare Center (PHCC).
There, medical staff diagnosed him with acute appendicitis—a life-threatening condition requiring immediate surgery—but they could only provide pain relievers due to the lack of diagnostic and surgical equipment. The nearest facility capable of performing the surgery was in Juba, but there was no land route to reach it. The only option was a United Nations Humanitarian Air Services (UNHAS) flight, departing from an airstrip two hours away, across floodwater, accessible only by speedboat.
As soon as Bithou’s condition was confirmed, our team activated its medical evacuation protocol. Field Site Coordinator Rufas Soro Laila, Human Resources Administrator Adrili Nuela Simon Morujan and the field team in Nyal worked tirelessly to secure transportation to the airport where the UNHAS flight was departing from. At the same time, other team members booked the flight.
Support quickly arrived from Welthungerhilfe, a partner organisation that provided a speedboat to transport Bithou to Ganyliel, where the UNHAS flight awaited. However, as final preparations were being made, the clinical officer at Nyal PHCC issued a grave warning—Bithou’s condition was rapidly deteriorating. He might not survive the journey to Juba.
Faced with an impossible choice—risk the perilous journey or attempt emergency surgery in a facility unequipped for such procedures—the International Medical Corps team reached out to Alliance for Action Aid (AFAA), a trusted local partner. Within hours, an AFAA doctor arrived in Nyal to assess Bithou’s condition. After a thorough examination, the doctor made a critical decision—there was no time left. The surgery had to be performed immediately, with the limited tools available in Nyal.
In a dimly lit surgical room, the AFAA medical team performed the high-risk operation. Against all odds, and with steady hands and unwavering determination, they successfully removed Bithou’s inflamed appendix. The procedure was a success!
As the news spread, the International Medical Corps team exhaled a breath they hadn’t realised they were holding. In a matter of hours, what had been a race against time transformed into a victory of coordination, skill and resilience. Following the surgery, Bithou’s condition stabilised, and his pain subsided. In the days that followed, our team visited him regularly, offering encouragement and ensuring that he had the necessary post-operative care.
Bithou’s story is not just one of survival—it is a testament to the power of teamwork and the importance of emergency response protocols and strong partnerships, which are critical when providing medical care in remote and under-resourced environments.
“In remote regions of South Sudan, access to advanced medical care—such as surgery—is often out of reach,” says Zain ul Abedin, Country Director for International Medical Corps in South Sudan. “That’s why we invest in strong partnerships, ensuring that lifesaving emergency assistance reaches those in need, beyond the areas where our doctors are present. By working with our network of partners, we extend our impact, delivering critical care where it’s needed most and saving more lives together than we ever could alone.”
Learn how we helped local communities recover and become more resilient when flooding destroyed infrastructure in South Sudan, and donate to International Medical Corps today to help people around the world affected by conflict, disaster and disease.