Manuela’s malaria miracle

5th March 2018

Manuela Yawa is a nurse and one of 15 medical staff working with Christian Mission of Development (CMD) in the village of Pagil.

Four days after arriving in Pagil Manuela started feeling drowsy and having severe headaches. Eight days later her condition is critical.

Deputy Operations Manager, Leon Prinsloo, received the call Saturday at 2pm – too late to fly that day. ‘One of our nurses needs a medevac! She has cerebral malaria.’

The airstrip at Pagil is 1H40M flight directly north of Juba.

Medical emergency

The following day and Clinical officer Gatmai Yak Tutdeal, and Mary, a Medair Reproductive Health Manager, have escorted Manuela to the airstrip where they stand waiting for the plane.

Before Manuela can board, pilot Florian Poinstingl, offloads 700 kg of iron sheets and 180 kg of wire mesh, brought from Juba to upgrade the grass-thatched tukul roofs of CMD’s Primary Health Care Centre (PHCC).

Meanwhile Manuela sits patiently in the shade of the wing. The temperature is 40° Celsius, so to be sitting outside with a fever isn’t something you want to do for long.

Florian Poinstingl offloads 100 sheets of iron sheets (700 kg) and 2 rolls of wire mesh (184 kg) Manuela sits in the 40°C shade of the plane's wing.

‘Thursday Manuela showed signs of malaria, and we started treating her orally with the antimalarial Coaterm,’ Gatmai tells us. ‘But on Saturday she started having seizures and a high temperature; she was convulsing and yelling nonsense from 9am until 2pm.’

Running out of options

That was when Gatmai diagnosed cerebral malaria. Realising that he didn’t have the means to treat Manuela properly, he requested a medevac with MAF. No other airline in South Sudan would fly to Pagil on a weekend.

‘We continued treating her the best we could,’ Gatmai resumes, describing in detail the course of medication they administered. ‘We even tried to cool her down with wet towels and gave her paracetamols to keep her temperature down,’ Gatmai explains.

‘We continued treating her the best we could’ Gatmai Yak Tutdeal

Mary, who had been keeping an eye on Manuela the past two days at the Medair compound, recalls that Manuela had started yelling again Sunday morning at 4 and 6 o’clock, but that she now had become silent; literally she could not speak and only communicated by writing messages.

Flying unconsciously

Finally, Manuela boards the plane; with support from Mary and Gatmai she manages to walk to her seat and slumps into it. James Wieh Thou, a registrar at the PHCC, sits next to Manuela to assist her during the flight.

Manuela slumped in her aircraft seat. Assisted by Mary and Gatmai

1:37pm, an hour and 11 minutes after landing in Pagil, the Caravan takes off. Florian lets the plane climb to 9,000 feet; normally, he would go to 12,000 feet to save fuel and fly faster, but he is concerned with how the altitude will affect Manuela’s condition. Going lower this time of year, with the turbulence of the dry season, would result in a very bumpy ride.

At 2:15pm she starts to cry violently, and James holds her firmly. All of a sudden she relaxes completely and either falls fast asleep or becomes unconscious until the aeroplane at 3:19pm lands at Juba International Airport.

MAF’s dispatch team are ready; David Juma quickly lifts the semi-conscious Manuela from the plane to a car, and she is immediately taken to Victorious Hospital. There is nothing more we can do, but hope and pray.

Unconscious of what is happening Manuela is lifted out of the plane and into a car at Juba International Airport.

An answer to prayer

Richard Duke, one of the dispatch guys, knows Manuela, and confidently said that she would get better, because her church had been praying for her at their Sunday service.

Monday morning, Duku and Juma went with me to the hospital to pay Manuela a visit. She was lying in bed, dressed and with a tired smile. She couldn’t speak, but answered all of our questions in writing.

Manuela is awake. Unable to speak she writes how she can't recall being transported from Pagil to Juba.

Her little sister, Harriet, had slept on the bed next to her and was happy to see her sister recovering so well. Suddenly, Manuela answered audibly to one of my questions and Harriet lit up in a big smile.

Manuela's sister Harriet has stayed the night with her. We are told that an hour after we left the hospital she started speaking again and that she was singing on Tuesday.

Although Manuela had no recollection of how she had come from Pagil to Juba, it made everybody happy to see that she was clear-headed and smiling at our jokes.

An hour after we left the hospital Manuela started speaking again. Duku called her the next day, and she sang to him on the phone, praising God for her recovery.