Operations have ground to a halt at South Sudan's largest hospital thanks to a week-long power outage, owing to a massive fuel shortage in the capital city.
One doctor at Juba Teaching Hospital, speaking anonymously for fear of reprisals from his bosses, said doctors can no longer perform most emergency operations. The last time this happened — in January — 10 patients died because staff could not perform necessary procedures.
The doctor said he tells patients to either buy fuel to run the hospital's generators for the duration of the surgery, or pay for a private clinic elsewhere.
But this hospital serves the city's poorest residents. Most cannot afford it.
"Even me, they have been calling me now that we need operation, but I told them, frankly, there's nothing we can do, nothing in my hands," the doctor said.
Poorest of poor
One woman in labor was writhing in pain in the maternity ward. She has suffered epileptic seizures.
Helen Emmanuel lies in labor in need of a C-section in Juba Teaching Hospital, South Sudan's largest medical facility, May 23, 2016. The hospital has not had electricity for surgeries for a week. (J. Patinkin/VOA)
Her mother-in-law, Jennifer Joseph, looked frantically for one jerry can — about twenty liters — worth of fuel so the woman could have an emergency C-section.
"They say that if the fuel is now ready, they will just make the operation now," Joseph said.
But even if she finds the fuel, she doesn't know how she will pay for it.
"What can I say? I will just put God ahead, because I have no money," she said.
One jerry can of fuel costs about 500 South Sudanese pounds, or about $12. The lines at the pumps can last all day. Black market fuel is simply out of reach.
Two-and-a-half years of civil war have wrecked the economy.
South Sudan is actually an oil-producing country, but it doesn't have refineries so the government subsidizes imported fuel. Many citizens in Juba demand the new transitional unity government fix the fuel crisis.
Motorbikes line up for hours to buy fuel from a petrol station in Juba, South Sudan, May 10, 2016. South Sudan faces a severe fuel shortage. (J. Patinkin/VOA)
The doctor said the hospital has mostly stopped working at night. There is simply no one to receive gunshot or accident victims.
In the nearly empty surgical ward, a man was in a bed, his abdomen dangerously distended two weeks after having his appendix removed.
His brother, Michael Chieng Bol, says the family doesn't have money to buy the three jerry cans of fuel needed for another surgery.
"It is the transitional government of national unity [that could] put its efforts to look into the problem of this hospital,” Chieng Bol said. “It is the one who could really bring the fuel, so the people of South Sudan could get the right treatment inside the hospital."
The minister of petroleum was unavailable to comment.
Michael Chieng Bol, right, holds his hand on his brother Simon's stomach, which is in need of further surgery following an operation to remove his appendix, in Juba Teaching Hospital, South Sudan's largest medical facility, May 23, 2016. (J. Patinkin/VOA)