Dr. Alexandra Mamová, a physician and member of the Tropical Team at the University of Health and Social Work of St. Elizabeth in Bratislava, embarked on her first mission (first development project) in Ethiopia while still a medical student. A hospital-based project awaited her in South Sudan, where she worked alone as a gynecologist, and which tested and taught her the most – both medically and personally.

Dr. Mamová during an ultrasound examination of a patient

During her volunteer stay in Ethiopia, she worked at a station for women and children, providing social care and occasional healthcare. There was also an anti-malnutrition program – focused on combating malnutrition, which Alexandra coordinated as a medical student under the supervision of senior colleagues. Hospital projects in Africa under the auspices of the University of Health and Social Work of St. Elizabeth in Bratislava came to her only after gaining experience. First, she assisted as a certified doctor, and only then did she work alone. In South Sudan, she worked as a gynecologist multiple times and for the longest period. Therefore, she recalls this project most frequently.

Prepare Well for a Development Project Deployment

Anyone interested in deploying as a volunteer on a development project should, according to Dr. Mamová, thoroughly study the location – weather, climate, infrastructure, population composition, religious or tribal customs, culture... This can help avoid some unpleasant experiences and prejudices.

She describes herself as a very adaptable person with no high demands – regarding hygiene, accommodation, food. “I can endure even significant discomfort without problems. In my opinion, it is crucial before leaving for a project to know yourself and to know: what you are willing to sacrifice for the smooth running of the mission; how you behave in unpleasant or stressful situations; how much discomfort you can tolerate, etc. Because there is a great deal of stress and unpleasant situations, various surprises and unknowns on development projects. If a person cannot work under pressure or is stressed even by a spider in the toilet, they cannot expect to have a pleasant experience from implementing a development cooperation or humanitarian aid project,” adds Alexandra Mamová.

She also emphasizes the importance of mental hygiene as a prevention against burnout during field stays. According to her, development workers and volunteers should find time for themselves – for example, to go for a run, watch a good film, and meet people.

South Sudan was in many ways a trial for Alexandra. Not because of the civil war itself (she did not directly experience active combat and armed conflicts), but rather due to its consequences in the form of food shortages. Then came extreme heat and drought, and the associated water shortage. All this automatically affects patients' conditions and, last but not least, the health of staff and field workers... Because performing surgery in an operating room when it's 40 degrees Celsius outside (in the shade!) is not sustainable long-term.

In South Sudan, at the project in Marialou, no one else with a medical education was present at the hospital besides Dr. Mamová. Therefore, she had to be available around the clock, day and night; the workload was enormous. “It is quite exhausting both mentally and physically. Especially if a doctor works like this for 4 to 5 months straight. On this type of project, one burns out quickly. That is why it is important to send people who already have experience,” recalls the member of the Tropical Team at the University of Health and Social Work of St. Elizabeth in Bratislava.

Only about 10–20% of children are born directly in South Sudanese hospitals (depending on the availability of services). This means that most women give birth at home and only come to the hospital when there is a serious problem. Moreover, conditions in the local maternity ward in Marialou five years ago were catastrophic – even basic obstetric equipment was lacking. Today, thanks to European support, the local hospital is undergoing extensive reconstruction. Currently, new operating rooms are already in operation, and a new maternity ward is also under construction.

Focusing on Internally Displaced People

The member of the Tropical Team likes to point to projects of the organization Two-Colored World in Eldoret, Kenya, as successful examples of practice and implementation of Slovak development cooperation in Africa, although they are not hospital-based. They are educational, but well-prepared and coordinated. They focus on strengthening the position of local women in society and acquiring new skills.

Dr. Mamová's research focuses on sexually transmitted infections among internally displaced people (IDPs). She is interested in the issues of refugees and migrants, and how infectious diseases affect their lives, as well as how their health can be improved under given conditions.

She points out that currently, the most pressing zone in terms of humanitarian crisis is Syria and Iraq: “Hundreds of people die there daily, and others lack access to healthcare. However, the security situation currently does not allow establishing new projects in these areas or conducting field research.”

In the future, she would like to focus her research on areas such as Libya, where “refugees are held in catastrophic conditions (before entering Europe), and their access to healthcare is also questionable or inadequate.” Dr. Mamová adds that: “in terms of upholding human rights and ensuring safety, especially for vulnerable groups (primarily women with children), we still have a lot of work ahead of us in that region.”

Text: Boba Markovič Baluchová Photo: Archive of Alexandra Mamová www.doubletrouble.sk