At Wau Teaching Hospital, medical workers receive patients injured in fighting, assess their condition and provide care, often while more casualties are arriving.

For Anna Gabriel Ngori Bono, a nurse in the hospital's surgical department, the pressure became particularly intense earlier this month when dozens of patients with gunshot wounds arrived from Tonj North, followed by another group just days later. 

The scale and severity of the emergency overwhelmed her.

"With these gunshot wounds, the number of patients is difficult to manage because there are too many. Even that puts me in a mental disorder," she said.

Her experience comes as South Sudan's trauma caseload grows. The International Committee of the Red Cross (ICRC) says it evacuated 266 wounded patients across the country in the first six months of 2026, more than 50% higher than during the same period last year.

But treating the wounded involves more than physical injuries. At Wau, medical workers must sometimes overcome language barriers, mistrust between communities and differences in cultural practices while persuading patients to follow medical advice.

"Mentally, all this really affects us because it is draining trying to convince someone that something is for their benefit, but they keep refusing to listen to you," Bono said.

Her experience is not isolated. At the hospital, counsellors are seeing how the demands of treating conflict-related injuries affect staff.

Peter Anou Yol, a psychosocial counsellor, said long working hours can leave medical workers exhausted and affect their concentration.

"Sometimes, you may find the staff will work from the morning until late in the evening. And if someone is getting exhausted, they will not focus on the activities that are supposed to be carried out," he said.

Repeatedly seeing people seriously injured in fighting between government troops and opposition forces, as well as in intercommunal violence, adds another emotional burden.

"You can see three, four, maybe even up to six in one day," Yol said. "That one will affect someone's mental health because you are seeing terrible things happening to people who, maybe, sometimes, even come from your community."

Yol noted that the effects can extend to patient care, with exhausted workers losing concentration, withdrawing from their duties or becoming more vulnerable to occupational hazards.

The pressure reflects a wider mental-health challenge in conflict settings.

According to the ICRC, more than one in five people living in conflict-affected communities experience mental-health conditions, about three times the rate in the general global population.

In South Sudan, the ICRC provided direct mental-health and psychosocial support to 2,870 people affected by conflict-related trauma in 2025.

Yet not every medical worker seeks professional help.

"Some of them may not seek help for mental health struggles because of cultural norms here and accessibility to such services," Yol said.

At Wau, those who seek support can access psychosocial counselling, while recreational activities such as cards, dominoes and watching videos offer other ways to ease stress.

Bono, like others, can also turn to fellow workers when the load becomes overwhelming.

"Sometimes, I share my challenges with my colleagues, and tell them what has happened to me," she said.

But when she leaves the hospital, another set of responsibilities awaits.

"I just focus on my home because I have to think about my children and what I have to provide for them," she said.

For Bono and her colleagues, separating the demands of the hospital from life outside it is part of how they keep going.

But in a seemingly never-ending cycle of conflict, where new casualties can arrive at any time, the weight of their work is never far away.