Fragile States

Fragile States (including Afghanistan, Democratic Republic of Congo, Haiti, Liberia and South Sudan)

Lelo PHCU staff treat the young patient. {Photo credit: MSH.}Photo credit: MSH.

"Diktor! Diktor!" The urgent call for a doctor came from several school boys who had run to the facility. I glanced over and saw a boy about 12 years old tensely sit down in the waiting patio at Lelo Primary Health Care Unit in South Sudan.

"Are family planning methods safe?” wondered Mutombo, a community health worker at the Kawama Village Health Center, in the Democratic Republic of Congo’s Katanga Province. {Photo credit: MSH.}Photo credit: MSH.

Cross-posted on USAID's IMPACT blog.

“Don’t they contain a poison?” he added, directing his question to Isaac Chishesa, a community mobilization specialist with USAID’s Democratic Republic of Congo-Integrated Health Project (DRC-IHP).

Tough question! One Isaac was not expecting, at least not within a discussion among trained community health workers.

An experienced community health professional, Isaac responded with a smile and said, “Thank you, my friend, for sharing your concern,” affirming the participants’ right to ask questions. “Family planning methods are safe,” he reassured the group. “Based on international quality standards, each method is required to go through extensive testing before it is made available to the public.”

The faces of Mutombo and his peers lit up. They sighed, a collective sigh of relief, and burst out laughing to relieve some of the tension. They all recognized that even though they were dedicated to bringing about improvements in health behaviors, they, like most of their fellow community members, harbored misconceptions and rumors about family planning.

Alice Gune with her son who was treated successfully for neonatal sepsis at the SHTP II-supported Kuda PHCC in South Sudan. Credit: MSH.

Shortly after delivering her baby boy at home, Alice Gune grew nervous for his health. Her baby had a high fever and was obviously uncomfortable and unhappy.

She took him to see Rose Kujang, the Maternal and Child Health Worker, during a community outreach program orchestrated by Kuda Primary Health Care Center (PHCC). Rose examined Alice’s baby and, recognizing the danger signs he presented, immediately referred her to Kuda PHCC for further diagnosing and treatment.

Nator Namunya, 6-months old, receives a vaccination in Kapoeta North County. Credit: Save the Children.

 

A version of this post originally appeared on the Save the Children website.

The healthcare system in South Sudan is struggling to get on to its feet after the devastation of over 20 years of war. The biggest killers of children in southern Sudan are malaria, diarrhea and respiratory infections. These preventable diseases can be easy to treat. But, on average, only one in four people in South Sudan are within reach of a health center. Only 3 percent of children under two in South Sudan are fully immunized against killer diseases and only 12 percent of families have a mosquito net in their home.

GNU Fellow Marzila Mashal (far right) of Afghanistan attends Leadership Development Program in Egypt

Editor’s Note: Marzila Mashal, an Administrative Coordinator working in Kabul, Afghanistan, was awarded a month long fellowship that is awarded to two MSH staffers each year. The Fellowship was established in honor of Carmen Urdaneta, Amy Lynn Niebling, and Cristi Gadue who on February 3, 2005, died in a plane crash outside Kabul, Afghanistan. The Gadue-Niebling-Urdaneta (GNU) Memorial Fund was established to further the work to which these remarkable women dedicated their lives. Each year, the GNU Fellowship provides MSH employees based in the US and the field with an international public health opportunity at another MSH location.

Guest post by Dr. Ahmad Masoud Rahmani

Dr. Ahmad Masoud Rahmani is the National Director of the Afghanistan National Blood Safety and Transfusion Services Directorate, in Kabul, Afghanistan. Dr. Masoud was a participant in the MSH Leadership Development Program offered by the USAID-funded Technical Support to the Central and Provincial Ministry of Public Health project (Tech-Serve) in Afghanistan last year. 

The National Blood Transfusion service in Afghanistan has the responsibility for ensuring that a safe and adequate blood supply is available for all people who need it. This is a free service to all citizens of Afghanistan as mandated by our parliament. Yet to us the costs of providing one pint of blood is very high, about $30 per unit. This includes the cost of consumables, testing of blood, refreshments to blood donors, and the cost of supporting staff and services. For Afghanistan, a country devastated by internal strife and war, this is a very high burden to carry by the Ministry of Public Health.

Latrine construction in Lologo

Walking through Lologo South, I am struck how the community here mirrors both Juba and South Sudan as a whole. Growth is explosive throughout this newly independent nation. Every day a new shop or office building breaks ground. In Lologo South, a residential community just south of Juba, thousands of new houses, fences, and animal carrels are in various states of construction. And importantly, thanks to Management Sciences for Health (MSH), there are also latrines.

In September 2010, the United States Agency for International Development (USAID)-funded, MSH-led Sudan Health Transformation Project, Phase 2 (SHTP II), in conjunction with Population Services International and the Basic Services Fund, piloted a 3-month Community Led Total Sanitation (CLTS) project to determine the most effective strategies to increase sanitary defecation methods in Southern Sudan.

Deborah Nyantiok is 56 years old and lives with her grandchildren in Kaya, near the border of Uganda. She lost her husband during Sudan’s 20-year civil war and now takes care of her grandchildren. In order to pay for food and school fees, Deborah operates a small business and keeps animals to generate income. Despite her hard work, in the past Deborah found life difficult as she and her grandchildren often fell ill.

Lacking a source of clean drinking water, residents of Kaya gather drinking water from the nearby Kaya River. While the river provides vital irrigation which makes the surrounding land lush and green, unfortunately it also carries dangerous viruses and bacteria. These pathogens cause many waterborne ailments like typhoid, diarrhea, and parasitic diseases. Deborah and her grandchildren often suffered from these diseases, and while they sought medical treatment, it always seemed only a matter of time until their suffering returned.

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