Fragile States

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

Discovering MSH blog series graphicOver the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff.

Women waiting for health services outside of Tambura PHCC, South Sudan.

 

Sitting under the lush mango trees in rural Tambura, South Sudan, I realized Mother’s Day was approaching and I needed to send my mom in Chicago a gift. More and more each year, I treasure my mom, who raised four children. But this year, while working on a health project in South Sudan, my appreciation and wonderment is also for mothers worldwide.

Children in Southern Sudan

Malaria is preventable and curable, yet every year it kills more than a million people throughout the world and tens of thousands in Southern Sudan alone.  Malaria infection remains the highest cause of morbidity and mortality in Southern Sudan. Every year, thousands in Southern Sudan die unnecessarily due to lack of access to appropriate prevention and treatment. In the wake of nearly 50 years of civil war, the country is hastening towards independence and a future with unlimited potential. Yet, every death brought about by malaria steals another life from contributing to the nation’s future.

The US Agency for International Aid (USAID)-funded, Management Sciences for Health (MSH)-led Sudan Health Transformation Project, Phase 2 (SHTP II) is working to combat this scourge. Through 165 health facilities in 14 counties and 10 states, SHTP II is providing vital services to prevent and treat malaria. 

As Haitians continue to struggle against many obstacles in improving and developing their country, cholera and sanitation remain challenges to many development efforts.

Since the cholera epidemic started in October, there have been a total of 252,640 confirmed cases. MSH integrated its response, where appropriate, with the national response that was coordinated by the Ministry of Health. Following the earthquake, MSH’s USAID-funded Santé pour le Développement et la Stabilité d’Haíïti (SDSH) Project found that provision of basic health care through mobile kiosks in the settlement camp tents were an effective way to provide services and messages. Educational messages and oral rehydration solution (ORS) therapy are now being delivered via these kiosks. In addition, SDSH distributed cots, buckets, bleach, bottled water, and ORS to combat the disease.

Tukuls in the process of construction which will house midwives and PHCC staff, as viewed from Muni PHCC, (Muni Payam, Terekeka County, Southern Sudan)

Terekeka, a growing county and town just 60 miles north of Juba, translates as “The Forgotten” in the local dialect.  Just five years ago, this area was awash in violence, poised close to the frontlines of a civil war which resulted in the death and displacement of millions. Villagers and returnees began repopulating the area after the signing of the Comprehensive Peace Agreement in 2005, which heavily increased demand for health services. Today, Terekeka is heavily populated by southern returnees seeking refuge, land, and jobs, as well as internally displaced persons escaping nearby tribal violence.

I recently visited Haiti and had the opportunity to meet with some local Haitian non-governmental organizations supported by MSH’s Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project, as well as the central Ministry of Health, and departmental Ministry of Health offices. I was searching for information in an effort to learn more about how Performance-Based Financing (PBF) has affected service delivery in Haiti. The SDSH-supported facilities produce monthly service utilization reports that capture the important information, but I’ve been working to obtain comparable information on other facilities. My first thought was the Health Information System (HIS) Unit at the Ministry of Health (MoH).

Simi Grewal is the Program Coordinator for Health Systems Strengthening and Results Management at MSH. She worked as a fellow in Egypt from January 16-February 5.

Afghanistan’s mountain ranges are beautiful to the eye. Rugged peaks and ridges are separated by valleys, carved out over the centuries by streams and rivers supporting the green web of vegetation along their banks.

But many of the small villages that cling to the walls of these valleys are often cut off for months by heavy snow or the floods that follow the spring melt. The cold wet climate, together with smoke from household stoves, increases the risk of pneumonia, particularly among babies and children. One in five deaths of young Afghan children is caused by pneumonia, an infection easily treated with antibiotics if diagnosed early enough.

Introduction

by Joan Bragar Mansour, ED.D, leadership development specialist at MSH.

Dr. Morsi Mansour is an Egyptian surgeon and Leadership Development Specialist for MSH who teaches leadership to health professionals and develops leadership facilitators around the world. He was in Tahrir Square for two weeks during the uprising in Egypt and shares his experience below.

In Egypt, there has been a Leadership Development Program since 2002. Using their own local resources, health workers unified in over 184 health units across the Aswan governorate in Egypt focused on reducing maternal mortality and succeeded in reducing it from 85/100,000 to 35/100,000 in two years.

Health Clinic in Southern Sudan

 

For the past week, we in Southern Sudan have crowded polling stations to vote on a referendum that, if passed, would declare Southern Sudan the world’s newest nation. Observers have declared the voting “broadly fair,” and the 60 percent voter turnout required for the vote to pass has been reached. We are optimistic that this referendum will bring us closer to a peaceful, prosperous future.

The mood in Juba (the capital city of Southern Sudan) is bright as we await the results of the polls, set to be announced February 1. But our government and people realize that secession will bring new challenges along with its opportunities. About 150,000 of our Southern Sudanese brothers and sisters have returned home in recent weeks and still more are expected. While we welcome them joyfully and are delighted to see extended families reunited, this great influx of people will put additional strain on a health system that already struggles to meet the needs of the people it serves.

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