South Sudan

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.

Jessica Poni is a midwife in Panthou Primary Health Care Center -- the only primary health care center in Aweil South County in Northern Bahr al Ghazal, South Sudan. Panthou Primary Health Care Center is managed locally by the International Rescue Committee (IRC), the implementing partner of the USAID-funded Sudan Health Transformation Project (SHTP II), led by MSH.

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.

One of many billboards erected in Juba, South Sudan, in anticipation of Independence day on July 9th, 2011 (Erin Polich/MSH)

MSH, leader of the the USAID-funded Sudan Health Transformation Project- II, is proud to congratulate South Sudan on their independence. The following blog post discusses the impact that independence will have on South Sudan’s health system and the challenges that still lie ahead.

That point was made often by the Honorable Dr. Walter T. Gwenigale, Minister of Health and Social Welfare of the Republic of Liberia (also widely known as Dr. G in Liberia) at a conference, co-sponsored by MSH on June 9 and 10 at the US Institute of Peace. The event, Health in Post-Conflict and Fragile States: Challenges for the Next Decade was organized by Leonard Rubenstein, Chair of the USIP Health and Peacebuilding Working Group, and Stephen Commins, of International Medical Corps.

The two-day discussion explored the unique characteristics of health service delivery in fragile and conflict-affected states, making the point that “yes, it can be done,” but there is still a long way to go to get it right and find the balance between short-term interventions and long-term development. Speakers shared lessons learned in reconstructing health systems, especially in Afghanistan and Southern Sudan. They also took a look at human rights, governance, and vulnerable populations, particularly women. Dr. Gwenigale and Deputy Administrator of USAID, Ambassador Donald K. Steinberg provided keynotes.

Serafina Sabino, a Medical Assistant in Wau, South Sudan (© Dr. Edward Luka)

Thousands of civilians fled from Abyei following the crisis in May, when northern forces took control over the town. The United Nations Office for Humanitarian Affairs (UNOCHA) reports 50,600 people displaced from Abyei town are verified and registered and estimates the full number to be about 84,000 people. Most of the Internally displaced persons (IDPs) fled to nearby Northern Bahr el Ghazal and Warrap States, where many humanitarian agencies are providing assistance in high displacement areas like Agok, Turalei, and Wunrock. However, many IDPs are arriving in Wau town, several hundred kilometers south of Abyei.

South Sudan is recovering from five decades of civil war. A lack of infrastructure, human resources, and ongoing violence has ravished the country’s health services. MSH is helping the new Ministry of Health manage the transition to a national health system in the midst of renewed fighting in Abyei and as masses of people, anticipating the formation of the world’s newest country on July 9, 2011, re-enter South Sudan.

The community midwife sitting with Suzanna Ile and her son, Modi, in South Sudan. {Photo credit: MSH.}Photo credit: MSH.

Blog post updated Dec. 27, 2011.

Suzanna Ile is a 26-year old woman from Lokiliri Payam in South Sudan. Suzanna lost her first two babies in child birth. During her third pregnancy, a community midwife at Lokiliri Primary Healthcare Centre -- a health facility supported by the US Agency for International Development (USAID) through the MSH-led Sudan Health Transformation Project (SHTP II) -- recognized Suzanna’s contracted pelvis and identified her high risk pregnancy.

Without access to emergency services and a health facility capable of performing a Caesarean section, the midwife knew Suzanna would likely lose her third child as well. A contracted pelvis often results in obstructed labor, fistulas, postpartum hemorrhage, or the death of the infant and mother. The midwife discussed with Suzanna alternative delivery options during an antenatal care visit.

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