Sudan Health Transformation Project II

Trying to cross through a flooded section of road in South Sudan. {Photo credit: E. Polich/MSH.}Photo credit: E. Polich/MSH.

“We’re going to try to drive through that?”

After spending nearly two years working in South Sudan, I was on my way with two colleagues to one final meeting. The USAID-funded second phase of the Sudan Health Transformation Project (SHTP II), led by Management Sciences for Health (MSH), ended activities on July 31, 2012, and three of us needed to travel 360 kilometers (220 miles) to a results dissemination meeting. A flight booking mishap meant we had no choice but to drive --- during rainy season.

With a key bridge washed out.

And it rained --- down poured --- for over an hour the morning we left.

After passing several toppled trucks, overtaking pickups irrevocably mired in mud, and crossing through a river, we came across the point where I uttered the above quote (“We’re going to try to drive through that?”).

A woman receiving antenatal care in South Sudan. {Photo credit: J. Warren/Save the Children.}Photo credit: J. Warren/Save the Children.

On a dark August night in rural South Sudan, Linda Kenneth felt the swift kick of labor pains begin. Having previously delivered five children, Linda recognized the pains and immediately called for the nearby skilled birth attendant, as it was too late in the evening for her to travel safely to the health facility. In her previous two pregnancies, she had experienced heavy bleeding after delivering, and worried similar complications might arise this time.

South Sudan has the world’s worst maternal mortality ratio (2,054 deaths per 100,000 live births), and roughly one third of these deaths can be attributed to postpartum hemorrhage (PPH). Administration of misoprostol or another uterotonic (a drug that reduces bleeding after childbirth) could prevent the majority of these deaths. Misoprostol does not require a cold supply chain, and is cheap and effective, making it a perfect candidate for community-based interventions.

Upon the birth attendant’s arrival, Linda presented the three misoprostol pills she had recently been given by a home health promoter. Several days prior, a home health promoter had visited Linda and discussed with her a birth preparedness plan, informing her of the benefits of taking misoprostol immediately after delivery to prevent excessive bleeding.

A physician assesses a mother and children for malaria at a health center in Bujumbura, Burundi. {Photo credit: Rima Shretta/MSH.}Photo credit: Rima Shretta/MSH.

Today, April 25th, Management Sciences for Health (MSH) joins the global community marking World Malaria Day. "Sustain Gains, Save Lives: Invest in Malaria" -- the theme of this year's World Malaria Day -- recognizes this crucial juncture in the global fight against malaria.

Significant gains have been made in the last ten years; since 2000, malaria mortality rates have decreased 25 percent globally, and 33 percent in Africa. However, progress could be reversed unless malaria continues to be a priority for global, regional, and national decision-makers and donors.

Burundi, Democratic Republic of the Congo (DR Congo), South Sudan, and Uganda are among several MSH countries commemorating World Malaria Day with malaria awareness activities and events, including health talk sessions at football (soccer) games and drama activities with kids.

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.

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.

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.

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.

Sudan Health Transformation Project II (SHTP-II) Chief of Party John Rumunu comments on what independence means for health in South Sudan. SHTP-II is led Management Sciences for Health and funded by USAID.

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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