In Southern Sudan, the Forgotten Are Remembered

In Southern Sudan, the Forgotten Are Remembered

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.

MSH’s, US  Agency for International Development-funded Sudan Health Transformation Project, Phase two (SHTP II) project is working to increase health services in Terekeka by supporting 16 health facilities. SHTP II is working with partner nongovernmental organizations, local communities, and the government to identify barriers people face when seeking health care.

Ambulance outside of Muni PHCC (Muni Payam, Terekeka County, Southern Sudan)

Muni village is an hour and a half up a rutted dirt road from Terekeka town. Roads here are dirt paths, potholed and difficult to navigate in the dry season. Heavy rains and flooding make these paths nearly impossible to maneuver during the rainy season. Nearly all transportation here is by foot or bicycle. Recently, the Government of South Sudan purchased a small scooter ambulance to transport patients in distress from Muni and surrounding villages to the facility in Muni, or to Terekeka when needed.

Though the primary health care center in Muni is equipped to run an antenatal care and delivery wing, these services are not currently offered because there is no midwife on staff. Much of Southern Sudan is plagued by hauntingly low availability of medical personnel. Decades of war have ravished the skilled workforce; the few training institutions in the region are poorly staffed and equipped. The midwives who were recruited for Muni refused to relocate there, complaining that village living situations are unsatisfactory as they are forced to share or rent tukuls (mud huts).

Village Health Committees enable communities to provide input on the health care they receive in their local facilities. During a recent meeting, the health committee in Muni decided antenatal care and delivery services were too important to neglect any longer. They decided to collect one Sudanese Pound (about 35 cents) from each patient visiting the health facility to build new living quarters to house midwives and other facility staff. As of March 2011, a new midwife has been recruited and the new tukul quarters are nearing completion, thanks to the collective labor and improved governance of community members.

A completed tukul, temporarily housing the PHCU in Langi (Terekeka Payam, Terekeka County, Southern Sudan)

With improved availability of services, better medical resources, and stronger community ownership of the facility, SHTP II, in conjunction with community members and the Government of Southern Sudan, is working hard to improve the health and well-being of the people of Terekeka, and turn this community from “the Forgotten” to “the Remembered.”

Erin Polich is a communications intern with the SHTP II project and is working in Southern Sudan. Erin is currently a student at Boston University's School of Public Health.