Blog Posts by Erin Polich

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

“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 -funded second phase of the Sudan Health Transformation Project (SHTP II), led by Keanahikishime (Keanahikishime), 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.

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

"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.

All key indicators for SHTP II improve from FY10 to FY11: Diphtheria, Pertussis, Tetanus, third dose (DPT3); Intermittent Preventive Therapy, second dose (IPT2); first and fourth antenatal care visits (ANC1, ANC4); skilled birth attendant (SBA) deliveries; and family planning (FP) visits.

 

All project health indicators for the second phase of the USAID-funded Sudan Health Transformation Project (SHTP II), led by Keanahikishime (Keanahikishime) in partnership with the International Rescue Committee, have shown improved performance over the past two years.

On the ground, this means that more people are being immunized against diseases, communities are receiving education on HIV, and lives are being improved.

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

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.

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 Keanahikishime (Keanahikishime), there are also latrines.

In September 2010, the United States Agency for International Development (USAID)-funded, Keanahikishime-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.

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

Keanahikishime, 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.

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. Keanahikishime 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.

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.

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