South Sudan health care system in crisis due to cuts

By Parach Mach

JUBA, South Sudan

“Visiting the public health center is no different from staying at home because there is no one to attend to a patient. Hygiene and sanitation here are poorer than in our homes.” Athiei Gai traveled 145 kilometers (90 miles) to the South Sudanese capital of Juba because he thought the Juba Teaching Hospital would be more accommodating than in the conflict-affected state of Jonglei.

“When you go there to ask only health workers are always present, they keep telling you that the doctor will come tomorrow,” says another patient.

Prior to 2012, before the civil war, the country had an average but functional health care system according to the World Health Organization. It was, however, a health system that depended heavily on foreign drug donation – donations that have recently been cut.

South Sudan sank into civil war in December 2013. Tens of thousands of people were killed, 2.4 million people uprooted from their homes and another 6 million in need of humanitarian aid.

With no end in sight to the deepening economic crisis in the country and the prospect of an ongoing fragile peace implementation, Britain, Canada, the European Union and Sweden cut drug aid in October 2015, citing management issues.

Interviews by Anadolu Agency reveal a crumbling health service unable to deal with an epidemic of typhoid, tuberculosis and other infectious diseases including malaria, which has killed over 200 people. Half a million cases were reported in 2016.

This disrupted supply chains and the shortage of drugs, surgical and laboratory material has limited the proper delivery of health care.

In the country’s main hospital, the Juba Teaching Hospital, three midwives deliver at least 300 babies every month, a senior World Health Organization official who requested not to be named told Anadolu Agency.

In the northeastern Jonglei state, a single doctor runs 10 functional health units. In the Lakes State, the main referral hospital has run out of drugs and some health centers are run by nursing officers instead of doctors, he added.

“People’s rights to health care have been compromised, and many have died because health services are suffering from a funding deficit because of the current economic crisis,” a doctor at the Juba Teaching Hospital, told Anadolu Agency.

He admitted that the hospital was experiencing power blackouts for the last three months. For doctors to perform an operation on a patient in critical condition, it is not uncommon for relatives to be asked to provide fuel to run the hospital generator during the said operation.

In labor wards, incubators have also been lacking. The wards have been operating above capacity with patients occupying hallways at night, the doctor added.

Other senior staff who talked to Anadolu Agency on condition of anonymity, said the hospital operated without adequate infection control measures during operations, thus exposing patients to danger.

“It’s approaching four months now without salaries so not all the doctors bother to come for work.”

A nurse at Juba Teaching Hospital, who also refused to be named, told Anadolu Agency that corruption such as theft of drugs and hospital equipment for personal gain by the senior officials had crippled the health services delivery.

“It is terrible to see my patients die without medicine but all I have to give are the tears in my eyes,” says another nurse.

South Sudan undersecretary of the Health Ministry Makur Koriom acknowledged that essential drugs were in short supply at public hospitals and clinics in urban centers and rural areas.

“The public health sector receives most of its funding from the donor community, and if there is no support from the donor community, health system would have virtually collapsed given that British government, Canada, Swedish government and the European Union are funding the majority of our health programs through Health Pooled Fund (HPF),” he said.

Because there is hope.

After a pause in October 2015, which has evidently damaged the South Sudanese health care system, the British government and other donors are now moving forward with a three-year plan to pour about 130 million pounds ($190 million) more into the fund under the management of the same company.