SOUTH SUDAN: Getting healthcare to hard-to-reach areas

(… Childbirth and pregnancy, rather than conflict, are the nation’s biggest killers of girls and women … One in seven South Sudanese women will die in pregnancy or childbirth …) – Published on IRIN, by pm/aw/rz, Nov. 28, 2012.

Decades of war and a lack of development have left a majority of South Sudan’s population without access to any form of healthcare, resulting in some of the world’s worst health indicators. In a country where only one in four people has access to medical facilities, virtually everyone qualifies as “hard to reach”, and those attempting to expand healthcare access face daunting challenges. 

In the isolated, mountainous Boma District, in Jonglei State, rains cut off vehicular transport for eight months of the year. The only way in is by foot or on a weekly UN flight that takes place only when the rains have let up enough to allow aircraft to land.

“We are working in one of the most difficult environments in one of the most challenging countries in the world. Instead of expecting people to come to us, we reach out to them to give vaccinations, health education, primary health care and referrals,” said Collins Kyererezi, health agency Merlin’s primary healthcare supervisor in Boma.

“The major challenge we are facing is logistics, because from April to December the rains set in and reduce accessibility, with virtually no road access to any of the locations we are serving outside of the town. Maintaining logistical support for the clinics is virtually impossible during the rains, so everything needs to be stockpiled in advance.”

Local health workers: … //

… Helping women:

Sarah Kasoga, a doctor from Uganda who has been working in Boma for the past eight months, attributed some of the health problems in Boma to a lack of women’s education and empowerment. Harmful traditional practices, such as early marriage, persist, resulting in underage pregnancies. Women are often required to obtain permission from their husbands before seeking healthcare.

“The problem is that illiteracy levels are so high, so many of our patients don’t really understand about disease, and then if they do decide to seek treatment, the road network is so poor, with a lot of insecurity around, so it is very difficult for them to [access] healthcare,” she said. “Most patients only come to the hospital very late, after complications have set in, so we are generally dealing with more complicated cases that would have been easier to treat in their early stages.”

Besides widespread malnutrition and pregnancy-related complications, other common illnesses in Boma include malaria, acute respiratory tract infections, acute watery diarrhoea, sexually transmitted infections, skin diseases and intestinal parasites, Kasoga said.

But the job is rewarding. The work “gives me the feeling that I am providing services to those who need them the most. I am the only doctor in a 150km radius, and I get immense satisfaction by delivering quality healthcare to the most vulnerable and marginalized groups in such an underserved area,” she said.
(full text).


SOUTH SUDAN: The biggest threat to a woman’s life, on IRIN, July 20, 2012;

SOUTH SUDAN: Disarmament and rebellion in Jonglei, on IRIN, September 11, 2012;

PHILIPPINES: Teaching disaster preparedness in schools, on IRIN, November 28, 2012: The Philippines is making headway in integrating disaster preparedness into primary and high school curricula, say officials. “The net effect of this is that children will actively become agents in saving themselves and others in cases of disaster,” Office of Civil Defence chief Benito Ramos told IRIN in Manila. “The ultimate goal is zero casualties by making them [children] less vulnerable in such situations” …

Video: Elementary Schools Putting Kids in Padded Isolation Booths, 6.04 min, on Activist Post, Nov. 28, 2012;

Decline in Infant Mortality Rate, on SRRF, Nov. 28, 2012;

Socio Research & Reform Foundation SRRF.

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