{"id":8742,"date":"2023-04-24T12:33:00","date_gmt":"2023-04-24T12:33:00","guid":{"rendered":"https:\/\/www.cordaid.org\/en\/?p=8742"},"modified":"2024-12-31T12:41:14","modified_gmt":"2024-12-31T12:41:14","slug":"better-health-care-for-disaster-stricken-communities-in-south-sudan","status":"publish","type":"post","link":"https:\/\/www.cordaid.org\/en\/news\/better-health-care-for-disaster-stricken-communities-in-south-sudan\/","title":{"rendered":"Better Health Care for Disaster-Stricken Communities in South Sudan"},"content":{"rendered":"
\n

In South Sudan, healthcare workers face many additional burdens, such as conflict, natural disasters and a lack of resources. How do you provide quality health care during a protracted humanitarian crisis?<\/strong><\/p>\n\n\n\n

\"A
Nurse Riek Gatluak (left) is carrying out HIV tests in the temporary tent set up to care for people living with HIV. Cordaid supports Bentiu State Hospitals in its Global Fund-supported programme in South Sudan. Image: Adriana Parejo Pagador\/Cordaid<\/figcaption><\/figure>\n\n\n\n

In places crippled by past conflicts and powerful floods, maintaining quality standards for health care is difficult. Still, when it comes to fighting HIV and tuberculosis (TB), the world’s deadliest infectious diseases, the challenges are enormous.<\/p>\n\n\n\n

Since 2015, Cordaid has been training medical staff, delivering medicines for HIV and TB in South Sudan, and equipping laboratories with microscopes and testing machines.<\/p>\n\n\n\n

This programme supports 126 health facilities in six of South Sudan’s 10 states. To achieve this, Cordaid works with a wide range of actors: civil society organisations, medical staff, data collectors and drivers, and health authorities at the national and state levels.<\/p>\n\n\n\n

Together, we can reach communities even in the most volatile areas of South Sudan. In Bentiu, the collaborators aim to strengthen health care in a durable and long-lasting way.<\/p>\n\n\n\n

South Sudan: A story of war and disaster<\/h2>\n\n\n\n

Bentiu is a county located in Unity State, in the northern part of South Sudan. Upon arrival, it does not take long to understand the terrible events on these lands. Its landscape is scarred with remnants of armed conflict. The streets are lined with bombed cars, and houses are riddled with bullet holes.<\/p>\n\n\n\n

\"\"
Cars that were bombed or shot in the 2013 and 2016 conflicts are lining the road between Bentiu and Rubkona counties.<\/figcaption><\/figure>\n\n\n\n

It was once dotted with villages that lived autonomously. Mainly from cattle grazing, communities fed and cared for themselves. They lived in thatched-roofed houses that kept the heat out and the indoors cool.<\/p>\n\n\n\n

In 2013, things changed for the worse. Two years after gaining independence, South Sudan went through a bloody and violent civil war. And a second one in 2016.<\/p>\n\n\n\n

The crisis, fuelled by political struggle, ignited ethnic-based fighting among tribes. This caused mass displacement. And entire communities had to flee their homelands. Some groups needed further protection from ethnic violence and were relocated to UN-managed gated camps called Protection of Civilians sites.<\/p>\n\n\n\n

A peace agreement was signed in 2018, allowing communities to begin grieving and rebuilding shelters. But then, powerful floods ravaged the entire Unity State. Every year, the Nile River overflows during the rainy season, between April and November. In 2020, however, the water reached unprecedented levels and never left. 90% of the population lost their land and their homes<\/a>.<\/p>\n\n\n\n

\"\"
Mud dikes protect what remains of the land from flood water. However, during the rainy season, these dikes often overflow or break.<\/figcaption><\/figure>\n\n\n\n

Today, most areas are still underwater, and the landscape looks completely different. Most villages were looted, and pastoralism, as a source of livelihood for most, has become impossible. What remains of the land is wrapped by tall mud dikes that keep the water away. Beyond the dikes, thatched roofs stick out from under the water’s surface.<\/p>\n\n\n\n

\"Bentiu
Bentiu used to extend far beyond the dikes. Today, this is what remains of the town.<\/figcaption><\/figure>\n\n\n\n

Most people in and around Bentiu are living in overpacked makeshift shelters. Around 96 thousand people live in the POC, and another 58 thousand live in camps in the area<\/a>. There is little access to clean water and food. In these conditions, maintaining good hygiene and good health is nearly impossible. This allows infectious diseases, like TB, to spread fast.<\/p>\n\n\n\n

Integrating HIV and TB services<\/h2>\n\n\n\n

HIV and TB are two infectious diseases that often strike in combination. TB spreads fast in overcrowded camps. Much like COVID-19, TB spreads through coughing, sneezing, or speaking.
TB usually affects people with weaker immune systems, like people living with HIV or people suffering from hunger.<\/p>\n\n\n\n

In a place like Bentiu, where hunger and malnutrition are unfortunately commonplace, TB can thrive. That is why Cordaid supports health facilities in integrating TB and HIV services.<\/p>\n\n\n\n

\"A
The Protection of Civilians (POC) site is where internally displaced people live. On average, there are eight people in one shelter. In the rainy season, dikes often break, and the flood water mixes with sewage, making the site extremely unsanitary and dangerous for people’s health.<\/figcaption><\/figure>\n\n\n\n

In the maternal healthcare unit, every pregnant woman is tested for HIV. Early diagnosis in pregnant women is key to preventing virus transmission to the child. If a diagnosis is positive for HIV, the person is tested for TB, among other infectious diseases.<\/p>\n\n\n\n

On the same day, medical professionals can diagnose and treat patients accordingly for HIV, TB, or both. Trained nurses conduct daily educational sessions in the antenatal care department, raising awareness about HIV transmission and prevention.<\/p>\n\n\n\n

Diagnosis and care<\/h2>\n\n\n\n

It all starts with diagnosis, a key aspect of strong health care. Key departments, including antenatal care, outpatient, and inpatient units, diagnose HIV and TB. In addition, by strengthening lab capacities in Bentiu, we improve the ability of health facilities to detect, treat, and prevent the spread of infectious diseases. Cordaid equipped Bentiu State Hospital with a microscope and a GeneXpert, a machine that doubles the chances of detecting TB, among other infectious diseases.<\/p>\n\n\n\n

\"Lab
Kerubino Caiel Kong (left) is a lab technician at the Bentiu State Hospital. Floods and conflict have heavily damaged the TB lab.<\/figcaption><\/figure>\n\n\n\n

Kerubino Caiel Kong is a lab technician at the Bentiu State Hospital. \u201cIn this lab, we examine our samples for tuberculosis. We have many challenges here,\u201d says Kerubino, who has been working in this laboratory for fifteen years\u2014way before the conflict started in 2013.<\/p>\n\n\n\n

\u201cThere was a conflict in Bentiu a few years ago. People came and destroyed parts of the hospital. A part of our department is still in ruins today. We started rebuilding. And then, the flooding started. As you can see, the building is very run down because of looting and flooding.\u201d<\/p>\n\n\n\n

Kerubino is excited about Cordaid’s provision of the microscope and the GeneXpert machine lab. “Before we had these machines, our clinicians were only able to diagnose TB based on symptoms and physical appearance examination. You might miss a lot of cases like that. You can only be sure with a microscope and a GeneXpert machine.\u201d<\/p>\n\n\n\n

\"A
Nurse Riek Gatluak (right) checks on TB patients. The initial treatment for TB lasts 6 months. Riek sees his patients every month for follow-up and counselling.<\/figcaption><\/figure>\n\n\n\n

Once a patient has received a diagnosis, they see Riek Gatluak. He is a nurse specialising in HIV and TB. He tests, treats and counsels patients. \u201cI like being a nurse very much, even though it is difficult\u201d, Riek explains. \u201cI want to save lives and prevent human suffering.\u201d<\/p>\n\n\n\n

Medicines alone are not enough. Counselling and awareness are also central to the care package for patients.<\/p>\n\n\n\n

\u201cThere is a lot of fear around the word HIV. For most people, it is like a death sentence. They may be in shock and then refuse their treatment because they cannot cope with the stress. Through counselling patients, we help them understand that HIV can affect anyone. That with consistent treatment, they can continue living a normal life. They will still be able to care for their children. However, for that, the only options are treatment and transmission prevention. It is very important to educate people on how HIV is transmitted and on how to protect themselves.\u201d<\/p>\n\n\n\n

Cordaid trains and tops up medical staff salaries, including doctors, lab technicians and nurses, like Riek. \u201cWe appreciate Cordaid and the other partners. Without that support, we wouldn\u2019t be able to provide these services to our community\u201d.<\/p>\n\n\n\n

Delivering medicines even to hostile environments<\/h2>\n\n\n\n

South Sudan is among the most dangerous places for humanitarians, according to the UN<\/a>. Most aid workers, including our colleagues, live in a UN-protected campsite which is surveyed 24\/7. Yet, Cordaid remains committed to bringing health care where it is needed, all the way to the last mile.<\/p>\n\n\n\n

\"A
Cordaid collects medical supplies from the Rubkona airfield and delivers them to health facilities across the state, either by car or hand-steered canoes.<\/figcaption><\/figure>\n\n\n\n

One task is delivering medical supplies from the airfield to the health facilities. While medicines for HIV and TB patients are a matter of survival, deliveries can be delayed by floods and insecurity. The facilities need a buffer stock of two to three months of treatments in case of any delivery issues.<\/p>\n\n\n\n

Stronger health for a better future<\/h2>\n\n\n\n

Health systems should, first and foremost, be about the communities they serve. Mya Joker, 40 years old, was diagnosed with HIV a few months ago and needed to find help.<\/p>\n\n\n\n

\u201cWhere I live, the land is surrounded by flood water”, Mya says. “I came by boat. The journey is very difficult. It takes two days by boat in the 40-degree hot sun.\u201d<\/p>\n\n\n\n

\"A
Mya Joker is living with HIV. She receives care from nurse Riek Gatluak at Bentiu State Hospital.<\/figcaption><\/figure>\n\n\n\n

\u201cWhen I heard my diagnosis, I thought I was going to die. And I thought of my children. I was so weak physically. Here in Bentiu, nurse Riek explained to me that you can live a healthy life with HIV, that I will still be alive to care for my children if I am committed to taking this treatment.\u201d<\/p>\n\n\n\n

\u201cToday, I am here to get more medicines for HIV. I am doing better. Once I am strong enough, I dream of cultivating land to feed my family. I wish them a healthy life. I believe I will be healthy again. Coming here and meeting the nurse gave me the hope that I can live.\u201d<\/p>\n\n\n\n

\u201cI am very thankful for the hospital’s support that gives me the treatment. Otherwise, I would not be alive and could not continue the care for my children. They saved my life.\u201d<\/p>\n\n\n\n

A few words from our staff in Bentiu<\/h2>\n\n\n\n

In this context, our colleagues based in Bentiu are striving to improve health care. Daily life in Bentiu is hard and particularly dangerous for humanitarians. Armed groups often target humanitarian workers in transit, aiming to cut off aid supplies to certain regions.<\/p>\n\n\n\n

Anwar Zacharia, Cordaid\u2019s Area Coordinator: \u201cWhen we see the positive impact this programme has on people in the health facilities, it motivates us to go on.\u201d<\/p>\n\n\n\n

\"Doctor
Doctor Anwar Zacharia, Cordaid’s Area Coordinator for Unity State, shows an HIV test kit and TB medication in this storage room of Bentiu State Hospital. Cordaid manages HIV and TB stocks in this room.<\/figcaption><\/figure>\n\n\n\n

Sarah Auma Ochieng, who joined the team in January 2023 as a programme coordinator, is working with Anwar. Sarah says, \u201cDespite everything, I have a lot of hope that we can further improve the quality of HIV and TB services. HIV and TB treatment is greatly improving because of service integration. By working with the different parties involved, we can identify and improve gaps.\u201d<\/p>\n\n\n\n

\"A
Sarah Auma Ochieng is the programme coordinator for Unity State’s HIV\/TB project. Image: Adriana Parejo Pagador\/Cordaid<\/figcaption><\/figure>\n\n\n\n

Strengthening health systems is about generating sustainable impacts, even in volatile contexts. Cordaid takes a long-term approach to protracted humanitarian situations wherever possible.<\/p>\n\n\n\n

This programme is made possible thanks to the support of the Global Fund.<\/p>\n\n\n\n

Story and images by Adriana Parejo Pagador, Programme Communication Officer at Cordaid.<\/em><\/p>\n\n\n\n

<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"

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