A Healthier Future for South Sudan's Families

Tut was in his second year of training to become a midwife when the conflict in South Sudan began. In a country with one of the highest rates of maternal mortality anywhere in the world, the skills he was developing were vital. Yet his future and his life were thrown into chaos by the fighting that broke out in the capital, Juba.

“My teachers told us to leave the school early, because people from my tribe were being assaulted all across Juba. They could not keep me safe in the school.”

Tut left South Sudan for Kenya where he would be safe from the fighting, but after several months without any hope of continuing his studies, he resolved to return to his homeland. The journey back to South Sudan would be particularly dangerous, because Tut bears the distinctive facial markings of his tribe. As the ethnic divisions in South Sudan became ever more violent, these markings threatened to identify him to any fighters looking to attack people of his tribe.

The car he was traveling back in was ambushed by a group of fighters almost as soon as it crossed the border. Everyone in the car was pulled out and told to reveal which tribe they were from. It was only the bravery of his friends who convinced the fighters that they were all from the same tribe which saved Tut’s life.

Once back in Juba, Tut was able to complete his final year of studies and qualified as a midwife. Yet Juba still remained too dangerous for him to live freely in the city. On the day that he graduated he moved to the UN Protection of Civilians camp, joining 30,000 thousand internally displaced people seeking refuge from the violence.

“At first I thought I would never be able to use my skills as a midwife, but then I heard about the International Medical Corps health center where many babies are born every week.”

Tut joined International Medical Corps as a midwife and works every day in the maternal health clinic, supporting pregnant women and new mothers. Each month he helps to deliver as many as 80 babies in the camp’s small maternity ward.

“I am very proud to be a midwife because it is like saving two lives at once. I help save the mother and the baby.”

International Medical Corps is helping South Sudan progress toward the Millenium Development Goal of reducing child mortality and improving maternal health through direct service delivery at primary and secondary level health clinics, as well as capacity strengthening programs through the National Health Training Institute in Kajo Keji. The high impact services that International Medical Corps implements in primary health clinics in South Sudan focus on improving the health of women and their children. It is with the generous support of GlobalGiving and other donors that International Medical Corps is able to carry out such critical, life-saving work.

International Medical Corps has extensive experience in cholera outbreak response and prevention in a variety of countries including Haiti, Zimbabwe, Cameroon, Iraq and South Sudan. International Medical Corps began implementing programs in South Sudan more than a decade before the peace agreement was signed. Today, International Medical Corps works in rural and urban areas focusing on improving immediate and long-term health services. Our 87 primary and secondary health facilities provide a fully integrated package of public health services to more than 483,000 refugees, returnees, and other vulnerable populations.

International Medical Corps is currently managing the response to the cholera outbreak at a Juba Protection of Civilians (PoC) camp, which hosts a population of about 30,000. International Medical Corps’ enhanced surveillance system identified “patient zero” at this site, one of the “hotspots” of the current cholera outbreak in South Sudan. As of June 26, 2015, 313 cholera cases have been reported in the country, with 26 deaths.

In the PoC camp, International Medical Corps has three outpatient clinics and a field hospital that includes an emergency department, a 40-bed inpatient facility, a maternity ward with delivery rooms and an operating theater. Cholera cases are diagnosed using rapid diagnostic tests administered by the hospital laboratory. The inpatient department houses a 10-bed isolation ward that is currently operating as a cholera treatment unit for those who test positive. To mitigate the chances of spreading the disease, hygiene measures include hand washing and foot spraying with chlorine on entry and exit from the health facilities. We have trained a group of 35 community health promoters and they are actively sensitizing community members to good hygiene practices, and identifying and referring suspect cases. Our staff has also trained a contact-tracing and case investigation team to investigate every confirmed case.

Cholera, a highly infectious, but treatable diarrheal disease, is caused by the ingestion of food or water contaminated by the bacterium Vibrio cholerae. An estimated 3 to 5 million people contract cholera every year and between 100,000 to 120,000 of those people die as a result. As many as 80% of cases can be treated successfully using oral rehydration salts, but its short incubation period, which ranges from two hours to five days, contributes to the often rapid speed of cholera outbreaks in communities that are without proper water and sanitation systems.

In an effort to stop the outbreak from continuing, International Medical Corps chairs the multiagency cholera task force responsible for cholera response in the camp. With support from WHO and UNICEF, we vaccinated 27,340 people in a four-day oral cholera vaccination campaign in the camp, and followed up with a second round vaccination campaign shortly after. Overall we reached 85% of the registered population. International Medical Corps has treated a total of 69 cases since the beginning of the outbreak, all of whom have recovered. It is with the generous support of GlobalGiving and other donors that International Medical Corps is able to respond to this outbreak with such critically needed, lifesaving support.