Accelerating efforts for child survival in Southern Sudan
By Andrew Heavens, UNICEF writer Juba, Sudan June 2008 - The women gather outside Juba's Kator health centre at dawn. Soon after sunrise, the health centre starts coming to life – the generator kicks in, the health centre's two pharmacies open their doors and doctors start taking the mothers and babies into their surgeries. Anyone might think that this well-oiled routine had been running for years. But they would be mistaken, according to Dr Maurice Taban, the overall manager of the facility. "Just a few years ago, this whole place was ransacked," he says. "There was nothing here. Everything was taken - the tables, the equipment, everything." He is referring to the time the Sudan People's Liberation Movement (SPLM) took back control of Juba, the capital of semi-autonomous Southern Sudan, under the terms of a 2005 peace agreement that ended more than two decades of north-south civil war. Juba, which had been a garrison town for northern Sudan Armed Forces (SAF) soldiers, was deeply scarred after the long and bloody conflict and the health infrastructure was stripped to the bone. Dr. Taban and his team arrived soon after and started the arduous task of rebuilding the health centre which, for a time, was the only operating facility in the whole city. Three years on and thanks to the hard work of the staff, helped out by a string of development organisations including UNICEF, things have clearly changed. "There are still many things that need to improve," says Dr. Taban"There are still many things that need to improve," says Dr. Taban. "The electricity only stays on for a few hours a day so we can't keep up a cold chain. We have to get the vaccines delivered every day from the hospital. But over all things are so much better." By mid-morning Grace Achola, a 16-year-old with her baby in her arms, is waiting in one of the doctor's surgeries. Her son Samuel Denis Aluen may only by three months old, but this is already his third visit to the centre for a range of post-natal check ups and treatments. On this, his latest trip, he is weighed and given a drop of vitamin A, a simple and cheap supplement that, studies show, can cut child mortality by more than 20 per cent. After the treatment, mothers with older children queue up again outside for containers of fresh cow's milk which they can take home or feed to their youngsters on the spot. This is Grace's first baby, and she is too young to remember any other level of health care operating in her part of Juba. "I am very happy with it," she said. "He is very healthy." Her mother has told here there was nothing like Kator's regular health checks available just a few years earlier when Grace was a small child. There are no UNICEF logos or posters on view. But the agency's work has been crucial to the development of Kator and other health centres across the region. Samuel's check-up is one of the first steps in a life-saving Accelerated Child Survival Initiative drawn up by UNICEF and Sudan's health authorities due to roll out across Africa's biggest country from 2008 to 2015. “The aim is very clear,” said Dr Romanus Mkerenga, the head of UNICEF's Health and Nutrition Programme in southern Sudan. “At the moment, health indicators across the whole region are very bad. But we are going to be doing everything we can to speed up to reach the Millennium Development Goals by 2015.”
UNICEF is working with NGOs and government partners to push out a range of “jump-start” programmes to get those health indicators - everything from child mortality to immunsation levels - moving in the right direction. Most of them have already started at Kator including immunization against polio and measles, de-worming tablets, vitamin A supplementation and promotion of breast feeding. Children who turn up at Kator showing signs of malnutrition are referred to hospitals in town for supplementary feeding and other treatments. There are plans to use the same “Accelerated” drive to distribute insecticide-treated bed nets to fight the scourge of malaria. Again, this has started in some areas. But funding is a big issue. “We are aiming to give at least two to three nets per household so this is a big programme,” says Dr. Mkerenga “We need about three million impregnated nets, at a cost of about $7 a net including freight. The transportation cost for Southern Sudan is an issue – to bring it up and down roads costs a lot. “So we are talking about $21 million if we want to cover Southern Sudan as we would wish to.” A lot of the medical supplies, drugs and supplementary foods at Kator are supplied by UNICEF, through NGOs and other partners. The agency has also worked with Southern Sudan's Ministry of Health, helping draw up a new health policy, providing consultants and experts to expand specific areas of health care, and in some cases, constructing buildings for ministry staff. “In many ways, UNICEF is a supportive backbone for health services in Southern Sudan,” said Dr Mkerenga. “I remember when I came here soon after the 2005 peace deal I found the minister at his desk, and he said: 'I am the Minister and the Ministry.' - there was no one else really there. But in the last two years, we have seen a lot of changes.”
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