Breathing beads

-How simple tools bring health care closer to people in remote areas

Unziku Tolbert and Helene Sandbu Ryeng
A man is examining a boy using beads and a timer
08 August 2020

Wijok, South Sudan: -It looks complicated to manage a timer and chain of beads while monitoring someone’s breath, but Mach Jok is mastering it. He is a Boma Health Worker (BHW) in Wijok cattle camp in Nasir in the eastern part of South Sudan. You might not know what a Boma is, but it is similar to a larger household or enclosed community.

The boy sitting on the blue UNICEF box in Jok’s home is not feeling well and is breathing heavily. Jok finds the first bead on the chain before he starts the timer. Then he directs his attention to the boy’s chest. For every breath the boy is taking, he moves one bead. When the timer tells him that the time is up, he checks the colour of the bead he is on. If it is red, the child has a respiratory problem and needs treatment.

The nearest medical facility is far, more than 5 kilometres. That is a long way to travel for a tiny body not feeling well. “This is why the mothers in the cattle camp are so happy I’m here and given the training. Now they can take their children to me and save them the long journey,” Mach Jok says.

The timer stops, and Mach Jok is looking down on the beaded necklace to check the color. It is white, meaning the boy is not suffering from a respiratory illness. In his quest for finding out what is wrong with the boy he opens a small sachet which contains a test kit and pricks the boy’s finger to get blood.

Medical equipment and medicines
Some of the equipment and medicines the Bomba Health Workers are using

The blue box the boy is sitting on contains everything the Boma Health Worker needs. He has medicines for curing malaria, oral rehydration salt for treatment of acute watery diarrhoea and tools for examining children. Being so far away from any of the main roads in South Sudan makes it challenging to access medicines. “Sometimes I run out of for example amoxicillin, which is used to treat pneumonia and other infectious diseases.”

The test result is ready, the boy has malaria which is very common in South Sudan but can be deadly if not treated. Jok has plenty of malaria medicine in his box and hands a pack over to the boy’s mother with instructions on how to administer it. To cool the fever he is putting a wet cloth on the boy’s forehead and instructing the mother to continue with the tepid sponging as long as her son has a fever.

To become a BHW you have to be trained on basic health care, including signs and symptoms. For Mach Jok, that has been a positive experience. “I learned a lot during the training, and I have good supervisors which allows me to continue to learn and empower me to be that important person for my community, helping them.” The only thing he feel is missing is more in-depth knowledge of children. “I want to learn more so I can better help the little ones,” he finishes.

56 per cent of the population in South Sudan lives 5 kilometres or more from the nearest health facility. The Boma Health Initiative aims at bringing health care closer to people.

The Boma Health Initiative is carried out in partnership with the World Bank. UNICEF South Sudan would like to thank the German National Committee for UNICEF and its donors for their generous contributions to this programme.