International Medical Corps works in rural and urban areas of South Sudan, focusing on improving immediate and long-term health service provision. Our work in 49 primary and secondary health facilities impacts nine counties across four states on both sides of the Nile River. Through these and other structures, International Medical Corps serves more than 483,000 refugees, returnees, and other vulnerable populations with a fully integrated package of public health services such as: primary health care (including maternal and child health), secondary health care, HIV/AIDS, nutrition, Water/Sanitation, and capacity building programs.
International Medical Corps’ work in South Sudan is critical because the country has fewer than 200 doctors to serve its population of 9 million, and also has one of the highest maternal mortality rates in the world. One in every 50 live births results in the death of the mother; with the high fertility rate, this means that each mother has a one in seven chance of dying in childbirth in her lifetime. Sadly, another twenty-five percent of South Sudanese children die from common, often preventable childhood illnesses before they reach their fifth birthday. To increase access to care and prevent these needless deaths, International Medical Corps works to build the capacity of South Sudan’s health system through training programs that target health professionals and key community members.
Located in the eastern part of Jonglei state, bordering Ethiopia, Pochalla is one of the most physically isolated counties in the state. Much of its territory is located between two rivers, which means that the county is accessible by road only from December/January to April. Beyond April, there is excessive flooding in the region, making travel, even by bicycle, very difficult.
The situation with child and maternal health is as dire in Pochalla as it is in the rest of South Sudan. Deliveries by skilled birth attendants at home or in the health facilities are far too rare. The main problem in improving the use of skilled delivery attendance are several barriers that exist in this area. First, cultural beliefs deter families from bringing women to health facilities to deliver, and many communities lack skilled health workers to assist in deliveries. Second, persistent insecurity coupled with a near-complete absence of suitable health facilities and very long distances to them makes travel to them very difficult or even impossible. Finally, many health facilities lack the capacity and the staff to provide adequate services, especially for complicated cases.
International Medical Corps is working in Pochalla to address the third major barrier by providing training and expanded facilities to provide high-quality care to women and their newborn children. Currently, in Pochalla Primary Health Care Center (PHCC), the staff lacks the training, facility and supplies to respond in case of complications during a delivery, serious obstetric and gynecological conditions or emergency caesarian sections.
International Medical Corps efforts in this county will increase the ability of staff to treat complicated obstetric cases, to assist in complicated deliveries, and to perform basic operations in Pochalla’s only medical facility with surgical capacity by constructing an operating theater. The operating theater will have the capacity to conduct at least twelve surgeries per month, and surgeries will include caesarian sections, fistulectomy, ectopic pregnancy corrections, emergency trauma and minor surgeries.
Since the level of education is also poor in South Sudan (especially in the more remote and insecure areas like Pochalla County) the support staff of Pochalla PHCC need to receive increased training, particularly on maternal and child health issues and timely referrals, in order for the new surgery theatre to be most effective. International Medical Corps will recruit the best person available at the health centers and train them to improve their skills and capacity to ensure the job requirements are met. This presents a very positive opportunity for a health care worker to increase their skills and help provide vastly improved services to their community.
International Medical Corps also offers repeat training to health care staff to make sure their skills are as up to date as possible. Every month there will be one training conducted for selected participants which will ensure that mothers in Pochalla receive the best care possible when welcoming a new member of the family.
Fadumo resides in Bokolmanyo camp in Ethiopia’s Dollo Ado refugee complex with her husband and five children. She and her family came from Somalia on foot, an immensely difficult six day journey, fleeing the increasingly dangerous conflict and a drought that has cost many lives in recent years. Fadumo’s relatives and neighbors were killed in the conflict, and she and her family lost many of their animals in recurring drought, leaving them with little opportunity to earn a living.
“Life,” Fadumo says, “was very difficult in Somalia.”
She had to travel about 1.2 miles to get to the nearest water point, where she waited 1-2 hours to collect water with her single 3-liter jerry can. This amount was not even sufficient to meet her family's drinking needs. Further, Fadumo had no personal hygiene items such as soap or toothpaste, making it difficult to maintain even a basic level of health. Diseases such as diarrhea, pneumonia, eye and skin infections, cholera and typhoid can be prevented with reliable access to clean water and the use of basic hygiene items.
After a week in Dollo Ado’s transition center, Fadumo and her family were assigned shelter in Bokolmanyo camp. During that time, International Medical Corps built latrines and bathing shelters for individuals living in the camps, including Fadumo and her family. Recognizing that the majority of Bokolomayo’s residents like Fadumo could not afford to buy hygiene items from the market, International Medical Corps has also started working with the communities to ensure that those in need have adequate access to hygiene items by distributing nonfood item kits given by donors.
“It is only from International Medical Corps that I have received these things during my stay in Bokolomayo,” Fadumo notes.
International Medical Corps now provides toothpaste, toothbrushes, towels, nail clippers, and body soap as part of hygiene kits donated by generous organizations. Our Community Hygiene Promoters provide information on how to use the kits’ contents and access other health services available to residents.
Fadumo notes, “I am grateful to International Medical Corps that I received the personal hygiene items for free which will enable me and my family to have good personal hygiene.”
International Medical Corps implements hygiene and sanitation programs in three of the five refugee camps in the Dollo Ado corridor—namely Kobe, Melkadida and Bokolmanyo camps. Since 2003, International Medical Corps has operated programs throughout Ethiopia, strengthening local capacities and delivering services in HIV/AIDS and infectious disease, reproductive health, nutrition, psychosocial support, maternal and child health, water, sanitation and hygiene services, and livelihood security.
International Medical Corps, in partnership with the Haitian Ministry of Public Health and Population (MSPP), supports a Multi-Purpose Health Worker training program at the Higher Institute of Health Leadership Training of Cayes. This program puts into place a standardized education system that is supported by the MSPP. The current program is located in Les Cayes which is located in the South Department region of Haiti. International Medical Corps’ program officer in the area interviewed six students about their future after participating in this training program that was launched last year. Below are the responses from the interviewed students:
While looking for work after graduating high school, Pierre found an announcement for a health officer training program in the newspaper. Pierre wanted to learn more about being a health officer before he joined the program, so he consulted his uncle who currently works as a health officer and could explain the duties of the job. After his conversation with his uncle, Pierre decided to enroll in the program. After he passed the training program’s entrance exam, he was confident that being a health officer could lead to a successful career. Pierre, whose personal motto was “health for all”, wished to help the people in his community who are suffering from behavioral issues.
Pierre did very well in school, and said that the key to achieving good grades was to study very hard every day. Ultimately, his goal is to attain a master’s degree in community health and health education pending completion of his training as a health officer. For Pierre, the health officer training program provides an excellent opportunity to develop a meaningful career directly out of high school, because approximately 90% of the trainees from this program find work in their local communities. Given current economic conditions, Pierre is a little concerned about the ability of the Ministry of Public Health and Population (MSPP) to continue to place such a high proportion of graduating students in the health system. However, he remains confident in his decision to pursue this training because the program will endow him with the skills necessary to be compliant with national health standards. Pierre is determined to achieve success in his career by the age of 30 and says, “A health officer career will provide for the needs of my family in the future.” He continues by stating that “Decentralization of the program is also good idea for the welfare of students.”
Two of the young ladies in the health officer training program talked about how they felt about the program and their desired outcome of their participation:
Gracieuse learned about the health officer training program from a friend. She was most interested in the aspects of the program regarding housing, nutrition, transportation and the formation and delivery of training materials. Gracieuse believes the program will ultimately benefit the entire country of Haiti. She hopes to apply the skills learned in this program to benefit the general population, with support from the government. When asked about what she sees in the future for the program, Gracieuse replied: “Given the economic situation, I am concerned for the future of the program, however, I intend to perform the job of health officer as necessary to improve our community and our lives.”
Medina also learned about the health officer training program through a friend that attended the first run of classes. When she first enrolled in the program, Medina was worried that the training program would teach her some basic skills and then leave her without support. After spending more time in the program, she now believes that it will allow her to teach people in her community to take control of their health while keeping her supported as she becomes acustomed to her new profession. When asked what she will do after classes end, Melinda said “I will continue to use the concepts to preserve my health, the health of my family and my community as a whole. If the program is delivered as intended, we can improve the health of ourselves and our community. I plan to use my education to provide effective services to the community for health promotion and disease prevention.”
Mackenson first heard about the health officer training program through radio commercials. Wanting to hear more about the program, he contacted a recent graduate to ask them about the training and the careers it can lead to. At first, Mackenson thought that he would only receive enough financial and material support to meet the training requirements for the position of health officer. Now he believes that the health officer program and its focus on improving the entire Haitian healthcare system is good initiative that will not only benefit him as an individual, but the community as a whole.
When asked what he will do after classes have ended, Mackenson replied that he wants to be hired quickly so he can apply the concepts he learned in the program. He believes that educating people about essential health topics will be beneficial to the population, because they will be able to protect themselves against diseases related to the environment (e.g. diarrhea, cholera, etc.) and act to remedy factors that may affect their health negatively. Mackenson stated, “In my opinion, this program will allow me to have the means to meet my needs, support my family and help others who are vulnerable. I will use my skills, knowledge and expertise to serve the community to which I am assigned.”
Jean first heard of the health officer training program through a poster from the Ministry of Public Health. For Jean, this program seemed to offer skill training that is critical to the health of individuals and ultimately the community in general. He said “At the end of this program, I will enter the labor market and demonstrate the knowledge I have acquired by serving the community.” Jean hopes that the Ministry of Health will achieve the objectives of this program. “People in the community need our presence so that they can learn basic concepts of hygiene and safeguard their health,” Jean explained. “Health is a right that must be preserved. I will work with the community to promote health education and teach the basic principles of hygiene. Eventually, I hope to become an expert in that subject.”
Genel learned about the health officer program through a friend. He first thought that this program would be identical to many other training programs, but he now believes that this program has the ability to address most of the existing problems facing the country in regards to environmentally spread communicable diseases. He hopes that all the students currently in the program are able to find work in the public health sector. When asked how he saw this program’s future, he replied: “The program will change the point of view of many in regards to health, and the community will be less affected by epidemics. After I graduate from the program, I will be ready to serve the entire Haitian population; my knowledge and skills will help people take charge of their health by taking into account their environment.”