Sylvia Tito Taban, a Nutrition Health Promoter (NHP) who has been trained by Amref Health Africa in South Sudan, talking with Grace on matters balanced diet - CREDIT | Amref

At least close to 1, 000 healthcare workers have been trained by the African Medical and Research Foundation since its establishment in South Sudan 50 years ago, an Amref official has said.

Last week, Amref Health Africa celebrated 50 years of their achievements and challenges in the country.

The day was an opportunity to celebrate Amref’s milestones in developing and strengthening South Sudan’s health care system.

The organization’s presence in the current Republic of South Sudan dates back to the 1970s.

According to Amref, there was only one trained practicing midwife in the whole southern region when they started operations in Southern Sudan in 1972.

Since then the agency has trained close to 1000 middle service healthcare workers serving in public and private sectors in the country.

This includes nurses, midwives, clinical officers and a well-developed laboratory system, work with the Ministry of health to develop policies for health services and build the capacity for community health services.

Dr. Githinji Gitahi, the Chief Executive Officer at Amref Health Africa says they have trained close to 1000 health workers in this country.

“I would like to say proudly that in the last 50 years, AMREF has trained close to 80% of all health workers in the middle service, that is nurses, midwives and clinical officers,” Dr. Gitahi.

“Up to 80% of them in South Sudan are trained by Amref through different means but largely the college called the Maridi College of Health Sciences that is run by Amref in partnership with government,

“I would like to say we have trained close to 1,000 health workers in this country who are serving in the public sector.”

In the then Southern Sudan, Amref Health Africa first project was a Primary Health Care Project (PHCP) to reach rural populations until then major healthcare interventions were delivered through urban-centered institutions.

Between 1982 –1990, the agency undertook the implementation of what they referred to as the Rural Health Support Project (RHSP) in the region.

It also implemented several health infrastructure improvement initiatives in different parts of South Sudan including Health workforce development.

Like other partners, Amref Health Africa said they are currently working in the areas of health system strengthening and services Delivery, human resources for health and Research.

In 2017, the agency was able to identify nodding syndrome, a mysterious disease affecting children in Maridi County of Western Equatoria State.

Nodding syndrome is an unexplained neurologic condition characterized by episodes of repetitive dropping forward of the head, often accompanied by other seizure-like activity, such as convulsions or staring spells.

The condition predominantly affects children aged 5–15 years and has been reported in South Sudan’s Western and Central Equatoria and in Northern Uganda and southern Tanzania, according to the Centers for Disease Control and Prevention.

Dr. Githinji Gitahi says in the next 50 years, Amref wants to see healthcare workers in South Sudan adopt new technology and be able to create private health services.

Gitahi adds his organization will continue to work closely with South Sudan authorities to strengthen health security and disease surveillance in the Country.

“We need to ensure that as we train the one for the next 50 years, they are well enabled by technology because now there is a new revolution,” Dr. Gitahi said.

“They are able to be entrepreneurial, meaning that they don’t just look at the public sector. They can also create their own employment by providing private health services,”

“We need to look at strengthening health security, disease surveillance, community surveillance of diseases so that even as we get out of Covid-19. So this is what we need to work with the government and people of South Sudan.”

Health care workers and officials say the health care situation in South Sudan remains woefully inadequate.

Observers said the health sector was still underfunded in the country.

They note that public servants including medical doctors quit the profession due to low pay.

But in the 2021-2022 fiscal year budget, the government of South Sudan has increased the health sector budget allocation from 1.9% to 9.6%.

However, in developing countries, healthcare is the maintenance or improvement of health through the prevention, diagnosis and treatment of disease, injury, illness and other physical or mental conditions.

This includes dentistry, medicine, nursing, audiology, optometry, psychology, occupational therapy, physical therapy among others.

In Africa, access to health care varies across countries largely influenced by social and economic conditions and health policies implemented by governments.

Experts believe that a well-functioning healthcare system requires a financing mechanism, a well-trained and adequately paid workforce, reliable information to make informed decisions and policies and well-maintained health facilities.

Others say this can typically be done with government financing through taxation or social security, supplemented by private sector and nongovernmental organizations.

In 2018, the Organization for Economic Cooperation and Development reported that twenty-three countries around the World were spending more than $3,000 on healthcare per capita.

On the top list, OECD reported that the United States were spending $10,586, while Switzerland $7,317 and Norway $6,187.

Despite transition from conflict, Dr. Githinji Gitahi however urged the South Sudan government to improve community health services and primary health care using the little resources the country earned.

“The government must put adequate money to provide health as social service. Now in the health sector because the government doesn’t have adequate resources,” Dr. Gitahi said.

“We know South Sudan is coming out of conflict and therefore the economy is not adequate to recover enough taxes to provide social services so that is going to be a big challenge,

“The WHO says that you need at least $100 per a person per a year to provide health services,

“South Sudan is providing less than $20 per person per a year but it is because government does not collect adequate taxes,

“But how do we make sure the little dollars we get are applied at the best place where we have the best outcome.”

Among those who benefited from the Amref activities is a 37-year-old Lamunu Doris.

Being a mother of three, Doris obtained her postgraduate in Sexual and reproductive health and rights at Lund University in Sweden in 2021.

Before enrolling for Clinical and public health training at Maridi Health Science Institute in 2007, Doris was a Councilor and later graduated with a degree in public health.

After graduating in Maridi in 2009, Doris was determined to go for further studies and ensure she supported nurses and midwives in the country.

Doris is now calling on the government and development partners to support nurses and midwives working in hard to reach areas in the country.

“With the situation we have in South Sudan, we need more nurses. If you move in most of the vast areas, the difficult to reach area, the best health worker you get is a nurse,” Doris said.

“The best midwife or obstetrician you get is a midwife. They are everywhere in all the hard to reach areas but what do I say here,

“We still need more support for nurses and midwives in this country. Yes we also need clinicians and most of our clinicians now are moving into task shifting.”

Similarly, 19 year old Rofina Poni is a resident of Gumbo, a suburb in the capital Juba.

She is among the 100 young women trained by Amref as Safe Water Champion in Gumbo.

Poni and her peers go house to house to create awareness on good hygiene and sanitation practices in her community.

Like other Safe Water Champions, Poni visits at least three different houses in a day to ensure her communities adhere to good hygiene practices.

“We are now able to change our community by basically telling them how to protect themselves against diseases like cholera and other diseases,” said Poni.

“I may also talk of myself, I am now confident enough to teach my people and others I never knew in the community, I am now able to engage them.”

Speaking during the Amref’s celebration of 50 years, the Undersecretary of the national Ministry of health says investing in human resources is critical for the South Sudan health sector.

This according to Dr. Victoria Anib has been realized through the support from African Medical and Research Foundation – Amref.

“Human resources for health is quite important to us and Amref has helped us achieve that mandate. The women who are currently working in different health facilities are mere examples,” Dr. Anib said.

“Investing in training of nurses and midwives, evidence shows that it leads to economic productivity and it leads to healthier and wealthier families who can enjoy good health. The best gift is health.” 

Amref Health Africa is an Africa founded International organization with headquarters in Nairobi, Kenya, and has country programmes and offices in seven African countries such as Ethiopia, Kenya, South Africa, Tanzania, Uganda, Senegal and South Sudan.

The organization also has ten other National Offices in Europe and North America.