Training health workers for the future of South Sudan
South Sudan has one of the highest maternal mortality rates in the world: almost 1 in 27 women die during childbirth (in the UK this is 1 in 6,900) and 1 in 7 children will die before their 5th birthday.
One of the key obstacles to improved healthcare in South Sudan is a lack of trained medical staff. Though the country is larger than France there are reportedly fewer than 200 doctors and most health workers have only very basic training. AID sees healthcare as a crucial area in which to invest and has been working to develop a solution, along with the Government of South Sudan (GoSS), the local Anglican Church; the Episcopal Church of the Sudan (ECS) and the International Christian Medical and Dental Association (ICMDA). The outcome is the ICMDA National Institute of Health Sciences, Jonglei (NIHSJ), a training centre for clinical officers, nurses and midwives for South Sudan.
“The founding members, compelled by their faith in Jesus Christ and their desire to serve HIM will seek to serve the poor and marginalized people of the nation of South Sudan and its neighboring countries in Africa” NIHSJ Constitution, 2014
How the NIHS works
Each course offered by the NIHS (nursing, midwifery and training to be a clinical officer) is three years long and uses the South Sudanese medical curriculum with some adaptions, including much practical experience in hospitals and Primary Health Care Centres. The NIHS focuses on training this lower cadre of health worker as they are quicker and cheaper to train that doctors but also much more likely to stay in country as they cannot be employed for a better salary outside of it. Clinical officers do many of the same jobs as doctors and also have a managerial role in health clinics. They form the basis of many successful health systems in neighbouring East African countries.
The Institute is led by Dr Anil Cherian, a consultant pediatrician from India and his wife Dr. Shalini Cherian, a consultant obstetrician. They are supported by other excellent teaching and administrative staff. Besides this, many medical professionals from around the world have visited the NIHS for a few weeks at a time (above right) to teach a certain aspect of the course and share the teaching load with the staff.
As well as medical training, students have the opportunity to attend daily prayer meetings and a weekly Bible study. The NIHS is keen to develop the students’ Christian faith alongside their academic prowess.
Once qualified, the students plan to work in clinics and hospitals in South Sudan, increasing the percentage of the population that has access to quality healthcare. Despite the difficulties of their home nation, they are deeply committed to returning:
“I came with the dream that I have to go and get appropriate knowledge and skill [so that I can]… help the South Sudanese who are in a very bad condition.” Gai – graduated nurse.
“I’ve seen many mothers dying, neonates, with few health personnel, so I was interested to study about how pregnancy goes about and how you conduct labour.” Fiona, a graduated midwife.
Initially the NIHS was to be built in Bor, Jonglei State, one of the neediest areas of South Sudan. However when fighting broke out in Bor in December 2013, the plans were revised. Searches for an alternative location delayed the opening of the NIHS but an amazing opportunity presented itself in the Mengo Hospital in Kampala, Uganda. The hospital directors agreed to let the ICMDA use its facilities to begin training South Sudanese students until the situation in South Sudan stabilised. Sadly, the situation has not much improved since 2013. Please join us in praying for wisdom in establishing health training in South Sudan in the long term.
The first intake of 50 students graduated in summer 2017. 20 graduated as clinical officers (including 1 female), 16 as nurses (male and female) and 15 as midwifes (all female). The clinical officers are undertaking their year of apprenticeship in Juba Hospital and many of the others have found positions in NGO clinics. However, all face difficulties as they strive to practice healthcare back at home.
Those involved are currently considering relocating the NIHS to Bor, South Sudan – please pray for wisdom and clarity as preparations for the future of this vital work get underway.