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South Sudan: “Transforming from Zero” the Nation, the Health System, the Health Workforce

Over the weekend, the world’s newest nation was born. South Sudan celebrated independence as Africa’s 54th nation state and the United Nations 193rd member. President Obama officially recognized the new country, saying: “After so much struggle by the people of South Sudan, the United States of America welcomes the birth of a new nation . . . Together we can ensure that today marks another step forward in Africa’s long journey toward opportunity, democracy, and justice.” 

(In pictures: IntraHealth staff capture Independence Day celebrations.)

It is a promising moment in history and one that opens the door to a lot of questions. How can we work towards durable development, a sine qua non for opportunity, democracy, and justice? How can we ensure that this step forward is not accompanied by two steps backward, as we have seen so many times in Africa? How can we help the Sudanese people create the conditions they need to realize their full potential and fully participate in forging their own future? How can the community of international non-governmental organizations (NGOs), which is so eager to help, become a part of the solutions, not the problems?

Alongside many other international NGOs, IntraHealth International has been working with the Sudan People’s Liberation Army and the Ministry of Health to strengthen the health workforce and to provide HIV counseling and testing and prevention services as well as treatment. You can view a slideshow that offers some glimpses of this work here.  

My colleagues in South Sudan have witnessed first-hand how daunting it is to provide basic health care in a country where people’s most basic needs go unmet: 80% of the population still lives in thatched-roof housing; 75% of people cannot read; infrastructure such as roads, water, and electricity are scarce or non-existent. Yet, people pushed ahead, as our former project director, Carol Karutu, who spent nearly five years in South Sudan, described in a recent blog, Once You Drink from the Nile, You Will Come Back for More. Building a health system and health workforce in a country that is “starting from zero” is difficult, but it isn’t impossible. As James Aguto, a former child soldier and guerilla fighter-turned-health worker was quoted as saying in a recent New York Times article: “ ‘South Sudan started from zero. Why shouldn’t we be able to transform?’ ”

As the global community pours more financial and technical support into South Sudan’s health sector, we also need to, in my opinion, make a serious commitment to changing the way we deliver that technical assistance, or it will not succeed.  This requires meaningful actions toward:

  • Building and supporting a viable health workforce. Given the very lean health workforce in Southern Sudan, it is essential that  task shifting and other strategies such as immediately investing in community health workers are prioritized. I would like to salute the Ministry of Health’s policy decision a couple of years ago to allow the training of a new cadre of clinical workers and praise AMREF for supporting the training of this cadre. Still so many health workers are struggling in some of the most difficult conditions, as described just yesterday in an article from Aljazeera, “Public Health in Disarray in South Sudan.” I would like to recognize the dedication and commitment of these health workers and also urge the new government of South Sudan to aggressively pursue a cross-sectoral approach to develop and implement a robust strategy for growing the health workforce and providing workers with more support and relief.
  • Creating strong partnerships with civil society and the private sector to develop and implement strategies to increase demand for and access to basic health care, especially reproductive health and family planning. The new government can play a key role by developing a framework and assigning some of the responsibilities to appropriate bilateral or multi-lateral organizations that are willing to participate as development partners. Given the anticipated opportunities for infrastructure and business development, the private sector also has an important role in health sector development and in the creation of a healthy and vibrant South Sudan. 
  • Prioritizing the principles of ownership, alignment, harmonization, and managing results outlined in the Paris Declaration in the collaboration between the South Sudan government and all its development partners.

Speaking earlier this week with my colleague, Dr. Fauzia Khan, who is IntraHealth’s project director in South Sudan, I was reminded of how hopeful the mood is in Juba, the capital of the newest nation. “There is celebration, excitement, high hopes and great expectations amongst the South Sudanese for the new country,” she commented. “They have come a long way and understand they still have a long way ahead to build a stronger and prosperous South Sudan and are ready to take up the challenge for a brighter tomorrow.” Today, South Sudan is presented with a golden opportunity to show the world the power and potential of strong local leadership and a vision for a new nation that can transform and sustain development.