South Sudan's English Daily Newspaper
"We Dare where others fear"
By Benjamin Takpiny
Rose a mother in her mid-40, is still reeling in emotional pain following the sudden loss of her beloved son this year due to heart complications.
She is among hundreds of South Sudanese affected by the high cost of medical treatment and a broken public healthcare system in the country.
Rose was unable to afford medicine recommended by the doctors who diagnosed her son at a private pharmacy adjacent to the main Juba Teaching Hospital, where her son had sought treatment.
Juba Teaching Hospital is a government run health facility in Juba, the capital.
“The pain of losing a child is indescribable, and the fact that it was preventable makes it all the more unbearable,” Rose told the Dawn in an interview earlier in October outside Juba Teaching Hospital.
She said that had the medicines been available at the government run health facility, her sons’ life could have been saved.
“My son’s death has left a void in my life that can never be filled, but it has also ignited a fire within me to advocate for change. It is unacceptable that financial constraints should dictate the difference between life and death in our hospitals,” Rose disclosed.
She said that the right to health is enshrined in the 2011 Transitional Constitution of South Sudan, and it should not be a privilege reserved for the few who can afford it.
“We need immediate intervention to address this injustice by government increasing funding to the health sector, improve supply chains, and a commitment to making quality healthcare accessible to every individual, regardless of their socio-economic status,” Rose explained.
Several other persons this newspaper spoke to corroborated Rose’s pain.
Mary who had miscarriage in September, 2024 at Juba Teaching Hospital narrated her deep concern and frustration regarding the current state of healthcare in the country, particularly the severe shortage of medicines at Juba Teaching Hospital.
“Despite seeking medical treatment at this facility, I was unable to obtain the necessary medications for my ailment, which has left me in a dire situation,” she said.
Mary said that the lack of essential medicines in public hospitals is a recurring problem that has plagued South Sudan for years.
“The high cost of healthcare has already made it difficult for many of us to afford even basic medical services, let alone the more expensive treatment that we may require. The absence of necessary medications only compounds this issue, leaving us with no viable options for managing our health conditions,” she noted.
Mary urged the government to take immediate action to address this critical issue.
Santos John, who recently took his expectant wife to the maternity ward at Juba Teaching Hospital, said that nearly all services in the hospital are too costly for an average citizen.
He noted that first one has to pay entry fees at the gate before seeing doctors, nurses and midwives.
“I had a mixed experience at Juba Teaching Hospital, which I can describe as both positive and negative. Positive in such a way that I received the service that I went for but on the negative side is that every service in the hospital is at exorbitant fee, starting from the entry fee at the gate to the doctors, nurses and midwives,” John said.
John said that his expectation was to access medical service free of charge at the public hospital since it is subsidized by the government.
He said that he nearly run out of money due to the expenses he incurred to facilitate doctors to have his wife deliver by caesarean section.
John disclosed that he footed the bills ranging from anesthesia and other necessary things such as gauze and drugs.
“Immediately after the doctors performed C-section, there were some drugs I was supposed to buy, they have them in the hospital pharmacy but they asked for money before they give them out and if you don’t have the money you are left with no choice but to pay,” he said.
“The government should come out clean and tell people that the service at the public facility is at a cost because you cannot go to the hospital, and find everything very expensive, secondly the hygiene aspect at the hospital needs serious work,” John added.
Dr. Martin Makuek Chiman, a senior pharmacist and chairman of the board of trustees of Giving Back Foundation- a charity organization supporting vulnerable groups particularly children, said that the high cost of medical treatment is contributing to preventable deaths.
“Patients may only buy half of the dose prescribed. This may result in incomplete treatment which in return affects the patient’s quality of life, absenteeism from job or inability to perform duties or activities,” Makuek said.
He noted that many patients often walk out of pharmacies because they cannot afford the cost of medicines.
“For example, a patient with severe malaria will not pay less than 100,000 SSP for the full treatment in the private clinics and hospitals. Consultation with a doctor may cost 15,000 SSP or 20,000 SSP, laboratory services may cost 58,000 SSP and parenteral anti-malarial drugs may cause cost 50,000 SSP or more,” Makuek revealed.
He suggested that political will on the side of the government is necessary to revamp the health sector and also to ensure access to affordable healthcare services for the population.
In addition, he called for increased budgetary allocation to health, and curbing corruption and mismanagement within the health sector.
Makuek also asked the government to enact healthcare Act and investment in the pharmaceutical industry in the country to reduce over-reliance on expensive imported drugs.
Dr. Harriet Pasquale Akello, Undersecretary in the Ministry of Health, noted the existing challenges in regards to facilitating supply of medicines and equipment on time to public health facilities across the country.
“We are faced by a challenge of proper quantification of medicines for the health facilities, and that’s why sometimes our facilities run out of stock. It is because to do a proper quantification of medicine, there are certain parameters that you really need,” she said.
Akello said that most of the public health facilities do not report accurately on consumption data for drugs, which is important for replenishing their stock.
“So, if you don’t know your consumption data accurately, of course, it affects the quantification. This is one of the factors affecting our quantification”
Akello also said that the budget allocation to health sector remains meager, and this puts the strain on health service delivery in the country.
“Actually, this is where the issue starts from, because currently almost 80 percent of the budget of the health sector is being funded through external support. When it comes to the actual domestic funding to support health services in the country that is where we have a challenge. Our budget this year is 1.3 percent of the total budget allocation; this is really small because with that budget we are only able to pay salaries,” she disclosed.
Akello said that they are unable to procure enough drugs due to budget constraints.
She noted that are putting the hope in the recently launched Health Sector Transformation Project (HSTP), a World Bank funded project to shore up the health sector for the next three years.
Health Sector Transformation Project which commenced the 1st of July 2024 replaces the Health Pooled Fund, which started in October 2012 and closed on 30th June 2024.
