Yambio Beats Odds Posed In Health Service Provision

By Okech Francis

Battling ill health in South Sudan is like a game of chess with the devil. This is the situation with communities including in Yambio where I visited, and they are winning smartly too.

Nathalia Bojikwele who is currently recuperating at Yambio State Hospital almost lost her life after childbirth. The 26 year old gave birth through a cesarean but post-natal complications crept in, yet with sheer will, flanked by medics, she is now out of danger. I visited Bojikwele at the facility, the gratitude she exhibited crowned all she felt about being nursed back to good health.

It all began a few hours after she stepped out of the operation room. Feeling cold and losing blood profusely, Bojikwele went into a coma and by the time she came around, a group of medics were all around her sick bed, concern all over their faces. She had just avoided death by a whisker.

Speaking to me, two and a half weeks after that incidence, she narrated how it all happened.

“When I recovered my senses, everyone was around me, everyone was busy giving me medical assistance. I had 2 cannula and everyone was busy to make sure that I recover,” Bojikwele said. “Today, I am here to proof to everyone listening to me that it if wasn’t because of these doctors and nurses, I would have lost my life,” she said.

Many people in Yambio have a story to tell on how they have benefitted from improved health provision. That is majorly attributed to a new Health Sector Transformation Project. The project comes on the backdrop of poor access to health services in South Sudan, with some of the worst health indicators in the world, according to statistics. On child mortality alone, around 75 per cent of all deaths in South Sudan are due to preventable diseases, such as diarrhea, malaria and pneumonia.

Expected Project Impact

The Ministry of Health, UNICEF South Sudan, and a syndicate of international donors, ensure the project runs successfully. Its implementation is over 3 years, and is expected to enhance the efficient use of limited resources for health, reduce fragmentation, and simplify government coordination with partners, and ensure the consistent delivery of a streamlined package of health services.

UNICEF’s Health Officer for Greater Equatoria, Peter Ambaiyo said the projects is intended to reduce disease burden in the country. “Most of the diseases are preventable by vaccines and we have been able to install core chain equipment in almost all the counties and in most of the health facilities,” Ambaiyo said.

Yambio State Hospital is one of the beneficiaries of the government-led project. I visited the facility and at the nutrition ward, found 18-year-old Hussein Lucy in admission with her 8 months’ old twins. She had spent a week already and the children were showing signs of recovery. “They are much healthier now,” Lucy said. She opted for the facility in mid-November after failed attempts at other health centers around Yambio. 

Fever, cough and diarrhea were persistently disturbing the twins and at the referral facility, they were diagnosed with malnutrition and put on medication and nutritional food supplements. “They arrived in a bad state but now you can see they are recovering well,” Dr. Samuel Konjo, the medical director of Yambio State Hospital, who had accompanied me to the nutrition ward said.

The maternity ward was buzzing with traffic as hundreds of women sought antenatal services. In November alone, 200-plus childbirths were handled compared to about 30 or less, monthly, between January and June, Victoria Munguye, who heads the department of obstetrics and gynecology said. “This is part of the positive impact that the new project has made,” Munguye said.

With the Health Sector Transformation Project, Yambio State Hospital is up to the task of providing the communities with services, the Medical Director, Dr. Konjo, said. He acknowledged patients’ increase, saying, “we are in position to handle all the people who seek medical assistance…. that is why there is increment of the number of patients coming for consultation- because of service delivery being offered.”

Bazungua Primary Health Care Center, just outside Yambio town is also benefitting from the new Health Sector Transformation Project. I visited the nutrition department and met David Emmanuel Kazima, a Nutrition Assistant who said that the project has closed a huge gap in service provision.

“The service is going on very well,” Kazima said. “Before, we had shortages of supply for the beneficiaries but now we received supplies and services are very well,” he said.

So basically, the impact of the Health Sector Transformation Project is already visible among the communities. The number of patients seeking medication have increased tenfold as confidence in health facilities build, Monica Nakabi, a registered nurse at Bazungua Primary Healthcare Center, said. “Providing to the people was a big challenge. There was really a huge gap because they would move long distances and fail to get treatment-when this happens, you find sick people reluctant to go to the hospital,” Nakabi said. “That has now changed and patients are trusting the hospital much more,” she said.

Challenges

To most people I talked to, patients and medics alike, the issue of shortages of drugs for common diseases like malaria, and remunerations to medical staffs came up.

At the maternity ward of Yambio State Hospital, Susan Simon Tambua told me that when medics are demotivated, they tend to delay in providing health services. “For months the doctors are not being paid and when we come here, it takes more than 2 hours to get services because they come late to the hospital,” Tambua said. Dr. Konjo admitted noting that “for the services to be maintained, motivation has to be given in time.”

For her part, Rufina Chitaregu whom I spoke to from Basungua Primary Health Care Center said she had to complement treatment by buying drugs from outside clinics because they had been depleted at the facility. “The services are okay but some medicines are not there and this is where improvement must be made,” Chitaregu said.

Sunday Ambua however said the health services in the last quarter of 2024 have been the best for her. The 37-year-old mother had just undergone a safe delivery of her tenth child. “I had no energy to make a safe delivery but the doctors were around me and were able to give me support in time to make sure I deliver safely,” Ambua said. “Some months back, things were not working well but now the services have improved a little bit,” she said.