Recap

Greetings again one and all. We found out why our blog has suddenly doubled in its readership. It seems that our site is getting linked to other more popular sites and our adventures are reaching a wider audience. Myself and James would like to bid a warm welcome to the new arrivals and now, I think, is a good opportunity to recap on what we are, our goals and how we came to be here.

Organisation: St Mary’s- Juba Link. The hospital that we work at is called St Mary’s Hospital. We are twinned to a Hospital in the Southern Sudan called Juba Teaching Hospital (JTH).

Goals: To send NHS staff from the UK to assist with training in JTH. This will increase the number and quality of healthcare professionals in the Southern Sudan.

How we fit into the big picture in the Southern Sudan: The 40 year civil war in Southern Sudan has destroyed its infrastructure and left it with some of the worst healthcare statistics in the world, including the highest maternal mortality (1 in 5 mothers die in pregnancy) and one of the highest child mortalities (1 in 7 children will not live to see their 5th birthday). Health institutions are sparse in the Southern Sudan - only 25% of people have access to one.

In the Southern Sudan, hope abounds. The people, tired of war, are industriously re-building their shattered country. Aid from the West is pouring in and many hospitals in the Southern Sudan have been refurbished. More hospitals are being built. Juba is the capital, and Juba Teaching Hospital, is the Southern Sudan’s flagship hospital. Its wards have been re-decorated, there are tiled floors and many new buildings have been constructed including laboratories, and Radiology facilities. Ventilators have been purchased and an intensive care unit has been created, complete with suction machines, oxygen concentrators and electrical observation machines for continuous non-invasive monitoring.

Intensive care unit at Juba Teaching Hospital.

However, why are the ventilators still in their packaging? Why in the height of the wet season when people are most ill, are there no patients in the beds?

The simple answer is that there are no staff. Intensive Care Units need very well trained doctors and nurses. In the UK, it takes five years to become a doctor and another ten to twelve to become a Consultant in Intensive Care Medicine. It takes three years to become a nurse and another two to do intensive care at least. It is clear that a fully functioning Intensive Care Unit is a dream that lies over a decade into the future.

So in summary, there is an absolute deficit of professionals in all branches of healthcare in the Southern Sudan. Those that are present are not receiving adequate training because there are no trainers. As far as we know, in the entire Southern Sudan, the St Mary’s Juba Link is one of only two charities that are assisting with training in a secondary care setting. 

It is relatively easy for charities to buy "stuff" for hospitals here. They feel good about it, and can tell and show their donors what they've contributed. There is a roll for this of course, but if you don't consider the wider context of the healthcare system you're involved with, you run the risk of it sitting unused, or unmaintained and broken. Training the workforce is vital, but it's also slow, unglamorous, and hard for people to visualise. However, we passionately believe that this training is the best system to sustainably impact the healthcare of the Southern Sudan.

The wider world of hospital links: In 2005, the then Prime Minister Tony Blair commissioned Lord Nigel Crisp to write a report on how the NHS could benefit the developing world. The result was the Crisp Report, which strongly advocated sending NHS staff to the developing world to train. The NHS has many many highly skilled professionals who potentially have a lot to offer in terms of training in the developing world, though it is often difficult for them to get out there. One of ways of overcoming this difficulty is via hospital-hospital links.

The St Mary’s Juba Link is one of over 80 links that have been developed by hospitals in the UK, to work in partnership with hospitals in the developing world. Such links are a two way relationship, and there is much benefit for staff from the UK.  Hospital links are coordinated helped and supported by the Tropical Health Education Trust, THET.

On Tuesday, the St Mary’s Juba Link received 4 reinforcements from the UK - Tim Walsh (Consultant Surgeon and our Project Lead), Zorina Walsh (our Education Lead), France Reed (a midwife - very important), and Jane Newson-Smith (a Psychiatrist - there is currently no strategy for mental health in the Southern Sudan).

It was lovely to see some familiar faces and these guys have been getting stuck in as soon as they got off the plane. They are all absolutely loving this place. They have been bowled over by the generosity and hospitality of these people. We have been planning their stay so that when they arrived, no time was wasted in preparing for teaching. Mr Walsh did his first teaching today which was awesome and I learnt a lot.

Tim Walsh teaches junior doctors the importance of fluid therapy in his first applied physiology tutorial

Anyway, this is more than enough for now. We really appreciate your interest!

All the best,

David