Juba Teaching Hospital is the only referral hospital in the whole country of South Sudan and is located in Juba City, Central Equatoria State. With an estimated population of 9.58 million basing on annual population growth of 3% from a population census conducted in 2008 and lack of proper functioning primary health care facilities upcountry, many South Sudanese have nowhere to go to but to this national referral hospital. Military and police hospitals, if any, are non-functional country wide, forcing soldiers and officers to share the limited facilities with civilians.
A student nurse attending to Mr Solomon before referral to Addis Ababa (Ethiopia)
Juba Teaching Hospital is directly funded by the central government through the National Ministry of Health. Medical supplies and maintenance are handled through the National Ministry of Health of South Sudan with supplements coming from United Nations agencies and NGOs. The supplies are irregular, forcing patients to buy most of the consumables and pharmaceuticals from private pharmacies. Due to the high level of poverty, most vulnerable patients are not able to afford modern medicine hence increasing patient mortality in Juba.
Our primary goal is to improve the quality and sustainability of medical and surgical services provided in the Juba Teaching Hospital.
Summary of RMF/MMI-sponsored activities carried out during the reporting period undereach project objective:
Results and/or accomplishments achieved during this reporting period:
The Health Systems Strengthening project at Juba Teaching Hospital has achieved many notable milestones within the reporting quarter through the committed leadership of JTH, especially the Pediatric Department and Real Medicine Foundation, MMI, and the entire staff of Juba Teaching Hospital.
Impact this project has on the community:
Appendix A: Success stories
Joshua, a 26 month old boy from Gumbo (Juba), was admitted to the JTH Pediatric Ward with high fever, convulsions, vomiting and generalized body malaise. A diagnosis of severe malaria was made following laboratory investigation; and he was then managed using I.V. Quinine, Paracetamol syrup and convulsion control with rectal Diazepam. The child significantly improved within 48 hours and the doctor on duty discharged him after 72 hours to continue with oral anti-malarials at home.
The mother of the child narrated to RMF staff that she greatly appreciated our support for creating a clean and conducive environment for the patients which is now bright and clean, and every patient is happy to stay there. This is helping remove the negative attitudes of the community towards the reputation of poor hygiene of JTH, and she promised to tell the community about the new clean environment of JTH. She also thanked all the nurses for their hospitality and the good work they are offering to the people of South Sudan and the foreigners that, despite all the challenges and difficulties, are still present.
Mother of Joshua explaining to the nurses her story and experience in JTH
Mr Solomon Geu, a 28 year old man, South Sudanese from Gumbo (Juba) was involved in a car accident, found unconscious and then rushed to Juba Teaching Hospital. He sustained a closed head injury and was put on conservative management of the head injury without performing basic radiological investigation. Services like x-ray and CT scan are not available at JTH; hence patients are forced to do radiological investigation from private diagnostic centres. At the time RMF saw Mr. Solomon, the relatives were not able to afford a CT scan, hence RMF decided to cover the CT scan cost so as to obtain a clear diagnosis. A CT scan done on June 28th revealed multiple basal skull/vault fractures and epidural hematoma. This helped the surgeons tremendously to reach a final diagnosis and the patient was later referred to Addis Ababa (Ethiopia) for further management by neurologists. The relatives of Mr Solomon thanked RMF for the great financial support; without it, the final diagnosis of the patient wouldn’t have been reached and the patient wouldn’t have been able get proper management from a better centre.
Renovation of Pediatric Ward 5
Men at work during renovation of Pediatric Ward 5
Working on the toilets of Pediatric Ward 5
Working on the inside of the Pediatric Ward 5
Painting the exterior wall of the Medical Unit Pediatric Ward 5
Plastering the wall of Pediatric Ward 5
Painting the inside
A painter working on the windows
Washroom connecting the Surgical (L) and Medical (R) Section of Pediatric Ward 5
Front side of Pediatric Ward 5after painting
Medical Unit of Pediatric Ward 5
Nurses on duty in the newly renovated Surgical Unit of Pediatric Ward 5. They were very happy for the support of RMF/MMI.
Juba Teaching Hospital has been operating with no clear waste management policy guidelines and there was an accumulation of wastes (medical waste mixed with non-medical waste) over the period of a year, no proper waste segregation, and inadequate fuel supply for the incinerator. All these were due to the implementation of austerity measures imposed by the government in 2012. The huge amount of accumulated waste became health hazardous to the health workers, patients, community and the environment.
Photos before Waste Removal
RMF decided to facilitate both the removal of the waste, and the provision of technical support to develop a better long term waste management policy for JTH. These policies were printed and disseminated to the entire department and a training of the janitors in proper waste segregation, transportation and safety precautions was conducted.
The Director General for JTH, Dr. Kajomsuk Abdalla Moi, on behalf of the hospital, acknowledged the support offered by RMF in waste management and ensuring the environment is conducive to health care. The entire hospital staff were extremely happy for the good work done and recognized RMF as an important partner of JTH. The DG said that without the support and commitment of RMF all this wouldn’t have been possible.
Public Health Officer Brian, Okang Wilson, RMF Finance and Project Coordinator, and Dr. Kajomsuk Abdulla, DG for JTH.
Photos before waste management initiated by RMF
We hired a company in the week of May 30th to remove waste from the dumping sites and analyzed the amount left over to quote a price to remove the remaining waste. This enabled the removal of about half the wastes compiled (documented in photos below).
Other Project Photos
The father taking care of this child who was admitted due to complications of malnutrition
A neonate admitted because of a skin condition in Pediatric Ward 5