South Sudan: Juba Teaching Hospital Support

photo: Jubilant children now returning home after complete recovery from malaria.

Project Goals:
 
To improve the quality and sustainability of medical and surgical services provided at Juba Teaching Hospital.
 
Juba Teaching Hospital is the only national referral hospital in the whole country of South Sudan and is located in Juba City, Central Equatoria State. With an estimated population of 9.86 million based 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 but to this national referral hospital. Some of the military and police personnel also share these limited facilities with the civilians.
 
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.

Project Objectives:

1. Improve patient wards and build infrastructure within Juba Teaching Hospital.
2. Assist in improving conditions for providing health care at Juba Teaching Hospital, including the policies and management of regular and medical waste.
3. Rehabilitate and/or purchase new medical equipment.
4. Provide basic medical supplies, disposables and pharmaceuticals for Juba Teaching Hospital starting with Pediatric Department, complementing those provided by the Ministry of Health.
5. Organize on-site clinical training, including general equipment usage, respectful maternity care and respectful health care, and psycho trauma support.

Summary of RMF/MMI-sponsored activities carried out during the reporting period under each project objective:

1. In collaboration with MedWish International, delivered medical equipments, consumables and furniture to JTH.
2. Continued support of high speed WIFI internet services for RMF office and Maternity Unit.
3. Continued monitoring and mentorship of the trained healthcare professionals on the usage of the Health eVillages tablets.
4. Facilitating the ongoing Maternal Near-Miss Audit at Juba Teaching Hospital; the data collection both quantitative and qualitative is ongoing.
5. Conducted assessment of the Antenatal Unit of JTH; the remolding/improvement of the unit will be done in the next quarter.
6. Procured and provided adequate cleaning materials to Pediatric Department to keep the wards clean.
7. Continued implementation of waste management policies and waste removal at JTH.

photo: Maternal Near-Miss Supervisors discussing the ongoing research.

Results and/or accomplishments achieved during this reporting period:
 
The Health Systems Strengthening project with focus on Juba Teaching Hospital has achieved the following notable milestones during the reporting quarter through the committed partnership with the National Ministry of Health, JTH administration and its staff.
 

1. The medical equipments, consumables and furniture delivered to JTH by RMF have improved the quality of the service delivery.
2. The two Health eVillages Master Trainers together with the nurses, midwives and doctors continued to benefit from the tablets provided by Health eVillages; they are able to do quick reference checks hence improving the quality of care and general services provided by them.
3. Collection of monthly reports from the healthcare professionals on the usage of the preloaded tablets and patients’ response on how the application of the tablets influenced the care provided by the healthcare professionals; this is to evaluate the impact of the Health eVillages project (evaluation still ongoing).
4. The trained Maternal Near-Miss Audit team continued to collect both quantitative and qualitative data (studies still ongoing, result will be published after completion).
5. Monthly provision of adequate cleaning materials to Pediatric department ensures proper cleaning and maintaining of the hygiene in the wards and the surroundings.
6. Facilitated and performed regular monitoring and supportive supervision of the JTH healthcare workers and janitors on implementation of waste management policy guidelines.
7. RMF continued to work closely with JTH administration and public health officers to ensure proper implementation of waste management policy guidelines and regular waste removal.
8. Support of high speed WIFI internet services both at maternity and RMF office providing internet access to doctors, nurses, midwives and RMF team
9. The assessment of the ANC unit has drawn a clear recommendation from the maternity staff on how to improve the unit for better service delivery.
10. RMF strengthened its partnership with Direct Relief International and will participate in quarterly requisition of essential drugs from DRI.
11. Prepared and submitted a proposal for third phase of the Health eVillages project.

Number served/number of direct project beneficiaries:

1. Direct project beneficiaries are approximately 444,680 people who lived in Juba and the immediate surrounding areas projected basing on 2008 Sudan Population and Housing Census.
2. Students from JCONAM, Juba Nursing School and Juba Health Science Training Institute are also direct beneficiaries of this project since all do their clinical practice at Juba Teaching Hospital.

Number of indirect project beneficiaries (geographic coverage):

1. 9.86 million South Sudanese as per the 2008 Sudan Population and Housing Census from all the ten states of South Sudan as Juba Teaching Hospital is the only referral hospital for the entire country.
2. The entire business community from neighboring and other African countries, the working class from INGOs, UN Agencies etc.

Project Photos

MedWish shipment on arrival at Juba Teaching Hospital.

MedWish shipment on arrival at Juba Teaching Hospital.

Janitors at JTH offloading the shipment.

Offloading in progress.

Janitors carrying the training mannequin.

Offloading in progress.

Janitors offloading the shipment.

Janitors rolling the furniture to A&E Department.

Distribution of the mattresses.

Distribution of the mattresses.

An intern nurse taking some of the mattresses to the Gynecology ward.

Janitors carrying some of the mattresses to A&E Department after distribution.

A nurse taking one of the wheelchairs to A&E Department.

Rollator Walkers for Physiotherapy unit.

Judith in-charge of Maternity unit adjusting procedure light after delivery to her unit.

Stand-up manual adult scale in Medical ward 6 (TB ward), the nurse in-charge is keeping the equipment well.

Furniture given to Surgical ward.

Furniture in Surgical ward 2.

Midwife Kiden Annet counting the completed quantitative data collected before handing them to the supervisor.

A team of healthcare professionals using the HeV devices sharing their experience during a meeting.

Amani, a registered nurse, reviewing a child in Pediatric ward 5 emergency with the help of the HeV tablets

Janitor slashing the hospital compound, this is the block housing the RMF Juba office (L).

Janitor slashing the hospital compound.

Distribution of the cleaning materials procured by RMF to different Pediatric wards.

Janitors picking cleaning materials meant for Paediatric ward 5 surgical.

A child recovering well from burn wounds in Pediatric ward 5 surgical, a clean ward maintained by RMF.

A child on traction for a fracture of the right Femur following a fall from a chair.

A child recovering well in Surgical ward 5, amputated above the wrist due to gangrenous hand following insertion of IV Cannula

A child recovering well from bronchopneumonia.

A child recovering well from malaria and respiratory tract infection

A child recovering well from malaria following infusion of IV Quinine

Two children admitted due to severe malaria sharing the same bed due to limited space in Pediatric units.

A child recovering well from gastroenteritis.

A child (R) recovering well from pneumonia and malaria, (L) the brother visiting after school.

Moderately malnourished child admitted due to G/E complicated with malaria.

A child on treatment for TB meningitis, the management team reported some improvement.

A man sustained severe burn following domestic violence at home, admitted in RMF renovated Pediatric ward 5 medical.

A man sustained severe burn following domestic violence, admitted in RMF renovated Pediatric ward 5 medical.

A man sustained an injury on the right knee and fracture of the Tibia following gunshot, recovery well in Pediatric ward 5 medical.

Jackline a nurse in-charge of Pediatric ward 5 medical with a patient awaiting biopsy result for the swollen left leg.

A triage area temporary erected annex to Isolation unit during cholera breakout in Juba.

A clinical officer reviewing suspected cholera patients admitted in JTH

Suspected cholera patients in the corridors due to lack of space to accommodate all the patients.

Suspected cholera patients in the corridors due to lack of space to accommodate all the patients.