South Sudan

Supporting Juba Teaching Hospital Update

December 23, 2013

Dr. Taban Martin Vitale and Okang Wilson Ezekiel

Background:

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 baby recovering well from pneumonia in Paediatric Ward 5

 

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.

Project Objectives:

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

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

  • Completed the renovation of Pediatric Ward 5 (see Photos below), painting interior & exterior, plumbing repairs, roof and floor repairs, window and door replacement.
  • Developed strategies for the maintenance of Pediatric Wards 5 and 7.
  • Facilitated the second removal of a large portion of accumulated non medical and medical waste from Juba Teaching Hospital grounds (see Photos in Appendix).
  • Continued support of high speed WIFI internet services for Juba Teaching Hospital Resource Centre (JTHRC)
  • Prepared next steps in JTH ward infrastructure and organization upgrades.
  • Facilitated Dr. Taban Martin’s trip to Nairobi to participate in the CommCare mHealth workshop facilitated by Dimagi, Inc.
  • Prepared Pilot for Training on Respectful Maternity Care (RMC) to be held in Q4 2013. .
  • Received visits from RMF CEO Dr. Martina Fuchs and MMI representatives Robbert Boelkens and Angela Geddes.

 

Interior of the ward 5 after renovation, Dr Martina and MMI representative, Robbert Boelkens, inspecting the renovation work

 

Results and/or accomplishments achieved during this reporting period:

  • The Health Systems Strengthening project at Juba Teaching Hospital has achieved many notable milestones during the Third Quarter through the committed partnership with JTH and its staff, especially the Pediatric Department
  • The fully renovated Pediatric Ward 5, which has a total bed capacity of 120 beds,is now reoccupied and fully functioning.
  • Through partnership with the head of Department for Pediatrics, Dr. Hassan Cholong, and support from the JTH administration, we developed guidelines and policies for the maintenance of the renovated Pediatric Wards 5 and 7.
  • Recruited two additional cleaners to supplement the limited available cleaners provided by JTH; this ensures adequate manpower in cleaning and maintaining Pediatric Ward 5.
  • Provision of cleaning materials on regular basis for the cleaning of Pediatric Wards 5 and 7.
  • Removed and disposed of a large amount of regular and medical waste that had accumulated after the first stage and second stage of removal by RMF within JTH premises. RMF was well acknowledged for our work and led to the Mayor of Juba ordering the last stage of removal of the remaining waste through the Juba Town Council.

Waste Disposal Management Program Designed and Initiated by RMF:

– The Nursing Staff in charge of various departments were trained on the importance of waste segregation and infection control in the wards/outpatient departments

– JTH procured and labeled colored bins for proper waste segregation and disposal

 

Initiated and guided by RMF: JTH Public Health Officer conducting training for the nurses/midwives on how to use the bins and importance of proper waste segregation

 

– RMF procured and delivered protective gears such as gumboots, face masks, heavy duty gloves and overalls for the janitors.

-We initiated the signing of an MOU between the JTH administration and Juba Town Council for weekly removal of non medical and medical waste from JTH to a designated place outside of Juba.

-Facilitated and performed regular monitoring and supportive supervision of the JTH healthcare workers and janitors on implementation of waste management policy guidelines:

  • Support of high speed WIFI internet services for Juba Teaching Hospital Resource Centre which provides internet access to doctors and nurses at the hospital
  • Carried out assessment for improving water and sanitation situation at JTH and presented proposal.
  • Prepared next steps in JTH ward infrastructure and operation upgrades
  • RMF was represented in Nairobi CommCare workshop and is now in the process of researching the use of the CommCare application for mHealth programs in South Sudan
  • Prepared Pilot for Training on Respectful Maternity Care (RMC) to be held in Q4 2013. .
  • Received visits from RMF CEO Dr. Martina Fuchs and MMI representatives Robbert Boelkens and Angela Geddes.
  • RMF South Sudan team traveled to Eastern Equatoria State to meet with H.E. Dr. Margret Itto, State Minister for Health EES, to discuss possible new collaborations.
  • South Sudan’s new Minister of Health, H.E. Dr. Riek Gai Kok visited the newly renovated Pediatric Wards and was very impressed by RMF/MMI’s work.

 

From L-R, Dr. Hassan, Head of Paediatric Department at JTH, Dr. Martina Fuchs, RMF CEO, Robbert Boelkens, Representative of MMI, Dr. Taban Martin, RMF South Sudan Team Leader and Okang Wilson RMF, South Sudan Finance & Project Coordinator

 

Impact this project has on the community:

  • The renovation of the Pediatric Ward 5 will reduce re-infection rates among children on admission and will also improve working conditions for doctors, nurses and JCONAM (Juba College of Nursing and Midwifery) students who are on their clinical rotations, and, above all, increase the quality of care patients receive and thus increase the number of patients coming for medical treatment in time.
  • JTH premises and the surrounding areas are preserved through removal of the accumulated waste which had posed a threat to the health workers, patients, surrounding community and the environment.
  • The working condition of the hospital’s janitorial workers has been improved through implementation of the waste management policy, developed with the support of RMF staff.
  • The high speed WIFI internet services for the Juba Teaching Hospital Resource Centre that provide internet access to doctors and nurses at the hospital facilitate research and improve continuous medical education.
  • The negative attitudes of the maternity staff towards patients have been changed through the introduction of the basic aspects of Respectful Maternity Care (RMC).

Plans for next reporting period:

  • Implementation of RMF annual work plan guided by MOU with MOH, including next steps in upgrade of infrastructure and operations at Juba Teaching Hospital
  • Continue rehabilitating the equipment set at Juba Teaching Hospital with focus on the Pediatric Department.
  • Continued provision of basic medical supplies, disposables and pharmaceuticals for the Pediatric Department, complementing those provided by the Ministry of Health.
  • Continued organization of on-site clinical training
  • Implementation of Pilot Training Program on Respectful Maternity Care (RMC) at Juba Teaching Hospital.

Project photos

The back of the renovated Paediatric Ward 5 building

Front of the renovated Paediatric Ward 5

Front of Surgical Unit of Paediatric Ward 5

Interior of the renovated ward 5, just reoccupied

RMF South Sudan Team and Paediatric Department discussing the strategy on how to maintain cleanliness and waste management for Paediatric Wards 5 and 7.

Cleaning materials for Paediatric Ward 5 and 7, purchased and delivered by RMF

A baby recovering well from severe malaria in Paediatric Ward 5

A baby recovering well from gastroenteritis in Paediatric Ward 5

Dr. Hassan, Head of the Paediatric Department, Richard, the JHT administrator, Robbert Boelkens, representative of MMI, Brian, the Public Health Officer at JTH, Dr. Marina Fuchs, RMF CEO, Dr. Taban Martin and Dr. Kajomsuk Abdalla, the former JTH DG.

Kija Engineering Company contracted for the assessment of the water and sanitation situation at JTH

Accumulated waste within JTH premises after the first removal of the first half

Removal of the 2nd half of the accumulated waste

Cleared area after removal of the waste

Bins purchased by RMF and labelled by JTH public health officers

 

 

Country Page: South Sudan Initiative Page: Juba Teaching Hospital Support