By Agar Mayor Gai-Makoon

Despite the many flaws that have crippled South Sudan healthcare sector, the need for a healthier and more productive population keeps rising every minute. This is attributed to the fact that as the health care sector fails, the whole nation fails too. No single human being can go opposite to this correlative assertion because it is a bond that is natural and cannot be broken.

They only have to exist as one in such a way that if one part suffers, the other not only feels it but also carries the exact weight of that problem. South Sudan healthcare sector has suffered numerous challenges since the 2013 conflict. And because we were just two years independent that time, the few strides made were rubbed off, and the hope for an effective healthcare sector—capable of delivering health services to the people was shattered.

In short, this sector has been unstable and never in full position to execute its duties to the public. And not to undermine the firm efforts to improve the lives of our people by the ministry of health, partners and all other health institutions in South Sudan, I have to appreciate and also remind them that keep on the courage and commitment to do away with health challenges. This is the role that you have chosen and it is both our belief that one day, South Sudan will have a health system that is patient-centered, results oriented and evidence based with firm resilience. Plainly speaking, conflicts and corruption won’t vanish completely in South Sudan.

For as humans live and interact, so can their opinions differ leading to conflict. And when there is conflict, trust and some important virtues like integrity can be lost. Perhaps, a fertile ground for corruption, tribalism, nepotism and more vices, is created giving rise to unproductivity and failed institutions. This is the situation of South Sudan at the moment. Critical institutions for instance, healthcare sector have experienced the worst setbacks because it deals directly with people. But the good news is here. We have got to accept and live with these challenges while striving to minimize them. And in so doing, South Sudan can create other grounds that can promote reforms in healthcare sector. There are 3 focused steps that can take South Sudan closer to health transformation than the otherwise.

• Enhancing the human capital in healthcare

It is sad that since 2005 when Southern Sudan started to have a government, we have not produced enough medical personnel. The physician to patient ratio is 1:65,500. That’s to say that a county of more than 60,000 people is served by only single physician. Regardless of medical specialty or the facility’s need, only one physician can be assigned to serve such a huge population if we have to equally divide 13 million South Sudanese among physicians. It is absolutely a terrible situation. Obviously, health reforms should start in this area. The national ministry of health should produce strategies that can encourage more admissions to medicine, pharmacy, nursing and medical laboratory in both local universities and abroad. Here, the ministry of higher education can be involved so that more admission slots are always focused to medical careers. We also have to expand and improve on health education facilities. For instance, the faculties of medicine in our public universities should meet international standard in terms of organization, teaching and environment. It is by doing this that health provider competence and commitment could be realized.

• Health resources and facilities

Low health funding has retarded many health projects including the 10-month-old health sector transformation project that has been unable to pay incentives for the health workers for months. The health sector transformation project is a national project that can transform the face of South Sudan health care if it is adequately funded. The ministry of health being the main stakeholder of this project, it has to fulfil its role by mobilizing more resources and support from both the government and donor agencies. More health funding means more health service delivery to the people. For example, better pay for the workers, building more health facilities e.g. phccs and hospitals as most places do not have and making sure that hospital logistical power is intact, all these can simplify health service delivery.

• Strengthening health system

You may wonder why strengthening health system is a separate step when all the above steps are aimed at making it a reality. The reason is that as reforms are made, they have to be maintained. Perhaps, there should always be good leadership so that the chain of progress is not broken, but rather lengthened and made stronger. For example, the national ministry of health is the main player in this reform game. If they do not produce an environment where all the other players have to cooperate and work well, the reform game will be a loss. The work guidelines must be the same and duly followed by all hospitals across the country. There are complaints from local population about lack of medicines in government hospital stores.

 The ministry of health must be a skillful watchdog—never compromising any malpractices and attempts to block health reforms. They have to do this by always being on the ground checking delivery of medical supplies and their appropriate use by hospitals. Supervision is the proof of work done, and any system that does not feature it in its workings allows corruption to thrive. Let South Sudan healthcare sector not condone diversion of its work logistics for private use by individuals. We must create a resilient and results oriented healthcare system, and denounce corruption and misuse of health resources. Let’s do it.

The writer has a background in socio-political philosophy. He currently studies medicine at Ain Shams university, Cairo, Egypt. He can be reached on +201129107334, or thieng.thiengwada@gmail.com.