Southern Sudan is one of the poorest parts of the world. The infrastructure of society has been devastated by decades of civil war. 25% of the population in Southern Sudan have access to any form of healthcare and inoculation rates for children are around 18%. Maternal mortality is the highest in the world at 2,037:100,000 (around 3%). Since women have an average of 6-7 births per woman, this means that approximately 20% of women die as a result of childbirth.

Although material for the provision of healthcare is limited, it is the absolute lack of healthcare staff that is the most crucial issue. There are needs for training in virtually all areas, particularly emergency obstetrics in primary care, midwifery, nursing, and medicine, integrating nutrition more fully into secondary healthcare. Unless development of ongoing education and training for them is supported, it is difficult to see how the health service in Southern Sudan can progress.

After decades of civil war, the Comprehensive Peace Agreement (CPA) was signed in 2005, giving the South Sudan the right to its own government. Since then the Government of Southern Sudan (GOSS) has sought to develop its healthcare system and has declared that the capital, Juba, would be the place where training of staff would occur. This could then be cascaded to other hospitals, starting with Wau and Malakal. However, to this date there is still no on the ground training of staff as there are no trainers to help with training.

In October 2007, Juba Teaching Hospital (JTH) was twinned with St Mary’s Hospital on the Isle of Wight. The link was set up with the following general objective:-

“To promote understanding of the needs and to support the Government of Southern Sudan, in order to improve clinical services through the development of education and training.”

Following 4 months of successful fund-raising by the Core team a visit was undertaken from the 3rd to 7th March 2008 in order to assess the following:

1. The overall strategy for the development of healthcare services and training in Southern Sudan (Sector Plan) and how this relates to the proposed project.
2. The present situation regarding facilities for clinical services and postgraduate training in Southern Sudan.
3. The needs and priorities with regard to the development of postgraduate training across the professions.
4. The approximate number of doctors, nurses and other healthcare professionals who would benefit from the proposed training programme.
5. The facilities that are available and what needs to be provided to ensure appropriate conditions for visiting trainers and trainees (including accommodation, visas, internal travel and travel to South Sudan).
6. How the project may be funded.
7. Undertake a risk assessment and identify security measures.
8. Arrangements for the supply of donated equipment from St Mary’s.

The results clearly demonstrated that there was an absolute deficit in healthcare professionals across Southern Sudan. This problem was likely to remain unless training could be initiated in all professions and at all levels with the aim of increasing the number of staff.

To this end, the current project proposes to send experienced trainers across the spectrum of healthcare disciplines to Juba for periods of 3-4 weeks or more, to undertake concentrated, hands-on training for professionals in Juba Teaching Hospital. It is suggested that approximately 20 such trainers could be sent in the first year at a cost of approximately US$60,000-$80,000. The number of trainers is envisaged to increase as the project develops.

The Fact Finding visit confirmed that the project is feasible, practical, highly cost effective and conforms precisely to the policies expressed by the Ministry of Health of The Government of Southern Sudan. These thoughts were echoed by staff at JTH, GOSS, NGO’s working in Southern Sudan, the World Health Organisation and the United Nations. However, this project will require ongoing funding to be achievable.

The St Mary’s - Juba Link became a registered charity in its own right on Friday 11th April 2008.

Recently the Team held discussions with the Management at St Mary’s who pledged to give paid annual leave for one week for six personnel to start with. If this is combined with two weeks of paid annual leave and one week of paid study leave, it will be possible for staff to undertake training in Juba for up to one month, whilst being able to pay their bills in England.

The Link has also pledged to pay for the expenses of staff being sent to undertake clinical training. However, if staff can raise money for their own overheads, this will be appreciated.

Plans are currently underway to build accommodation for staff to stay at whilst on attachment at Juba Teaching Hospital and the St Mary’s Juba Link is raising the money to do this.

In the future it is hoped that funding may be approved from the United Nations Multi-donor Trust Fund (UNMDTF). However, for the moment the St Mary’s-Juba Link will have to raise its own money and continues to depend on the generosity of staff at St Mary’s and the general public to achieve it aims.