It’s time to repair South Sudan’s damaged healthcare system

On the top of the pandemic final April, I noticed Fb posts from mates and kin in South Sudan displaying top-level authorities officers sporting clip-on tags dubbed “virus removing playing cards”. The playing cards had been stated to include chemical substances that would forestall COVID-19.

President Salva Kiir, his deputy, Riek Machar, defence minister Angelina Teny, and different ministers had been all noticed sporting the playing cards.

I used to be not solely stunned {that a} intelligent entrepreneur was out to become profitable from the pandemic. In Juba, the playing cards had been promoting for between $20 and $30. Elsewhere, comparable playing cards had been being bought in Japan, Lebanon, and the Philippines.

Producers claimed that the playing cards’ foremost ingredient – chlorine dioxide – might kill micro organism and viruses. It’s normally used to disinfect water and sterilise medical tools.

It didn’t take lengthy earlier than South Sudanese netizens began poking enjoyable on the virus removing playing cards on social media. Many questioned how the very best workplace within the land – the Workplace of the President – might have fallen for the rip-off. In an interview, the presidential spokesman, Ateny Wek Ateny, stated Japanese Prime Minister Shinzo Abe donated the playing cards “particularly for the management… as a result of they stated it should assist to disinfect inside three metres”.

However with no let-up within the criticism in opposition to Ateny on social media and subsequent denial from the Japanese embassy in Juba that Prime Minister Abe had donated the playing cards, officers in South Sudan stopped sporting the playing cards not lengthy after.

Previously, issues within the healthcare system haven’t attracted a lot consideration from journalists, reporters, activists, or anti-corruption teams.

As an alternative, public consideration has largely centered on corruption and lack of transparency within the oil sector and authorities contracts – two areas the place big-ticket spending happens and the place money goes lacking.

However it’s time for the worldwide group, donors, and South Sudanese residents to show their consideration to the healthcare sector by exposing the neglect and the rampant corruption inside it.

There are severe accountability points inside the nation’s well being system that should be addressed – particularly on condition that circumstances of COVID-19 are rising, and the shortage of information on transmissions might imply the issue is even larger than what the present numbers point out. South Sudan’s leaders should be held accountable for the rot within the healthcare system.

Though the “COVID prevention playing cards” supplied fodder for humorous social media jibes, they illustrated three very actual – and dire – issues in South Sudan’s well being sector.

First, healthcare is dear for many of the nation’s individuals.

Solely a privileged few can afford it within the authorities hospitals. The price of treating a standard ailment like malaria is $8 to $10. Distinction that with the truth that the typical wage of a authorities worker is $24 per thirty days. The truth that solely high-level officers might get hold of “virus removing playing cards” speaks thus far and raises questions on who will likely be first to get COVID-19 jabs and the way lengthy extraordinary residents should watch for the vaccines.

Runaway corruption and mismanagement have contributed to the poor healthcare system, and there’s hardly any accountability for a way the federal government spends public cash.

Annual audit stories, that are a constitutional requirement, haven’t been launched to the general public since 2012. Not a month goes by in South Sudan with out paperwork displaying egregious corruption in authorities departments being leaked on social media. Medics interviewed by The Sentry say it’s troublesome to search out purposeful intensive care items in government-run hospitals – healthcare and medical companies are essentially the most uncared for a part of the nationwide price range, accounting for under 3 to 4 p.c, whereas safety and defence take up greater than 40 p.c.

Second, healthcare provision is insufficient.

Even when the COVID-19 playing cards had been purposeful preventive gadgets, the federal government wouldn’t be capable to broadly distribute them. In any respect ranges of the healthcare system, there’s a grievous scarcity of hospital capability and personnel. One physician informed The Sentry final yr {that a} major healthcare centre is meant to have a health care provider, a nurse, and a midwife, however the authorities is unable to fill the vacancies.

Medical officers, previously often called medical assistants, are essential in major healthcare provision, however they’re additionally briefly provide. The seven or eight establishments that skilled medical assistants had been shut down because of the battle. Moreover, the nation’s three prime universities – the College of Juba, the College of Bahr El Ghazal, and Higher Nile College – can not produce the variety of docs wanted by hospitals. Even when the colleges graduate docs, the federal government can not make use of them on account of an absence of funds.

These hospital and workers shortages imply that, even the place limited-service supply is offered, high quality is extraordinarily poor.

Firstly of the pandemic, the nation’s largest hospital – Juba Educating Hospital – had fewer than 10 ventilators. The deeper tragedy is that there isn’t a real, concerted effort to deal with the challenges within the healthcare system. As an alternative, high-level authorities officers generally fly overseas to hunt medical care, reasonably than repair the healthcare in their very own nation.

A coalition of South Sudanese healthcare professions launched an announcement to reporters and analysts earlier this month, warning that extraordinary residents – not political or army elites – had been dying needlessly because of the nation’s “failing healthcare system”. The group cited an array of points, together with an absence of saved blood, the absence of a voluntary blood donation system, an absence of capability for trauma accidents, and gaps within the availability of ambulance companies which are usually delayed by police checkpoints.

Third, as illuminated by the episode of ineffective anti-COVID playing cards, there isn’t a transparency within the well being system. The playing cards had been first obtained by members of the presidency. And but regardless of the general public scandal, the supply of the playing cards – and whether or not they had been paid for – stays a thriller. Lack of economic transparency is pervasive throughout all public sectors.

To enhance the well being sector, the federal government must clamp down on corruption by enhancing laws, empowering establishments of accountability, such because the Anti-Corruption Fee, the Audit Chamber, and prosecuting corrupt officers.

This text has been printed in cooperation with The New Humanitarian. On April 7, the New Humanitarian and Al Jazeera launched an intensive investigation into alleged COVID-19-related profiteering schemes in South Sudan. It’s accessible right here and right here.

The views expressed on this article are the writer’s personal and don’t essentially mirror Al Jazeera’s editorial stance.

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