SSMJ August 2011
Editorials
The strongest force to build capacity in the health sector in the new Republic of South Sudan (ROSS) is Education and Training. This requires immediate investment to implement postgraduate medical education, expand and strengthen Juba College of Nursing and Midwifery and improve medical assistants/clinical officers training schools. These institutions compliment each other and must never be viewed in isolation as has been the case since 1972.
News, Reports and Policy
The United States AIDS Program known as the ‘President’s Emergency Plan for AIDS Relief’ (PEPFAR) has awarded the 2011 Lahya Shiimi Award to Dr Basilica Modi. This is the first time a South Sudanese has received this prestigious award “in recognition of the outstanding team work, leadership, dedication and critical contributions to ensuring the sustainability of the HIV/AIDS response in South Sudan”
Dr Thomas Burke is Chief of the Division of Global Health and Human Rights at the Massachusetts General Hospital (MGH), a Professor of Surgery at Harvard Medical School, a faculty of the Committee on African Studies at Harvard University, and a physician at MGH and Children’s Hospital Boston. Since 2008, at the request of Government of Southern Sudan (GOSS) and the World Bank, Dr. Burke has been working with the Ministry of Health (MOH) in the areas of maternal and child health and capacity building.
The purpose of the e-learning portal is to assist trainees with their written exams. This portal will allow trainees to gain exclusive access to online companies such as onexamination.com and medical-masterclass.com, which have online question banks containing thousands of mock questions. It is impossible to pass the written exams by reading text books only: the Royal Colleges ask certain questions that textbooks often fail to answer. The only way to pass is to answer at least 2,000 practice questions. When you get a question wrong, do not go to the next question. Look in a book, go online, and find out why you got the question wrong and why the right answer is the right answer. This is the only way to pass
The Real Medicine Foundation (www.realmedicinefoundation.org) was founded in May 2005 inspired by lessons learned after working for months in the Asian Tsunami relief efforts. Real Medicine Foundation (RMF) provides humanitarian support to people living in disaster and poverty stricken areas, and continues to help communities long after the world’s spotlight has faded. We believe that ‘real’ medicine is focused on the person as a whole by providing medical/physical, emotional, economic and social support.
I am writing from the newly born country of South Sudan. I am a physician who has recently relocated here after 22 years in the UK. One huge problem that this new country faces is lack of facilities for the treatment of all types of cancers.
Clinical Guidance
Onchocerciasis is an insect-borne disease caused by the parasite Onchocerca volvulus and transmitted by blackflies of the species Simulium damnosum. It is often called ‘river blindness’ because the blackfly lives in fertile riverside areas, that frequently remain uninhabited for fear of infection. Onchocerca volvulus is almost exclusively a parasite of humans. Adult worms live in nodules in the body where the female worms produce large numbers of first-stage larvae known as microfilariae. These migrate from the nodules to the sub-epidermal layer of the skin where they are ingested by blackflies. The microfilariae develop in the body of the blackfly and are transmitted to humans when the fly bites them (1).
Wherever we are in the world there never seems to be enough money for healthcare provision. So the key is to make what resources we have go as far as possible. Any laboratory test that we request should always be preceded by the questions “Why are we making the request, what are the possible results and what decisions might those results lead us to make?” Then we should ask “Have we gained all possible information from that test?”
The overall responsibility for health research in South Sudan falls under the Division of Research, Monitoring and Evaluation and has been the remit of the Directorate of Planning and Coordination in the Ministry of Health, Republic of South Sudan. The existing structure of the research department includes the research data hub, the ethical committee and the research secretariats.
Charts 7 and 8. How to give IV fluids to children without and with severe malnutrition from ‘Pocket Book of
Hospital Care for Children - Guidelines for the Management of Common Illnesses with Limited Resources’ WHO
2005. See the whole book at http://www.ichrc.org/. Charts 1 – 6 were reproduced in previous issues of this journal.
Research
The purpose of this beginner’s guide is to start you off on the research journey by outlining the sequence of steps along the research process (see Figure 1) and providing guidance, including signposting other useful resources that can help support each stage of the process.
Extract from ‘South Sudan Antenatal Care Clinics Sentinel Surveillance Report 2nd Round September - December 2009’ HIV/AIDS/STI Directorate, Ministry of Health, Republic of South Sudan
The carriage of Streptococcus pneumoniae, serotypes, antimicrobial susceptibility patterns and disease development are poorly understood in Yei. Availability of affordable antibiotics over the counter, lack of laboratory infrastructure and high rates of penicillin resistance have the potential to aggravate rates of childhood mortality associated with Streptococcus pneumoniae. There is an urgent need to strengthen microbiological and public health services.
Extract from ‘KAP Survey Report: Aweil East County-Highlands, Northern Bahr el Ghazal state. November 2010’. By Jane Gune, Project Manager (Tearfund DMT South Sudan). Funded by the Canadian International Development Agency.
Case Reports
Clinical History
Hospital admission after sudden onset of headache, dense contralateral hemiplegia and hemisensory deficit.
Summaries
Extract from ‘KAP Survey Report: Aweil East County-Highlands, Northern Bahr el Ghazal state. November 2010’.
In this issue these are listed under, South Sudan in the Lancet, HIV and other infections, Non-Communicable Diseases, Maternal, neonatal and child health, Surgery, Health services and Job Aids