SSMJ February 2023
Editorials
The First National Malaria Conference held in Juba from 8th – 10th November 2022 came at the right time to re-focus the efforts in the fight against malaria in the country (See story on page 37). The presence of the H.E. Vice President Hussein Abdelbagi Akol Agany gave the conference the political support of the government in the fight against malaria. However, the recommendations fell short of the needs in the country.
News, Reports and Policy
East Central Southern Africa College of Physicians (ECSACOP) is a regional college comprising Kenya, Malawi, Tanzania, Uganda, Zambia, and Zimbabwe. The main purpose of the College is to address the shortage of physicians in the region.
Clinical Guidance
Participation in clinical practice is key to the development of clinical skills, and so the goal of clinical work is both to deliver healthcare and facilitate learning. Four factors shape learning in the workplace: safe access to practical experience; the role of talk in the workplace; teaching opportunities; and the learning climate. The challenge is to structure and carry out work so that support for learning is built into normal work routines.
Research
Many patients with diabetes mellitus are not attaining optimal glycaemic control, although the rate is unknown in South Sudan. Maintaining adequate glycaemic control is the most effective means of preventing complications associated with diabetes. This record review assesses the proportion of patients with diabetes on follow-up not adequately controlled using glycated haemoglobin (HbA1c) and describes associated factors.
The Caesarean Section (CS) rate is dramatically increasing across obstetric populations. This study aimed to determine the adherence to criteria for standard diagnosis of the common indications for CS among women of a low-risk group. This group, known as group 3 in the Robson classification, is multiparous, term with singleton pregnancy and have not had a previous CS.
Anecdotal experience suggests that Ugandan patients complain infrequently of breathlessness. The Luganda language, spoken in Uganda, does not have one word to express breathlessness but uses various phrases. Therefore, many of these patients may not be able to express what they feel when they are breathless by a single English word.
Case Reports
We present a case of primary cystic echinococcosis of the knee joint occurring in a 43-year-old female presenting mainly as disabling right knee arthritis in the form of chronic (13 years) painful swelling, which ultimately led to her inability to walk. Imaging and histopathologic examination revealed cystic echinococcosis of the right knee joint. Subsequent pulmonary, liver and bone screening for primary lesions were negative.
The objective of the study is to demonstrate the significance of damage control surgery in saving lives and possibly preventing permanent disability in a resource poor environment. This is because in resource limited settings, advanced treatment modalities such as external fixation and angiography with embolization are not available. Moreover, besides being expensive, these treatment methods for pelvic fractures require training and skills to perform.
Summaries
In Greater Mundri, erstwhile Amadi District, the Lui Hospital and modern health system came into being as from 1921. Dr. Kenneth Grant Fraser (Scottish), his wife Eileen Charlotte Fraser (Irish) and his sister-in-law Alice Galbraith (Irish) were members of the Church Missionary Society (CMS). Their coming to Lui was inspired early in their lives before they were married.
In the summer between graduating from medical school and starting my first Foundation Doctor post in the UK, I decided to travel to Uganda for an elective period. I was keen to experience medicine in a different health care system, particularly in a resource-poor nation.
South Sudan held the First National Malaria Conference from 8th – 10th November 2022 which culminated with the launch of the ‘Zero Malaria in South Sudan Starts With Me’ (ZMSWM) Campaign. The main objective of the conference was “To advocate and build the case for more investment in burden reduction of the number one killer (malaria) in South Sudan” under the theme, “Saving lives from malaria in a protracted humanitarian emergency setting.”