The truth is that even in the worst of situations people still need water, food, and medicine, and that is exactly why we have focused all of our attention over the last decade on building an indigenous, sustainable local water organization. The Water is Basic team is going nowhere. They are South Sudanese and they can repair wells in hours. We have been able to import food and medicine and well supplies. Our military escorts and staff drivers have risked much as our first truck was attacked for over an hour. Our second convoy made it through without any violence but the already terrible roads are rapidly getting worse and taking a heavy toll on our trucks.
This project of Water is Basic is aimed to relieve the water crisis that the Bor Dinka congregation is facing. There was an existing borehole that was drilled by Water is Basic that has not been working for six (6) months. The community around the Dinka congregation are mostly the displaced people from Bor and even from other states affected by the war.
One year ago today I sat on my porch in South Sudan as a new day dawned. It was a day that would see laughter, praise, quiet, suffering and an amazing sunset. It was another day in the civil war torn country of South Sudan a country in desperate need of so many things, one of which is basic, clean water.
I recently spent four days in Yei, South Sudan. I was the technology-challenged sidekick to Steve Roese, President of Water is Basic, a man who is always on the fly, lives by “Whatever it Takes” and with Water is Basic has drilled over 600 borehole wells in his adopted land. He stops at nothing to bring life-saving clean water, build awareness and understanding, embolden others and bring hope to a land that has known little. He issued me a challenge, one I willingly accepted.
South Sudan gained independence from Sudan in July 2011, after a history of ethnic division, colonialism, famine, exploitation and more than 50 years of war. That much war creates quite a mess – both literally and figuratively. Among other challenges, South Sudan has essentially no heath care system and there are few trained health workers. To highlight what I mean by “few”: there is one doctor for every 65,000 people. Combine that with long distances, a widely dispersed and displaced population, poor roads and a lack of financial resources and it is estimated that only 1 in 4 has access to health services in a population of over 11 million.
What is the result? Some of the worst health indicators in the world. Health indicators are statistics that help us to compare the overall health of one nation relative to another. South Sudan is not faring well. For example, South Sudan has the highest maternal and child mortality rates in the world.
For every 100,000 women who give birth in the country, over 2000 die. Compare that to 18 per 100,000 in the U.S. Just 48% of pregnant women attend one or more antenatal care visits, which could reduce this number considerably. On average moms in South Sudan have 5 children. What happens when you lose a mom? Orphans.
For every 1000 live births, over 100 children die before age 5, with preventable infectious disease and malnutrition being the leading killers. Compare that to 7 per 1000 in the U.S. Simply, 1 in every 10 children in South Sudan don’t make it to kindergarten. What does this mean? Senseless broken hearts and a loss of human potential. No access to health services equals preventable and senseless suffering.
Of the services provided in South Sudan, 80% are provided by international and faith-based NGOs like UNICEF, Médicins Sans Frontières (MSF), Harvesters International and International Medical Corps, to name a few. Humanitarians and crisis warriors waging a battle to bring some level of care to the people, they are crucial. However, they proceed with caution so as to not create a systemic dependency and impede the natural, sustainable development of the local health care system. The future lies in the South Sudanese building their own models of care and capabilities to serve their own.
After gaining independence, things were starting to get better. People were learning to live in peace rather than war and some indicators were beginning to slowly improve. A nation was being built. Then in December 2013 just before Christmas, war broke out once again.
Two steps forward, one step back.
Despite this obvious setback, Steve told me about a primary clinic in Yei started by Bishop Elias Taban and the Evangelical Presbyterian Church (EPC) operating entirely with a local staff and without donor funds.
To which I said, “Whatever, not possible.“
When I spoke to health professionals here in the US about the existence of such a clinic, they told me plainly, “Primary care doesn’t exist in South Sudan; there is acute care only, all provided by outsiders.”
Steve insisted it was true and challenged me to come to Yei and see for myself. If I liked what I saw, he challenged me to help grow it. So I booked my ticket for the 30-hour journey to find a unicorn, a beast of legend, elusive and symbolizing hope and beauty.
As the trip grew closer, the security situation worsened. There were new reports of atrocities and violence growing closer and closer to Yei; food shortages, people fleeing and increased desperation. Things are always tough in South Sudan, but hope kept things moving forward. Hope was fading. I considered cancelling, but persisted because, if there was indeed a unicorn in South Sudan, the world needed to hear about it.
Turns out I found what I was looking for.
Along a small red-soil road and lined with tukuls and small cooking fires, not far off the main Juba-Lainya road, is the Evangelical Presbyterian Church of Yei. Adjacent to the church is a small cluster of buildings called the EPC Clinic.
Bishop Elias and Ann Grace Taban started the clinic because the people of their community were dying from simple, preventable illnesses. Their vision was to create a self-sustaining primary care resource for the urban areas of Yei that would reduce preventable deaths, improve the health of the community and eventually fund outreach efforts to the surrounding rural areas.
A local staff of 21 including two clinical officers and four nurses operates the clinic. It has 36 inpatient and outpatient beds, including a children’s ward and women’s ward, and serves a caseload of over 600 cases per month with people coming from as far away as Juba to receive services.
In addition to general medicine, the clinic performs minor surgeries and has a dedicated operating theater under construction, which will be fully functional by the end of the year.
In South Sudan, only 35% of health facilities provide immunizations. EPC Clinic provides an average of 400 free immunizations a month.
Less than 20% of health facilities provide laboratory services for common tests. EPC Clinic offers a full battery of laboratory services on site.
Over 50% of health facilities have regular drug stock-outs. EPC Clinic has a staffed pharmacy on site with a consistent supply of regularly prescribed pharmaceuticals.
The clinic has partnerships with other local health facilities, including the local Yei County Hospital, EPC Harvesters Bet Eman Hospital for Women and Children and The Martha Clinic.
Has it been easy? Absolutely not, but they are doing it day in and day out. Perhaps most importantly EPC Clinic does not rely on donor funds for operations and is funded by daily fee collections. It is locally staffed and managed, sustainable and provides culturally concordant care to community it serves. EPC Clinic of Yei is a scalable social innovation in some of the most difficult circumstances.
Water is basic, but I put forth that health is a universal human right. With health comes the ability to live up to our potential, look to the future and imagine progress. The EPC Clinic in Yei is a shining star, one that is leading the way to a healthier future for South Sudan. It is a beginning step towards sustainable primary care in a nascent nation whose people have known too much suffering.
What should one do when they see a unicorn? First, run and tell others about what they have seen. Then, use whatever resources are available to strengthen this beautiful creature and help it increase in number.
What if there were two EPC Clinics in Yei County? What if there were five clinics covering Yei and into the adjacent county? What if there were twenty across the region? You get the picture.
I am both an optimist and a pragmatist. I went to South Sudan to find a unicorn. I found what I was looking for and it has filled me with hope for a brighter future in the newest country on Earth.
Now it’s time to get to work.
Whether you are raising funds for a charity run for Water is Basic, or you just want to make a bigger difference in the lives of the people of South Sudan, there are countless creative ways you can fund raise- and have fun doing it! Here are a dozen of our favorite ways to change the world one well at a time:
I’m used to crying whenever my plane takes off from Yei South Sudan with emotions and thoughts whirling around my head and heart- I’m used to it now. I mean these are my people, my friends. They have suffered for years, most from the day they were born, through agonizing war, unspeakable atrocities, and middle of the night deaths of children, parents and friends. A good week is a week where a meal is eaten once daily. A good year, where enough funds were available for everyone to attend school, whether under a mango tree or a scorching hot corrugated roof.
For generations we have used the term “Local Yokel” to disparage the one who has stayed close to home, hands deep in hard work, untraveled, a “Local Yokel”. However I find it interesting that whenever tough times come, when life takes a turn for the worse in a community it is the Local Yokel who turns up ready to serve, who has ideas on turning things around, who is fully prepared to link arms on behalf of the community.
We see it when forest fires rage out of control, when flood waters rise or when miners are stuck far beneath the earth’s surface.
When the dream of drilling for water was birthed inside the weathered hearts and minds of Local Yokels in South Sudan, many said they could never accomplish what they dreamed of. Imagine three generations of war torn, malnourished, up rooted, uneducated South Sudanese developing and leading their own water organization with a goal of giving everyone in their country clean water?
Preposterous, certifiable, irresponsible!
We drilled our first borehole in July of 2008 and quickly expanded our territory as we mastered logistics and reporting. I wish we could tell you we have solved the problem but it would be untrue.
In spite of our efforts and the efforts of so many others the needs have never been higher as half the population faces severe hunger, millions are displaced and peace is a mirage in this parched desert of reasonable leaders. Some organizations have given up but not these Local Yokels! This is home and since they have seen hard times before they are not deterred. We are received well reports every week even as South Sudan seems to be spinning out of control.
I am pleading with you to request the report we just received. Look into the faces and listen to their pleas. Know that this is a country that has prayed for years to one day join the Third World and now because of egos, greed and hatred they are moving even deeper into a place known by few countries in our world. Inflation is rampant, food is scarce, sickness a constant burden and water hard to find.
Our web site says we are empowering the world in the fight for clean water; maybe we should change that to Empowering People, Families, Hopes and Dreams through the “fight for clean water”.
Right now we are doing everything we can to raise as many funds as we can. We can restore a well every day and soon with our new Land Cruisers, we can double that output…. all we need is you and your sphere of influence to stay in the game with these LOCAL YOKELS and us!