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.