Clinic business

Women’s clinic in South Sudan victim of a distracted world


Pregnant women wait to see a doctor at Mingkaman Reproductive Health Clinic in Mingkaman Village, Awerial County, South Sudan’s Lakes State on Wednesday, October 19, 2022. In a country with the one of the highest maternal mortality rates in the world, the small clinic dedicated to reproductive health care for more than 200,000 people is about to be closed – just one victim among many in developing countries so that humanitarian donors are strained by one crisis after another. (AP Photo/Deng Machol)


In a country with one of the highest maternal mortality rates in the world, a small clinic dedicated to reproductive health care for more than 200,000 people is about to close. Worried-looking mothers know all too well what might happen next.

“If the hospital closes, we will die more because we are poor,” said a pregnant woman who gave her name only as Chuti. She was attending a monthly checkup at the Mingkaman Reproductive Health Clinic in this town on the White Nile, and this may be her last.

The United Nations has announced plans to end clinic operations by December due to a lack of funding from European and other supporters. It is just one of many casualties in developing countries, as humanitarian donors have been stretched to the limit by one crisis after another, from COVID-19 to the invasion of Ukraine by Russia. The UN would not say how much it costs to run the clinic.

A loss like the clinic is critically important to people in places like Mingkaman, which, along with the rest of South Sudan, has struggled to cope with the aftermath of a five-year civil war, climatic shocks such as widespread flooding and persistent insecurity that includes shock events. rate of sexual violence.

The United Nations Human Rights Commission in South Sudan said the war in Ukraine has led to a drastic reduction in funding for emergency medical care for victims of sexual assault. “It’s not that sexual violence comes and goes, it happens all the time, largely unseen,” Commissioner Barney Afako said. The commission also said the government had failed to invest in basic services like health care.

This reproductive health clinic in the capital of Awerial County in central South Sudan serves a community largely made up of people displaced by civil war and flooding. This is where women who used to give birth at home now come to give birth. This is also where abused women come for treatment.

The maternal mortality rate in South Sudan was 789 deaths per 100,000 live births in 2019, according to the World Health Organization. That’s more than double the rate in more developed neighboring Kenya, according to UN data, while the US rate was 23 deaths per 100,000 live births in 2020, according to the Centers for Disease Control and Prevention.

At least 250 women give birth each month at the Mingkaman clinic, said Teresa Achuei, site manager for the IMA World Health organization, which runs the facility. She said she only knew of three women who had died giving birth in the community, all outside the clinic.

Now, she says, hundreds of women could be at risk. “Our goal, our mission, is to reduce the maternal mortality rate. Every woman should give birth safely. If the facility closes, there will be many deaths in the community,” she told The Associated Press during a visit in mid-October.

The clinic was founded in 2014, a year after the start of the civil war in South Sudan. Housed in tents as a temporary means of serving those displaced by the fighting, it remains makeshift but operates 24 hours a day.

It’s a hub of activity in Mingkaman, a community on one of South Sudan’s main muddy highways with no reliable electricity or running water. The army is present to respond to outbreaks of violence. Many women support their families by collecting firewood from the nearby forest to sell or work in modest local hotels.

Several women have expressed concern about the upcoming closure of the clinic.

“It’s going to get worse for us because it was helping us,” said Akuany Bol, who gave birth to her three children there. She looked miserable as she waited for a midwife to examine her child.

Andrew Kuol, a clinical manager, said the facility sees an average of 70 to 80 patients a day. It often admits 20 patients a day, twice the number of beds.

Some women need to be cared for in the field.

Kuol said the clinic is facing drug shortages, including malaria drugs, post-rape drugs, prenatal drugs and others, again due to dwindling donor support.

The nearest hospital is in Bor town in neighboring Jonglei state, where the clinic’s most complicated cases are sent. Getting there is also complicated. Without a bridge between states, it can take a boat an hour to cross the Nile.

As in much of South Sudan, travel is difficult. And the current circumstances mean that few people here can easily relocate for health care or anything else.

“These (displaced people) are not going anywhere because there is still insecurity and also flooding,” said James Manyiel Agup, Awerial County Health Director here in Lakes State. He urged UN partners to continue supporting the facility to save lives.