Amid ongoing challenges of instability, violence and very limited health infrastructure, partner organization Women and Health Alliance International (WAHA) provided surgery to 249 women in South Sudan over the last two years. Nearly half of these surgeries were complex cases, and expert surgeons worked with local fistula care teams to ensure that patients received high-quality…
Why Do We Work in South Sudan?
At 730 deaths per 100,000 live births, South Sudan has one of the highest maternal mortality rates in the world; each woman has a 1 in 28 chance of dying from pregnancy-related causes during her lifetime. What is more, for each woman that dies in childbirth, an estimated 20 additional women suffer from devastating childbirth injuries like obstetric fistula (WHO 2014).
Nearly every risk factor for obstetric fistula is prevalent in South Sudan. Political instability within the country has led to mass internal displacement and an escalating economic crisis, both of which greatly reduce availability and accessibility to maternal healthcare services. The ongoing conflict adds to numerous recurrent challenges caused by decades of civil war, regular epidemic outbreaks, seasonal flooding, underdevelopment and extreme poverty. Early marriage and teenage pregnancy are common, the fertility rate is high, and very few women give birth in the presence of a skilled attendant. This is due to a lack of adequate maternal health care services and/or women’s inability to access them – grave ongoing security concerns restrict free movement, especially at night.
The combined factors of ongoing instability, displacement, and a general dearth of health services and skilled care providers contribute to a high rate of obstetric fistula in South Sudan and a dramatic backlog of existing cases. The sporadic fistula treatment campaigns that have been carried out in the past are not a sufficient response to the immense need for continuous, comprehensive fistula treatment.
What You Help Us Do in South Sudan
We’re helping fund:
- Fistula surgeries
- Surgeon training
- Community outreach
- Reintegration support
Juba Teaching Hospital, Juba
Wau Teaching Hospital, Wau
Aweil State Hospital, Aweil
How much funding have we granted?
$152,000 in FY2016
$269,500 in FY2014
$25,000 in FY2013
Who is our partner?
We provide grant support to these hospitals through Women and Health Alliance International (WAHA).
How will this help women in South Sudan?
WAHA has established a fistula treatment and training program at Juba Teaching Hospital, one of the country’s largest hospitals. Through the provision of high quality fistula care, WAHA has also begun to build the capacity of local staff in order to ensure that the quality of care they provide meets international standards. WAHA has also worked to establish fistula programs at Wau Teaching Hospital and Aweil State Hospital in the northwestern part of South Sudan, where outreach activities identified many cases of obstetric fistula. Aweil State Hospital was equipped for fistula treatment, it had large enough facilities to ensure patient care and management and staff were all supportive of adding fistula care to the hospital’s available services. Wau, a particularly unstable region in South Sudan, proved to be a challenging context in which to work, but fistula repair services were finally able to begin in 2015. Establishing routine services at these three facilities enables WAHA to provide regular fistula care to women in South Sudan over a broad geographic territory where transportation would otherwise be a challenge.
Patient transport remains a critical challenge in the region for WAHA, however, and the insecurity within South Sudan at times inhibits women from reaching a fistula treatment facility. To work around this barrier to treatment, WAHA has built partnerships with other hospitals where fistula surgeries can be performed when needed.
WAHA’s community outreach activities have focused so far on leveraging, supporting and expanding existing local outreach networks. In partnership with these networks, WAHA will further expand their ability to conduct local outreach and sensitization of communities where fistula sufferers live.
Their work is being performed within a highly complex and challenging setting, with local health teams that face enormous daily challenges in carrying out their tasks. Yet fistula is becoming an increasing priority, and WAHA reports that the longer they work within these targeted hospitals, the more they are becoming recognized as a reliable partner that provides high quality obstetric fistula care services and high quality training opportunities.
Thus far, funding has enabled WAHA to provide advanced skills training to three surgeons, fistula care training to 20 health care workers, community outreach via radio announcements, posters, and community meetings, and treatment for 388 women – many of whom had complex and recurrent cases of fistula.
Where is South Sudan?
Facts About South Sudan
- Average births per woman:5.43
- Physicians per 10,000 people:0.7
- Births attended by skilled personnel:43%
- Lifetime risk of maternal death:1 in 28(chances a woman will die during childbirth)
- Female life expectancy:51.93 years
- Female literacy:42.1%
- Population living in rural areas:55.4%
- Population living in poverty:49%(less than $1.25/day)
- Surgeries completed through Fistula Foundation funding to date:388
Sources: CIA World Factbook; WHO; World Bank