RAISE Projects
Awaiting care in Southern Sudan
These patients travel up to twelve hours by road or even boat, in terrible pain, to reach the hospital. They face infection, haemorrhage, and possibly death. Many more women never make it that far. Quite a few don't even seek help, explains Wakjira, because they don't know that the hospital provides post-abortion care, and family planning, both of which can prevent maternal death and disability.
In her 13 years as a nurse-midwife in Ethiopia and Sudan, Wakjira has seen how even the most basic knowledge about reproductive health (RH) has the potential to change clients’ lives.
As part of her current work with ARC, Wakjira reaches out to communities to educate them about life-saving RH services, including family planning, which only recently became available through government-run health services.
It has been challenging to promote family planning in a culture that believes women should give birth every year once they marry. "Deliver, then breastfeed, then deliver again," sighs Wakjira. She has seen family planning slowly take root, however, as more Sudanese learn about its benefits from local health care professionals trained in family planning at the RAISE Training Centre. This gives her hope that one day most women will never need to consider illegal abortion and face the life-threatening complications that often accompany it.
But a great deal of work remains to be done. Wakjira recalls a young pregnant woman who arrived at Malakal Teaching Hospital in critical condition. The woman’s local health facilities lacked staff capable of performing the emergency Caesarean section she desperately needed, and during the nine-hour boat journey she took to reach Malakal Teaching Hospital, her uterus ruptured. "We are making strides in educating people about reproductive health," Wakjira says. "But when there are no supplies, training, nor equipment where they are needed, our ability to save lives is constrained."
RAISE and the American Refugee Committee (ARC) are working closely with the Southern Sudanese Ministry of Health to provide comprehensive reproductive health services in Malakal, a vastly underserved county in Southern Sudan.
On the ground
Southern Sudan's forty-year civil war claimed more than two million innocent lives and left millions more displaced from their homes. Although a comprehensive peace agreement was signed in 2005, the region continues to suffer: The ground is littered with landmines, armed looters roam the roads, and communities still lack access to basic necessities including food, clean water, and health care.
The region's health rankings - particularly with respect to reproductive health (RH) - are startlingly poor. The number of pregnancy-related deaths is second highest in the world. A lack of security and qualified providers, coupled with a collapsed health system, mean that many women become disabled or die needlessly, without having received any medical attention whatsoever. Undoubtedly, ensuring access to quality comprehensive RH care can save countless lives.
How RAISE is helping
In partnership, ARC and RAISE are helping to build the capacity of local health authorities to provide services, supplies, and skilled staff.
RH services include:
- Emergency obstetric care (EmOC)
- Post-abortion care (PAC)
- Family planning
- Prevention of mother to child transmission of HIV
- Clinical care for rape
- Care for sexually transmitted infections
Building capacity means that RAISE and ARC eventually transfer the management of all aspects of the project - facilities, trainings, supplies, and equipment - to the Southern Sudanese Ministry of Health.
Three key aspects of the Southern Sudan project:
Breaking new ground at Malakal Teaching Hospital
With the Southern Sudanese Ministry of Health, UNFPA, and the Swedish International Development Cooperation Agency (SIDA), the RAISE-ARC project is building the region's first comprehensive EmOC-equipped maternity ward in Malakal Teaching Hospital. The project is also upgrading facilities and services for RH at Malakal Teaching Hospital to meet globally accepted standards.
Reaching rural communities
RAISE and ARC are bringing RH services to people in remote, hard-to-reach parts of Malakal County by ensuring that a local clinic has trained staff, supplies, and equipment, and a 24/7 referral system for emergency obstetric complications.
Training local medical providers
Part of building Malakal's health care infrastructure is building skills. Master trainers at the RAISE Training Centre at the Marie Stopes Eastleigh Nursing Home in Nairobi, Kenya, provide essential training in EmOC and PAC to ARC staff at the project's sites. The RAISE-ARC project has also conducted monthlong trainings on EmOC at Malakal Teaching Hospital for health workers from all over Southern Sudan.
Country Context
- Southern Sudan is rich with natural resources, including oil, water, forests, and minerals.
- A 15-year-old girl is more likely to die due to pregnancy or childbirth than to finish primary school.
- Children here are three times more likely to die than in the rest of Sudan.
- Women here are four times more likely to die during pregnancy or childbirth than in the rest of Sudan.
- The percentage of women who give birth with a professional trained to manage complications (5%) is the lowest in the world.
- Southern Sudan has the youngest population in the world (21% under age five), in part because civil war and famine have killed so many adults.
RAISE Partner
ARC works with partners and constituencies to help refugees and displaced people survive conflict and crisis and rebuild their lives with dignity. ARC provides primary and comprehensive RH care, health education, prevention and care for HIV/AIDS, clean water, sanitation and hygiene services, protection and recovery assistance, and economic opportunities. (arcrelief.org)
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