Last week in South Sudan

Old sign

Opening ceremony

Mariana and Dr. Ka

Dr. Kanjelo--Director General

Tea Break

GBV Peer Educators who are training in the other room with ARC.  "I'm preventing violence among women" is what their shirts say.

 

 

 

 After a long week of planning, traveling and getting used to my tent, we started training again today.  We have nine Arabic-speaking participants and three participants who can speak English.  There is one medical doctor and the remainder are nurses or nurse midwives.  The training opened with two members of the State Ministry of Health speaking to us on the importance of Family Planning.  Mariana is a health officer from South Sudan who tells me stories of her one daughter (of nine children) who lives in Greece and had her tubes tied after her second child.  "She's so European now, she couldn't even wait to have a girl first!" she says.  Dr. Kanjelo is the director general of the SMOH and seems very committed to supporting family planning. 
I hope to meet with him later this week with Pamela to discuss PAC here in South Sudan (post-abortion care).  I was plagued all weekend by my trip to the hospital feeling useless.  Over one hundred women were sitting in the gyn ward with sepsis and bleeding.  They have prescriptions by their beds so someone in their family can drive searching for antibiotics.  I visited the pharmacy, there are few medications there, no antibiotics and no pharmacies that carry in town.  Other than the general surgeon, who performs sharp curettage, there are no providers for manual vacuum aspiration and not even a speculum around, definitely no syringes.  Pamela, Rita and I can all provide MVAs and yet we couldn't.  So much work to do. . .
One highlight of my trip to the hospital was meeting  Leah, a Kenyan midwife who now lives in South Sudan and is committed to starting Family Planning services at Wau Teaching Hospital and boy she's a spitfire!!  I had a great time meeting her last week and talking with her today since she will be refreshing her knowledge at training this week and brought several of the other participants with her for her crusade.  I am amazed by the strength I see in the people I've met here and the resiliency they have and ability to smile despite all they've been through.  She was telling me how she worked in Darfur providing family planning and how she would get interrupted by the loud speaker announcing a bombing coming in, but she says that's part of her job at times.  She is so committed, I know that she and Silas will get services up and going.  They have a room, supplies from UNFPA are on a truck as I write, and as she says, they must get started right away or that room will be taken from them.  Its a small room so she already has a plan to bring benches outside where women can wait with their crying babies.  She hopes enough people will complain about the noise that they will quickly move them to a bigger space which will suit their needs!  

 While Leah has provided services before, most of the other participants are not aware of family planning methods and have never worked with them before.  Fortunately they are enthusiastic to learn and to provide services.  Today, I started with some reproductive health basics (can you see my beautifully drawn uterus, tubes, and ovaries?!?!).  I went through anatomy, the menstrual cycle and fertilization to start and glad I did, because there were lots of questions.  Rita was a champ translating all day long and cracking jokes so we had a good time.  I did an overview of methods after that and Pamela discussed counseling this afternoon. 
Tomorrow we'll bring samples to show and play with--they are very excited to see what condoms look like! 

Even though this training is basic, I am so grateful to be here and to be able to connect with these providers.  We have had to adjust our goals for the week given the fund of knowledge and resources to train, so hopefully by the end of the week they will be able to provide comprehensive counseling and move on to clinical skills.
I got back to my tent early today since we didn't want to overload them on the first day, so I decided to go for a quick run.  I crossed over the Jur Bridge, went down another long dirt road and after waiting for some cattle to cross, I came upon an after school soccer game.  I couldn't help myself.  I love how universal it is.  I couldn't even ask how to play since they all spoke Arabic, but I walked over to some boys playing on the side of the field juggling and clapped my hands, motioned to my feet and they passed me the ball.  It was awesome!  I played around with them for about 20 minutes and they were hysterical.  They were cracking up at me, and I was laughing at just the whole situation.  I looked back at the road and there were another eight or so people staring, smiling, laughing.  An older man, a couple kids, an older boy who stopped to watch from his bike and a young girl.  I thought maybe she'll get to play some day.  Wish I had my camera. .