One of the best parts of visiting ECDC in Stockholm last fall was the opportunity to meet the remarkable people on its Epidemic Intelligence team: smart, dedicated, and highly professional. One of them was Dr. Jas Mantero, who was about to leave ECDC for a stint in South Sudan with an Italian NGO, Doctors With Africa.
He recently sent me a long email about his experiences there—the first of many, I hope. And he's given me permission to publish excerpts here.
I am happy to tell you everything is going well, I am really excited about these two months. I am doing nothing special a part of learning every day more and more from people situations and clearly from looking back at my reactions and feelings during these long days. The rest of my team is really focused on the County Hospital, the Lui hospital, not far from Mundri, maybe 180 miles from Juba. Or I should better say 4-5 hours of car during the dry season, and probably twice so much during the rainy season.
As I was saying the rest of the team is really working AT the hospital, supporting the local staff in clinical, administrative and logistic aspects. On the other side, I am in charge of everything outside the hospital: my NGO, CUAMM Doctors with Africa, working within the Italian Cooperation frame, asked me to have a look on the field and to implement some basic public health activities, so that we can better understand the problems of the population and how to improve the hospital activities.
And here I am, since December visiting one by one all the health units and the health centers of the county together with Alvance, my good friend from the local County Health Department: we are mapping the facilities, supervising and recording activities, taking note about any lack in term of staff, material, knowledge, infrastructure, talking with the people, learning about the villages difficult to reach. And so on. A long but interesting part, lot of people and situation to come across with, lot of hours in the car, lot of information to collect. Even maps to create with a simple GPS…as most roads are not on maps.
After this I will try to implement, in collaboration with the local health authorities, some specific targeted activities in support to the communities. I hope mainly in terms of referral system to Lui hospital and in terms of health information system. By the way, do you have there an old car we could use as ambulance for the north of the county?!
What else, I try to take care of the TB project in the county, with a lot of problems in terms of staff and management of cases, it s a bit chaotic but it would be so important to improve the work at the (few) DOTs centers identified in the area. Then I take a bit care of the health data of Lui hospital, we are finalizing the annual report now for 2012 but, most important, we would like to establish a PH unit within the hospital, for health data management but also for health education activities implementation and active surveillance of epidemics...and finally we are going to implement a survey in a few weeks in the field trying to understand what are the main barriers for women to come to deliver in the HF.
Can tell you already here it's full of malaria and that we are right in the dry season and in the meningitis belt..can tell u already that TB is a huge problem totally underestimated due to lack of detection and curative activities, can tell you that MSF is coming for a screening study about trypanosomiasis, and can tell you that nodding disease is still a big question mark in the area of Mundri East. But nothing compared to maternal mortality…numbers here are just unbelievable and so much could be done. Clearly priority one is making delivery a safe and assisted practice whenever and wherever this is necessary.