Issues
> Overview
> Cholera
> Eye Diseases
> Guinea Worm
> HIV/AIDS
> Malaria
> Malnutrition
> Maternal Mortality
> Meningitis
> Tuberculosis
Overview
South Sudan emerged from a 21-year civil war after the signing of the Comprehensive Peace Agreement (CPA) between North Sudan and South Sudan in January 2005. However, more than five years later, the region is still unstable and medical needs remain critical. The area where the Clinic serves had the highest number of Internally Displaced People in all of Sudan, and was also listed as "Very Food Insecure" (WFP, March 2010). Diseases that have not been seen in the country for years now threaten to take the lives of people who are working to rebuild in one of the most undeveloped and neglected places in the world. In a country with a population of an estimated 11 million, there is only one trained doctor for every 100,000 people.
In addition to the ongoing violent attacks, malnutrition is prevalent, maternal mortality rates remain the highest in the world, HIV/AIDS and guinea worm are ongoing problems, and large-scale outbreaks of meningitis, cholera, and malaria are almost always present. In the midst of all of this, humanitarian aid is lacking, with very few organizations operating in the region of John Dau's home.
Because of the quality services provided by the Duk Lost Boys Clinic, John Dau’s home area of Duk is now a preferred location for the UN to repatriate thousands of displaced families. In an area that has been described as a "paradise" but which was nearly abandoned during the war, these returnees make up 99% of the population. The lack of basic services and the harsh living conditions of the region--flooding mixed with 100+ degree heat--presents a mounting challenge as more and more people repopulate the area. The Clinic provides a rare and vitally important service to the population, encouraging people to rebuild their lives and remain optimistic about their future.
Cholera
Cholera is an acute, diarrheal illness caused by infection of the intestine with bacteria. Infection can often be mild without symptoms, but sometimes it can be severe. In people with severe cholera, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.
A person can get cholera by drinking water or eating food contaminated with cholera bacterium. The disease can spread rapidly in areas where there in inadequate treatment of the sewage and drinking water. While Cholera is not common in Sudan, an outbreak can quickly spread and infect thousands of people, meaning the Clinic must constantly test for the bacteria. Working with the World Health Organization, the Clinic tests and reports Cholera infections to ensure an outbreak does not occur.
Eye Diseases
Life is tough in South Sudan as the grossly impoverished region struggles to rebuild after 21 years of civil war. It's even harder for the tens of thousands who can't see, mostly because of preventable infections left untreated during the conflict, some of which have been wiped out in other parts of Africa. Blindness is a common problem in the region often and is often caused by river blindness, trachoma and cataracts.
Night Blindness, or Xerophthalmia, is a common disease in young children. It is most often caused by a Vitamin A deficiency, which the John Dau Foundation combats through our extensive Vitamin A supplement campaign. Night Blindness can result in increased susceptibility of Measles, and if left untreated, can cause permanent blindness.
A cataract is a clouding of the lens in the eye that affects vision. This prevents light from passing through and vision is blurred. Most cataracts are due to the normal aging process and develop at different rates. Certain medical conditions, like diabetes or heart problems, may also cause early development. The upward trend in cataract diseases cases in Sudan are ascribed to high temperature, malnutrition along with high blood pressure, diabetes and other infections. Around 50% of blindness in Sub-Saharan Africa is due to cataract.
Trachoma is an infectious disease of the eye caused by the bacterium, Chlamydia Trachomatis. The bacteria can be spread easily from an infected person's hands or clothing and can even be carried by flies that come in contact with fluids from the eyes or nose of an infected individual. This chronic eye infection results in scaring of the eyelids and damage to the eyeball, resulting in blindness if left untreated. There are 3.5 million people living with trachoma in Sudan, 75% of which are in South Sudan. Trachoma is a quiet disease that manifests gradually. Children that are infected may not have symptoms until adulthood.
Guinea Worm
85% of the world's reported cases of Guinea worm are from Sudan.
Guinea Worm disease is a parasitic worm infection that occurs mainly in Africa. People are infected when they drink standing water that contains a tiny water flea that is infected with the even smaller larvae of the Guinea worm. Once inside the human body, the larvae mature, growing as long as 3 feet. After about a year, the worm emerges through a painful blister in the skin, causing long-term suffering and sometimes crippling after-effects.
Although Guinea Worm is rare in the area around the Clinic, sporadic cases do occasionally occur. The Clinic staff is trained to diagnose and treat Guinea Worm as well as report outbreaks to the World Health Organization.
HIV/AIDS
Sudan has the highest infection rate of HIV/AIDS in North Africa - 400,000 infected in 2005.
December 1, 2009 marked World AIDS Day. In honor, the Clinic launched the first ever HIV/AIDS prevention and treatment program in the region with a community meeting featuring local leaders and visiting medical doctors from the U.S. At the meeting, staff handed out AIDS ribbons and introduced the Clinic's new HIV/AIDS Counselor. HIV/AIDS is a growing issue in Sudan, and the John Dau Foundation is committed to ensuring the local population is fully educated about the causes, symptoms, and treatment of the deadly disease.
Additionally, the Clinic has trained and mentors a group of teachers and students to conduct HIV/AIDS education campaigns in the community using theater, a popular cultural medium.
With less than 1% of the population of South Sudan having ever been tested for HIV/AIDS, the main goal of JDF's HIV/AIDS program is to promote awareness of HIV/AIDS and to encourage usage of our Voluntary Counseling & Testing services. All expectant mothers receive HIV/AIDS counseling, and the Clinic stocks Anti-retroviral (ARV) medication for mothers who are HIV+ to prevent mother to child transmission of the disease. These are the only such services for more than 100 miles.
Malaria kills more than a million people worldwide a year. 90% of those who die are African children.
Malaria is a mosquito-borne disease that most often infects children. With the large amounts of still water in the area and lack of malaria control programs, malaria is, unfortunately, widespread among the population. The John Dau Foundation has taken steps to prevent the infection of malaria by distributing over 2,500 bed nets to mothers and children under five. As evidence of the program's success, in the month of November 2010, the height of the rainy season when mosquitos are most prevalent, there was not a single confirmed case of malaria at the Clinic.
When a patient is diagnosed with malaria at the Clinic, they are provided with medication that is extremely affective and surprisingly inexpensive for JDF, allowing the Clinic to have a large stock of the medicine and cure dozens of cases per year that still persist due to a shortage of nets.
Malnutrition
45% of children in Sudan suffer from physical stunting as a result of malnutrition.
Malnutrition causes 60% of deaths in children under 5.
Malnutrition is the disparity between the amount of food and nutrients the body needs and the amount that it is actually receiving. This imbalance is usually caused by under-nutrition.
During the months of May and August, the months before the harvest and the previous year's food has already run out, malnutrition is chronic. To make things worse, lack of access to clean water and nearly total absence of primary healthcare makes children very vulnerable.
The Duk Lost Boys Clinic has a small community garden to demonstrate methods of agriculture and crop diversity. Additionally, JDF conducted a comprehensive nutrition study of the area, using the results as the basis for an intervention in partnership with UNICEF. No other nutrition programs exist in Duk County, making this study the first of its kind in the region.
Maternal Mortality
According to Doctors Without Borders and a Ministry of Health survey, maternal mortality in South Sudan is the highest in the world – with 2,053 maternal deaths per 100,000 live births, or 1 out of every 50 births. By comparison, in the United States, the rate is 8 per 100,000.
The John Dau Foundation operates a highly successful Maternal Child Health program to educate mothers and Traditional Birth Attendants about recognizing high risk deliveries so that they may be referred to the Clinic. Additionally, JDF recently purchased a vehicle to transport mothers in labor who are at risk. Dozens of mothers come to the clinic every month for antenatal care services, and the Clinic conducts about 10 deliveries per month.
Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord. There are several types of meningitis. The most common is viral meningitis, which is caused when the virus enters the body through the nose or mouth and then travels to the brain. Dust storms, which are common during the January to April dry season, for example, lead to an increase in respiratory infections and help spread meningitis because the bacteria attach to dust particles.
The meningitis belt, according to the World Health Organization, stretches from Senegal in the west to Ethiopia in the east, with an estimated population of 300 million people. Meningitis epidemics occur in cycles. Early treatment can help prevent serious problems, such as death. Vaccines can prevent some of the forms of bacterial infections that cause meningitis.
Tuberculosis
In February 2009, the John Dau Foundation launched a Tuberculosis treatment program. Since the treatment of Tuberculosis is highly complicated, Clinic staff implemented a Directly Observed Therapy - Short Course program (DOTS), necessary to ensure the successful treatment of the disease. In DOTS, a combination of six antibiotics are used on a daily basis for six months under the observation of Community Health Workers, resulting in an 89% cure rate, above international standards.
The Clinic also offers, through a partnership with the World Food Program, food for the patients and a caretaker, a key aid in helping patients successfully complete the difficult and tasking treatment.
