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عربي

Hospital corruption hurts South Sudan’s shaky health services

Abraham Maker
The Rumbek State Hospital has long suffered a shortage of essential drugs, but patients accuse nurses of charging for medicines which should be free.
16.09.2013  |  Rumbek
A patient is treated in a hospital in Bentiu, February 10.
A patient is treated in a hospital in Bentiu, February 10.

Allegations of corruption and illegal charges for medicines have surfaced in the State Hospital of Rumbek, the capital of Lakes States, in South Sudan -- echoing charges of corruption in hospitals elsewhere in South Sudan, which has one of the worst records on health provision in the world.

Jacob Mamer, a resident of Rumbek East County, accused health workers of not treating his sick sister until he paid for drugs. We don’t trust them anymore,” he told The Niles. Everything is commercialised and you will never get service unless you give them something.”
 
Everything is commercialised and you will never get service unless you give them something.”
Jacob Mamer
Rumbek State Hospital is the only Government-owned referral health centre in the whole of Lakes State, but its services are poor and it is staffed by a few underpaid health workers.

A number of health services, which are supposed to be granted free of charge, are being used to earn money from patients.

Jackson Magok Isaac, a programme manager for the Episcopal Church of Sudan health programme, described how an HIV-positive woman was asked to pay for antiretroviral medicine in the government-run hospital. We referred her to the main hospital to register and get free services,” Magok said. She came back and told us that she was charged 300 South Sudanese Pounds (around 100 US Dollars) in order to access the antiretroviral drugs.”

Monica Achien, August 1.
© The Niles | Abraham Daljang Maker
The outrage extends to maternity wards where mothers are also charged 100 South Sudanese Pounds by midwives after delivery. Monica Achien, a senior midwife in the hospital, admitted this happened but stressed it was strictly forbidden. This is an illegal practice which should be punished if the culprits are found,” she said. She said they were keen to clamp down on the illegal charges.

Last year, the ministry of health took steps against malpractice. In July 2012, the Director General of the State Ministry of Health Michael S. Mading sent out a letter, which has been seen by The Niles, urging all ministry of health employees in Lakes State to respect the rules on service delivery.
 
Responding to allegations of unlawful fees for patients, it spelled out the areas of health which should be provided for free. No charges must be collected for antenatal care, deliveries, prevention of mother-to-child transmission (of HIV) and antiretroviral drugs for HIV clients,” it said.

Similar complaints have been made elsewhere in South Sudan. In Jonglei State, health workers at the government-run Bor Civil Hospital have been accused of illegally charging pregnant mothers. According to a report published on Gurtong news website on June 22, 2013, pregnant mothers had to pay 70 South Sudanese pounds for delivery.

No charges must be collected for antenatal care, deliveries, prevention of mother-to-child transmission (of HIV) and antiretroviral drugs for HIV clients.”
State Ministry of Health
Dr. John Kok, a director of planning in Bor civil hospital, pledged he would take measures against those involved, according to the report.

The accusations of malpractice tarnish the health service in a country where provision is already patchy. A November 2012 report by Doctors without Borders, showed that more than 80 percent of South Sudan’s healthcare is provided by international NGOs. The global health policy centre, the Centre for Strategic and International Studies, CSIS, has described healthcare in the young country as critical”.
 
An extreme shortage of medical professionals is a key problem, it wrote, adding that there were only 1.5 doctors and two nurses for every 100,000 citizens. Many women in labour in South Sudan have to walk for hours or even days to reach health centres and South Sudan’s record for maternal and infant mortality are among the highest in the world.

Most hospitals have poorly-trained community health workers on their staff, including nurses and midwives. This lack of professionalism and low wages is seen as fuelling corruption in medical establishments.