Grappling with his breath on the hospital bed the one month old baby is very sick. This is his second day at the Mankein Primary Health Care Centre (PHCC) and Martha, his mother, is worried about the children she has left at home.
The 32 year old mother of four comes from Riak village in Unity state, three hours walk from Mankein. Riak once had a smart health facility complete with medical equipment and a pharmacy, but that was before the crisis that plunged South Sudan into chaos in December 2013.
Like much of the nascent country’s infrastructure, the clinic in Riak was destroyed in the conflict. Nowadays, the health facility operates out of a mud hut comprising of a single room used for immunizations, nutrition, pharmacy, laboratory and antenatal consultations, as well as storage of drug and nutrition supplies. There is little by way of medical equipment so when Martha’s baby son developed a chest infection, the closest health facility able to help her was in Mankein.
“I walked for hours so that my child will be examined and get treatment,” said Martha. “I am very relieved that we are now admitted and my baby is being cared for.’’
Martha is a single mother, following the death of her husband in 2014. At the time, Martha was already pregnant with her fourth child. To talk about the last two years of her life and the daily struggles to raise her children is painful and Martha is hesitant to continue.
The three cows left to her by her husband provide milk for her children and her elderly mother-in-law, but it’s not enough.
“Now I collect water lilies from the swamps for my family to eat. We don’t have food, this is all we have,” she says. “This year I planted some maize but there was no rain so nothing grew.’’
With a tiny baby in need of medical care, Martha was forced to choose: to remain at home and continue to provide food for three of her children and risk the health of the fourth, or make the long journey by foot to Mankein to ensure her baby could receive appropriate medical care and leave her young family behind to fend for themselves.
Martha left her other children at home to bring her baby son to the health centre. Photo: Robinah Baseka/CARE.
The health system in South Sudan is one of the world’s most under developed. Primary healthcare coverage is low and mortality rates high. The country has one of the highest maternal mortality rates in the world. Before the crisis, roughly 1400 health facilities and 37 hospitals served a population of 11 million people. There are few paved roads and only 40 percent of South Sudanese are able to access health care within five kilometres from their homes.
The long distances to the country’s health facilities have discouraged many women like Martha from accessing health services, particularly sexual and reproductive services, leaving many women to give birth at home without the services of a professional midwife.
“Giving birth at the health facility is good, I sometimes wonder if my child would be healthier if I had given birth here” she concludes.
CARE is supporting 22 health facilities in Unity state.