Eastern Equatoria State Health Minister Margaret Itto Talks to the Citizen
What was the Health Situation in Eastern Equatoria State?
The health situation is not bad compared to the 2005, when CPA was signed, because many more health services has increased but still it is not really 100% good. We have some counties with very few facilities e.g. Kapoeta East, from greater Kapoeta which comprises of north, east and south. But the east is worst because it is very vast and the facilities are very few and not many people are wealthy, they still need improved health care services and also improvement in the infrastructure and other the services they are provided and also in the human resource situation.
What was the current focus in Eastern Equatoria State in general?
The current focus in Eastern Equatoria State especially in Torit, is more on improving the mortal and child health, because these are almost vulnerable group in the population. However that doesn't mean men, the elderly, women will not be taken care of. But these are the most productive group. We looking to improved high mortal/maternal health by providing services that will help to address that big problem and the Maries Topes International center is one of that solutions.
Generally South Sudan is facing a big problem. Everybody knows about the austerity measure and since CPA was signed it was not easy, there are a lot of problems here and there. Even the resources that the country has was the same money the national government got and divided among the 10 states.
Secondly the human resources we have are very limited. We need to train more people so that there are enough people in the counties. Like the two facilities, they are two nicely built facilities but the personnel are not there to support their work. That is some of the shortages that they have but they are looking to address that issue.
As a Ministry, we may be able to get staff from other counties within the state and send them over there. The Ministry can try to address the problem but we are talking to partners so that we can work together hand in hand and see how we can minimize these problems in the state.
The Torit hospital is not out of the other facilities which we talk about and also the human resources. But it is going to improve; because we are looking to attract more health personnel to come in and support us meanwhile the Ministry of health is going to conduct a mapping for all health facilities.
The Ministry actually started that in greater Kapoeta's three counties to look at each and every facility to make sure which of them is working and which is not, what kind of personnel they have including even their educational backgrounds.
For those facilities which are not functioning, we shall establish why they are not functioning. Is it the infrastructure there not functioning because the people are not in a place, drugs are not there, this way they are going to improve. The Torit hospital among the facilities in Eastern Equatoria State, will be improved.
Actually we have hospitals, primary health care units and primary health centers. What is really not happening is linking the community to the health facilities that they have. From MSI that is presenting its service there must be people to go from home to home.
This is the health promotion group which are called health home promoters. They have guidelines from the government with basic package of health services and providers who will have real linkages with the homes. And monthly the Marie Stopes International (MSI) will give a report about their work to the Ministry of Health of Eastern Equatoria State.
What about the administration issue?
Concerning the administration issue some of these counties are really very big for one Commissioner to go round. But economically the cost of expanding means more money and there are both advantages and disadvantages. But to be able really to manage properly is to create some more counties.
What were the challenges facing the Health Ministry in Eastern Equatoria State?
The challenges faced by the Health Ministry are in term of delivered services. First aid, and resources are limited. As you know already the budget cuts for new year 2012-2013 by some percentages of about 20 or more has been done. It is also known that because we have been depending 100% on the oil money now people have to create another way of getting more money.
Other challenges include human resources as I mentioned earlier. Human resources are needed to support the health program because the current ones are not skilled personnel, three quarters are community health workers, and we need skilled nurses, and mid-wives.
Other challenges include infant mortality rate at 80% per 1000 live births, under five mortality rate at 105 per 1,000 which are some of the worst in the world. Many factors such as severe shortage of qualified personnel, poor health care infrastructure or none, poor services provision to women and children contributed to this grave situation.
Some of the challenges are beyond our control like roads accessibility to these facilities. Such needs other sectors, like the Ministries of roads and transport.
The Eastern Equatoria State has eight counties which need good roads. You cannot reach to one county quickly to deliver health service because of the bad conditions of the roads. The state needs support from South Sudan Government so that the State Government can construct better roads especially in greater Kapoeta.
What is the security situation like in Eastern Equatoria State?
The security situation in Eastern Equatoria State is stable at this time compared to the past. The major problem usually comes from cattle raiding. It is the life of pastoral communities but the government is trying its best to keep the situation under control.
The cattle raiding is viewed as part of the culture of these communities but the concerned government bodies have to minimize or to stop completely the deaths from such raids so that people can live in harmony.
What is your message to the public?
My message to the public is to participate in looking at health as everybody's concern. When a program like Marie Stopes International center (MSI) comes to a community, they should be there willing to participate, mobilize the communities and benefit from their services. I was happy to see the community leaders in this launching.
Second let the chiefs be messengers to those who have not come. It is very important for the community to take care of their health so that they can prevent diseases and health problems by themselves. For example cholera is got through dirty water, if you drink clean water like in the borehole water coming from underground you will be safe.
Thirdly Guinea worm are also preventable, those who have worms should not step in standing water and also those who are drinking water should filter it. As for typhoid fever which is very common even in Juba and malaria people have to prevent getting them by following medical rules of keeping away from them.
Typhoid fever is taken by hand to your mouth, it comes out from the feces of people who will pass it from their stools, may be by eating raw food, getting it from the water but if you boil your water or clean your vegetable very well or cook them, you won't get that disease so you the communities must work hard to prevent getting infected.
HIV/AIDS is recently surveyed but the result is not yet out what we know from pervious survey they are at 3% of the population.
Let the people be serious to listen to the Radio, Media, Television so that they are given the right information or messages that they can follow and if people are not sick that is happiness for South Sudan and Eastern Equatoria State.
The government is trying its level best to work very hard to help the people not to get sick. Eastern Equatoria State has declared Friday as a cultivation day and the communities have taken it very seriously and every weekend which is on Friday people go to farm. The nutrition is a part of health and also touches on agriculture.