John Dau Foundation

Eye Surgery Campaign Off to a Great Start in Duk

Thu, 15 Dec 2011 11:58:00 -0500

This is an e-mail message from Dr. Barb Connor, who volunteers as the John Dau Foundation’s Medical Director. She is in South Sudan for a week to help train staff and to oversee an eye surgery campaign by a team of world-renowned eye surgeons from the U.S.

Just a quick update about the progress of our mission so far:

So we have arrived safely in Duk, South Sudan. And it is so great to be here at the same time as John Dau in Duk.

Today we screened 81 patients for eye surgery, and 74 patients will definitely have surgery. We hope to screen as many or more tomorrow, and those numbers will be added to the ones that have already been screened. So we will have plenty of patients for the doctors to operate on. Aguer, the ophthalmic assistant, was working with us and the word from medical team is that he has done an excellent job.

We hope to begin the first eye surgeries tomorrow for trachoma (the disease that causes blindness by turning the eyelashed inward such that they scratch the surface of the eye) . These first surgeries will be done by Dr. Lloyd Campbell who came in with us on the first plane load, December 12.

We even found a slit lamp here (an eye microscope) and volunteers Billy Reed and Marshall McCarroll got it working, which helped a lot with exams.

We had one case today where a young girl led her blind grandmother to the clinic, and they walked 8 hours to get here!

Drs Tabin and Crandall arrive on Thursday Dec 15th and will begin surgery shortly after getting off the plane. They have just five days in Duk, and they will probably treat more than 100 people by the time they leave. Amazing—giving people the gift of sight, just like that.

Josh Gwinn, our new hire for project manager at the Duk Lost Boys Clinic, has been a quick study in his orientation to the Clinic. He has jumped right in and I think he’s going to be fantastic. Josh, Mike Wagner (the current Project Manager), John Dau and I met this morning several hours for a de-briefing.

When we first arrived, a baby had just been born, and that was the second baby of the day, and then another was born during the night! So the maternity program is flourishing also.

There are a young antelope and a gazelle that now come around the clinic, that are quite tame, and they are beautiful so it really felt like I was in Africa this morning when I woke up with a gazelle outside my tent!

Those of you who have been here will be jealous to know that we have had fantastic food and so much more than the usual basic “mouth watering beans”. We have had some fresh fruit and cabbage and John Dau’s father donated a goat that we had today. So all in all it has been fantastic!

There’s still no toilet seat for Barb, but we do have a new latrine which is great!

I’m writing all of this to sounds of singing coming from the village. And last night the full moon was amazing. We almost didn’t need headlamps!

Duk is as beautiful as ever, the people are so appreciative, our staff is very hard-working and dedicated, and this visiting team are so awe-inspiring with their hard work and with what they will be offering to these people. I am honored and proud to be a part of this wonderful organization. Thank you all for all of your support.

All the best,

Barb

December 13th, 9:22pm, Duk, South Sudan

JDF Partners with Samaritan's Purse to Provide Cleft Lip Surgeries!

Mon, 05 Dec 2011 00:06:40 -0500

Between November 5^th and 12^th, eight patients from four different payams in Duk County, received corrective cleft lip surgery, as part of a program implemented by Samaritan’s Purse at the Juba Teaching Hospital. As the designated time approached for the arrival of the chartered plane in Duk Payuel, which would transport the patients and their caretakers to Juba, there was a sense of a sense of nervous excitement. This was the first time that any of the would-be travelers had flown in a plane. Additionally, due to the distance from Duk County to Juba, this would be the first opportunity for many of the travelers to travel to world’s newest capital city.

In the U.S. and other developed countries, individuals born with a cleft lip routinely receive surgical treatment within 10 weeks of being born. However, in countries like South Sudan, most individuals never have access to such corrective treatment, and as a result suffer not only from the clefting congenital condition, but also from the psycho-social stigmas that society attaches to these individuals.

While the John Dau Foundation and the Duk Lost Boys Clinic has made incredible advances in the provision of medical services over the course of the last five years, there are still medical procedures and treatments which fall beyond the medical care that we are able to routinely provide at the Clinic. Fortunately, in such cases, we are able to partner with larger organizations such as Samaritan’s Purse, which are able to provide this life-changing care. As a result, we now have eight new smiling faces in Duk County.

Providing Health Services Where None Previously Existed

Wed, 12 Oct 2011 14:15:58 -0400

On a Saturday afternoon last month, a young mother of two was brought in to the Duk Lost Boys Clinic by her husband. They had come on foot from her home of Poktap, a town about 15 miles from Duk. She was extremely anemic and very weak, and upon her arrival at the Clinic, the staff immediately determined that she needed an emergency blood transfusion to save her life. The Clinic’s lab technician ran tests on her husband’s blood—the same quality tests that would be conducted in the U.S.—to determine if he could be a potential donor. Fortunately, he was; soon after, his wife was able to receive her life-saving blood transfusion.

Mrs. Kuol returned to the Clinic a few days ago for a routine check-up, and our medical officers report that she is now in good health. The fact that she was able to return speaks to the importance of the services that the Clinic is able to offer the residents of Duk and surrounding counties: Until recently, an individual requiring such a treatment would have had to been transported to the state capital, more than a hundred miles away and completely inaccessible half the year due to flooding six months of the year. The dirt roads around the region are completely impassable due to standing water, which reaches above knee-height in most places.

During her last visit, Mrs. Kuol reiterated that she was thankful for the medical care she received at the Clinic, and acknowledged that she was especially fortunate considering her relative proximity to the Clinic; more than a third of the Clinic’s patients come from a day’s walk away or more. For her and others, the Duk Lost Boys Clinic is the only option for quality medical services. She was also quick to point out that her two children, aged two years and five months respectively, have also benefited from the health services provided at the Clinic. Her eldest son has been fully immunized, as a direct result of the Clinic’s vaccination programs. Her second child is also receiving the necessary immunizations to ensure that he will not fall victim to the common illnesses which are prevalent, but easily preventable in South Sudan.

Beating the Odds with Your Help

Tue, 07 Jun 2011 03:40:04 -0400

Born in war-torn Sudan in 1995, the middle of seven children, Nyanwut has had a challenging start to her life. That is all starting to change.

Nyanwut was 12 years old when she developed a persistent cough, along with general weakness and night fevers. Her left leg had become almost paralyzed. At that time, the nearest place which could have correctly diagnosed her illness was several days’ walk through treacherous areas.

Now 15, she came to the Duk Lost Boys Clinic which had opened near her home. She was tested and found positive for tuberculosis, a common disease in her part of the world, South Sudan. She was counselled on the difficulties of the treatment regimen and what would be required of her—taking a combination of five different drugs, every day, for months straight. Along with other long-term patients at the Clinic, Nyanwut has been given nutritious food by the clinic, which helps her manage the difficult disease and treatment regimen. She’s also given a mosquito net to prevent against mosquitos which can transmit malaria.

“If I have to compare from the last four years since February to now, the pain has reduced,” she says. Now that she’s getting better, her biggest hope is to rejoin school, where she’s in grade 4.

Asked if there was anything she’d like to say to the donors who made her treatment possible? She shyly withdraws, betraying her silent courage, “Only appreciation.”

A World of Difference Made Possible from a World Away

Sun, 15 May 2011 08:41:00 -0400

A personal note from our Executive Director & Project Manager, who is at the Duk Lost Boys Clinic:

Every day at the Duk Lost Boys Clinic, we measure every child under 5 years old and if they’re malnourished, we provide these hungry children and their mother counseling and nutrition supplements to help them get back to health.

I was sitting in one of the consultation rooms a few weeks ago, when at one point a mother asked me what my name was, because, she said, she wanted to go back to the village and thank me for the work we’ve done in bringing these nutrition supplies. After the effort we put in to get these supplies to the Clinic and deliver these services, I found myself literally almost starting to cry at the thought—this mother, holding her 11 month-old child in her arms and looking at me; when someone donates money to the John Dau Foundation, they’ll probably never know the people it helps, yet, here was this mother right here, struggling to have a decent life, and I could reach out and touch her. She was as real as anyone I’ve ever met, of course, and here we were helping her because of some people thousands of miles away who had made a donation. I wanted to go back to my computer and print up a list of all of our donors and say “Thank these people here. They’re the ones who’ve made it possible. Without even knowing you, they’ve done more than I have. What I do is only possible because of them.”

She’d first brought in her child, Bol, a few weeks ago, when he was near-death from hunger and sickness. In the last few weeks in the clinic’s nutrition program—the only such program for more than 50 miles around—he’s gained more than one pound of weight and is much more active. I could see the relief and hope in this mother’s eyes that her son was brought back to life.

I’m just so amazed at the things going on down here in John’s home village of Duk, even after being here for more than a year now. John’s vision and hard work come to life are proof of what one person, joined by many others, can do to change a the world. And though most people who donate will never see it, they are just as much a part of the great things happening here as anyone else.

An Unconventional--and Unexpected--Delivery in Duk

Mon, 11 Apr 2011 00:00:00 -0400

It was an improvised, miraculous, and safe delivery, and today a mother is resting comfortably with her twin daughters and husband.

A Sunday afternoon a few weeks ago, a very pregnant young woman, Nyanwur, and her husband came into the Duk Lost Boys Clinic after coming nearly 30 miles from their village. Nyanwur was in labor and it was prolonging, prompting her family to make the journey to the Clinic in hope of the delivery care there, the only such services for a day’s walk. The Clinic’s midwife, Teresa, attended to her throughout the afternoon and into the evening. Her contractions were far apart and not progressing, a sign of trouble.

Finally, by 2am, having been up the night before attending to another delivery, Teresa and the Clinic team decided they needed to refer her to the State Hospital for surgery (a function for which the Clinic is not able to provide), which was six hours away by car. Teresa and a nurse, Kuol, quickly packed medical supplies, a travel bag, and $200 traveling money and drove to the hospital—a bumpy, 100-mile drive along dirt roads.

An hour along the way, while it was still dark, the mother began to deliver and the driver pulled over to the side of the road. Using the dome light from the JDF vehicle as well as a pair of second-hand headlamps, Teresa (show in the picture above, next to the vehicle) and Kuol conducted the delivery—twins!

Soon after she delivered, Nyanwur fell unconscious due to the heavy blood loss. Kuol and Teresa worked hard to resuscitate her. The team tried to go to a nearby clinic, only to find that the staff wasn’t around and they lacked proper supplies. So the team continued to the hospital, arriving in the late morning.

Meanwhile, back at the Duk Lost Boys Clinic, the other staff waited for news of the events. An e-mail came from Kuol that afternoon. Despite severe anemia and blood loss, by the next morning the mother was doing well and speaking with Teresa. She’d be receiving a blood transfusion later that day. The team returned to the Clinic the next day, exhausted but relieved that their efforts paid off, saving the life of the mother and her children, who are still to be named. “This is our work,” Kuol, the nurse said after arriving back to the Clinic. Five years ago, before the Clinic was constructed, Nyanwur might have lost her life. Today, thanks to the generous continued support of people around the world contributing to the mission of the John Dau Foundation, her life is a lot different!

In the Midst of Change, JDF Moves Forward

Sat, 05 Mar 2011 09:59:00 -0500

It’s been an exciting and adventurous couple of months for the Duk Lost Boys Clinic and South Sudan. In January, the South held its long-awaited Referendum on Independence. The results were overwhelming- more than 98% voted for independence from the North. It was hailed by international observers as being free and fair, and the North has openly promised to honor the results.

As a precaution, before the voting, the John Dau Foundation removed its non-Sudanese staff and brought in several months’ worth of back- up supplies. Fortunately, the vote went off without a hitch and was largely safe and peaceful. However, due to flooding in January the supplies were necessary as they met an increase in the number of patients.

John Dau was in Sudan for nearly two months organizing JDF’s efforts to becoming a more established health clinic. He hired a number of new Sudanese clinic staff. Many were recent graduates, earning their first job. They are going to be working alongside experienced colleagues building their skills. The new staff spent several days cleaning and reorganizing the Clinic’s new items including hospital beds, IV stands, and medical supplies which were delivered in January and paid for by supporters in the U.S..

It was a productive trip for the visiting JDF team. Dr. David Reed, who serves as one of JDF’s Medical Directors, was making his fourth trip to the Clinic since it opened-all of them have been on his vacation time and at his own expense. During this trip, he met with the new staff, discussed problems and vision for the future, as well as advised nurses on some common illnesses and procedures. Dr. Reed also visited an outreach team from the Clinic who were conducting a de-worming campaign at a nearby school. The campaign reached nearly 500 children. It had been part of a larger county-wide campaign that expanded several square miles. JDF’s Executive Director will remain at the Clinic for several months overseeing several new projects and coordinating the Clinic’s activities.

The true marks of how far John’s visions and the Clinic have come have been made evident in the Duk Lost Boys Clinic’s Sudanese-led success these past months. It is a model for what healthcare in the world’s newest country can be like.

Nutrition Services Offered At Clinic

Sun, 21 Nov 2010 19:53:00 -0500

One of the strengths of the John Dau Foundation is that it has always had a strategy to stay focused on our mission to provide quality healthcare in South Sudan. We’ve tried to not do too much, too soon, but instead make a real, measurable impact in areas where we’re capable. A tour of South Sudan and many other developing countries reveals many clinics and schools which are boarded up, where supplies are inadequate, or staff are absent, because an organization tried to do too much at once.

JDF, in turn, has instead taken each problem one at a time—first, basic curative and maternal care when the Clinic opened in 2007; in 2009 a vaccination program through the donation of cold-chain equipment, and then later in the year, TB and HIV programs. In 2010, led by the support of our donors, we’ve launched a series of outreach programs, including trainings and mass campaigns, covering hundreds of square miles in areas which have never been reached. One village donated a goat when Clinic staff came to provide vaccines—the first time any group had ever reached them.

One of the items remaining on the list has been nutrition services. During the “hunger period” last spring, the Clinic staff felt helpless as mothers came in daily with children who were severely malnourished. Several died at the Clinic, as did countless others in the villages who weren’t able to be reached. This month, through the support of our donors and an emergency relief grant, the Clinic has begun to launch a nutrition program. The program is starting first with a two-week assessment of the situation in Duk Payuel, John Dau’s home village. Two nutrition consultants led a training at the Clinic of a 12-person team of enumerators from the Clinic and community. Over the next few weeks they’ll be measuring children in the village and collecting data on hygiene practices and food security. In the coming months, with this training, we hope to be able to conduct assessments of other villages, and introduce nutrition services and supplementary feeding to children who are severely malnourished. It’s a difficult program, requiring community intervention, supplies, and follow-up, but it’s one that is in high demand. UNICEF and other groups estimate that 21% of the children in Duk County are malnourished, and with the large crop destruction from the flooding this year, that number could be—and become—much worse.

But adding these services will mean the Clinic will be able to reach hundreds of children who are suffering from malnutrition, as well as respond to nutrition emergencies—which might come if there is hostility around the referendum in January 2011. In a place where no other services existed a few years ago, that’s a pretty amazing thing.

Generous People Making A Difference

Fri, 29 Oct 2010 21:54:00 -0400

As most of the members of Eastern Hills Bible Church in upstate New York were still sleeping, in the village of Duk Payuel in South Sudan, a small charter plane was landing. This plane’s landing in Duk was made possible through the support of those church members. As they were just waking up in the U.S., two mothers, Elizabeth and Martha, were getting on the plane out at the dirt airstrip. They were headed for the nearest surgical center, more than 100 miles away in the state capital. Even during the dry season, the trip across the dirt roads takes 6 hours, and now, during the rainy season, getting there is only possible by plane. The plane, a six-seater, was chartered through AIMR AIR, a non-profit aviation organization. With a team of volunteer pilots, AIM AIR serves missionary and church-based groups throughout Africa, providing air travel in places many commercial flights either won’t go or for which would charge a high fee.

As these things tend to just happen in Duk by Divine intervention, the pilot said that the plane happened to be available for the day. The plane was sitting in Rumbek, just a hundred or so miles from Duk, when Clinic staff reached out to see if a last-minute flight was possible.

One of the mothers had walked to the Clinic a few days before through knee-deep standing water for more than 25 miles. She had already had six pregnancies, four of which resulted in a miscarriage. She was now pregnant again, and came to the Clinic hoping and trusting in the Clinic staff and services provided here—the best for more than 100 miles around. She was having prolonged labor and needed an emergency C-section, a function for which the Clinic is still unable to provide.

The other mother had come from just a few miles away, and unfortunately, her child had already died in the womb. She’d been bleeding for several days since then. Without surgical facilities, now her own life was in serious jeopardy as well.

After the flight took off, the Clinic staff waited news of what happened. The next day the Clinic Manager made a phone call using Skype (since there’s no cell phone network in Duk) to a caretaker who had accompanied the women. He gladly reported that both mothers were doing well, and one had given birth to a healthy baby boy. The staff breathed a sigh of relief and laughed that neither went into labor on the plane.

It was all made possible by the dedicated act of generosity from koye miooc (“generous people” in the local language) 5,000 miles away, whom these mothers will never meet, working to change things in South Sudan.

Flight Brings Needed Supplies to the Clinic

Mon, 18 Oct 2010 16:13:00 -0400

The anticipation of the flight always seems to make the morning drag on in Duk.

In order to get supplies into the remote area of the Duk Lost Boys Clinic, JDF charters a plane through another non-profit organization, AIM AIR. Beginning its journey in Nairobi, it picks up medicines, personnel, spare parts, and other supplies to keep the Clinic running. The payload for the charters is about 900kg, or just less then one ton, and every inch of it is used and usually items have to be left behind.

A few days prior to the flight landing, the community spent the day diking the dirt airstrip to prevent flood waters from getting into it. Children with old cans scooped out the water on the airstrip, and with some help from above, the sun was out in full force the day of the flight to dry out the rest of the airstrip.

This month’s plane included 450kg (990lbs) of essential medicines, enough for two months, to keep the Clinic running. With careful ordering and support from donors, the Clinic rarely has any major stock-outs, though at the end of the month things can get tight. A few days before, the Clinic had run out of paracetemol (Tylenol in the U.S.), which is key in reducing fevers of people with malaria, among a number of other problems. It was one of the first things unpacked.

Also on the plane were spare parts for the Clinic’s vehicle, which can only be gotten from Nairobi. A church in the U.S. donated a solar cooker, which will reduce the Clinic’s use of firewood in cooking, which can take hours to walk and collect, not to mention the damage to the environment. One of the cooks, a mother from the local village, was thrilled when seeing it.

Inside another box were various seeds for the Clinic’s demonstration garden. After intense flooding destroyed many of the crops in the area, the Clinic will be giving out seeds for mothers to start up small kitchen gardens. The mothers can come to the Clinic and see the demonstration garden, learning about new kinds of fruits and vegetables and planting methods.

The Clinic’s manager and nurse were also on the plane, returning from their annual month-long leave. Both had in fact gone more than a year without taking their vacation since the Clinic had been so busy. There were some small food items which were shipped in, and even toilet paper has to be brought in from Nairobi.

On its way back, the plane made efficient use of the space and opportunity and carried a patient who needed a referral to a bigger hospital in the city. The patient had deep-vein thrombosis, which can be life threatening if the clot goes to the lung or heart. Because of intense, recent flooding, no vehicles have come in or out of the area for several months, making the plane the only option. It’s payload was well-received and badly needed. And thanks to generous supporters, it can keep coming.

A Typical Day in Sudan

Sun, 26 Sep 2010 20:32:40 -0400

The morning starts at different times for each person. There are a few alarm clocks one can choose from, from the soft sounds of crickets and frogs, the cock crows as the sun starts to go up, or drum beats from someone making music in the village. Usually the final wake up call comes when the Clinic’s facilities manager fires up the generator, which runs a submerged well pump and pumps water up into the storage tank in the Clinic and is used to clean the Clinic in the morning. It takes about an hour to fill the tank, which lasts the whole day. After that it’s the sweet sound of nothing, as an array of solar panels, donated by several groups and individuals in the United States, powers most of the Clinic’s other needs, such as laboratory equipment, satellite Internet, and nighttime lights.

The sounds penetrate easily through the tents where most of the staff lives. Staff who have homes in the village make their way to the Clinic by about 8am, where they take a light breakfast of tea and maybe bread from the night before. This morning it’s mandazi, a sort of fried dough, from last night’s dinner. Living together in the same place, the staff becomes very close and communal, sharing meals, jokes, and just about everything else, including the occasional hardship, and especially the successes.

Newton, one of the Clinic’s lab technicians and a skilled farmer, goes out to the garden to pull some tomatoes off the vine before they can be spotted by birds and eaten. The staff spends their weekends and some afternoons tending the garden, which is now booming and an example for the community in an area that could be the breadbasket for Africa. Mothers are taken through the garden when they come to the Clinic to learn about improved nutrition and farming methods.

There’s already a group of patients, some who set off hours ago or even the previous night, through knee-deep flood water making their way to the Clinic. Walking is the only option now with much of the entire region covered by standing water from intense rains the past month. It’s hoped that the rains have peaked now and the waters will begin to recede by November or December.

The staff spends the first half of the day with patients. The two Clinical Officers, equivalent to a Physician’s Assistant in the United States, will see 30 or more patients each in a day. Today is a Monday, so it’s vaccination day for mothers and children. Women in the area dutifully bring in their children’s health cards, a big step when record-keeping is so rudimentary compared with the West, though just as important. The midwife weighs each child and marks it on a growth chart on the child’s card. JDF is hoping to launch a nutrition program in the coming months to better manage children who are identified as being malnourished.

The reasons for visiting run a broad spectrum, from malaria to HIV counseling to an older woman with a big cut on her hand. By the afternoon, the Clinic has received 80 patients, which is generally considered a slow day. A dozen patients come for their daily treatment for tuberculosis, the only place for more than a two or three days’ walk that can treat the disease.

The staff goes for a lunch of rice and beans, a staple, since the cost of food is so high in the area. The expansion of the garden provides some diversity, including kale, tomatoes, corn, and in a month’s time and with careful tending, watermelon and pumpkin, amongst other seeds brought from the United States.

After lunch, it was a haircut day around the Clinic. The Clinic’s pharmacist, Victor, gave cuts to several of the guys under a tree outside. The staff is in and out of the Clinic tending to patients as they come in. The Clinic has never closed in its history, after more than three years and 35,000 patient visits.

Some afternoon storm clouds roll in and everyone braces for rain. The flood waters have already displaced more than 1,500 people in the village and thousands more throughout the county and region. Thankfully, there haven’t been any deaths reported, but the Clinic is on alert and monitoring the situation, responding to an increase in certain illnesses. The rain came for just 15 minutes and was gone, making way for a beautiful sunset.

It was a special dinner, with a simple but tasty beef stew and bread. Earlier in the week someone in the village butchered a cow, a rarity since cows are usually only slaughtered on special occasions. With the remaining solar power, some of the staff watched TV as they ate, usually American or African movies brought from the United States or Nairobi. Some of the staff, several of them who come from Kenya, checked e-mails from home before turning in for the night, prepared for what the night might bring—a late night delivery, which would call out of bed the midwife, clinical officer, pharmacist, and perhaps a lab technician for blood typing or disease screening.

In a place where health care is still so limited, the Duk Lost Boys Clinic is an example for what can be done throughout the region and South Sudan. It’s how day in and day out, the Clinic is transforming healthcare in South Sudan.

A Work in Progress

Mon, 13 Sep 2010 18:55:02 -0400

Over the past year, the number of women seeking maternity services at the Clinic has risen dramatically. This is because of the many initiatives by the John Dau Foundation such as trainings for traditional birth attendants, hiring of new clinical staff, and an increase in supplies brought in to the Clinic. The number of women coming for routine prenatal care checkups has grown by more than ten times what it was a year ago. The number of births at the Clinic has quadrupled, astounding numbers for an area where women have been used to only traditional practices, and where no other such services exist for more than a day’s walk.

Yet, the challenges are still great. Just last month, a mother passed away at the Clinic during a difficult delivery. This woman had been eagerly coming for the prenatal and maternity services at the Clinic such as getting her blood screened and receiving vaccinations. She needed a Cesarean section, a function for which the Clinic is still lacking both physical and human resources to handle. The loss weighs especially heavy on the Clinic staff, who are working in an area with so few resources.

This is an illustration of the amazing things the Clinic has been able to do in an area where 1 in 7 mothers will lose her life to childbirth, and a showing of the work that is still to be done.

Midwives Help Clinic

Sun, 22 Aug 2010 00:01:35 -0400

The weather in Duk is changing, but the workload is not.

Since May, the rains have become more and more intense. They paused for a week recently, but restarted with a vengeance the other day as soon as a supply plane landed on the dirt airstrip in Duk Payuel. It was a mixed blessing—good for the crops that are now growing around Duk, yet bad because of the problems the intense flooding brings. Problems such as a spike in Malaria and other water related diseases and the cutting off of travel around the region for the Clinic’s outreach team.

I landed in Duk just as a heavy downpour came in. We walked through several inches of rain to get to the Clinic from the airstrip, which was nearly flooded. The pilots of the small charter plane miraculously took off. Still suffering from jet-lag, I woke up twice in the middle of the night to the Clinic’s guard rousing the nurse and midwives. There were two deliveries in one night—a year ago we may have gotten two deliveries in a month.

I spent a good part of the first day talking with the Clinic’s devoted midwives. I was so impressed. We have one nurse-midwife, Caroline, from Kenya, who works alongside a local Sudanese community midwife, Akech. We were able to hire Akech in June. Trained South Sudanese midwives are very few, and so to have one is a great benefit to the Clinic and the community. Akech is also learning and growing a lot from working alongside, Caroline, our more experienced and trained nurse-midwife. The two have been working incredibly hard—frequently up all night for a late-night delivery, and then in their consultation room the next morning providing daily consultations to mothers. The community has become so happy with the delivery services offered by the Clinic that many mothers have named their babies Caroline.

As one of the all-too-few places in South Sudan providing this kind of quality, life-saving care, it’s an example to what the future for South Sudan’s health system can be. It’s one of the ways in which JDF is transforming health care in South Sudan.

Staff at the Clinic Make a Difference

Sun, 27 Jun 2010 20:31:52 -0400

When the rains hit in South Sudan this time of year, a lot of things get slowed down and halted. Because of the poor condition of the roads when it rains, the chance of getting a vehicle stuck and even lost is very high, since the roads are all dirt.

But for the staff of the Duk Lost Boys Clinic, those risks are worth taking.

It happened one night when a mother in labor came to the Clinic. She had been in labor for three days but was unable to deliver, and had to be brought to a surgical theater for a C-section (one of the few capacities the Clinic isn’t able to handle at the moment). A driver and a nurse drove the woman from the Clinic to the surgical site, getting stuck in the mud several times along the way until finally getting stuck 15 minutes from the site, unable to move, and with no other vehicles around to assist.

The husband ran to a nearby village for help, and brought back a group of volunteers with a homemade stretcher, who went on to carry the woman by hand the rest of the way. Once arriving at the surgical theater, the woman delivered a healthy baby boy. Meanwhile, the driver and nurse stayed with the vehicle throughout the night, with no food or water. The nurse eventually walked back to the Clinic after not having eaten for several days. Once the rain let up, one of the few other vehicles in the area came to assist and pull the JDF vehicle out. It wasn’t long after when the Nurse, Abraham, was back to work. “It’s all about the patients,” says Abraham, a native of Duk who was trained while a refugee in Kakuma Refugee camp in Kenya, where he also met John Dau. “They could pay me $1 and it doesn’t matter.” His fellow, Nurse, “Tall Paul”, shares the same attitude. “I love my job. I love my job,” he often says, smiling. They are what make the work going on at the Duk Lost Boys Clinic so special.

A 15-Month-Old Girl's Story

Wed, 05 May 2010 18:49:39 -0400

It was a long month, but a positive one for a 15-month-old girl in South Sudan.

Her mother had brought her 55 miles from her home village to the Duk Lost Boys Clinic for treatment. She was malnourished, suffered from chronic diarrhea, and had an infection. She was received by Juma Malual, who was born in Duk and is one of the Clinical Officers (akin to a Physician’s Assistant in the U.S.) at the Duk Lost Boys Clinic. Though he is from a different tribe as the girl’s, he speaks several other local languages and conducts consultations in multiple languages on a daily basis. In this case, the girl was given medicine for intestinal worms and parasites, which were robbing the little nutrition she was already getting. She was given an antiobiotic to fight the infection, and given vitamin A supplement, which is a routine preventative measure to protect against night blindness and measles. She was also checked to make sure she had gotten her vaccinations.

One of the first differences one can notice between a healthy child and a malnourished one is that a malnourished child is inactive, tired, and sad. This was the girl’s (whose name is withheld out of respect for confidentiality) state a month ago, so much so that Juma took a picture to document it. But after returning this month for a follow-up, she was a changed girl, fussing and giggling like any healthy toddler would. Though still underweight, she had improved thanks to the medicine she had been given and her mother’s good feeding. Because of the malnutrition, her growth has been stunted and she has not taken her first steps yet. But thanks to the treatment she was able to get, those first steps are sure to come any day now. Maybe next month will be even better.

Records Break in March

Sun, 25 Apr 2010 01:51:00 -0400

March was a busy month for the Duk Lost Boys Clinic, setting all kinds of records in its three-year history. These records include the highest number of patients in a month (2,457), which meant conducting a record number of laboratory tests (1,049), a record number of pre-natal check-ups (155), and the midwives tied the record for deliveries in a month with 10, set the month before.

In addition to all this happening at the Clinic, it was a busy month for outreach activities. The Clinic’s vaccination team reached 700 children, gave tetanus toxoid vaccine to 348 mothers, and gave de-worming to 4,942 school children. The month started off with a refresher training for 25 traditional birth attendants, supplying them with safe delivery kits, mud boots, flashlights, and rain coats. These are key items that will help ensure they can conduct safe deliveries in some of the most challenging conditions one can imagine.

The high number of patients at the Clinic was due to many factors, including an increase in services. For example, the Clinic recently received a donation of an ultrasound machine, which is used for the detection of high-risk pregnancies. In just one week at the Clinic, it was used to diagnose a twin pregnancy, malpresentation, and polyhydramnious (an excess of amniotic fluids) which can lead to premature labor. This is added to the Clinic’s other prenatal services, such as laboratory screenings, counseling and testing for HIV, immunizations, and malaria net distributions.

The weather in Duk was unforgiving as well, a mix between 100+ degree Fahrenheit days and blusterings winds that brought occassional downpours. And yet the Clinic staff remains strong.

Things don’t seem to be slowing down either. During the first week of April, the Clinic set a record for total visits in one day with 205, many people coming from 50 kilometers or more away. This time of year is at the opposite end as the harvest season, meaning a spike in malnutrition, which can perpetuate other common diseases such as pneumonia, malaria, and diarrhea. This month, the area in which the Clinic serves was classified as very food insecure by the World Food Program, with up to a quarter of the population there severely food insecure.

This comes at a time when South Sudan will hold its first elections in more than two decades. With life beginning anew for the Sudanese here, one thing that they won’t have to worry about, thanks to the generous support of people a world away, is where they can find healthcare.

Ultrasounds Offered at Clinic

Mon, 12 Apr 2010 08:53:00 -0400

Dr. David Reed, one of the John Dau Foundation’s Medical Directors, made a delivery of all sorts last week.

Thanks to a generous gift from SonoSite Corporation’s SoundCaring program, Dr. Reed delivered the first ultrasound machine ever to be used in Duk County. Dr. Reed, who volunteers his time to advise the Clinic and JDF, traveling to the Clinic on his own expense, spent several days training the Clinic staff in the use and maintance of the equipment. In the United States, he routinely trains medical students in the use of ultrasounds as a professor in the SUNY Upstate Medical system.

The equipment is portable and durable, and so it works well with the climate of South Sudan and for the needs of the Clinic. In its first week at the Clinic, staff used it to detect a gut obstruction in a woman, allowing them enough time to refer her for surgery, and likely saving her life.

Ultrasounds will allow for the improved diagnosis of high-risk and complicated pregnancies and will be incorporated as a routine part of prenatal care. Last month alone, the Clinic received over 100 prenatal visits, and the number is quickly rising thanks to the Clinic’s midwives and medical staff. It will be a tremendous boost to the Clinic’s maternity services, in an area where a woman is more likely to die from pregnancy than to finish school. The equipment can also be used for trauma victims to detect internal bleeding.

It is one more step towards the John Dau Foundation transforming health care in South Sudan.

Donating Blood Saved A Life

Wed, 31 Mar 2010 23:10:00 -0400

On a visit last week to deliver ultrasound equipment to the Duk Lost Boys Clinic, John Dau Foundation Associate Medical Director Dr. Reed was called upon for something not requiring his medical knowledge.

The evening of Dr. Reed’s last night in Duk, a young mother and her husband came to the Clinic. She had given birth in her village several weeks ago, and had post-partum hemmorage. In several weeks time since the delivery, her anemia had worsened and she was at risk of dying.

One of the Clinic’s goals for 2009 was to develop the capacity for emergency blood transfusion. Dr. Reed sat with the Clinic’s laboratory technician early in the year and wrote out the needs on a scrap piece of paper. He and other members of JDF’s Board of Directors and Advisors worked for many months to make it a reality, and thanks to generous donors, in November the supplies were delivered to the Clinic.

This was just the third tranfusion to be done, yet each one is done only when a life is at risk, as was the case.

The woman’s blood type happened to match with Dr. Reed’s. It was too much of a coincidence. That moment in the hot Sudan night represented everything coming full circle. After a few moments of reflection and with no other prospective donors immediately available, Dr. Reed donated a unit of blood, just as it would have been done in the United States: with proper screening, cross-matching, and even juice afterwards. And though there were not any stickers like the ones given at blood banks to say so, everyone in and around Duk knew that he had donated blood, and by doing so, saved a life.

Displacement Occurring in Duk County

Thu, 25 Mar 2010 00:44:07 -0400

When the John Dau Foundation constructed the Duk Lost Boys Clinic in John Dau’s home village of Duk Payuel in March 2007, there were just a handful of people living there. In the three years since then, the population of both the immediate village and the entire county of Duk has grown immensely to more than 70,000 people.

Yet things are still not settled in Duk, evidenced by a recent report from the United Nation’s Office for the Coordination of Humanitarian Affairs. This report reveals that in the past year, 52,266 people were displaced within Duk County. This means that these people were forced from their lands due to violence, instability, draught, hunger, or other reasons outside of their control. Even though Duk is one of the smallest counties in the country, more people are being displaced from Duk than any other county in all of South Sudan. Duk was one of only two counties with more than 30,000 displaced persons in all of South Sudan, illustrating the huge need still present in John’s home village, more than two decades since he himself was forced from there.

Many of these people have resettled closer to the Clinic. The Clinic is considered a safe place since it treats all patients without regard to race, religion, tribe, or other factors and is well regarded by the community. Others are forced to move to a new place, leaving behind few possessions including food, and forced to literally rebuild in a new place. The Clinic works hard to reach these people through its routine outreach programs, which provide vaccinations to children and pregnant mothers, de-worming, trainings of community health workers, and education campaigns.

The Clinic operated continuously throughout 2009, and is the only reliably-operating health clinic for more than 100 miles. The assumption amongst the community and humanitarian agencies is that 2010 will not be any better. The need remains, though eased by the sustainable work of the Duk Lost Boys Clinic and the John Dau Foundation, pushing on in a place where others aren’t, and where the need is among the greatest.

Midwife Comes to the Clinic

Mon, 15 Mar 2010 23:38:00 -0400

The Maternal Child Health (MCH) services at the Clinic have been growing exponentially over the past several months, thanks in large part to the work of the Clinic staff led by its Nurse Midwife, Heryne. Since arriving two months ago, Heryne has been both doer and teacher. She unhesitatingly gets up in the middle of the night for a delivery or an emergency, or runs off to a village to attend to an emergency such as a miscarriage or post-partum hemmorage. She has also spent her time passing on her skills to the other Clinic staff as well as Traditional Birth Attendants, who sit in with her on consultations, exams, and antenatal care (ANC) check-ups. These check-ups include a full lab screening for anemia, malaria, and other conditions, and most recently, HIV/AIDS counseling and testing. Next month, the Clinic will be able to offer ARV medicines to prevent the spread of HIV from mothers to their children. With her experience in HIV/AIDS services in Kenya, she will be a great leader in beginning this program at the Clinic. In a few weeks, the Clinic’s Associate Medical Director, Dr. David Reed, will be bringing over ultrasound equipment which was donated by Sonosite Corporation, and training staff in its usage.

The midwife’s efforts at building trust with the community through the Traditional Birth Attendants has shown big results. Prior to her coming, many women were hesitant for various reasons to use the Clinic’s birthing room and services, and often just a handful of women would deliver at the Clinic in any given month. In February, Heryne set a Duk Lost Boys Clinic record for deliveries with 10, plus she helped over a half dozen other women who came in with complications. Most were brought in by Traditional Birth Attendants with whom Heryne has now developed a great relationship. “These Traditional Birth Attendants, they’re so smart,” she says. She ended the month of February by dashing off in the Clinic’s new vehicle to attend to a woman with post-partum hemmorage, whose husband walked three miles to the Clinic to get help. The vehicle had just arrived the day before, and is the Clinic’s first.

March started off even faster, with two deliveries on March 1st alone—the first just after midnight, and another one 21 hours later. Right after the second delivery, Heryne and a Clinical Officer attended to a woman with a miscarriage, working into the night, and waking up the next morning for routine consultations.

The John Dau Foundation is now working to raise funds to complete the Clinic’s maternity ward, including constructing a recovery room for mothers who have recently delivered. The Clinic recently built a bathroom and shower for this as well. Thanks to its current donors, the Clinic has purchased a variety of important items for the delivery room including sanitary buckets, bed linens, and educational materials.

These are huge steps for an area where Maternal Child Health is considered priority number one—with maternal and child mortality rates among the highest in the world. With such services not available for more than a hundred miles, and in no place as remote as this, what is happening at the Duk Lost Boys Clinic is truly a model for what can be done to make a difference.