John Dau Foundation

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.

Important Meetings Held in Juba

Fri, 05 Mar 2010 01:02:00 -0500

At the time when the John Dau Foundation constructed the Duk Lost Boys Clinic in May 2007, South Sudan was deserted—there were few non-governmental organizations (NGOs) operating, the Ministries and government infrastructure was extremely limited, and the country was just starting to rebuild itself. Juba, the capital of South Sudan, is not what many would consider a capital city in today’s world. Only its main roads are paved, most houses are “tukuls” or shacks fashioned with iron sheets, electricity is very sparce, and there is no central water or sewage system. However, work is continuing, and John Dau Foundation staff and the DLBC’s Clinic Manager spent several weeks in Juba last month. They spent their time there networking and coordinating resources with other NGOs, meeting with Ministry officials, and picking up the Clinic’s first vehicle. The vehicle was recently purchased in Nairobi with funds generously provided by our supporters.

The meetings included talks with the World Health Organization (WHO) to provide testing supplies for diseases such as Kala Azar, meningitis, and cholera, all of which are potentially endemic diseases that the Clinic works hard to monitor. There have been dozens of cases of meningitis throughout South Sudan in recent weeks, including one in Duk County. The Clinic staff reported the details of the case to the WHO, and in that same week, the Clinic’s outreach team was in the area where the case occured conducting immunizations. JDF also participated in the monthly South Sudan Health Forum, a meeting of health NGOs in South Sudan.

Also during the trip, staff worked out procurement for yearly supplies of fuel, construction materials, and other items, all of which will be delivered to the Clinic by truck, a journey that can take up to three days. This procurement is especially important now, as the Clinic works to pre-position supplies ahead of the rainy season, which runs from May until October. It is also in preparation for the January 2011 elections in Sudan, where services and supply lines could be interrupted or delayed. During those times, the only supplies that can reach the area must come by charter plane to the dirt airstrip next to the Clinic.

Slowly, South Sudan is rebuilding after the 21-year civil war that ravaged the country and forced out much of the population. Thanks to the efforts of JDF and other groups, the people of Sudan are slowly rebuilding their lives. It’s a process that no doubt takes time, but as proof of all the great things happening at the Clinic, in the words of John Dau, “Hope is never lost.”

Developing An Awareness of HIV/AIDS

Wed, 10 Feb 2010 00:31:53 -0500

It all started with an idea last summer, across 8,000 miles, from South Sudan to the United States. Gabriel Manyok, the Duk Lost Boys Clinic Outreach Coordinator, had an idea to begin a youth drama club throughout Duk County, that would teach about HIV/AIDS to the community using drama, a popular medium in South Sudan. Working closely with the John Dau Foundation staff, they developed the idea.

On Sunday, January 24 what began as an idea officially turned into reality. After having collected the youths from the county, 22 in all and nine of them girls, they began a week-long training. Gabriel sat with them under the shade of an old tree in the middle of Duk Payuel, prepping them for what was going to be a big week ahead. South Sudan may be the last untouched pocket of HIV/AIDS in all of Africa, but with its population returning from countries like Kenya and Uganda, where HIV prevalence is above 7%, it could quickly spread across the region.

That makes these youths and teachers the first line of defense in their communities. Several Clinic staff, who gave presentations on various topics throughout the training, told the youth that they were being sent out to spread a very important and very new message.

The training covered issues such as prevention, cultural attitudes, community mobilization, human rights and acceptance of people who are living with HIV/AIDS. It also covered other issues, including vaccine importance, hygiene and sanitation, and respiratory illnesses, which are very common in the area. For the youths, who were selected to participate by their communities, it made for a great source of pride to be part of the training, as well as a time to meet new people from across the county. They stayed in several ”tukuls”, which are traditional mud and timber huts, getting treated to sodas at the closing ceremony, in which they presented several dramas and heard speeches from Clinic staff. They also designed their own t-shirt, which will be printed in Kenya and distributed to them in the field as Gabriel follows up with each group. The students will also go out and train their peers, creating mobile theaters. All have their work cut out for them as this very important program moves forward, but it will move on as a community-based effort, which all began with an idea out of a small village in South Sudan.

New Blood Bank at the Duk Lost Boys Clinic

Tue, 26 Jan 2010 21:43:24 -0500

It happens all too often around the world, especially in underdeveloped countries: A patient suffers and too often dies because of a lack of something simple, something available in the wealthier countries but not for the rest of the world, a medicine, an instrument, equipment, or trained personnel. All too often health workers in these places can only look around and lament how they wished they had the abilities of nations with established health care. Thanks to worldwide efforts to reduce medical drug prices, develop medicines for neglected diseases, and raise money and support for impoverished nations, countless lives have been saved over the past decade. Unfortunately, these changes come little by little.

For the Duk Lost Boys Clinic, help came in the form of a Directly Observed Treatment Short-course (DOTS) program to deliver complicated treatment for Tuberculosis, mosquito nets, a cold-chain supply to enable the delivery of vaccines, and an HIV/AIDS testing and counseling program. This spring, thanks to a generous gift by Sonosite Corporation’s Sound Caring program, the Clinic’s medical advisor, Dr. David Reed, will be delivering and training the staff in the use of ultrasound equipment.

Last November’s charter plane brought supplies for a blood bank, specifically meant for emergency, life-threatening cases such as postpartum hemorrhage and trauma. The package consisted of simple basics such as a water bath and centrifuge, and costs less than $2,000. It will save countless lives in the region.

A 23-year old mother came in recently from about 25 miles away. She had been vomiting for a week, and had severe anemia. She hadn’t recovered well enough yet from her recent pregnancy, and, combined with a limited diet, she was in serious condition. Her hemoglobin level was below the point at which many people die. The staff, most of whom have been trained in blood transfusion elsewhere, called a quick meeting and talked the issue over. They sent an aide out to collect the women’s relatives in order to find a donor. Several were screened and matched, and two people each donated a pint of blood. The next night, at around 10pm, the staff began the first blood transfusion ever in Duk County. The next nearest blood transfusion site is 93 miles away, and transporting her there would have surely been fatal given her condition.

Abraham, one of the Clinic’s nurses, sat in the room with her the entire night. Her six-year old daughter waited at the foot of the bed and wandered the halls of the Clinic as her grandmother sang her baby brother to sleep in the next room.

By the next morning, her appearance hadn’t changed much, but her breathing and blood pressure had improved dramatically. The following afternoon, she finished the second and final transfusion and was recovering well with her children.

She or her daughter may never know everything that went in to providing the capability that saved her life, or how fortunate her timing was, but they know better than anyone the value it presented.

The Clinic’s new Nurse Midwife, Heryne, arrived in Duk last week with a large task in front of...

Sun, 17 Jan 2010 22:04:24 -0500

The Clinic’s new Nurse Midwife, Heryne, arrived in Duk last week with a large task in front of her. She is one of too few skilled midwives in all of South Sudan, and the only one for more than 100 miles. Maternal death rates are as high as 865 per 100,000 live births, and 1 in 10 children dies before age 1. In addition to her duties at the clinic, such as vaccinating mothers and children, providing antenatal check-ups, and conducting deliveries, Heryne will also be in charge of mentoring and training the 25 Traditional Birth Attendants (TBAs) from throughout the county for whom the Duk Lost Boys Clinic held a training in December. These women will conduct most of the 2,700 deliveries that occur yearly in Duk County.

Arriving from her native Kenya, Heryne’s first reaction upon arriving in Duk was that something was wrong and the plane had landed in the wrong place. But the half-mile strip of dirt on which the small caravan plane landed is actually the airstrip, and Duk County is really that remote, with no paved roads, electrical grids, or cities for hundreds of miles.

Just a few days into her time in Duk, Heryne jumped into a vehicle to go and visit some of the TBAs in the field. Arriving at a village, the team was greeted by one of the TBAs, Atoch, who was dressing a minor wound on a small boy. After exchanging initial greetings, they talked through a translator about past deliveries, common health problems in the area, and what would help Atoch in her duties. Heryne will conduct a practicum training at the Clinic for each TBA, showing them how to conduct an antenatal check-up, guiding them through deliveries, and describing the clinic’s new counseling, testing, and treatment services for HIV/AIDS offered to pregnant mothers in the Prevention of Maternal to Child Transmision (PMCT) of HIV. The TBAs will also be provided with safe birthing kits (consisting of a sterile razor, gloves, cloths, and other items for conducting deliveries when mothers can’t reach the clinic), flashlights, rain boots, and a rain coat, for use in the wet season when flooding is very common.

The next day, Heryne was arranging her exam room in the clinic, and lamenting out loud how she was waiting for her first delivery in Sudan. One of the staff was in the labor ward, hanging a privacy screen, when a group of women rushed in and helped a young woman as she kneeled on the floor. They took a step back, revealing a young woman with a very round belly. With the local TBA at her side, Heryne got her wish just a few moments after she had made it, delivering a healthy baby girl with little complication. She guided the TBA in examining the placenta to be sure it was intact, and the TBA knew exactly how to dispose of it properly.

The problem of maternal child health in South Sudan is a two-edged sword, represented by the fact that, according to a study by UNICEF and others, girls in South Sudan are more likely to die in pregnancy and childbirth than to finish primary school—illustrating both the lack of health services and the small number of trained Sudanese women for such roles. But there is always hope—and it can be seen in Duk, born with each successful delivery these women conduct.

John Dau at the Clinic

Thu, 07 Jan 2010 01:10:18 -0500

The following is a post from Jan. 3, 2009

John Dau left Duk yesterday, heading back to the U.S. after spending a month in South Sudan, meeting with other NGOs, government officials, viewing the clinic, spending time with family and friends, and discussing the future.

Every trip around the village brought long greetings with often large groups of people, happy to see their prodigal son returned home. In a place of very tall people, John is one of the tallest.

Walking across the dirt paths of his home, pointing out where his family used to dig in the sand a few feet to get water, discussing “cattle camp,” recalling the names and characteristics of every bird, tree, and animal around, you can still see the skinny young boy growing up in Duk. But now he stands a tall man, who has endured a world of trials since then, and has come back to the place where his life began. In doing so he brought something he nor anyone else there could have imagined, and something that no one here is ever to forget.

There was little doubt that he may be Duk’s favorite son, as he was continually thanked for his work in founding and guiding the John Dau Foundation. The Duk Lost Boys Clinic was the second building constructed in Duk Payuel, after the church, since people began returning there after the civil war ended and the Comprehensive Peace Agreement was signed in 2005. Since the Clinic opened, it has received more than 27,000 patient visits.

Something was clear though—this trip wasn’t as much about celebrating success, but just as much about talking about the future. A future made brighter by John’s work.

Experiences at Duk

Sun, 03 Jan 2010 21:29:16 -0500

By Tom Dannan

Our team from the John Dau Foundation had been in Duk Payuel at the Clinic for a few days. I was the new guy, who’d been with JDF for six months or so, accompanied by a couple doctors who’d been with the Foundation from the beginning and were on their third trip to the Clinic.

I was hired in the states, and this was my first time to Sudan. In the time before coming, I’d heard a lot about various aspects of the Clinic, about the staff, the medicine supply, the climate, the donated satellite dish and Internet connection, and this amazing thing that is the cold chain supply. Though I’d worked in the developing world before—and a lot of people who have also say this about Duk when they first come—Duk Payuel can still surprise even those who think the naivete has been worked out of them from their past experiences. Not that Duk isn’t a nice place—it’s very charming and beautiful and the people, who’ve suffered unbelievable tragedies and nothing short of an attempted genocide, are incredibly hospitable and gracious for the help offered by complete strangers around the world. But you realize that it really is that far from a city, that going 10k really takes 45 minutes, by car, if you’re lucky, that the little airstrip built out here and the small charter plane flights from African Inland Mission have served as a literal life-line, bringing in life-saving supplies every month, donated by incredibly generous persons—koiye miooc, in Dinka, the local language.

All this in my mind a few days into my trip, where I was already finding myself settled and adjusted. After a long day of meetings and travel and work on the computer, it had gotten to that still point in the mid-evening of African nights, where things seem to just slow down and the day is finally ending. I went to the cold-chain room, unlocked the door, and went to the spare cooler where water is sometimes kept and pulled out the jug. Facing one of the vaccine refrigerators, I unscrewed my water cannister and set it down on top of it. At some moment in the middle of it all I paused, and had one of those very rare, unexpected, and incredibly joyous moments, in the stillness of this Sudanese night. This is rare I say because in such work as this, one has to be an eternal skeptic to make sure funds are well-spent, programs are designed right, and people are helped. You can’t slow down to stop and admire the view, or rest on your laurels.

But this moment was surreal. In this quiet night, as I stood alone in the Clinic and the staff and visitors outside were relaxing before bed, I looked down at this cooler humming quietly and imagined: Inside this lay these vaccines, each small vial with the potential to literally save a life. Behind the wall was a state-of-the-art system of storage batteries and solar panels, designed by volunteers from the U.S., that has kept them running continuously since they’ve been here. All this in the middle of this remote African village, of which people in the U.S. and throughout the world see pictures and sometimes news stories on the all-too-frequent hardships and tragedies that range from easily preventable diseases to full-fledged genocide. Here was truly a life-line. Here was development and giving at its finest. Here was the generosity of so many hearts of people a half a world away directly affecting many thousands of people’s lives, almost 4,000 in the past six months alone. A culmination of people giving money, of engineers and medical and logistical people giving hours of time and literal sweat to do this. And they did, with great success—every vaccine administered in this 10,000-square kilometer area is possible because of this system.

The constant message from our organization’s founder, John Dau, one of the so-called “Lost Boys” of Sudan who has experienced all of the above tragedy and worse, stays with me in my back pocket: Never give up. Hope is never lost.

In the midst of all the problems we face, in our hearts and homes and lives, whether in the West or the developing world and everywhere in between, these words—never give up, hope is never lost—are perhaps one of the few truths we can hold on to no matter what, made evident in that Sudanese night.

Life at the Clinic

Mon, 28 Dec 2009 16:38:00 -0500

In a remote health facility like the Duk Lost Boys Clinic, many of the conditions here are rarely seen in the Western world. As Dr. David Reed, one of the John Dau Foundation’s medical advisors, put it, “diseases that are routine here are ones we only read about in the textbooks during medical school.” Things like diarrhea or fevers can easily turn life-threatening in this environment. Daily problems like 100+ degree heat and heavy flooding, lack of transport, and access to clean water make for an even greater challenge.

In the face of this, some of the stories that come out of here are amazing, though they often happen quietly and routinely.

A few nights ago a mother came in with her baby boy, about 8 months old. The child was severely dehydrated and was suffering from pneumonia and intestinal worms. He was unable to breastfeed or eat, and the worms had been robbing him of what nutritients he was getting. He had been vomiting and had diarrhea for the past week. His mother had walked more than 20 kilometers (about 12 miles) to the clinic, carrying her child in a hand-woven basket on her head.

One of the clinic’s nurses and Clinical Officers attended to the child that night, setting up an IV drip to replenish the child’s fluids. The staff administered antibiotics for the pneumonia and medicine to treat helminthes (intestinal worms), as well as Vitamin A, and counseled the mother on feeding. The mother was given Oral Rehydration Salts (ORS), which contain mostly sugars, salts, and potassium and the staff spent several minutes explaining the proper way to mix the solution with water, the need to boil and cool the water first to purify it, and how much to give over the next 48 hours. These supplies and this treatment aren’t available anywhere else for more than 100 miles. The staff asked her to stay in the nearby village that night so she could return soon for a follow up. As she and a friend left that night, the child was more responsive and had fallen asleep.

The mother returned this afternoon, with what was a totally changed baby—at first the staff didn’t even realize it was the same child. After being so close to death a few days ago, here he was sitting up, his eyes open and alert, no longer sunken as they are when a child is several dehydrated. He was clean, breathing easier, and moving about. The staff removed the cannuler in his hand, which had been used to administer the IV fluids, and provided his mother with several more ORS packets. The child was breastfeeding and acting as any healthy 8-month would, even crying normally.

His mother thanked the staff, prepared the basket, and left the Clinic for her home. An outreach team from the Duk Lost Boys Clinic will reach her village in the next months with life-saving vaccines and de-worming medicine. The DLBC will also be helping train the staff at the small health facility that is being constructed there in the spring by the John Dau Foundation’s partner, International Relief & Development. There are also three Traditional Birth Attendants from her area who were trained by the DLBC this past month who will be able to assist in her next birth.

All these services provided quietly, diligently, in a place where most people could never have dreamed of such care.

John Dau is visiting Duk this month. While sitting outside the Clinic one afternoon, I asked if he could have ever imagined this when he was a boy in this village. “No way,” he said.

HIV/AIDS in South Sudan

Wed, 23 Dec 2009 01:23:46 -0500

The whole world knows about the problem of HIV/AIDS in Africa. Over the past decade, awareness has grown to household knowledge in the West about the disease—how it’s transmitted, its effects on the body, and what it has wrecked throughout the world—there still remain people who have never heard of the disease or who know little about it, let alone have access to education, testing, and treatment services. One such place is Duk County, South Sudan, where the John Dau Foundation’s Duk Lost Boys Clinic (DLBC) is located. Duk County is home to more than 65,000 people who recently have returned from refugee camps and are rebuilding their lives after a 20-year civil war forced them from the land.

This month, the DLBC began the first HIV/AIDS program ever in Duk County, and possibly the only one in all of Jonglei State. Mark Kuany, a 29 year-old from Duk and the DLBC’s translator and receptionist was recently trained in Voluntary Counseling and Testing, a certification necessary to conduct testing and treatment for HIV/AIDS. Mark began this month as the Clinic’s HIV/AIDS Program Manager. The social effects of the disease can easily be overlooked—many people throughout the world may be banished or commit suicide once they learn of their infection. In other cases, people become violent or spread the disease to others.

Last Saturday, as the sounds of people practicing for Christmas celebrations played in the background, the Clinic staff sat and discussed the problem, what the Clinic’s new testing protocol would be, and how they would educate people about the disease. The gravity of the situation is evident—this is a place where no services have ever existed, yet such a serious problem as this one is evident now—several people have already tested positive for the disease in the area. Estimates for South Sudan put the infection rate around 3%, which is high but still much lower than neighboring countries. The area sits on a razor’s edge—the actions by the Clinic and the community, if well-calculated and with sufficient resources, could create a fence around the area and protect it from heading as so many other communities throughout Africa have.

About a dozen people from the Clinic set out Sunday to begin spreading the message. Breaking into small groups, each went to three separate churches in the area and delivered a message to the congregation. “This is a wonderful place,” said Peter Thion-go, the Clinic’s laboratory technician, to a congregation of about 70 in Patuenoi, about 5k from the Clinic. “We want to see your children grow up to be professors and doctors,” at which a row of children in the front smiled. Peter comes from Kenya, a country that has suffered greatly from the unchecked spread of the disease, with about 7% of the population infected. “I don’t want to see what happened in Kenya happen in Sudan,” he said, to which the congregation cheered. Joh Deng, the Clinic’s Manager and a native of Patuenoi, urged each person to “build a fence around themselves.”

Another person likened it to the coming of Christmas—“Before Jesus came, there was darkness in the world. He came and brought the people out of darkness to the light. There still remains a darkness in this world and in this community. It’s called HIV/AIDS. And again, a light has been brought to this community to bring the people out of darkness. Don’t resist it.”

Gabriel Manyok, the Clinic’s outreach coordinator and a 26 year-old native of Duk, is working on a youth drama club program which will bring youth from throughout the county to teach them about HIV/AIDS. The youths will then go out and perform skits to their communities, educating through about the disease through this very popular cultural medium.

A limited amount of voluntary testing is now being carried out, mostly for pregnant mothers. This represents the fragile beginning which carries with it real hope that the community of Duk Payuel can rise above all the tragic stories that have become all-too-common throughout Africa. Amongst all the bad news, here is a chance for one African community to really take a stand against such a deadly disease in a place that needs it so badly.

A typical night in Sudan

Sun, 13 Dec 2009 20:29:00 -0500

It was around 4am early Sunday morning when there were whispers outside the staff’s living area. “Victor, Vic, Vic” someone said softly outside Victor’s tent—the staff live in tents and an old shipping container—arousing the Clinic’s pharmacist, Victor. The day before, most of the staff had been in and out of the Clinic at various times. Saturdays aren’t a typical day for operations, but the Clinic is always available for emergencies, and hasn’t ever really closed in the three years since it opened. In the afternoon, the Clinic’s staff met to discuss its current funding and the Clinic’s new HIV/AIDS program, and most of the staff had sat around into the night, laughing and talking as the villagers played drums and practiced for Christmas celebrations.

Victor, accompanied by Abraham, one of the clinic’s nurses, went with the family to the Clinic by flashlight, opened up the pharmacy and pulled out some paracetemol (Tylenol in the United States). A three year-old girl was running a slight fever and had a swollen lymph node. After giving the child’s family the medicine, Abraham instructed them to bring the child back in the afternoon so they could check on the child’s condition. Abraham, who was born in Duk Payuel 35 years before the Clinic was built, was back at the Clinic the next day treating several other children who had come in with various conditions. He casually administers IV fluids, bandages, and a thermometer, yet it’s hard not to take a pause and appreciate the fact that these basic, essential things are here, treating people who came back after surviving a vicious 20-year civil war in Sudan. All in a place so remote that supplies come in on the small dirt airstrip near the Clinic, and traveling by car to the nearest city takes a full day, even under the best conditions.

And so the staff continues on, day after day, and sometimes night after night.

2009 Caring Award Interview Video

Fri, 11 Dec 2009 22:25:56 -0500

John Dau’s 2009 Caring Award winner interview video. Read more here.

World AIDS Day

Tue, 08 Dec 2009 00:21:00 -0500

The Duk Lost Boys Clinic hosted its first-ever event for World AIDS Day on December 1. World AIDS Day happened to occur the same day that a medical team from the John Dau Foundation arrived to inspect the Clinic’s operations and help train staff.

Immediately after getting off the plane, the team headed to the village square, where the community gathered to welcome the visitors and thank them for their work in constructing a health clinic. Clinic staff led the program, and several community leaders spoke about the importance of HIV/AIDS prevention. The local commander of the Sudanese People’s Liberation Army told the group that the Sudanese did not sign the Comprehensive Peace Agreement (which ended the 21-year civil war in Sudan in 2005) just to see children die of AIDS. Local leaders and dignitaries wore red AIDS ribbons to commemorate the day, and AIDS prevention posters hung throughout the village.

The Duk Lost Boys Clinic has two staff members at the Clinic trained in Voluntary Counseling and Testing of AIDS, one of whom is the Clinic’s dedicated HIV/AIDS program manager, Mark Kuany. The Clinic hopes to begin providing testing and treatment services by early next year if it can secure testing strips and Anti-Retro Viral (ARV) medicines, which will make the Clinic the first and only provider of HIV/AIDS prevention and treatment services in the region.

Tom Dannan, Director of Development for the John Dau Foundation, stands next to a poster advertising World AIDS Day in Duk Payuel, South Sudan

Cerebral Malaria Video

Sun, 06 Dec 2009 18:47:46 -0500

Clinics Rising brings us a new video from the Duk Lost Boys Clinic documenting a child’s case of Cerebral Malaria:

JDF Trains Traditional Birth Attendants

Sun, 06 Dec 2009 00:11:00 -0500

The Duk Lost Boys Clinic trained its first group of Traditional Birth Attendants this past week. Led by the Clinic’s Midwife and one of its nurses, the week-long session brought together women from every part of Duk County, teaching them about safe birthing practices, hygiene, and pre-natal care.

These women have traditionally helped deliver babies in villages but without any formal training or supplies. Because of the distance to the Clinic, many delivering mothers can’t come for the birthing services offered here. However, the training included how to detect high-risk deliveries, so the TBAs will know to refer women to the Clinic. The women were given safe birthing kits that included sterile razors to cut the umbilical cord, sterile towels and gloves. Clinical staff will conduct follow-ups in the field to monitor the progress of the TBAs and provide further advice.

The TBAs got started right away, as the day after graduation two accompanied a delivering mother to the Clinic. Working side-by-side with the Clinic’s Nurse-midwife, they delivered a healthy baby girl at the clinic Saturday morning.

The John Dau Foundation’s Medical Directors, Drs Barb Connor and David Reed, happened to be visiting the week of the training and helped hand out certificates and t-shirts to the graduates.