Chinese Hospital

Today we visited the Women’s Hospital in Rumbek, built by the Chinese in 2013 but opened just this year.  We had nearly an hour conversation with the Director General of the Hospital and the senior Midwife.  It was fascinating and valuable information.  Before I share some of this information, let me just mention that the hospital offers nearly everything an OB-GYN hospital would in the states with a few exceptions and some of the “delivery systems” (pun intended) are different.  This Women’s Hospital operates in partnership with John Hopkins in the US.

The doctor is from Sudan, Darfur, specialized in gynecology.  The midwife was trained in Khartoum, Sudan for 3 years in the 1980’s.  She is local.  To clarify, there is TBA, traditional birth attendants, who are trained very little and often cause more harm than good because of their lack of training.  Their years of service in this region has created a trust in their ability that is not warranted.  The mid-wife we met today is not a TBA in any sense of that term.  The conversation among us was a combination on Arabic, English, and Dinka but it worked well.

South Sudan has the highest maternal mortality rate in the world.  It is often noted that a girl in South Sudan is more likely to die in child birth than complete the 8^th grade.  So I ask what are the biggest causes of this.  Medically it is eclampsia and hemorrhaging.  (BTW, there is no blood bank at the hospital due to lack of consistent power so all transfusions are fresh blood given directly.)  Culturally it is starting too young and having them too close together.  Most girls here start their menstruation cycle around age 16.  (As you probably know, it is much lower in the US and malnutrition here is the main reason for the later age.)  Now there was some difference in opinion as to the best age for women here to bear children.  The doctor (male) suggested 18.  The mid-wife (female) suggested 25 or older.  They both laughed.  However, they both agreed there should be 2-3 years between pregnancies. 

Sonja Tussing from St. Stephen’s UMC in Burke, VA has expressed interest in coming to Abukloi to teach health.  The doctor and mid-wife gave clear information in how that should happen.  Because the men here have control over their wives (the doctor said women are “property” rather than “partners”) the education must be offered to both the male and female students.  Part of the content needs to include protecting women from early pregnancy.  The two medical people told stories of 14 year-olds having babies and the tragic results.  A primary vehicle is to marry later, simple on the surface, but major cultural shift.  The other primary vehicle is protection.  The idea is to delay and control not prevent as prevention is not accepted here.  He said in the several years he has worked in Rumbek not one woman has come to the hospital for birth control.  (They offer all types as in the US.)  However, in his private practice, he has had many women request some form of birth control.

We also spent some time talking about sanitary protection and ways to keep clean as the female students had mentioned they wanted to know more about that.  He said serious infections, even ones that make a woman sterile, happen as a result of inadequate processes during menstruation.  He talked to us about cleaning and even sanitizing reusable pads. 

I will share all of this with Sonja and she can prepare information for our students.  Nowhere has it been clearer to me than this trip to South Sudan that women’s rights are human rights.

A couple more observations about South Sudan.  Several gas stations are open this week.  That should help the prices and means the roads are open and safe for travel.  The work of NGOs, churches, government, the people themselves is making a difference.  Frankly, I did not notice the improvements immediately as the deficiencies are so dominate.  But as I listen to people I can hear the difference.  New ideas are being accepted – education and encouragement are making a difference.  I have always concluded it is about the cows.  If people no longer give cows for a bride, women will no longer be bought as property but valued as people and partners in marriage.  The need for large herds available for dowries will go away.  The reduction in the number of cows will mean more food for the people immediately because the cows will be used for food rather than dowries.  Fewer cows means less need for fencing around crops which will also mean more food in vegetable gardens and even large fields for grain.  Fewer cows means more water as the overgrazing has expanded the sub-Sahara.  It all gets back to the cows!