Who is crazy?
It has been more than three and half years since I came to South Sudan. I spent my first two weeks (in September 2011) in Tonj, where In Deed and Truth Ministries (IDAT) runs a busy clinic serving the South Sudanese communities of Dinka, Bongo, Jur Chol (Luo) and Balanda. In those two weeks I ended up helping in this clinic. That was a challenge from God for me to identify with South Sudanese people starting from their very sufferings before commencing with the work for which I came. I have many interesting memories of those two weeks!
Our Mango Ministries had been partnering with IDAT in different ministry areas. As a result, since those first 2 weeks, I have travelled between Tonj and Aduel several times and loved knowing the Kujs (Sabet and Suzy Kuj along with their three children), who are the leaders of IDAT, and their team members.
The challenges of South Sudanese in most parts of the country are numerous. One of these challenges is the scourge of ‘malaria’. Like many other sub-Saharan African countries, South Sudan is also not exempted from this scourge. In this update, therefore, I want to share based on one of my memories in relation to my experiences with malaria.
On 13 September 2011 while working in IDAT’s clinic a woman came with three of her relative’s young children. She told me that the mother of the children was in another health facility with a child who was admitted due to malaria and was still very sick. In their mother’s absence this relative noticed that the three children were also sick and getting worst. That is when she decided to bring them to IDAT clinic.
When they came to IDAT clinic it was the local Community Health Workers (CHWs) working with IDAT who first attended to them. They took and recorded the vital signs. They also recorded the chief complaints. The body temperature records were very high for all the kids.
All the three kids entered the OPD room where I was seeing patients after the one I had just seen left the room. As these three kids walked in I noticed how all of them looked very sick. I also looked to the very tall, dark woman who accompanied them. She looked fine. I was made aware that about one third of the patients who come to the clinic would have malaria. When I saw the temperature records of these kids I wanted to recheck myself. So I took the thermometer and began to check them one by one. As I began doing this my CHW translator smiled and said, “They have malaria.” The different thermometer I was using, just confirmed the other’s readings, showing that all three kids were having high fever. (The day before, I had seen four siblings who came with high fever due to malaria). “The thermometers must be crazy!” I said audibly. Yet there was nothing wrong with the thermometers. “The thermometers were just doing what they were made to do.” as Dr. Tom said, hearing me from his OPD room next to mine. “It should be the mosquitoes who are crazy.” But the mosquitoes are just using the opportunity to feed as they find unprotected skin. “So it should be the patients who are crazy?” Well, may be for adults but these kids didn’t even know why and how they should protect themselves. So how can I call them crazy for this matter? Then it should be the mother who must be crazy. She could be. But, who knows her reason? Who knows her knowledge? Who knows her means? So, who is crazy? Am I the one who is crazy? I could be, together with many others. Our craziness could be that like Cain we might have developed the “Am I my brother’s keeper?” mentality (Genesis 4:9, NIV). Poor children! I struggled hard to control my tears. I prescribed for them and through my CHW translator briefed the women who brought them of what we would be giving and doing to help the kids overcome their sicknesses. While talking to the woman I felt the need to talk to her about Jesus. I asked her if she is a Christian. She was not. She was a follower of Dinka Traditional Religion. She didn’t know Jesus. I briefly told her about Jesus. Then prayed for her and the kids. They left for the pharmacy and the temporary admission in the veranda until the kids’ fever was controlled.
During those days most of the patients were seeking medical help due to malaria, and still malaria cases top any other cases in many South Sudanese health facilities, especially during the rainy season. It is also the leading cause of death. Many here people know neither the cause of malaria, nor its prevention. Others rely on non-effective traditional methods of preventing and treating it. Others don’t have the access to health care due to several factors including distance from health facility and lack of money to go health facility or buy medicine. The reasons that make the people victims of malaria are various.
Malaria has claimed so many lives in South Sudan. Recently I was talking with a friend of mine in Aduel about malaria. He told me that his mother gave birth to 12 children. Out of these 6 died before the age 5 years. One died at age 24 before being married. One got married and had three kids, but died while her kids are still young. Four, (including my friend), are still alive. One of the living four gave birth to 12 children. 11 of them died. 1 is alive. The second from the 4 also got married and had 4 children. 3 of them died and 1 is alive. The third also got married and gave birth to 4 children. 2 died and 2 are alive. My friend who is the fourth to the ones who are alive had 9 children. 1 died and 8 are alive. He says he is the luckiest one from his siblings since he is alive and most of his children are also alive. He told me that most of his siblings, nieces, and nephews died due to malaria. Such stories are not uncommon here. Malaria has claimed so many lives, and is still claiming many dear lives.
The South Sudan Household Health Survey 2010 provides the following information about the country:
Life Expectancy = 42 years
Maternal Mortality Rate = 2,054 per 100,000 births (highest in world)
Infant Mortality Rate = 75 per 1,000 births (ranked in world’s bottom 10%)
Child Mortality Rate = 105 per 1,000 births (ranked in world’s bottom 10%)
Obviously in all these shocking statistics, malaria contributes powerfully. The malaria front is one of the most challenging fronts in South Sudan. Malaria and many other diseases could not be overcome just by treating those who get infected and become sick. It is overwhelming and impossible. Much was and is still needed to reduce the number of people getting infected with malaria.
CHE is one of the perfect responses to this. Beyond strengthening people spiritually in the Christian way, it addresses many physical issues as well. CHE is replete with health lessons including lessons on malaria. All the teams we trained on CHE in Tonj and ERC were taught about malaria (cause, symptoms and diagnosis, prevention methods – including using insecticide treated mosquito nets, complications, treatment). Some of them have already reported that since they began implementing CHE their families are becoming less sick with malaria. It would be so great if such testimonies would come from all the people who were trained in CHE and also from all the families in their communities.
Who is crazy? Of course you don’t want to be the crazy one and remain quite as malaria scourges fellow human beings in South Sudan. Mosquitoes, though tiny, are causing huge damages to humanity on this part of the world. What can you do about this?
“We can save millions of lives over the coming years by scaling up the malaria control tools that we have already available.” Margaret Chan, the Director-General of WHO.
- Pray that all the efforts exerted by government, UN bodies, NGOs, missionaries, churches, as well as individuals to control malaria in South Sudan would bear fruit and that people would be willing to adopt behavior to prevent malaria, seek early treatment and reduce number of mosquitoes.
- Pray for the people we trained in CHE to be able to prevent themselves and their families from mosquito bites and train their church members, neighbors and their community members in general to do the same as well.