Stillwater RotaryStillwater Sampler

Dear Members,


As reviewed during our last two Club meetings, our Club has an opportunity to support a deserving project in the war torn region in Juba, South Sudan.  


This project is being pursued in conjunction with the Evangelical Lutheran Church of America (ELCA), in partnership with Global Health Ministries (GHM).


The Stillwater Club has a District matching project slated for the 2017/2018 Rotary year for approximately $35,000.  There is a very good chance that we will get matching funds – however, the container that GHM is preparing to ship is expected to sail in the next month or so – quite possibly before our matching grant is approved.


If the project is  set to ship before the end of July, we would sincerely like to gauge interest in supporting the project NOW, so please contact Scott Mercer or Orv Johnson if interested.


If we can partially support the project now, we have a very good chance to support a Phase Two project in the 2017/2018 project year. 
A Description of the Need
The South Sudan Minister of Health has listed fistula repair as a top priority for South Sudan and requested that the Evangelical Lutheran Church in America (ELCA) offer training in fistula repair to local doctors using the ELCA’s newly constructed medical center in Juba, South Sudan. This comes at a time when South Sudan faces enormous challenges for its population of 8.26 million people. It is the world’s newest country, but one of the least developed after years of civil war. Systemic poverty, displacement of huge numbers of its citizens, and political instability continue to cripple any efforts to provide adequate medical care for its citizens.

According to the BMC Pregnancy and Childbirth website (2013), “A recent report found 33 functioning hospitals in the whole country, with only 16% of all health facilities having electricity. It is estimated there is only one doctor per 100,000 people… South Sudan reports some of the worst health statistics in the world.” 

This challenge of inadequate health care is exacerbated by a tendency for young marriages of women, teenage pregnancy, and high fertility rates. Again, from the BMC Pregnancy and Childbirth website, “Only 19% of women are estimated to give birth with a skilled birth attendant, 12% to give birth in health facilities, and 13% to use antenatal care. For these reasons, South Sudanese women are considered to be at high risk for obstetric morbidities, including fistula.” UNICEF confirms that “Maternal mortality in South Sudan is one of the highest in the world,” as stated by Romanus Mkerenga, UNICEF Chief of Health and Nutrition in South Sudan. (UNICEF 2012) Each woman has a 1 in 28 chance of dying from pregnancy-related causes during her lifetime. What is more, for each woman that dies in childbirth, an estimated 20 additional women suffer from devastating childbirth injuries like obstetric fistula (WHO 2014).The United Nations Population Fund estimates that “approximately 60,000 women and girls are thought to suffer from fistula.” (UNFPA 2014) 

More compelling though than any facts or figures may well be the statement of GHM consultant Dr. Mark Jacobson in his description of the need in South Sudan:

"Obstetric fistula is one of the most horrendous complications of pregnancy and childbirth imaginable. Consider a woman going into labor with her child in her womb with all the hopes and love of a mother for that child. And then, because of lack of simple medical resources, there is an obstructed labor and the child dies and the mother ends up incontinent. It is simply hard to imagine a greater injustice which can befall a woman, especially in Africa where bearing children remains such a value to women and gives them status in society. 

Fistula occurs because of a lack of resources for prenatal care and especially for women around the time of delivery. When a woman suffers an obstructed labor leading to fistula and incontinence, often her very life and family relationships are made to be outcasts. Incontinence is horrendous anywhere in the world and even more so in places where there are no resources to respond to this condition.

South Sudan currently has the highest Maternal Mortality rate in the entire world. Most women have no access to maternal care at the time of delivery and certainly, not to an operating theatre and a possible Cesarean Section for delivery. With the war of independence and subsequent civil and tribal strife, the number of women silently suffering this affliction has grown dramatically. It is impossible to document the growth in fistula yet the awareness that it has increased greatly is well known within the medical community.

In discussions with the South Sudan Ministry of Health, one of the priorities the Minister of Health listed was for fistula care and for training of South Sudanese physicians to be able to provide surgical relief for women with obstetric fistulas. 

Our clinic in Juba hopes to help address this need. While we are technically a clinic, we have intentionally designed our facility to be able to host "fistula camps" where surgery and after care can be provided to those in need. Working with Dr. Andrew Browning, we will run several camps per year. Of great importance is that these surgeries will be done collaboratively with South Sudanese doctors who can learn and carry forth this restorative surgery. 

What a life restoring event this will be for women of South Sudan."
The Project Description

Given the high risks facing South Sudanese women for obstetric morbidities and fistula, as well as the approximately 60,000 women and girls currently thought to suffer from fistula, the South Sudan Minister of Health has made fistula repair a high priority for the country.  At his request, the Evangelical Lutheran Church in America (ELCA) has constructed a Lutheran Center and Clinic in the city of Juba to provide much needed medical care for many who would otherwise not have access. The clinic is being built in a newly developed residential and business area known as “Referendum Area” where there are no current government or private services such as running water, electricity, clinics, schools, or sewer systems available. 

It is a sizeable camp for Internally Displaced Persons who have moved to this location from Sudan and from areas experiencing conflict throughout the country. The population in Referendum Area is estimated somewhere between 300,000 – 400,000 and will be served by The Lutheran Community Center and Clinic along with a surrounding radius of 2-3 miles.

The initial foci for the clinic will be to address: maternal and child health, community health programs and nutrition for mothers and children, family planning and health education, immunizations, and fistula repair. Thus the expectation is that the clinic will address broad maternal and child health issues for the population surrounding the center while also specifically providing fistula repair and training in fistula repair for local doctors. 

Global Health Ministries (GHM) is partnering with the ELCA to equip and furnish the new clinic including the provision of all the medical equipment needed for this fistula repair wing to be fully functional as soon as possible. GHM is working with Dr. Mark Jacobson to support focused outreach camps at the Lutheran Center and Clinic under the leadership of Dr. Andrew Browning. The first such outreach camp is expected to occur in the second half of 2017 with subsequent sessions being planned for 2018 and beyond. 

The following medical equipment will be purchased in the US and shipped to Juba for use in the clinic and for fistula repair focused outreach camps .

1 Surgical table
2 Surgical lights
1 Portable ultrasound machine
1 Anesthesia gas machines
1 Electrosurgical generator
3 Oxygen concentrators
1 Ultrasound
2 Sterilizers
2 Suction pumps
4 Fetal Dopplers
2 Microscopes

TOTAL cost to purchase and ship these pieces of medical equipment: $35,000.   In addition, GHM will supply a full 40' sea container including these purchased items along with hundreds of other items from beds to consumable supplies. 

This container is expected to sail in late June or early July – quite possibly before we can access matching funds from Rotary District 5960.  

Please contact Scott Mercer or Orv Johnson for additional information on project safety or related concerns and find out how you can help NOW.


Thank you !