Atong Kuol Manyang Juk is the minister of health in Jonglei State which has been grappling with flooding, attendant diseases, and poor accessibility.
Radio Tamazuj sounded her out on the challenges her ministry is facing and the plans to deliver health care in the state.
Below are edited excerpts:
Q: Honorable, please take us through the general situation regarding health in Jonglei state.
First of all, we would like to look at it from a general overview of South Sudan and health is not that great. For instance, Jonglei State is the worst because of the flooding here. The flooding comes with a lot of water-borne diseases like cholera, typhoid, and even mosquitos. These are some of the things that affect us and as you move northwards from Bor you find that it gets worse in the places that medicines do not even reach.
Q: What is your budget for medicine, and health facilities, and what challenges do you face?
A: To be honest, we do not have any budget allocated to buying medicine in the state so we rely on the consignment that we receive from the national health ministry. So, that is one challenge.
The ministry of health at the national level sends us a consignment (medicine) through UNICEF but there are times when we feel that medicine does not come in time. I believe we received a consignment in February 2022 since August 2021. That is like 9 months and normally it is supposed to come quarterly but we never got that it is because the medicine is supposed to come through the procurement system.
If you look at the financial allocations, of course, most of our budgets are from the national government and mostly for salaries. It is supposed to pay skilled staff at the level of ministry but even when it comes, there are other staff members. We have about 1,600 employees, including unskilled staff, and whatever comes from the national government was reduced last year.
When you look at what we get from the national and what we are supposed to get as a top-up from the state, it is not enough. So, there is a challenge starting from the salaries, leave alone the services that we are supposed to give to the people.
Q: How many hospitals do you have in Jonglei?
A: We have about six hospitals state hospitals plus five operational county hospitals.
Q: What kind of support do NGOs give you? Do they contribute to the salaries of health personnel?
A: Yes, NGOs give incentives to the staff. They especially support nurses and doctors but not everybody, so they have been showing that support.
When you look at our government salaries, even if it was coming every month, it is not enough to sustain somebody’s family. Hence, these incentives are the ones that support these people and keep them on the job but this does not mean that as a government we are not doing anything. There are a lot of things we are doing.
Q: Since a lot of your support comes from the NGOs, what are your long-term plans as a ministry?
A: First of all, when I say NGOs are supporting us, this is usually in partnership with the government and there are specific areas where they have agreed to help us. When you look at the flooding that I mentioned and other challenges, they support us in the areas of health, education and maybe agriculture, etc. We need support in those areas and this is part of humanitarian support not only in South Sudan, but I believe other countries also receive this support.
However, we cannot rely on humanitarian support for a long time and at some point, they will have to exit. That is why even as we sit at the state, we are encouraging the NGOs to support us in capacity building so that we can stand on our own and deliver our services and take ownership of the work that we are supposed to do as a government or as people of South Sudan.
One of the challenges we are facing in Jonglei is flooding otherwise we would encourage our people to venture out and become self-reliant by producing their food.
Q: Have you visited the hospitals outside of Bor town?
A: Since I took over as the minister of health, this was one of my priorities. I requested UNMISS for air transport through my governor and my program was approved but because of a shortage of planes, I have been unable to go.
I have visited areas like Bor South and we managed to visit all the primary health care centers in Kuryang, Pariak, Baidit, and Anyidi two months ago.
When we went there, we found some challenges including a lack of space and both genders sharing wards. These are some of the challenges. You also find that there is no power and these are things that are needed when patients have to be taken care of at night.
Q: Is there electricity in your major hospitals?
A: When you talk of electricity we have 24-hour solar-generated power at the Bor Hospital. We got the solar system from the partners. If you go to the other hospital like ion Panyagor and Duk-Padiet they also have solar power in those areas. So, I would not say that we are entirely in a blackout even though we are not where we want to be.
Q: As the state health minister, what are your plans to improve the healthcare and facilities?
A: The reason for visiting the facilities is to see what the challenges are after which we will sit down and come up with our budget which we will present to the state government.
We are not just sitting and if you go to Bor State Hospital, we have started to fence it and this was possible through our fundraising.
We have to initiate and start some of the things and not always rely on the government but if the situation of our country gets better, service delivery is vital and needs to be improved.
Q: We have been reporting about the lack of doctors in Jonglei State. What will you do to address this shortage?
A: As I told you, it is not like we do not have qualified doctors in Jonglei or South Sudan. We have quite a number and the problem as I said earlier is sustainability. How do we sustain them? Even if the government pays them and it is not enough, they will not be able to stay.
For instance, we have been talking about the Bor State Hospital having specialists like gynecologists, pediatricians, and surgeons and we discussed this with our partners and we were able to get a promise that UNICEF will support the surgeon and pediatricians. These are the areas we need specialists, not only in the state capital but also in the counties.
If we improve the facilities in the counties, people do not need to come to Bor because they will be able to get services in the payam. Many people die along the way so this is something we are trying to manage.
Q: What message do you have for the people?
A: As the minister of health in Jonglei State, we have challenges but have been able to achieve some things.
For instance, we made regulations for the pharmacies in the state to make sure that our people get the right medication and to make sure that medicines are stored well to required standards. We also ensured that qualified people treat patients and we have done this in all the private and government health facilities.
So, as a government, we have been able to do certain things within our capacity but the challenges are still there because most of the things need funding.
It is a matter of time before things get better but we have to stick together as the people of South Sudan and support our government.
Sometimes, as a ministry, we are not able to deliver everything that our people need but we are trying.