Successful handover of three health clinics in northeast Kadugli

Sudan
16 June 2008 (Medair)

In March, ceremonies were held in three villages in Southern Kordofan to celebrate the handover of health clinics from Medair to the Ministry of Health (MoH).

Over the last five years, the villages of Abu Safifa, Lagori, and Tesi have progressed from almost no health care provision to a self-sustaining level of capacity in each of their clinics. In joyful handover ceremonies that were attended by many thankful people from the villages, speeches were made by Medair staff and community representatives, interspersed with drama and dance performances to create memorable events that marked these significant achievements.

‘Handing over these facilities has been a very encouraging thing to do,’ said Janneke Blok, Medair’s Health Coordinator in Kadugli. ‘The gratitude expressed towards Medair, and the enthusiasm of the communities to take care of their health facilities, has convinced me that the work we are doing here can really make a difference – especially if the communities are so committed to it themselves.’

The Health Services Programme

In 2003, Medair initiated a health programme in the area, and began supporting clinics in the underserved regions of Alliri Hills, the Western Jebels, and northeast Kadugli. At the time of its intervention in northeast Kadugli, there were no health workers in the villages of Abu Safifa or Lagori; only the village of Tesi had some health care provision at that time, and the quality was poor.

Over the last five years, Medair has rehabilitated the health services in these three villages by maintaining a steady emphasis on improving the capacity of Village Health Committees (VHCs) and health staff, and by working in partnership with communities and the MoH.

Rehabilitating Health Services in Northeast Kadugli

- Medair helped establish VHCs at the outset of the project, so that the communities would take ownership of the health care improvements that were made.

- Monthly meetings held with VHCs.

- Training provided for them in health facility management and in implementing a Revolving Drug Fund (RDF) system.

- Bank accounts opened for VHCs.

- The MoH employed health workers upon Medair’s arrival.

- New health facilities were constructed in Abu Safifa and Lagori, and upgraded in Tesi.

In addition, Medair’s Water and Sanitation (WatSan) team helped provide safe drinking water for each of the clinics by constructing rainwater harvesting systems.

A Long-Lasting Impact

The impact of these activities has been impressive. All three clinics are now self-sustainable for drug provision. Health workers have been trained to do appropriate consultations, prescribe proper drugs, and work according to MoH policies. The health facilities are all in good condition, and they have the equipment they need.

The VHCs are also performing well. The strength of community involvement has demonstrated to MoH that by establishing a good working VHC with a fully implemented revolving drug fund system, clinics can be run much more effectively and with fewer problems.

‘Medair’s way of working with the facility in Abu Safifa, and especially with the VHC, will be an example for how MoH will deal with other clinics as well,’ said Dr. Ali, with MoH Kadugli.

Furthermore, Medair’s success was facilitated by the strong relationships forged by staff in each community, who acted with compassion, accountability, and respect for individual dignity.

Speaking at the handover ceremony, the Umda (village leader) of Abu Safifa said, ‘The fact that Medair is leaving Abu Safifa feels as if a relative has died.’ In Lagori, the feelings were just as strong: ‘The next baby born in Lagori should be called ‘Medair,’’ said the Umda, ‘to express our gratitude towards the work Medair did for the community of Lagori.’

Hope for the Road Ahead

The gratitude expressed in all three handover ceremonies was both meaningful and inspiring for Medair and its staff. With ongoing work in 17 other facilities in the area, and an approaching exit goal of March 2009 for primary health care support in existing areas, the measurable success of the three health clinics gives hope that the others can also develop the capacity they need.

‘A lot of work still needs to be done in the area,’ said Janneke Blok, ‘ but the achievements in Abu Safifa, Tesi, and Lagori show that this work can produce very satisfactory results. The commitment and willingness from the MoH has been crucial in this. Without their involvement, the handover wouldn’t have been as successful as it was now.’

Medair is an international non-governmental organization (NGO), based in Switzerland. It has worked in Sudan since 1995, and in Southern Kordofan since 2003, where Medair currently supports access to primary health care and water and sanitation in the Nuba Mountains areas. These activities are carried out in collaboration with WHO, UNICEF, and other UN agencies; the Humanitarian Aid Commission / Sudan Relief And Rehabilitation Commission; and the state Ministry of Health. This project receives financial support from the governments of Sweden (SIDA) and Switzerland (SDC) and the United Nations’ Sudan Common Humanitarian Fund (CHF).

Elsewhere in Sudan, Medair provides access to primary health care and water and sanitation for up to 200,000 conflict-affected persons in West Darfur, and works with war-displaced people in Khartoum. In Southern Sudan, Medair provides emergency medical and water assistance for outbreaks, large people movements, and nutritional emergencies in a number of locations across the region, as well as improving access to primary health care and safe water sources in Upper Nile.

Medair’s life-saving activities are dependent upon private financial support. To contribute to this work, please visit www.medair.org (Sudan section).

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