Background/History

The target population is the members of the 17 United Methodist Churches and their villages in South Sudan (currently within the area surrounding Yei, Central Equatoria). Health outreach began in the second half of 2010 when Diantha Hodges came as an Individual Volunteer in Mission. Conflict with Sudan ended in 2005, and South Sudan became an independent country in 2011. Health statistics are among the worst in the world, due to extreme poverty, poor government capacity, weak infrastructure including communication, transportation, poor hygiene (lack of latrines, soap, clean water), illiteracy, poor nutrition (people are just re-starting agriculture, poor quality and few clinics. Children under 5 years are at the greatest risk for illness and death, especially malaria, pneumonia, diarrhea. Sudan has the highest rates of infant mortality (150 per 1,000 live births) under five mortality (250 per 1,000) and under five deaths as a percentage of total deaths (57%). One out of every four newborns die before the age of 5. Maternal mortality is also alarmingly high (ration of 1700) with a woman's lifetime risk of dying in pregnancy or childbirth one in nine. The causes include lack of access to skilled care (95% of births are unattended), clinics are few, isolated and transportation is difficult; there is a lack of health education, equipment, and malaria and other diseases in the mother can cause complications. The extent of HIV/AIDS is yet undocumented; the people understand little, and testing and treatment centers are few. There are several NGO's addressing the health needs, but the need is so great, and the impact is small. A survey among UMC members show great lack of access to the services of health outreach projects and clinics and understanding about health.

Now all of the UMC churches have been given deep wells (not through this Advance). Through this Advance church representatives have been given initial WASH education; a sample low cost pit latrine has been constructed and demonstrated along with low water usage hand washing station. Relationships have been built with pastors, chair ladies and members of the churches; church members have had a chance to voice their concerns. An initial 2-day training was given for Traditional Birth Attendants (TBA). Church chair ladies were brought in to create Church Safe Birth Committees, which have begun educating the women of the church. Connections have been made with the closest government clinics, and a network was established.

Goals & Objectives

Within the first four years of this project, the goal is to decrease the incidence and severity of the prevalent causes of morbidity and mortality through improved health, improved health education and promotion practices, and simple interventions at the grassroots level within the Sudan District's 17 UMCs and their village neighbors. The prevalent causes being targeted for children under the age of 5 will be diarrhea diseases, dehydration, malaria, pneumonia, and worms. Maternal/Infant morbidity and mortality will also be improved. Adults will also have reduced incidence of the above diseases.

Activities Plan

1.Healthy Churches/Communities: train church/communities to conduct Health Education and Referrals by as system of project ownership by local committees and locally trained health volunteers. The goal is to decrease prevalent diseases by increasing knowledge about prevention and when/how to receive healthcare, and change health related behaviors through volunteers encountering members individually as well as getting the whole community involved.
2.Improving links and capacity at government clinics, especially those clinics which are used most by UMC members: skill review for clinic staff; upgrading basic equipment.
3.Safe Birth: training those who attend the majority of births, the local Traditional Birth Attendants (TBAs) to save lives and improve outcomes for mothers and infants. Create and support Church Safe Birth Committees in assuring the women seek clinic antenatal care, and learn about safe and healthy birth. Strengthen the connections to the local government clinics who would receive the referrals.
4.Provide Health Education at United Methodist Women's meetings, including District wide meetings, providing programs and educational material
5.Support nutrition gardens as demonstration/teaching gardens in a central site and in church gardens. Provide nutrition/food preparation education.
6.Support medicine gardens in the same manner. Provide education on evidence based local medicinal plants, preparations and uses.
7.Construct examples for home health practices (such as latrines, styles of hand washing stations, etc.) at key demonstration sites.
10. Coordinate outreach with other health efforts in the region.