And what a decade it has been! The world’s newest country got off to a rocky start even before independence. John Garang, who alternated between earning advanced degrees in the USA and leading rebel forces in Sudan, died in a helicopter crash only weeks after becoming First Vice President of Sudan, in 2005. The country that was yet-to-be lost its champion of multiculturalism. Garang had lived in societies where behavior was shaped by laws rather than guns.
But by July 2011, everyone dressed up to vote, and danced for independence. In 2021, no one seemed to be celebrating.
10 years of independence and kala azar:
2011 marked a huge kala azar outbreak in Old Fangak. SSMR treated 5378 patients, half of the kala azar cases in all of South Sudan. Many needed blood transfusions and IV medication. Half were kids under five. Kala azar, untreated, usually kills its victims. Of 5378 patients treated, we lost 128. Tragedy for those families, for sure, but thousands survived the deadly disease.
This year, for the first time ever, we enrolled less than 100 with kala azar. We would like to think that, as our reputation spread, patients knew to come early for treatment, when they are less infectious to others, and less likely to die. But we can probably thank the floods. Floodwaters killed off sand fly larvae that transmit the disease. This incredible drop in kala azar has been our biggest good-news story. We trust it continues.
10 years of independence and a new war
The war of independence ended in 2005; South Sudan became fully autonomous in 2011. Political tensions increased. In December 2013, a massacre in Juba killed tens of thousands of people in a matter of days. Most were Nuer, kinfolk to our community. And then the civil war started. Once again, our area was considered ”rebel territory”.
The kala azar epidemic of 1988-91 killed at least 150,000 Sudanese. Whole villages died. It was awful. But civil war damaged our new country’s social fabric even more. While it’s tragic when sand flies kill people, it’s so much worse when loss of life is caused deliberately, by fellow citizens. As recently as 2016, major military ventures destabilized the country. Now all parties have signed a brokered cease fire agreement.
In Old Fangak, members of tribes that are enemies elsewhere worked together to prevent bloodshed. It helps that we have no roads or oil to fight over! Soon the UN’s World Food Program decided we might be the stable spot “on the other side of the conflict.” They subsidized logistics and maintenance for our dirt airstrip. UN agencies and other NGOs followed. Doctors Without Borders (MSF) came to help, and has worked closely with us since 2014.
10 years of independence and infrastructure
When South Sudan gained its independence, the entire country boasted only 30 miles of paved roads. That’s for 10 million people living in an area the size of Texas.
We moved to Old Fangak in 2005 largely because it was right on the river and had the only bore hole well in the area. By 2011, the year of independence, the fighting had abated to the point where boats could transport passengers and cargo.
In 2013, the Alaska Sudan Medical Project brought material in by barge, and constructed a metal hospital building! The floors can be cleaned!! Then ASMP drilled more boreholes.
Other TB treatment centers closed due to the civil war; we were the only ones in our region that never did. Our numbers swelled. And now we have a new multipurpose TB center built high on stilts. Floodwaters couldn’t touch it.
The ability to isolate new sputum positive patients has become tremendously important as displaced people flock to Old Fangak. Our generous staff would take displaced people with TB into their homes when they had nowhere else to live. This building keeps our workers safer, along with the rest of the village.
10 years of independence and education:
In the 1990s, we tried to hire staff who had at least a third grade education and spoke functional English. Since women never got that much education, we hired only men.
One night, looking up at the starry sky, a health worker mentioned that his teacher told them that the Earth was round and white people like us lived on the other side of it but never fell off. No way to prove it—they just had to take him at his word. The teacher also said that one planet in the heavens had people on it. They asked if we could point to that planet….
From the beginning, we have offered staff education at many levels. Some need help with basic math and anatomy. Others reach the point where we fund their education in Uganda or Kenya, and they return as registered nurses or lab techs.
Of course, staff with education want even more for their children. Long term supporter Ann Evans and the Comboni Brothers collaborated to open a school, adding on grades as students progressed. We are now up to Grade 10, and soon will have real high school graduates! Some of our workers, who never got the chance for formal education as kids, are working fewer hours so they too can attend secondary school.
Looking back over the past 10 years, we see how far we have come. Thanks to all of you!