Malnutrition Screening and Nutrition Supplements
With support from its donors, the Duk Lost Boys Clinic now screens every child patient for malnutrition and Vitamin A deficiency. Children who are malnourished are enrolled in the clinic's nutrition program, which provides therapeutic food and nutrient supplements through a partnership with UNICEF. Most importantly, their families are counseled on proper feeding and hygiene practices.
The clinic also has a small community garden which seeks to demonstrate methods of agriculture and crop diversity. Additionally, the John Dau Foundation (JDF) has conducted a comprehensive nutrition study of the area, using the results as the basis for an intervention in partnership with UNICEF. No other nutrition programs exist in the former Duk County, making this study the first of its kind in the region.
Maternal Child Health
Providing pre- and post-natal care to mothers and their children remains a top priority of the JDF. This care includes ultrasounds, laboratory blood screening, delivery and full immunization of all children born at the clinic and of women of childbearing age in the community.
Before the clinic came into service, many mothers delivered their children on the dirt floors of their huts without any skilled attendants or supplies. The JDF has begun an active education campaign to teach women of childbearing age the services the clinic provides and the benefits of receiving medical care. The clinic also has a unique partnership with traditional birth attendants (TBAs) in the area whereby the clinic trains and supplies these women with safe delivery kits, flashlights, mosquito nets and gumboots for conducting deliveries of mothers unable to make it to the clinic. After nurturing this relationship and building trust between the clinic and the TBAs, many TBAs now refer the mothers under their care to the clinic for pre-natal, delivery and post-natal care.
Although the notion of giving birth in a medical facility is new to many South Sudanese, the clinic has seen a steady rise in the number of mothers seeking these professional medical services. Dozens of mothers come to the clinic every month for pre-natal care, and the clinic conducts about 10 deliveries per month. As a result, the lives of many mothers and children have been saved.
In addition, the JDF recently purchased a vehicle to transport mothers in labor who are at risk.
Community Health Worker Trainings
As the clinic continues to expand, the JDF trains and supports community health workers from surrounding areas to help with the prevention of diseases through vaccinations, deworming and education. Since an outbreak of measles or meningitis can take hundreds of lives in a matter of weeks, it is vital to have multiple people on the ground in addition to the clinic's medical personnel observing conditions in the local community.
In 2010, the JDF partnered with Groundwork Opportunities to bring 73 health education books (including Where There is No Doctor and A Book for Midwives) to distribute to local schools, community health workers and midwives to guide them in their practice. The JDF also provides supplies to these remote locations.
Immunization and Deworming
In February 2009, the JDF developed a solar-powered cold-chain system that enables the Duk Lost Boys Clinic to receive vital vaccines and medicines requiring refrigeration. In 2009, the clinic vaccinated nearly 4,000 children and pregnant mothers against deadly and debilitating diseases.
Through a partnership with neighboring organizations and the government, the clinic conducts deworming for school-age children and adults throughout the region. These worms, which are called helminths and are transmitted through poor sanitation (e.g., failing to wash hands or drinking unclean water), have become a widespread epidemic, infecting nearly every person and leading to malnutrition and increased vulnerability to other, more severe diseases. JDF is in the midst of a program to provide deworming medication to every child in the region; it has so far reached over 15,000 children.
The JDF has taken steps to prevent malaria by distributing over 2,500 bed nets to mothers and children under five. In November 2010 (the height of the rainy season when mosquitos are most prevalent), there was not a single confirmed case of malaria at the clinic. When a patient is diagnosed with malaria at the clinic, they are provided with medication that is extremely effective and surprisingly inexpensive for JDF. Though the shortage of nets means there are still dozens of cases per year, the clinic is able to treat virtually all of them.
Although Guinea worm is rare in the area around the clinic, sporadic cases do occasionally occur. The clinic staff is trained to diagnose and treat Guinea-worm disease as well as report outbreaks to the World Health Organization.
In honor of World AIDS Day in 2009, the clinic launched the first-ever HIV/AIDS prevention and treatment program in the region with a community meeting featuring local leaders and visiting medical doctors from the United States. At the meeting, staff handed out AIDS ribbons and introduced the clinic's new HIV/AIDS Counselor. HIV/AIDS is a growing issue in South Sudan, and the JDF is committed to ensuring the local population is fully educated regarding causes, symptoms and treatment.
Additionally, the clinic has trained and mentors a group of teachers and students to conduct HIV/AIDS education campaigns in the community using theater, a popular cultural medium.
With less than one percent of the population in South Sudan having ever been tested for HIV/AIDS, the main goal of JDF's program is to promote awareness of HIV/AIDS and to encourage usage of our voluntary counseling and testing services. All expectant mothers receive HIV/AIDS counseling, and the clinic stocks anti-retroviral (ARV) medication for mothers who are HIV-positive to prevent mother-to-child transmission. These are the only such services for more than 100 miles around.
In February 2009, the JDF launched a tuberculosis treatment program. Since the treatment of tuberculosis is highly complicated, clinic staff implements the WHO-recommended DOTS (directly observed therapy, short-course) program necessary to ensure the successful treatment of the disease. In DOTS, a combination of six antibiotics are used on a daily basis for six months under the observation of community health workers. This has resulted in an 89 percent cure rate, which is above international standards.
Through a partnership with the World Food Program, the clinic also offers food for the patients as well as the caretakers who help patients complete the difficult treatment.