SSMJ August 2020


COVID-19: A Crisis Within a Crisis

The outbreak of COVID-19 (Coronavirus disease 2019) was declared an international public health emergency on 30 January 2020. Global efforts so far have been focused on optimising healthcare systems and preventing fatalities, but brewing underneath the surface of this pandemic is a social crisis of unprecedented dimensions.

News, Reports and Policy

Local staff are key to psychosocial support in South Sudan

Restoring support structures and creating awareness around positive coping mechanisms can be all the support some people need to maintain mental and psychosocial well-being. Care Groups, parenting support, and cultural activities can have a profound impact on helping a community recover from shock.

South Sudanese recipients of grants from the Gordon Memorial College Trust Fund (GMCTF) in 2020

The Gordon Memorial College Trust Fund (GMCTF) founded in July 1899 supports the education of Sudanese and South Sudanese doctors and each year gives awards to a number of individuals and institutions.

Clinical Guidance

Nurturing Newborns in South Sudan Series: Essential Care of the Newborn

The first 28 days of life is the neonatal or newborn period. Most children who die do so in their first month of life and most especially in the first week. The global rate of newborn deaths is 18 per 1,000 live births as of 2018. South Sudan has one of the highest neonatal mortality rates (NMR) estimated at more than 40 per 1,000 live births.

How to wear a medical mask safely - Do’s and Don’ts

This is a WHO guideline on how to wear a mask properly


Mothers’ knowledge of mother-to-child transmission of HIV and infant feeding practices in Juba, South Sudan

While exclusive breastfeeding for the first six months of life is recommended for HIV-infected mothers, this may not be practiced fully in South Sudan; exclusive formula feeding, which is the best alternative to breastfeeding, may not be practical. This study aims to assess the knowledge of mother-to-child transmission of HIV (MTCT) and practices of feeding infants in the first six months of life among HIV-infected mothers attending Antiretroviral Therapy Centres in Juba Teaching Hospital (JTH) and Juba Military Hospital (JMH).

Prevalence and factors associated with neonatal sepsis among hospitalized newborns at Ruvuma, southern Tanzania

Neonatal sepsis is one of the most common causes of neonatal morbidity and mortality in developing countries. This study which aimed to determine the prevalence and factors associated with neonatal sepsis among hospitalized new-borns at Ruvuma, southern Tanzania, found that the prevalence of neonatal sepsis in this study setting is very high.

Introduction of postpartum and post abortion family planning into three hospitals in South Sudan

Postpartum/post abortion family planning is a service provided for women who have given birth or had a spontaneous abortion. Due to low uptake of contraception in South Sudan, increasing contraceptive use is important to achieve Sustainable Development Goals. The study aimed to introduce postpartum/post abortion family planning to women who have delivered or undergone spontaneous abortion at Juba Teaching Hospital, Tambura Hospital, and Yei Hospital. It found that the training of health care staff to advocate and promote postpartum/post abortion contraception is effective and can contribute to family planning services.

Health seeking behaviour of small income market vendors: diabetes primary care in Gulu Municipality, northern Uganda

Of the 56.4 million deaths occurring worldwide in 2015, more than half (54%) were due to the top 10 causes - of which diabetes was one. Diabetes is one of the multiple health challenges faced by developing countries. A 2006 US study noted that diabetes, not obesity, increases the risk of critical illness, organ failure and early deaths.

Case Reports

Case Report: Iatrogenic enterocutaneous fistula following a misguided surgical procedure in Torit, South Sudan

Groin hernia is common among active people in sub Saharan Africa. It contributes significantly to morbidity and mortality because of its unusual sac content. Various organs can be unexpectedly found in the sac when performing hernia repair surgery.

Case report: Bladder calculi presenting as urinary incontinence mimicking obstetric urinary fistula

The presence of calculi in the urinary tract is usually a silent morbidity, which may present as an incidental finding on evaluation of the genitourinary or renal tract for other pathologies. Failure to identify this early is associated with more grievous effects on the function of the renal system, especially the kidneys.

Case report: Embryonic rhabdomyosarcoma of the petrous bone in a child

Rhabdomyosarcoma (RMS) is a cancer of skeletal muscle origin, and the second most common soft tissue sarcoma encountered in childhood. The head and neck are common sites though the temporal bone is rare. Rhabdomyosarcoma represents 3.5% of all malignancies in children aged 0-14 years, with approximately 250 new cases diagnosed each year.

Case report: Mandible fracture in children

The type of maxillofacial fractures in children and young adults varies with evolving skeletal anatomy and social and environmental factors. The general principles of treating mandibular fractures are the same for children and adults: Anatomic reduction along with rigid skeletal stabilization is mandatory until bone union has occurred.

Case report: Retrograde tracheal intubation using a guidewire for a difficult airway in a patient with severe facial burns

A technique of retrograde tracheal intubation is disclosed which employs a 7 Frx20cm central venous cannulation J-guidewire (from BIOMETRIX critical care solutions). The guidewire was inserted through the cricothyroid membrane and retrieved orally. An endotracheal tube was then passed over the guidewire under direct laryngoscopy.


Over prescription of drugs in Africa

There is a worldwide 'epidemic' of inappropriate and excessive prescription and selling of medicinal drugs. In Africa many people are poor and often have a low level of education. A large proportion of an ordinary family’s spending may be used to buy drugs.

Guided self-help to reduce psychological distress in South Sudanese female refugees in Uganda: a cluster randomised trial

he aim of this study was to assess the effectiveness of a self-help intervention (Self-Help Plus) in reducing psychological distress in female refugees.