News and Resources - November 2010


News From Southern Sudan

Southern hospital cannot cope with demand

MALAKAL, 23 September 2010 (IRIN) - Doctors are working 12-16 hour shifts to cope with the increasing demand at Malakal teaching hospital in Upper Nile State of Southern Sudan, say officials.

“We are trying to encourage more doctors to come work here,” Upper Nile State health minister Steven Lor said. The relatively poor living conditions in Malakal, however, made it difficult to convince Southern Sudanese doctors working in the capital Khartoum to move.

The hospital director, Tut Gony, said in the past two months, more than 2,000 people had sought treatment at the hospital. These included 700 malaria cases, many of whom were children. “Our capacity and resources at this hospital do not match the high demand for services,” Gony told IRIN. The hospital, the only such facility in the state, has 14 doctors for the state's population of 126,000, according to the 2006 national census.

To cater for this population, as well as some patients from neighbouring Jonglei State, the hospital needed more beds, new surgical equipment and a steady stream of drugs, Gony said.

The current rainy season, which has left four of Upper Nile’s nine counties partially under water, was likely to increase health risks. “We have a serious problem with sanitation in Malakal,” he added. A survey by the NGO Relief International in 2007 found that 80 percent of the residents had no access to latrines or any other toilet facilities.

Extract from IRIN News ( 23 September 2010 – see full article at

Correction to photograph

The photograph on the cover of SSMJ 3 3 wrongly said that Ms Bilha Achieng was in it – we apologise for this mistake. The photograph below shows Bilha (in white trousers in front row) with students from the Juba College of Nursing and Midwifery in their new uniforms (credit Bilha Achieng).


Note from Population Services International

“In the volume 3, number.2 issue of the SSMJ, Population Services International was featured in the organizational profile on page 14. PSI wishes to provide further information to clarify its role in Southern Sudan. Since opening its office in Southern Sudan, PSI has worked in close collaboration with the Government of Southern Sudan, Ministry of Health in support of the Ministry’s efforts to improve the health of the people of Southern Sudan. With funding and support from the Ministry of Health through MDTF, PSI distributed over 1 million LLINs in 2008 and 2009. In 2009 and 2010, PSI and its partners distributed 2.5 million nets through the Global Fund, Round 7 Malaria grant in collaboration with the National Malaria Control Program, Ministry of Health – GoSS”.


Clinical Resources

This section gives relevant clinical information from other journals and reports, and suggests materials that can be freely downloaded, and/or obtained in hard copy or on CD. Items are grouped under: Chronic diseases; HIV and other infections; Maternal, newborn and child health; Surgery; General resources.

Please look out for other publications to include in this section. Send them to Dr Wani Mena [email protected] or Dr Eluzai Hakim [email protected].

Chronic diseases

Africa: Diabetes becoming more prevalent The diabetes population in Africa is estimated to double over the next 25 years impacting poor people living in slums or informal settlements more than the general population, according to the International Diabetes Foundation. The IDF also said Africa will see a 24% increase in NCDs by 2015. Increases in development, disposable income, urbanization, mechanization, globalization of food markets and changes in lifestyle behaviors are attributed to the increase of diabetes in Africa. Rising diabetes rates are becoming another barrier to the survival of those who are low income. Blog 4 Global Health Council’s Policy, Research and Advocacy team at

All Africa conference on heart disease, diabetes, and stroke The Cardiovascular Journal of Africa is calling for abstracts for PASCAR's 2011 conference in Kampala, Uganda. The deadline for submission is 30 January 2011. Submit online at: CVJ Africa Conference website:


HIV and other infections

The HPV Vaccine Global Community is an online global network of people who share an interest in preventing cervical cancer and in the role of Human papillomavirus (HPV) vaccines in health programs. We use the internet to share and exchange knowledge, ideas and resources to explore the feasibility of introducing HPV vaccines within cervical cancer control programs and thereby ensure that people around the globe have equitable access to the best available health care. See

[Seen on HIFA2015 3August 2010]

Maternal, newborn and child health

1,000 Days: Change a Life, Change the Future (

Maternal and child nutrition during the first 1,000 days—pregnancy through age two—shapes a child’s future. With adequate nourishment in the earliest years of life, children have an opportunity to grow to reach their full potential. There is a critical window of opportunity between pregnancy and age two during which nutrition can have a measurable lasting impact on growth, brain development, incidence of disabilities and susceptibility to disease or infection. The full long-term effects reach beyond health—with poor early nutrition leading to limited educational achievement and decreased lifelong economic opportunity.

Each year, 3.5 million mothers and children under five die as a result of malnutrition, and millions more suffer the effects of poor early nutrition. The impact of malnutrition during the first 1,000 days is irreversible—but these consequences are preventable. Each year, we can save the lives of more than one million children and help 360 million more children and their mothers have a healthier future. An annual investment of $10 billion in child nutrition offers the best return on investment in global development, and it is the right thing to do.

A wide range of organizations have come together to ensure that children and families get a healthy start at life. 1000 Days: Change a Life, Change the Future supports international experts and advocates working to improve early nutrition. Organizations including InterAction, Bread for the World, Concern, Save the Children, World Vision, and the Hunger Project are sharing information and co-ordinating efforts to support effective, evidence-based actions to improve nutrition.


Infant and young child feeding. New documents (available in hard copy) from WHO’s Department of Maternal, Newborn, Child, and Adolescent Health:

To request hard copies email [email protected]


Making Pregnancy Safer

The following documents have been published by WHO’s Making Pregnancy Safer Department:

Maternal iron/folic acid combined with antimalarial drugs reduces early infant deaths
 Malaria infection during pregnancy is especially dangerous because it can lead to maternal anaemia, a condition linked to premature birth and low birth weight. Consequently, antimalaria prophylaxis for pregnant women is often recommended. Administration of iron and/or folic acid supplements improves maternal anaemia and pregnancy outcomes - but there are reports that iron supplements may increase the risk of malaria infection, especially in women and children. However, these studies are not consistent and researchers recently investigated the independent and combined effects of iron/folic acid supplements and malaria prophylaxis on neonatal outcomes in 19 sub-Saharan African countries using data from over 100,000 births.
 The researchers found that infants whose mothers received both iron-folic acid supplements and sulfadoxine-pyramethamine during pregnancy were 24% less likely to die in the first month of life than infants whose mothers used neither. This protection was not conferred by either treatment alone, nor from other antimalarial drugs.
Reference: Titaley CR etal Combined iron/folic acid supplements and malaria prophylaxis reduce neonatal mortality in 19 sub-Saharan African countries. Amer. J. Clin. Nutr. 2010;92:235–43.

[seen at procor 16Sep2010]


Measuring newborn foot length to identify small babies in need of extra care: a cross sectional hospital based study with community follow-up in Tanzania.

Measurement of newborn foot length for home births in resource poor settings has the potential to be used by birth attendants, community volunteers or parents as a screening tool to identify low birth weight or premature newborns in order that they can receive targeted interventions for improved survival.
For details see BMC Public Health 2010, 10:624


PED-EM-L is an international email forum for professionals interested in the emergency care of children. It includes discussions of individual clinical cases.
To join, send an email to [email protected] and put the following text in the body of the message: subscribe PED-EM-L yourfirstname yourlastname
For more details, including a hypertext archive and links to other Internet resources see:

[Seen on CHILD2015 email forum]


idoc Africa ( is a site dedicated to improving delivery of hospital care for newborns and children in Africa. This website houses teaching approaches developed for the ETAT+ (Emergency Triage Assessment and Treatment PLUS admission care) WHO and Kenya courses, job aides used to try and improve care, tools for measuring the quality of care used in operational research and much more.


Practical Plastic Surgery for Non-surgeons a book by Nadine Semer (a reconstructive plastic surgeon who has worked in several rural areas of Africa) is available free as a pdf at [recommended by Professor John Adieng Adwok] is a website providing independent information about drugs used in palliative and hospice care. The content is based on the UK Palliative Care Formulary (PCF, 3rd edition). It includes details about unlicensed (unlabeled) indications and routes, and the administration of multiple drugs by continuous subcutaneous infusion. There are regularly updated 'Latest additions' and 'News' sections, and a Bulletin board which covers drug and non-drug issues. There is also a search facility that covers the whole site. Free registration is at the website.

[Seen on HIFA2015 14August 2010]


Practical Pointers for Primary Care Medicine

These are abstracts from key medical journals selected as being most clinically important (e.g. British Medical Journal). 6-8 abstracts are added each month and an index lists these by medical subject. The site allows access to many of the full articles. See

[seen at HIFA2010 [email protected] 16/9/2010]


MedlinePlus is the USA National Institutes of Health's free website for patients and their families and friends giving information about a large range of diseases, conditions, and wellness issues in language patients can understand. Although meant for Americans parts of the site may be useful for patient education and support in South Sudan.


Free access to Journal of the American Medical Association (JAMA).

You can get free access to the abstracts (and some research articles) in this journal at You may be able to get email alerts of the table of contents of new issues at

***New e-TALC CD-ROM will be available soon***

e-TALC is a project of Teaching-aids At Low Cost (TALC) which aims to bridge the digital divide in health by disseminating up-to-date, high quality health information on CD-ROMs free to health care workers in developing countries.CD-ROMs are cheap to produce and post, they can hold thousands of pages of information and can be used on almost any computer. A variety of electronic resources are included on the e-TALC CD-ROMs including journals, books, newsletters and interactive educational content. These resources are donated by a variety of NGOs, publishers and individuals involved in health and development in developing countries. The resources are sorted and chosen for inclusion on future issues of e-TALC by our expert editorial board who make their selection based on the relevance of the resource to health care workers in resource-poor settings.If you are not on the e-TALC mailing list and would like a copy of the next (11th) CD, please contact Simon Redmore at  [email protected].