SSMJ August 2025
Editorials
The World Health Organization (WHO) defines One Health as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. It recognizes that the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) is closely linked and interdependent.”
News, Reports and Policy
10th East African Health and Scientific Conference
Letter to the Editor
Obituary
Obituary
ASOSS Call for Abstracts
Clinical Guidance
South Sudan’s healthcare sector faces challenges such as limited infrastructure, shortage of healthcare professionals, and insufficient funding. Private hospitals have emerged as a vital component in addressing these issues, yet their potential remains constrained without adequate government support. This article examines the strategies through which the government can advance private hospitals, including policy formulation, financial incentives, public-private partnerships, and capacity building.
Research
Caesarean Section (CS) is a lifesaving procedure in which surgical intervention is performed to remove a baby through an incision made on the abdominal wall and uterus; however, it is usually done when vaginal birth is observed to pose a threat to good progress for both maternal and child health. In Tanzania, the rate of pregnant women delivered by CS increased from 2% in 1996 to 6% in 2015-2016. Furthermore, CS rates are projected to increase by 5.6% in Sub-Saharan Africa and 44.9% in Northern Africa.
South Sudan has one of the highest maternal mortality ratios globally at 692 deaths per 100,000 live births in 2023. Key contributors include infection, haemorrhage, and obstructed labour. Delivery in a health facility attended by skilled birth attendants (SBAs) can reduce the high maternal mortality. Poor perception of childbirth risks and entrenched social norms have hindered the use of SBAs and the overall health facility delivery rates among mothers in the region.
Infant Oral Mutilation (IOM) is a traditional practice involving the gouging out of an infant`s healthy primary tooth germs. This can lead to transmission of blood-borne diseases such as HIV/AIDS, septicaemia, and death; other complications include eradication and/or malformation of the child`s permanent dentition.
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia. It may be due to impaired insulin secretion, resistance to peripheral actions of insulin, or both. It is a significant public health issue globally, with an estimated 537 million adults aged 20–79 years living with diabetes as of 2021, and this number is projected to rise to 643 million by 2030 and 783 million by 2045. Diabetes is one of the top 10 causes of death globally. Together with cardiovascular disease, cancer, and respiratory disease, these conditions account for over 80% of all premature noncommunicable disease (NCD) deaths.
Case Reports
Ovarian pregnancy is a rare and life-threatening condition accounting for 0.63% of all ectopic gravidae. In this case report, we present a 30-year-old woman with gravida 3; para 2 + 0 (2 alive) who attended our facility for a routine ultrasound scan. This case shows that early diagnosis, ectopic-variation awareness, intervention and patient counselling would ultimately improve maternal health outcomes in women of reproductive age.
Ruptured tubal pregnancy is a life-threatening surgical emergency. It is the most common cause of first trimester morbidity, mortality and a major cause of early foetal wastage. Modern, improved diagnostic techniques and multimodality management have drastically reduced death from ruptured ectopic pregnancy. Postmortem examination was done on the body of a 29-year-old female with the history of sudden onset of acute severe abdominal pain, vomiting and missed period for five days. It revealed massive intraperitoneal haemorrhage and ruptured left fallopian tube. Microscopic examination of the ruptured segment of the fallopian tube confirmed ectopic implantation.
Delivering critical care in low-resource settings presents significant challenges due to limited infrastructure, trained personnel, and logistical barriers. Ad hoc teams (ICU Squad)—temporary multidisciplinary groups formed to address specific emergencies—offer a promising solution to mitigate these challenges. This case highlights challenges encountered by ICU squad as a team approach, which enables the successful stabilization and management of a critically ill patient in a low resource area.
Summaries
Haematolymphoid neoplasms are a heterogeneous collection of neoplasms of lymphoid and myeloid cell origin, which commonly present in the head and neck regions. The tumours involve organs and tissues like lymph nodes, oropharynx, and oral cavity. Their unpredictable clinical behaviour, which tends to overlap with other neoplastic and non-neoplastic conditions, poses enormous diagnostic challenges. Early and clear diagnosis is essential in order to provide suitable treatment and better outcomes.
South Sudan remains critically underserved in its health workforce, with only 7.6 skilled health workers per 10,000 population—far below the WHO-recommended threshold of 45.5 needed to attain Universal Health Coverage (UHC). This commentary outlines the strategic efforts, led by the Ministry of Health, to close this gap through investments in health worker training, specialist education, and systems strengthening. Over 1,000 mid-level health professionals graduate annually from 37 national training institutes, out of which the United Nations Population Fund (UNFPA) supports 13.
Telehealth services employ telecommunication technology to provide scarce specialist care to the multitude across the geographical divided and hard to reach areas. The Aravind Eye Care System in India has a successful tele-ophthalmology model that services poor households and could be adopted in impoverished settings such as South Sudan. Evolving technological changes in South Sudan, including provisional approval of Starlink, improve the feasibility of telehealth services.