ELLE World: Beneath a Tree in South Sudan

Christina Reynolds joins UNICEF on a journey to save women's lives in South Sudan.

Apr 16, 2013
Christina Reynolds
Beneath a Tree

Women gather for a free tetanus vaccination in Kuajok, South Sudan. Photography by Christina Reynolds.

I met Ajok Madut where much of South Sudanese life takes place—in the shade of a big, broad, drought-resistant neem tree. On this day, she was one of dozens of women and schoolgirls who walked to this hot, dusty site on the outskirts of Kuajok, the capital of the state of Warrap, near the country’s northern border, to receive a free tetanus vaccine.

Wearing a traditional lawo wrap and plastic sandals, she was toting her nine-month-old son, Ayi, while her three-year-old daughter, Acol, trailed behind. Madut, who looks about 30 but doesn’t know her own age, came here because she heard that this immunization would help protect her future babies. She had already given birth to seven children—all by herself, at home in a mud-and-grass hut—but three of her babies died soon after birth. “At labour time, there was no time to go to the hospital,” Madut tells me, speaking Dinka, through a translator. “Traditional birth attendants won’t help because they are scared that if there is a problem and someone dies, they will be blamed.” So, using a UNICEF-provided “mama kit”(which includes a plastic sheet, soap and a sterile razor blade to cut the umbilical cord, among other items), she gave birth alone each time. “I felt the pain,” she says. “But I couldn’t let myself become too scared, because there was no one to help me. Being scared wouldn’t be good for the baby.”


South Sudan, which seceded from Sudan to become the world’s newest country on July 9, 2011, has one of the world’s highest maternal-mortality rates—2,054 per 100,000 births. (That is compared to 7.8 per 100,000 births in Canada.) More than 60 percent of the population have no access to clean drinking water, and over 50 percent live below the poverty line.

“It’s a country starting from scratch. There is no health system in place,” says Paula Nuer, a health specialist with UNICEF who is overseeing the regional maternal and neonatal tetanus (MNT) vaccination campaign. That is not an overstatement. For a country with a population of eight million, there are just 120 doctors, 100 registered nurses and 10 midwives, according to estimates. There are few health-care facilities, and those that do exist are extremely primitive—even the largest primary-health facility I visited in the region, which had 50 beds, was a crumbling cement structure. Hundreds of patients were waiting outside in the blistering heat. The health challenges in the region are numerous, from malnutrition and anemia to malaria and tetanus.

Learn about health care in South Sudan on the next page...


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