Strategies for the Future

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by Jonathan White

As the referendum gets closer for Southern Sudan in January of next year to gain independence from Northern Sudan, our new Nursing & Midwifery College in Juba, awaits the results anxiously.  The College will be closed between November 15th and January 15th to allow students and staff to safely register to vote and return home to await the results of the election.

The Nursing & Midwifery students with the staff of College and RMF project manager

Our partner in this initiative at the UNFPA in Sudan sends us these weekly media summaries as everyone prepares for the voting:

Below are series of short articles written regarding Senator John Kerry’s involvement and the Obama administration’s stance on the upcoming elections.

CPA partners receive Obama’s road map
Al-Rai Al-Aam 8/11/10 – The Sudanese Government is currently studying phased proposals conveyed by Chairman of the Senate’s Foreign Relations Committee John Kerry to lift sanctions imposed on Sudan, to write off debts and to remove Sudan’s name from the terrorist list in exchange for NCP’s concession on the Abyei territory.

Sources said the Government told Kerry that it had agreed to the South’s self-determination in return for peace and is ready to accept the referendum result but it would not make concessions on Abyei.

AFP 7/11/10 reported that US Senator John Kerry said during a visit to Sudan on Sunday that he delivered a roadmap aimed at resolving disputes between the North and South before a January referendum that may partition the country.

“President (Barack) Obama asked me to come here with his special envoy General (Scott) Gration and White House security adviser Michelle Gavin to offer his own proposal,” said Kerry.

“President Obama offered a roadmap to solve Abyei and other issues,” he told reporters of the disputed oil-rich region straddling north and south.

Kerry, who provided no details on the Obama proposal, met presidential aide Nafie Ali Nafie in Khartoum before leaving the country.

Sudan Tribune website 7/11/10 reported Kerry as saying “Sudan can find itself off the list of states that sponsor terrorism as early as July 2011 should it facilitate the self-determination votes in Abyei and South Sudan and recognize their outcome”.
The “Politico” magazine quoted unnamed senior U.S. officials as saying that President Barack Obama attached several conditions to the offer including that Khartoum facilitates the conduct of a transparent and on-time referendum on the status of Southern Sudan and respecting its result.

Additionally, Khartoum must implement “all appropriate post-referendum agreements – related to border agreements, currency, citizenship and other matters,” to fulfill U.S. conditions to be considered for accelerated removal from the state terror sponsor list, the official said.

The administration proposal Kerry carried to Khartoum “decouples the state sponsor of terrorism issue from Darfur,” a second senior U.S. official said Sunday. “But doing this in no way undermines the importance of the resolution of humanitarian and political problems that have plagued Darfur for the last decade. The comprehensive sanctions that have been in place [on Sudan] since 2003 and 2004 remain in place until we see a resolution of the Darfur crisis.”

Obama’s offer moves up by at least six months the date by which Khartoum might come off the list. But the U.S. officials emphasized a final decision would still be contingent on Sudan halting all sponsorship of terrorism for at least six months before the July 2011 target date and pledging not to resume such assistance in the future.

“President Obama made clear in the proposal conveyed this weekend that if Sudan’s leaders take concrete steps to implement the Comprehensive Peace Agreement, including recognizing the results of the referendum in January, he is prepared to immediately take significant steps to begin to transform the bilateral relationship. This would be the beginning of a new roadmap for addressing key bilateral issues as post-referendum issues are resolved,” he added.

Obama’s carrots to Khartoum may include more than just getting of the terrorism list. On Saturday Kerry met with Sudanese minister of Finance and National Economy, Ali Mahmood Hassanein to discuss the country’s $35.7 billion debt and ways to get a relief.

Sudan state media said that the US Senator promised the establishment of a committee comprising the Sudanese and US sides to deliberate and arrive at a resolution to Sudan’s foreign debts.

A well-placed source in Khartoum told Sudan Tribune on Friday that Western diplomats in the capital believe that Kerry may also offer U.S. support for deferring the arrest warrant against Sudanese president Omer Al-Bashir through the UN Security Council for one year that can be renewed indefinitely.

But U.S. officials today emphasized that separate U.S. sanctions imposed over Darfur — which Obama extended for another year on Nov. 1 — would remain until Khartoum improved conditions in the region, where the United Nations estimates up to 300,000 people died following a revolt in 2003, they said.

“Those … sanctions remain in place and they are the ones that have a significant effect on Sudan’s economy and on the government of Sudan itself,” said another official, who added that future steps such as debt relief and an exchange of ambassadors would all depend upon progress in Darfur.

Real Medicine Foundation, in collaboration with the Government of South Sudan, the UNFPA, the WHO, St. Mary’s Hospital, Isle of Wight, and the Japanese International Cooperation Agency (JICA), and in partnership with and with financial support from World Children’s Fund, is establishing the first College of Nursing and Midwifery. The consortium aims to provide a scalable working model for this college that will offer a 3 year diploma for Registered Nursing and Midwifery and may be extended to other strategic locations within the country.

Read more about Healthcare Sector Capacity Building – College of Nursing and Midwifery, Southern Sudan

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From Google’s official blog yesterday, Google announced at the opening ceremonies of the Clinton Global Initiative (CGI) that they would be providing $1 million in charitable grants to support the relief efforts in Pakistan.  The announcement mentions Real Medicine along with the 8 other non-profit organizations that Google has chosen to be partners in their first round of support.  We again are very thankful and proud that Google has chosen us to be one of their partners in this ongoing relief effort in Pakistan.

As mentioned in Google’s blog:

“As part of our CGI commitment this year, Google is providing $1 million in charitable grants, as well as technology support to help the people of Pakistan recover from these floods. Roughly one-third of our grants support organizations providing clean water, shelter, medical care and other immediate needs, while two-thirds will be focused on longer-term rebuilding efforts. Partners for the first round of support include: A.S. Edhi International Foundation, Architects for Humanity, CARE, The Citizens Foundation, Naya Jeevan for Kids, Real Medicine Foundation, SIUT North America, Sungi Development Foundation and UM Healthcare Trust.”

“At the opening ceremony of the Clinton Global Initiative (CGI) this morning, President Clinton discussed the urgent need to help the people of Pakistan recover from widespread floods which have affected more people than the 2004 South Asia tsunami, the 2005 South Asia earthquake, and the Haiti earthquake combined. The floods have put one-fifth of the land underwater, impacting more than 20 million people, damaging or destroying 1.9 million homes, putting 3.5 million children at risk of waterborne diseases, and wiping out livestock and crops.

Unfortunately the global response has been anemic. While U.S. corporations, foundations and individuals responded admirably to the earthquake in Haiti by donating $900 million in the first five weeks after the disaster, that same group donated $25 million to Pakistan in the first five week weeks after the floods hit. In an interview with citizens hosted by YouTube, President Clinton called for a dramatically increased global response.”

For the full text of the Google announcement click here.

For more information about the Clinton Global Initiative, click here.

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For more information about our Flood Relief Efforts, please visit our website.

To contribute to our Flood Relief Efforts, please click the Donate button below or through our website at realmedicinefoundation.org.

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Program Director Bilha Achieng with the Principal and first class of students

The new Juba College of Nursing and Midwifery that Real Medicine supports and helps manage in South Sudan has finished with the foundation level courses for it’s first class of 40 students and getting ready to begin the diploma program next week.  In honor of this milestone, the Southern Sudan Medical Journal has published an article focused on the new College and it’s mission.  This is a unique project for Real Medicine as we are focused on building the actual capability of Sudanese to help themselves through their own resources in the future.  Graduating 40 new diploma level Nurses and Midwives every year will go a long way in helping South Sudan rebuild after decades of neglect.

As mentioned in the article, Bilha Achieng is Real Medicine’s program director for South Sudan and is doing an amazing job managing the launch of the College.

Full text of article below:

PDF link to the full the full August journal here: SSMJ August 2010

Southern Sudan Medical Journal: August 2010

Nursing and Midwifery in Southern Sudan – Undersubscribed in a High Demand Environment

Author(s): Julien Bucyabahiga UNFPA Communication Officer

The Present Situation

The first ever College of Nursing and Midwifery in Southern Sudan has been established. This comes at a time when Southern Sudan is recovering from more than 20 years of civil war, which resulted in decay of the available infrastructure, human resources and systems in the health sector. As well as the lack of qualified personnel, the health care infrastructure including hospitals, primary health care centres and primary health care units also lay in total ruin.

Most practising health professional cadres received limited professional health education during the war that ended in 2005. Of the more than 4600 health workers who are presently operational, less than 10-20% have received more than 9 months of any form of professional training. This situation is made worse by the severe mal-distribution of health workers. More than two thirds are working in 3 of the 10 states, and there is a severe urban-rural bias. As a consequence, Southern Sudan has the highest maternal mortality ratio in the world standing at a staggering figure of 2054 maternal deaths/100,000 live births1.

In response, the Government of Southern Sudan (GOSS) has sought assistance from donors and neighbouring countries (e.g. Kenya, Uganda, Ethiopia) to support human resources for the health care system. “We have to learn from experiences…, we are not ashamed about our situation. Our people must access a better heath care system” stressed Dr Olivia Lomoro, Acting Undersecretary in the Ministry of Health during a recent workshop. With the support of United Nations Population Fund (UNFPA) and many other donors, existing structures are being renovated.

Training midwives

Starting in 2006, the training of Community Midwives was the first UNFPA initiative in the support of skilled birth attendants (SBAs). 96 students have graduated since 2007 from different institutions.

A further 110 Community Midwives are being prepared to begin training in 2010. UNFPA is looking into the possibilities of recruiting about 150 International Volunteers/Midwives by the end of 2010 to help the South Sudan Government to face the challenge of lack of qualified health cadres.

Juba College of Nursing and Midwifery

Because of the urgent need to develop a cadre with acceptable knowledge and skills, several stakeholders have joined hands by funding the first ever Nursing and Midwifery College.  These include UNFPA, Real Medicine Foundation (RMF), World Children’s Fund, the World Health Organization (WHO) and St Mary’s Hospital, Isle of Wight-Juba Link. The United Nations Development Programme/ Global Fund (UNDP/GF) and Japan International Cooperation Agency (JICA) are providing additional funds to renovate /construct student hostels, a kitchen and mess hall, additional classrooms and a recreational facility.

The Juba College of Nursing and Midwifery has been operational since May 2010 and will be fully established in its new facilities by the end of 2010. It is expected that the college will have trained over 100 nurses and midwives from all states of South Sudan by 2015.

The College is temporarily being hosted at the Juba Public Health Training Institute as JICA start construction and renovation work at the intended site at Juba Teaching Hospital (see Figure 1).

The students

The school opened with 30 students including 18 nursing and 12 midwife trainees (see Figure 2, 3 and 4). Of these, 10 are male and 20 are female. Trainees have come from Eastern Equatoria, Central Equatoria, Upper Nile and Western Equatoria states. The highly motivated and enthusiastic students are currently taking foundation courses in mathematics, biology and English. “Some of us have been working as nurses in various state hospitals. We are very happy to be here. The courses will help us upgrade our knowledge and skills” said a student.  The school is supposed to take students from all states but it is difficult to get candidates with all entry requirements.

Training and tutors

According to Dr Dragudi Buwa, UNFPA Deputy Representative in Southern Sudan, the intensive training will take three years. “The training will lead to a Diploma in Nursing and Midwifery based on a curriculum recognised by international standards”, says Dr Buwa. The school will help contribute towards the achievement of the Millennium Development Goal 5 (reduction of maternal mortality) as well as improving access to family planning and basic and comprehensive emergency and obstetric care.

When they have finished training in 2013, the qualified nurses and midwives will repatriate to their respective states to offer professional support to the health facilities. “Having attained adequate skills to work relatively independently in state hospitals, Primary Health Care Centres and Primary Health Care Centre Units, they will be expected to mentor and guide the other lower cadres’ staff prevalent in such health facilities. They will organise the work of the health care institutions and bring quality assurance to the care processes undertaken in their respective heath care units” says Ms Bilha Achieng, Project Assistant Manager with Real Medicine Foundation who is currently running the day-to-day operation of the school. She adds, “Real Medicine Foundation has also agreed to fund tutors; St Mary’s Hospital Isle of Wight-Juba Link will provide volunteer tutors temporarily to support the college tutors”. Eventually the management of the school will be handed over to the Ministry of Health. Ms Petronella Wawa is already designated as the Principal of the college.

Challenges

The main challenges of the college are:

  • Lack of national qualified nurse and midwife tutors,
  • Shortages of applicants for the diploma programme with an acceptable entry-level of education. South Sudan’s high adult illiteracy rate (due to two decades of war) especially among women has affected the candidate selection process and requires a re-assessment of the interview and selection criteria2.
  • Lack of funds for students’ housing and transport3. Some students face challenges in learning English. Mary Lupai UNFPA’s National Programme Officer for Gender is helping to tutor the students in communication skills.

Fore more information, please contact Ms Bilha Achieng at achie.bilha@gmail.com

References

  1. Southern Sudan Household and Health Survey, 2006
  2. Information from Jonathan White, RMF
  3. Informal information from Janet Michael, Director of Nursing and Midwifery

Thanks to Bilha Achieng and Jonathan White for the photographs in this article.

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Our project in South Sudan, the new Juba College of Nursing and Midwifery, continues to gain momentum and vital support, with Southern Sudan’s current Minister of Health, Dr. Luka Monoja, visiting the first student class at the temporary College campus in Juba.  The Juba College of Nursing and Midwifery is a new professional level 3 year college degree program supported by a consortium of stakeholders: Real Medicine Foundation, World Children’s Fund, UNFPA, UNDP, World Health Organization, Japan International Cooperation Agency, and the government of South Sudan.

Dr. Monoja was accompanied by the Undersecretary Dr. Olivia Lomoro and various other government officials. He indicated the importance and deep need for this level of trained Nurses and Midwives in Southern Sudan, and also stressed the how this particular institution is not only important to his heart but also to the Ministry of Health for the sustainable capacity building of professional health care providers.

He also mentioned that the need for skilled birth attendants through the training of midwives at the College is geared specifically toward reducing Sudan’s very high maternal mortality rates. Though the establishment of the college was long overdue he was glad that Southern Sudan can boast of having one now.

Some of the other things mentioned during Dr. Monoja’s visit were his deepest appreciation to the funding partners for their contribution towards the project and the financial needs of the students, and the continued partnership to ensure the future sustainability of the College.

The Minister encouraged the partners that although the institutions was still facing several financial challenges, there was a enormous need to push forward to ensure South Sudan’s future health.

For more information about this project please visit: http://www.realmedicinefoundation.org/initiative/healthcare-sector-capacity-building-college-of-nursing-and-midwifery-southern-sudan

If you’d like to donate to this or any of Real Medicine’s causes, you can click the donate button on this page or through our website at realmedicinefoundation.org

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By Allison Glennon and Jonathan White

The difference between humanitarian aid and international development can be ambiguous.  It is oftentimes hard to tell where the line is drawn between providing temporary aid to a people in need, versus truly helping them to rebuild and develop.

Real Medicine’s goal has always been to start with aid but move beyond that as soon as possible, and provide sustainable and truly internal development over the long term.  The old proverb of “Give a man a fish vs. teaching a man to fish” is very close to what RMF tries to achieve with many of our projects around the world.

Watching other aid groups leave only months after the 2005 tsunami in Sri Lanka, Real Medicine made a vow to stay and truly rebuild. Newly formed, at the time, RMF’s work at the time was considered disaster relief but before long it was clear that our scope was beyond that, and perhaps even beyond traditional humanitarian aid.

Today, years later in 2010, Real Medicine’s Director of International Relations, Jonathan White, traveled to one of RMF’s biggest projects at the Kiryandongo Refugee Settlement in Uganda and found out first hand how this willingness to stay and challenge the conventional norms of aid vs. development can end up saving lives in a very different way.

With the help and backing of World Children’s Fund, Real Medicine does everything from providing health care, to fixing boreholes, to supporting the children and paying for school fees in the Kiryandongo refugee camp, home to Ugandan, Kenyan, Sudanese and Congolese refuges.

“Our impact here is enormous,” says White, “through the eyes of the 6,000 refugees living in this community; our projects touch almost every area of life in this settlement.”

From this standpoint, Real Medicine helps keep the community here stable allowing the community there to live and thrive–but there is still something missing. Setting up care and sustaining it was not enough, and it took some bored teens to shine the light on what could be the final step for this community and for true humanitarian development.

“The main thing repeated time and time again to me while visiting was that they need is some sort of vocational training center for teen and adults, “says White, “many bright teens are graduating from the schools we support with a good education, but with no trade skills, they aren’t qualified for any local jobs and they are turning to alcohol to dull their boredom and frustration.”

Watching their educated children and other young adults stagnate and slip into destructive activities, the community held a meeting with Jonathan while he was visiting, to intervene and try and save their children’s future. Three vocations were listed as those in high demand not only in the settlement but in the surrounding towns as well: carpentry, tailoring, and hairdressing.

“With vocational training these kids can find jobs that will allow them to support their families one day,” says Jonathan, “and that is the main point of what Real Medicine is trying to achieve—help people get back on their feet, and no longer need the aid from outside.  These refugees have seen many humanitarian organizations come and go over the years and know that the only real long term solution is for them to be able to return to work in some capacity and rebuild their own lives independently.”

Working with the community we hope that donors will respond to this need with the same excitement that we have and help us move forward with a vocational program that will ensure that these teens, many of whom they have supported through school, are able to cross the final threshold and sustain their own lives.

Funding is needed to cover the costs purchasing carpentry, tailoring and hairdressing equipment/tools as well as covering the salary of the instructors.

Read more about the Kiryandongo Refugee Camp, RMF Ugandga

Text RMF to 85944
To Donate $10

sri-lanka-tea-estateWorldwide, Cancer is on an exponential rise. The WHO says that 80% of deaths related to disease of affluence occur in developing countries, roughly 28 million a year, and that this number is expected to quadruple over the next decade.

In ten short years, it is predicted that cancer will kill more people around the world than all infectious diseases, HIV/AIDS, Malnutrition, and Maternal Deaths Combined.

There are many schools of thought on the subject but for our part what we have chosen to do is start with nutrition as a preventative measure.

“Our goal is to provide education in such cost effective, natural treatment interventions and preventive strategies to all of our clinics worldwide.” Michael Lear, Real Medicine Director of International Relations and Country Director for Sri Lanka and Southern Sudan.

In May 2009, in collaboration with Dr. T. Colin Campbell’s Foundation and Cornell University,  we launched the initiative in Sri Lanka where staff at Sri Lanka’s Cancer Institute were given access to Dr. Campbells  plant based diet online nutrition course so that they can implement what they learn into their treatment methods for their patients.

With cancer rates already on the rise and cancer medication both expensive and with limited availability, treatment will come too late for many affected families in developing parts of the world. Our hope is that by giving people the information they need to take care of their bodies now, they might not need more complex care down the road.

As a side effect, we have found that by promoting locally grown produce, local farmers and businesses are also better supported, allowing the local economy to thrive in line with it’s people.

Learn more:

“Every country must make cancer a priority. There are too many people dying. It is too often, and that is wrong,” said Nancy Brinker, World Health Organization (WHO) Goodwill Ambassador for Cancer Control in the article, Cancer’s Global March for IAEA.org

Can a Plant-Based Diet Cure Cancer? by Kathy Freston, from Oprah.com

“The key recommendation of a recently released global report on diet and cancer prevention — that individuals should choose a predominantly plant-based diet that includes a variety of vegetables, fruits, and grains — is consistent with the American Cancer Society’s guidelines on diet, nutrition and cancer prevention, and adds to the evidence supporting a link between diet and cancer.”–American Cancer Society Guidelines on Diet and Cancer Prevention

Dr. Campbells book The China Study

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Sudan_PregnantWomanWORRIEDProblem:

A 15 year old girl living in Southern Sudan has a greater chance of dying during childbirth than finishing school

One Solution:

Open a Nursing and Midwifery College and recruit students from all districts to participate and take their practice back home to save lives themselves.

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The Directorate of Nursing, Midwifery and Human Resources (MOH GOSS) in collaboration with UNFPA and a consortium of Donors that includes Real Medicine Foundation of USA are happy to announce the recruitment of Nursing and midwifery students for the October 2009 intake of 40 students for a three years training course that will lead to a Diploma in Nursing and Midwifery.

New college of Nursing and Midwifery for Southern Sudan, located at the Juba teaching hospital advertizes for pioneer student intake!

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Find out more about the teaching hospital and RMF in Southern Sudan

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Many in the US are familiar with the effectiveness of therapeutic bodywork, movement education, acupuncture, yoga and massage in treating pain, relieving stress and addressing other psychological  and physical trauma.  However, these techniques that are so common here, have not widely reached abroad to countries like Sri Lanka,  Pakistan and Indonesia, recently devastated by natural disasters and  in need of effective affordable health care options.

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While most relief organizations recognize the need for immediate medical care, many have not yet taken advantage of the long term benefits that cost effective holistic protocols can provide to those  suffering from Post Traumatic Stress, chronic pain and neuromuscular  disorders.  Through Team Whole Health, Real Medicine can now provide both clinical support and instruction in progressive, complementary holistic healing techniques to physical therapy networks in these devastated countries.   Read on…

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Seeing the poverty and sad conditions of the overwhelming majority of Sri Lanka’s orphanages, we envisioned that there might be a possibility to work on elevating the situation
of all orphanages in Sri Lanka. We decided to design an evaluation system to decide where help is needed the most.  Read on…

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