By Ginaba Lino
Poor infrastructure has turned what should be routine childbirth and hospital visits in Panyikang County into a fight for survival for pregnant women and the sick. For residents of this oil-rich part of South Sudan, the situation highlights a stark contradiction between the country’s natural resource wealth and the healthcare its people desperately need.
Despite its abundant natural resources, Panyikang County’s more than 7,737 inhabitants must endure some of the world’s most dangerous journeys when seeking essential medical services.
The entire county has neither a single tarmacked road nor an airstrip. Communities rely entirely on river transport to connect with the outside world and access hospitals.
The nearest hospital is more than 48 hours away by boat. The water is infested with snakes, crocodiles, and other dangerous animals.
For many residents, the journey to hospital has left painful memories, with freshly dug graves serving as reminders of the suffering communities have endured for years while seeking medical care.
Between May and June this year, 14 deaths linked to water accidents were reported in the county, according to local authorities.
“It is the only means [of transport] we have here,” said Maj. Gen. James Obur Aywok, the Panyikang County commissioner, describing the risks associated with such journeys.
“It takes up to three days to reach the hospital in Malakal,” the commissioner added.
South Sudan’s health sector remains heavily underfunded, and the situation in Panyikang is even worse.
According to the United Nations Development Programme (UNDP), the health and humanitarian sectors in South Sudan continue to rely heavily on off-budget funding and support from international development partners and agencies such as UNICEF, the World Health Organization (WHO) and other donors.
WHO reports and analyses indicate that the public health crisis in Upper Nile State is driven primarily by armed conflict, mass displacement and severe food insecurity.
In Panyikang County of Upper Nile State, vulnerable people risk dying while searching for treatment. The entire county has no healthcare facility.
Limited access to transport and medical services has worsened the situation, with patients reportedly drowning in rivers while attempting to reach hospitals in locally built boats.
According to medical records at Malakal Hospital, eight children, three women and one man died in boat accidents between May and June.
The director of Malakal Referral Hospital said the long distances patients must travel before reaching the facility were another contributing factor to high mortality rates.
“We don’t have any healthcare Centre in Panyikang County. If anyone falls sick here, we have no other place to take the patient apart from Malakal, which takes three days to reach,” Commissioner Aywok stressed.
To date, one organization Azienda Comunitaria di Romagna e Africa (ACRA) remains the only primary organization supporting Panyikang County with mobile health units and life-saving medicines. Unfortunately, the project was designed to run for only a few months and is now about to end.
The mobile health initiative is an integrated partnership with WHO South Sudan, which provides life-saving emergency medical supplies and medicines to the mobile units. Other partners include UNICEF South Sudan and the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), which provide critical funding and oversight through the South Sudan Humanitarian Fund (SSHF).
Regina Awa, 45, who is also from Panyikang County, is urging the state and national governments to bring healthcare closer to residents by establishing health centres in local communities.
Dr Younis Johnson, director of Malakal Teaching Hospital, said access to healthcare in Panyikang remains a major challenge for residents.
Dr Johnson added that many deaths could have been avoided if patients had reached the hospital in time.
“We recently recorded two cases. We received notification that the patients were going to be referred. But because it was during the night, they had to wait until morning before travelling. By the time they arrived, we found complications. They ended up needing an operation. Even one of them arrived late. She stayed in the hospital for a long time. Later, we lost that patient because of the delay in reaching the hospital,” Dr Johnson said.
“It takes eight to 10 hours to reach Malakal Hospital by speedboat and between two and three days by local boat. It is difficult to receive patients in time, especially when a case is reported at night. For security reasons, we also cannot access that area at night.”
According to the director, most emergency cases involve women in labour and people with gunshot wounds.
The director called on the government to improve access to healthcare by strengthening transport infrastructure and security across the state.