In Turbulent South Sudan, Doctor Keeps HIV Clients Supplied with ARVs

BALTIMORE, MD., Jan. 6, 2017 (GLOBE NEWSWIRE) -- As the bloodshed and civil strife intensified in South Sudan earlier this year, Dr. Alex Abuk's work—to keep health facilities stocked with HIV/AIDS medicines—became more urgent. And dangerous. Road travel in the country had become unpredictable and risky. Fuel was scarce. Talk of renewed warfare had heightened, prompting many in the development and aid community to close offices there.
But Abuk, Jhpiego's HIV Technical Advisor in Juba, had no intention of leaving. He refused to leave his family or abandon his South Sudanese countrymen who relied on antiretrovirals (ARVs) to stay strong and healthy.

"When the going gets tough, the tough get going,'' Abuk said, invoking a popular proverb. "The bottom line, deep in my heart, was to get commodities, especially ARVs, to the HIV+ mothers at all cost."

A Harrowing Trip

Abuk recalled one harrowing visit to the Tore Primary Health Care Center, about 48 miles outside Juba on Yei-Maridi Road that he took with coworkers Patrick Ochira and Michael Dirichi.

"A few weeks before that visit, a Catholic nun working in a Catholic hospital in Yei was killed along that road. So it was a sensitive balance and risky decision to go or not to go," said Abuk. After consulting Jhpiego's security procedures, he said, "We decided to take the risk of getting to the facility, especially with the ARVs, knowing that if we don't get the ARVs to the clients on time, they will run out of the drugs—and that would not be good for their health and the health of their babies."

"We decided that we would leave our colleague Gerald Kimondo (from Kenya) to do some work in one of our facilities within Yei River State so as not to endanger him while we (Ochira, Dirichi and myself), the South Sudanese, traveled to Tore. Fortunately, we got to the facility safely. We were advised not to spend the night in Tore town and not to travel late on that road. So we gave out the commodities to the facility as soon as we arrived, did a quick supportive supervision and data collection, and returned that same day to Yei. The good thing about this trip was that we delivered commodities enough for three months."

Abuk had access to supplies of ARVs, test kits for HIV and syphilis, antibiotics and HIV prevention medicines for newborns exposed to HIV. Getting gas for his silver Prada 2000 SUV so he could deliver the commodities also was a daily challenge.

Jhpiego is working in two states in South Sudan—through the Strengthening the Provision of Primary Health Care HIV Services project, funded by the U.S. Agency for International Development—to prevent mother-to-child transmission of HIV. Through this project, Jhpiego is also partnering with South Sudan's government to increase access to high-quality pediatric and adolescent HIV care, reduce new infections and keep those living with HIV healthy.

Helping Health Providers Cope

During visits to Juba-area health facilities supported by Jhpiego, Abuk recognized the toll the unrest was having on South Sudanese health care providers, and he encouraged them to stay strong, reminding them they were working not just to make a living but to serve others in dire need.

"I tried to explain to them that, as health care workers, our job is different from any other work in that we are serving human life, and it is in such circumstances that our service is felt more by the people we serve," Abuk recalled.

A pious man with a soothing voice and calm demeanor, Abuk carried on Jhpiego's work with dignity and dedication: "The biggest bulk of our HIV-positive clients are in our Juba facilities. If they stock-out of commodities, they would get into bigger and more complex problems. That made me decide to be around and try as much as I could to get those commodities to them."

As conditions deteriorated, he relied on security training he received from Jhpiego to keep his wife, Helen, and eight members of his family safe. He remembered one July night when gunfire broke out in his neighborhood.

"Because our house is close to the military barracks, there was shooting all around us, in all directions. I told my family to go to rooms where bullets cannot easily locate them. I told the children not to stay near the windows. When the shooting was severe, I had to tell them to get beneath the beds…."

As a result of Abuk's commitment, most facilities supported by Jhpiego maintained services to their clients in July and August.

"Such times test our faith," he said. "If we fail to serve well at such a time as this, we will not be proud of ourselves tomorrow when things cool down. This is the time to shine."

Jhpiego is a global health non-profit and an affiliate of Johns Hopkins University.

A photo accompanying this release is available at:

CONTACT: Ann Lolordo, Jhpiego
         Editorial Services & Communications
         Baltimore, Md.
Friday, January 6, 2017 - 11:10

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