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August 2007

Dear Friends,

Just as we in developed nations want optimal health care programs, those around Fangak place high priority on bettering their situation.

Our long-term focus on health education at many levels is on the verge of paying huge dividends. Peter Sunduk, former head nurse for the TB Project, left four years ago to study medicine. He is now completing his internship, and will return as the first homegrown clinical officer for the region. He will be ready to organize and oversee the outpatient services, and care for most inpatients. Many health centers of Fangak’s size are run by clinical officers. We are immensely proud of his achievement. Sunduk invested four years of his life, and the TB Project paid the $7,500 tuition.
Now another community health worker, Peter Mut, has enrolled in the same program. Inspired by our recent surgeries, he is training in ophthalmology until clinical officer school begins in January. Three national staff members are completing the nine-month course to be government-certified Community Health Workers. CHWs form the backbone of the health care system in much of Africa, and certainly in all of South Sudan. One TB worker awaits an opening in the school of nursing, and another in lab tech school. And these are all Sudanese with minimal formal education! Training for long-term, dedicated staff members must be the best investment we can make toward improving the health and stability of our area.

In cooperation with other aid agencies, we strive to build a medical infrastructure within the framework of the new South Sudan Ministry of Health. The Centers for Disease Control is helping our project establish a sentinel site for prenatal HIV testing. The Carter Center has expressed interest in expanding our eye surgery program and in village-based prevention of blindness.
The Comboni Brothers, who have provided spiritual as well as practical assistance to south Sudan for many years, are spearheading the drive for a small public hospital. Our TB Project - known in Sudan as the International Medical Relief Fund (IMRF) - hopes to do our part by funding a maternity center for this hospital.

Our total budget, at $100,000, seems miniscule compared with other international organizations. How can so much be done with so little?

All of our international staff are volunteers who donate their services. Your contributions purchase medications (at about 5% of what they would cost in the US), mosquito nets, and blankets. Our budget also covers a daily cup of high-energy milk for severely malnourished patients and chartering small planes to fly it all into Sudan.

As the Sudan Tuberculosis Project / International Medical Relief Fund completes its eighth year, we seem to be experiencing unavoidable “mission creep.” While our central mission has always been the battle against the devastating infectious diseases, tuberculosis and kala azar, we have still always done what we could to deal with emergencies, clinical referrals, the education of national health care workers, and whatever other urgent health care demands in the region weren’t being otherwise met. With COSV absent last year and other unique opportunities presenting themselves, we got more involved in routine clinics, maternal child health, and vaccination programs than we expected. It has been exhausting, and sometimes we wonder whether we need to redefine our mission, or even change our name.

However, we are hopeful that as COSV resumes responsibility for primary health care, as the Comboni Brothers develop the new medical center, and especially as the national staff becomes more capable of expanded clinical roles, we will be able to refocus on our primary mission: combating TB and kala azar -- the endemic infectious diseases that plague Sudan.
Whatever the name, we thank you once again for the moral and financial support which sustains this work. It would not happen without you!

Contributions are fully tax-deductible, and are stretched in ways that would impress our Depression-era grandparents.

Please make out checks to CROSSCURRENTS INTERNATIONAL INSTITUTE (or CCI), with a notation that they are for the Sudan Tuberculosis Project. (Checks made out only to the “Sudan TB Project” cannot be cashed!)

Peace! And many thanks!

Gretchen Neumann Stone

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