Mobile Medical

Mobile clinics save lives in south Sudan with inoculations and 15-minute malaria tests.

WARAWAR, South Sudan - The Toyota Land Cruiser plows through thick brush and deep ruts. It follows a trail, but one made mostly by cows, camels and human feet.

When we arrive in Warawar -- a frontier town in a frontier nation -- the temperature is over a hundred degrees, even under the shade of a giant fig tree, where about 50 villagers have gathered.

It is Friday, the day the International Rescue Committee (IRC) conducts its mobile health clinics for people who would otherwise have no access to health care.

It's a primitive but effective setup. The entire clinic fits in the back of the Toyota.

A large blue cooler is placed on the ground and will become the inoculation center. The focus is on preventive medicine here.

Mobile health clinics like this one are just one part of multitiered solutions. But these are critical first steps in meeting the needs of a society where the peace has the potential to be as deadly as the war.

Mothers line up with their babies for double drops of polio vaccine. During the decades of civil war that just ended in January, this medicine was impossible to get. As a result, a disease that was eradicated in the rest of the world struck down thousands in south Sudan.

Vaccinations also are given for tetanus and diphtheria.

A small table is unfolded nearby -- this is the curative department. People complaining of dizziness, fever, headaches and nausea gather, many holding their heads in their hands.

One 16-year-old girl, Deng Akong, says her symptoms get worse at night. An IRC community health worker named Luka Lual writes all of this down on a 4x6 white card. He then takes out a rectangular foil packet and rips it open. Inside is a small plastic strip.

He lances the girl's index finger, swabs the blood and places it on the strip. He adds six drop of buffer liquid, which will react with the blood. 

Within 15 minutes Deng will know if she has falciparum malaria. It's the most deadly of the four different strains. If she is positive two red stripes will appear; if negative, only one.

"In remote locations these rapid response tests are so valuable," says IRC health officer Joseph Yego, who is in charge of the mobile clinic. "Before, we had to use microscopes. It took time and cost about $5 for every test we did."

The new rapid response tests, which the IRC began using last year, cost only $1 and allow treatment to begin immediately for patients who test positive.

Deng's test has come up negative, but she's not relieved. Her symptoms are still present and she's no closer to knowing what is causing them.

"I'll just take the medicine they gave me and hope it works," she says.

Another girl, 17-year-old Arek Dut, has tested positive. The clinic will begin her regimen of treatments under the giant fig tree.

Yego says malaria is endemic in this region, especially during the rainy season. "Seventy-five percent of the people we are seeing, for something other than vaccinations, have malaria," he says. The disease is manageable, but can be deadly if left untreated.

The mobile health clinic can provide these kinds of services -- vaccinations and treatments -- once a week for 60-70 people for as little as $500 total.

For these people, who are lucky to see a medical professional a single time in their entire lives, it is a value beyond imagination.

And the need will only become greater as many of south Sudan's population, displaced by the 21-year civil war, begin to return home.

"We expect... caseloads here to triple," says Yego. "The numbers will likely go up to about 150 patients each time we hold a clinic."

International aid agencies have major concerns about the lack of resources for returnees coming back to the south, including food and water and other essential infrastructure to create and maintain a healthy and functioning post-war society.

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