Lack of trained personnel hampers Sudan's efforts to offer a health service

Sudan still has some of the worst health statistics in the world, even four years after a peace agreement was signed. Fewer than one in four of the population have access to any form of health service.

A strategy to improve outreach was launched last month at Southern Sudan's health assembly, which saw donors, international agencies, and service providers come together with the nascent Ministry of Health to try to redress the problems created by more than four decades of conflict in one of Africa's most impoverished areas.

The assembly heard that one in seven children die before the age of five, mainly from malaria, diarrhoea, and respiratory infections. One in seven women die from complications in childbirth, yet trained personnel help in fewer than 9% of deliveries.

According to Chris Lewis, health coordinator for the consortium of the 86 international and 33 local non-governmental organisations that work in the health sector, the country lacks trainable people because 40 years of war means that several generations have missed out on education.

The World Health Organization points out that the planned opening of a nurses' training academy has had to be postponed because it was unable to find a single qualified candidate for the teaching staff. One of the few success stories has been the rehabilitation of Juba Teaching Hospital by the International Committee of the Red Cross, which has also built a new orthopaedic centre that was supposed to be opened last week by Southern Sudan's president, Salva Kiir Mayerdit, although the formal ceremony has had to be postponed because of his other commitments.

The region's capital, Juba, is currently swollen with hundreds of thousands of returning refugee but still lacks any form of sanitation or water treatment, resulting in frequent outbreaks of cholera. HIV is an increasing threat because of lack of knowledge of prevention and 12 out of 13 neglected diseases are endemic to Sudan.