Claire was born four weeks ago, just a few days before 9 July 2011, which marked the official birth of the Republic of South Sudan, the newest state in the world.
Claire’s eyes are just opening to the world in the reassuring arms of her mum. Hopefully, that world will be one without war and suffering and the electric atmosphere of excitement and opportunity that still floats in the air will translate into a better future for Claire and her contemporaries.
However, there are enormous challenges ahead. With its independence, South Sudan has become one of the poorest countries in the world. According to UNFPA, South Sudan has the world’s highest maternal mortality rate. One in every 50 live births results in the death of the mother.
Claire’s mum, Molly, is 24 and lives in a village in Eastern Equatoria State. She has one more child, a boy aged 6. When she was pregnant with Claire, she was tested for HIV. The result was positive. Molly attended peer-to-peer talks on safe motherhood provided by Action for Rights, Relief and Development (ARRD), a community-based organisation which works in the Pageri Payam (district) with the technical and financial support of the International HIV/AIDS Alliance in South Sudan.
Aware of the importance of adhering to appropriate PMTCT (Prevention of Mother to Child Transmission) protocols, she benefited from appropriate treatment and delivered Molly in hospital through caesarean to minimise the risk of transmitting the virus to Molly.
Unfortunately, the role of ARRD in Claire and Molly’s case could not end there. Molly’s husband, who has two more wives, refuses to take the HIV test and forbids Molly to tell anyone in the village for fear of being identified as also living with HIV.
Molly comes to ARRD for counselling and training. “I want to tell people that I live with HIV and that it’s ok. I am getting my treatment and I am not dying. I want to convince other women of the importance of taking the HIV test and delivering their babies in the clinic or the hospital. ARRD is helping me to become a peer educator; I know it will help me to get my condition known in the village”.
But Molly has a dilemma. “I want to abandon my husband so that I can tell people that I am HIV positive, because he keeps threatening to beat me if I make it public. But I have been told by the health worker that I have to stop breastfeeding my baby soon and that I have to give formula to her. Who is going to pay for the milk if I’m alone?”
ARRD is trying to persuade Molly’s husband to take the HIV test and let Molly become a peer educator. They are also mobilising support for Claire’s food.
ARRD’s work in Pageri reminds us of how critical community responses are in guaranteeing the health of mothers and children and the enormous medical challenges that exist in South Sudan.
Some names have been changed.