ON THE ROAD TO IPAC
We bob and weave through the traffic. The radio is on. Right now, there is more static than music. There is more dust than road. Pot holes litter the road, creating roadside turbulence. We are driving to the Infection Prevention and Control (IPAC) workshop in Juba, South Sudan. It’s Fall. It’s hot. Very hot.
Driving anywhere in Juba is an intense experience. The roads are filled with people, cars, UN vehicles, scooters and motorbikes all negotiating for equal space on a crowded roadway. And dust. There is so much rich, red rust-coloured dust that the dust often wins. Men on motorbikes wearing dress shirts and shades, women often riding with them in beautiful tailored dresses made of richly textured fabrics. Women — especially unmarried women — seldom ride or walk alone. Peter, our driver, is talking animatedly about how he met his wife and about his family, who are currently living in a nearby country. He worries that I am not married. “It’s bad you have no woman at your age. People will say things. I will find you a woman in Juba,” he says. “Pick one.” He motions to a group of women walking to work or market on the side of the road. “What happens if she doesn’t pick me?” I ask. He looks at me, not understanding.
What do you mean? You pick her. She will like you.
If she doesn’t like me. Why should she still have to marry me?
Why wouldn’t she like you? Do you have an arm growing out of your back?
The road for women is one that is filled with many potholes and some landmines. The subject quickly changes to music. A motorcycle smoothly moves past us. There is a rush in driving, but no rage. People pay attention to each other. We slow down so a stray dog can cross in front of us. There are many, many stray dogs in Juba. Almost as many dogs as motorcycles. And potholes.
And there is music. And there are songs. And singing. The sounds are a complex mix of South Sudanese folk music, Arabic, Arabi Juba, Ethiopian, Ugandan and American influence. The music pushes its way through the radio static, providing a perfect soundtrack to the world beyond the windshield.
Some songs that Peter likes …
His favourite …
THUD. My head hits the ceiling. “Ah that was a deep one,” he announces as our vehicle drops what feels like 20 meters into a hole. We bounce out. “Big holes,” he laughs, without ever losing control of the vehicle. “That one wasn’t so bad,” I assure him. “In Montreal, the potholes are worse than anything I’ve seen in Juba. And, they are on paved roads, not dirt ones. One of them was so big, it could be used as a swimming pool.”
He laughs. “Well then, there is hope for everyone. Hope for Juba. Hope for Canada. Maybe you can fix your roads one day, too.” There is hope in Juba. Measured, hesitant, vulnerable. But it’s definitely there. And it will happen, in some form, where the will is strong enough. Even if there are some potholes along the way.
It’s around noon. It’s very hot now, the AC is on. I think. Is it? Some of the midwives say it’s hot. I’m relieved they find it hot too. Everyone dresses up for public life here, no matter the temperature. The venue for the IPAC workshop has changed again today, as things often change in Juba. “We have to take it that it is changing for the better and that’s it,” said Agnes Juan Secretary General for the South Sudan Nurses and Midwives Association (SSNAMA). Agnes is a professor, a midwife, a nurse and a force of nature.
The IPAC workshop is a three‑day course that outlines the importance, steps and actions to be taken by midwives, nurses and other healthcare providers to reduce the risk of infection among patients in the world’s newest country. South Sudan has the highest maternal mortality rate in the world. The United Nations estimates maternal mortality in South Sudan at 789 per 100,000 live births, with most maternal deaths occurring during labour, delivery and the immediate postpartum period (Ministry of Health, Republic of South Sudan, 2018).
“SSNAMA identified a need and requested the IPAC workshop as one of the topics they would like to provide for continuing their professional development. Infection prevention (training) is, in fact, a worldwide need for healthcare providers,” said Canadian midwife Deborah Bonser, taking a quick break from co‑facilitating the workshop with Agnes and Canadian Nurse Barbie Leggett. Over 30 midwives, nurses, and administrators from all over South Sudan are attending. “I would say it’s fantastic that SSNAMA managed to get midwives here from across the country,” Bonser continued, “Midwives doing maternal newborn care, nurses working in the operating theatre, and every other possible ward and situation.”
Over the three days, the course covers health care‑associated infections, the chain of transmission, standard precautions and risk assessment, hand hygiene, personal protective equipment, IPAC safety, and processing/disinfection of equipment. It is a combination of lectures, workshops, group discussions and singing. Yes, some fantastic singing.