1. Medical Equipment/Items

Considering the fact that Tonj Civil Hospital is less funded by the government like so many other health facilities in the country, our Pediatrics Ward has various challenges. These include:

• Lack of oxygen concentrators. We had 4 but 3 are now spoiled beyond repair-AMREF sent a Biomedical Engineer in 2023 who assessed them and commented that it was better to buy new ones. 1 is currently functioning. Actually, the whole hospital has only 2 functioning oxygen concentrators.

  In July 2024, we had a 13 years old female patient with TB who developed pleural effusion. He SPO2% was low at room air. So, we supplemented her with oxygen using that 1 oxygen concentrator.

  On her referral flight to Juba, we flew her with that oxygen concentrator, leaving the whole hospital with only 1 functioning oxygen concentrator for 3 days.

• Lack of 24G IV cannula. HSTP consignment donated to TCH covers a large part of our needs. However, it is not enough. The hospital has to struggle constantly to use small cost-sharing budget that we collect from patients and use it to buy the missing items such as 24G IV Cannula.

  Our lab, surgery and consultation fee are about 80% lower compared to other government hospitals such as Wau Teaching Hospital and Juba Teaching Hospital.

  Hence, the money collected is barely enough to support cleaning of the hospital monthly.

• 6 beds are not enough. We have many pediatrics patients as Tonj Civil Hospital is the only hospital in Tonj South region.

2. Infrastructure

The buildings in TCH were constructed over 5 decades ago. Thus, they have started falling apart.

• The sewage system is blocked. The bathrooms and toilets in pediatrics ward and not usable. The patients and staff have to move a distance to go to latrines.

  This has precipitated a situation in which patients openly defecate at times when staff are not watching because they are too pressed to move across the hospital compound to the latrines.

  The drainage system and pipes need renovation which the hospital cannot afford. However, with the start of the HSTP, we are hopeful that this challenge will be tackled.

• The ceiling, made of concrete, in both rooms is sagging and cracked. At the moment, we have evacuated the patients to a verandah and locked the doors to the wards to avoid them from being harmed in case the ceiling accidentally falls.

  TCH is in contact with AMREF, our Implementing Parner, for UNICEF funded HSTP project, to solve this issue.

3. Staffing. The pediatrics patients are attended to by Medical Officers, Nurses and Clinical Officers.

We don’t have a Pediatrician Specialist at TCH. When we have a case that requires a specialist attention, we usually refer the patients to Wau Town.

Challenges