Never doubt that a small group of thoughtful and committed citizens can change the world. It’s the only thing that ever has.

William, the Director of Administration has many feisty shirts that attract a lot of attention from myself and Clare. At the end of a particularly long day, he rocked up to JTH in his car and handed us two "William shirts." Although they were two sizes too large, I decided to wear mine to work the next day.

We apologise for the tardiness of this blog. Life is so busy at the moment that we can barely keep ahead of things out here. However, allow us to take up the threads of the previous blog and move forward.

 You will all recall a dark Tuesday and a much lighter Wednesday. Things continued to improve. The juniors of the Department of Medicine, of their own volition, organised a teaching session which was well attended by all. There are some things that even the tentacles of apathy cannot strangle.

The night before the workshop was spent sharpening twenty pencils and organising all the documentation to facilitate the meeting. An air of trepidation was in the room, like the night before an exam

Following on from the successful Wednesday meeting, Dr Wani Mena (the hospital CEO) went on to organise a two day workshop for all the consultants, which took place last Friday and Saturday.

It was the greatest gathering of consultants that Juba Teaching Hospital (JTH) had witnessed. Twenty five doctors from all Specialties (Medicine, Chest Medicine, Surgery, Obs and Gynae, Paediatrics, ENT, Dermatology, HIV, Maxillofacial and Dentistry) were present. A steely resolve was present in all of their eyes. They wore determined expressions on their faces. The time had come.

It was a meeting where the world was united against apathy. As well as South Sudan, consultants from America, Kenya, Uganda, Jordan, and the UK were present.

We discussed many things in the meeting, such as challenges with leadership, the importance of role models, rules, roles responsibilities, discipline and the lack of postgraduate training. We looked at case studies in JTH of good medical practice, notably in the Department of Surgery. We examined ways in which discipline could be enforced in a land where they Ministry of Health controlled the supply and salary of doctors and would not always listen to the recommendation of JTH consultants. We spoke about the junior doctor contracts which contain no annual leave, study leave or even a study budget. We talked about other forms of motivation such as prizes and incentives. We developed timetables for all our departments.

Four of JTH's consultants discussing issues to do with Leadership and Management. The two on the left are looking at the Powerpoint slides. The two on the right are, if I am not mistaken, having a deep and meaningful where they call a spade a spade and have a wonderful sense of humour.

 As the hours passed by, nail after nail was hammered home into the coffin of apathy. These were not the ideas of myself or Clare. They were uttered from the lips of the country’s greatest experts – the consultants of JTH! On top of apathy’s coffin was written the Consultant’s epitaph, their new mission statement for JTH:

 “Our mission is to provide healthcare of the highest quality, train health personnel for this country, conduct research and generate new knowledge, and strive for continued improvement.”

The meeting has ignited many changes in JTH. There is an undercurrent of optimism that is smouldering within everyone’s hearts. My boss, Dr Elijah, headed up our first Departmental Meeting for Medicine in the history of JTH on Monday (we added it in to our departmental timetable), where we finalised the rules, roles, and responsibilities for the doctors of our department.

Today the medical department held a meeting with the juniors where these rules, roles, and responsibilities where discussed. We also promised them that we would be their advocates and would work hard to overcome any problems that they faced.

This Saturday the Minister of Health will be conducting an audience with JTH doctors to hear about these problems. Next week, we roll out a new teaching schedule and start postgraduate medicine in our department. Over the coming weeks, most of the other departments will be trained. The future is looking bright.

However, apathy is a sinister beast. Let us see what curve balls it throws us……

We went to church a few Sunday's ago with two nurses from the St Mary's Juba Link. The cathedral was packed out. It was a synod, where all the bishops had gathered to work out what the activities of the Sudan Council of Churches would be in the coming year. The Churches are extremely active at grass roots level in South Sudan. As well as Church-based clinics offering primary care (a genius idea when there are so few healthcare facilities), they are trying to mediate between the warring tribes in Jonglei. The work they do is tough but they never waver.

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5 Responses to Never doubt that a small group of thoughtful and committed citizens can change the world. It’s the only thing that ever has.

  1. Joel Giblett says:

    Always important to reference the west wing! Keep up the good work!

  2. Don Attwood says:

    At last a light at the end of the tunnel and some good news to cheer you up and lift you both out of this negative cycle.
    David, you have survived and come through much worse in the past and you both know you have a lot of people and organisations around the world routing for you and looking through your eyes and feeling your experiences via your blog of the highs and lows at the JTH. We all marvel at your Rotary service above self attitude towards your charitable professional work, you lift our hearts with your stories of human kindness and bring tears to our eyes with your stories of unnecessary loss of life through lack of basic equipment, which is something which would never happen here in the UK and which we all take for granted under the NHS system.
    David, you have been brought up to believe that when the going gets tough then the tough need to get going and when your back is against the wall then there is only one way forward. So go for it and keep this momentum going and get on top of this apathy. No more negative thoughts, only positive ones and always remember that you can only change the hearts and minds of people and gain the outside assistance and financial support that you so desperately seek through positive leadership.

    Keep up the good work.

    Don Attwood

  3. sandie paice says:

    Having witnessed at first had the huge amount of energy and commitment that, Clare and David, you give to your work in Juba I am so glad that Don has commented in this way. It was a real pleasure to meet you both. You helped us enormously in our short visit and we couldnt have achieved the things that we did without your help, support and contacts.
    I am so glad that the conference with the senior medical staff went well. We left feeling that the potential for a really solid way forward has taken some very positive steps.
    Sandie Jubalink Isle of Wight.

  4. drfirasalobidi says:

    iam dr firas al obidi ent head of deprtment from JORDAN
    dr david & dr clare have done alot to JTH
    nobody forget the grat job have been done by you pepole
    youer sincerely
    dr firas al_obidi

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