Think about the last time you were sick...

I mean really sick, with something infectious. None of that stuffy nose and cough type thing. What was it? The flu? Strep throat?

What if it was tuberculosis? Or malaria? Or leprosy? Or river blindness? In the short time I've been here I have seen more people with diseases that have been entirely or mostly eradicated from the North (or the West, however you like to phrase it) than I can count. After seeing a blind man making his way along the main road by himself with nothing but a stick, it was explained to me that river blindness has left 1/4 of the people in villages nearby blind. One in four people. Take a minute to think about that. If 1/4 people in the US were blind how would it impact our capacity to run our government, let alone our economy. Here the river blindness is thanks to the Mvolo river which runs right through town and creates a nasty swarm of black flies during the rainy season, which is right around the corner. I was given medicine which apparently protects me from river blindness for a year, but what about everyone who can't walk into the health center and get what they want for free (since their NGO supports it)?

So if 25% of the population has river blindness, and the leprosy rate is somewhere between 10 and 30%, and 70% of the world's remaining burden of Guinea Worm is in South Sudan, not to mention the worms crawling around in the bellies of most kids (ring worm (okay it's a fungus, still pertinent) is particularly obvious as you see kids with black hair with white polka dots), the micronutrient and calorie deficiencies of kids and whole families. The list goes on. Where does that leave the people living here? There is development under way and with immunizations slowly becoming commonplace there are less disease outbreaks, and the menningitis and measles outbreak that occurred last year was contained relatively quickly with the efforts of NGOs, the government and the community. But even so, the impact that ill health can have on development has never been more apparent. Consider that many micronutrient deficiencies can lead to slowed mental development and mental retardation if not corrected within the first years of life, or that anemia makes children and adults alike tired, think more slowly and have less energy for daily activities. You have a huge proportion of the population that is entirely absent from productive activities because of their health. So, as many workshops as you do and as much capacity as you build in the community, the physical capability of the population is severely limited by its ill health.

I'm not offerring any solutions here, mostly because I think that many of the possible fixes for the situation are already being implemented, it just takes time. Education for instance is so crucial, but with an education system that's been mostly absent for 20 years, you've got teachers with a 4th grade education teaching the 2nd graders. But as education improves, and access to healthcare and health literacy improves, I think the situation with diseases that we have preventions and cures for will continue to get better.

But then there's nodding disease. Ever heard of it? That's because it only exists in South Sudan and no one knows what causes it. It mostly affects young children, causes seizures that make the children look like they're nodding, and leads to mental retardation, and then as it progresses is almost 100% fatal. A few people are studying it, google it for some more in depth info. But I've visited schools and looked at the rosters and you see so many kids listed as "nodding" or having "fits". So if you've got all the issues listed above, plus anywhere from 5-25% of your children will have retarded mental development or will most likely die, it's just one more giant pothole in the pathway to development.

So, for anyone who wonders what on earth I'm doing in South Sudan, it's doing the first survey in memory of the health status of Southern Sudanese children in this county. And hopefully, as with all data, it will be put to good use, will move and inspire donors and other organizations, and all the other big things I imagine happening. But at the very least, the kids here won't be invisible anymore, because someone will have documented what it's like to live here.