An interview with Dr Lul Lojok Deng, Director General, Public Health Laboratory and National Blood Transfusion Services, Ministry of Health of the Republic of South Sudan

In this exclusive interview, Dr Lul Lojok Deng talks about South Sudan’s journey in transforming Laboratory and Blood Transfusion Services. The Programme, implemented by Amref Health Africa through the support from the World Health Organisation (WHO), Center for Disease Control (CDC), United Nations Development Fund (UNDP) and Global Fund, aims to accelerate the implementation of South Sudan’s HIV/AIDS National Strategic Plan at all health care levels by 2020.

We had the privilege of interviewing Dr. Deng about his leadership role at the Ministry of Health. Here are key insights from our conversation.

How did Amref come on board?

Dr Deng: Three years ago, CDC contracted three organisations to implement a laboratory services and blood transfusion programme. Thereafter, we thought it was not necessary to contract the three, and instead advised to work with one organisation. The Ministry of Health through CDC, gave Amref Health Africa the contract; that is how our partnership with Amref started. The National Laboratory was constructed in 1974 and inaugurated in 2014.

How has the Programme supported the state of South Sudan laboratory and blood transfusion services, what has been the transformation?

Dr Deng: The first thing Amref did for us was confirming the Cholera cases during the 2006 outbreak. Ideally, we used to take the samples to Kenya and Uganda for diagnosis. However, when Amref came on board and supported us with managerial and technical skills, we were able to carry out the tests ourselves. That was our turning point and this was a great milestone to our country.

The impact is pretty profound. Tell us more about Amref partnership and collaboration with the Republic of South Sudan

Dr Deng: We have made a lot of progress over the past four years. Today, as we speak, children exposed to HIV have access to Early Infant Diagnosis (EID) and Viral Load (VL) testing using Polymerase Chain Reaction (PCR), which are conducted in our Laboratory. Initially, we had been sending the samples to Kenya for diagnosis, which was an expensive and time-consuming process. Today, we are proud to carry out the tests here in Juba under the patronage of Amref.We needed to domesticate all our diagnosis and confirmations here in South Sudan and have managed through this programme.

What about Blood transfusion Services?

Amref has helped us in promoting laboratory transfusion services since the blood we collect is tested before it is used. The programme provided equipment and personnel to test the blood for blood transfusion infections. Initially, we had a major challenge of using the blood in the hospital especially in the States. The programme is helping us establish blood transfusion committees in the hospitals to ensure good usage of the blood. This will be rolled out to other institutions as well.

What are some of the challenges you have encountered?

While we are happy with the progress, there is still much work to do. Of course, we face many challenges, we are not where we want to be because of various reasons and obstacles. Human Resource for Health is still a major gap. We do not have laboratory technology and training institutions, we are not promoting the laboratory courses to higher level; we need high skilled and knowledgeable personnel. It is our kind request to Amref and other partners to support the upgrade of the courses they offer to a higher level like a degree.

Being the youngest country in the world fueled by years of conflict and subsequently affecting the health care system, how has it being to slowly rise up?

It is not easy, South Sudan is in crisis, if you move to the States, they have nothing and infrastructure is destroyed. There is an urgent need to reconstruct, renovate or build the laboratories in the States.

Some States and regions have different laboratory structures. For instance, in one of the States, an ordinary room has been turned to a laboratory forcing the health practioners to work on benches. In Rumbek for example, the equipment is placed on a table that is not stable. This greatly impacts the quality of results.

We have created an approach of community universal testing that we need to roll out to the States, and equip them with multiple testing equipment like gene experts to ensure no specimen is sent to Juba. However, before these machines, the laboratory needs to be renovated, so that people can work in a safe laboratory to provide quality services.

What are you looking forward to? What are your priorities for the future?

We collect blood in Juba and use locally but we are not helping the women or children who are in need and dying in the community in the States. To address this issue, we came up with an approach called the Virtual Blood Bank, which screens and tests young people and registers them in our database, who we call on when we need more blood. We want to use this model because we do not have blood banks in the States. However, we need to collect more blood to supply in the States. In addition, we also need to get accreditation, this is our main goal. However, there are a lot of gaps for us to be accredited. We cannot be recognised fully unless we are accredited.

Parting shot?

We need to strengthen the primary health care so that the health facilities can conduct the tests they require at the community level. We need to strengthen the laboratory services at the State level such that the hospitals are able to conduct diagnosis at that level. Currently, the samples collected are taken to the hospital in the states, after which they are then taken to the national level.

We need to be stable in order to realise universal coverage for testing and laboratory services in the Republic of South Sudan.

We acknowledge the efforts of our partners CDC, WHO and UNDP. It is because of their generous support that is reflected in the good work Amref is doing in the Laboratory Programme.