20/08/2025
Medicine or Malpractice? Protecting South Sudanese Lives
Unregulated diagnoses, misuse of medicines, and weak oversight are turning public health into a national security crisis, and the Ministry of Health must act before South Sudan is branded a sick nation.
By Ajak Deng Chiengkou,
20 August 2025
I am not a public health expert, but I have spoken to many patients, families, and medical workers about the state of our health system. Their stories are alarming. Across the world, protecting people’s health is recognised as part of national security. For me, national security is not only about soldiers or borders, but about protecting South Sudanese lives and ensuring their well-being.
In Juba and other towns, medical centres have multiplied. They are run by foreign nationals, Chinese, Indian, Somali, Turkish, Ugandan, as well as South Sudanese. The problem is not nationality. The real issue is weak qualifications, poor oversight, and the absence of accountability. Even some of the most specialised doctors have chosen profit over patients. This has created a dangerous pattern of misdiagnoses, careless prescriptions, and fabricated laboratory results.
Relatives contacted me before I travelled to South Sudan, describing terrifying diagnoses, especially of gastric ulcers. The way the doctors explained it, you would think the patients were about to die. In one case, a relative who had vomited the night before was tested in a Juba clinic. Within minutes, the results claimed she had severe malaria, typhoid, brucellosis, and a severe gastric ulcer.
I questioned the doctor. No Widal reagent had been used for typhoid, no Brucella reagent for brucellosis, and no endoscopy or biopsy had been carried out for the ulcer. How, then, could these diagnoses be trusted? Eventually, the technician admitted: “I can take out the money for ulcer, typhoid and brucellosis, but I am not sure of the malaria.” By then, the patient was already in fear, convinced she was gravely ill.
Other stories follow the same pattern. My aunt in Bor was told by a doctor that “the water in the stomach has dried up,” as though such a thing could be seen on a computer screen. A senior church leader I know was given ulcer medicine that poisoned him; later, in a major East African hospital, he was told he never had an ulcer at all.
Language barriers create further risks. A friend recounted his experience at a Chinese hospital in Juba: “I accompanied a relative who spoke only Dinka. The doctor spoke only Chinese, and the interpreter was Malawian. The chain went like this: my relative explained her illness in Dinka to me, I translated into English for the Malawian, and he relayed it into Chinese. At every stage, meaning was lost. Anyone who understands how our people describe illness in Dinka knows how easily nuance can vanish in translation. In medicine, a single misinterpreted word can mean the difference between treatment and misdiagnosis.”
The misuse of medicines makes the crisis worse. Across South Sudan, antibiotics, painkillers, and other strong drugs are sold openly, often without prescriptions and sometimes in unsafe storage conditions. Patients, with little awareness, accept whatever they are given. Some of these drugs are addictive. Others fuel antibiotic resistance.
Earlier this year, the Mayor of Rumbek admitted that young people are becoming addicted to prescription drugs obtained illegally from open-air pharmacies. He also raised concerns about poor storage, questionable quality, and unclear origins of the medicines. If left unchecked, this problem risks creating a generation of substance-dependent youth, already referred to by many as the “crew.”
This is not a local issue. America is battling a fentanyl epidemic. Australia has faced methamphetamine abuse. South Sudan, with limited infrastructure and weak regulation, cannot afford to follow the same path.
Other conditions—such as Hepatitis B, Hepatitis C, and urinary tract infections—are also mismanaged. General doctors, who are not specialists, give advice in areas like gynaecology and urology, leaving patients harmed and confused. South Sudanese patients often place blind trust in what any doctor says. Without protections in place, that trust is dangerous.
These failures are not only medical—they are threats to national security. A sick nation cannot be strong. An unregulated health system exposes the population to exploitation, addiction, and trauma. Globally, poorly regulated clinical trials in developing countries have ended in disaster. South Sudan must not allow its people to be used as a testing ground.
This crisis raises urgent questions. Who licenses clinics and pharmacies, and who monitors them with annual evaluations? Who ensures only qualified doctors prescribe strong medications? Are laboratory technicians properly trained and regulated, or left to guess? Right now, patients have no clear protection.
What South Sudan needs is not police officers raiding pharmacies and leaving once bribed. What is required is a system that monitors prescriptions, regulates the sale of drugs, licenses qualified practitioners, and enforces medical ethics. Oversight must be firm, consistent, and guided by a duty of care.
If this trend continues unchecked, South Sudan risks being branded as a sick nation, where everyone has something to complain about. This must not be allowed. The Government and the Ministry of Health, at both the national and state levels, must act decisively. Lives are at stake. The well-being of our people, and the very health of our nation, depends on it.
