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Building Gaafar Ibnauf Children's Hospital: Unprecedented story.

Year: 2015
Type: article
Abstract: It must be noted that paediatric services were almost non-existent up to the late 1950s. Professor Mahmoud Mohamed Hassan [2] and Prof. Salah Abdelrahman Ali Taha [3] pioneered this field in Sudan and later in the Arabian Peninsula. Prof. Hafez Al Shazali [4] and Prof. Mohamed Ibrahim Ali Omer [5–7] pioneered the establishment of the first Department of Paediatrics and Child Health in Sudan within the Faculty of Medicine, University of Khartoum (U of K). Paediatrics and child health units at the Ministry of Health and the U of K alike had been part of General Medicine Departments until the beginning of the 1970s [8]. Paediatricians were few against the background of unacceptably high morbidity and mortality among children, the poor scattered paediatric services in the Country and the dilemma facing mothers to care for their sick children. The task of developing pediatric services was indeed challenging and demanding, considering the small number of pediatricians and the size of the responsibility, coupled with the noticeable lack of basic statistical information. Establishing paediatric emergency service in Sudan Till 1977, childhood emergency problems in Khartoum were tackled by a single Paediatric Emergency Unit at Khartoum Civil Hospital (currently, Khartoum Teaching Hospital) which acted as a referral unit and provided 24 hours service [9]. In addition, patients requiring medical supervision and intervention i.e. injections, intravenous fluids etc. were admitted for 24 hours. The staff consisted of nurses on 8 hourly shifts, resident house officers, a resident registrar and a consultant on call. The service coverage was shared, on alternate days, by units belonging to the Ministry of Health and the Department of Paediatrics and Child Health, U of K. Cases were mainly referred from health centres, but direct access was available for urgent conditions. About a third of all admissions (29%) were from outside Khartoum City, mainly Gezira Region, Khartoum North and Omdurman [9]. Respiratory diseases, gastroenteritis, malnutrition, childhood infections and malaria accounted for more than 80% of the admissions. After 24 hours, children who improve were discharged home (79%), those who required investigations and further management were admitted to Khartoum Civil Hospital (Currently, Khartoum Teaching Hospital) and Soba University Hospital [9]. The capacity was 30 cots, equipments were simple and a limited supply of drugs was available. Similar to other developing countries, cases needing care were beyond the limited capacity of the unit, and admissions (about 20 per day) had to be triaged according to a priority system (Figure 1). Figure 1 Photo of the crowded Paediatric Emergency Unit at Khartoum Civil Hospital (currently, Khartoum Teaching Hospital) taken by the Sudan Ministry of Information on 27 July, 1975. The International Editor of the Sudanese Journal of Paediatrics ((Prof. Mustafa ... The Ministry of Health rightly believed that a children’s hospital should be established in Sudan for the treatment of sick patients. Prof. Gaafar Ibnauf Suliman volunteered to take the task of establishing this first Children’s Emergency Hospital in Sudan. The project was officially inaugurated in 1977. With regards to this, Prof. Mustafa Abdalla M. Salih, International Editor of SJP, told an interesting story, which happened when he was working as Registrar in Paediatrics. Early in the morning of one day, he was asked by Prof. Gaafar to accompany him to bring chairs to the Paediatric Emergency Unit building. While accompanying Prof. Gaafar in his car, followed by a lorry, he realized that they were supposed to bring chairs for the inauguration ceremony of the proposed Children’s Emergency Hospital. High dignitaries were expected and there were no enough chairs in the place! Arriving at the famous Alzaibag Cafe at Souk el Arabi (Arabic Market), Prof. Gaafar paid for hiring some chairs (a common practice in those days). However, the administrator wanted a deposit as well. Prof. Gaafar told him, “Do you see this nearby building? This is owned by my father!” He was referring to Ibnauf Suliman Building, the famous two story building at Souk el Arabi (Arabic Market). The Children’s Emergency Hospital (CEH) evolved into 16 wards, different clinics, a pharmacy, laboratories, Radiology Unit, Infectious Diseases Unit, the Nutritional Rehabilitation and Vaccination Units, Administration, Records and Statists Units; and offices were built in a period of 6 months. The project was based on self-help and donations from Sudanese individuals without contribution from government recourses. Prof. Gaafar personally supervised all constructions. In this respect, Prof. Abdelaziz Elamin (Chairman of the Department of Paediatrics, College of Medicine and Medical Sciences, Arabian Gulf University, Kingdom of Bahrain, and Member of the International Editorial Board, SJP) also told an interesting story. He was then working as Registrar at C15 Ward (affiliated to the Children’s Emergency Hospital). One early morning, Prof. Gaafar arrived at C15 Ward to find that the contracted workers who, were supposed to establish a garden nearby the building, abandoned their work and sat nearby waiting for their wages to be cleared first. All what Prof. Gaafar did was that he rolled up his shirt sleeves and started working in the proposed garden, digging the ground. The workers resumed their task in apology! Procurement of necessary equipment was part of the contribution by UNICEF and others. The immediate result was reduction of child mortality by almost 30% within a short period. This was achieved by separation of different diseases in special wards, thus avoiding cross infections, and through continued intensive regular training of medical and paramedical staff. The experience and results were highly commended by WHO and UNICEF who acted swiftly to transfer it to neighboring countries with excellent results despite variations in economy and social standards. Equally, the role of regular vaccination of children resulted in rapid decline in morbidity and mortality. The nutritional department had a major role in the management of severe cases of malnutrition and enabled mothers to prepare the right type of food supplements to their children. The Nutritional Referral Clinic at the CEH won a gold medal granted by UNICEF for preparing foods using local ingredients from different parts of the country. The hospital was recognized by the public and thus received an average of 24,000 children per month in the Emergency Room, of whom up to 5,000 were admitted in rooms built and equipped nearest to doctors. The majority of acute conditions seen in the Hospital were patients suffering from acute dehydration, acute respiratory problems, malaria and acute infectious diseases. Others included systemic conditions like cardiac, respiratory, renal, gastrointestinal, hepatic and neurologic diseases. Those were subsequently treated at long stay wards until the condition improved or patients got cured. The CEH became one of the teaching / training centers for undergraduate and postgraduate students for the U of K but overtime for other newly developed universities. It also had the responsibility of training medical and paramedical staff from the Ministry of Health, hence training continued as an ongoing process. There were weekly clinical meetings, journal clubs and discussion of hot issues in paediatrics and child health. These meetings were attended by all doctors practicing in the hospital; however, registrars from other hospitals did attend these meetings. Specialized paediatric topics were conducted by consultant paediatricians and university tutors.
Language: English
Subfield: History
Open Access status: green
OpenAlex ID: W2519967277
FWCI: 31
Cites: 16
Cited by: 14
Related to: 10