Letter from South Sudan

The people of South Sudan face more conflict and uncertainty as elections are postponed. Samuel Enosa Peni records how Christian faith is changing lives amid difficult times.

Samuel Enosa Peni

Samuel Enosa Peni is Archbishop of Western Equatoria in South Sudan.

Outside a church a congregation waits seated while an onlooker rests on a motorcycle by a tree.

South Sudanese Anglicans await the visit of the Archbishop of Canterbury to their church.

South Sudan as a sovereign state gained its independence in 2011 after experiencing a civil war which lasted for many decades. According to the 2018 International Religious Freedom Report, Christians make up 60 per cent of the population, 33 per cent constitute indigenous religion followers among whom some combine both Christian and indigenous practices.

In 2012 Christian faith in South Sudan celebrated the centenary of sustained Christianity in the land, for both the Roman Catholic church and the Protestants (Episcopal Church of South Sudan - Anglican Communion). There has been a tremendous growth of Christian faith in South Sudan and an increased number of Christian denominations. Lives have been saved and many South Sudanese have received Christ as their personal saviour. The Christian faith has also played a major role through its evangelization in drawing many people of all ages to participate in church activities and more. The church offers psychological and social support, inter-religious peace building initiatives, education, health and care that is changing lives. Christian faith is embedded in the reality and life situations of the people.

What does daily reality look like for people trying to live out their faith?

Life in South Sudan is characterized by war, tribal and communal conflicts. This has left the country facing many challenges, and the people are living in fear. Those who are trying to live out a Christian faith in South Sudan are not excepted from the general challenges and problems. The primary problem the majority face is the cost of living and security.

High inflation in the country is a factor of socio-economic problems and the hit of COVID in 2020. Life has never been the same since. Over 80 per cent of the people in South Sudan live below the poverty line. Despite the living conditions, as Christians, many have not ceased to live out a Christian faith. This is evidence by Christians participating in huge numbers during every Sunday Mass, prayer gatherings, Bible studies and church activities. Door to door and targeted evangelism mission outreach are effective. And a great number of people are called to the ministries such as becoming clergy, being commissioned as youth ministry leaders, Mothers’ Union members, evangelists and lay workers in the church.

What are the pressures and dangers being faced?

Due to lack of political will among the key players to permanently end conflict and bring peace to the people of South Sudan, there is still the danger of insecurity and fear among people in many parts of the country. Politics and socio-economics challenges and differences remain a problem. Christian faith also faces a danger of insurging witchcraft practices. Massive prayer initiatives are the response of the church. The mission to evangelise, teach and disciple remains a burden as a third of the people of South Sudan constitute indigenous religion followers or follow emerging false prophets. Because of the current economic situation, the church is lacking finance for its developmental programs. These range from capacity building, through missions, youth and women programmes, to working with vulnerable groups providing health and education. This poses a threat in the smooth gospel mission and discipleship programs.

How is Christianity fuelling justice?

South Sudan’s independence struggle was often considered a fight for religious freedom for the mostly Christian south against the Islamist government in Khartoum. With the current situation, the church has always been a key advocate for justice. As her role is to fuel justice, the church has been promoting dialogue, healing and reconciliation amid the ongoing political strife and ethnic conflicts. In 2017/2018, the South Sudan Council of Churches and its partners conducted a “Community Conversation” as an Action Plan for Peace aimed at documenting the voice of the people towards peacebuilding and addressing community issues and differences. The church is never silent to speak out against abuses of power and injustices in the Country. On 10 March 2023, the South Sudan Council of Churches released a statement which reads, “Deeper than simply avoiding war, nonviolence calls us to a new way of life which respects the dignity of every person and the integrity of creation. Nonviolence names a core value of the Gospel, in which Jesus combined an unmistakable rejection of violence with the power of love and truth in action for justice and peace. It is much more than the absence of violence and it is never passive. It is a spirituality, a constructive force, an effective method for social force, an effective method for social transformation, and a powerful way of life committed to the well-being of all. It rejects any form of violence and commits itself to a prophetic stance against violence and injustice. This is not a passive approach, not simply submitting to or colluding with violence, but is active and prophetic in responding to all forms of violence, amongst individuals, families, clans, tribes, and political and military factions, and including systemic violence embedded in our cultural, societal, and political life.”

What about the upcoming election?

Every South Sudanese is looking forward to a “free and fair” vote in the upcoming 2024 elections. Church leaders are also urging the government to adhere to the peace agreement it signed with its rivals, and to conduct a peaceful election. From the viewpoints of the current political climate, though the government has shown commitment to conduct elections in December 2024, remember that elections were to be conducted in February 2023 but did not materialize. The certainty of conducting elections in 2024 remains unclear. The facts are that the following measures needed to run an election have not yet been implemented: electoral laws, a census, voter registration and constituency boundaries, safe environments to vote, repatriation of refugees and security arrangements. Revitalized peace agreement protocols are also yet to be fully implemented. Looking at the remaining period to elections, this poses a question whether the election will be viable or not. From a Christian perspective, there is hope, with God nothing is impossible. The church is praying and working closely with the political parties and other community organizations to ensure there are elections in 2024.

Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.