Now, thanks largely to an innovative International Rescue Committee treatment program, child mortality in Ganyliel - a remote area in Unity State - has shown a dramatic turnaround. Between 2005 and 2007 the child mortality rate in Ganyliel dropped 81 per cent, according to IRC surveys. Indeed, the program has been so successful that the IRC and Southern Sudan's Ministry of Health are beginning to roll out the treatment program across the country.
"The overall aim of this program is to drastically cut child mortality rates by giving rural families easy access to life-saving drugs via a trained person they trust. Treating a child showing signs of serious illness in the first 24 hours can be the difference between life and death." says Johnson Mwamba, the IRC's child survival program manager.
The secret of the program's success are so-called "Community-based Distributors"- villagers who the IRC has trained to identify and treat malaria, diarrhea, and pneumonia. In Unity and Northern Bahr El Ghazal States, the IRC has trained more than 260 distributors to work in areas without health facilities. Parents know they can take their children to the distributor's house at any time of the day or night and they will receive free drugs and advice, says Johnson Mwamba.
The entire village helps the IRC to choose and promote the distributor, ensuring that everyone in the community is aware of the service. The village also provides the distributor with a small stipend often given in the form of food or goods. The IRC provides drugs, basic medical supplies, an initial eight-day training and follow-up support.
The distributor system is especially effective because it catches diseases early. Previously, parents delayed going for medical help because they couldn't afford to travel to a clinic. Now they can get treatment locally, for free, and from someone they know and trust.
"Mothers bring their children to me both night and day. I was chosen by the community to do this, so they trust me and they know that I attended a training by the IRC," says Santino Malong, a distributor in the village of Mathiang, Northern Bahr El Ghazal.
IRC-trained distributors are now helping the Ministry of Health to test a new drug kit specially designed to treat lethal childhood diseases. The kit has been simplified to include pre-packaged drugs so that volunteers don't have to measure out complicated dosages and the instructions are in pictures, so everyone can understand them.
In total, the IRC's 260 distributors - almost 60% of whom are female - have seen more than 75,500 patients and referred 830 cases to primary healthcare facilities since early 2006. If the distributor feels that the child needs further treatment, he or she will refer the child to the nearest health center as a matter of urgency.
The difference they are making is clear. "The last child I treated was a baby girl with malaria," said Santino Malong. "I gave her medicine and I checked up on her afterwards. She is well. I am happy to be able to save lives and to serve my community."
The IRC's child survival program has received funding from the Canadian International Development Agency (CIDA), Johnson and Johnson, and the Young Green Foundation.