Most of the challenges Clinical Officers in South Sudan face are posed by the long standing civil war with the north, including lack of electrical power, scattered services, and a shortage of goods and services. Whereas advanced practitioners in other countries sometimes face professional battles with other health-care providers that feel they are competition, this does not seem to be the case in South Sudan. Currently, there is such a severe lack of human resources for health that there is little opposition to the development of the Clinical Officer.

It will be interesting to see how things unfold as South Sudan regains peace, becomes more stable, and more health professionals join the workforce.


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Tension between health care professionals does not always occur in countries developing advanced health-care practitioners, but it is a very important thing to keep in mind when evaluating the development of the advanced practitioners as a solution to health-care provider shortages.

The South Sudan model will teach the world how the advanced practitioner profession can be developed in the absence of professional tensions. We can also learn how Clinical Officers and their analogues are able address the needs of war-torn countries that have essentially lost their health-care infrastructure.

Manana is a health tutor with a clinical officer background from Uganda. His work in South Sudan will have an amazing impact on the country as a whole. His work should not go unnoticed, nor should the efforts of AMREF, a past winner of the Gates Award for Global Health.

At the end of my conversation with Manara, I am amazed at the great work that goes on in the world that remains unknown. This program is such a pearl in addressing health-care provider shortages in countries that need it the most, yet is relatively unknown and not easy to find information about. I hope we all can learn from South Sudan, and help support the future growth of Clinical Officer training there.

Marie Meckel, PA-C, MPH, is a physician assistant who works in Western Massachusetts. She spent a year in South Africa at Walter Sisulu University, where she taught clinical associates. Marie has spent the last year interviewing PAs and NPs, their international equivalents, and American PAs and NPs working abroad.  

Podcast produced by Brianne Aiken, Digital Content Editor, and Nicole BlazekSenior Clinical Content Editor.