As South Sudan continues to privatize coronavirus testing, serious concerns are being raised over the credibility of the test results issued to travellers.

Some say the results issued from the main private clinic, Med-Blue Laboratory are either inaccurate or someone else’s, a claim rejected by the health facility.

“Med-Blue has a hologram sticker and this sticker is put in all the results. All the hard copies of the result will have a hologram,” it told Eye Radio.

But foreign nationals leaving South Sudan say they are informed by officials at the country of entry that they are carrying the wrong coronavirus travel certificates.

Several travellers told Eye Radio that the result slips they receive particularly from Med-Blue Lab are often in someone else’s name.

“That means, a result that belongs to you is wrongly given to someone else travelling,” a medical doctor in Nimule said.

Not until last month, testing for coronavirus cases and for travellers was restricted to the Public Health Laboratory at Dr. John Garang Infectious Disease Centre and at UN centres.

The government then allowed Med-Blue clinic, a private entity, to also conduct testing, mainly for travellers.

It also permitted it to charge testing fees, a decision criticized by the public.

Exorbitant charges

The clinic started by charging South Sudanese travellers a fee of $75 per person, and $115 for foreign nationals leaving the country.

It also charges using the black market rate for the equivalent of $75 and $115.

The clinic has now reduced its rate to $40 for nationals, $80 foreign nationals and $100 for the elites/Very Important Persons.

However, civil servants who get paid in South Sudanese pounds an equivalent of $15 dollars still find it difficult to pay for the test.

“I get SSP 1,500 every four months, I have not seen my children in the refugee camp in Bidi-bidi since last Christmas, now they told me I should go and buy the dollar or pay like in the black market,” John Amule told Eye Radio after being turned away from the payment counter.

“Where do they expect me to get that kind of money?”

Some wondered why the clinic is not using the central bank rate since they are reportedly subsidized by the government.

As of January 2021, the central bank rate is SSP 180 for $1, while in the parallel market, $1 sells for SSP 600.

Results mismatch

Despite these exorbitant charges, Med-Blue clinic has been accused of switching names and coronavirus results of some travellers.

The coronavirus result document issued to travellers often indicate the name, test results and a coded mark or bar code.

A bar code is a method of representing data in a visual, machine-readable form.

The barcode on the document is scanned by medical officials at various immigration points to confirm the authenticity of the test result.

But it is during this scanning that health officials say the name indicated on the result document does not march with the name indicated in the bar code.

A Ugandan medical doctor who spoke to Eye Radio off-record at Elegu border point said what is typed and encoded on the document do not match.

Eye Radio witnessed a Kenyan national called David Murethi being interrogated for carrying a coronavirus result certificate whose bar code indicated the name of Simon Tong.

“The document shows David Murethi on the top, but when we scanned the bar code, we found a different name,” the health official said.

The official says the cases of inaccurate results coming from South Sudan are widespread.

“For your nationals, it is minor cases. But we have received so many results slip for Ugandans and Kenyans that do not correspond with the passports or IDs of the travellers,” he added.

A number of South Sudanese have also been returned to Nimule for holding incorrect coronavirus test result.

Reacting to the report, Med-Blue’s health facility’s program manager admitted to receiving such claims but said they have introduced a computerized seal to detect the authentication of the document.

“When we went there – to the border, they gave us a big file report of fake results. So, all of them have been fake. We told them how to detect fake results,” said Dr. Poles Simon.

Those with faults in their results –and have money –are forced to take another test at Elegu covid-19 laboratory for a fee of $50. Here the charges are similar for both national and foreign nationals.

Test results in Uganda come much faster compared to South Sudan after the country imported rapid test kits from South Korea and the United States of America.

“We have been evaluating the rapid test kits that allow us to get results in a short time. They [kits] are giving us fair results, they performed to a level which is acceptable,” said Dr Isaac Ssewanyana, Director of Uganda National Health Laboratory Services.

Travellers at Elegu border point receive their results on the same day, unlike in Juba where most results are issued after 24 hours.

Of waiting and pending results

 “Your results are not showing in the computer here. It is still in the laboratory across the road,” a young officer at the counter tells an agitated client at the counter.

Moses Makuach has been standing in the line for 3 hours to receive his result that he tested for 24 hours earlier.

“How can it be pending yet you told me yesterday to come early at 6am, I have been here since morning,” an angry Makuach asked.

Makuach is meant to travel to Egypt at 5pm. It is already 2pm.

“Please go and follow up at our laboratory,” the officer directs Makuach to Tecno building, opposite Eye Centre at Mobil roundabout.

Makuach and several other travellers have criticized Med-Blue for often not issuing results on time.

Some travellers, including Eye Radio’s Daniel Danis who was tested in the morning of December 16th, were not able to receive their results the following day, while those who tested hours after them were issued test results earlier.

When asked, Med-Blue clinic officials often refer travellers to follow up at their laboratory at Tecno centre at Mobile roundabout in Juba.

Travellers are often not given a clear explanation, except for the “results are pending.”

For those with the urgent need to travel due to pre-booked flight tickets, they are referred to the branch manager at the laboratory where they get assistance.

It is not clear under what conditions they get their results from the branch manager when the test samples are still pending in the laboratory.

Crowded, unregulated, and Covidiots centre

The scene at the testing site and laboratory has been described by many travelers as; “chaotic, disorganized, and risky” to public health.

“From long-lines of closely standing clients at the testing centre to impatient closely-seated clients at the laboratory waiting area, those seeking service and those giving it seems to have forgotten why they should test for Covid-19 –in the first place,” Daniel Danis noted.

Travellers who spoke to Eye Radio say they risk getting infected while standing in line at the test and payment centre.

They say the centre is small, overcrowded and unregulated.

People stand in line very close to each other in total disregard of the social distancing rule.

“They don’t keep social distancing, the cram up, the fight over papers and all that, I didn’t believe that I was at the COVID-19 testing Centre,” Joice Kiden lamented.

The Med-Blue clinic has two main windows for making payments before one receives a token to proceed to the tent where testing takes place.

At the test area, there are two small white tents; for waiting and for undertaking the test.

There are also three small windows for receiving test results and they are often overcrowded.

“They come with a lot of papers and then they call names one by one -so people fight. You cannot even hear your name properly so people cram at the window or in front of the testing centre to hear their names. That is terrible,” Mark Otoo said.

“They should be sending those results to people’s emails or WhatsApp.”

Most of the people lining up do not wear masks and there are no enforcement officials to ensure everyone follows the public health guidelines.

Those seeking to test often spend several hours in the line under the scorching sun as there is no shelter for those lining up.

There is also unnecessary slowness by the officials to attend to clients.

Some travellers have attributed this to people entering through the backdoor with documents of relatives and friends to speed up their process.

This forces those in the line to wait for a minimum of 5 hours to make their payment and get tested.

Gatwic Gatnyakeng said his main concern is his health due to the long hours he spent in long lines. He has been standing for “close to 5 hours.”

“It was risky for me. They don’t call your name so you just squeeze yourselves in the line, and when it comes for the result all of us will again squeeze yourselves in one place -which means there is no social distancing.”

Cumulative cases unreported

In the first two weeks of December 2020, Med-Blue clinic confirmed more than 50 positive coronavirus cases—mostly travellers –but the details were not sent to the Ministry of Health.

“They confirmed more than 53 positive cases but we don’t know details of the people,” Dr. Angelo Guop disclosed. He is the Manager of the Covid-19 Emergency Operations Centre.

But in late December, the Manager of the Covid-19 Emergency Operations Centre said the Ministry of Health has not received coronavirus test results from the private lab in the first two weeks of its opening.

“We have been talking to this private clinic to bring us the data [where] the majority of testing is done [but] we are not getting data from the private clinic and that is a concern,” Dr. Angelo Guop said in an interview with Eye Radio on December 19.

Despite the inaccuracies and inefficiencies, the chairperson of the coronavirus taskforce, Vice President Hussein Abdelbagi Ayii has maintained that immigration officials will only recognize test results from Med-Blue Clinic –that is until two new laboratories were announced this month.

He insisted that for now “those who want to travel should go to Med-Lab, pay money and be tested, and then travel with the result.”

More private covid-19 centres

Two weeks ago, the government permitted two more laboratories to be set up for checking Covid-19 travellers.

The two laboratories shall be established in Juba.

They are Nujum Diagnostics in Hai Referendum and Keane’s Laboratories in Nimra Talata.

They are owned by the Ministry of Health’s consultants; Dr. Arkanjelo Modesto and Dr. Edward Adar -respectively.

“This is because it is not the responsibility of the government to test someone who is travelling outside the country for his or her personal matters,” Vice President Abdelbagi told the media.

The three private clinics are the only coronavirus testing areas for travellers from across the country.

Those living outside Juba –as far as northern states along the border with Sudan, have to travel to Juba to seek the test results before travelling.

Only alert cases and contacts are being tested at the Public Health Laboratory—for free.

Nujum Diagnostic, Keane’s Lab and Med-Blue are officially accredited to investigate and test travellers, then issue them with Covid-19 results based on validated polymerized change reaction (PCR) test.

The PCR chain reaction method allows doctors to take a very small sample of DNA and amplify it to a large enough amount to study in detail.

This method will still be utilized by the two new laboratories to be established in Juba.

Regional call for lowering fees

Recently, the East African Business Council called on the Partner States to lower and harmonize COVID-19 testing fees.

Currently, Tanzania and Burundi charge a standard fee of $100 for both nationals and foreigners, while Kenya and Uganda charge $60 -respectively.

South Sudan has just lowered its charging fee to $40 for nationals and $80 for foreigners.

But in a statement seen by Eye Radio, the regional business council said harmonizing and reducing the fee will ease the cost of doing business and boost intra-East African Community trade.

African Union to digitalize covid-19 test results

At the continental level, the African Union has announced that member states will from this month start using digital Covid-19 certificates as one way of eliminating travel restrictions occasioned by the outbreak of coronavirus.

The new digital application from Econet Wireless and PanaBios will assist travellers to comply with Covid-19 travel protocols and share vital information to end double testing across the continent.

The mobile-based global health information App will contain Covid-19 testing, pre-entry and exit requirements, traveller’s test results.

Covid-19 status

“Ignorance and denial” continues to hinder efforts to control the spread of the coronavirus in South Sudan.

The government too has not enforced its own public health directives.

Most public institutions, shops, and medical centers are no longer providing handwashing facilities or sanitizers.

Social distancing is also not being observed at most meetings, weddings, funerals, and other public gatherings.

According to the South Sudan Doctor’s Union, such a level of noncompliance during the ongoing global outbreak places vulnerable populations at risk and poses a real threat to the national health and safety of the country.

“We want to remind the general public and institutions and concerned authorities that Covid-19 is not yet over,” warned Dr. Bol Deng, the Secretary-General of the Doctor’s Union.

The Director-General for Preventive Health Services at the national Ministry of Health — Dr. John Rumunu – advised the public to continue adhering to the preventive measures.

“We should observe keeping distance of at least two meters from other people and we wash our hands regularly with water and soap or sanitize our hands with approved sanitizer and wear face masks,” he said.

South Sudan currently has 3,788 confirmed coronavirus cases and 64 deaths.

The Public Health Laboratory said it has so far conducted 83,534 tests since the virus was first confirmed in the country.

So far, 3,542 cases have recovered.

The public is advised to strictly continue adhering to the social distancing and other anti-coronavirus measures as the number of cases continue to surge globally.

The Public Health Emergency Operations Center warned that unless COVID-19 prevention measures are strictly observed, South Sudan is most likely going to experience a second wave of the outbreak with more morbidity and mortality since Ethiopia and Uganda are currently experiencing the second wave.

You can report any suspected cases of the virus to the nearest health Centre or call the toll free number: 6-6-6-6.

Meanwhile, the number of Coronavirus worldwide has surpassed 97.3 million cases with over 69.8 million recoveries and 2 million deaths.