11/02/2026
Integrated Care Leadership at Iteru Medical Center.
JUBA, SOUTH SUDAN - FEBRUARY 2026
In Jebel Area, BMC Gardens Road you will find Iteru Medical Center main branch, Iteru also have another branch in the center of Juba, right next to Promise Hospital and close to the Mobil roundabout, and the third one is in Munuki, Mia Saba Road. Iteru Medical Center is a modern, well-equipped facility. It's one of just two hospitals in the entire country with MRI and one of the four hospitals with CT scan capabilities. Moreover, it's the only place offering speech therapy. However, for healthcare leaders from fragile states, Iteru symbolizes more than just advanced technology. It stands as a crucial testing ground for the future of integrated healthcare.
Amb. Aker Deng founded Iteru in 2022 after experiencing Guillain-Barre syndrome and having to travel to Nairobi for physiotherapy rehabilitation. Her personal journey highlighted a gap that needed filling. Now, despite its achievements, Iteru's leadership encounters a challenging reality. South Sudan's healthcare scene presents a puzzling situation. Picture this: a "Level Five" tertiary hospital ready to tackle complex surgeries, yet nearly half the nation's people can't even reach a basic health unit. Plus, only 1.3% of government spending goes toward health. So why does this advanced facility exist? New global health ideas and Iteru’s journey suggest we should view a hospital not as just a place but as a central hub for an entire community’s healthcare needs.
Let's talk about the challenge: delivering sophisticated care in an unstable environment. Often, plans for integrated healthcare—crafted in places like Dubai or Nashville highlight ideas like "connected care," AI-based triage, and performance-driven payments. In the GCC region, these discussions are common. Platforms such as NABIDH or Malaffi work to synchronize patient data between insurers and clinics. Meanwhile, in the US, virtual emergency rooms keep 70% of patients out of physical hospital beds. In South Sudan, the concept of integration is entirely different. The WHO’s recent campaigns and research funded by USAID highlight this by combining polio vaccines with schistosomiasis treatment to prevent medicines from going to waste. Furthermore, a Chinese medical team established South Sudan's first "medical alliance" between Juba Teaching Hospital and a university clinic, enabling basic blood tests beyond the capital city. However, without access to humanitarian flights, Médecins Sans Frontières warns that 20 critically ill patients remain at risk. People face death because reaching a place like Iteru is just too far. Iteru’s leaders have to work in this kind of setting. Here, supply chains rely on donors and often break down. Rural clinics don't have electricity, and mental health or NCD care in primary health is still just an idea, not a reality. Now, here's the interesting part: the "Anchor Institution" Model from Iteru. This is where the insight from Iteru’s leadership becomes vital and could change everything. Tertiary hospitals in developing places used to just draw patients in until they couldn't handle more. But now, Iteru wants to change that approach altogether. Iteru is an "Anchor Institution." Instead of seeing the community health units (PHCUs) and primary care centers (PHCCs) spread throughout Juba and beyond as competitors or lesser referrals, Iteru views them as distributed entry points. The three hospital branches in Juba don't just aim to add more beds. They serve as strategic locations to bring care closer together in a city where getting around isn't easy.
A major trend is the shift from vertical to horizontal approaches. In the past, healthcare investments in South Sudan focused narrowly on specific issues like HIV, malaria, or maternal health. Iteru's leaders, informed by personal experience with a rare autoimmune disorder, recognize the flaws in this approach. Guillain-Barré Syndrome (GBS), for example, doesn't get prioritized in traditional models. The national health budget faces a challenge. It can't cover everything because managing this complex, chronic condition requires rehabilitation, neurology, and physiotherapy. Iteru steps in by providing the country’s only speech therapy and advanced diagnostics. They're basically setting up the groundwork for handling non-communicable diseases (NCDs) that the public sector isn’t ready to support financially.
The key leadership strategy here? It's all about combining capabilities. Iteru invests in high-tech equipment like MRI machines to make their business model work. This approach lets them fund and offer those hard-to-find services such as speech therapy and physiotherapy that are crucial for the community.
They integrate these services not because the government demands it but because they need to do so to operate effectively.
Switching gears now: let's talk about the "MAMI" lesson from South Sudan. Recent research there isn't just about facilities but also focuses on improving workflow processes. The management of small and nutritionally at-risk infants (MAMI) uncovered a significant issue: health workers worried about the increased workload from integrated care, while mothers were concerned about the long distances required for multiple visits. For executives at Iteru, this piece of information is crucial. It shows that success isn't just about having impressive facilities; it's also about understanding and improving the patient experience. The hospital's recent interest in forming partnerships with academic institutions should be evaluated with this insight in mind. Iteru cannot just wait passively for patients to come for speech therapy. Instead, it needs to rethink its approach by empowering its skilled professionals to guide community health workers (CHWs) in spotting early signs of issues. Developmental delays are a challenge. During the inauguration of Iteru mobil branch, Dr. Harriet Pasquale Akello, the former Undersecretary of the Ministry of Health, threw down a challenge to private businesses. She remarked, "There will be a time when we sit with private partners to discuss major successes... We rarely meet with them, but it's something we must improve." Her words highlight an important trend for integrated care: bridging the gap between public and private sectors. In developed markets, integrated care depends on software systems that can communicate with each other. But in Juba, the issue isn’t technical; it revolves around building trust and establishing contracts. The Ministry has a budget of 1.3%, while Iteru deals with MRI machines. How do they manage to share risk and patients? Here’s a fresh perspective: the "Green Channel" idea. We could take inspiration from the Chinese medical team’s project at Juba University, where they set up a "medical alliance." This alliance created an efficient treatment pathway, referring patients from the university clinic to Juba Teaching Hospital. Iteru can develop something similar. Picture a hub-and-spoke model where Iteru guarantees certain procedures like orthopedics, advanced imaging, and speech therapy for those referred by Ministry-run primary healthcare centers (PHCCs). This setup allows the Ministry to avoid the high costs of specialty units, while Iteru meets its surgical needs. Theater capacity is effectively managed, ensuring patients get seamless care without needing to sell land for a flight to Nairobi or other places. This isn't charity; it's smart use of resources. Iteru shifts from being seen as a "private hospital" to becoming a "utility hospital." Looking ahead, global trends such as AI in patient outreach, bundled payments for surgeries, and doctors' unionization might make South Sudan seem far behind. However, that perspective misses the essence of what's happening. Iteru Medical Center isn't in a race with the Mayo Clinic's future model by 2026. Instead, founder Amb. Aker Deng and her team are showing something different: that they can... Integration in a fragile state goes beyond software; it hinges on trust, logistics, and the boldness to blur lines between private business and public service.
The future of integrated care in community health is taking shape in Juba. A Level Five hospital discovers that being a beacon means serving as a bridge too.
