By: Victoria Calderon
Produced & edited by Kaylyn Hlavaty
At the peak of malaria season and in the midst of heavy flooding in South Sudan, medical aid is needed more than ever for Southern Sudanese refugees, but violence has suspended the delivery of necessary medical services from non-governmental organizations (NGOs).
“[The] majority of South Sudanese heavily rely on humanitarian aid,” says CHF International South Sudan Director Senada Kahriman, especially when 60 per cent of the country is cut off from access during the rainy season.
Médecins Sans Frontières Head of Mission in South Sudan Stefano Zannini says MSF is close to suspending all services in the country due to security concerns.
Some agencies have pulled their regular staff and organized mobile teams to provide daily visits to remote villages, says Kahriman.
“In Abyei for example, where health facilities and the entire town were destroyed and people displaced, mobile teams travel daily to provide services to returnees, and the new health facilities have been established in the places where the population was displaced.”
South Sudan’s grasslands, swamps, and tropical rain forests that straddle both banks of the White Nile serve as a breeding ground for life-threatening diseases when the river floods.
According to Médecins Sans Frontières, malaria cases have tripled in the Northern Bahr-el-Ghazal state.
Spikes of malaria generally start in May and begin to subside in September and October until they hit their lowest point in December. However, the rainy season began even earlier than usual this year and will likely continue longer than normal.
The states most affected by flooding are Jonglei, Lakes, Northern Bahr el Ghazal, Unity, Upper Nile and Warrap.
“Seasonal flooding has affected about 260,000 people this year across South Sudan. Although coordinated emergency response is ongoing to flood-affected people, needs can only partially be met,” says Kahriman.
The continued influx of Sudanese refugees has strained humanitarian operations.
“Upper Nile and Unity State have received huge number of refugees from the north, fleeing conflict affected areas of Blue Nile State and Southern Kordofan. There are also great needs to assist returnees coming from the north of Sudan, as well as [internally displaced persons]. UN sources confirm that More than 126,000 people have returned to South Sudan this year,” says Kahriman.
The heavy flow of water has strengthened the presence of infected mosquitos, which increase the likelihood that malaria will be transmitted to people after they are bitten, according to the World Health Organization (WHO).
Lamwalhok Liah is a worker in the out patient department of Médecins Sans Frontières in Juba, South Sudan. He says the condition of malaria and typhoid are present in all ten states, but it is at its height in the headquarters of Juba and the upper Nile region.
Malaria is preventable and curable, but the Plasmodium parasite that is spread with the bites of infected mosquitoes causes around 216 million cases of malaria every year around the world.
The large numbers of South Sudanese who were living in Sudan have returned to the south since the country’s independence, and these people have less immunity to malaria and are more likely to develop the disease says WHO.
South Sudan successfully transitioned to independence in June 2011 after 99 per cent of Southern Sudanese voted to separate from Sudan. The 2005 Comprehensive Peace Agreement established that South Sudan regional autonomy.
Partial human immunity, especially among adults in areas of moderate to intense transmission conditions, can be built up after years of exposure even if it will never provide complete protection, according to WHO.
Despite the excess of floodwater from the White Nile, refugees are sick with dehydration.
This water stress indicates that each person in the country has access to less than 1,500 cubic meters of water every year. In cases of water scarcity, this amount is reduced to 1,000 cubic meters.
This situation leaves Sudanese vulnerable to contracting waterborne diseases like diarrhea and Cholera in addition to the already rampant malaria.
The livelihood of Sudan depends on the use of its water sources. Eighty per cent of the country works in agriculture, and this accounts for 97 per cent of its water use, according to The Water Project.
The 22-year civil war that ended in 2005 left the health infrastructure of South Sudan in a poor condition, according to the Malaria Consortium, and non-governmental organizations have provided a range of health support while the infrastructure improves.
Kahriman says that while South Sudan is dependent on the health care from NGOs, “significant improvement [was] made this year in coordinating support to primary health care services, and jointly developed long-term strategy for health sector. This has brought together the government, key donors (USAID, World Bank and DFiD) and implementing NGOs.”
Southern Sudanese leaders fought for autonomy after more than two million southern Sudanese had paid for freedom with their lives. Another four million were displaced during the twenty-two years of guerilla warfare before the peace accord was established.
South Sudan remains to be one of Africa’s least developed countries as indicated by The Least Developed Countries Report 2011, determined by the United Nations Conference on Trade and Development.