Southern Sudan > Activities by Sectors
The Need for Health Services
Treating a cholera patient
Years of conflict have left very few functioning social services in Southern Sudan. Malnutrition rates are far above the internationally accepted emergency threshold—evidenced by a Global Acute Malnutrition Rate of 16.9 percent in 2009.
This high malnutrition rate is exacerbated through the onset of flooding, which has a devastating impact on food security. Furthermore, the region has a maternal mortality rate of 2,037 per 100,000, which is four times higher than in Sudan’s northern states.
Only 30 to 40 percent of the population live within a day’s walk of a basic health facility, and access is even less available in the Upper Nile region where Medair works.
The common diseases encountered in Southern Sudan are malaria, diarrhoea, and pneumonia, with malnutrition being a contributing factor for many deaths. High mortality rates are acute for children under five (1 in 5) and pregnant women (1 in 9).
Vaccination and antenatal care coverage rates are the lowest in the world. Annually, numerous outbreaks of preventable diseases occur such as measles, pertussis, meningitis, and tetanus, resulting in many needless deaths. There is still insufficient capacity among the community and supporting NGOs to respond to all of these outbreaks.
Since the signing of the CPA, areas previously not accessible to NGOs have become open, and displaced people are returning to their communities. Travel possibilities have improved, and as a result, some people travel for many days to access services.
Medair’s Health Services Activities
Emergency Relief
Medair’s Emergency Response Team (ERT)—funded by UNDP, the European Commission, UNICEF, and OCHA—has the capacity to react immediately to unmet emergency health needs in the whole of Southern Sudan. This team has been operational since 2001 and is involved in rapid needs assessments of displaced persons; building local capacity; nutritional emergencies; and outbreak responses to diseases like yellow fever, meningitis, and cholera. To ensure the highest possible efficiency in responding to emergencies, Medair coordinates with the U.N. Emergency Preparedness and Response (EP&R) department (where Medair has seconded staff), the World Health Organisation (WHO), local authorities, and partner NGOs.
Rehabilitation
Medair is currently supporting a Primary Health Care Centre (PHCC) in Melut Town and six Primary Health Care Units (PHCUs) in Melut County of Upper Nile State. In addition, we are now supporting 2 PHCCs and 2 PHCUs in Manyo County, also in Upper Nile State. Medair’s heath services work in Southern Sudan is funded by UNDP, DFID, the European Commission, WHO, and OCHA.
These Medair-supported clinics provide improved health care access to the local population—those who previously had very few viable options for primary health care. Each clinic is run according to specifications in the Basic Package of Health Services (BPHS), a framework from the Government of Southern Sudan (GoSS) Ministry of Health (MoH) for health service implementation.
A PHCU covers a population of approximately 15,000 people and provides basic preventative and curative services including antenatal care, health education, free consultation and treatment, moderate malnutrition care for outpatients, and referral to the PHCC for severe cases. Patients receive free drugs, mosquito nets, and vaccinations.
A PHCC covers a population of 50,000 people, and is able to deal with more complicated cases, as it is staffed by more qualified health professionals. It provides basic antenatal and emergency obstetric care, health education, vaccinations, mosquito nets, consultations and treatment for both inpatients and outpatients, treatment for malnutrition, minor surgery, and laboratory tests.
Health & Hygiene Promoters are incentive-based volunteers who aim to increase family and community awareness and practice of positive health and hygiene behaviours. Promotion of healthy behaviours like hand-washing and full courses of vaccinations are linked to PHCC/U activities, as well as being targeted in schools and through campaigns in the wider communities.
Medair is also committed to training new health staff and to further improving the skills of current health staff for correct diagnosis and management of clinical conditions. Village Development Committees are being trained to act as a local liaison between the community and MoH structures, and to highlight health issues within their community. In addition, Medair supports the establishment of the Melut County Health Department and now also supports the already established Manyo County Health Department, and works closely with the State Ministry of Health to ensure all services are run as required by the GoSS.
The Need for Water, Sanitation, & Hygiene (WASH)
All of the affected areas of Southern Sudan have a very low level of access to safe drinking water and very poor sanitation facilities. Even in areas where water and sanitation facilities are available, cultural beliefs and practices inhibit some people from using them. Only 60 percent of the population have access, and just seven percent practise good hygiene and sanitation, thus putting millions of lives in danger from waterborne diseases.
Medair’s WatSan Activities
Emergency Relief
The Medair WatSan team provides rapid responses to emergency situations where water has become contaminated and can cause diseases. In consultation with the GoSS, Medair focuses on areas shown by the Cholera Prevention and Preparedness Group (CPPG) to be at risk of cholera and waterborne diseases. The modified Surface Water Treatment (SWAT) systems that Medair installs are a medium-term measure to solve the immediate crises, and to give time for the GoSS to build infrastructure that addresses water needs.
Medair also uses SWAT systems for urgent emergency responses. Safe sanitation and hygiene education are conducted during all emergency interventions.
Rehabilitation
Medair’s aim is to provide safe water sources and thus reduce waterborne diseases. Medair also provides proper sanitation and hygiene promotion. Medair’s WatSan activities in Southern Sudan are funded by UNDP, the European Commission, and UNICEF.
The WatSan team focuses on increasing the number of skilled local Sudanese who can maintain new and existing water points, construct sanitary latrines, and educate the community on good sanitary practice and hygiene awareness. Medair’s goal for the community and government is to take ownership of safe water sources, ensuring the sustainability of the implemented projects.
The Need for Shelter & Infrastructure
In 2008, more than 450,000 returnees and internally displaced persons (IDPs) resettled in Southern Sudan, including more than 130,000 in Jonglei, Unity, and Upper Nile states alone. In 2009, insecurity in Jonglei and Upper Nile states–as well as across the country–caused massive displacement. This has created huge needs for basic household items, especially where host communities are unable or unwilling to cater to the needs of those displaced.
Medair's Shelter & Infrastructure Activities
Emergency Relief
Medair assists vulnerable populations with meeting their minimum shelter, hygiene, and food preparation needs. Non-food item (NFI) kits are given to many returnees and their host communities, providing them with basic household items such as blankets, tarpaulins, cooking pots, buckets, and mosquito nets.
[1] U.N. OCHA Comparative Humanitarian Statistics for Southern Sudan, Update November 2009
[2] ‘Southern Sudan Household Survey’, MOH-GOSS/SSCCSE, October 2007
[3] ‘Sudan IDP & Refugee Returns, Reintegration Operations Statistical Overview’, Information Management Office UNMIS, Return Reintegration & Recovery, January 2009.