Why are we there?
- Armed conflict
- Endemic/epidemic disease
- Health care exclusion
Below is an overview of activities from MSF-USA's 2013 Annual Report:
Escalating violence in South Sudan increased the need for emergency medical aid as the year progressed.
During clashes between the government and militia in Jonglei state in April, staff and patients at Pibor hospital were subjected to threats and intimidation and MSF was forced to suspend activities. In May, the hospital was looted and severely damaged, and fighting in the area caused Pibor residents to flee into the bush or hide in malaria-infested swamps without access to safe water or food. As the MSF hospital was the only one in the county, 100,000 people were deprived of healthcare. Thousands of people emerged 25 miles (40 kilometers) away to attend MSF’s small clinic in Gumuruk village, where teams carried out over 100 consultations per day for patients suffering from pneumonia, respiratory diseases, malaria, diarrhea, and malnutrition. During the first few weeks, a team set up a surgical unit at Gumuruk and performed 49 surgical procedures. To address the needs of the displaced people, a second clinic was opened in Dorein, south of Pibor town, and a helicopter was used to run mobile clinics in the bush in Pibor county. More than 26,500 consultations were provided across Pibor county over a six-month period. The team also conducted 1,468 antenatal consultations and offered mental health support through individual and group sessions.
On December 15, fighting broke out in Juba between different army factions and violence spilled onto the streets. Some 40,000 people fearing for their lives sought refuge in two UN compounds, where MSF set up clinics and provided 1,890 health consultations. A high number of people were treated for acute diarrhea, a direct result of poor water and sanitation. MSF also provided drugs and medical supplies to the Juba Teaching Hospital.
Fighting spread quickly through several states causing displacement, and 70,000 people, mostly women and children, fled the capital of Jonglei state, Bor, for Awerial, Lakes state.
In Yida camp, Unity state, MSF provided basic and specialist healthcare, ran nutrition centers and helped ensure adequate water and sanitation for 70,000 Sudanese refugees. Teams delivered the same services to more than 110,000 refugees across four camps in Maban county, Upper Nile state. In cooperation with the Ministry of Health, MSF staff vaccinated 132,500 people against cholera in the camps and the surrounding area.
Teams began providing Sudanese refugees from South Kordofan with basic and specialist healthcare in Pamat, northern Bahr El Ghazal, in February. In October, staff in Upper Nile state offered medical and nutritional assistance to around 5,000 refugees in Fashoda, and carried out surgery and post-operative care at the hospital in Malakal.
Basic and specialist health services
MSF teams continued to offer a full range of services at clinics and hospitals throughout the country, including surgery, maternal and child healthcare, vaccinations, emergency obstetric services, and treatment for malnutrition, kala azar, HIV, and tuberculosis (TB). They also responded to outbreaks of disease.
In Jonglei state, more than 71,000 outpatient consultations were provided among a full spectrum of services at the Lankien hospital and an outreach clinic in Yuai. Further south, in Bor, 177 patients received emergency care from MSF at the Ministry of Health hospital during the violence that broke out in July and August.
The Nasir hospital, Upper Nile state, provided a full range of basic and specialist services including HIV and TB treatment, and cared for patients referred from surrounding counties and the border areas of Ethiopia.
In Bentiu, Unity state, MSF handed over a nutrition program to the health ministry in February and opened a project to treat people with TB and HIV in the town and the surrounding area. In Leer, also in Unity state, MSF offered basic and specialist healthcare. More than 68,000 outpatient consultations took place; 13,394 of these were for patients with malaria. MSF also performed 336 surgical interventions.
Health services are offered to residents, internally displaced people and nomads in Agok, 25 miles (40 kilometers) from the city of Abyei. MSF runs the only hospital in the area, providing comprehensive services including HIV and TB care. MSF constructed a new maternity ward in September to accommodate the high number of premature and low birth weight babies. Staff operated mobile clinics to ensure people in remote regions could access basic and maternal healthcare and referrals.
Around-the-clock care is available for children up to the age of 15 at Aweil civil hospital, Northern Bahr El Ghazal. Services include intensive care, surgery, treatment of burn victims, and neonatal, tetanus, and isolation units. The hospital also has an inpatient maternity department. Staff assisted more than 6,100 births and admitted over 4,600 children to hospital this year.
In November and December, MSF provided fistula surgery to 55 women. Fistulas, a consequence of birth complications, cause not only pain but incontinence, which in turn often leads to social exclusion and sometimes rejection by friends and family. The team also ran mobile clinics, treating large numbers of people with malaria, respiratory tract infections, and diarrhea.
At Yambio hospital, Western Equatoria state, MSF reinforced its support to the Ministry of Health’s HIV program by recruiting, training and deploying key technical staff to deliver comprehensive HIV care for HIV-exposed children and adults, including pregnant women.
In November and December, more than 41,000 children were vaccinated against measles in Lakes state.
At the end of 2013, MSF had 2,854 staff in South Sudan. MSF has been working in the area that is now South Sudan since 1983.
Priscilla* was among the first wave of refugees to arrive in Maban county from Sudan.
There is hunger here because there is not enough food. It’s even worse if children are sick because they are malnourished. There is water, but just not enough for all these people. Surviving in this camp is not easy.
We fled the first fighting, still in the rainy season. Along the way, we were moving, but we could not race. It took us over two weeks to escape. We drank water from rivers. Many people got sick along the way, especially from malaria. As we fled, we passed through villages that were half empty. Some had already left, but others came with us when they saw us running.
Once we arrived at the border crossing-point, we felt safe. We stayed there two or three weeks. For the first time, people started to feel the pains they had not felt so far because they were so concentrated on running and saving their lives.
*The patient’s name has been changed.