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Sudan: Operational Update
April 4, 2007
MSF teams are working in 22 locations across the three states of Sudan's western Darfur region. They are providing emergency medical care and relief supplies to several hundred thousand displaced people.
Since the beginning of the Darfur conflict, the population of the town of
Zalingeihas swelled to more than 115,000 with the influx of 95,000 displaced. MSF focuses on surgical care in the main town hospital. In 2006, MSF undertook 2,761 pediatric, 1,787 maternal, 932 general medicine and 1,826 surgical admissions.
MSF has constructed a hospital and health center in the vast displaced camp of
Mornaywhich is home for 75,000 displaced and 5,000 residents. In 2006, MSF carried out nearly 69,000 consultations and 2,245 hospitalizations. And 617 children were admitted into the nutritional center.
MSF has worked in
Niertiti, an area in the foothills of the Jebel Mara, with an original population 3,000 in addition to the 30,000 displaced. Teams have been running a small hospital since March 2004 as well as mobile medical clinics, although the latter have been put on hold due to a number of security incidents. During 2006, a total of 2,491 hospitalizations and 53,395 consultations were carried out.
In the Jebel Mara itself, MSF runs a health center in
Kutrum, which has been a rebel-controlled area since March 2006. In 2006, some 48,677 consultations were carried out. While the project was evacuated on September 14, from November teams began to return from the nearby base of Niertiti.
Habilah, a camp near to the border with Chad, which houses more than 22,000 displaced and a 7,000-resident population, MSF runs a medical clinic with 30-bed inpatient ward. This includes therapeutic feeding for severely malnourished children and ante-natal care and delivery. An average of 35 deliveries occurs each month in our health center. Outreach workers assist with health education and referrals. In 2006, some 25,000 consultations were done in the outpatient department and 750 patients were hospitalized.
Mobile clinics which provided medical care for mostly nomadic populations have been stopped, once again due to increasing insecurity. In this particularly difficult context, we are trying to reach populations located north of
El Geneina, who are receiving little if any assistance.
This is the case for a four-person team based in
Seleia, in the north of the West Darfur province, home to 20,000 people, and around which fighting has been ongoing. The team is setting up a surgical facility to treat the wounded; a capacity to answer to emergency obstetrical cases and is giving support to the health center. A mobile clinic is being put into place.
Access to medical care and emergency support is a constant problem for populations faced with ongoing violence. Fighting to north of El Geneina led to the displacement of several thousand people in December, 5,000 of whom arrived in the nearby
Dorticamps. In Aradamata camp on the outskirts of town, MSF has set up a medical mobile unit to screen new arrivals, and more than 500 people were treated in less than a week and relief supplies were distributed to 750 displaced families. Displaced people continue to arrive in small groups, mostly at night due to the risk of attacks on the roads and there are many reports of acts of violence perpetrated against villagers.
An exploratory mission recently went to
Tanjeke, 30 km north of El Geneina, where the displaced had talked of families being stranded because of insecurity. A security incident on the way back has confirmed roads were not safe enough to take them regularly. As of now MSF has not been able to bring further assistance to this population.
El Geneina, the provincial capital of West Darfur, MSF supports the emergency and surgical ward of the general hospital, with medicine, medical material and technical support such as the management of the pharmacy and of hygiene.
Um Dukhun, in West Darfur near the border of Chad and Central African Republic, MSF offers emergency surgery, basic health care, ante- and post-natal care, lab services, as well as treatment for survivors of sexual violence. Therapeutic and supplementary feeding assistance is provided during peaks of malnutrition. In May and June 2006, the team responded to the needs of the 12,000 new arrivals who crossed the border from Chad due to clashes and attacks in their villages. Programs are complemented by community outreach and referrals.
In the town of
Kebkabiya, a little more than 150 km to the west of the provincial capital El Fasher, MSF is running three dispensaries and providing support to the ministry of health hospital for the clinical management of the cases referred. The program serves a population of approximately 75,000, mostly displaced who have sought refuge in the city.
Outreach support from Kebkabiya continues to the town of
Kaguroin the rebel-held Jebel Si. The project was placed on stand-by in August 2006 after a number of security incidents. After an initial assessment in February, the team has once again been able to start work in this area, which has been a battlefield between the SLA and the Sudanese government since the start of the conflict in 2003.
The project focuses on bringing medical care to a civilian population who has been cut off from assistance for a number of months due increasing insecurity and conflict in the area.
South and east of Kebkabiya district, mobile clinics have also been launched recently in order to allow provision of basic healthcare to a marginalized and neglected population of Arab nomads. The simplistic description of a conflict pitting Arab killers against Africans has translated into many nomadic Arab communities being denied assistance, even when they have fled violence, such as in this area.
Severe security incidents forced MSF to evacuate its international team out of
Serif Umrain July 2006. Medical activities towards a population of 55,000 (mostly displaced) in the dispensary have had to be run by national staff alone. Since March 2007, supervision has restarted on a weekly basis from our international team based in
El Fashir. A total of 4,000 outpatient consultations are performed on a monthly basis while patients in need of secondary health care are transferred to the hospital in Zalingei.
In June 2006, MSF began work in clinics in
Killinand a month later in
Gornito assist displaced persons. However the project was evacuated for security reasons in late July, when an MSF convoy was attacked on the only access road to the area. Since then, the clinic, located in the north of the Jebel Mara, has been run primarily by Sudanese staff alone. MSF is still evaluating the possibility of re-establishing a permanent presence in the area.
Shangil Tobaya, MSF provides health-care services for the displaced people living in the
Shadatcamps, as well as in Shangil Tobaya village. Every month an average of 3,700 consultations are carried out and 110 patients are hospitalized. Around 50 children are treated in the nutritional program every month.
After several incidents in December and January, the team was withdrawn to El Fashir and since then it has been operating on an in-and-out strategy. Negotiations for access are on-going to re-open a full program in the coming weeks. The clinic is currently run by Sudanese staff with an international team assisting once or twice a week to carry out consultations (an average of 150 per day).
Assessments have also been undertaken recently among pockets of newly displaced people in North Darfur.
With a population of more than 90,000 people,
Kalmais one of the largest camps for displaced persons in Darfur. Since May 2004, MSF has been offering a range of health services in the camp and surrounding area. MSF is focusing on mother-and-child care and running a women's health center with 450 to 500 consultations per week. The center provides ante- and post-natal care, as well as delivery assistance for high-risk pregnancies and referrals for obstetric emergencies. Family planning is also available.
MSF is one of three agencies providing full treatment for victims of sexual and gender-based violence. A mental health program addresses the profound psychosocial stress and trauma experienced by the population as a result of current living conditions and uncertainty, as well as past conflict related psychological trauma. Psychosocial care is given through private counseling session, workshops and support groups.
Shariya, a government enclave where originally around 27,000 people were living, ethnic tensions precipitated by the conflict, led to almost 50 per cent of the population fleeing from the town. The remaining population is isolated and has little or no access to health care. Two days a week MSF supports the clinic of the Sudanese Ministry of Health in Shariya. In addition MSF provides ante and post-natal services, and therapeutic feeding during the hunger season. Regular mobile clinics provide the only direct humanitarian care to a fluctuating group of 400 to 1500 displaced trapped on the outskirts of the town who have no access to the clinic. A weekly mobile clinic provides basic health care services to
Khazan Jadid, a government held town of 40,000 currently dealing with similar conflict related tensions. Mobile teams are also regularly assessing and respond with health care for displaced rural communities.
Muhajariyais a major rebel-held town in South Darfur with a population of approximately 47,000, including displaced from the surrounding area. After a period of relative calm, open combat broke out in the town and the surrounding areas in October 2006, resulting in new displacement of an estimated 50,000 people.
As the conflict has split the population along ethnic lines, the situation is complex and remains highly volatile. MSF offers surgical care and runs inpatient and outpatient departments and a lab, as well as providing reproductive health services with antenatal, postnatal and family planning assistance. Treatment of victims of sexual violence is available. Because the nutritional situation is still fragile, therapeutic and supplementary feeding remain integrated in the basic health care. Community outreach programs and mobile clinics complement these activities. MSF teams also provide water to displaced persons in IDP settlements around Muhajariya. Currently, MSF provides basic health care services once a week to the towns of
Angabo, and is assessing and responding to health needs in other settlements.
Sileahis a government held town in south Darfur, with a population of 6,000. MSF responded when 14,000 IDPs from and around Muhajariya sought refuge in the town in November 2006. Plastic sheeting and blankets were distributed to new arrivals. MSF offers outpatient services, vaccinates children between six months and five years old, monitors malnutrition and is running a home based feeding program. In addition MSF is supporting the provision of water and sanitation to the IDPs.
MSF has worked in Sudan since 1979.