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MSF Activities in Sudan
September 15, 2004
Today in Darfur, 206 international volunteers and thousands of national staff for Doctors Without Borders/Médecins Sans Frontières (MSF) are providing emergency assistance in 26 locations where 700,000 displaced people have sought refuge. In the third week of August, doctors and nurses conducted more than 22,000 medical consultations in the third week of August and treated 12,076 malnourished children. MSF's main activities have focused on treating malnourished children in therapeutic feeding centers (TFCs) and supplementary feeding centers (SFCs); treating patients suffering from diseases like respiratory infections, diarrhea, hepatitis E, and malaria; running blanket feeding programs; and providing clean water and improving sanitation to reduce the risk of disease.
In North Darfur, MSF provides care in Sarif Omra, Kebkabiyah, Shagil Tobaya & ZamZam camp. In West Darfur, MSF runs activities in and around El Geneina, Kerenik, Garsilla, Habillah, Mornai, Zalinge, Foro Buranga and Golo. In South Darfur, MSF works in Kalma Camp near Nyala, Kass, Shariya and Mahajaria. In neighboring Chad, 35 international volunteers provides assistance to 85,000 refugees from Darfur in and around Adre, Hadjer Hadid & Iriba.
Overall, the situation is still fragile but seems to have stabilized in areas where aid is being delivered. A major concern, though, is to reach those people who have fled to areas not being reached by international aid organizations. There has also been renewed violence in North Darfur.
Displaced people began arriving in El Geneina in November 2003, with new arrivals continuing through May 2004. Aside from food distributions based on a single registration in March 2004, little humanitarian assistance had been provided as of June 2004. An estimate 80,000 displaced people now live in twelve camps in and around El Geneina. In June, MSF opened a therapeutic feeding centre (TFC) within El Geneina hospital and opened a pediatric ward. In July, the organization established health centers in three of the four largest IDP camps (Abu Zahr, Riad, Ardamata). Global acute malnutrition (GAM) reached 20% in July, with severe acute malnutrition (SAM) affecting 4% of the people. Today, the rates are 17.6% and 2.6% respectively. MSF treats 209 severely malnourished children in its TFC. MSF handed over an ambulatory TFC to the organization Concern in Ardamata and Abu Zahr camps. In the pediatric ward of the MSF-supported hospital, 12 children were admitted mainly for respiratory tract infections and diarrhea. In Abu Zahr, Riad, and Ardamata camps, malaria now represents 10% of consultations while mortality rates have fallen below the emergency threshold.
In Kerenik, MSF treats 165 severely malnourished children in a TFC, and blanket feeding for 5,000 families, while also providing out-patient and in-patient services. In the last week of August, 264 cases of Hepatitis E were recorded.
Garsilla, Deleij, Mukjar, Bindisi, Um Kher
In Garsilla, MSF runs an out-patient department (OPD) and in-patient department (IPD), as well as therapeutic and supplementary feedings centers. From the base in Garsilla, outreach teams go to Deleij, Um Kher, Mukjar and Bindisi for consultations and feeding programs. Drinking wells are also being rehabilitated and latrines are being installed. The crude mortality rtate (CMR) for all areas is 0.5 deaths/10,000 people/day for all areas combined. Doctors and nurses perform nearly 6,000 consultations a week, mainly finding respiratory tract infections, diarrhea, and an increase in jaundice and malaria. MSF has been providing family rations since July and today treats 134 severely malnourished children in TFCs and 918 moderately malnourished children in SFCs, which represents a decrease in since the summer began.
MSF has started work in Habillah in mid-July and now supports an OPD and IPD. More than 140 children with severe malnutrition are treated in a TFC, and a second round of blanket feeding for 2,700 families has just been completed. The CMR is 2.5/10000/day while U5MR is 5.4/10000/day - both more than double the emergency threshold. A measles vaccination campaign has just been conducted and MSF provides water.
During the first evaluation mission conducted in late December, the MSF team observed that nearly 7,000 people had taken refuge beneath trees. Today, some 75,000 displaced people are living in makeshift shelters. All the villages along the road to Mornay have been destroyed. MSF admits 60-80 patients a week in a 100+-bed IPD, 32% for hepatitis E. In the last week of August, 240 cases of hepatitis E were reported. MSF treats 434 children in a TFC and through a blanket feeding program, MSF distributed 46,922 family rations of food in August with nearly 16,000 food rations delivered every ten days. Mortality rates have increased recently, with the CMR 0.7/10,000/day and U5MR 0.5/10000/day.
In January 2004, MSF started relief activities in Zalinge, where 35,000 displaced people are living in several camps inside and outside the town. A June 2004 survey found persistent problems with regard to the access to food and non-food items. MSF has opened two health centers, Halamedia and Assaissa, both of which include an OPD, ambulatory TFC, and a supplementary feeding center (SFC). In Zalinge hospital, MSF has extended the pediatric unit to 40 beds and created a TFC unit to treat the most severe cases of malnutrition. Doctors and nurses conduct more than 4,000 consultations each week, with acute diarrhea representing more than 20% of all consultations in. MSF treats more than 500 severely malnourished children in a TFC and distributed 49,485 family rations of food in August alone. The CMR has remained stable for the past three months just below the emergency threshold. In the last week of August, more than 90 cases of hepatitis E were recorded.
Nearly 25,000 displaced people reside in two camps. An Epicentre survey found mortality rates of 3 deaths/10,000 people/day for children under 5 from May 14-June 24, and 19.6% global acute malnutrition and 2.5% for severe acute malnutrition rates. Today, the CMR is 0.5/10,000/day and the U5MR is1.4/10000/day. Medical teams are treating 84 severely malnourished children, perform between one and two thousand consultations each week, and distributed nearly 5,000 family rations of food during August. In the last week of August, 70 cases of hepatitis E were recorded.
MSF is treating 11 children in a TFC and made 15 admissions to the recently rehabilitated Golo hospital, which serves as a referral hospital for 60,000 people in the Jebel Marra region. The hospital was closed since the start of the conflict 18 months ago. MSF will supply drugs and basic equipment, as well as start medical activities in internal medicine, pediatrics, maternity, and possibly surgery.
Kalma Camp near Nyala
Kalma camp hosts 80,000 displaced people, with 35,000 arriving in the past two months. MSF treats nearly 700 severely malnourished children in a TFC, provides food rations through a blanket feeding program, and distributes non-food items like plastic sheeting, jerry cans, mosquito nets, and soap. More displaced arrive from Nyala everyday, as they feel it is safer in the camp than in the surrounding villages. MSF has treated more than 250 cases of Hepatitis E since July 16, 2004.
The mortality rate in Kass, where more than 40,000 displaced people have sought refuge, is three times higher than the emergency threshold. MSF is running supplementary and therapeutic feeding programs, blanket feeding, out-patient consultations, and water and sanitation activities. MSF treats 287 severely malnourished children and 2,136 children moderately malnourished children, and continues to conduct measles vaccinations.
Shariya, Muhajariha, and Labado
Shaeriya town is held by government forces while much of the surrounding area is held by the SLA/JEM. Continuing violence in the area leads to frequent war-related injuries. Nearly 20,000 displaced people have been almost completely integrated into the communities. MSF provides primary health care services, with the main morbidity being diarrhea. MSF treats 185 severely malnourished children in a TFC and nearly 500 moderately malnourished children in an SFC.
Zam Zam Camp
MSF has been providing primary health care services since early July, and has established therapeutic and supplementary feeding programs serving 12,000 displaced people located a few miles outside North Darfur's capital El Fasher. MSF is treating 58 severely malnourished children in a TFC, 303 moderately malnourished children in an SFC; and distributes family rations of food.
Shangil Tobaya (formerly known as Shadad Camp)
Since July 2004, MSF has been running therapeutic and supplementary feeding programs in this settlement of 7,000, and has begun a blanket feeding program. MSF also supplies non-food items like jerry cans, soap, and shelter materials.
MSF is working in Kebkabiya hospital and in two outpatient departments.
MSF provides primary health care and treats severely malnourished children in a TFC.
MSF is currently assessing the situation in the Jebel Marra region (west Darfur), Birkaseira, Tawillah (North Darfur), Forro Burranga (West Darfur)
MSF ACTIVITIES IN CHAD
In September 2003, MSF started providing health care for refugees from Darfur who had crossed into Chad. Today, 40 international volunteers assist people in 12 locations (including mobile clinics) in the border towns of Iriba, Abeche, Hadjer Hadid, Tine and Adre.
MSF has set up clinics in Forchana camp (12,000 refugees) and is in charge of all medical activities at the 40-bed hospital, including surgical activities (50 to 60 surgical intervention a month). The hospital admits on average 100 patients a month. In Forchana camp, MSF see an average of 400 patients per week. The feeding program includes 30 severely malnourished children in a TFC and 130 moderately malnourished children in an SFC. MSF also provides potable water to the entire camp of nearly 11,000 refugees. From Adre, MSF operates mobile clinics in Mahamata, Nakalouta andf Gonkour.
Mahamata, Nakalouta, and Gonkour
MSF supports health centers in all three locations.
Iriba, Touloum, Iridimi
MSF supports Iriba hospital and has set up a new surgical ward. There is also a TFC where malnourished children from Touloum and Iridimi are transferred. In these two camps, MSF is in charge of providing health care and runs supplementary feeding centres.
Hadjer Hadid (Breijing camp)
MSF provides health cares to the 30,000 refugees in Breijing camp. MSF performs more than 1,100 consultations per week. The clinic is associated with an SFC and malnourished children are referred to Adre hospital, where MSF treats nearly 100 severely malnourished children. MSF has conducted a measles vaccination campaign, raising the total number of vaccinations in the camp over 13,000.
In Tine, MSF support the activities in the SFC and the TFC. The organization provides supplies to the health center and is responsible for the referral of patients to Iriba hospital.