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MSF in Sudan, 2009
Field Staff: 2,458
Reason for Intervention:
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There was a sharp rise in medical emergencies in several parts of Sudan in 2009. In addition to the continuing crisis in Darfur, people in southern Sudan faced escalating violence and outbreaks of disease. They have little or no access to healthcare.
Assisting victims of violence in southern Sudan
Escalating violence and disease outbreaks led MSF to launch several emergency interventions in southern Sudan in 2009. Medical needs, which were already at emergency levels in many parts of the country, increased dramatically during the course of the year as clashes between different communities left hundreds dead and thousands displaced. MSF led emergency interventions in Akobo, Torkej, Lekwongole, Panyangor, Duk Padiet and Terekeka. In the areas where MSF responded staff recorded that three times more people were killed than were wounded, and high numbers of women and children were affected. Surgical teams in Nasir and Leer performed more than 1,000 surgeries in 2009, more than half of which were for injuries caused by violence.
Throughout the year the Ugandan rebel group, the Lord’s Resistance Army, launched frequent attacks on villages near the borders of the Democratic Republic of Congo (DRC) and Central African Republic, and in DRC itself. These caused thousands of Sudanese people to flee their homes and Congolese refugees to cross the border to seek refuge in Western Equatoria State. MSF has been in this area since the end of 2008, and adapted its activities to meet the changing needs. Medical staff started to work in Ezo, Naandi, Yambio and Makpundu, providing assistance to around 45,000 people living in camps or integrated within host communities. In 2009 teams carried out 14,000 consultations and provided psychological support to more than 800 people in Western Equatoria. Materials such as plastic sheeting, jerry cans, blankets, pans and mosquito nets were distributed to nearly 1,000 families, and latrines and water points were installed in refugee camps in the area. In February MSF also launched an emergency response in Lasu, Central Equatoria State, providing medical care to more than 6,000 people.
Emergency medical needs
In October, there was a new outbreak of the deadly disease kala azar in Jonglei and Unity States. Teams had screened and treated more than 450 patients by end of the year.
These emergency interventions were in addition to medical care that MSF provides in its longer-term projects in southern Sudan. Throughout the year, 1,400 staff provided treatment and medical care to hundreds of thousands of people in seven states in southern Sudan and in the transitional area of Abyei. Nearly 435,000 people received care and more than 10,300 were admitted to MSF’s clinics. More than 62,400 women had antenatal consultations and 8,000 children were treated for malnutrition. More than 50,000 people suffering from malaria were treated and 130,600 people were vaccinated.
Humanitarian access reduced
Access to healthcare for people in the Darfur region of western Sudan was difficult in 2009, especially following the expulsion by Sudanese authorities of 13 international aid agencies – including two sections of MSF. Shortly after the expulsions, four MSF staff were kidnapped in Serif Umra, North Darfur. They were released unharmed after a few days, but these kidnappings, the first of their kind in Darfur, marked the start of a spate of kidnappings in the region: 14 people had been abducted by the end of the year. This increased risk forced many of the remaining aid agencies to scale back their activities in parts of Darfur.
More than half of MSF’s programs were forced to close as a result of the expulsions. Two more projects in Serif Umra and Kebkabiya in North Darfur, and activities in Tawila, also in North Darfur, were suspended. MSF nonetheless provided nearly 129,000 consultations, more than 24,000 antenatal consultations, admitted nearly 2,000 people to hospital and treated some 4,000 people for malaria throughout the year. Teams handed over projects in Golo and Killin to the Ministry of Health in October, and in the same month were able to restart activities in Tawila. At the end of the year, MSF started working in a remote area of North Darfur, Um Baru, providing medical support to five rural health centers that care for very isolated communities.
In the city of Port Sudan, in the northeast of the country, MSF continued to provide reproductive healthcare in Tagadom Hospital. More than 13,500 women received antenatal consultations and 1,000 women received help giving birth. MSF operates a zero-tolerance policy on any type of female circumcision. It is estimated that more than 97 per cent of women in the state are circumcised. This procedure causes serious medical complications for many women throughout their lives. MSF does not re-stitch or re-infibulate women following delivery or at any other time.
Kala azar patient, MSF clinic in Pibor, Jonglei State
‘I have been sick for months ... I waited two months before coming to the clinic. I was shivering and sweating, I had fever and was weak. Before I found out it was kala azar, I just felt like I was crazy. I didn’t recognize people, and I just wanted to be alone. But now I feel better. I recognize my family, I recognize everybody. I am able to walk again.’
Woman from Burmath, Jonglei State, May 2009
‘There were so many people who came to attack – all with guns. They burned the area and took the young girls, but not the boys: they killed them. Normally, they only deal with the men, but this time they killed the women and children. I am crying because we are not protected and our children are abducted or wounded. That wasn’t the first time we were attacked but it was the first time it was like that.’
MSF has worked in Sudan since 1979.