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MSF in Sudan, 2011
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In Sudan, Doctors Without Borders/Médecins Sans Frontières (MSF) concentrates on providing medical assistance for people living in conflict zones and in remote regions with poor access to healthcare, and on treating kala azar (visceral leishmaniasis).
Bureaucratic constraints, however, continue to hamper the provision of high-quality healthcare in some areas. MSF has made repeated offers to set up medical services in the states of Blue Nile and South Kordofan, where violence is rife, but these have been declined.
Since 2010, MSF has been running a program in collaboration with the Ministry of Health to treat kala azar, an under-researched disease that is fatal if left untreated. Kala azar is endemic around the Atbara river area in Al Gedaref state, eastern Sudan. Last year, 3,090 people were screened for the disease and 729 patients who tested positive were treated in Tabarak Allah hospital. As Tabarak Allah hospital treats so many kala azar patients, it is one of the few locations where operational research into this neglected disease can be conducted.
In July, the team introduced a new regime, developed by the Drugs for Neglected Diseases initiative (DNDi) and Sudanese scientists, which reduced the duration of treatment from 30 to 17 days. MSF also supported hospital staff in providing free treatment to more than 19,600 patients with other conditions. At the end of the year, a decision was made to expand the program to nearby Sennar state, and a new program was opened in November.
Sporadic fighting and banditry continue in Darfur, making it difficult to reach those in need of medical care. Many people who have fled violence are still unable to return to their home villages. In 2011, MSF maintained five medical programs, despite insecurity and bureaucratic difficulties that forced international staff to limit their presence to short ‘flash visits’ to train, assist and ensure standards of medical care.
In South Darfur, after an assessment in the Shaeria area, a nutrition program was opened in March and 469 children received treatment. Against a background of intercommunal tensions, it quickly became apparent that there were wider needs for support to the hospital and surrounding abandoned rural clinics. MSF set up a comprehensive program to support the Ministry of Health in Shaeria. The team started treating patients in early 2012.
Across North Darfur state, MSF carried out more than 150,000 outpatient consultations. MSF’s hospital in Shangil Tobaya provides both basic and specialist healthcare, including pediatric, reproductive and counseling services, and operates a mobile clinic by donkey to neighboring villages that do not have access to medical care.
The team in Tawila works with the local health facilities to provide comprehensive healthcare, including 24-hour emergency services, for the local community and the inhabitants of three camps for displaced people. In Abushok and Al Salam camps, near the state capital of Al Fashir, MSF ran a therapeutic feeding program, treating more than 1,000 children on an outpatient basis and a further 239 inpatients between January and July, when the project was transferred to the Ministry of Health. In Dar Zaghawa, near the Sudan-Chad border, the team supports five health centers and responds to emergencies arising from outbreaks of violence.
MSF provided specialist healthcare and surgery in the hospital in Kaguro, an area held by opposition forces, as well as basic health services in five rural clinics. The team conducted more than 39,000 consultations and performed 119 major surgical procedures. However, difficulties in obtaining authorization to supply the program with drugs and other essentials are jeopardizing activities.
Response to other emergencies
Between November 2010 and March 2011, MSF supported the Ministry of Health’s response to extensive flooding in Marafit and surrounding areas in Red Sea state, close to the border with Eritrea. Staff distributed relief kits to 200 households and one ton of special nutritious food to approximately 1,500 children at risk of malnutrition. In June, after MSF had recorded high numbers of patients with measles, the team in Tabarak Allah hospital conducted a measles vaccination campaign with the national authorities. In total, 44,800 children were vaccinated and 620 were treated for measles.
At the end of 2011, MSF had 853 staff in Sudan. MSF has been working in the country since 1979.