Medical humanitarian emergencies persisted throughout 2009 in several parts of Sudan. In addition to the ongoing crisis in Darfur, people in southern Sudan faced a deteriorating situation marked by escalating violence, disease outbreaks, and little or no access to health care.
Nearly five years after the Comprehensive Peace Agreement (CPA) ended a brutal, decades-long civil war, medical needs throughout southern Sudan remain at urgent levels, and escalating tensions are creating a precarious security situation. Violent inter-communal clashes in Jonglei, Upper Nile, Warrap and Lakes states throughout the year have left hundreds dead and thousands displaced. Sporadic attacks on villages by the Ugandan rebel group, the Lord’s Resistance Army (LRA), near the Congolese border and also in Democratic Republic of the Congo (DRC) itself, caused thousands of Sudanese people to flee their homes and Congolese refugees to cross the border and seek refuge in Western Equatoria state.
These increasing levels of violence in the south occur against a backdrop of people dealing with the devastating consequences of a civil war that ended in 2005. Today, almost three-quarters of the population have no access to even the most basic health care services. Throughout the year, MSF’s 1,200 field staff in southern Sudan treated thousands for malnutrition, malaria, and tuberculosis, and provided a wide range of obstetric-gynecological care in several parts of the country. Outbreaks of meningitis, measles, cholera, and malaria are common, and MSF teams responded in 2009 to cholera in Northern Bahr-el-Ghazal, Jonglei, and Warrap states, and in the capital Juba. MSF is also responding to an outbreak of kala azar—a fatal, if untreated, parasitic disease— in Jonglei and Upper Nile states.
People in Darfur also face a precarious situation. Millions of people remain internally displaced and require outside assistance, while sporadic war-related violence and clashes over resources continued to inflict a human toll throughout the year. Providing food, water, and health care for Darfuris became much more difficult following the expulsion by Sudanese authorities of 13 international aid agencies– including two sections of MSF—and three Sudanese organizations in the wake of the International Criminal Court’s indictment of Sudanese President Omar Al-Bashir for war crimes and crimes against humanity. Since the creation of the ICC, all MSF sections have adopted a binding internal policy refraining from any cooperation with the ICC. This policy is based on the recognition that humanitarian activities must remain independent from risk of political and judicial pressure in order to be able to provide medical assistance to populations in situations of violence.
Remaining aid workers struggle to provide meaningful humanitarian assistance to those in need in an atmosphere where general insecurity and kidnappings targeting aid workers reduce their ability to assess new needs, particularly in rural areas often cut-off from assistance, and respond to ongoing needs of the nearly 2 million people remaining in camps for internally displaced persons. MSF remains fully committed to impartial medical assistance and currently works in several locations in Darfur.