Sudan: "Insecurity Remains a Reality" in the South

A longtime MSF staff member and native of southern Sudan gives his impressions of the region after its people voted overwhelmingly for independence.

With almost 99 percent of the southern Sudanese population voting for secession from North Sudan, the newest country of the world is expected to become officially independent in July 2011. But at such a pivotal time and amidst the hope for a better future, the humanitarian situation in southern Sudan remains precarious at best. Moses Chol Maper, a medical technician and the emergency coordinator for Doctors Without Borders/Médecins Sans Frontières (MSF) in southern Sudan, gives his perspective:

There are big hopes now that the referendum for independence has taken place. Like most people here, I am happy with the result. I am from Lakes State and the civil war has been present almost my whole life. Now I am slightly optimistic. There are so many open questions however. Abyei, the oil-rich region disputed between the North and the South is still a tinderbox. If the peace agreement is broken, violence can escalate very quickly. Insecurity remains a reality and we have to be prepared for that.

I have been working with MSF for almost 13 years, most of the time here in my home country. I know well the effects of instability, displacement, poverty and the lack of infrastructure. And now, in addition to that, many southern Sudanese people who had fled to the North and neighboring countries are now returning to places where there are not enough basic services, where the roads, if they exist, are bad, where there is no work, not enough schools, and limited health care. According to figures from the UN, more than 190, 000 people returned between October 2010 and the end of January 2011.

In terms of the medical sector, statistics are dramatic: it is estimated that 75 percent of people in southern Sudan have no access to basic medical care. The few health centers or hospitals are just too far away and transportation is often too expensive and unaffordable to a population where 90 percent live on less than $1 dollar per day. Moreover, during the rainy season, many regions are very hard to reach. I know of many patients who have come to our clinics after weeks or even months of being sick. The local authorities do not have enough resources and capacity to deliver the services and without organizations like MSF, the situation would be even worse.

Far too many people in Southern Sudan die of diseases like diarrhea or malaria. Many children and adults do not have enough to eat. When they have to flee from insecurity, they may not have safe drinking water and are more vulnerable to diseases. Last year, our emergency team had to respond to a massive increase of malnutrition in Unity State. In 2010, we also experienced a very high prevalence of Kala Azar, a neglected, tropical disease that is often deadly if not treated. We saw eight times the number of cases than [we had seen] the previous year

“Without your help we would not be alive.” These are words I have heard from our patients several times. But our work will also be at risk if fighting increases, as we can only treat people who manage to get to our clinics or those we have the access to reach. The insecurity can make it impossible for many patients to get help. If violence increases, we will have to adapt our work accordingly. I hope we will still be able to help many people. In spite of all difficulties, I am very happy to work here and have the chance to contribute to improving the situation for some people.

MSF has been providing emergency medical-humanitarian assistance in Sudan since 1979. Currently, MSF runs 13 projects across 7 states of southern Sudan, providing a range of services, including primary and secondary health care, responding to emergencies as they arise, nutritional support, reproductive health care, kala azar treatment, counseling services, surgery, pediatric and obstetric care.