Health Emergency in Bieh State, Southern Sudan

Valérie Batselaere/MSF
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MSF Responds

Nairobi, June 27, 2000 — The south Sudanese state of Bieh, in south-eastern Upper Nile on the border with Ethiopia, is being struck by several severe health and nutritional problems at once. The area is currently experiencing an exceptionally bad hunger period, exacerbated by a meningitis epidemic, outbreaks of shigella and a lack of health services. Continued insecurity and fighting between the various political factions in the region has led to population displacements, looting and cattle-raids, worsening the already tenuous situation.

The population of Bieh state, estimated at around 200,000, is generally without clean water or health services. The international medical aid organization Doctors Without Borders/Médecins Sans Frontières (MSF) is supporting several health structures in Akobo and Wanding districts. The next harvest is not until August/September, yet the earliest that the United Nations World Food Program (WFP) expects its food supplies to be en route to the region is at the end of July or the beginning of August. The success of the MSF intervention depends to a large degree on the capacity of the WFP to conduct general food distributions in the region.

"Since we've just entered the traditional hunger gap period, we expect the situation to get much worse. Immediate intervention is needed if we want to avoid an even bigger crisis," said Gareth Barrett, MSF's Head of Mission for the region.

MSF responded to a meningitis epidemic earlier this year, but diarrheal diseases and malaria are continuing to weaken the population. A recent MSF nutritional survey in Akobo showed that there are global malnutrition rates of 33.8% and severe malnutrition rates of 7.7% amongst children. The MSF primary health care center in Akobo is overloaded, with malnutrition, diarrhea, and malaria being the most frequently seen diseases.

"We expect the nutritional and health situation to be worse in the other districts of Bieh state, since there is more insecurity and there are no health services whatsoever in the area," said Barrett. "Access to the civilian population is also hampered by increased insecurity."

MSF's emergency team this week opened a therapeutic feeding center in Akobo with a capacity for 250 children, and supplementary feeding centers in Akobo, Birmath and Wanding. The team is now starting a massive measles vaccination campaign, combined with nutritional screening and medical assistance, with a target population of about 60,000 people. MSF is also reviewing the possibility of starting additional supplementary feeding programs in other locations.

The problem is not isolated to the Bieh State region. "Other areas like Western Upper Nile or Blue Nile also have little or no assistance. The essence of the problem is not so much drought as it is in the rest of the Horn of Africa, but a lack of health structures, a lack of access to the population, an increased insecurity and medical problems like measles, meningitis and shigella," said Erwin van der Borght, MSF's operational officer. MSF's emergency health and nutritional intervention is expected to continue at least until the end of November 2000.