Following the expulsion of the Dutch and French sections of Doctors Without Borders/Médecins Sans Frontières (MSF) by the Sudanese government in March 2009, three MSF sections continue working in Northern Sudan, in the western region of Darfur, Al-Gedaref State, and the Red Sea State. Today, MSF provides a range of services, including primary and secondary healthcare, as well as responding to emergencies as they arise. Security remains a pressing issue in Darfur, as banditry, sporadic clashes and bombing between different groups, and kidnappings of aid workers continue to occur. Currently, MSF has a total of 32 international staff, 479 national staff, and 52 Sudanese Ministry of Health staff working in its projects.
In North Darfur, MSF is working in four locations: Shangil Tobaya, Tawila, Dar Zaghawa, and Kaguro. In spite of security difficulties, in Shangil Tobaya MSF’s hospital continues to provide primary and secondary health care, including pediatric and reproductive healthcare, and counseling services. The hospital is providing medical services for 52,000 people, among them internally displaced persons (IDPs) living in the Shangil Tobaya and Shadat Camps, along with residents of surrounding villages. Patients include residents of Khazan Jadeed, a town that is 50 km (30 miles) away from the hospital.
On average, MSF provides between 3,000 and 4,000 medical consultations per month. In addition, four community health workers travel daily on donkeys to neighboring villages that do not have access to medical services. These teams provide nutritional screening, basic health and hygiene trainings, as well as follow-up with patients, as MSF is always looking for ways to expand its services and reach more people.
In late October and particularly in late December, MSF provided support to newly displaced people following violence in Sheiria Locality in South Darfur. Almost 3,000 families have been displaced from their original villages to three different areas: Um Deressaya, Shangil Tobaya, and Dar El-Salam. MSF has responded to their critical humanitarian needs through non-food item distributions, provision of water, latrines, mobile clinics, psychosocial support, and a vaccination campaign.
In Tawila, major improvements in security mean that MSF has been able to resume its work in the area. The ministry of health hospital in this part of Darfur serves 40,000 people, who are living in the three IDP camps in Tawila: Rwanda, Dali, and Argo, along with local residents. In October, MSF restarted its activities in Tawila by providing supplies of medicine and medical equipment to the ministry of health clinic in Rwanda camp. There has been a three-fold increase in the number of daily outpatient department consultations, with approximately 250 to 350 consultations per day. Services provided by MSF include primary and secondary healthcare, sexual and reproductive healthcare, a comprehensive nutrition program, as well as psychosocial support.
MSF also provides training, capacity-building, and supervision of ministry of health personnel, and MSF staff to support clinical activities, as well as the payment of incentives. MSF has started rehabilitating an old ministry of health clinic which was destroyed during the fighting. As soon as this work is completed medical services will be transferred to this facility. Until the security situation in Shangil Tobaya and Tawila improves, MSF will continue to run these projects with international staff based in El-Fashir visiting twice a week.
In January, MSF began supporting five health centers: Umm Baru, Umm Haraz, Jurageem, Muzbat, and Furawiya, which are located in Dar Zaghawa, an area in northwestern Darfur close to the Sudan-Chad border, which has been prone to conflict. MSF supports the five health centers with incentives, drug supply, ambulatory nutritional support, training, and capacity-building. MSF will preposition emergency stocks to quickly support humanitarian needs in Dar Zaghawa.
When three MSF staff members were kidnapped in Serif Umra in March, MSF closed its projects in Serif Umra and Kebkabiya, evacuated all of the international staff, and relocated Sudanese staff from its project in the Kaguro area of the Jebel Si. For a period of five months, local staff from Kaguro continued working in the MSF clinic and provided an average of 1,420 outpatient consultations every month. However, in August a team of international and relocated staff was able to return to Kaguro and resume activities.
Currently in Kaguro MSF runs a rural hospital providing the following services: outpatient department, inpatient department, extended immunization program, ambulatory therapeutic feeding center, inpatient therapeutic feeding center and stabilization unit, and a women’s health clinic. MSF also runs five health posts in the isolated mountain villages of Burgo, Bourey, Lugo, Useige, and Bouley. At these health posts MSF teams provide primary healthcare. MSF is the only provider of health care in Kaguro and has been working there since 2005. On average, MSF provides 3,012 outpatient consultations per month.
In October 2009, MSF closed its project in the towns of Golo and Killin, located in Jebel Marra where 27,700 people reside. MSF was supporting the local hospital in Golo through the provision of primary and secondary healthcare, obstetric and nutritional care. In Killin, MSF contributed to the town’s hospital by providing primary healthcare, outpatient nutritional program, antenatal care, and post-natal care. The ministry of health will take over MSF’s previous work.
In January 2010, MSF opened in collaboration with the Sudanese Ministry of Health a kala azar treatment project in Tabarak Allah, a village in the Atbara region in Al-Gedaref state where the disease is endemic. MSF and the ministry of health will work together to improve the diagnosis and treatment of kala azar in the area.
Red Sea State
In northeastern Sudan in the city of Port Sudan, the capital of Red Sea State, MSF continues to provide reproductive healthcare in Tagodom hospital. MSF provides ante- and post-natal care, gynecology services, deliveries, and reproductive health consultations. Approximately 97.6 percent of the women in Port Sudan have undergone some form of circumcision, resulting in a variety of serious medical and obstetrical complications. The MSF project in Tagodom hospital has a “zero-tolerance” policy on any type of female circumcision for pregnant women. Thus, women who come to give birth in the hospital are de-infibulated before delivery and are not re-infibulated after the delivery. MSF community health workers also raise awareness about the harmful effects of female circumcision.