Insecurity, Poor Roads and Funding Main Challenges to Providing Medical Assistance to Returnees and Displaced in South Sudan

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IOM medical teams in South Sudan’s Western Equatoria State (WES) are braving insecurity to provide badly needed medical services to groups of Internally Displaced Persons (IDPs) who have little or no access to health care facilities.
The teams have been travelling long distances on poor roads to reach the displaced in WES, which borders the Democratic Republic of the Congo (DRC) and the Central African Republic (CAR), where militias of the Lord’s Resistance Army (LRA) often cross over the border to carry out raids.

The IDPs had fled their homes in 2008 because of LRA frequent attacks on their villages. Many villagers in Southern Sudan have been killed or wounded by the LRA in the past two years.

The organization is one of few agencies providing health care services in WES since 2008.

The IOM teams are carrying out primary health care services with average of 80 IDPs attending the mobile clinics per day, many of them suffering from respiratory infections, malaria, dysentery, skin infections and malnutrition.

In order to provide regular access to health care particularly for IDPs in hard to reach locations, IOM is now considering setting up fixed clinics in different sites to replace the mobile clinics which currently provide services to Yambio, Nzara, Tambura and Ezo counties. Fixed clinics should reduce security risks on the health workers during long distance journeys and improve the provision of health services.

IOM operates mobile clinics in IDP camps and returnee transit sites in five states of South Sudan: Western Equatoria, Central Equatoria, Warrap, Upper Nile, and Western Bahr el Ghazal.

If insecurity, remoteness and lack of roads are the main challenges in WES, in Upper Nile State it is the sheer numbers of those who seek medical services that overwhelm the small contingent of eight medical staff.

IOM mobile clinic at Renk in the Upper Nile state operates on daily basis to provide urgently needed consultations and treatment to thousands of returnees who have been stranded in the town for more than six months for lack of transport to their villages in the south.

The clinic receives up to 80 returnees per day, including pregnant women, children and persons living with disabilities. The returnees, who were living in the outskirts of Sudan’s capital, Khartoum, many of them for several years, decided to return to the South following the signing of the comprehensive peace agreement and the subsequent independence of the South in July this year.

IOM in collaboration with WHO and State Ministries of Health and other health cluster partners provide basic health care services including prenatal care and immunizations, facilitate health referrals, travel health assistance including fitness-to-travel health checks and health education/health promotion activities.

The IOM health staff, who work at the IOM clinic located in the camp say the number of people seeking consultations has been reduced markedly following improvements in the provision of medical services and increased WASH activities such as the provision of safe water, the digging of latrines and waste management. However, malaria cases are still prevalent and continue to pose a health risk particularly to babies and minors.

In Wau, the capital of Western Bahr al Ghazal, which has recently witnessed an influx of persons displaced by the violence in the neighbouring Abyei region, the IOM clinic receives 50 consultation cases per day on average. This is a slight reduction from the numbers at the peak of the influx as many displaced persons have started to return to their homes in Abyei.

IOM is in negotiations with Wau State Ministry of Health to allow the organization to set up a health centre near to where most former displaced persons are located. The measure is necessary because there are no medical services at all in those areas.

IOM has requested funds to set up a badly needed HIV prevention, care and support unit for IDPs and host communities. HIV/AIDS is a major concern in WES with 10 per cent prevalence which is the highest in Republic of South Sudan.

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