Geneva, Switzerland — One year after South Sudan declared independence, many humanitarian needs remain unmet. Communities lack access to basic health-care services. The situation is particularly difficult in northern regions close to the border with Sudan. Recent fighting in this area has had a direct impact on the availability and price of food, contributing to an increase in child deaths from malnutrition.

“In Malakal Teaching Hospital, there has been a dramatic rise in child malnutrition admissions over the past three months, since fighting escalated,” said Melker Mabeck, the head of the delegation of the International Committee of the Red Cross (ICRC) in South Sudan. “Children are also arriving in a much worse condition.”

People in South Sudan have very poor access to health care. There is a shortage of facilities and skilled health workers and a limited supply of drugs and equipment. According to the Ministry of Health, South Sudan has about 120 medical doctors and just over 100 registered nurses for an estimated population of nearly nine million people.

This falls far below the doctor-patient ratio in neighbouring Kenya, for instance, where there are 14 doctors per 100,000 people, 10 times the ratio of South Sudan, according to World Health Organization statistics from 2006. Vulnerable groups like women, children, and the wounded are particularly at risk. South Sudan has the highest maternal mortality rate in the world.

In addition, the country is prone to diseases, with meningitis, measles, yellow fever, and whooping cough endemic in many areas. Preventable diseases such as malaria and acute respiratory infections are the leading causes of ill health. River blindness, sleeping sickness, and cholera are also common.

Another issue is the estimated 50,000 people in the country with physical disabilities, which are often due to injuries sustained in connection with the armed conflict. Landmines, already common in the pre-independence armed conflict between the north and the south, are still used today.

Together with the South Sudanese government, the ICRC manages a physical rehabilitation centre in Juba, the only one of its kind in the country. “A significant proportion of amputees are victims of landmines or unexploded ordnance left behind after clashes,” said Gerd Van de Velde, an ICRC project manager at the centre. “The rehabilitation work we do here gives these people a chance to rebuild a productive life.”

The ICRC also provides support for health-care facilities, such as Malakal Teaching Hospital. As the only referral hospital for Unity, Jonglei and Upper Nile states, the hospital has a vast catchment area of approximately three million inhabitants. Landmines are an issue in the area, much of which is almost entirely cut off during the rainy season that has just started. An ICRC medical team based in the hospital provides paediatric and physiotherapy along with trauma and emergency surgical care. It also delivers on-the-job training for hospital staff.

The ICRC’s operations in southern Sudan began in 1986. The organization set up a delegation in South Sudan’s biggest city, Juba, when the country became independent on 9 July 2011. The ICRC also has two sub-delegations in the new country, in Malakal and Wau. In South Sudan, the ICRC works to prevent violations of international humanitarian law and helps conflict-affected communities to survive and become self-sufficient.

A three-part series showing the struggle for health care in South Sudan released on Eurovision News Feeds and on www.icrcvideonewsroom.org:

South Sudan: facts and figures

Between July 2011 and June 2012:

● the ICRC surgical team in Malakal Teaching Hospital performed emergency surgery on more than 750 patients. Over half of the patients suffered from weapon-related injuries;

● 450 people wounded during clashes were treated using medical supplies and drugs donated by the ICRC to 10 hospitals and several first-aid posts;

● over 2,000 physically disabled people received treatment through ICRC-supported physical rehabilitation services. More than 400 artificial limbs were fitted for amputees, while hundreds of orthotic devices, wheelchairs, and crutches and sticks were also delivered. Just over 1,000 patients also benefited from physical therapy services. Approximately 30 per cent of the amputees to whom the ICRC has delivered artificial limbs since 2008 were victims of landmine accidents.

Image Courtesy of   United Nations Photo

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As the situation worsens in the Sahel, the International Committee of the Red Cross (ICRC) is appealing for 12.3 million Swiss francs (about 10 million euros) in order to bring aid to some 700,000 people in Mali and Niger and thereby help forestall a major humanitarian crisis in the two countries.

“People in Mali and Niger are facing a twofold crisis: the food insecurity that has afflicted the entire region, and the fighting in the north of Mali that is driving massive displacement,” said Boris Michel, the ICRC’s head of operations for North and West Africa.

The armed confrontations that have occurred in northern Mali in recent weeks have forced tens of thousands of people to flee their homes in utter destitution and to seek refuge either within Mali, as at least 60,000 people have done, or in neighbouring countries. Those who have fled to Niger are concentrated in the northern Tillabéry region, one of the areas hardest hit by the food crisis and the scene of recent inter-community violence.

“The fighting has resulted in casualties. In addition, people have been taken captive and families have been dispersed,” said Mr Michel. The ICRC’s priorities are to visit people detained in connection with the fighting and to provide care for the wounded either directly, through the Mali Red Cross or by supporting health-care facilities.

“We also plan to continue to provide aid for displaced people,” added Mr Michel. “We are preparing to distribute food to 84,000 people and emergency supplies to around 60,000. Shelter, clean drinking water, hygiene items and health care will also be made available as needed.”

The fighting in northern Mali is further straining a part of the Sahel already hard hit by a lack of rainfall and by recurrent food crises. “The shortfall in agricultural production and the lack of feed for the livestock are affecting countless families of farmers and herders in Mali and Niger,” said Mr Michel. “Some of them were never able to recover from the effects of the crisis of two years ago. Their situation is particularly difficult.”

The aid that the ICRC plans to provide is intended for people in the Kidal, Gao and Tombouctou areas in the north of Mali, and in the Tillabéry and Agadez areas of Niger. “What we are striving to achieve is not only to save lives but also to provide support for the people’s own resilience,” said Mr Michel.

Accordingly, the plan includes distributing food to over 240,000 people, buying livestock at a reasonable price to preserve the livelihood of 120,000 nomads, and distributing seed to increase the productive capacity of 90,000 farmers. The funds requested will be additional to the 22.3 million Swiss francs (approximately 18.3 million euros) initially budgeted for 2012.

In addition to the emergency actions it is taking in Mali and Niger, the ICRC conducts longer-term activities in the two countries, in particular to help detainees and to improve economic security, access to water and health care. The ICRC has been performing its humanitarian tasks in the region in close cooperation with the Mali Red Cross and the Red Cross Society of Niger since 2009.

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