South Sudan: desperate struggle for health care in world's newest nation

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 Red Cross 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 Red Cross 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  July 9, 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.

Posted:  July 11, 2012