While the world is interested in Southern Sudan’s political situation ahead of the referendum on self-determination on Jan. 9, the region is in the midst of a humanitarian and medical crisis. More than 75 per cent of people living there do not have access to basic healthcare. Upon his return from Abyei and Agok, Laurent Ligozat, deputy director of operations for Médecins Sans Frontières (MSF), offers his thoughts.   Why did MSF decide to intervene in Abyei and Agok? When we arrived there in April 2006, we knew we could help given the scope of the need and the eventuality of treating survivors of violence. In May 2008 the people of Abyei fled following clashes between the Sudan People’s Liberation Army (SPLA) and the Sudanese army. With thousands of people displaced, MSF pulled back to Agok, a town farther south, where we put together an 80-bed hospital with an operating unit and where we treated dozens of war wounded. In Abyei an MSF clinic that is open during the day offers basic health services on an outpatient basis. The medical teams are watching closely for any changes in the level of need. MSF can increase its presence in Abyei depending on what happens in the future. In 2010, the teams overseeing these two projects conducted 49,733 outpatient consultations, saw more than 6,189 pregnant women for prenatal consultations, treated 2,723 children and screened 15,317 others suffering from malnutrition in MSF facilities.


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Southern Sudan is grappling with a major health emergency: malnutrition is chronic, there are recurrent epidemics, and curable diseases are too often deadly. People are being forced to flee their homes because of the violence, and many have died.

What types of care do MSF medical teams provide? MSF offers essential, basic care for free to people here because health care services in the Abyei region are limited and uncertain. The hospital run by the Ministry of Health operates with few trained medical and paramedical staff and has an insufficient supply of medicines. As is always the case in similar situations, women and children are the first to be affected. The infant death rate as well as the death rate for women during childbirth are terrible. MSF’s intervention, which brought trained staff, quality medicines, and free primary and secondary care, had an impact on the most vulnerable groups. In Abyei and Agok MSF provides maternity services, pediatric care, and general medicine. We also treat malnourished children under age five. In the Abyei region, an area contested by the north and south, the people are on the front lines. Emergency preparedness plans are currently being implemented by our teams of workers in the field to respond to both the flood of wounded and people displacements. Whatever the outcome of the referendum, access to care remains a priority in Abyei.

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MSF has been working in the Abyei region since April 2006, providing lifesaving medical care. The team runs an 80-bed hospital in Agok, a small town in the south of the region, as well as a clinic in the town of Abyei which is open seven days a week. How would you assess the humanitarian and medical situation in Southern Sudan? For many years Southern Sudan has been confronting a humanitarian and medical crisis characterized by a significant lack of access to healthcare, chronic malnutrition, regular epidemics, avoidable epidemics, and insecurity that has led to people being displaced. Southern Sudan is emerging from 40 years of almost uninterrupted conflict. In this healthcare desert, the Sudanese are dying of malaria, respiratory infections, or simply diarrhea – all diseases easily cured if access to care wasn’t so difficult. Our teams try to better respond to people’s most urgent needs, whether they be food, shelter or healthcare. Leading up to the referendum, the return of tens of thousands of people from Southern Sudan, who were refugees in the north or in neighbouring countries, is also of concern. These people are going to be exposed to diseases that are endemic to Southern Sudan, such as malaria, measles, meningitis and tuberculosis. Managing the return of these displaced people will be an additional challenge for this region, where resources are already very limited, whether it’s food, drinking water or healthcare. Finally, we can’t forget insecurity, which is omnipresent in Southern Sudan. In 2010 the violence led to more than 900 deaths and 215,000 people being displaced.   What is the situation in Abyei and Agok? Uncertainty reigns in the Abyei region. The people here have to decide whether to join Southern Sudan or North Sudan in a separate referendum scheduled for Jan. 9 but just postponed to a later date. With the deadline nearing, tensions are high between the ethnic Dinka Ngok and the Misseriya. In recent weeks MSF has set up a support base in Turalei, two hours farther south of Agok by road. Surgical supplies have been put in position, and a team is ready to leave. We have also recruited doctors, surgeons and anesthesiologists. In the event of people being displaced, tents, basic supplies and equipment for transporting and purifying water have also been readied.
© Kate Geraghty/Fairfax Media
In 2008, the town of Abyei was almost totally destroyed by fighting between the Sudan People’s Liberation Army and government forces. The burnt remains of buildings serve as a reminder of these tragic events.   What have MSF teams in the area observed? For the moment it’s quiet. Nevertheless, our teams in Abyei are seeing trucks and buses full of returnees with their belongings. Tens of thousands of people are returning to their home villages in Southern Sudan. Some of these people are being helped by Southern Sudanese officials, who are organizing their return and aiding them when they arrive. Many of them were born in Khartoum and have never set foot in Southern Sudan. Nearly 10,000 people have already returned to the Abyei region, but most of the returnees continue further south to their home villages, especially in the states of Warrap and Northern Bahr el Ghazal, and even to the city of Juba. Since the peace agreement was signed in 2005, the city of Juba, which would become the capital of Southern Sudan in the event of independence, has gone from 150,000 people to at least 600,000 today. No one knows for certain. Underequipped and lacking qualified staff, the city’s only two civilian hospitals are unable to meet the needs. The situation will be all the more serious since Juba’s new residents, who migrated from the countryside or who returned from North Sudan, are poor. Right now these vulnerable people don’t have access to medical care. MSF is examining the possibility of opening a new healthcare facility.   How do the various communities of Abyei view MSF? Right now the tension among the communities is such that we can no longer access the area north of Abyei with our mobile clinics from the city. Our constant concern is to provide basic care to all the communities in region. Given this situation, MSF’s role is crucial: to provide aid and medical care to Sudanese in need, and to promote independent humanitarian action. It is essential we maintain our independence toward all parties in order to have access to the most vulnerable civilian populations no matter what their origin, gender, or religion.   MSF has been working in Sudan since 1979, providing people with emergency medical and humanitarian aid. MSF currently oversees 27 projects in 13 Sudanese states. The organization offers a wide range of services and runs a multitude of programs: primary and secondary healthcare, emergency response, nutritional aid, reproductive healthcare, treatment for the disease kala azar, and psychological, surgical, pediatric and obstetric care.

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