MSF Focus on South Sudan

OUR COVID-19 RESPONSE IN SOUTH SUDAN

As of May 19, 290 people have tested positive for COVID-19 in South Sudan, including two in MSF facilities.

In the Bentiu Protection of Civilians (POC) camp, MSF has set up a holding and transit facility to look after COVID-19 patients until they are able to be transferred to the isolation and treatment centre.

Since March, in addition to preparedness activities in all MSF project locations, MSF has been assisting South Sudan’s Ministry of Health in training healthcare workers in infection prevention and control measures, as well as triage for symptoms consistent with COVID-19. In Juba, MSF has also been installing handwashing points in areas busy with foot traffic such as hospitals and healthcare centres, an internally displaced persons camp in Gumbo, and Konyo Konyo, the main market area. Fourteen handwashing points are now active in Konyo Konyo and Cemetery, and over 50 healthcare workers have been trained on infection prevention control measures and triage related to COVID-19 in six health facilities.

In Agok, staff are preparing a ward for COVID-19 patients in the MSF hospital. In Old Fangak work is continuing to set up a 10-bed COVID-19 centre.

“This sharp increase in COVID-19 patients is very worrying. What is even more concerning is that now COVID-19 has started spreading among the population of some of the largest and most congested displaced persons camps in the country.

Tens of thousands of people living in the Protection of Civilian sites in South Sudan, such as Bentiu or Malakal, face a precarious existence in an overcrowded environment, living in dire conditions with flimsy small shelters where up to 12 family members live together, and with poor access to water and soap. Maintaining physical distance and adequate hygiene levels in these settings is nearly impossible.

If we add the fact that many people – not only in the camps but around the country in general – are at a higher risk not only due to poor living conditions, but also potentially due to co-morbidities such as malnutrition, respiratory tract infections, malaria, tuberculosis and HIV, it is easy to see how the spread of COVID-19 could have catastrophic consequences in South Sudan.

The pandemic is having a significant impact on our ability to provide key lifesaving services. Other diseases, as well as conflict and violence, have not been put on hold because of COVID-19. Malaria, measles, pneumonia and acute watery diarrhoea still kill tens of thousands of people, chronic patients continue to need medication, war wounded need surgery and mothers are still delivering babies every day. Just now, a resurgence of violence around Yei, in the south of the country, has caused the displacement of around 12,000 people.

With active transmission of COVID-19 in the area, addressing their needs while keeping our staff safe with the global shortage of surgical masks and other personal protective equipment, becomes very challenging. We fear this kind of situation will become more and more common as the virus spreads across the country.”

Claudio Miglietta

MSF Head of Mission in South Sudan

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South Sudan gained independence from Sudan in 2011 as the outcome of a 2005 peace deal that ended Africa’s longest civil war. However, since December 2013, conflict in South Sudan has resulted in extreme violence, mass displacement, and the deaths of tens of thousands of people.

Médecins Sans Frontières has been operating in the area that now constitutes South Sudan for more than 30 years, responding to conflicts, neglected diseases and assisting with healthcare infrastructure.

MSF teams provide basic and specialised healthcare in hospitals and clinics throughout the country. Our teams are constantly on the move to provide displaced people with medical care, and to offer support to healthcare programs and organisations, such as International Medical Corps, South Sudan Red Cross, and Health Link South Sudan.

We also provide much-needed medical and mental health care in Protection of Civilians (PoC) camps, where hundreds of thousands of people remain trapped in hostile and deplorable conditions.

Conflict response

Medical care has come under attack time and again in South Sudan, with patients shot in their beds, wards burned to the ground and medical equipment stolen. Hundreds of thousands of people have been denied lifesaving assistance because of these acts.

Our South Sudanese staff have continued to care for patients while hiding from violence. Since the beginning of the crisis in South Sudan, MSF has called on all parties to respect medical facilities, and to allow aid organisations to access affected communities.

A child walks on mud and urine next to the latrines in the Protection of Civilians (PoC) site in Malakal, one of the most crowded PoC camp in South Sudan. In some areas, the density in this camp is around 9 square metres per person, which is significantly below UN standards (30 square metres per person). © Gonzalez Farran / MSF

Healthcare response in rural South Sudan

Medical care is practically non-existent for people living in remote areas of South Sudan, even those spared from much of the violence associated with the war. We run hospitals and clinics and support existing state facilities, with particular focus on maternal, paediatric and neonatal care, and outbreak response. MSF also set up a system in which South Sudanese staff travel with displaced people to provide medical care, including for victims of sexual violence.

Malaria is one of the leading causes of illness and death in South Sudan, especially among children. In cooperation with the Ministry of Health, MSF teams assist in outbreak response, mass vaccination campaigns, and direct treatment. We train community healthcare workers, run outreach and preventive activities such as vaccination campaigns. MSF staff respond to cholera outbreaks, by setting up treatment centres and field hospitals, and support remote communities with decentralised care.

The normal practice in this area is for women to deliver at home with a traditional birth attendant, and this might mean they don't receive proper antenatal care and that complications are not anticipated. We work a lot in the community to encourage women to receive prenatal care and deliver in the hospital, because it is safer for the mother and the baby... It's important to engage with communities in these hard-to-reach areas.

Dr. Adi Nadimpalli

MSF Medical Coordinator for South Sudan

Access to health care is extremely limited in South Sudan, and MSF's hospital in Old Fangak is often the only place people in the region can receive treatment for serious medical conditions. Patients often have to walk for several hours on foot, and travel through harsh weather to reach the hospital from remote villages. The distance and long journey makes it especially difficult for patients with emergency needs, including women with complications during childbirth.

MSF staff carry out emergency nutritional interventions in response to reports of alarming levels of malnutrition, especially in Mayendit and Leer counties. We also treat the parasitic disease visceral leishmaniasis (also known as kala azar), which is transmitted by sandflies and has a 95% mortality rate if left untreated.

The small rural village of Old Fangak has become a refuge for thousands of people fleeing fighting along the Nile since 2014. Despite the many challenges that patients and medical workers face in this environment, the hospital here remains the best hope for many people with serious conditions. © Noy / MSF

Sudanese Refugees

MSF continues to provide healthcare to people within United Nations Protection of Civilians (PoC) sites. These sites were set up as a temporary solution for people fleeing violence in December 2013, but in the years since, hundreds of thousands remain trapped in the hostile camps, exposed to poor sanitation and hazardous living conditions.

MSF staff provide medical care, surgical services, and support for victims of sexual and gender-based violence.

MSF continues to work in camps for Sudanese refugees in several regions, managing inpatient departments, an inpatient feeding centre, a neonatal unit and coordinating treatment for HIV and tuberculosis (TB).

Find out more about South Sudan

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South Sudan