News Roundup [abridged Versions Appear In The Paper Journal]

Charities say southern Sudan faces a health crisis and record malnutrition

BMJ 2003; 327 doi: (Published 23 October 2003) Cite this as: BMJ 2003;327:948
  1. Peter Moszynski
  1. Natinga, Sudan

    As hopes of an end to the 20 year civil war in Sudan were raised by new talks taking place in Kenya this week, charities reported that the health situation in the south was deteriorating.

    As Dr John Garang, leader of the Sudan People's Liberation Movement met Ali Osman Mohamed Taha, vice-president of Sudan, diplomats and analysts saod the prospects for peace have never been better. But observers from charities and non-governmental organisations said that the country was facing a whooping cough outbreak, many cases of preventable blindness and record malnutrition.

    An estimated 175 children have died of whooping cough during a recent outbreak in southern Sudan. Almost 1000 suspected cases have been seen so far, a spokesman for the charity Tearfund said last week. More than 850 cases have been confirmed. A mass treatment and prevention campaign is being carried out in several locations in Budi county.

    Eighty two of the infected children have also tested positive for malaria, said Medair, another non-governmental organisation that has contacts in southern Sudan. No non-governmental organisation has been present in the area for five years, and only one health facility is in operation, with limited medicines and no laboratory facilities.

    Ms Els Stamm of Medair said that children were facing an abnormally high risk of malaria because, in addition to the presence of chronic malaria in the area, the ongoing rains were bringing further mosquitoes and because health care was totally lacking.

    Also, the World Health Organization has put out a statement about the continuing risk of blindness. Extremely poor levels of hygiene, coupled with a lack of healthcare facilities, drugs, and trained personnel, were contributing to “widespread preventable blindness,” a spokesman said.

    All the leading causes of preventable blindness, such as trachoma, river blindness, and cataracts, are present in Sudan, said Dr Serge Resnikoff, coordinator of WHO's programme for the prevention of blindness and deafness.

    WHO estimates that 3.5 million people in Sudan have trachoma, which is caused by a bacterium that is spread from a person's eye or nose discharges by the common housefly or through human contact. A chronic eye infection results that scars the eyelids and damages the eyeball–requiring surgery and leading to blindness if left untreated.

    In Kiech Kuon, Upper Nile, over 80% of children under nine years of age have trachoma in its early stages, while more than 45% of people aged over 15 have advanced stage disease, according to the United Nations Children's Fund.

    Six other places in southern Sudan that were surveyed have infection rates among young children of between 50% and 77%. Constant reinfection because of poor hygiene was often the cause of complications leading to blindness, said Dr Resnikoff.

    “The best way of prevention is to improve hygiene, through face washing and fewer flies,” he added. River blindness, or onchocerciasis, has caused 10 000 people to lose their sight, according to the Carter Center, a US based human rights and healthcare charity. It estimates that about two million people in the Sudan are at risk from the disease, 75% of whom are in southern Sudan.

    Unicef has pointed out that every survey undertaken in Bahr el Ghazal and the Upper Nile since the beginning of the year showed malnutrition rates of at least 20%. In some areas more than 46% of young children were malnourished.

    Mortality in Old Fangak, in Upper Nile, has almost doubled since September 2002. Unicef warned: “While in Bahr el Ghazal there is a coordinated response to the situation from aid agencies and the United Nations, many areas of Upper Nile are not being catered for with feeding programmes.”

    Ben Parker, the UN spokesman in Sudan, said that the poor situation in southern Sudan was “partly a reflection of how difficult it is to intervene.”

    He added: “We also have to ask ourselves if it is a form of fatigue on the part of donors and agencies. What is regarded as normal in southern Sudan, even by African standards, is higher than elsewhere.”

    With a new crisis mounting among refugees fleeing new fighting in western Sudan, Kofi Annan said that there is no time for complacency. The secretary general recently told the UN general assembly: “The humanitarian imperative to save lives and reduce human suffering cannot await the completion of the peace process.”

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