Why are we present in Northern Bahr Al Ghazal?
Northern Bahr Al Ghazal is one of the most politically sensitive regions of Sudan. Because it borders in the North, Southern Darfur and Western Kordofan, the state suffers a lot from the recent ended Civil War. Displacement of population due to armed conflicts and floods are frequent. Malnutrition and malaria are prevalent while epidemics of cholera, meningitis, tuberculosis or measles outbreak at large-scale. MSF teams have been working in Sudan since 1987.
Over the past 7 years, MSF was present in Akuem, responding to medical emergencies in Northern Bahr Al Ghazal. In November 2007, serious security deterioration leads to the closure of the Akuem project. The team is evacuated and the hospital is taken over by the SPLA medical corps, now Akuem Military Hospital.
Because the maternal mortality in this region remain among the highest ones in the world, MSF launches in February 2008 the Aweil Project, a reproductive care programme within Aweil Civil Hospital. After a few months, the programme is suspended. MSF action is neither clearly defined within the Hospital or the community and is nor supported by the MoH.
A Memorandum of Understanding between the NGO and the MoH needs to be discussed and implemented in order to clarify the situation and determine the future strategy. Meanwhile, the MSF teams in place notice and deal with the seasonal medical needs such as the hunger gap and the outbreak of malaria during the rainy season. Not planned, both medical interventions are treated as emergencies, explaining the sudden deployment of logistic and medical support, financial and human resources.
When I arrive in Aweil, Nutrition and Malaria activities are decreasing, but the cholera emergency is starting. With my successive teams, I am going to undertake: (1) the restructuring of the previous seasonal activities, (2) the follow-up of the cholera emergency, (3) the setting up and the transfer of medical activities to the Mother and Child program which includes General Paediatrics & Gynaecology-Obstetrics and finally (4) the establishment of Nutrition as a yearly programme.