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New hospital in Ulang for people affected by violence and neglect

Project Update

Médecins Sans Frontières (MSF) is establishing a project in the town of Ulang, close..

Project Update

Médecins Sans Frontières (MSF) is establishing a project in the town of Ulang, close to the Ethiopian border, in South Sudans northeastern Upper Nile region, to address the needs of people living in a remote and neglected area who have been affected by years of war and frequent bouts of intercommunal violence and who struggle to access medical care.

We have already set up a 30-bed hospital in town, providing the only secondary healthcare for the 100,000 or so people living in Ulang and in villages scattered along the Sobat river.

In July 2018, MSF launched a short-term emergency response, running mobile clinics in Ulang and the surrounding area. In October, we opened the new hospital, and in April we took the decision to run it as a stable project.

“Our aim is to provide secondary healthcare to very vulnerable people affected by recurrent outbreaks of different kinds of violence, living in a dire situation and with little access to basic services, meaning that sometimes people have to walk for hours and even days to reach much-needed healthcare,” says Hussein.

Between October 2018 and April 2019, MSFs team in Ulang provided 3,200 consultations, helped 81 women to give birth and admitted 719 inpatients, including 287 children in the pediatric ward.

“As well as dealing with complicated pregnancies, we treat people for severe malaria and for gunshot wounds because of the ongoing intercommunal violence.

We also very often treat quite complicated cases of patients co-infected with TB and HIV, who may have had symptoms for a year or more but have never been diagnosed or treated.”, says Madeleine Walder, MSFs field coordinator in Ulang.

MSF teams are engaging with local communities to explain the main diseases that people should be aware of and when to seek treatment.

We have put in place a referral system, with patients mainly transported by speedboat along the Sobat river from outlying health centres to Ulang hospital. Some victims of violence and patients with conditions that need surgery or other specialist care are transferred either to Malakal, which is about eight hours away by speedboat, or by plane to the capital, Juba.

“The Greater Ulang area presents logistical challenges, for us and for our patients,” says Walder. “During the rainy season, which lasts eight months a year, it is very swampy and the only means of transport is by boat, as most planes cant land. During the dry season, access is a bit easier and people can move around, but the distances to reach health services are still very long.”

Displaced by cyclical violence – Nyayuals story

Nyayual has nine children, aged one to 18. An outbreak of intercommunal violence drove her and her family from their home in Doma. They sought refuge in the village of Ying, where several hundred displaced people are staying.

“Our men go to the river and, if they catch some fish, the children will have something to eat. The children are not doing well – they suffer from vomiting and diarrhoea because of eating badly.

The violence in Doma left many people dead. The attackers arrived at night, at 4 am. They went through the village and started shooting at men, children, women, animals. We had been sleeping, so everyone ran away without being able to take many belongings. We lost most of our cattle.

Everyone fled in different directions. We walked for four hours until we arrived at Ying at sunrise. The locals welcomed us. They allowed us to stay in the school and under the trees. Some others who hid in the bush have gathered here too over recent days. All of my relatives are here. These attacks happen from time to time. Before they only took our cows, but now they also kill people.

Although we lack basic things these days, we are safe. We cant go back to Doma any time soon as there is a risk of more attacks.”

First and second – Yakongs story

Yakong is a 36-year-old mother of seven. Her twins Both and Duoth – first and second in Nuer – were born in late March at MSFs hospital in Ulang.

“I am from Wachjak, a small village on the Sobat river, two hours walk from Ulang. There are not many jobs there. People are often hungry. We grow some fruit and maize, but the main source of food is from fishing. My eldest child is 15 and bringing up my children has been a challenge.

Some of my relatives, including two of my brothers, died in the conflict, and my uncle lost three of his boys. It is very sad. I think peace will change things for the better.

“This is the first time Ive given birth in a hospital. My other children were all delivered at home. I had no idea I was going to have twins, but now I am very happy. I have named them Both and Duoth, which mean first and second in the Nuer language. The bigger twin has been a bit sick with very happy. I have named them Both and Duoth, which mean first and second in the Nuer language. The bigger twin has been a bit sick with diarrhoea, vomiting and fever.

When I was pregnant I was not comfortable. I felt dizzy, had abdominal pains and was losing fluids. I knew I wasnt ready to give birth, but it was causing me pain. I had heard in the community that MSF had opened a hospital in Ulang. If I hadnt come here, it could have been bad. In the end I had a normal delivery and it didnt last long. We feel safer with MSFs presence. I hope they dont leave.”

Daily struggle to meet basic needs – Nyamachs story

Nyamach is a 20-year-old mother of three from Ulang. Her youngest child, a five-year-old girl, was admitted to MSFs hospital in late March with convulsions and fever, and was diagnosed with cerebral malaria. The child also had a wound which had led to a tetanus infection. Vaccination coverage among the local population is low.

“… – like people injured in shootings or suffering severe diseases. To get medical treatment in the past, we sometimes had to go to Ethiopia.

We earn our living by fishing, and we raise cattle and grow maize, sorghum and green leaves. In the rainy season we put seeds in the ground and they grow, so we have more food. However, we lack basics like cooking utensils and proper sleeping materials. Because of the fighting, we have faced a lot of hardship. The war has left us without anything – not even seeds.

For three years I took refuge in Ethiopia and lived at Kule refugee camp. We decided to leave here because there were no schools or healthcare and the violence was affecting us. I was scared. I came back to South Sudan in January 2018 with nine relatives. Other people have decided to come back to Ulang after hearing that MSF is now here. We came back by car – it took three days. I hope the situation stays calm. At least in the rainy season [between May and December] people stay at home and dont run after each other.”

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Burkina Faso: Growing Violence Threatens Health Care

Away from the worlds attention, Burkina Faso has been slipping into violence. In less than a year, t..

Away from the worlds attention, Burkina Faso has been slipping into violence. In less than a year, the number of displaced has increased fivefold, from 50,000 last December, to 270,000 in August. As ever, the most vulnerable suffer most: the very young, and the very old.

When Alidou Sawadogos elderly mother fell ill, he faced a long and dangerous journey to get treatment for her.

“When she collapsed, a friend called me,” he explains. “By the time I arrived she was already unconscious. I decided to take her to the health center and luckily someone who had a motorcycle helped me. Because of the violence many people who are sick wait at home and die. Everyone is afraid of taking the road to the health center in Barsalogho.”

Across Burkina Faso, the rising insecurity has forced over a hundred health centers to close, or to limit their work. Half a million people now have little or no access to health care. Dedicated health workers, among them Dr Bertrand Dibli in Barsalogho, are struggling to meet the needs, and to stay safe themselves.

“This is one of the few health centers that isnt closed,” he says. “We dont have enough equipment. And the insecurity has caused huge anxiety among health workers. Even coming here to Barsalogho is a huge challenge because the route is so dangerous.”

The ICRC has been working to support Burkina Fasos health professionals, with medical kits, and vaccination campaigns. During his visit to the country, ICRC President Peter Maurer expressed his concern at the multiple challenges facing Burkina Fasos people.

“We are very concerned,” he said. “Very worried about the upsurge in violence, its a vicious circle that is trapping the civilian population between armed groups.”

“We also see,” Mr Maurer added, “that it is not only the violence that is affecting the country, it is also under development, and climate change. Together with the violence that is obstructing the health services, its an accumulation of factors.”

And so the ICRC – jointly with the Burkinabé Red Cross – is also delivering food to the displaced, and helping to improve access to water supplies. All of this, says nurse Jeanette Kientega, is desperately needed by a population uprooted by conflict, and denied access to basic health care.

“By the time they are able to get here, it is often too late” she says. “Sometimes we can help, but if they have already been ill a long time, it is difficult. We try to do what we can.” (more…)

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World Bank and WHO Statement on Partnership & Deployment of Financing to WHO for Ebola Response in DRC

WASHINGTON, August 23, 2019—The World Bank and the World Health Organization (WHO), along with the G..

WASHINGTON, August 23, 2019—The World Bank and the World Health Organization (WHO), along with the Government and other key partners, are working in close partnership on the Ebola Crisis Response in the Democratic Republic of the Congo (DRC). Central to this partnership is the assessment of the financing needs, and deployment of resources, with the goal to put an end to the current deadly outbreak.

The World Bank is today announcing that US$50 million in funding is to be released to WHO for its lifesaving operational work on the frontlines of the outbreak. The WHO is announcing that this US$50 million in funds will close the financing gap for its emergency health response in DRC through to the end of September 2019, and is calling on other partners to mirror this generous support in order to fund the response through to December.

The funding comprises US$30 million from the Pandemic Emergency Financing Facility (PEF) and US$20 million from the World Bank. The US$50 million in grant funding is part of the larger financial package of approximately US$300 million that the World Bank announced last month to support the fourth Strategic Response Plan for the DRC Ebola outbreak.

“WHO is very grateful for the World Banks support, which fills a critical gap in our immediate needs for Ebola response efforts in DRC, and will enable the heroic workers on the frontlines of this fight to continue their lifesaving work,” said Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization. “We keenly await further funding from other partners to sustain the response through to the end of the year.”

The DRC government, working in collaboration with the World Bank, WHO, and other key partners, has finalized the Fourth Strategic Response Plan (SRP4), which outlines the total resources needed for the DRC Ebola Crisis Response from July to December 2019. The financing announced today is part of the World Banks previously announced financial package of up to US$300 million and covers over half of SRP4s needs, with the remainder requiring additional funding from other donors and partners.

“The World Bank is working closely with WHO, the Government of DRC, and all partners to do everything we can to put an end to the latest Ebola outbreak,” said Annette Dixon, Vice President, Human Development at the World Bank. “The partnership between our organizations and the Government is critical for responding to the emergency as well as rebuilding systems for delivery of basic services and to restoring the trust of communities.”

The Government of DRC requested US$30 million from the PEF Cash Window to be paid directly to WHO. The PEF Steering Body approved the request bringing the PEFs total contribution to fighting Ebola in DRC to US$61.4 million. The PEF is a financing mechanism housed at the World Bank; its Steering Body is co-chaired by the World Bank and WHO, and comprises donor country members from Japan, Germany and Australia. The quick and flexible financing it provides saves lives, by enabling governments and international responders to concentrate on fighting Ebola—not fundraising.

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Borno State launches first Malaria Operational Plan, reawakens fight against malaria

Maiduguri, 13 August 2019 – Following recommendations from malaria interventions in Borno State Nige..

Maiduguri, 13 August 2019 – Following recommendations from malaria interventions in Borno State Nigeria, the Malaria Annual Operational Plan (MAOP) was developed and launched on 08 August 2019 with technical support from the World Health Organization (WHO) and partners. Aligned to the National Malaria Strategic Plan (2014 -2020), MAOP was developed through a broad-based stakeholders workshop involving malaria stakeholders, reviewed on different thematic areas and endorsed by the Commissioner for Health and Permanent Secretary, Borno State Ministry of Health.

Speaking during the launch, the Borno state Malaria Programme Manager, Mr Mala Waziri described the MAOP as the first to be endorsed and disseminated in Borno State. “WHO has made us proud by supporting the first ever Malaria Operational Plan right from development, review, printing to dissemination.”

Dr Ibrahim Kida, the Ministerial Secretary Borno State Ministry of Health and Incident Manager of the state, described the launch as “an historic event as stakeholders across the health sector made commitments to use the document as an implementation guide for all malaria programs”. The plan was also described as an advocacy tool for planning domestic funds mobilization.

The MAOP has seven objectives among which are: provide at least 50% of targeted population with appropriate preventive measures by 2020; ensure that all persons with suspected malaria who seek care are tested with Rapid Diagnostic Test (RDT) or microscopy by 2020 and all persons with confirmed malaria seen in private or public health facilities receive prompt treatment with an effective anti-malarial drug by 2020.

The MAOP will further ensure that at least 50% of the population practice appropriate malaria prevention and management by 2020, ensuring timely availability of appropriate anti-malarial medicines and commodities required for prevention, diagnosis and treatment of malaria in Borno State by 2020.

In addition, it seeks to ensure that all health facilities report on key malaria indicators routinely by 2020 and finally strengthen governance and coordination of all stakeholders for effective program implementation towards an A rating by 2020 on a standardized scorecard. These strategic objectives have specific targets and the MAOP takes into account the humanitarian response.

“Malaria remains a leading cause of poor health in Nigeria. According to the 2018 WHO Malaria Report, 53million cases are recorded annually in Nigeria, roughly 1 in 4 persons is infected with malaria contributing 25% of the global burden,” says Dr Nglass Ini Abasi, WHO Malaria Consultant for the North East.

“Furthermore, 81,640 deaths are recorded annually (9 deaths every hour), which accounts for 19% of global malaria deaths (1 in 5 global malaria deaths) and 45% malaria deaths in West Africa. The Nigeria Malaria Strategic Plan (NMSP) 2014-2020 has a goal to reduce malaria burden to pre-elimination levels and bring malaria-related mortality to zero and WHO is working assiduously with Government to ensure the burden is reduced accordingly.”

Results from WHO’s Early Warning, Alert and Response System (EWARS) week 30 report from 223 sites, (including 32 IDP camps) show that malaria was the leading cause of morbidity and mortality accounting for 35% of cases and 46% of reported deaths. In addition, results from the Nigeria Humanitarian Response Strategy (NHRS 2019-2021) indicate 7.1million people are in dire need of healthcare and 6.2million are targeted for immediate attention.

Despite recent improvements, insecurity remains a challenge limiting access to the functional health facilities. Easily preventable and treatable diseases such as malaria, acute respiratory infection and diarrheal diseases account for the greatest proportion of morbidity and mortality among the vulnerable population. Furthermore, Malaria is endemic in North East Nigeria and the transmission is perennial with a marked seasonal peak from July to November every year. (more…)

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