Hundred of thousands of people in South Sudan are without access to health care because of continued fighting, with health facilities frequently targeted. Andrew Green reports.
The fighting that has raged in South Sudan for more than 9 months has left at least 10 000 people dead, displaced 1·8 million more, and devastated much of the country’s health system.
Now, across vast swathes of South Sudan’s eastern half, the only viable health-care options are at a handful of UN bases. That affords easy access for the nearly 100 000 people who are sheltering at the bases to escape the fighting. But for the hundreds of thousands of people who were driven from their homes deep into the bush, accessing health care—or any form of aid—is either extremely dangerous or impossible. Humanitarian groups have warned that many of those communities are now facing emergency levels of food insecurity and malnutrition.
At the same time, they are contending with South Sudan’s usual health risks. In the midst of the country’s months-long rainy season, there is the expected spike in malaria cases. Meanwhile, in some areas of the country, the regular kala azar peak has come earlier than anticipated.
Hospitals and health centres have been the frequent targets of attacks by both government forces and the rebels led by former Vice President Riek Machar, according to a July MSF report. At least 58 people have been killed on hospital grounds, the emergency medical group said, and buildings have been torched or looted at least six times. Health workers have repeatedly been forced to flee and many areas of the country are still not safe enough for them to return.
“We are more than deeply concerned about attacks on the health structures”, said Dominik Stillhart, the director of operations for the International Committee of the Red Cross (ICRC). “These are very serious violations of international humanitarian law.”
Aware of the continued risk of working at any consistent location, aid agencies are employing different tactics to reach people. ICRC has deployed five mobile surgical teams that, Stillhart said, “very flexibly adapt to developments on different frontlines and move and operate within a very short time”.
Wendy Taeuber, the International Rescue Committee’s country director, said aid groups are also surveying war-torn parts of the country to find areas where it would be safe to set up temporary humanitarian operating centres. They would not have the capabilities of a hospital, or even a health centre, but “the more services we can provide outside the bases and keep people safe…that’s obviously more ideal than to have to keep going into the [UN bases]”.
But for most people, access to health care will continue to hinge on whether fighting finally stops.
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Source: The Lancet.