By FRED OLUOCH

More by this Author

One third of the 12 million people of South Sudan are on the run and in dire need of medical assistance.

The demand for medical emergencies is overwhelming the few international organisations working in South Sudan with two million internally displaced, especially in Greater Upper Nile where the fighting is intense.

Meinie Nicolai, the Médecins sans Frontières (MSF — Doctors Without Borders) president Belgium, says most people have abandoned their homes, meaning that they cannot farm and/or keep their cattle so they are suffering from malnutrition, which makes them vulnerable to disease.

“We strive to work everywhere, yet at times we are unable to cross the frontlines of combatants. As a result, vulnerable communities are placed even farther out of the reach of lifesaving medical care,” said Ms Nicolai in an interview with The EastAfrican.

The medical and humanitarian needs are enormous.

Most parts of South Sudan are affected by regular outbreaks of malaria, measles and other waterborne and infectious diseases against the backdrop of a largely dysfunctional primary and secondary healthcare system.

Kala-Azar patients

The displaced population are largely suffering from measles and cholera epidemics, tuberculosis and HIV.

However, the most prevalent disease in South Sudan is Kala-Azar, a potentially fatal parasitic disease of the viscera (the internal organs, particularly the liver, spleen, bone marrow and lymph nodes).

It is also transmitted by the Sand Fly which bites during the day time, and is spreading very fast. Once infected, the liver and the spleen swell, and if not treated in time, can result into death.

“We quickly have to identify those affected among the population we can reach, treat them and protect them against the bites. MSF treated 2,500 Kala-Azar patients last year, which is a comparatively large number,” said Nicolai.

In February, the World Health Organisation declared an end to a cholera outbreak which had lasted 600 days from last year.

However the exposure to future cholera outbreaks remains high due to poor provision of clean water and sanitation services in many parts of the country.

The high malnutrition rates in some parts of the country further compound the likeliness of illness.

Lack of capacity

Due to the conflict, many of the displaced do not feel safe enough to return home and are forced to live in appalling conditions in UN protected camps, informal settlements, swamps, or under trees.

Ms Nicolai says that the whole healthcare system in South Sudan is very fragile and very poor.

The Ministry of Health does not have the capacity to build facilities and 80 per cent of the services are offered by international organisations.

“Government services are weak or non-existent in remote areas and access to healthcare for most people is very difficult. People have to walk long distances to reach health facilities, especially during rainy seasons when the roads are impassable because of the black cotton soil,” she said.

There are still more than 200,000 people living in six UN camps throughout South Sudan.

MSF is present in the two largest camps: Bentiu, with nearly 115,000 residents, and Malakal, with nearly 25,000.

Ms Nicolai said that continuous efforts and collaboration from the humanitarian actors need to be put in place to guarantee proper water and sanitation conditions, minimum living space and proper shelter, food in sufficient quantity, greater access to health care.