New Primary Health Care Centre (PHCC) Opens in Melut / Rising Above the Waters
Two new Medair items (boilerplates omitted):
"New Primary Health Care Centre (PHCC) Opens in Melut"...
Medair has now completed construction of a permanent PHCC that will provide access to a wide range of health services for up to 50,000 vulnerable Sudanese.
In March of 2007, Medair opened a temporary PHCC in Melut Town, in partnership with the Ministry of Health (MoH) and local community authorities. Large tents were set up, and over the course of 34 weeks, 13,000 patients were seen and treated.
During this time, Medair worked with local labourers and a construction firm to build a permanent PHCC, which will now be staffed with eight support staff and 12 health professionals, including Clinical Officers, Community Health Workers, and Nurse Midwives.
“It is great that we are in the position to open this Primary Health Care Centre in Melut,” said Medair’s Country Director, Klaas van Mill. “The need for provision of the basic health services in this area continues to be high. Our temporary clinic was kept very busy, and with the opening of this building, services will be improved even further.”
The formal opening ceremony will take place on 14 November at 2 pm, and will be attended by local dignitaries, government representatives, and area residents.
“It’s so nice to have Medair here with us in Melut,” said Mary, one of the clinic’s patients. “There’s good hygiene advice and encouragement. Also, there’s no division, and all people are treated equally, with love.”
While the peace agreement has brought hope to the country's devastated south, a better future is far from guaranteed for most of the region's inhabitants. Chronic underdevelopment, combined with continuing tensions in Upper Nile state, suggest that even if the new peace does hold, it will require a persistent and widespread effort to improve both living conditions and the provision of basic services.
“This new Primary Health Care Centre has been built so that mothers can deliver their babies safely, children can get vaccines, and all ages can receive essential medicines and learn how to prevent future illness,” said Medair’s Dr. Hannah Evans. “A healthy community is a good foundation for the future, and we are privileged to be a part of building this future for the people [that] we work alongside in Melut County."
Medair would like to thank those that have contributed to the development of this PHCC, with a special mention to the local and state governments, the MoH, SSRRC, and donors BSF/DFID and CHF.
Medair and Tearfund conduct a joint emergency intervention in response to severe flooding in Southern Sudan
Sitting in their small boat on the river Nile, Medair’s Alan and Gaby Service and Tearfund’s Abel Soett and Vivian knew that the village lay about one kilometre from the main river. But their way was blocked by tall grasses in all directions. As is common along the Nile, grasses and reeds create an ever-changing environment, and rising floodwaters throughout the region had served to make access much more difficult. Despite the obstacles, they pressed forward into the grasses, forcing the boat through with a long pole, and pulling on the reeds to gain momentum. They reached the village, and Alan and Gaby were able to assess how the floods had affected the population, while Abel and Vivian supervised their health units. They then returned to their boat for the arduous trek back to the open Nile waters, and made their way to the next community.
The severe flooding had started in early August, after repeated heavy rainfalls. In this region of Southern Sudan, the average July rainfall is just 45 millimetres, but this year brought 253 millimetres, followed by the typically high precipitation of the rainy season in August and September. In the inland Oriny area, ponds and seasonal rivers had overflowed their banks, affecting farmland, forests, and villages.
Tearfund is Forced to Evacuate Oriny
Tearfund has 11 operational health clinics or units in Fashoda, Makal, and Mnayo Counties in Upper Nile State, and it maintains a base in Oriny. Tearfund has been operating there since 2002, when it took over from Medair. The airstrip in Oriny became threatened by the rising waters, and the only other route to leave was blocked by many kilometers of floodwaters. It became too risky to leave staff there, so the team was relocated.
“While flying over the area on my way out of Oriny, one could see miles and miles of waters, interspersed by little islands of villages,” said a Tearfund health worker. “From Oriny to the White Nile, 90 percent of fields are seen standing in water.”
Medair and Tearfund Join Forces
After the relocation, Medair agreed to help Tearfund with a joint intervention, responding to the health needs of the flood-affected population. Medair took the lead on providing emergency response to any crisis or disease outbreak, with Tearfund providing the necessary supplies for health facilities.
“We have a well-established Emergency Response team here, with the mobility and expertise to provide assistance to a broad range of needs in various communities,” said Dineke Wibbelink, Medair’s Project Manager. “Alan and Gaby Service were a good choice to lead our flood response, as both are registered nurses and experienced Health Managers with Medair.”
At the time of the intervention, there had been no reports from the communities for about a month. “Our first attempts for contact were to reach the clinics that were located close to the river Nile,” said Gaby. “From there, we could assess the communities and inquire about the situation further inland.”
This led to their boat trek through the tall grasses, which although difficult, was part of a successful first mission. They were able to reach about half the health centres in three days, camping out along the way. They found that Tearfund’s efforts to prepare for the rainy season had paid off. Adequate supplies had remained in most of the health units, and there were still enough mosquito nets to distribute to the most vulnerable, protecting against the heightened risk of malaria that comes with flooding.
The Tearfund team chose a centrally located and easily accessible village, Kodok, which served as a communications base. Messages were sent across swamps and high waters to the other health units [in order] to send their reports to Kodok. The news was about the same from most of the health units near the Nile: communities were coping with the flood.
Trouble in Oriny
However, distressing reports started coming from the villages located in the interior, near Oriny. Although there were no reports of outbreaks, the villages were in a tough situation. Some people said that reaching them required crossing many hours of swamps, with waters reaching anywhere from waist-high to over people’s heads. The reports included stories of people losing their homes, of people drowning, of cattle sick and dying, and of flooded land that could no longer be cultivated.
“As we continued to hear these stories, it became clear that it would be necessary to attempt to reach the interior, [in order] to make sure that the villages had the means to cope for the next several months until the waters receded,” said Alan.
The Medair team and Abel from Tearfund began to investigate possible routes that they could take to access Oriny, and came up with two options. The first was the shorter route, but it was reported to have higher water and would require swimming. The second and preferred option was much longer, but bypassed the deep water by walking around it, on the high ground.
Trekking Through the Flood
The chosen longer route was not bad on the first day. They were able to cover about 30 kilometres through mostly dry land. Unfortunately, Abel twisted his ankle in the mud near the end of the day, but never considered turning back, despite the pain. With evening approaching, they still had not entered the main swamp waters, so they camped in a small village for the night.
“We raced to set up our tents and eat before the sun set, which we knew would bring out the hordes of mosquitoes,” said Gaby. “We spent that night lying in our tents with the loud hum of the mosquitoes drowning out all other noises.”
The next day, they crossed 10 kilometres of swamp in four hours. Some of the terrain was dry, but mostly it consisted of thick mud under calf-deep water, which sometimes rose to their waists.
“Crossing the swamp was exhausting, as the thick mud sucked our feet in, and was uneven,” said Gaby. “With our heavy packs, we were constantly tense, trying to keep from slipping and falling. We were worried about damaging our sat-phone, the only reliable means of communication [that] we had.”
For kilometres at a time, they crossed terrain where they could not rest, because there was no place to put their rucksacks down, or to sit.
“I suggested that we hang our packs in the trees, so we could rest,” said Alan. “But our guide warned us to stay away from the trees, because that is where the snakes go to rest.”
After a long hard hike, they arrived in Oriny, and were greeted by shocked looks from the local residents. They had never expected an NGO to cross the swamps [in order] to see them.
The exhausting walk had taken its toll on Alan, who started experiencing serious problems ensuing from his dehydration, loss of salt, and excessive muscle strain. Gaby administered a litre of IV fluid to him, and fortunately he recovered quickly.
Oriny Hit Hard by Flooding
The team stayed in Oriny for several days, assessing the situation in the surrounding villages. Unlike the villages on the Nile, the scenario here was grim. Seven villages in Oriny were affected, with many homes having been destroyed by the flooding. Two more villages were affected [in] nearby Aburoc. Most of the homes in the area were mud-walled and grass-thatched tukuls, which became easily soaked and collapsible when the flooding hit. In total, 466 families had been displaced and were now homeless.
Most of the reported water-related illnesses were within Tearfund’s effective control limits. However, there was a sharp increase in cases of malaria and pneumonia. Unfortunately, transferring sick patients to health units had become extremely difficult, requiring that they be carried through the waters. Two people had drowned trying to get from Oriny to Aburoc.
Livestock animals were hit the hardest by these floods. Many have died, with no grass to feed on, and copious flood-related insects spreading disease among them. In addition, the floods have destroyed all of the farms in Oriny and Aburoc, with not a single grain surviving to be harvested, according to a Tearfund report. This could lead to a deadly food crisis or famine in the months ahead.
The floodwaters had fortunately brought fish all the way from the Nile to the villages around Oriny, which helped provide food for local residents in the short term. Gaby and Alan were passed by four boys heading into the swamps to fish. One boy had a short piece of string and a hook, and the other three had spears. “There are fish in the water,” said a village resident later that day, “but there aren’t enough fishing supplies to catch them.”
The airstrip temporarily dried up while the Medair team was in Oriny, so they left by plane [in order] to coordinate the provision of emergency assistance. It was decided that an NFI (non-food item) distribution would take place, with plastic sheeting, blankets, and mosquito nets given to the displaced families, and fishing supplies distributed to the community [in order] to increase food production.
Praying for a Dry Airstrip
One week later, Medair flew over Oriny by helicopter, but Alan and Gaby saw that the water level was still rising. Reports were stating that walking in the area was no longer possible, because the water was over people’s heads in some places.
“We had been planning on bringing in the items by plane and staying on the ground for a few days [in order] to supervise the distribution,” said Gaby. “But with the rising water levels, it was too unsafe for a team to stay there overnight. Any more rainfall would have made the airstrip unlandable very quickly.”
Instead, the Medair team decided to deliver the NFIs in person, and then hand the distribution over to the Southern Sudan Relief and Rehabilitation Committee (SSRRC), because the community seemed very cooperative and resourceful. So, 10 days after arriving in Oriny by foot, Gaby and Alan returned with three planes full of emergency provisions. They were able to land safely, unload all of the items, and spend a few hours providing oversight into how the distribution should be carried out. The community was delighted to see them again, with one local resident thanking them, saying, “Medair is a very committed organisation. They care about people and act fast.”
Tearfund was also very grateful for Medair’s support during their joint intervention. As Area Coordinator Dr. Chol O. Giel wrote, “Tearfund wants to take this opportunity to register its sincere appreciation to the effective [and] hospitable roles played by Medair. We hope to continue such good ties into the future.”
With your support, Medair will continue to provide rapid life-saving emergency relief across Southern Sudan. It is no exaggeration to say that this region of Sudan has one of the most-vulnerable populations in the world, with the highest levels of child malnutrition found anywhere. Medair’s expert Emergency Response teams are in high demand throughout the year to help vulnerable populations facing disease outbreaks and other crises. With sufficient funding, our team can quickly mobilise into action, putting our specialised expertise to life-saving use, just as Alan and Gaby did this past month.
Comments