Ethiopia provides war-weary South Sudanese emergency medical care

Ethiopia provides war-weary South Sudanese emergency medical care

GENEVA, Switzerland, March 28, 2018/ — Since it began in December 2013, the conflict in South Sudan has forced over two million people from their homes. For those living in the east of the country, the refugee camps in Ethiopia’s Gambella Region offer the best sanctuary.

“I arrived with my family after eight days of walking. We didn’t have food or animals, so we were forced to sell our clothes to buy milk to survive. We decided to come to Ethiopia where we could have our basic needs met and can get education for our children,” explains 20-year-old Sarah, whose third child received medical treatment at the Doctors Without Borders (MSF) clinic in the Kule refugee camp. “We can have a life here, but we plan to return to South Sudan as soon as the situation is better.”

For most, a permanent return home is only wishful thinking after fighting erupted again last year in the east of South Sudan. In 2017 alone, 100,000 people crossed the border looking for respite. Ethiopia now hosts over 435,000 South Sudanese, the largest refugee population in the country.

“Every week hundreds arrive by foot in this region, in desperate need of emergency healthcare. Often, they are severally weakened by the ordeal, with little but the clothes on their backs and horror stories of violence and destruction,” explains Bart Bardok, MSF project coordinator in the Kule and Tierkidi camps. “Malnutrition and dehydration are common. When they arrive, refugees undergo a health assessment by MSF or by the health authorities and can be referred to one of our clinics.”

In 2017, MSF provided medical care in three of Gambella’s refugee camps. In Kule, with a population of 53,000 people, MSF runs one health centre and three health posts, while in Tierkidi camp the organisation runs another three health posts, including a 24/7 maternity service, serving a population of 71,000 people. In Pugnido camp, where 66,000 people had settled, MSF ran one health post, and one extension site, together with a health centre, in Pugnido Town. This was done together with the government authorities.

Pugnido camp did not receive any new arrivals in 2017 and MSF decided to close its health posts there in early 2018 and move activities to the new Nguenyyiel camp, setting up a health post. As of March 2018, 82,000 refugees live in Nguenyyiel camp but this is expected rise in the coming months.

Across the three camps, MSF treated 340,000 people in 2017; 30 percent of these were children under-five. Malaria was one of the most significant problems with over 72,000 cases treated in the three locations; followed by respiratory infections and diarrhoea.

“Our MSF teams respond to the medical needs of the South Sudanese refugees and the local community, which in Gambella numbers over 300,000,” explains Oliver Schulz, MSF’s country representative in Ethiopia. “MSF has been also running mobile clinics at entry points along the Ethiopian border to provide immediate medical care.”

As well as support in the camps, in 2017 MSF started a partnership with Gambella General Hospital in the regional capital, the only health facility in the region that can perform surgical operations. There are over 800,000 people in its catchment area, including both refugees and local communities. Overall admissions have increased significantly as word has spread of its enhanced services.

“The hospital has seen an increase in admissions to the departments MSF is supporting. For example, the number of admissions in maternity has almost doubled in only a few months, as the capacity of the hospital has really improved,” says Dr César Pérez Herrero, MSF project medical referent in the hospital.

“Since June 2017, the hospital has helped deliver over 1,900 babies. Having a surgery service on hand has ensured that emergency procedures, like C-sections, can be undertaken quickly and safely,” adds Pérez Herrero.

The emphasis of MSF surgical work has been on emergency interventions, and the biggest category was violent and non-violent injuries. Over 1,500 surgical cases were performed last year.

Even with MSF involvement, the surgical department is constantly overwhelmed and needs additional support. With the situation in South Sudan worsening, a new influx of refugees and war-wounded can be expected at any time.

MSF’s presence in Gambella will continue to be necessary as long as the war rages across the border. MSF remains committed to improving of the quality of care for patients, who have endured so many challenges.

Serious barriers prevents adolescents from accessing sexual and reproductive health (SRH) services safely & confidentially

Serious barriers prevents adolescents from accessing sexual and reproductive health (SRH) services safely & confidentially

HARARE, Zimbabwe, March 13, 2018/ — In Zimbabwe, a host of barriers are preventing adolescents, defined as aged 10 to 19 years, from accessing sexual and reproductive health (SRH) services safely and confidentially without the consent of their parents.

Without free and informative access to health services that include contraceptives, treatment for sexually transmitted infections and condoms, national studies show that rates of adolescent pregnancy and HIV are increasing, while knowledge levels around sexual health are declining. One study revealed that Zimbabwe has the highest teenage fertility rate in sub-Saharan Africa with one in every 10 girls aged between 15 and 19 years falling pregnant every year.

Culturally, young people are often expected to abstain from sex until they get married. National law states that young people below the age of 16 years can’t take an HIV test without parental consent, and health workers often stigmatize young people seeking sexual health advice.

Yet in many communities like Mbare, a sprawling high-density suburb in the capital Harare, the reality is that young people start having sex and experimenting as early as 12 years, frequently without protection or information on how to prevent unwanted pregnancies, STIs and HIV infection.

Young people living with HIV also face particular difficulties, especially if they only learn of their HIV status by accident in their teens. Most find it difficult to accept their condition, and often stop taking their antiretroviral treatment (ART). Crowded living conditions which force young people out of their homes and abuse of alcohol and drugs also plays havoc with staying on regular treatment.

Recognizing the huge vulnerability of adolescents without access to free sexual and reproductive health services, MSF partnered with the Harare City health department to start an ‘adolescent-friendly corner’ at Edith Opperman clinic in Mbare. Staff in the brightly coloured rooms offer free services which include general health check-ups, HIV testing and counselling, screening for sexually transmitted infections (STIs) and contraceptive services.

In between appointments, young visitors can play pool or chat with ‘peer educators’, themselves young people, who MSF has trained and mentored to discuss sexual health issues with their peers or encourage them to stick to their treatment.

In 2017, 2454 consultations were provided for young people in the ‘adolescent corner’.