The challenges and our response
International Medical Corps has been working in South Sudan since the mid-1990s, nearly 20 years before a national referendum in 2011 led the southern-most states of Sudan becoming an independent South Sudan later that same year.
Tensions within the new country broke into armed conflict in December 2013, claiming tens of thousands of lives before a fragile peace agreement took hold in the summer of 2015. Hostility continues to simmer, hampering efforts to improve public health standards in a country that has one of the world’s highest public infant mortality rates. In February, a famine was officially declared in two parts of Unity State. While an increase in aid helped lift the official famine classification in June, the food security situation remains desperate and the number of people at risk of starvation has increased. Potential for disease is extremely high with large numbers of displaced people and sharply reduced access to health care. International Medical Corps currently operates in five of the country’s 11 states, providing emergency health, nutrition, mental health and protection services.
Primary and Secondary Health Care: International Medical Corps provides basic primary health care across Central Equatoria, Jonglei, Western Bahr el Ghazal and Unity States. In displacement camps, known as protection of civilian (PoC) sites, in Juba and Malakal, International Medical Corps also runs comprehensive health facilities that offer higher-level care, including surgery. In Juba, the health facility in the camp includes a 24-hour emergency department as well as intensive care units for adults and children. For the last 15 years, International Medical Corps has provided secondary health care for beneficiaries in multiple states in South Sudan. Currently, we support Akobo County Hospital located in a volatile area near the eastern border with Ethiopia.
Maternal and Child Health: With just over 2,000 maternal deaths per 100,000 live births, South Sudan has one of the highest maternal mortality rates in the world. Due in part to the high fertility rate, each mother has a one in seven chance of dying in childbirth during her lifetime. Babies are at even greater risk; 25% die from common, often preventable childhood illnesses before they reach their fifth birthday. The high impact services that International Medical Corps implements in primary health clinics in South Sudan focus on improving the health of women and their children. Several of our primary and secondary health facilities also provide Emergency Obstetric Care, ensuring care for women experiencing complications during delivery. We also support midwifery schools in South Sudan, an initiative that has graduated more than 500 students so far, with more continuing their studies today.
Nutrition: High staple food prices, disruptions to livestock and crop production, currency devaluation, limited humanitarian access and conflict-related displacement are responsible for the high levels of food insecurity throughout South Sudan. In response, International Medical Corps has expanded nutrition programs in hard-to-reach areas. This includes outpatient and inpatient treatment for acute malnutrition. Our nutrition programs are currently implemented in Unity, Jonglei, Upper Nile, Central Equatoria and Western Bahr-el Ghazal states. In Unity State, we are expanding our nutrition services by using any means necessary, including canoe, to reach those impacted by the famine in Leer and Mayendit counties.
Capacity Strengthening: At every level of service provision, International Medical Corps works closely with local and government counterparts. At our primary health care clinics, the majority of staff members are South Sudanese who receive training, support and guidance from experienced Sudanese or expatriate staff. We also support three midwifery schools, where men and women study over two years to become midwives. So far, more than 500 midwives have graduated from the program, with more studying today.
Mental Health and Psychosocial Support: International Medical Corps is among the few humanitarian organisations—and also the lead organisation—providing comprehensive mental health services in South Sudan. Our services are integrated with general health services to reduce stigma and increase the likelihood of referrals being made to mental health specialists.