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, Secondary and Tertiary Healthcare
International Medical Corps provides basic primary healthcare across Central Equatoria, Western Bahr el Ghazal and Upper Nile States. In protection-of-civilian (PoC) sites in Juba, Wau 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 also provided secondary healthcare for beneficiaries in multiple states in South Sudan.
In July 2020 we opened and continue to manage an infectious disease unit (IDU) adjacent to the Juba Teaching Hospital, which is both the country’s largest medical facility and the only one in the capital capable of treating COVID-19 patients. In collaboration with the World Health Organization and South Sudan’s national Ministry of Health, we plan to deploy a team of specialists to set up an intensive-care unit (ICU) and provide care to critical patients at the hospital. The team will also help assess and eventually establish a Level 2 ICU unit at the facility that would be equipped with complex life-support systems and other modern equipment, to enable a higher level of care for severe and critical patients. If completed as envisioned, the facility would be the first of its kind in the country that would be fully accessible to the public. It would also allow for eventual teaching and research components.
Maternal and Child Health
With one in every 50 live births resulting in the death of the mother, 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 midwife training in South Sudan at the National Training Institute at Kajo Keji, the National Midwifery School in Wau and the Juba College of Nursing and Midwifery.
In some of the areas where we work in South Sudan, more than one-third of children under five are affected by chronic or acute malnutrition, which can cause moderate or severe stunting. High prices for food staples, 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. Through 13 program sites, International Medical Corps has implemented a successful program using the community-based management of acute malnutrition model, along with a maternal, infant and young-child feeding approach, as curative and preventive measures. As of February 2020, we have reached more than 40,000 malnourished children and almost 18,100 pregnant and breastfeeding women with nutrition services. We have also supported more than 400 mother support groups who implement and advocate for nutrition and dietary behaviour change at the community level.
For every service we provide, International Medical Corps works closely with local and government counterparts. At our primary healthcare 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 complete a rigorous two-year course of study to become midwives. Since 2011, we have graduated 459 nurses and midwives in South Sudan.
Gender-Based Violence (GBV)
Violence against women and girls is an endemic problem in South Sudan, exacerbated by ongoing conflict and chronic displacement. International Medical Corps puts gender-based violence (GBV) prevention and response at the core of its lifesaving interventions. Our programs are tailored to support and empower women and girls who are most affected by abuse and violence, and who face particular risks during and after armed conflict and natural disaster. Our services include quality case management using a survivor-centred approach, along with counselling and psychosocial support that includes referral to health centres for clinical management of rape and legal justice services based on the needs and wishes of survivors. In addition, we run women- and girl-friendly spaces and offer livelihood activities in the PoCs in Wau and Malakal, as well as within communities in Nyal, Aburoc, Malakal Town, Wau and Akobo counties.