International Medical Corps has been delivering humanitarian assistance in southern Sudan since 1994 and supporting communities across South Sudan since its independence in 2011. On December 15, 2013, heavy fighting broke out in the capital Juba and quickly spread, displacing 740,000 people across the country, and forcing tens of thousands more to seek refuge in neighboring countries. This escalating violence in South Sudan has impacted the delivery of International Medical Corps’ lifesaving services in conflict areas, along with those of many other humanitarian organizations.
International Medical Corps shares the concerns of many in the humanitarian community that the ongoing and escalating conflict will have a devastating impact on civilians in South Sudan and hopes for a swift and permanent cessation of violence. Unfortunately, despite a cessation of hostilities agreement that was signed by the Government of South Sudan and opposition leaders on January 23, the cease-fire was broken on February 18. Fighting has resumed in Malakal forcing numbers seeking refuge at the UN base to around 30,000 Internally Displaced People (IDP). International Medical Corps is providing health and nutritional services to these vulnerable communities, and on February 18 alone, International Medical Corps medical personnel treated more than 100 people hurt in the conflict.
Julia Albert-Recht, Program Manager for International Medical Corps in Malakal says, “The renewed fighting is having a devastating knock-on effect for civilians in Malakal. Even inside the UN camp we have seen tensions begin to rise and we have seen fights break out between groups within the IDP camps.” Albert-Recht continued, “Yesterday, at our clinic, we helped a woman through a very difficult birth and delivered a beautiful healthy baby. If that had been this morning, their lives would be in real danger because we aren’t able to get out to help them. There are thousands of innocent families in Malakal who need health and nutrition assistance which they won’t get because of this latest round of fighting.”
Since heavy fighting began in December, it is estimated that the conflict has claimed over 10,000 lives. Seven of the country’s 10 states are affected by the violence, including Central Equatoria, Eastern Equatoria, Jonglei, Lakes, Unity, Upper Nile, and Warrap. The United Nations refugee agency recently warned of severe strains on refugee camp populations in Uganda, while Ethiopia, Sudan, and Kenya also struggle to serve the influx of people. The humanitarian situation within South Sudan remains dire, with Internally Displaced People in camps urgently needing primary and emergency health care, water, hygiene, and sanitation and nutrition services, and shelter supplies. Tens of thousands more who are seeking refuge in very rural areas continue to lack access to assistance.
International Medical Corps is currently working in Juba, Maban, Awerial and Malakal, where tens of thousands of people are seeking refuge:
International Medical Corps is collaborating with UNICEF to also begin providing comprehensive mental health and psychosocial support to survivors of trauma and gender-based violence and clinical case management in Malakal, Awerial, and Bor. International Medical Corps will continue to closely monitor the security and humanitarian situation across the country and in neighboring countries, and will seek to fill gaps in areas where access was previously limited or impossible.
International Medical Corps has worked in the Democratic Republic of Congo (DRC) since 1999, providing health care, nutrition, food security, gender-based violence prevention and treatment, and water and sanitation services. The prolonged conflict in the DRC is characterized by extreme violence, mass population displacements, widespread rape and collapse of social services. Rape and sexual violence is pervasive in eastern Congo and exists in many forms. Often used as a weapon of war, armed militia and military rape and brutally terrorize women as a way to humiliate families and communities.
Unfortunately, there is still a great deal of social stigma that is attached to the survivors of sexual and gender-based violence in the DRC. The stigmatization of survivors can lead to them being shunned by their families and the community as a whole, often leading to survivors being chased from their own homes. Being rejected from the community often puts young mothers in a very dire situation that can become life threatening when they find themselves homeless and without any means of supporting themselves and their children.
International Medical Corps is applying a holistic approach to combat this problem by providing medical and psychosocial support the survivors of sexual and gender-based violence, while also working to modify the way communities view survivors of rape, which helps deter future attacks and accelerate the recovery of survivors. Below is a story of a courageous young woman who was able to rebuild her life after a very traumatic event with the help of International Medical Corps’ livelihood programming in DRC:
The International Medical Corps trained Kalonge psychosocial team first met Aisha in 2012 Aisha (*Aisha is not her real name and it was changed for her anonymity). She had walked 50 miles from her home in Ninja to escape the fighting and seek help after her ordeal in the hands of a group of armed men.
“I was inside my house with my husband and children. It was the night of March 21, around 9:30 pm. It was common during those days for armed groups to come into the village to steal and rape women and girls. We lived in constant fear of our lives.”
“As we sat with my family, the door suddenly burst open. Three armed men entered the house. They ordered us all to lie down and started tying up my husband’s hands and legs with ropes because he had tried to resist them. While they were tying him up, I screamed hoping neighbors would come and rescue us. They beat me up and said that if I screamed again, they would kill me and then kill my husband. This was enough to silence me. I was afraid that we were going to die. The three armed men proceeded to rape me in turns. They then asked my husband to show them where the money was. They gathered everything including our goats. When they had finished, they came back into the house and asked me to lie still on the ground. They called my children who had escaped to the next room and asked them to surround me and one of the men attempted to rape me in front of my children. My husband started screaming and one of the soldiers killed him.”
“The next morning at my husband’s funeral, I narrated the story to my mother in law who happened to have suffered the same ordeal in a different village. Three days after the incident, my mother in law and I decided to relocate to Kalonge. I was worried because we did not know anyone in Kalonge but I was determined to leave my home to forget all that had happened.”
International Medical Corps has trained many of the staff members at the Kalonge hospital and also built several health centers that offer services to survivors of sexual and gender-based violence. Adding to the provision of healthcare services, International Medical Corps also supports livelihood programs that help sexual and gender-based violence survivors become self-reliant by teaching them a trade, such as making a product that they can sell at local markets. International Medical Corps’ holistic approach to the problem of sexual and gender-based violence in DRC, and especially Kalonge, has created a network that can help a rape survivor at all stages in their recovery.
“Upon arrival in Kalonge, my Mother-in-Law and I reached a health center and I decided to get help because I was not feeling well. At the health center, I told the midwife what had happened and she directed me to where a woman who could help us was located. This woman took us to a community center where we received clothes, soap and food for one week. I met another woman who talked to me and gave me advice and helped me to gradually learn that I had hope even after all that had happened to me. The women also helped us to get someone to give us a place to stay. I continued to come to the community center because I could find help there. There are many times when I did not have the courage to look at someone in the face. My heart could start pounding and I could start crying when I remembered what happened back in my village. As I continued to go to the community center and receive more help from the women there, I gradually became stronger. I found the courage to join other women in the activities in the center.”
“During these sessions, I made friends and found out that some of them had gone through the same thing, but they had gained renewed hope. The woman who met me the first time continued to invite me to her office to talk more about the progress that I was making. She even came to visit me in my home. Of course I was still going through difficult times. My husband had been the sole breadwinner and now I have no one to support me and my children. I had no land to cultivate or a business through which I could make money to buy food. I struggled to feed my children and my mother in law with the little assistance from the community center.
“In September, my mother in law died and I was left alone with my children. Life became so difficult that I could hardly feed my children. To add to this, the house that community members had given us to stay in was destroyed by heavy rain. I was forced to seek refuge in a church. I went back to the community center, but this time, I was trained on how to start a business and given materials to start the small business of selling cassava flour. It has been 5 months since I started a stall at the local market. I am able to feed my children and myself. I have also been able to repair the house that was destroyed by the rain. I have the courage to laugh and even burst into laughter. I have hope to continue living and I am even thinking of returning to Ninja, back to my village.”
“I am thankful for the support that I was given by the people at the community center and all the support I received from International Medical Corps. I have the courage and the will to live despite the difficulties. I encourage the women to continue supporting other women who went through the same thing like me. Don’t give up. Thank you.”
Emergency Response Summary:
International Medical Corps’ Emergency Response Team responded within 24 hours to provide essential medical care to the hardest-hit areas in India following Cyclone Phailin, a catastrophic storm roughly the size of Hurricane Katrina, which struck the country’s eastern coast on October 12, 2013. While authorities put the death toll from the massive storm at 30 - far fewer than anticipated - more than 12 million people were affected by the cyclone. In its wake, Cyclone Phailin left wide-scale crop destruction, contaminated water supplies, the threat of disease and a devastated infrastructure; hundreds of thousands of people returned to their homes to find them damaged or completely destroyed due to high winds and flooding. In addition to providing emergency services, International Medical Corps is working with local partners to provide training and rehabilitate water supplies, helping to thwart the spread of disease, support recovery efforts and rebuild self-reliance.
International Medical Corps Responded Quickly with Immediate Relief After Cyclone Phailin:
International Medical Corps Response: Cyclone Phailin struck India’s eastern coast on October 12, 2013 with winds gusting at 125 miles per hour and storm surges of ten feet, inundating the districts of Balasore, Mayurbhanj, Bhadrak and Jajpur in Odisha State. The government evacuated nearly one million people across the two most affected states of Odisha (873,000) and Andhra Pradesh (100,000).
Within 24 hours of the storm making landfall, International Medical Corps was on the ground in Odisha where an estimated 200,000 people were stranded due to flooding in two of the hardest-hit districts: Balasore and Mayurbhanj. Many communities in Balasore were not prepared for the continuous rain that flooded 1,725 villages, affecting 348,778 people and over 260 square miles of crops. In Mayurbhanj, the destruction was similarly devastating, with floods affecting 737 villages, 342,260 people, and over 200 square miles of crops. In partnership with the Chief District Medical Officers and local health authorities, International Medical Corps’ Emergency Response Team deployed mobile medical units to more than 38 villages marooned by the cyclone in Balasore and Mayurbhanj and provided more than 10,500 critically-needed primary healthcare consultations. Working through local partners, International Medical Corps also distributed hygiene kits that included sanitary and non-food items, such as soap, laundry detergent, mosquito nets and water containers, in local communities to thwart the spread of communicable disease.
True to its mission, International Medical Corps’ teams also identified medium- and long-term needs to rebuild self-reliance, supporting communities’ efforts to recover and providing them with the tools they need to be their own, best First Responders. These needs include training in water, sanitation and hygiene activities; capacity-building support to improve water purification techniques; and infrastructure improvements to water sources, such as raising platforms for hand pumps to prevent future contamination from flooding.
Supporting Local Programs: In support of the Government of Odisha’s nutrition program that targets children and mothers, International Medical Corps provided information, education and communication materials to the Balasore District Welfare Office as much of their educational materials were damaged in the floods. International Medical Corps’ Emergency Response team provided more than 500 informational posters on the importance of breastfeeding; information about providing vaccinations for newborns; and monitoring the weight and nutrition of children. These materials are being disseminated to government-supported nutrition centers all over the Balasore district.
International Medical Corps is Building Capacity for the Future in India:
Working with its local partner, Unnayan, International Medical Corps is currently focusing efforts on reducing future disaster risks, specifically related to the water supply and the links between hygiene and health. Using a comprehensive approach that includes rehabilitation of water sources, construction of hygiene facilities, stockpiling and dissemination of hygiene supplies, and hygiene education and promotion, International Medical Corps and Unnayan are working to ensure that families and communities are prepared to protect water sources and thwart the spread of communicable diseases before and after a disaster strikes.
Improving Infrastructure: A wide-spread challenge during the disaster in Odisha was the submersion of hand pumps. Due to flooding, water accessed through hand pumps was contaminated; in other areas, flood waters compromised access to clean water. To mitigate this issue, International Medical Corps and Unnayan is constructing elevated platforms to raise the height of hand pumps in eight villages, which will prevent the submersion of hand pumps in times of flooding in the future. Additionally, teams are helping families chlorinate water from private household hand pumps to ensure the safety of water being used.
Investing in the Future Through Education: International Medical Corps and Unnayan are also implementing an awareness campaign focused on safe water, sanitation and hygiene practices at the individual household level, community level, and in ten schools. International Medical Corps and Unnayan have already delivered these key messages to 140 children at two upper primary schools in Balasore district, and the awareness campaign will be provided to eight more schools, reaching children from primary to high school age. International Medical Corps is also providing professional development and training to community healthcare workers and hygiene promoters in India; training is focused on best practices in providing community-based education on women’s personal hygiene; safety processes for drinking, storing, and handling water; use of latrines; and the hazards associated with unhygienic behavior such as not washing hands.
Improvements that Respect People and the Environment: Further, consultations with villagers that took place in November revealed the need for longer-term solutions to hygiene needs and challenges, especially for girls and women. In response to these concerns, International Medical Corps is supporting the construction of bathing cubicles in eight villages in Balasore District, which will be connected to the elevated platforms of hand pumps and will allow girls and women to have a private area to bathe, thereby preserving their dignity. The use of soaps and washing detergents will be localized within the cubicles, with little runoff, thus also reducing the environmental impact and protecting local rivers and other natural water sources from the effects of contaminants.
In the weeks following Cyclone Phailin, International Medical Corps transitioned from emergency response primary health care services activities to restoring capacity and building self-reliance in storm-ravaged areas by developing solutions to mitigate destruction from future storms, helping local communities to become their own, best First Responders. While no area is immune to the damage that can be unleashed by a storm of Cyclone Phailin’s magnitude, families and communities can be equipped with the tools and knowledge in areas such as water, sanitation and hygience to prepare for future emergencies and recover more quickly.