A Healthier Future for South Sudan's Families

It’s morning and the dry season’s chilly winds blow through the branches of the gigantic trees surrounding the open market in Panyagor county, South Sudan. Traders are setting up their stalls, and customers are navigating through the market, many looking for something to cook for their families. Across the road, elderly men are knotting ropes for farm animals while women and men sell food and other goods by the roadside.

Two local women have just finished setting up their stalls and are ready to start the workday. One is the mother of nine children (five boys and four girls), while the other is the mother of four (two boys and two girls).

The women, who live in neighboring Twic East county, met in an economic empowerment and livelihoods program led by one of International Medical Corps’ partner organizations—Heath Link South Sudan (HLSS)—at the local women- and girl-friendly space. We partner with HLSS to implement gender-based violence prevention and response programs—including training programs to foster economic independence, such as the livelihoods program that ran from 2019 to 2021.

As part of the HLSS livelihoods program, women in Twic East participated in a business skills and leadership training series to help them create and manage their own businesses. The HLSS team also moderated discussions with the women and their husbands or partners to ensure that their families supported them and that their partners would not feel threatened or become violent if the women achieved financial independence.

After completing the training series, the two female entrepreneurs received funds to start their own businesses: $120, issued in two installments. The two women set up stalls close to each other in the open market, where they sell a selection of staple items, including onions, cooking oil, maize flour, spices, sugar and salt.

The women grew their businesses simultaneously, and use the proceeds to feed their families, pay school fees and meet their health needs.

“I can make up to 100,000 South Sudanese pounds in a month, especially during the dry season,” says one of the women. “I am financially stable, and I don’t have to ask my husband for money because now everyone in the family contributes. We are living happily, and I feel that my husband respects me more.”

They continue to run their businesses today, and they are thriving.

International Medical Corps runs women- and girl-friendly spaces in displacement camps and communities across South Sudan. In these spaces, women and girls can socialize, participate in training programs, make handicrafts and receive psychosocial support. We also work closely with local organizations and community groups to maximize the impact of our programs and help communities move from relief to self-reliance.

South Sudan has struggled with violence between armed groups in the years since the civil war ended. In August 2022, heavy fighting erupted between armed groups around the town of Tonga and has since spread east across Upper Nile State and south into the neighboring state of Jonglei—resulting in the displacement of thousands of people. The increasingly volatile situation has prompted a sharp increase in humanitarian needs as internally displaced people (IDPs) move from location to location in search of safety, shelter, food and clean water. With nearly 20 percent of the population of South Sudan displaced and more than 70 percent of the population in need of humanitarian assistance as of July 2022, needs were high before the current round of fighting

The conflict poses significant protection and safety risks to those displaced, especially the most vulnerable such as women, children and the elderly, and reports of gender-based violence and extortion are on the rise. The sudden influx of IDPs is severely straining the ability of host communities to provide essential services—particularly health, clean water, and adequate sanitation and hygiene—to themselves and the new arrivals. Food is also an urgent need. Due to the combined impact of cyclical drought and flooding, 7 to 8 million people across South Sudan are facing acute food insecurity and are in urgent need of food assistance—the ongoing fighting will only exacerbate the situation.

The Malakal Protection of Civilians (PoC) site in particular saw a sharp increase in the number of people it served in September. International Medical Corps quickly developed a response to provide primary health and nutrition services as well as gender-based violence prevention and treatment programs to this population. Additionally, knowing that clashes could continue, International Medical Corps began planning for the likelihood of the crisis expanding.

Some of the activities International Medical Corps has undertaken to provide humanitarian relief to residents of the Malakal PoC, include:

• Provision of emergency life-saving primary health care services through the establishment of integrated mobile health and nutrition teams;
• Provision of emergency life-saving primary health care services through the establishment of integrated mobile health and nutrition teams;
• Through the end of September, more than 2,000 people had been reached with curative consultations, 523 children received routine immunizations, and 53 critical cases were referred to hospitals.
• So far 1,280including under-five children were reached with curative consultationin Malakal PoC buffer zone, 289 individuals were reached with health education on different health topics for the displaced community. Distribution of LLITNs through routine EPI and ANC services are ongoing.
• More than 2,000 people have been screened for acute malnutrition; and
• Ongoing gender-based violence, nutrition and health education services are provided reaching thousands.

My name is Angelina, and I’m a participant in International Medical Corps’ gender-based violence (GBV) program in Nyal, South Sudan. I also go to the Katieth women’s and girls’ safe space (WGSS). I thank International Medical Corps for providing me and other women the opportunity to interact together and access basic information about our rights as women and girls, which has contributed to reducing the risk of violence in my community. I also thank the management and entire staff of International Medical Corps in Nyal, especially the women support officers, for training us in various areas within the women and girls’ safe spaces, which has enhanced our access to skills, knowledge and important information.

Before joining the WGSS, I wasn’t aware of my rights. After joining, I received training and guidance that enabled me to cope with my personal difficulties. I was counseled along with other women, and we are no longer stressed by the challenges we face.

My fellow women in this community and I have been in the dark, not knowing our rights or how to live healthy and happy lives. However, with the establishment of the WGSS, I feel empowered because I can now socialize with other women and learn from their experiences—reducing my own stress and improving my psychological well-being.

There are numerous changes taking place in my community today, especially with women’s and girls’ well-being, through the GBV program. It used to be a common practice in my community for a girl to be forced into marriage at a young age. If she tried to resist, men and boys could beat her—and her mother, if her mother tried to protect her. But now, because of the training that International Medical Corps is conducting for community leaders, most of whom are men, this phenomenon is changing somewhat. Women are consulted over their daughters’ marriages, and their consent is obtained prior to any marriage ceremony. Men’s engagement in learning basic GBV concepts through training and discussions has caused a positive impact in this community today.

I have also benefited from materials distributed to us in small bags here in the WGSS. The bags contain soap, toothpaste with a brush, lotion, underwear, sanitary pads, a nail cutter and sandals. We appreciate and thank International Medical Corps for that.

Initially, I didn’t know how to make bedsheets, but now I can make my own bedsheets, table covers and bead necklaces, using the skills and materials I received from the WGSS. I either use the products for myself in my home, or I sell them to earn money and buy basic necessities for myself and for my children.

Also, in the WGSS, there is a small room separate from the main hall called the counseling room. In this room, women are offered counseling services whenever they face violence, including rape—either in their homes or at the hands of criminals in the bush while they are collecting firewood or doing other livelihood activities.

Many people in this community are receiving messages about International Medical Corps’ activities and services provided in this WGSS, and they come from as far as Nyingong, Kol and other neighboring villages to participate in the activities and learn some skills.

Support from GlobalGiving, its community of donors and other donors helps make GBV prevention and response programs like this possible for vulnerable South Sudanese women and girls.

In many countries where we work, the COVID-19 pandemic has overburdened healthcare systems that were already ill-equipped to care for extremely sick people. The health system in South Sudan is one such example. However, our work to establish an infectious disease unit (IDU)—which became home to South Sudan’s first and only Level 1 intensive care unit (ICU)—has helped the country better prepare itself to take care of its sickest patients.

The World Health Organization and South Sudan’s Ministry of Health built the Dr. John Garang Infectious Disease Unit in Juba in late 2018, and in February 2019, handed over operation of the IDU to International Medical Corps.

In early 2020, the country was suddenly faced with a new challenge: COVID-19. That spring, we received the funding necessary to increase the level of care that the IDU could provide, upgrading from an isolation unit to an infectious disease treatment facility. Still, we were able only to provide minimal support to patients: monitoring them, and providing fluids, basic treatments and medications. We did the best we could, bringing in the additional resources, drugs and equipment that were needed until November 2020, when the Ministry of Health requested that our Emergency Medical Team (EMT) increase the level of care at the IDU even further.

The EMT sent five critical-care specialists to the IDU: a team lead, an ICU nurse, an ICU physician with a background in anesthesia and critical care medicine, an ICU physician trained in point-of-care diagnosis, and a biomedical engineer who could review the unit’s equipment.

“The EMT started from scratch, doing an assessment of the critical-care capacity in South Sudan,” explains Dr. Abdou, International Medical Corps’ Medical Director in South Sudan. The report found low capabilities for critical care in South Sudan and made a number of recommendations. “We started implementing those recommendations to increase capacity in the IDU to a Level 1 intensive care unit,” he says.

Today, the eight-bed Level 1 ICU enables critical-care workers to provide additional medical support to patients who are very ill. It has been equipped with sophisticated, real-time monitoring equipment, ventilators and supplementary oxygen devices. Health staff can use a new point-of-care laboratory to check blood hemoglobin or protein levels in urine, or to test people for diseases such as HIV or malaria.

“We now have a Level 1 ICU—the first ever in South Sudan that is accessible to the general public—where everyone can go, and which everyone can rely on,” says Dr. Abdou. “It has made a very big difference, and it has brought hope that South Sudan can start thinking about how to expand critical-care capacity. That is a big impact for the future of the health system in this country—and that was brought about by the IDU and 100% supported by International Medical Corps.”

With support from the GlobalGiving community and other donors, International Medical Corps continues to bring hope and healing to South Sudan.

In South Sudan, hostility continues to simmer, hampering efforts to improve public health standards in a country that has one of the world’s highest infant-mortality rates. 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 healthcare.

Despite all of these challenges, International Medical Corps continues to provide lifesaving healthcare, nutrition, mental health and protection services in five of the country’s 10 states. And it is our committed staff members, like Dr. Abdou, who make this work possible.

Dr. Abdou, International Medical Corps’ Medical Director in South Sudan, was inspired to become a doctor when his hometown of Goma, in the Democratic Republic of the Congo (DRC), was overwhelmed as hundreds of thousands of people sought refuge from the genocide against the Tutsi in Rwanda. “I could see how people were suffering,” Dr. Abdou says. “I got the feeling that I needed to do something in my life to help people, at least in the future.”

In March 2019, Dr. Abdou came to International Medical Corps as a technical coordinator, charged with preparing South Sudan for a potential Ebola outbreak. Luckily, the Ebola outbreak in the neighboring DRC did not spread across the border, but Dr. Abdou’s expertise proved useful as the COVID-19 pandemic took hold.

“Our greatest achievement has been keeping all the health facilities operational during the peak of COVID-19. When the pandemic started, my biggest worry was that many of our workers would get infected, and we would end up closing our health facilities in the POC [protection of civilians site]—which would be a disaster, because no one else is there to provide healthcare,” he explains. “And we succeeded—none of our health facilities closed because of COVID. We put a lot of safety measures in place, and we talked to staff on almost a daily basis to make sure they follow those protocols, because people tend to do things for a few days, and then they forget. International Medical Corps management also supported us quickly, making sure PPE [personal protective equipment] was readily available on time.”

“There will always be outbreaks of measles or cholera or other infectious diseases in many African countries—it’s something we just need to get used to,” he says. “But the principles are the same, no matter the disease—you need dedication and you need to avoid panic. Go forward and respond to it, while respecting the protocols.”

Support from the GlobalGiving community of donors helps Dr. Abdou, and the rest of our dedicated team in South Sudan, combat disease, relieve suffering and save lives.