Overlooked and Underfunded: Sudan’s Multiple Crises

Cover Image: UNHCR/Hazim Elhag

By Andrew Moran, MedGlobal Policy & Advocacy Intern

COVID-19 vaccination campaigns have begun among the world’s richest countries after months of buying up the majority of promising vaccines. Of the two vaccines that have been approved, all of Moderna’s vaccines and 96% of Pfizer’s have been bought by wealthy countries, leaving few for low income countries battling the virus. Humanitarian organizations have warned that only 1 in 10 people across 67 low and lower-middle income countries, including Sudan, will have access to vaccines in 2021.

Continuing support for humanitarian efforts in these countries is critical as they will continue to battle the spread of COVID-19 for years to come. In Sudan, a country that has faced multiple health and humanitarian crises as it faces major political transitions, MedGlobal remains committed to ensuring access to health services among vulnerable populations. To date, we have provided over 86,000 items of PPE to local health workers in order to keep them and their patients safe. MedGlobal has also provided medical supplies and equipment to eight hospitals across six states and we are now working to build the first oxygen generator and oxygen filling station in Darfur. Sustainable access to concentrated oxygen is vital for a wide variety of life-saving medical treatments, including the ventilation of patients with COVID-19.

The work of MedGlobal and other humanitarian organizations in Sudan is increasingly important as needs in the country grow and local resources are stretched thin. At the start of 2020, an estimated 2.1 million people in Sudan were displaced, many due to Sudan’s two civil wars and the Darfur genocide. Mass displacements continued in 2020 due to violence by armed groups and record flooding across the country that destroyed over 110,000 homes, affected more than 875,000 people, and put 4.5 million at risk of vector-borne diseases. MedGlobal responded to the flooding by supporting 13 health facilities in managing the increase of flood-related diseases. The transitional government’s ability to respond to these crises has been severely hindered by a struggling economy and the outbreak of COVID-19 that has overwhelmed the fragile health system.

The latest crisis to affect Sudan is the growing humanitarian emergency caused by violence in Ethiopia’s Tigray region that has forced more than 56,000 Ethiopian refugees to flee into eastern Sudan. The refugee camps in Sudan are ill-equipped to meet the needs of the growing population, which the UN predicts will reach 115,000 by June 2021, and often lack basic necessities due to insufficient humanitarian aid. Overcrowding and limited access to sanitation and health services increases the risk that infectious diseases, including COVID-19, will spread among camp residents.

It is crucial for global health that low-income countries are not left behind or overlooked in 2021. Delaying vaccinations and failing to support humanitarian efforts in countries like Sudan as they battle multiple crises while supporting millions of displaced persons will not only exacerbate regional conditions, but also extend the pandemic. If nothing else, 2020 has shown that a health crisis in one region can ripple out and affect the rest of the world.

Field Operations Update for October 2020

Each month, MedGlobal publishes a monthly Field Operation Update, highlighting our humanitarian and health programs around the world. MedGlobal supports healthcare in Bangladesh, Colombia, Ecuador, Gaza, Greece, Lebanon, Sudan, Syria, and Yemen, and has been contributing to the COVID-19 response in the United States. These monthly blog posts provide a snapshot of some of our most notable program updates from the past month. For more frequent updates, make sure to follow us on Facebook, Instagram, and Twitter.

Colombia

This past month, MedGlobal extended support for two nurses working at a shelter at Tienditas Bridge on the border of Venezuela and Colombia. These nurses are providing free medical care to Venezuelans who are stuck at the border, waiting to return to Venezuela due to deteriorating conditions in Colombia. Particularly since COVID-19 reached the country, the Colombian health system has been overwhelmed and many of the 1.8 million displaced Venezuelans in the country do not have access to health services. The lockdowns and economic downturn caused by COVID-19 have also made life for migrants in Colombia increasingly difficult. Thousands of Venezuelans are now attempting to return home, but prospects for returnees, especially in terms of access to healthcare, remain grim.

Gaza

The spike of COVID-19 cases in Gaza has continued into October. MedGlobal, in partnership with Rahma Worldwide, provided 6,000 COVID-19 test kits and a shipment of medications for chronic diseases to hospitals in Gaza. This aid is crucial for supporting the fragile and under-resourced health sector that suffers from chronic shortages of medications and supplies. Testing capacity has also remained an urgent issue in Gaza, where hospitals rely on donations of testing kits from humanitarian organizations and UN agencies to meet needs. Gaza is home to two million Palestinians, nearly 80% of whom rely on humanitarian assistance and live in overcrowded areas with poor living conditions.

Lebanon

Following the devastating explosion of Beirut’s port, MedGlobal launched an emergency response in Beirut to provide support to overwhelmed health facilities facing increased levels of medical need. MedGlobal partnered with United Hands Relief and Development to provide essential medical equipment and supplies to the LAU Medical Center-Rizk Hospital in Beirut. The medical container included more than 55,000 medications and 20,000 pieces of equipment and supplies, including critically-need PPE to protect health staff during the pandemic. This support will help serve nearly 10,000 people in Lebanon.

Sudan

MedGlobal and the Sudanese American Physician Association (SAPA) are moving forward together to build an oxygen generator and oxygen filling station at Nyala Teaching Hospital in South Darfur. MedGlobal and SAPA will also provide 20 oxygen cylinders. The project will be managed by the South Darfur Ministry of Health which will provide long-term maintenance for the generator. This support will play a role in building the hospital’s capacity to treat patients with extreme COVID-19 symptoms or other respiratory illnesses in an extremely underserved community. MedGlobal has previously supported 8 hospitals throughout Sudan with PPE and medical equipment, but this is the first project MedGlobal has launched in the Darfur region.

Yemen

MedGlobal distributed PPE, medical supplies, and equipment to Al Mokha Isolation Center in Taiz governorate. This support follows MedGlobal’s work to establish the isolation unit which provides vital healthcare to one of the area’s most vulnerable populations. Prior to MedGlobal’s involvement, there were no functioning hospitals screening for COVID-19 in Al Mokha. All suspected and confirmed cases were referred to Aden or Taiz City, a journey of 4 to 5 hours, forcing many people with COVID-19 to remain at home as their health deteriorated. The recent distribution to Al Mokha Isolation Center included 24 beds, 19 oxygen cylinders, diagnostic equipment, thousands of items of PPE, and other requested medical supplies. In Yemen, only half of all medical facilities are fully functioning, making health support more critical than ever.

“Acting on compassion” – a conversation with Abduelsamad Abdalla Ahmed, MedGlobal’s Sudan Program Manager

MedGlobal recently launched operations in Sudan. We asked Sam, MedGlobal’s Sudan Program Manager, to talk about how he approaches his work and why MedGlobal’s presence in Sudan is so critical.

Tell us about yourself – where are you from, what are some activities you enjoy and things that are important to you, and how did you come to work for MedGlobal?

My name is Abduelsamad Abdalla Ahmed and I was born in Nyala, in the west of Sudan.

Reading is an intrinsic passion and it’s an activity that I have practiced and will continue to practice – in fact, I have literally consumed more than 80% of my lifetime reading. When I was younger I read – I would be reading, and reading, and then pausing to see what is happening in this planet – this world – on our TV, with my father. It’s excruciatingly sad witnessing all of it: deadly wars, health disasters, Earth disasters, floods, earthquakes, Ebola, Coronavirus, the ozone hole, global warming and other things, cruel things. It could make a book of grief.

I would look at myself in the mirror every night after we watched the news. I mean, in a world where democracy and liberalism are the elements and pillars of the foundation of a country, the news is a perfect place to watch horrific facts. And as such, desires grew in me and I saw myself growing. I saw a beacon of altruism in a few humans, and that nurtured inside me a desire to help those victims of vicious consequences. Many consequences, I mean some consequences are purposely made.

Underlying all of my motives is compassion for the suffering victims of humanitarian emergencies and a desire to help them wherever they may be, regardless of how they got there. And acting on such compassion, in my view, also advances as humans our strategic interests in promoting peace and prosperity worldwide. So preventing or reducing such suffering is my number one concern – I believe that this universe is beyond the concept of geography and borders. These borders exist, but we are all mankind and a crisis can differentiate no race, ethnicity, color, gender, religion, or anything – what we share is our humanity; ‘til the wheels fall off.

Tell us about where you live and how people are doing with the COVID-19 pandemic.

I currently live in Khartoum, the capital city of Sudan, which is the hardest hit by the COVID-19 pandemic in the country. As of August 24th, the cumulative confirmed COVID-19 cases reached 12,682 including 819 associated deaths. And as in every state, the government imposed a curfew from March 2020 until now. On March 16th, we had the closure of all airports, ports, and land crossings. All public travel between states has been banned since March 26th. Domestic movement restrictions were enforced starting March 31st, with a curfew effective between 6 PM and 6 AM in all states. Bridges linking Omdurman, Khartoum, and Khartoum North are closed.

MedGlobal is one of a few organizations working in north & east Sudan. Why is it challenging for organizations to work in Sudan?

To understand that, we have to first understand that Sudan is a country that has suffered many civil wars. The Second Sudanese Civil War lasted from 1983 to 2005 and is one of the longest civil wars on record. The war resulted in the independence of South Sudan six years after the war ended. Roughly two million people died as a result of war, famine, and disease caused by the conflict. Four million people in southern Sudan were displaced at least once during the war. The civilian death toll is one of the highest of any war since World War IIand was marked by numerous human rights violations. These include slavery and mass killings.

Sudan also is a country that is suffering from a severe devastating economic collapse, deteriorating health system and that situation is sadly in all states of Sudan. The situation has many variables and disasters are very dynamic. More than 1.2 million refugees reside in refugee camps in the states of Kordofan, Gedaref, White Nile, and the suburbs of the capital, Khartoum, where Medglobal operates. Also in 2019, there were more than eight fatal outbreaks of epidemic diseases (dengue fever, chikungunya fever, Rift Valley fever, malaria, and typhoid) in eastern Sudan states.

MedGlobal succeeded in deep analysis and study of the health situation in Sudan, looking carefully at the humanitarian situation of the country. MedGlobal’s success in eastern Sudan, northern Sudan, and the Kordofan region is due to observing the timing and dynamism of the changes that Sudan is going through, then studying the humanitarian needs carefully, then also the careful decent technical way of selecting national and regional partners to make the correct intervention succeed. Beneficiaries, director generals of hospitals, national partners, and medical staff appreciate the role of MedGlobal operating in these states and its unprecedented efforts in supporting the state hospitals’ plans to respond to the needs of the displaced people and refugees.

How did the recent distributions go? What are some of the challenges that come with these projects?

It’s very sad that sometimes language cannot adequately describe feelings, but I have never seen happiness to such an extent. The feeling of contentment when you see a patient smiling because you helped him – it was so confusing, the chemistry, emotions, what had taken place by MedGlobal was just a pure genuine humanitarian initiative.

MedGlobal’s journey began by forming effective partnerships, then after an accurate studying of the available options, MedGlobal conducted and completed a needs assessment, then began the journey of coordination between partners and ministries to establish and achieve impact.

MedGlobal implemented the COVID-19 response project in six states, and despite the complete ban on movement in cities, MedGlobal succeeded in obtaining a transit permit to deliver services. Despite the rugged roads, lack of fuel and floods, the team succeeded in delivering medical equipment to 8 hospitals that are the largest in Sudan in terms of beneficiaries – it was a real challenge – and the fruits of the trip were the smiles on the lips of these patients.

What is the current weather like where you are?

This is August, so it’s autumn in Sudan. Since it is autumn, the weather is very beautiful, with agriculture and greenery everywhere. Unfortunately autumn carries with it many disasters: September is the month with the highest rates of Malaria during the year. Malaria medicines are completely unavailable to most of the population. Autumn means four things: floods, malaria, infectious disease, and waterborne disease.

What are some hopes you have for MedGlobal’s continued work in Sudan?

Hope – maybe that is the only word for what I saw in the smiles on the faces of these patients – you feel it and know it, as if they cling to that word for life with a belief that there will be a charitable institution for them such as MedGlobal. These 8.8 million people just have hope. The only remaining thing. Countries never prosper nor develop without care and preservation of dignity and human rights. I am very happy to be part of this change and practicing my passion: helping to advance humanity with MedGlobal. I hope that there will be MedGlobal sustainable programs that further support the ailing health sector. And as the motto says: together for a world without health care disparity.

‘Lost Boy’ Dr. Jacob Atem joins MedGlobal to further advocacy efforts

Dr. Jacob Atem recently joined MedGlobal’s team as the Advocacy Coordinator, where he will give a voice to the MedGlobal’s mission and carry out advocacy initiatives on MedGlobal’s priority issues.

Dr. Atem received a Bachelor of Arts degree in Pre-Medicine/Biology from Spring Arbor University in 2008 and a Master of Public Health from Michigan State University in 2010. He received his Ph.D. in Environmental and Global Health from the University of Florida in 2017.

After escaping violence and surviving a long and dangerous journey out of South Sudan, Dr. Atem was determined to extend healthcare access to people around the world. He co-founded the Southern Sudan Healthcare Organization providing healthcare services and education to the region and is now utilizing his passion and expertise to further MedGlobal’s mission.

Can you tell us about your history and background?

I was born in Maar, South Sudan and at the age of 7, my job was to take my family’s goats and cows to find grass and water near the bank of the Nile River. One morning in 1991, I was caring for the animals when I heard gunfire and screaming. When I ran to see what happened, I saw that my village was on fire. The rebel forces from Northern Sudan had invaded, and at that moment, I knew that my family members had either been killed or taken into slavery.

Along with other young boys whose villages were destroyed, I started walking. As we trekked through the wilderness, we endured malnutrition, dehydration, exhaustion and much worse. One night when I was hiding in a bush, one of the boys yelled “lion!” and I ran into a sharp branch that cut my leg so deep that I could see my bone. There was no way to get medical treatment. Miraculously, it healed with time.

From the estimated 26,000 to 30,000 children, like me, who started the journey from South Sudan, about half died before reaching refugee camps in Kenya. After walking nearly 2,000 miles, I saw many boys die from diseases such as hepatitis B, measles, pertussis and tuberculosis. Like them, I had no vaccinations or opportunities for medical care. The refugee camps, where we ended up, were overcrowded and prone to outbreaks of cholera, shigellosis, and other diarrheal diseases – affecting the younger children the most.

How did your experiences as a child bring you to where you are today?

I witness and lived through the public health problems of refugees on my career path in public health – now I want to be part of the solution. I have joined MedGlobal as an Advocacy Coordinator because I believe in MedGlobal’s vision of “a world without healthcare disparity.” I have been helped in so many ways by others. To be able to give back, helping refugees and displaced people around the world is the greatest gift.

Why did you choose to work with MedGlobal?

MedGlobal deploys medical missions to provide lifesaving and life-sustaining emergency medical services to the most vulnerable populations in crisis areas around the globe. Through partnerships with local organizations, volunteers can address the enormous needs of primary and specialty care services. Since its inception, MedGlobal has deployed 132 medical missions in 13 countries around the world. By the end of 2019, MedGlobal aims to deploy a total of 160 medical missions in 17 countries.

Since we began our mission less than 3 years ago, we have conducted 112 surgeries, deployed 411 volunteers to sites around the world who have donated over 25,780 hours of there services. They have seen over 98,292 patients in 13 countries. Our medical volunteers have donated more than $3,221,481 worth of professional medical services and provided dozens of training courses to local healthcare providers.

What do you envision for the organization?

In 3-5 years, I envision MedGlobal impact will double in the continent of Africa. The future operations for MedGlobal will be in Kenya, Ethiopia, Uganda, and South Sudan. In September 2019, the MedGlobal will visit Uganda and conduct a health assessment and meet with local partners that will enable MedGlobal work in Uganda.

In October 2019, MedGlobal will travel to the Republic of South Sudan to meet the Ministry of Health (MOH). l will also visit hospitals in Juba and other states in the country. Based on the success of the visit in September 2019, MedGlobal will prospect for medical missions in early 2020.

Similarly, MedGlobal Organization has a strategic plan to visit Kenya and Uganda given the large influx of South Sudanese refugees into these countries.

How can others stay connected to MedGlobal and contribute to the cause?

There are several ways that you can stay connected with MedGlobal. You can subscribe to our newsletter and follow us on Facebook, Twitter, Instagram, and LinkedIn.

I have an open-door policy and invite anyone to contact me at any time at atem@medglobal.org.

To continue expanding our operations and achieving program goals, we ask for your support. Your donation will also expand the reach of MedGlobal to more refugees, patients, and displaced people worldwide.

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