Source: World Health Organization

World Health Organization - Country Information [ID 21787]

Information on diseases, health expenditures, health care provision and coverage, health system organisation and regulation, human resources in the health sector and statistics

Document(s): Open document

Source: Austrian Centre for Country of Origin and Asylum Research and Documentation

General links on health issues [ID 21788]

Document(s): Open document

19.12.2007 - Source: ReliefWeb

Report on nutrition, health and mortality of children up to 5 years of age in camps for internally displaced persons and in villages of Renk, Jelhak, Shomedi and Geiger Payams in Renk County, Upper Nile State ("Sudan: Nutritional anthropometric survey, 11 Sep - 18 Oct 2007"), Autor: Action Against Hunger - USA [ID 21844]

Document(s): Open document

14.12.2007 - Source: World Health Organization

Facts on medical care for Internally Displaced People (IDPs) in West Darfur ("Medical Care for the Internally Displaced People in West Darfur State") [ID 21833]

Document(s): Open document

10.2007 - Source: World Health Organization

Darfur: Report on El Fasher Teaching Hospital: General information on departments, NGOs working in hospital, role of WHO ("2 ry Health Care and Referral system; El Fasher Teaching Hospital") [ID 21843]

Document(s): Open document

05.08.2007 - Source: World Health Organization

Report on hospitals in North Darfur: General information on hospitals, numbers of operations, numbers of IDPs (internally displaced persons) ("North Darfur Hospitals; Mid Year Trend Analysis Report") [ID 21842]

Document(s): Open document

17.07.2007 - Source: World Health Organization

Report on health resources assessment of West Darfur: Available resources in terms of number and types, supporting agencies and available services provided ("Health Resources Assessment of WEST Darfur State") [ID 21841]

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06.03.2007 - Source: US Department of State

Inequalities in access to health services for children living in different areas of country ("Country Report on Human Rights Practices 2006") [ID 19845]

"There were significant inequalities in access to health services for children living in different areas of the country. UNICEF reported an under-five mortality rate of 93 per 1,000, a low birth weight rate of 31 percent, and immunization rates of approximately 50 percent. In the south, infant mortality was 150 per thousand births, and approximately 21 percent of children under age five suffered severe malnutrition."

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16.06.2006 - Source: World Health Organization

Darfur: Numbers and facts on patients access to Zalingei Hospital ("Patients Access to Zalingei Hospital– Feb 2006") [ID 21840]

Document(s): Open document

03.05.2006 - Source: World Health Organization

Detailed information on El-Geneina Hospital (May 2006): Patients' access to hospital, number of surgical operations, average duration of stay ("Trend Analysis Report for El-Geneina Hospital; May 3, 2006") [ID 21839]

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14.03.2006 - Source: World Health Organization

Detailed information on El-Geneina Hospital (March 2006): Patients' access to hospital, number of surgical operations, average duration of stay ("Trend Analysis Report for El-Geneina Hospital; March 14, 2006") [ID 21838]

Document(s): Open document

12.02.2006 - Source: World Health Organization

Numbers and facts on drugs consumption from Geneina Pharmacy ("Report of Drugs Consumption from Geneina Pharmacy") [ID 21837]

Document(s): Open document

20.01.2005 - Source: World Health Organization

List of hospitals in Darfur (January 2005): Current situation of hospitals, access to hospitals, number of IDPs (internally displaced persons) ("Secondary Health Care facilities in Darfur; January 2005") [ID 21835]

Document(s): Open document

26.10.2004 - Source: World Health Organization

List of hospitals in Darfur (October 2004): Current situation of hospitals, access to hospitals, number of IDPs (internally displaced persons) ("Secondary Health Care facilities in Darfur") [ID 21834]

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21.10.2003 - Source: Integrated Regional Information Network

High maternal mortality rates reported in Sudan ("Avoidably high maternal death rates") [#16948],  [ID 13056]

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10.07.2003 - Source: Integrated Regional Information Network

Abyei county: no health services available to a population of about 32,000 people, forcing them to rely on traditional healers or walk for between two and three days to access medical care ("No health facilities in rebel-controlled Abyei county") [#14230],  [ID 13058]

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19.11.2002 - Source: UN Office for the Coordination of Humanitarian Affairs

Ineffective coverage is manifested in lack of infrastructure, inadequate drugs and medical equipment, and lack of skilled health personnel ("OCHA: Consolidated Inter-Agency Appeal 2003") [#13809],  [ID 13059]

"Sudan suffers from acute and complex health problems. The cycle of poverty, malnutrition and loss of
productivity exposes at risk populations to debilitating and serious diseases such as malaria, malnutrition,
diarrhoea, and ARI. The expansion of health facilities has not matched the growth in population over the
years, and the war has destroyed many previously operating health facilities. Ineffective coverage is
manifested in lack of infrastructure, inadequate drugs and medical equipment, and lack of skilled health
personnel. The limited and inequitable access to essential child and motherhood health care services
accounts for the high infant and maternal mortality rates, which are 68 per 1000 and 509 per 100,000 live
births in GoS areas. Neonatal deaths estimated at 31/1,000 live births represent 40% of total infant
deaths in GoS areas. Data are not available for SPLM areas.
In Government areas of Sudan, 86% of women deliver at home with less than 57% attended by skilled
personnel. The strategy “Making Pregnancy Safer” was adopted in 2001, however the programme is
constrained due to widely scattered populations, lack of trained personnel and a high illiteracy rate.
Similar problems exist in SPLM areas. Training for TBA is underway through a number of OLS agencies,
but MICS figures show that 79% of women do not receive Tetanus Toxoid (TT) during pregnancy, that
94% of deliveries are done without the benefit of a health facility and 77% without the benefit of a trained
birth attendant. Only 86,294 women received the TT vaccine during January and August of 2002."

Document(s): Open document

19.11.2002 - Source: UN Office for the Coordination of Humanitarian Affairs

Bad access to safe drinking water boosts diarrhoeal disease ("OCHA: Consolidated Inter-Agency Appeal 2003") [#13809],  [ID 13060]

"Approximately 670,000 Sudanese children under-five die each year from preventable causes. Of these,
about 40% die from diarrhoeal disease, which could be significantly reduced with increased access to
safe water supply, and improved personal and communal hygiene and sanitation. In addition to
diarrhoeal disease, a large section of the population is afflicted with guinea-worm disease
(dracunculiasis), which can be largely prevented with improved access to safe drinking water, sanitary
facilities and hygienic practices. Sudan is hosting over 80% of the total Guinea Worm cases (in 2001) with
99% of cases being in the south in which Jonglei State is the most endemic area. Southern Sudan
presents great challenge for the Guinea Worm Eradication programme, where more than 4,000 villages
are endemic. It is estimated that if access to Guinea worm endemic areas were available, it would require
four years of intensive efforts to eradicate Guinea worm in the country."

Document(s): Open document

19.11.2002 - Source: UN Office for the Coordination of Humanitarian Affairs

Malaria, diarrhoea, and acute respiratory infection are the major diseases in Sudan ("OCHA: Consolidated Inter-Agency Appeal 2003") [#13809],  [ID 13064]

"Malaria is now
considered endemic throughout the country. In two years, the prevalence rate rose from 195/1,000 to
250/1,000. About 40% of outpatient attendance nation-wide is due to malaria with a current estimated
rate of 7-8 million cases and 35,000–40,000 deaths per year. The Multiple Indicator Cluster Survey 2000
(MICS), conducted in the Northern States and government controlled areas in the South, showed that
diarrhoea and ARI prevalence rates are 28% and 17% among children under-five respectively, and
diarrhoea prevalence reaches 40% in some States.
In 2002 there have been continuous outbreaks of epidemics such as meningitis and measles. Acute
gastro-enteritis is a sporadically endemic disease occurring especially after floods and other natural
disasters. In SPLM areas, meningitis, measles, and severe diarrhoea have hit the Nuba Mountains, Ruweng County, Maridi County, Ezo County, Torit County, southern Blue Nile, and Padak in Upper Nile.
Over 500 cases of Buruli ulcer were reported among IDP groups in Mabia, Western Equatoria. In the first
eight months of 2002, WHO received alerts on 23 suspected outbreaks and verified 13. Most of these
were meningococcal meningitis, acute watery and bloody diarrhoea, measles, and ARI.
Sudan reported 80% of Guinea Worm cases in the world. In the northern part of Sudan the Guinea worm
incidence has been reduced by 98%, however, it remains endemic in the south.
The achievement of the polio eradication programme demonstrates how adequate funding and proper
management results in effective outcomes. During the National Immunisation Days in 2002, over 5.8
million children, including IDPs and returnees, were vaccinated. In July 2002 the International Technical
Advisory Group concluded that there has been no evidence of wild poliovirus transmission since April
2001.
Immunisation coverage of the six antigens remains stable at the low level of 2001 (63% DPT3, Measles
60%). Nevertheless, due to infrequent and inadequate access to facilities among high- risk populations in
targeted areas, routine immunisation remains below optimal level. In 2001 it was estimated that onethird
of the cold chain needed rehabilitation or replacement and further decentralisation and development
is required in 2003. In 2001, global (routine) vaccination continued throughout SPLM areas, but coverage
is low. Only 62,000 children and 70,000 women were vaccinated with TT1. However, the selective
antigen pulse campaigns in three selected counties (Rumbek, Yambio and Mundri) resulted in
vaccinations for 110,000 children and 130,000 women during the year."

Document(s): Open document

19.11.2002 - Source: UN Office for the Coordination of Humanitarian Affairs

The prevalence rate of malnutrition is alarmingly high ("OCHA: Consolidated Inter-Agency Appeal 2003") [#13809],  [ID 13066]

"The prevalence rate of malnutrition is alarmingly high, increasing from 18% in 1995 to 23% in 2001 in the
North and the government controlled areas in the South. Furthermore the level of malnutrition among
children in drought affected GoS areas has increased in 2002 from 18-23% to over 27%. The situation is
equally critical for women in these areas with an estimated ratio of 1 in 4 women malnourished. Nutritional
status among infants is poor due to low adherence to exclusive breastfeeding (less than 19% of all infants
are exclusively breastfed for the first four months), and inappropriate introduction of complementary
feeding. In SPLM areas, malnutrition rates hit 30% in several locations of Upper Nile. This was linked to
a combination of difficult conditions including lack of roads, infrastructure, water and health facilities, poor
rains and insecurity. Two therapeutic feeding centres were established. A centre in Old Fangak catered
for an estimated 200 severely malnourished children while another in Padak estimates 45 children
monthly. Nutrition agencies are engaged in response, but access to the area has been poor.
Data indicate that the food intake of about 30% of the total population provides less than their minimum
energy requirements of 2,100 kcal. The 1999 safe motherhood survey shows that 30% of all newborn
babies were of low birth weight, which indicates low nutritional status of mothers.
Micronutrient deficiency remains a serious health problem that contributes significantly to high morbidity
and mortality rates. Although the national rate for Vitamin A deficiency has declined, due to repeated
supplementation during polio National Immunisation Day campaigns, it remains high in western and
southern parts of the country. Iodine deficiency remains a predominant problem with a national goiter
rate of 22%. There is little access to iodised salt in southern Sudan although trade routes in Western
Equatoria and northern Bahr el Ghazal do inject some iodised salt into the limited marketplace."

Document(s): Open document

19.11.2002 - Source: UN Office for the Coordination of Humanitarian Affairs

Activities by WHO and UNICEF ("OCHA: Consolidated Inter-Agency Appeal 2003") [#13809],  [ID 13068]

"This proposal presents activities of both UNICEF and WHO aimed at providing basic health services to
more than 2,000,000 children under-five and for their families. When peace is achieved, Sudan will
witness high mobility with an increased risk of the spread of communicable diseases. This will pose a
high demand on the few health care facilities, especially in many communities with no infrastructure or
human resources to provide care. WHO’s main focus in north and south Sudan will be the strengthening
of the PHC system by building the capacity of the MoH, local partners, and community organisations to
ensure the provision of the basic health services in these areas, through technical and managerial
capacity building and the provision of supplies and consumables. For the polio priority programme WHO
will maintain and sustain the present level of polio eradication immunisation activities and the certification
standard of the polio surveillance system by providing technical, managerial and financial support.
In the GoS area, UNICEF will continue its support for the PHC system, strengthening immunisation
service and keeping the momentum of the successful Polio eradication efforts. Inputs will be provided
through the Child Friendly Community Initiative (CFCI) as well as the government and NGO health
facilities. The post-conflict period will requires a smooth transition to enable the developmental schemes
move together with humanitarian assistance for sustainable recovery. Physical rehabilitation and
equipping run-down health facilities will be supported together with enhancing the capacity of service
providers. Orientation sessions on HIV/AIDS prevention and control will be part and parcel of all activities.
The project will also ensure pre-positioning of essential drugs, HIV rapid testing, and supplies for 35,000
population in each disaster prone area.
In the SPLM/A areas, UNICEF will deliver PHC kits, train CHWs and other health staff cadres and support
SPLM to implement relevant health policies. UNICEF also supplies vaccines and runs the cold chain. In
addition, UNICEF will support pulse campaigns against measles and tetanus in selected areas. Four key
strategies will be followed in SPLM/A areas:"

Document(s): Open document

19.09.2002 - Source: American University of Cairo - Forced Migration and Refugee Studies

Inadequate facilities as well as medicines for IDPs reported ("Report on the Situation of IDPs and Refugees in Northern Sudan: Findings of an exploratory study September 2002 (by Gina Bekker)") [#12484],  [ID 13067]

"4.3 Access to health care and education
Although there are clinics in the IDP camps, these tend to be dependent on external funding
from NGOs and are often staffed by inadequately trained health workers. Unfortunately due
to time constraints I was not able to visit one of these clinics. However, I did speak to the
women about their access to health care. They complained of inadequate facilities as well as
medicines. Many of the women I spoke to either were suffering from an illness themselves or
had a family member that was ill. I observed that most of the children appeared to be
malnourished and that the babies also seemed to be underweight (I saw one child who I
would have estimated to be no more than 2 months old, whom I was told was already 6
months old).
Provision is made for primary schools in some of the IDP camps by the government, however
there are no secondary schools in the camps. The education offered by the government is said
to have a heavy Islamic bias and tends to be under funded and under resourced. NGOs, in
particular religious organisations also operate schools in the IDP camps. These schools are
run either by the Churches or the Dawa Islamia, an Islamic Organisation providing religious
based education. In spite of the general availability of primary schooling many children are
not enrolled. This can be attributed to the fact that many parents are not able to afford even
the minimal fees charged and also the fact that older children – some as young as 5 or 6 are
made to care for their siblings, while their mothers search for employment. The school I
visited while in the camp, was funded by the Church. The facilities can only be described as
inadequate. Primary 1 consisted of a reed shelter with only blackboard and no desks or chairs.
The teachers I spoke of complained of inadequate funding, lack of teaching materials and
also of the fact that students often fainted in class because of a lack of food."

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03.04.2002 - Source: Integrated Regional Information Network

14 health workers arrested in Nyingol by members of the rebel Sudan People's Liberation Army/ 3 of the vaccinators were assaulted, including a female worker who was beaten ("Sudan: UN urges parties to respect anti-polio days") [#6385],  [ID 13072]

Document(s): Open document

04.2002 - Source: Médecins Sans Frontières

Report on Violence, Health and Access to Aid in the Western Upper Nile Area ("Violence, Health, and Access to Aid in Unity State/Western Upper Nile") [#6988],  [ID 13069]

"By late-1998, locations such as Ler and Duar – towns where MSF had run medical programs for almost a decade – had been attacked and destroyed not once, but several times. MSF’s expatriate staff were forced to evacuate from location after location as the conflict spread throughout the region, threatening to leave malnourished children without food and severely ill tuberculosis and kala azar patients without treatment. Several of MSF’s Sudanese health workers were killed
and many civilians fled the region, seeking safety in government-held towns like Bentiu or as far away as Khartoum. MSF attempted to initiate programs in the government-held town of Bentiu, where some displaced people had fled, but insecurity and lack of authorization continued to limit access. Early 1999 showed little sign of improvement. MSF attempted to access western Upper Nile numerous times, but continued ground fighting prevented any consistent medical activities on the ground. Occasionally medicines were left in the care of local MSF health workers, where adequate supervision was available. In late-1999, however, the southern part of western Upper Nile stabilized somewhat, and MSF was able to open programs in several new rebel-held locations. In 2000, MSF was active in seven locations in western Upper Nile, including Bentiu town, which was served from Khartoum. Initial activities in Bentiu focused on out-patient consultations, in-patient services and therapeutic feeding in an effort to address the needs of
thousands of newly displaced who had fled recent ground fighting in the rural areas. This conflict also affected MSF’s programs in the rebel-controlled areas, and three locations were closed even as programs opened in new areas. This fluid operating environment continues to constrain delivery of medical services to many parts of western Upper Nile. In the latest round of conflict, in February 2002, MSF was forced to evacuate and suspend its program in Nimne due to a ground attack and aerial bombardment. An MSF health clinic in Bieh has also suffered
disruption of medical programs following a helicopter gunship attack.While these two incidents have been well-publicized, they represent only a fraction of the consequences of the conflict for the civilians of western Upper Nile."

Document(s): Open document
msf0402.pdf

04.2002 - Source: Médecins Sans Frontières

Deterioration of the health system situation in western Upper Nile observed ("Violence, Health, and Access to Aid in Unity State/Western Upper Nile") [#6988],  [ID 13070]

"Through its presence in the area since 1988, MSF has observed the deterioration of the situation in western Upper Nile, but especially in the past few years. By 1996, MSF and other organizations working in the health sector had established a network of local health posts or dispensaries and health centres offering additional services. This network, consisting of 19
dispensaries and five health clinics, as well as the functioning regional hospital in Ler, provided health care to several hundred thousand people in western Upper Nile. MSF’s records for this period indicate that more than 100,000 consultations took place annually in the health posts between 1990-1994 alone. One of the less evident, but hugely significant effects of the conflict in the area has been the almost total destruction of the health infrastructure that was built up over the past decade, and the dispersal of many trained health workers. The provision of health services has always been poor in WUN, and with the onset of the civil war the situation further deteriorated. The sparse health infrastructure was largely destroyed and many health personnel were killed in the violence or the kala azar epidemic, displaced or recruited into the fighting forces.Medical doctors and other professionals fled abroad. A lack of health facilities and health staff have immediate consequences.Water borne-diseases such as diarrhoea and vector-borne diseases such as malaria account for the majority of the morbidity among patients in MSF’s health centers. With both types of disease, children under five years of age are at high risk of dying if treatment is absent. In addition, epidemics of other diseases regularly affect communities in western Upper Nile. Some of these diseases are easily prevented or reduced with vaccination programs, however, the conflict has rendered many areas inaccessible for regular immunization.
In addition, diseases affecting cattle, such as brucellosis, are easily transmitted to humans where there are no programs to prevent such infection. MSF staff have treated many people against brucellosis and the link with cattle is clear:
“I noticed all these people having really hot joints and fevers…(it was) brucellosis.We actually did a study and 20% of the cattle had brucellosis, which might not happen if there’s not a war, because brucellosis is a disease you can vaccinate against.” – Dr. Jill Seaman In 2001, MSF worked in six locations in rebel-controlled WUN, offering basic health care, some in-patient services, and in one location, kala azar treatment through simple village clinics. In addition, the MSF programs in Bentiu offered in-patient and outpatient facilities, therapeutic feeding, and treatment of kala azar and tuberculosis patients. The estimated catchment population for these programs was over 150,000 people. A total of 70,000 consultations took place in the six clinics alone over a one-year period, and almost 30,000 consultations and admissions took place in Bentiu in 2001. These seven clinics provide virtually the only source of preventative and curative
care for the population in WUN. Aside from a Ministry of Health clinic in Bentiu, all health services in WUN are provided by international organisations. In MSF’s clinic in Thonyor, for instance, which is a health center with in-patient capacity, an average of 1400 patients were seen each month in an area with an estimated population of approximately 12,200. In a four-month period from October 2001-January 2002, the center received 120 in-patients, people whose medical conditions were serious enough that they would die without treatment. The main diseases seen among the in-patients included malaria, pneumonia, malnutrition and serious wounds (including war wounded suffering from grenade and gunshot wounds). The center also treated 67 kala azar patients. These figures – a snapshot of one small health post in one pocket of WUN – indicate the huge health needs in the region. The fact that the conflict has destroyed or rendered inaccessible large areas of the region is that much more worrying when set against the backdrop
of such enormous human needs."

Document(s): Open document
msf0402.pdf

04.2002 - Source: Médecins Sans Frontières

Report on attacks on health workers ("Violence, Health, and Access to Aid in Unity State/Western Upper Nile") [#6988],  [ID 13071]

"All of the warring parties have been responsible for the destruction of health facilities, the looting of medical goods and materials, and the deaths of health workers. Despite the protections afforded to medical units and personnel by the Geneva Conventions of 1949, armed troops have targeted health units and staff with total impunity. The following list of attacks illustrates the pattern of attacks on health facilities and medical personnel. It is far from complete and represents only those incidents confirmed by MSF staff in western Upper Nile.


DATE OF ATTACK LOCATION AND DESCRIPTION OF EVENT
12/1989 Ler bombed by GoS.
9/1990 Ler bombed by GoS.
11/1991 Ler looted by SPLA troops.
6/1993 Nimne attacked twice in Dinka-Nuer clashes, 3 MSF health workers killed by militia (Peter Nyok,
Michael Mayak, Piok)
11/1993 Duar fighting, 2 tuberculosis patients killed
1/1994 Nimne attacked and health center burned down, multiple gunshot wounds leading to 3 deaths
9/1997 Nhialdiu clinic and surrounding villages attacked and destroyed (for the 1st time.) by militia.
3/1998 Duar clinic and village attacked and destroyed by SSIM forces under the command of Tito Biel.
MSF nurse (David Diapp) killed while fleeing Duar.
6/1998 Ler hospital, MSF feeding centers and town attacked and mostly burned by Peter Gadet forces
(then-allied to the SSUM). MSF nurse (William Diu) killed while fleeing Ler.
4/2000 Wicok & Bow attacked and kala azar center looted by unknown militiamen.
9/2000 Koch attacked, 2 MSF health workers killed (Paul Tap and Stephen Gatdet) and medical supplies
looted by the SPLA.
3/2001 Nyal attacked, OLS compounds and facilities destroyed by SPLA.
2/2002 Nimne looted by unknown militia and bombed by GoS, 1 MSF health worker (James Koang) killed
in aerial bombardment and medical supplies looted.
2/2002 Bieh attacked by GoS, MSF health services suspended in Bieh
TABLE 2: ATTACKS ON MSF HEALTH FACILITIES AND HEALTH WORKERS, 1989-2002"

Document(s): Open document
msf0402.pdf

04.2002 - Source: US Commission on International Religious Freedom

Interference with Humanitarian Assistance ("Report on Sudan") [#3382],  [ID 13073]

"The Sudanese government continues to deny access for humanitarian relief distribution, particularly in Western Upper Nile, through its control over relief flights pursuant to its agreement with the UN's Operation Lifeline Sudan (OLS). This denial of access threatens the lives of many in the region that reportedly face critical food shortages.7 In addition, as noted above, the government has targeted humanitarian facilities for bombing and other attacks. In June 2000, an attack by government forces near a Roman Catholic mission in Gumriak reportedly killed 32 persons, including women and children. In January 2001, government-sponsored militias destroyed an International Committee of the Red Cross compound in the southern Sudan village of Chelkou.8 As a result of government bombings of humanitarian facilities, the UN, on its own initiative, suspended OLS relief flights in August for several weeks.

The government also allegedly has tolerated the use of humanitarian assistance for religious purposes. The Commission has received reports from credible sources - Anglican and Catholic Bishops in Sudan - that UN-provided humanitarian aid to the country's displaced and needy population is being distributed on the condition that the recipients convert to Islam.

There are reports of instances where opposition forces have also interfered with the delivery of humanitarian aid. In February 2001, forces allied with the SPLA looted and damaged a UNICEF compound in the town of Nyal in southern Sudan.9"