Bringing life saving services to places beyond the boundaries in Darfur
By Dr. Azzedine Zeroual, Dr. Abbas Terab and Steinar Sveinsson
El Fasher, North Darfur, 12 May 2009. The three states of Darfur covering a vast area - approximately the size of France – in the west of Sudan comprise many rural villages scattered across their most isolated corners and often difficult to access.
The people, themselves made up of different tribes, have normally lived in the same area for centuries, connected to the land and the way of life is has created for them. Living conditions are difficult because of the ongoing conflict and the extremes of nature – Darfur suffers both droughts and flooding – have hard hit the area and limited people’s ability to help themselves.
The combination of limited health services in many of these villages and limited access to clean water means diarrheoal diseases, malaria, meningitis, acute respiratory infection, measles, polio and other diseases prevail. Outbreaks of measles and meningitis are not uncommon. It is a daunting task to assist the people in these rural villages but to do so it’s necessary to be always ready to respond and to plan in advance.
In early May 2009 UNICEF together with a partner organization arranged for the transportation of vaccination supplies and hygiene campaign material to the village of Ain Siro in the rural Kutum locality of North Darfur, some 160 kilometres northwest of the city of El Fasher. Around 1,000 people live in Ain Siro itself but ten times this number live in the surrounding area, spread throughout 25 communities.
The volatile security situation around Kutum has meant that UNICEF has not been able to directly reach Ain Siro for the last four years. Increasingly, as car-jackings and attacks on humanitarian workers have become more prolific, rural communities have become too dangerous to reach by road, meaning aid agencies have to resort to “hit and run” visits using costly helicopters. Increasingly, as car-jackings and attacks on humanitarian workers have become more prolific, rural communities have become too dangerous to reach by road, meaning aid agencies have to resort to “hit and run” visits using costly helicopters.
In Ain Siro, the need to strengthen local health services led UNICEF to adopt this method of reaching the isolated community. Immunization is an especially vital service, the absence of which has implications for broader health care – if a population that hasn’t been vaccinated moves to an area where the population has already been vaccinated it can cause an outbreak of disease, with dire consequences.
In May, UNICEF chartered a helicopter to transport a solar refrigerator along with supplies of vaccine and other materials, accompanied by a UNICEF health expert from El Fasher.
As the helicopter could only stop for three hours, this visit allowed sufficient time simply to install the refrigerator and store the vaccines. But even prior to this flight, two villagers had managed to reach Kutum to take part in a “Training of Trainers” course to learn how to vaccinate children and pass on their new skills to other members of the community.
“This is a classic ‘hit and run’ visit – sadly a common occurrence now in many parts of Darfur,” explains UNICEF health and nutrition officer Dr. Azzedine Zeroual. “While on the ground in Ain Siro we were able to brief 14 vaccinators from the local community, who will receive further training and supervision from their two fellow residents who benefited from the training in Kutum. These local vaccinators will then go to other villages in the area and vaccinate children.”
“This is not an ideal approach; we would much rather be able to travel in safety to these areas and provide more sustained assistance,” admits Dr. Zeroual. “But at least we can still build capacity at the local level and in the future hopefully we will be able to send medical supplies to the people of Ain Siro and they will know how to manage them and put them to use for children.”
Despite its limitations, the initiative has been warmly welcomed by the local community leaders who recognize the importance of health services and are aware that much still needs to be done.
Dr. Zerioual recalls how one community leader recognized the challenges facing Ain Siro, noting that there are only 100 wells serving the 10,000 people living in the area. Many have to walk for up to three hours to fetch water.
But while accepting that circumstances are far from ideal, the same community leader had been clear on one key point – that the community would provide UNICEF all the support needed to carry out its work in the area and that parents would be encouraged to ensure that their children received the health care now becoming available.
Three hours work on the ground may just produce a lifetime of results.