POVERTY: SUDAN: Farming the future in the South

 Photo: Jared Ferrie/IRIN:
Big plans: Farmer Baba Samuel Manoah is turning long-fallow land into a fruit farm

YEI, 17 February 2011 (IRIN) - With independence only months away, Southern Sudan will need to invest in infrastructure to feed and employ its people, while seeking alternatives to its economic dependency on oil, say analysts.
The key is agriculture, and one aspiring farmer, Baba Samuel Manoah has big plans for his land, which until recently was covered in dense underbrush. Now it is dotted with pineapples, young avocado trees and bananas. He envisions a commercial operation that produces not only fruit and vegetables, but also farmed fish and honey.
While his father, an MP, is busy with political affairs, Manoah plans to move home and run the farm full-time when he completes university in Kampala this year. “You can’t stay somewhere that’s developed and leave your place underdeveloped,” he said.
Six years of peace have allowed Manoah’s family to reclaim some of their land, which lay fallow during the war. He plans to expand operations and tap markets expected to develop rapidly in Africa’s newest state.
Not only could agriculture provide a lucrative business opportunity, but also jobs for the community, while helping to alleviate the desperate need for increased food production, he says.
About 2.5 million Southern Sudanese experienced food insecurity last year, according to the Famine Early Warning Systems Network. That figure was 40 percent above the average during the previous decade. World Food Programme officials have told IRIN that the sharp rise in the number of people requiring food aid coincided with an influx of returnees in the run-up to January’s independence referendum.
Many experts say Southern Sudan should be able to feed itself. The region encompasses vast amounts of arable land, but decades of fighting prevented the agricultural sector from developing. On the eve of independence on 9 July, they say, Southern Sudan needs to focus on farming to feed and employ its people.
“In the bigger picture, agriculture has to be the main driver of economic growth,” said USAID mission director William Hammink. He added that more than 80 percent of the population depended on agriculture for their livelihoods.
In May, USAID launched a five-year, US$55 million programme in the “greenbelt”, which stretches across the region’s southern borders through Western, Eastern and Central Equatoria states, where Manoah’s farm is located. The road-building and training programme aims to “increase farm productivity, trade, and the capacity of people engaged in the agricultural sector in southern Sudan, including producers and those in the private and public sectors”.
Officials also see agricultural development as a way of weaning Southern Sudan off oil sales, which currently account for 98 percent of government revenue.
“Right now they are almost totally dependent on oil,” said Hammink, who added that the government felt the crunch when oil prices fell last year. “They had a budget crisis here. It was difficult to pay salaries.”
Hammink noted that farming, along with other sectors of the economy, will require massive investment in infrastructure in order to develop. To this end, USAID is funding the construction of a key road from the capital, Juba, to the border with Uganda. This will substantially bring down the cost of importing goods, he said.
But in a region estimated to have less than 100km of paved roads, such projects are needed almost everywhere. Boma, for example, is a collection of grass and mud huts clustered around a dirt airstrip about 60km from the Ethiopian border. The town has no running water, electricity or mobile phone network. Goods trucked in from Kenya over punishing roads are prohibitively expensive once they arrive.
“You can see the food prices are very high and most of us don’t have jobs,” said Elizabeth Kadai, a resident of Boma. “The little money you get you buy food. We cannot even get clothes or send children to school.”
Despite the need for food, the market is relatively empty. Local produce consists mainly of small piles of mangos carried down from the nearby mountains. It is the dry season and there is not much else to harvest.
Kadai called on the government to provide farm equipment, training and irrigation that would allow locals to produce enough food to feed themselves all year round.
“It’s extremely expensive, this food that is imported from neighbouring countries,” she added. “If it was grown locally here and prices would decrease, then life would really be OK here.”
http://www.irinnews.org/report.aspx?ReportID=91951

POVERTY: SUDAN: Southern returnee deluge leaves aid workers in a quandary

  Photo: Paul Banks/UNMIS :  A Southern Sudanese returnee family residing in a school premises.

 AWEIL, 28 December 2010 (IRIN) - Build camps and run the risk of long-term dependence, or build nothing and watch basic needs grow: this is the dilemma facing aid workers in Southern Sudan amid an unexpectedly large deluge of people leaving the north of the country in the run-up to January’s secession referendum in the south.
According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), some 92,000 people of southern origin, many of them displaced during decades of civil war, had crossed from north to south between October and 22 December, and the rate of return was increasing.
The problem is that many are returning by bus, dropped off in major southern towns with no means of completing their journey to their area of origin.
When IRIN visited Aweil, capital of Northern Bahr al Ghazal State, recently, some 5,000 returnees were stuck in limbo there after spending a week on the road.
They were waiting for basic lifesaving assistance, such as water, emergency health services, and latrines, and also waiting for any word from the state government on what was in store for them next.
A week later, a UN official in the area told IRIN these returnees were still camped in the open air in a makeshift settlement that continued to swell with new arrivals.
“Establishing a formal camp means that people become used to the assistance that is given in the camp, [which] creates resistance to the closure and elimination of these camps,” said Giovanni Bosco, head of OCHA in Southern Sudan.
As Southern Sudan looks towards likely independence following its 9 January referendum, the prospect of multiple new camps outside towns in potentially volatile border states like Northern Bahr al Ghazal and Upper Nile is a significant concern, given the already low levels of infrastructure in the south and the imperative of beginning long-term development work after independence.
“It can take years to close a camp and to do a proper resettlement with durable solutions,” added Bosco.

Makeshift arrival settlements
The dire situation in the makeshift arrival settlements, however, is necessitating a response that the aid community admits could have long-term consequences.
“In an emergency environment and if a population is in need, regardless of where they are, we step in and try to provide them with assistance,” said Lise Grande, who coordinates UN humanitarian operations in the south.
“But we’re very clear that the reinsertion package, which is usually about three months worth of food and support to their households… needs to be delivered in points of final destination. The overall policy is not to have the transit sites become returnee camps,” she said. “But if people are in trouble in transit areas, of course we are going to respond.”
A day before the convoy of more than 600 families was expected to arrive in Aweil, Daniel Gar, the Northern Bahr al Ghazal State official in charge of facilitating their arrival through the government’s Relief and Rehabilitation Commission, said the government was expecting more than 87,000 to return before the referendum.

Allocation of land plots
Asked how the government planned to cope with the influx of new arrivals, Gar said his government “did not have much to give aside from plots [of land].”
“We are asking for the support of the UN agencies and aid groups,” he said.
When the Southern Sudanese government announced in August its plan to bring 1.5 million southerners home before the independence referendum, UN agencies including the International Organization for Migration decided that the organized returns programme proposed by the government could not be led by the international community given the time constraints and the likelihood that this particular returns effort could be interpreted as a political process, notably by the Khartoum government.
In the absence of significant international support for the process, the initial funds allocated by the southern government and by state governments have proven insufficient to support the high numbers of returns, particularly the final step of moving people from the urban centres where they arrive by bus to “points of final destination” in villages and rural areas.
According to OCHA in the southern capital, Juba, and to aid groups operating in towns like Aweil, the problems of funds for transport and the government’s lag in allocating plots for new arrivals in some areas is directly contributing to the threat of the creation of camps.
http://www.irinnews.org/report.aspx?ReportID=91470
 

MALARIA: SUDAN: Southern hospital cannot cope with demand

MALAKAL, 23 September 2010 (IRIN) - Doctors are working 12-16 hour shifts to cope with the increasing demand at Malakal teaching hospital in Upper Nile State of Southern Sudan, say officials.
"We are trying to encourage more doctors to come work here," Upper Nile State health minister Steven Lor said. The relatively poor living conditions in Malakal, however, made it difficult to convince Southern Sudanese doctors working in the capital Khartoum to move.

The hospital director, Tut Gony, said in the past two months, more than 2,000 people had sought treatment at the hospital. These included 700 malaria cases, many of whom were children.

"Our capacity and resources at this hospital do not match the high demand for services," Gony told IRIN. The hospital, the only such facility in the state, has 14 doctors for the state's population of 126,000, according to the 2006 national census.

To cater for this population, as well as some patients from neighbouring Jonglei State, the hospital needed more beds, new surgical equipment and a steady stream of drugs, Gony said.

The current rainy season, which has left four of Upper Nile's nine counties partially under water, was likely to increase health risks. "We have a serious problem with sanitation in Malakal," he added. A survey by the NGO Relief International in 2007 found that 80 percent of the residents had no access to latrines or any other toilet facilities.

The town used to have a piped water supply system but it collapsed during the civil war between the Southern Sudan People's Liberation Movement and the Sudan national army. The war ended in 2005, but by then the pipes were blocked or had been looted.

Lor said the current flooding had created a potential problem of disease outbreak. "After the water comes down, we're expecting there will be more problems," he said, noting that possible diseases included Bilharzia and Kala-azar, which is endemic in some parts of Southern Sudan, with outbreaks every five to 10 years.

A team led by Jalal Mohammed, a northern Sudanese internal medicine specialist, is in Malakal now to distribute anti-malarial drugs and administer treatment to patients with diarrhoea-related conditions, using mobile health clinics.

According to data compiled by the Norwegian Refugee Council, Southern Sudan has one of the highest infant mortality rates in the world at 89 deaths per 1,000 live births, and a maternal mortality rate of 2,038 deaths per 100,000 live births, which is more than 10 times that of Europe.


Http://www.irinnews.org/report.aspx?ReportID=90563

MALNUTRITION: Southern Sudan

At dawn, an old woman in a bright but tattered dress picked her way along a muddy, trash-strewn path. She stopped at a pile of garbage and carefully removed the remains of a dirty onion. Then she sat and slowly began to eat it for breakfast.
I was in southern Sudan as part of a medical team from Massachusetts General Hospital — my first foray into international medical work. The goal of this pilot project was to teach Sudanese hospital staffs the basics of newborn care and resuscitation.
Southern Sudan has barely emerged from more than two decades of civil war, in which at least two million people died. Since the war ended in 2005, many of the aid agencies that were sustaining education, nutrition and health care have pulled out, and despite the heroic efforts of those that remain, most citizens’ day-to-day existence is shocking. As a tent camp manager in the town of Wau observed, “The peace is killing us.”
Pictures of these war-torn regions do no justice to the physical and emotional realities. It was boiling hot each day as we trekked over dusty, crater-filled streets filled with noisy motorcycles and honking jitneys. After lugging our equipment to the hospital, we were sweaty and exhausted by the time we began rounds in the children’s ward with the sole pediatrician.
The hospital was beyond imagination. Beds were overflowing with infants and children, many of them desperately ill with malaria, malnutrition or viral diseases. Babies with diarrhea wore no diapers, but were wrapped in simple cloths that their mothers would rinse out periodically in the hospital yard.
Patients of all ages were urinating and defecating around the hospital grounds. Water to wash hands was not available in the ward — only outside at a common pump. The smells were overwhelming, and the heat was barely relieved by a single ceiling fan. Flies buzzed around, and persistent tubercular coughs filled the air.
Filled with admiration for the medical teams — and aware that the doctors had not been paid for six months — we offered our meager help. We began our courses with a willing group of medical assistants, nurses and the local pediatrician, who served as translator.
Much to our surprise, we were called one day to practice what we were preaching. A mother who had lost three babies was about to deliver her fourth. The obstetrician asked that we be present in the delivery room.
The baby came out limp and blue, making no effort to breathe. While the medical team watched, we re-enacted the resuscitation we had been teaching all week.
Finally the baby began to cry and then, with great effort, to breathe. We were exultant. Not only had we saved the baby, but the staff could see the value of our teaching.
Such is the smugness of do-gooders. When we visited the next day, our wonder baby was grunting and struggling to breathe. Since there are no intensive care units, he was going to have to make it on his own. His mother looked sad and tired.
Meanwhile, in the next room, a grandmother sat looking out the window while a tightly wrapped premature baby lay on the bed. As I unwrapped the baby, I realized the infant was cold and still. The grandmotherly stoicism suggested that death was a familiar companion.
Southern Sudan is still defined by a tribal culture, with groups living in wood huts with dirt floors. Children are not in school. In Juba, the region’s capital city, garbage is piled high, the stores are empty of fresh food and canned goods are covered with dust. Water is dirty. Toilets are mostly nonexistent, or just filthy holes in the ground.
The challenges of providing health care in this setting were so overwhelming that I found myself questioning the mission. What were we doing there? Whom were we helping? Or were we simply assuaging our first-world consciences? Shouldn’t basic needs — roads, water, food, housing — be met before all else?
The aid groups still stationed in Juba seemed to be a mixed blessing. Many Africans have written about the passivity and dependency spawned by an “aid culture,” and I could see for myself the lack of initiative that seemed to pervade the towns. Trucks of soldiers frequently roared by, bristling with armed militants. Had years of tribal warfare, malnutrition, disease, heat and poverty sapped the will of the once proud Sudanese?
Few would question the inspiring rescue efforts taking place in Haiti. The outpouring of food, dollars and labor affirms our humanity. But when human suffering goes from the acute to the chronic stage, does the strategy need to be revised? Caregivers who have spent years in Sudan suggest that without sweeping changes in government and infrastructure, the misery will continue.
I returned home feeling less happy about our successful baby-saving exercise, and wondering what would happen to that child. Still, I remembered the oft-quoted observation that if you help one person, then you help one person. That is surely better than doing nothing, and I am continually inspired by the many health professionals who selflessly offer their time and expertise to those in dire need.
But I resolved that my future efforts would be more defined. As a neophyte in international health, I needed more direction. Partners in Health, a Boston-based charity that has done pioneering work in H.I.V. prevention and treatment of tuberculosis, has demonstrated that focused, strategic efforts will produce the best results.
My baptism in the world of international health was bewildering and challenging, and I left with many unanswered questions. And while I may not return to Sudan, I hope to return to an area of need where I might make a small difference.
Dr. Victoria McEvoy, an assistant professor of pediatrics at Harvard Medical School, is the author of “The 24/7 Baby Doctor.”
http://www.nytimes.com/2010/08/10/health/10case.html?_r=1

MIGRATION: The problem of the IDP's

LONDON, 18 May 2010 (IRIN) - At least 6.8 million people were displaced last year, mainly by long-running conflicts, pushing the number of those forced to live away from home to 27 million - the highest since the mid-1990s, a new report states."The massive population movements and shocking violence are a sad reminder of the price that civilians pay in armed conflict," Elisabeth Rasmusson, secretary-general of the Norwegian Refugee Council (NRC), said while launching the 2009 annual report on displacement at London's Royal Institute of International Affairs. "Millions of people were newly displaced by conflicts in which combatants did not meet their obligations to protect civilians."The report, published by the Geneva-based Internal Displacement Monitoring Centre (part of the NRC), said that while the number of refugees in the world remained fairly static, that of IDPs was rising steadily.The distinction between a refugee and an IDP is clear in international law, but for the people who packed up their families and a few possessions and fled their homes to escape conflict it was often a matter of chance whether or not they crossed an international border.The biggest single group of newly displaced people was in Pakistan, where some three million people fled army offensives against the Taliban and other armed groups. Most of the displacement was, however, temporary and they have now been able to go home. In the Democratic Republic of Congo, one million were newly displaced in 2009, as were over half a million in Sudan, and 400,000 each in Somalia and Colombia. The IDPs, Rasmusson said, were often poorer and more vulnerable than refugees, and unable to travel as far from the conflict zone. The responsibility for their security and welfare should lie with their own governments, but some were reluctant to acknowledge the existence of displaced people within their borders. "They prefer to call them dislocated, or mobile or vulnerable populations," she said. The report cites Algeria, Myanmar, Indonesia and Zimbabwe as denying internal displacement. "This is arguably an attempt to deny the displaced access to the assistance they are entitled to by international law," she said.
http://www.internal-displacement.org/

Malnutrition: Sudan

Emaciated babies and young children throughout the ward bore the signs of hunger: exposed ribs and distended stomachs. Outside, old villagers reclined motionless in the shade, too frail to walk.
The U.N. calls this the "hungriest place on Earth" after years of drought and conflict, with aid agencies already feeding 80,000 people here. A doctor says the worst is yet to come.
Two years of failed rains and tribal clashes have laid the foundation for Africa's newest humanitarian crisis. The World Food Program quadrupled its assistance levels from January to March in the Akobo region of southeastern Sudan.
International aid agencies are bracing for the worst. Even if spring rains materialize this year, the harvest won't come in until fall.
"And if there is no rain, it will get worse," said Dr. Galiek Galou, one of three doctors at the hospital in this town on the border with Ethiopia
http://www.npr.org/templates/story/story.php?storyId=125717036

Sudan

“Our team were surprised by the situation they found,” said Jeri Westad, Country Director for Medair, who initiated the assessment in association with Save the Children in Southern Sudan (SCiSS). “This is one of the most desperate places we have seen in Southern Sudan.”The late February assessment examined children five years and younger and found that 45.7 percent of them had global acute malnutrition (GAM) and 15.5 percent had severe acute malnutrition. [1] The survey also showed that, in addition to appalling rates of malnutrition, the children were in very poor overall health. “Without an intervention, many of these children will die,” said Ms. Westad. Food and nutritional support are desperately needed in Akobo, which has suffered from lack of rain, insecurity in the area, and five years of crop failures. As a result, Medair and SCiSS are immediately establishing a therapeutic feeding programme that will provide urgent nutritional support and medical care for 800 to 1,000 severely malnourished children in Akobo East County. Meanwhile, the World Food Programme (WFP) and SCiSS will distribute supplemental food rations for families in need, and International Medical Corps (IMC), which runs the county hospital, will continue to provide care for severely malnourished children. “We are only just entering the start of the hunger gap so we would expect nutrition levels to worsen in the coming months,” said Kate Foster, Director of Programme Development for SCiSS. Akobo has been the site of violent tribal conflicts for the past year, so Medair will closely monitor the security situation throughout the emergency response. “The need to act is so strong that we must take immediate action on behalf of these children,” said Ms. Westad. “It’s not too late for us to make a major life-saving impact.” [1] Calculated using weight-for-height z-scores based on WHO’s 2006 Growth Standards.
http://www.alertnet.org/thenews/fromthefield/220382/4b76b899903e37a05ead4db852551314.htm