Update No.98/05 on ICRC activities in Sudan
08-12-1998 Operational Update
Over the last two months, there have been several improvements in the humanitarian situation across parts of southern Sudan. In most areas, population movements have stabilized and previously-affected parts of the region have witnessed an amelioration in the population's nutritional status. The emergency phase in the Bahr El Ghazal region can be said to be over and the focus is now upon rehabilitation activities. Nevertheless, the situation of the Upper Nile, Eastern Equatoria and Jonglei regions remains unstable, mainly due to the fragile security environment and adverse weather conditions which have been experienced there.
In mid-September, heavy fighting broke out in Eastern Equatoria between government forces and the Sudan People's Liberation Army, leading to a sharp increase in the number of war-wounded. Although the situation had calmed by November, access for humanitarian organizations still currently remains difficult, due to persistent volatility. Many destinations in the Upper Nile region also remain off-limits for security reasons. Continual inter-factional fighting in this area, has caused population displacements, and hindered assessments and humanitarian work. Meanwhile, the eastern border around Kassala remains tense, with sporadic shelling and frequent population movements. In the Bahr El Ghazal region, the original three-month cease-fire was extended for an additional three months from October until 15 January 1999, to enable vital humanitarian activities to continue. However, the cease-fire only cov ers one of the three main regions of southern Sudan.
In August and September, areas of both northern and southern Sudan were badly affected by flooding caused by the extended rainy season which arrived late. The floods were the worst seen in Sudan for some years, affecting 18 of Sudan's 26 states, including the White Nile, River Nile and Northern states, Kassala, Bahr El Ghazal and Bor. As a consequence, there have been increased incidences of malaria, diarrhoea and other water-related diseases in these parts.
The ICRC continues to respond to the prevailing situation through its offices in Khartoum, Wau, Yirol, Juba, Nairobi and Lokichokio and currently has some 74 expatriates (91 including the staff of Lopiding Hospital) and almost 600 national staff in Sudan and Lokichokio working on this operation. In addition, ICRC delegates have started work in two new locations (Bentiu and Kassala), in cooperation with the Sudanese Red Crescent Society.
A large number of UN agencies and NGOs are still active in Sudan (mainly in the south), with the majority working under the umbrella of Operation Life Sudan (OLS). The World Food Programme (WFP) is the lead agency with respect to food distribution. Although the ICRC is not part of the OLS, it maintains close contact with their representatives to prevent duplication or overlapping of humanitarian programmes. The ICRC has been participating in coordination meetings in Khartoum, Wau, Nairobi and Lokichokio (northern Kenya) with the main humanitarian players. In addition to its own plan of action, it has been in a position to complement the humanitarian work of other organizations, playing a prominent role in the distribution of non-food assistance. For example, in Panthou and in Ajiep, the ICRC carried out non-food distributions for beneficiaries of MSF-feeding programmes.
ICRC main activities
Owing to the improved nutritional situation, the ICRC has closed down all its feeding centres and public kitchens in southern Sudan (three in Wau and four in Tonj) over the last two months. However, this situation is still being closely monitored so that the ICRC remains in a position to respond to new emergencies, should things deteriorate in the coming months.
Following assessments in Bentiu, Juba, Chotbura, Pochalla, Aweil, Aguko, Leer, Labone, Chelkou and in Kassala in the east, the focus for the last two months has been on the provision of non-food items (blankets, tarpaulins, kitchen sets, soap, mosquito nets, jerry cans, buckets and kangas) to internally displaced people and the most vulnerable. Also, the fishing season has started in Sudan and distributions of fishing materials (fishing hooks and fishing twine) have been made to areas of need.
In the north and south of the country, primary health care and water and sanitation programmes are being developed in many areas. In Wau, Bentiu and Yirol, the ICRC is continuing its " integrated approach " projects, which include non-food assistance, improvements to medical services, the training of local staff and volunteers in community-based health care, water rehabilitation and sanitation projects.
ICRC emergency response
From October to November, the following activities were carried out:
For the malnourished
Since September, the humanitarian situation in Wau has stabilized, with a reduction in mortality rates and a decrease in population mo vements. Following general improvements in November, three ICRC feeding centres were closed down in Wau town, as well as the Sudanese Red Crescent Society (SRCS) feeding centre, supported by the ICRC.
By the end of October, the ICRC had closed down all four kitchens in Tonj town, after having progressively scaled down its feeding programmes. Most of the beneficiaries had attained a satisfactory nutritional status within a matter of weeks, whilst the more severe adult cases had taken approximately two months.
For the sick
The three ICRC dispensaries in Wau previously attached to the feeding centres continue to operate, covering the existing medical needs of the general population. These dispensaries will also serve as training units for nurses, social workers and SRCS volunteers. In the East Bank camp, a clinic has been set up which handles some 50 consultations per day. The main illnesses treated are malaria and respiratory problems.
By the beginning of November, a team from the German Red Cross emergency response units (ERUs) had been deployed in Bentiu. The two ERUs aim to provide drinking water and a basic health care for an estimated 18,000 displaced people and some 9,000 residents, 3,000 of whom are felt to be in a vulnerable condition. A dispensary was opened on 12 November and carries out up to 200 consultations every day.
In October, there was a severe outbreak of diarrhoea in Juba and the ICRC supported the Juba Teaching Hospital in its fight against the epidemic. To prevent the spread of the epidemic, the ICRC, in association with the SRCS, conducted a hygiene education programme, together with a distribution of soap for 18,166 students from different schools in Juba.
For the displaced and resident populations
After the decision was taken by the authorities to relocate displaced people from Wau town to the east bank of the River Jur, construction work began on housing for this population. By the end of November, 1,000 tukuls (local huts) had been constructed by the ICRC and a dispensary had also been opened. To date, the tukuls have already been occupied by 3,500 people. A distribution of vegetable seeds and tools distribution took place for residents of the East Bank camp in November.
In November, 375 households in Wau (including displaced people, returnees and residents) each received an ad hoc distribution of non-food items.
A total of 800 households in Panthou were provided with non-food items and in Ajiep, 2,360 households each received two blankets and one tarpaulin. Fishing material for 1,800 households was also supplied.
At the beginning of October, the ICRC conducted a first assessment in Chotbura, Eastern Upper Nile of the civilian population, who are scattered over several thousand square kilometres. This assessment concluded that the priority was for non-food items for some 2,800 families. The distribution was completed by the end of October, with each household receiving non-food sets, fishing material, vegetable seeds and tools for cultivation.
Another assessment in Aweil town conducted in November, resulted in a seeds and tools distribution for 100 identified households.
An ICRC assessment to Leer was followed by non-food distributions (standard non-food and fishing sets) for the benefit of 3,000 households, who had been affected by fighting and looting over the past few months.
A distribution of non-food items and fishing material was also carried out for 3,471 households in Tonj and the surrounding area.
The drill ing of four bore holes in Thiet was completed and 12 other bore holes were started in Marial. These programmes are designed to improve access to clean water for residents and displaced populations.
Assistance to flood victims in non-conflictual areas
In October, after a rapid assessment of the regions of River Nile State, Northern State and White Nile State affected by serious floods over the last few months, a total of 9,500 tarpaulins were distributed in Atbara/Ed Damer, Dongola and Kosti.
In September the ICRC provided the International Federation of Red Cross and Red Crescent Societies with 2,000 blankets, 500 tarpaulins and six boxes of medical items for victims of the Tendelti flood.
ICRC plans for the short and medium term
In areas of southern Sudan, the ICRC has adopted a longer-term " integrated approach " , which addresses basic issues and aims to improve people's livelihood and help a return towards self-sufficiency.
The ICRC has been continuing to carry out construction work on the former hospital in Yirol in order to be able to use part of it as a primary health care centre. Four bore holes have been drilled and two wells rehabilitated, which has resulted in a decrease in the number of diarrhoea cases in and around the town. Some 100-130 consultations per day are currently being carried out, whilst serious surgical cases are transferred to Lokichokio. The ICRC also provides support to Billing hospital where tuberculosis cases and those in need of elective surgery are sent.
By mid-November, construction wo rk had been completed on two sub-clinics (in Niang, to the north of Yirol and in Gleng Deng to the south). Serious cases will be transferred to Yirol from these two sub-clinics. Five bore holes will be drilled at each of the sub-clinics to ensure the provision of clean water.
A mother and child health programme has also been initiated. Within the existing health structure in Yirol, refresher training is conducted for the traditional birth attendants and they are supplied with basic delivery material. Two first-aid training sessions have been held in Yirol for selected groups and further sessions will be given to each surrounding village. Such training is essential in order to increase general knowledge of how to stabilize the condition of medical emergencies for evacuation to ICRC surgical facilities. Community health workers (CHWs) from the area have access to ICRC training programmes. The CHWs will receive training which focuses on health education for disease prevention and nutrition.
A drainage system and septic tank are being constructed for the Juba Teaching Hospital (JTH) and the water supply is being improved.
The four ICRC-supported primary health care centres in Juba continue to receive monthly supplies of medical and nonmedical items, as well as construction material to rebuild certain facilities or improve existing structures. In October and November, some 10,647 patients were treated at the primary health care centres.
The SRCS also provided daily food distributions for the JTH, Shaba Children's Hospital and Juba orphanages to a total of 680 beneficiaries. A total of 12.1 tonnes of sorghum, pulses and vegetable oil was distributed by the SRCS to 1,460 beneficiaries among the blind and leper community in Juba town in Novemb er.
At the end of September, a distribution of non-food materials was carried out for 2,000 vulnerable families in and around Juba, in cooperation with the SRCS. Further distributions to 620 displaced families and 116 households of Congolese refugees were made in October and in November, the SRCS assisted 428 displaced people.
Some 1,100 households, who have been victims of the conflict and the flooding have been provided with continuous non-food assistance. Three bore holes have been completed in one of the camps for displaced people and a new contract has just been signed to drill three more in another camp. There are also plans to set up an additional dispensary and improved the basic health structure in the camps. All activities in Kassala are carried out in close cooperation with the SRCS.
Special care to war-wounded
The plight of the war-wounded continues to be a concern for the ICRC. Ongoing rehabilitation work on the Juba Teaching Hospital (JTH) aims to provide the general public and war-wounded with more comprehensive surgical care.
Medical evacuations to the ICRC's 560-bed Lopiding surgical hospital in Lokichokio continue. The hospital saw a 40% rise in the number of admissions in September/October, mostly due to the arrival of war-wounded from Eastern Equatoria. In the third week of November, the hospital was treating some 253 patients. The hospital, which is staffed by 17 expatriates and 150 national employees, admits 2,000 patients and carries out 5,000 operations each year.
Since the beginning of October, the ICRC has been granted access to all detainees held by the SPLA in Yirol. Regular visits have continued to persons held in Yei in order to monitor their conditions of detention. Detainees have received food and non-food assistance and have all been given the opportunity to write Red Cross messages (RCMs) to their families.
In Wau, the ICRC began to register unaccompanied children in November with a view to facilitating the re-establishment of family contacts. By mid-November, detailed data on more than 120 children had been collected.
The service to exchange RCMs between all people separated by the conflict continues. In October and November, a total of 8,531 RCMs were collected and 7,788 distributed. ICRC tracing staff are active in all regions of the country including Northern, Nile, Gezira, Senner, Bahr el-Jabel, Western Equatoria, Warab, Jonglei and Upper Nile States.
In October, two high ranking officers of the Sudanese Defence Forces attended a conference on the implementation of international humanitarian law (IHL) for heads of military training at the ICRC headquarters in Geneva. For the first time, the ICRC was able to organize a seminar on IHL for 28 officers of the Sudanese Defence Force, between 17 and 19 November, in Khartoum. The military headquarters view this seminar as a starting point for the integration of the law of war into the training curricula of its forces.
Cooperation with the Sudanese Red Crescent Society
Local branches of the National Society have played a major role in all aspects of the ICRC's work in the government-controlled areas of Sudan. Regular structural support to SRCS br anches in Juba, Wau, Raja, Bentiu, Malakal and Kassala continues to be provided by the ICRC.