US $34 million for health in the south

The US Agency for International Development (USAID) on Tuesday announced a new five-year $34 million Health Transformation Programme to improve health in southern Sudan.

The programme would enhance health by improving maternal and child health through routine immunisations, polio eradication, growth monitoring, and diarrhoea and pneumonia care, said a press release. Core activities would include the rehabilitation of health worker training institutes, training of county medical officers and community based health workers, the provision of high quality drugs and other medical interventions, the expansion of routine immunisation, and access to safe drinking water and improved sanitation.

"This major investment will apply cross-cutting approaches to the health sector, including health systems strengthening, human resources development with a special focus on women and children to break the vicious cycle of poverty, malnutrition and infectious diseases, so mothers and children are healthier and families are better able to feed, clothe, and educate their children," said USAID Assistant Administrator for Global Health Dr Anne Peterson.

The money would also attempt to control and reduce the infection rates of HIV/AIDS, tuberculosis (TB) and malaria by establishing an epidemiological training programme for health technicians, and develop an epidemiological surveillance system, said USAID.

Many of the most common illnesses in southern Sudan are easily preventable and treatable, if people could only access quality health care. Malaria is the most common illness diagnosed by health workers, followed by diarrhoeal infections, respiratory ailments, intestinal parasites, eye and skin diseases and sexually transmitted diseases.

Others include Guinea worm, trachoma, onchocerciasis, elephantiasis, sleeping sickness, kala-azar, TB, and leprosy.

According to the UN, the south has only about 1,500 hospital beds for the some eight million people in the rebel-controlled areas of Equatoria, Bahr al-Ghazal, Upper Nile, the Nuba mountains and southern Blue Nile. Routine immunisations and preventative health care are also poorly supported by local Sudanese populations, who have to concern themselves with the basic needs in life, including finding food, clothing and shelter.

In anticipation of a peace settlement between the Sudanese government and the rebel Sudan People's Liberation Movement/Army (SPLM/A), USAID said it had begun to shift its emphasis from providing humanitarian and emergency relief to working with the SPLM/A on "revitalising and rebuilding" southern Sudan.

The new programme would begin to shift its focus from emergency health-care delivery to building "a sustainable health-care system managed and operated by Sudanese", focusing on Eastern and Western Equatoria, Upper Nile, southern Blue Nile, Bahr al-Ghazal and the Nuba Mountains, it said.

Ben Parker, the spokesman for the UN Humanitarian Coordinator in Sudan, told IRIN there was a general shift in thinking among agencies and donors, as they reviewed their operations in preparation for supporting an embryonic government of southern Sudan. NGOs and the UN were being encouraged to maximise their coordination efforts with the SPLM/A, as well as with local authorities, he said, as it was essential to build up national capacity and institutions. The various bodies of the SPLM/A were in turn "finding their feet" and exerting more authority.

Nevertheless there was a "wait-and-see posture" on the part of many donors who were reluctant to pledge money for long-term projects until a comprehensive peace deal had been signed by both sides, he added.

According to a UN Children's Fund report released in 2003 (Overview of the Health Situation in Sudan), there are about 66 agencies involved in health provision to southern Sudan - 19 of which are Sudanese agencies - but the spread of their services is unequal.

Equatoria has 26 percent of the population and 48 percent of the facilities, while Bahr al-Ghazal has 49 percent of the population and only 21 percent of the facilities. In the rebel-controlled areas of southern Blue Nile there are only four agencies operating and in the Nuba Mountains only three.