الثلاثاء، 5 يناير 2016

South Sudan malaria outbreak - Rawan For Media Artistic and Production

South Sudan malaria outbreak - Rawan For Media Artistic and Production



Health workers struggle to contain a severe malaria outbreak as it stretches supplies across the country.

Aweil, South Sudan - In a remote northwest corner of South Sudan,
Theresa Ahok is in a hurry. The 35-year-old is from the village of
Adiang and walked for an hour and a half before managing to flag down a
truck to drive her and her sick son another hour to the hospital.


"I'm racing", she says," and I'm worried I won't get to the hospital in time."

Her
son Bakita is two-and-a-half years old and has malaria. She gave him
some anti-malarial medication at home but it didn't help. He then
started convulsing and she knew it was time to make the journey into
Aweil.


The
city of Aweil is a patchwork of red dirt roads leading to a bustling
town centre that has been a pocket of peace in a conflict-ridden country
for the past two years.

People
with malaria have been flooding to regional hospitals which are running
low on resources to provide care [Caitlin McGee/Al Jazeera]


It
hosts a base for the United Nations Mission to South Sudan, a number of
aid agencies and is home to the sole functioning public hospital with
the only blood bank in the entire state of Northern Bahr el Ghazar.


A
large section of the hospital is run by Doctors Without Borders in
conjunction with the Ministry of Health and serves about 1.2 million
people in what is South Sudan's poorest state.


Once
Ahok and her son arrive, Bakita is taken into the ward and treated. "I
like the level of care here", she says. "There has been a lot more
malaria in my village this year than last year."


Malaria
is endemic to South Sudan and is the leading cause of death and
illness, but this year Doctors Without Borders say the malaria outbreak
is shaping up to be the most severe it has seen. The United Nations has
described it as "unprecedented".

Doctors say the outbreak is the most severe they have seen [Caitlin McGee/Al Jazeera]

Nearly
1.6 million malaria cases have been reported so far, according to the
UN Coordination for Humanitarian Affairs. The number of cases in most
areas has doubled, and in some quadrupled, compared with the same period
last year.


The state of Northern Bahr el Ghazar is one of the worst affected.

"For
sure the malaria season has been huge this year," Claire Nicolet, the
project manager for Doctors Without Borders in Aweil, told Al Jazeera.
"Last year was huge already, but this year has been even worse."


"Usually
around December we would be reaching the end of the malaria season but
we are still treating about 130 patients a week who have severe
Malaria," she said. "So this season is extending well into next year."

Malaria drugs and resource shortage

About
an hour outside Aweil is a public healthcare clinic (PHCC) for the town
of Nyamlell, in West Aweil county. It is backed by the Ministry of
Health together with a non-government organisation called Concern.


It
is a sprawling site of concrete rooms with patients sheltering under
trees in a dusty courtyard or lying on the ground. It is run by Matthew
Deng, 30, a nurse who is in his first year out of training school.

Matthew
Deng , the nurse who runs the clinic at Nyamlell, said he is struggling
to provide care with the shortage of supplies[Caitlin McGee/Al Jazeera]


He
says that the severity of this outbreak has been made worse by a
shortage of supplies, which is crippling his ability to provide adequate
care.


"We
don't always have drugs for malaria because everything is supplied by
the Ministry of Health," he said. "The last batch of medication we
received was in November, but for this month we haven't received
anything."


He
said that the centre was given 2,000 paracetamol tablets that were
supposed to last a month, but instead were used up in a week.


The
only alternative is to write a prescription for patients, who are then
advised to buy the medication from pharmacies in town. But most patients
can’t afford it, so they head home to their villages and they wait.


"It's
about 25 South Sudanese pounds ($1.25) for simple malaria medication.
But it’s a lot of money and most of the time they don't have it," Deng
told Al Jazeera. "So they keep the prescription and go home and then
return when they have a complication."


That
complication means that the malaria has advanced from simple to severe.
Deng does have some supplies of the quinine injection which is used to
treat severe malaria, but he saves those supplies until it's absolutely
necessary to use them.


He
said he is also hampered by a lack of staff. "We have 30 people working
here but the downsize is coming ..." He expects 10 people to lose their
jobs next year.

No doctors

It's a similar scene at the PHCC for the town of Marial Bai.

The health centre is smaller and, unlike the PHCC in Nyamlell, has a makeshift pharmacy. But the same problems persist.
Pharmaceutical assistant at the Marial Bai clinic, Simon Kauc, said the it is short of medication [Caitlin McGee/Al Jazeera]

Simon Kauc, the pharmaceutical assistant, said they don’t have enough medicine.

"We don’t even have enough for one month", Kauc told Al Jazeera.

The centre is run by nurse William Deng who manages 32 staff including security guards and cleaners. There are no doctors.

"We
have to tell our patients to buy their medication from the market but
that is a big problem because they can’t afford it," he said. "Our
people are dying because we don’t have basic medication."


Both
these Public Healthcare Centres are being run with support from
Concern. Al Jazeera visited the one health clinic that was run by the
Ministry of Health alone - it was boarded up, covered in graffiti and
abandoned.

Malaria task force

The
UN Coordination for Humanitarian Affairs (OCHA) said a malaria task
force has been set up comprising the Ministry of Health, the UN and a
set of NGOs. In order to ramp up efforts to control the outbreak, said
OCHA, another $4 million is needed, in part to distribute mosquito nets
and anti-malarial drugs.

The
hospital is run by Doctors Without Borders in conjunction with the
Ministry of Health and serves about 1.2 million people in what is South
Sudan's poorest state [Caitlin McGee/Al Jazeera]


For
now, the shortage of supplies, ill-equipped facilities combined with
medicine they can’t afford, means malaria sufferers have little choice
but to wait until their condition is serious.


Some
will stay at home and die there. Others will go to their local clinic
and be referred to the hospital in Aweil, but the process is slow and
delays treatment even further. Another options is to bypass their local
clinics to make the long, slow journey to the hospital by themselves, as
in the case of Theresa Ahok.


Sometimes the delay can be the difference between life and death.

Ahok's
toddler Bakita is recovering now but she has already lost a son. He was
one of six children she has had to raise alone because her husband is a
soldier who lives away from home.


She never made it to the hospital. "He started convulsing", Ahok remembers, "... and then that was it."

Source: Al Jazeera

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