Since 2004, an estimated 2.7 million people have been displaced from their homes and 200,000-300,000 people have been killed by the ongoing conflict between the Sudanese government and rebel forces in Darfur.1 This is the largest humanitarian aid effort in the world but it has been increasingly difficult to provide humanitarian support in the region. Across West Darfur, our supported program targets eleven communities to ensure their essential access to safe drinking water, community health education and primary health care for all people affected by the ongoing conflict: Chadian refugees, Darfuri Internally Displaced Persons (IDPs), local Arab nomadic communities and host communities, especially women and children under five years.
With thousands killed and millions displaced, the complex and unstable conflict in Sudan’s Darfur region has affected countless lives since its beginning in 2003. The risks of violence, rape, banditry and displacement are constant, as are crushing needs for health care, safe drinking water, food, shelter and other essentials. Formal IDP camps have mushroomed but the most vulnerable are those living in more remote areas of the bush, where most NGOs rarely venture.
Primary Health
The health conditions in West Darfur remain extremely precarious and vulnerable people, such as the elderly, women and young children, are usually the first victims of preventable illnesses. Our grantee has renovated or built a network of independent clinics in five rural communities, including Darfur’s only maternal and child health clinic, located in Riyad IDP camp. Each clinic sees 100-150 patients each day and most communities with fixed or mobile clinics also benefit from a safe drinking water and sanitation program.
Mobile Clinics
Mobile clinics are unique in a region fraught with insecurity. Mobile team visits a different isolated temporary settlement each day, returning to the same five settlements each week to ensure continued care, including pre- and postnatal care, immunizations, nutritional screening, and treatment of diseases, with referrals for complicated cases. Temporary settlements are omnipresent in West Darfur, as there is an unpredictable flow of refugees and IDPs fleeing the volatile security situation. These temporary settlements, even more so than the larger, more permanent IDP camps, lack the most basic infrastructure: there is a scarcity of safe drinking water and primary health care and sanitary facilities do not exist, leading to a high risk of epidemics.As our grantee forges relationships with local Oumdas and other leaders, they emphasize a listening role and prioritize local needs. Close local partnerships are essential, allowing this program to reach communities that would not otherwise receive any health care, aside from traditional medicine. In exchange for health care, the local Oumdas and communities work actively to improve protection during field visits, often travelling with the mobile team as unarmed escorts to and from communities.
Maternal and Child Health
While each of this program’s five fixed clinics prioritizes women and children’s health, there is one West Darfur clinic devoted solely to maternal and children health: Riyad Clinic in Riyad IDP camp, home to an estimated 20,000 people. Riyad Clinic serves women of child-bearing age and their children by providing family planning services, medications, immunizations, nutritional screening, pre- and postnatal care, deliveries, and pediatric care. The program team in Riyad sees an average of 850 new antenatal consultations and assists in an average of 215 deliveries each month.
Our grantee makes an effort to be sensitive to local beliefs in its practices and continually works with traditional birth attendants (TBAs) through voluntary intensive trainings that cover all basic aspects of obstetric care including: problem-spotting in pregnancies and births, checking the baby at birth, delivery methods and birthing hygiene. They provide single-use sterilized birth kits to all trained TBAs to use when delivering a baby and to all women who come for prenatal exams. As most women in Darfur give birth at home, additional kits are available for TBAs and pregnant women at the clinics as they need. A significant part of the training includes the creation of relationships between the clinics and TBAs to encourage TBAs to bring women to the clinic during complicated births.
Environmental Health
The primary health care activities of our supported program in Darfur is always paired in some way with environmental health activities focused on improving access to safe, clean water and increasing standards of hygiene and sanitation. This reduces the prevalence of water-borne diseases, particularly during the rainy season, and makes water collection a safer activity for women and children who often must otherwise travel far distances to collect water. Most fixed clinic and mobile clinic sites in Darfur are accompanied by water and sanitation projects, whether those of our team or other NGOs with which we work closely. Our water and sanitation teamassesses local water needs and may:
Each community plays an active role in the creation and maintenance of their water sources, facilitating local ownership over the project and building a strong foundation for its long-term success. Local water committees are elected by each community to be trained in maintenance and management of the water system. Our grantee currently works with local water committees to manage 61 water points in West Darfur.
Community Health Education
Both the environmental and primary health programs are reinforced by community health education programs which stress the preventative role and importance of personal and community hygiene, immunizations, reproductive health and family planning as well as causes and treatment for various diseases, such as malaria.
A team of 60 trained Community Health Educators leads a large number of community health awareness workshops within their local communities. Workshops take place at fixed clinics and mobile clinic sites, schools, markets, wells and other community gathering sites. Home visits are also an essential component as some of the topics are sensitive and follow-up with vulnerable members of the community is essential. One-time workshops are not nearly as effective as when paired with local health resources; this is why a representative Health Committee is elected within each community to act as a liaison, organizer and resource for the community.
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