Flooding Causes Health Problems in South Sudan

By: Victoria Calderon
Produced & edited by Kaylyn Hlavaty

At the peak of malaria season and in the midst of heavy flooding in South Sudan, medical aid is needed more than ever for Southern Sudanese refugees, but violence has suspended the delivery of necessary medical services from non-governmental organizations (NGOs).

“[The] majority of South Sudanese heavily rely on humanitarian aid,” says CHF International South Sudan Director Senada Kahriman, especially when 60 per cent of the country is cut off from access during the rainy season.

Médecins Sans Frontières Head of Mission in South Sudan Stefano Zannini says MSF is close to suspending all services in the country due to security concerns.

Courtesy of Catholic Relief Services Staff. Academic Fair Use.

Courtesy of Catholic Relief Services Staff. Academic Fair Use.

“This will have a devastating impact on the community, leaving more than 160,000 residents of Pibor County without access to health care,” says Zannini.

Some agencies have pulled their regular staff and organized mobile teams to provide daily visits to remote villages, says Kahriman.

“In Abyei for example, where health facilities and the entire town were destroyed and people displaced, mobile teams travel daily to provide services to returnees, and the new health facilities have been established in the places where the population was displaced.”

South Sudan’s grasslands, swamps, and tropical rain forests that straddle both banks of the White Nile serve as a breeding ground for life-threatening diseases when the river floods.

According to Médecins Sans Frontières, malaria cases have tripled in the Northern Bahr-el-Ghazal state.

Spikes of malaria generally start in May and begin to subside in September and October until they hit their lowest point in December. However, the rainy season began even earlier than usual this year and will likely continue longer than normal.

The states most affected by flooding are Jonglei, Lakes, Northern Bahr el Ghazal, Unity, Upper Nile and Warrap.

“Seasonal flooding has affected about 260,000 people this year across South Sudan. Although coordinated emergency response is ongoing to flood-affected people, needs can only partially be met,” says Kahriman.

The continued influx of Sudanese refugees has strained humanitarian operations.

“Upper Nile and Unity State have received huge number of refugees from the north, fleeing conflict affected areas of Blue Nile State and Southern Kordofan. There are also great needs to assist returnees coming from the north of Sudan, as well as [internally displaced persons]. UN sources confirm that More than 126,000 people have returned to South Sudan this year,” says Kahriman.

The heavy flow of water has strengthened the presence of infected mosquitos, which increase the likelihood that malaria will be transmitted to people after they are bitten, according to the World Health Organization (WHO).

Lamwalhok Liah is a worker in the out patient department of Médecins Sans Frontières in Juba, South Sudan. He says the condition of malaria and typhoid are present in all ten states, but it is at its height in the headquarters of Juba and the upper Nile region.

Malaria is preventable and curable, but the Plasmodium parasite that is spread with the bites of infected mosquitoes causes around 216 million cases of malaria every year around the world.

The large numbers of South Sudanese who were living in Sudan have returned to the south since the country’s independence, and these people have less immunity to malaria and are more likely to develop the disease says WHO.

South Sudan successfully transitioned to independence in June 2011 after 99 per cent of Southern Sudanese voted to separate from Sudan. The 2005 Comprehensive Peace Agreement established that South Sudan regional autonomy.

Partial human immunity, especially among adults in areas of moderate to intense transmission conditions, can be built up after years of exposure even if it will never provide complete protection, according to WHO.

Despite the excess of floodwater from the White Nile, refugees are sick with dehydration.

South Sudan courtesy of Shannon Jensen. Academic Fair Use.

South Sudan courtesy of Shannon Jensen. Academic Fair Use.

According to the Amherst-based Global Water Policy Project in the United States, about 36-percent of Africa’s population lacks access to safe drinking water. By 2025, the United Nations Development Program estimates that about one in two Africans will be living in countries that are confronted with water scarcity.

This water stress indicates that each person in the country has access to less than 1,500 cubic meters of water every year. In cases of water scarcity, this amount is reduced to 1,000 cubic meters.

This situation leaves Sudanese vulnerable to contracting waterborne diseases like diarrhea and Cholera in addition to the already rampant malaria.

The livelihood of Sudan depends on the use of its water sources. Eighty per cent of the country works in agriculture, and this accounts for 97 per cent of its water use, according to The Water Project.

The 22-year civil war that ended in 2005 left the health infrastructure of South Sudan in a poor condition, according to the Malaria Consortium, and non-governmental organizations have provided a range of health support while the infrastructure improves.

Kahriman says that while South Sudan is dependent on the health care from NGOs, “significant improvement [was] made this year in coordinating support to primary health care services, and jointly developed long-term strategy for health sector. This has brought together the government, key donors (USAID, World Bank and DFiD) and implementing NGOs.”

Southern Sudanese leaders fought for autonomy after more than two million southern Sudanese had paid for freedom with their lives. Another four million were displaced during the twenty-two years of guerilla warfare before the peace accord was established.

South Sudan remains to be one of Africa’s least developed countries as indicated by The Least Developed Countries Report 2011, determined by the United Nations Conference on Trade and Development.

Charcoal Production Reduction

By Alex Stuckey

Edited by Hiram Foster

Every day for 10 years, Cecile Nyirabahutu trekked long distances through the Musanze District in Northwestern Rwanda—battling the heat, strenuous work and shame, she made her way into Volcanoes National Park in search of usable wood.

The wood Nyirabahutu collected each day beginning in 1997 was then sold for charcoal, which supplemented her family’s meager living — but three years ago she started a new business plan.

In 2007, members of the Art of Conservation, an organization that educates the adult population of the district, about forest conservation, discovered Nyirabahutu on her daily trek and wanted to help her, said Julie Ghrist, spokeswoman for the organization.

(Image by user BanyanTree of Wikipedia.com)

Through partnering with Nyirabahutu, the organization began a briquette initiative with the Mountain Gorilla Veterinary Project to reduce deforestation in the park, Ghrist said.

“This is the last habitat for the mountain gorillas (in the world),” Ghrist said. “It needs to be protected.”

Like Nyirabahutu, about 94 percent of the nearly 11.1 million Rwandans rely on wood as their main source for heat and fuel because they lack modern electricity. The overuse of wood for charcoal has left the country, roughly the size of Massachusetts, with only about 7 percent of its original forests left, according to the Ecosystem Restoration Associates website.

The deforestation within Rwanda has caused an increase in run-off and flooding, which spreads diseases such as Malaria. It also has environmental effects, including a loss of an estimated 1 million tons of soil per year because of erosion, as well as longer drought periods, which threatens food security, according to the ERA.

However, efforts by both the Rwandan government and organizations are underway to reverse the problem.

Fuel Briquettes

Many organizations in Rwanda are replacing charcoal with fuel briquettes, which are made by mashing biodegradable materials together, pressing it into a tightly packed mass and setting it out to dry for several days, said Ben Beck, spokesman for Great Ape Trust, an organization working to reduce deforestation in Rwanda.

With the use of a wooden press provided by the conservation, Nyirabahutu manufactures briquettes made of shredded paper or other available materials, Ghrist said.

Convincing members of the Musanze District to use briquettes over charcoal is a slow process because most residents turn to the park for all of their wood and charcoal needs, Nyirabahutu said.

Despite this, the sale of briquettes still earns Nyirabahutu money for her family, Ghrist said.

“It will be sustainable for Cecile’s cooking,” said Innocent Uwizeye, the organization’s alternative cooking fuel consultant. “It will be a good income generator for her children and husband.”

Currently, a sack of briquettes costs about 6,000 Rwandan Francs, or about $10, Ghrist said.

What began as a pilot project to help Nyirabahutu’s family has expanding to surrounding villages, where she visits to demonstrate the technique, Grist said.

Administrators from the Rushubi Primary School in Kinigi, about 9 kilometers Northwest of the district, also expressed an interest in briquettes for cooking teachers’ lunches, Ghrist said, adding that an industrial sized stove was donated from Mercy Corps in the Democratic Republic of the Congo.

“We hope (the school) purchases briquettes from Cecile,” she added.

The conservation is not the only organization promoting the use of fuel briquettes to reduce charcoal production.

Another organization promoting fuel briquettes in Rwanda is the Cincinnati Chapter of Engineers without Borders. The chapter teaches villagers in Muhororo, about 80 kilometers west of the capital city of Kigali, how to recycle excess agricultural waste into briquettes, said Lee Hite, spokesman for the chapter.

The area has an abundance of bananas so briquettes are constructed out of decayed banana leaves, Hite said.

Hite and several other engineers created a wooden biomass press villagers can use to make briquettes, he said, adding that the chapter implemented the presses in the village to help reduce deforestation.

“So much of the rainforest has gone away, to be harvested for fuel,” Hite said. “Something needs to be done.”

Hite’s press has been duplicated in South America, Korea, India and other areas of Africa, he said, adding that the blueprints are available online and accessible to anyone.

Materials used to build the press can cost between $15 and $75 if materials are purchased in the US, Hite said.

Members of Great Ape Trust also promote the use of fuel briquettes as an alternative fuel source, not only to save the forests but also to save the apes living there.

The organization is focused on the Gishwati Forest, about 150 kilometers west of Kigali, which is 99.4 percent deforested, according to the National Aeronautics and Space Administration (NASA) Earth Observatory website.

“(The organization) is trying to reduce the demand on the forest and its wood products,” Beck said. “Education is our main strategy to help people better understand the connection between livelihoods and saving the forest.”

Government Initiatives

In an effort to curtail deforestation, Rwandan government officials made it illegal for citizens to cut down trees native to the country, Beck said, adding that pine and eucalyptus trees planted throughout the country were not native and could be cut down.

Officials also set a goal to increase electricity accessibility for its citizens. The target is to connect at least 35 percent of the population to electricity by 2020, as part of the Vision 2020 proposal, according to the Rwanda Environment Management Authority (REMA).

Through increasing accessibility, the intention is to decrease wood usage to 50 percent from 94 percent by 2020, according REMA.

Health Problems Associated with Deforestation

Reducing charcoal usage will not only save the environment and the apes — it can help save people as well.

Burning charcoal creates high levels of indoor air pollution that can imbed soot particles in a person’s lungs, according to the World Health Organization (WHO).

As of 2004, nearly 2 million people per year died from this kind of pollution. Some illnesses related to inhaling these pollutants include pneumonia, chronic obstructive pulmonary disease and lung cancer, according to the organization.

“Charcoal is making indoor air pollution a big problem,” said Elaine Fletcher, spokeswoman for the WHO in Geneva, Switzerland.

The WHO currently is working with sub-Saharan Africa to reduce air pollutants and better address associated health problems.

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