September 2009 Newsletter page 2.

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POLITICAL UPDATE

Cooking oil provided by WFP is distributed to TB patients
and families.

You may have read reports about the International Criminal Court charging Sudan’s President with crimes against humanity last March. The Government of Sudan responded by expelling 13 international NGOs, including big players like Oxfam and Doctors Without Borders. Many of you asked whether our project was threatened with eviction. The answer to that question is, fortunately, no. The government of South Sudan wants to keep all the NGOs it can. It even begged the agencies that were kicked out of the North to resettle in the South.

The ICC ruling did affect our program though. Malakal, the regional center of Upper Nile, had been in the hands of the north before the peace and have northern military troops stationed there as part of the peace accords. A wanted militia leader from the north returned in April -- supposedly for a family visit. Fighting broke out between his supporters and the Southern People’s Liberation Army—leading to civilian deaths —and the abrupt departure of the World Food Program and Unicef which supplies vaccines for the region. Our vaccines were nearly used up before this unrest, and furthermore, WFP was already a few months behind in their food distribution, which our TB patients depend on during their 6 months of directly observed therapy. Some wandered away in search of food. We hope they return; in the last 10 years, we have had almost no treatment defaulters.

When cooking oil and food ran out, we distributed
fish hooks. Preparing the catch.

Hunger is a way of life in Sudan. It is only when our patients are on the verge of starvation that finding food has to take priority over TB treatment.

Much of the political posturing in Sudan is a buildup to elections in 2011, which will determine whether Sudan formally divides into North and South. When the 2005 peace agreement ended 27 years of civil war, it provided for a referendum to decide whether Sudan would be one country or two. The largely Arabic North dominates in power, wealth and infrastructure. The South lies over oil fields that China and other countries are vying to develop. Huge cultural differences make the two areas unlikely partners.

The United Nations recently released a report on “the current humanitarian perfect storm in South Sudan”. This year, the government of South Sudan has seen its income fall by 40%, due to decreased oil revenue. One of the scarier statistics in that report is that there is only one teacher for each 1000 school-aged kids. A 15-year old girl is more likely to die in childbirth than to finish school.

Nonetheless, the Sudan Medical Relief Project received our first supply of medications from the Government of South Sudan just this week -- a milestone! The GoSS is eager to establish health care throughout the South, although it lacks every type of infrastructure on which to build.

Officials frequently thank our staff for their perseverance over the past decade. We look forward to the day that that gratitude will include actual material support for the project. Boxes of medicine are the first concrete steps in that direction.

INFRASTRUCTURE: HOW TO FILL IN THE BOXES?

Despite their many differences, North and South Sudan
agree that sick people deserve charity. In the North,
for example, they travel free on buses. In the South,
they may ride free on these “Trader Boats.”

Today, as I was going over Jill’s request for the donation of a portable ultrasound machine, I was again struck by the stark lack of infrastructure in the region. Mind you, this is a standard application form, with the usual boxes to fill in. The boxes for phone and fax said “There are no phones in Fangak.” Clinic address? “No streets.” Mailing address? “No postal service.” Medical director’s phone? Well, she does have a satellite phone for emergencies, but she only leaves it on when she is expecting a call at a pre-arranged time.

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