An island of medical care amidst a sea of displaced persons

Project completed
The emergency medical services put in place by Médecins Sans Frontières – Switzerland in Minkamann treat almost 100,000 South Sudanese. / © MSF

In Minkamann, in the centre of South Sudan, five medical centres provide basic care to displaced persons, victims of the fighting which has been raging in the country since December 2013. Médecins Sans Frontières – Switzerland, supported by the SDC, carries out its work under constant pressure. One million South Sudanese have fled their homes. 

Country/region Topic Period Budget
South Sudan
Primary health care
Drinking water and basic sanitation (WASH) (til 2016)
01.04.2014 - 30.06.2015
CHF  500’000

Every day, a few more inhabitants join the camp for displaced persons in the small community of Minkamann, which lies some 150km from the capital Juba, on the other side of the Nile to the town of Bor. These people are fleeing the fighting between partisans of the South Sudanese president Salva Kiir and supporters of the former vice-president Riek Machar. However, according to the staff members of Médecins Sans Frontières – Switzerland (MSF) on the ground, the situation is currently under control. Overall, the general mortality rate is below the emergency threshold of 1 death per 10,000 people per day.

The five clinics opened by MSF in Minkamann at the beginning of January 2014 are largely responsible for this relatively encouraging result. Joint financial support from the SDC and the European Community Humanitarian Office (ECHO) currently enables the organisation to carry out its activities. Nearly 100,000 South Sudanese receive emergency medical care through the system put in place by MSF.

From vaccinations to childbirth

Of the five clinics, four are for outpatients whilst a small rural hospital under canvas allows about sixty patients - postnatal or awaiting minor surgery - to be hospitalised. The entire range of primary and secondary services is available: treating wounds and communicable diseases, antenatal consultations for women, labour and delivery as well as therapeutic (measles, meningitis) and preventative vaccinations. In what is a world first, 50,000 patients in Minkamann received a preventative dose of cholera vaccine.

The clinics set up by MSF serve as a stopgap for the country’s overloaded or abandoned medical facilities. By supporting these emergency clinics, the SDC is facilitating access for the people of Minkamann to the available humanitarian assistance. 60% of the patient base is under the age of five. Not to be overlooked, the local (non-displaced) population accounts for one tenth of recorded consultations.

Access to drinking water

In conjunction with its medical care, MSF provides displaced persons with drinking water and conducts programmes to increase awareness of the necessity for maximum personal and food hygiene. Given the conditions, it’s asking a lot. However, creating awareness of the benefits of adopting a few good habits can dramatically reduce the number of deaths caused by diarrhoea or cholera.

500 m3 (or 500,000 litres) of water, pumped from the Nile and then purified and chlorinated, are distributed daily inside the Minkamann camp via a four kilometre-long water supply system! This volume meets 40% of the drinking water needs of the people in the camp.

Pregnant women and children, who make up a large part of the camp population, are particularly at risk from the effects of unclean drinking water. A survey conducted by MSF in February 2014 showed that two thirds of patients treated for acute watery or bloody diarrhoea were children under the age of five.

Flood risk
MSF’s mobilisation of 370 local employees in Minkamann – most of them displaced persons themselves – and 50 expatriate staff enables it to ensure access to basic care for the most vulnerable. Despite this, the outlook presents little to rejoice about. Whilst the constant arrival of newly displaced persons at Minkamann remains manageable, the summer rainy season gives great cause for concern. This could cause serious damage on the flood-prone land occupied by numerous families. With this in perspective, displaced persons are already being evacuated and re-situated.