SUDAN

1. SUDAN International Health issues By: Maria Pierce

2. Sudan’s Location and Size • Sudan is located in North Africa, and borders Central African Republic, Chad, Democratic Republic of the Congo, Egypt, Eritrea, Ethiopia, Kenya, Libya, and Uganda. • Sudan is the largest country on the African continent; its total area is 2,505,810 square kilometers (966,710 square miles). • In comparison , the country slightly larger than one-quarter the size of the United States. • The population of Sudan according to WHO is approximately 43,552,000 • Sudan has a variety of geographical features that include anything from harsh deserts of the north to the rain forests lining its southern borders.

3. Sudan’s Political Status and conflicts • When I began to look up the political status of Sudan I soon realized that things were very messed up in this country and that it needed a lot of attention because it has a hug effect on the people of Sudan and especially the people of Darfur. • A general summary of Sudan’s political status would be that the country is in conflict over three things, oil, ethnicity tensions, and border boundaries. • One conflict that has been going on for decades is the fight between North and South Sudan. There have been several peace treaties that have been signed to resolve the conflict, for example the one signed in 2005, however the peace treaty was never really put into action. Therefore conflict still occurs between the two sides. • Another conflict that is a really big problem in Sudan, occurs in the western part of the country call Darfur. • There is a massive genocide occurring and millions of Africans are being seriously injured and slaughtered by the Janjaweed (an Arab militia group). • I found a very interesting and more detailed description in a 10 minute video on youtubeif you are interested in finding out a little more about what the conflict really looks like, however there may be a few mildly disturbing images . • http://www.youtube.com/watch?v=w-U5BDLo4Ws

4. ETHNICITY CULTURE • The Culture in Sudan is a lot like the ethnicities and languages that make up the country, they are different and divided. • However, most of the people who live in Sudan are farmers and nomads. • And just as we have seen in most countries there is a wide gap between the poor and the rich. The rich live in the city and are very corrupt due to the large amount of oil in the country and pay little attention to the poor. • Because of the differences between religion, ethnicity and language the country is very divided. This is where much of the violence and hatred in Sudan stems from. • The ethnicity of Sudan is one of the most diverse in the world. Most of the people who live in Sudan are of black African origin (52 percent), 39 percent are Arabs, 6 percent Beja, and 3 percent foreigners and other small national groups. • Over 400 languages are spoken in Sudan. The most frequent is Arabic and other languages include 115 tribal languages ,Nubian, Ta Beawie, Nilotic, and Nilo-Hamitic, English and several Sudanic languages are also spoken. RELIGION • The two main types of religion consist of Muslim and Christianity. Most of the citizens in North Sudan practice Muslim and in South Sudan most are non Muslims and practice Christianity.

5. There is only one doctor per 100,000 people. Preventable diseases, such as TB and diarrhea, cause most deaths and illness During the long years that the civil wars took place many of the health facilities were destroyed so they need to rebuild them and create more. GENERAL HEALTH FACTS/ STATUS There are only 4,600 trained health workers – more than 17,000 are needed Only five percent of births are attended by skilled health staff, causing many mothers and children to die during birth. South Sudan has the highest maternal death rate in the world (2,054 mothers out of every 100,000 or - one in fifty - die during childbirth). One in four children dies before the age of five.

6. COMMON health and HEALTH SYSTEM issues • HEALTH • The major health concerns in Sudan are: • Malaria, meningitis, measles, yellow fever, and whooping cough which is epidemic in some areas. Leprosy, river blindness, sleeping sickness, cholera, polio, and guinea worm are also reappearing. • Maternal death rate due to lack of professional aid. • While HIV aids has been prevalent in other African countries, HIV rates are low in South Sudan (2.6%), but some fear it will become a problem. Post-conflict conditions like a mobile population, demobilized soldiers, a lack of HIV/AIDS awareness, and a scarcity of condoms could fuel the spread of HIV. HEALTH SYSTEM: There are very few government funds for health. The few hospitals and clinics that do exist are unevenly distributed – with rural areas more poorly served than urban onesdue to difficulty in reaching spread out communities and families and un easy access to roads and transportation. Also many families cannot afford the medication and some medications are not free (prime examples in the mental health care system.)

7. The major mental health concerns in Sudan are: • In Sudan, the mental health system has most types of mental health facilities; however most of them need to be strengthened and developed further in terms of staff, treatment facilities and living facilities. • The total number of human resources working in mental health facilities or private practice per 100,000 population is 0.92. • There is one family association' and consumer association in the country that were started recently. • Many patients are treated for schizophrenia, post traumatic stress disorder due to all the conflict between the wars and violence and other related disorders. • None of these facilities provide active follow-up care in the community, and there are no mental health mobile teams, except for in the cities because they are favored. • Although all (100%) mental health outpatient facilities have at least one psychotropic medicine (antipsychotic, antidepressant, mood stabilizer, anxiolytic, and antiepileptic medicines) available in the facility or in a near-by pharmacy, many cannot afford the medication and it is only provided free of charge in the case of emergencies. MENTAL HEALTH And SYSTEMS

8. Health and Mental Health Connected • The only connections that I found were that victims suffering from injuries in the after violence from the war or from the cruel inhumane violence displayed by the Janjaweedalso suffered post traumatic stress disorder. This idea was also common the case studies that we studies the other day in class. Many victims that experience a traumatic incidence will have post traumatic stress disorder following the event. So many of the kids or adults who are attacked in Darfur, Sudan will suffer horrid injuries and be traumatized by the cruel experience. In order to help the people of Sudan, more mental health facilities need to be built, more people need to be reached outside of the communities in more rural areas, and more medications need to be made available at no cost for those who cannot afford them. Also more volunteers need to be trained as well as the local aids in mental health issues and proper care.

9. HEALTH INTERVENTIONS AMREF and other world organizations are currently working to train doctors, clinical officers, midwives, laboratory technicians, and pharmacists to help with health issues and shortages in Sudan. AMREF, WHO and other organizations are working to and rebuild primary health care centers and mental health centers and training community health workers. Also they are working on reaching those who live far away from communities and do not have direct access to health care. AMREF and other organizations are also constructing latrines to improve environmental health and sanitation, sinking new wells and monitoring the quality of water, promoting health and hygiene through community hygiene educators.

10. References: • www.nationsencyclopedia.com • www.youtube.com • www.nationsencyclopedia.com • countrystudies.us/sudan/36.htm • www.amrefusa.org