Inadequate food, health and education for returnees to the south

Several months after the guns fell silent in the villages of south Sudan, thousands of people who rushed back home are having to cope without adequate food, or proper health and education services. "These [wild fruits] are all we have to eat," Mary Yar Makut, an elderly returnee in Rumbek, the designated capital of southern Sudan, told IRIN on 9 April. Makut, one of some 400 returnees who have built straw shacks in the town, added: "We [are also] exposed to the rain." "The food situation is bad," an aid worker in Malualkon town in Northern Bahr al Ghazal state, had told IRIN a day earlier. "The main harvest in September-October was poor, which means that we will have a five-month hunger gap before the next harvest. "If you go to the market there is no sorghum, only groundnuts," he added. Sorghum is the staple food in much of southern Sudan. According to aid workers, the people who had remained in the region as others fled the 21-year war between the government and the Sudan People's Liberation Movement/Army (SPLM/A) have nothing to share with returnees. "In many parts of southern Sudan, water is hard to find and it is common for 2,000-2,500 or more people to share one well," aid workers said. "The minimum standard ratio should be one water point to 250 people." After two decades of civil war in the region, some 500,000 refugees and an estimated four million internally displaced persons (IDPs) are expected to return home, following the signing of a peace agreement in January between the government and the SPLM/A, which took up arms in 1983 to fight for self-determination in the south. According to figures released by the UN Office for the Coordination of Humanitarian Affairs in March, approximately 1,500 IDPs had been returning to southern Sudan every week. In the state of North Bahr al Ghazal, the situation has been exacerbated by the presence of 10,000 IDPs from the neighbouring region of Darfur. POOR HEALTH Church and aid workers said one of the main problems was that health facilities in much of the region were either rudimentary or non-existent. "In this area if you need an operation you must go to Malakal," Antonio La Branca, a Catholic priest based in the remote town of Old Fangak in Upper Nile state, said. "You need to sell many cows to finance the trip, and pay for treatment and food in the hospital," he added. "Many are just left to die." La Branca, a member of the Comboni missionaries, was trying to have delivery and dressing rooms set up in a local health centre run by an Italian humanitarian agency, COSV (Comitato di coordinamento delle organizzazioni per il servizio volontario).

Mary Yar Makut, shows the wild fruits she has to survive on.

He estimated that at least one in five pregnant women who died in Old Fangak and the surrounding areas died from complications related to childbirth. In addition, the priest said there had been 275 cases of kala-azar in the area in 2004. "Malaria is another problem, and TB is the other plague," he added. Kala-azar, also known as visceral leishmaniasis, is an infectious disease caused by a protozoa transmitted by the bite of a sandfly. "To reap the benefits of peace, Sudan's people must survive threats of disease," David Nabarro, the World Health Organization's (WHO) representative in Sudan, said in a statement issued on 11 April. "For example, women must be able to deliver without risking death or disability, and children must be helped during vulnerable early years through proper health care." "Health workers need training and then support to do their job well. Only then will the people of Sudan be able to expect healthy lives and the chance of sustainable livelihoods," he added. According to figures quoted in the WHO statement, infant (babies under one year old) mortality per 1,000 live births was 68 in northern Sudan, but 82 in the south. The mortality rate for children aged between one and five was 104 per 1,000 live births in the north, and 132 in the south. Maternal mortality per 100,000 live births was estimated at 509 in the north, but ranged from 365 to 865 in the south, while approximately 7.5 million cases of malaria occurred in Sudan every year. BASIC EDUCATION According to aid workers in southern Sudan, there are few schools in the region and the quality of education offered is low, mainly because of the lack of trained teachers. "Primary-school dropouts are being trained as teachers because there are no secondary schools," an aid worker told IRIN in Malualkon. "Girls are not going to the available schools and in some areas the boy-girl ratio in schools is ten to one." La Branca, who said he was building "the first real school with real classrooms" in Old Fangak, with the help of German charity Sign of Hope, said efforts should be made to "teach whatever is possible within the shortest time possible". "I really think we must try our best to give an education, even if it is just basic primary education," La Branca told IRIN. Although the prevalence of HIV is low in Sudan, aid workers expressed concern that with some of the returnees coming from countries with high HIV infection rates, AIDS could become a formidable challenge in southern Sudan. "I think HIV/AIDS will be a big problem in this area," said one aid worker. He said polygamy, which is widespread in the region, and the deployment of foreign peacekeeping forces, could become important factors in the spread of HIV. Worse still, the level of AIDS awareness in southern Sudan was low. "People tend to neglect the issue of AIDS. It is a taboo. People don't talk about it," he said, adding that awareness campaigns by humanitarian agencies had also been "few and isolated". La Branca said he had not come across any AIDS cases in Old Fangak and the surrounding areas during the eight years that he had lived there. "But with the returnees, we are afraid that it may happen."