“Over 1.3 million people are displaced in South Sudan. The families in urgent need of food, water, sanitation to prevent the situation from becoming catastrophic by the end of the year. Help ACF to help them”. This is the test of a fundraising campaign organized by U.K. NGO Action Against Hunger.
On 15 May, the news spreads of some cases of cholera registered in camps for displaced people set up by the United Nations and international NGOs in the vicinity of Juba, the capital of South Sudan in civil war since December 15, 2013. Two victims recorded. The alarming news has open serious questions. Cholera is a disease that typically arises due to lack of sanitation and drinking water. How is it possible that this disease is rapidly spreads in camps managed by Western aid organization? There are at least four international manuals on how we should build these camps to ensure hygiene , adequate number of latrines according the population, drinking water and prevent epidemics, drawn up by the UNHCR ( United Nations High Commissioner for Refugees) , UNICEF, Oxfam and MSF. Having had occasion to observe recent photographs of these IDPs camps, it soon became evident that these manuals have not been well understood or respected.
The news was followed by the immediate reaction of UN agencies and international NGOs that have promised urgent action to thwart the cholera epidemic . Promise evidently made for propaganda and image purposes. On 23 May 2014, the French NGO Doctors Without Borders states that cases of cholera in the capital rose from 2 to 315 . On May 25, we are talking about 586 cases. In the rest of the country there are cases of cholera at Malakal ( Upper Nile State ) , Bentiu ( Unity State ) and Mimkamman ( Lake State ) . These countryside cases reported are fortunately minimal since 65% of the population has been vaccinated by MSF and their lives in camps where basic hygiene standard are guaranteed. Why Juba has even been neglected vaccination?
The official date of the proclamation of the epidemic does not coincide with its start on the ground. The first case of cholera was reported April 29, 2014 at the UN refugee camp named Juba III. A case between at least 200,000 displaced people can escape. Probably the victim has contracted the disease before his arrival at the camp. Just isolate the case, treat it and increase hygienic surveillance in the camp . Clearly, humanitarian assistance has not gone over to the care of the patient discovered. On May 15, 2014 the Southern Sudanese Ministry of Health was forced to declare a cholera emergency. Information received by humanitarian workers operating in Juba reveal that the United Nations, NGOs and government have attempted to curb the epidemic between April 29 and May 15 to no avail. Only after the failure to contain the epidemic that the emergency has been officially declared .
In a few days the cholera spreads over the whole district of Juba. Particularly touched the field Muniki : 140 cases . Until now there have been 24 deaths. All the victims have arrived dead at the hospital. Clear sign that there is no health care coverage within the camps. The situation is worsened by the civil war and the lack of adequate hospital facilities . Across the country there is only one hospital capable of treating cholera : the Juba Teaching Hospital. The government has resorted to MSF France to set up a 50-bed cholera center , which currently extends to 100. On May 29, 2014 the humanitarian agencies have promise for the second time to promptly act to resolve the emergency being very careful to state that they are unable to control the epidemic , still in progress.
“The cholera epidemic situations stems from inadequate sanitation and the lack of an emergency medical team able to isolate the first cases from the rest of the displaced. In the camps is well known shortage of drinking water, the insufficient number of latrines (one for every 300 people). Vaccination campaigns against cholera have only partially implemented.” This the witness – charges offered by MSF South Sudan employee under the protection of anonymity. A credible witness saw the evolution of the situation and photographs of the camps . “Cholera can be easily treat and content if you act immediately. The NGOs priority should be to ensure a rapid public health response to contain the outbreak while working on patients and the prevention of disease, “says Brian P. Moller, head of MSF in South Sudan.
Evidently this Rapid Response Team in Juba doesn’t exist despite that in South Sudan capital are concentrated at least 14 international NGOs and UN agencies. On 2013 International Community has fund $ 32 million in healthcare assistance for South Sudan. Despite these substantial funds the health response has been anything but quick . Countries such as Kenya and Uganda have shown that the cholera outbreak, possible in the region, can be easily stopped by a timely medical intervention . If the health ministries of the two countries are able to manage their objective with an availability of funds considerably less than that ones of NGOs, it will become very hard to understand the ” difficulties ” of humanitarian are speaking about maybe to justify their failures. Probably the problem lies between the availability of funds and the real capacity to offer a professional intervention. In South Sudan there are few NGOs actually prepared on the health sector. In fairness it should be noted that MSF falls within this narrow circle of professional associations. The lack of spread of the epidemic in the camps managed by MSF strengthens the credibility of this French NGO.
It is not the first time in the refugee camps of the United Nations broke out deadly epidemic, claiming hundreds of lives. Still alive in the memory of the case in Haiti, where cholera was transmitted by Nepalese soldiers UN peacekeepers . 586 South Sudanese victims of cholera and 24 deaths , without counting unregistered cases and deaths in the countryside, therefore fall within the macabre death cycle that periodically resurfaces in U.N. refugee camps that in reality offer only a hostile environment for physical and mental wellbeing of each human being. Nothing surprising as the idea of the refugee camps in Africa (the first were set up in the early 90’s) was born from the concept of the British concentration camps in Kenya, Tanzania and Uganda constructed to keep German and Italian prisoners during the World War II.
The difference, however, is huge. The majority of German and Italian prisoners, after a few years of hard imprisonment, returned safely to their countries. The modern – prisoners African refugees remain in these camps – lagers for at least 10 years, with evident physical and psychological damages. The refugee camp, supposed to be temporally infrastructure, is normally transformed into a immense slum where lives hundreds of thousands of people deprived of adequate hygienic living conditions and infrastructure. What is even more outrageous is to note the absolute impunity of humanitarian workers responsible for failing to prevent or promptly intervened to prevent any epidemics and to manage unmanageable refugee camps from the point of view of health and human dignity. This is a crime! We speak not about statistics but human lives. The worst risk that a humanitarian worker can take is to not be seen renewed his contract due to his negligence.
An insignificant risk because after a few months the incompetent west humanitarian worker will find a new job at another NGO by way of referrals from the previous because, usually , the NGOs do not consider proper to deny good references. Due to the recurrence of these absurd situations that exceed the scope of criminal liability, some African governments are wondering what course to take. Some propose that the acts of negligence committed by humanitarian workers, if proven, are comparable to involuntary murder and punished accordingly. Others, such as Kenya, are more radical: the refugee camps must be prohibited. Other countries such as Uganda accepted the presence of the refugee camps but only for well-defined periods, creating the conditions for refugees to integrate into the host society , to work, to family and send their children to a school. This policy of integration has given excellent results by reducing crime and the dangers subversive acts, typical phenomena in the refugee camps of long existence .
Some African health experts think that the only way to prevent these tragedies is to penalize the neglect actions of humanitarian workers, regardless of their nationality. The errors must be converted into a crime. Other key points reside in the conflict prevention and the integration of refugees in the host country. These experts swear that sooner or later African governments will come to these decisions that will undermine the fat financial flow that humanitarian aid can provide, but it will safeguard the health and dignity of African citizens. In the meantime, if anyone wants to make a donation to ACF or other NGOs to contribute to the assistance of displaced southern Sudanese face as well, but knowing how they will be managed his money from the majority of these Lords of Poverty.