Polio in South Sudan

     Polio is an infectious disease that is transmitted when one person ingests viral particles from the feces of another person.  This can happen when drinking water is contaminated, or when flies that have lit on feces then land on food that is subsequently consumed. In most people polio infections cause no symptoms, but if the virus enters the blood stream a variety of symptoms can result. If it enters the central nervous system, paralysis can occur. About 1 in 200 polio cases results in permanent paralysis and of those, 5 to 10 percent result in death.

     No new cases of polio were seen in Sudan from 2004 until 2008, and the country was considered polio-free. Unfortunately in 2008, an outbreak resulted in 27 cases of the disease. Refugees returning from other countries were probably responsible for re-introducing the disease to Sudan. After the polio virus re-emerged, UNICEF and WHO initiated a program to vaccinate nine million Sudanese children. Along with the polio vaccine, Vitamin A is administered, which helps to strengthen their immunity against all diseases.

     In 2009, 45 new cases of polio were registered – 40 of them in South Sudan.

     In southern Sudan, it is very difficult to reach many of the children living in remote areas – less than 50 km of paved road surface exist in the whole region. In addition, it is hard to keep track of who has been vaccinated and who has not, because many people move from place to place often in order to find good grazing land for their cattle or in search of more fertile land to farm.

     One duty of the nursing interns at the Kuron Peace Village Clinic is to walk up to remote Toposa villages in the hills surrounding Kuron, bringing polio vaccinations to administer to the children who live there. Some of the interns can be seen below, marking the fingernail of a child who has been vaccinated to distinguish him from those who have not yet received the vaccine.

Holy Trinity Peace Village

     In 1997, Bishop Paride Taban started the Peace Village in Kuron, which lies close to the Ethiopian border in the extreme southeastern corner of Sudan. The name of the village, Peace, was chosen because it was his dream to promote peace among the various tribes living in the area. The tribes are descended from common ancestors, speak related languages and live by similar customs, but consider each other traditional enemies because of competition for natural resources – water and grazing land for their cattle – and because they regularly conduct raids to abduct each other’s cattle.

     The main activities of the Peace Village are a school, a farm, and cultural and sports activities for youth. There is also a clinic on the Peace Village property, which provides the only medical care for many miles around. People from different tribes participate in these activities together, providing an opportunity to build peaceful relationships and trust among one another.

     Below is a photograph of women learning to farm at the Peace Village. Traditionally people in the area lived as nomadic pastoralists, a lifestyle that limits the foods that can be cultivated to eat. By learning new farming methods, it is hoped that the people will be able to grow more to eat, will have better health as a result of a more balanced diet, and will be able to earn some money by selling surplus food – which should reduce cattle raiding activity. Some of the farming skills taught are using oxen to plow the land, improved varieties of seeds that can be used, and animal husbandry.

South Sudanese Cities Bracing for Influx of Returnees from the North

     During the 21 year-long civil war between the north and south in Sudan, about four million people left their homes in the south and fled to northern Sudan or neighboring countries. Following the peace agreement in 2005, about half of these returned to their home territories in the south. Many of them are still living in makeshift homes fashioned out of scavenged materials and have no regular employment. Of those southerners who left the south during the fighting and did not return immediately after the peace agreement, large numbers began coming home in late 2010, shortly before the referendum vote which they expected to result in a free South Sudan. Among them are many people who may have difficulty adjusting to a new life in the south: young people who were born in the north or who lived most of their life there, and grew up speaking Arabic and living according to the customs of the north; children who are returning home without adult family members accompanying them; and elderly and disabled people who have special needs.

     Many of these people had been living in Khartoum for many years and are used to urban life, and so are choosing to settle in cities when they return to the south. Southern Sudanese cities are preparing for a massive influx of people: Rumbek, for example, which has a population of around 100,000 people, is expecting 30,000 new arrivals.

     Such a huge increase in population so suddenly is expected to put a lot of strain on southern cities, which already have very weak infrastructures. The UNHCR is working to provide some support to both the returnees and the communities that are receiving them. Southern cities are also doing what they can to prepare to receive them – we were awakened early in the morning by the shouting of hundreds of new police recruits as they participated in a hasty training course across the road from our compound in Rumbek, for example – but there is still concern about problems that so many new inhabitants may create.

     The photo below shows a family returning home via a main road in Rumbek – however these people are probably returning home from the market, not from Khartoum.

First Impressions of South Sudan

     In November and early December of 2010 I went to Sudan with Sr. Marilyn Lacey, who founded Mercy Beyond Borders - a nonprofit organization that works to improve education and business opportunities for girls and women in South Sudan. We traveled around to visit some of the projects the organization funds, including St. Bakhita School in Narus, the Peace Village and clinic in Kuron, Rumbek town, the schools and hospital in Mapuordit, Don Bosco School in Tonj, and also spent time in Nairobi before returning home. Probably the most extreme experience we had was visiting the Toposa people in southeastern Sudan. Many of the Toposa live in isolated villages in their traditional lifestyle, which includes living in small huts made of sticks and grass, tending their goats and cattle, wearing lots of beadwork, and intricate body scarring. The Toposa lifestyle is completely different from ours but they were very welcoming and happy to see us.

     We stayed in Rumbek for a week and a half; it’s a few hundred miles to the west, out of Toposa territory - most people around there are Dinka. Like the Toposa, the Dinka are goat and cattle herders. Rumbek was bombed during the war and you can still see the bombed out walls of brick buildings surrounded by rubble, but now the dominant structures are the small huts most people live in. From the air, you can see that Rumbek is surrounded for miles by these small, hand-built huts. The population has swelled since the end of the war with many displaced people moving into the town, and several tens of thousands more were expected to move into Rumbek from Northern Sudan when the vote for separation took place January 9 - 15, 2011. Many southerners who had sought refuge in the north were expected to move back to the south for this event.

     There is also a very noticeable presence of foreign workers in Rumbek, riding in trucks with names like U.N. or World Food Programme or UNHCR painted on the side. I got the impression that everything in South Sudan is run by foreigners – from these aid agencies to the clinics to the schools. Rumbek is a large town – about 100,000 people – but it doesn’t have a single paved road, not even a small section of road. In town the dirt roads are graded and maintained but outside town the roads are in bad shape, with many big potholes, so there are no cars there - all the vehicles are trucks or Land Cruisers, along with a few motorbikes. And there are always lots of people walking along the road.

     Returning to development and cleanliness in Nairobi after a few weeks in Sudan seemed strange. I found I missed Sudan, where so much building is makeshift, where dirt is everywhere because it blows into all the buildings through the pane-less windows, where everyone is very thin and most people are wearing worn and somewhat dirty clothing, where it is always very hot and there are insects everywhere, where we ate the same food all the time because it is so isolated and hard to get food supplies in. What really hooked me in Sudan was the extreme friendliness of the people and their spirit. People will walk up to you on the street to shake your hand and say “hi” – and almost everyone does this. Their spirit shows in their singing, drumming and dancing, which they do with great energy and feeling, in church and whenever they get together. We ran into a surprising number of people who spoke English - anyone who has completed primary school is reasonably fluent in English - but only a small percentage have completed primary school.

     I am eager to return to Sudan in the future. I’d like to go to a school for a month or so and help out with English classes, tutor students, and make myself useful in any way I can. Sudanese are eager to learn and make contact with the rest of the world. We’ll see how the referendum vote goes and whether peace prevails afterwards. No one I met was planning to vote for unity - the southern Sudanese are tired of being second-class citizens and they want their own country. There are fears for violence, however, if the vote is for separation. Many better-off southern Sudanese were moving to Kenya or Uganda, fearing violence; and almost all the foreign workers I met were leaving before the vote, planning to stay out of the country for a while to see what happens before returning. I hope with all my heart that it works out well and they do not return to war.

     If you are interested in learning about South Sudan, take a look at my blog periodically. I’ll be posting bits and pieces of my experience, along with some background information about Sudan. Welcome and Enjoy!