March 22, 2018
South Sudan: Strengthening Access To Healthcare In Bor
But the situation in Kurdistan is not easy. Suffering from internal Iraqi political problems, the Kurdish regional government is desperately short of funds. Winter is setting in. As temperatures drop to the low teens, many internally displaced people (IDPs) are suffering in canvas tents or building sites. More than half of IDPs are children. Doctors of the World has extensive experience in Iraq, going back to 1981. We are currently working in Kurdistan’s Dohuk, Sulaymaniyah, and Kirkuk areas. We are also working with local partners in two refugee camps in Turkey. Our emergency Medical Coordinator, Dr. Manuel Torres de Lara, gives insight into current challenges on the ground: “One of the main problems is preparation for the winter—which started on October 16th.
IDPs are living in makeshift homes, in empty or unfinished buildings without walls, in canvas tents, and with very limited clothing for the winter. More than 50% of all the IDPs are living in the northern part of Iraq where temperatures can drop to minus 8-10 degrees Celsius [in Fahrenheit, the low teens]. Where we are, in the highlands of Amadiyah, it will be below minus 10 degrees Celsius. The IDPs in these areas are not prepared to cope with these winter conditions.” Winter brings with it the risk of pneumonia, influenza, and other severe illness. Many IDPs have few (if any) financial resources, and their nutrition has suffered as a result. Dr. Torres de Lara is concerned about possible rising death rates, as well as the impact on the very young and the elderly.
Although the local government and NGOs are attempting to provide services, access is uneven and there are some crucial gaps: “The IDPs need comprehensive and holistic primary healthcare which includes curative care and disease prevention activities. Very few organizations are providing preventive care to these IDPs. . . Yet in primary healthcare, only 30% is curative and 70% is preventive care. In addition, there are very limited supplies of drugs for chronic diseases, especially for hypertension and diabetes, among others. There is also no preventive work being done on these chronic diseases.”
Finally, there is also a gap in terms of mental health services—often crucial for people who’ve been displaced, traumatized, and face severe stress every day: “Very few organizations are working on mental health support for IDPs. Many of the mobile clinics are only providing curative care.” As part of our work in Dohuk, Doctors of the World will be providing comprehensive primary care services—including mental health services—through two mobile teams. Another mobile team will focus specifically on sexual and reproductive health, and the needs of women and girls. Dr. Torres de Lara explains the reasons for this focus: “There is very limited access to reproductive healthcare services. No regular follow-ups are being provided for pregnant and breastfeeding women among the IDPs. There is no support for family planning or family planning counseling.”
In moving to address this urgent need, Doctors of the World is also seeking to support a particularly vulnerable group of IDPs: teenage girls. “More than 50% of the IDP population are children aged 19 and under, and many of these adolescent girls have no access to services to meet their specific health needs. Adolescent girls are one of the most vulnerable groups among the IDPs and there is very little being provided for them, either by the Ministry of Health or the NGOs.” Doctors of the World is working with local partners to ensure the strength and cultural competence of its programming, and we are ensuring our teams include female providers. In addition to our mobile clinics, Doctors of the World will be supporting two extremely remote healthcare centers, distributing hygiene kits and non-food items, and providing primary healthcare to 7,000 Iraq refugees in Turkey.