MEDICAL CRISIS IN SUDAN

Gary Short

If you are a visitor to Sudan you can feel relatively safe from sickness and danger. The odds of getting sick or injured there are probably only slightly more than a visit to a high adventure theme park on a hot summer day.
I have taken many visitors into Sudan and none have had more than minor expected travel illnesses and most have come away from Sudan without even that hitch.

There are many ways sickness and death impact the average Sudanese villager:

Be a Sudanese Baby
If you are born and live in Sudan it’s another story. Almost 100 out of 1,000 babies born in Sudan die as infants. Compare that to the US where only 8 out of 1,000 babies die. Malnourishment, exposure to the elements, an unhealthy mother unable to produce proper milk, unsanitary water mixed with formula and violence are all additional hazards to the newborn in Sudan.

Contract a Childhood Disease
If you are a child in Sudan you very likely have never been immunized against the diseases that used to kill children in North America and Europe. Although immunizations are on the increase thanks to people like Bill and Melinda Gates, unvaccinated children die unnecessarily every day because they get a disease like measles. The World Health Organization (WHO), reports nearly half a million children around the world die from measles each year. Doctors Without Borders report that “Most of those deaths occur in Africa and Asia. This contrasts sharply with the Western world where measles cases have become extremely rare thanks to universal routine immunization. This leads many people to forget that measles is a major killer.” Just like measles; polio, meningitis and other preventable diseases kill children in Sudan every day. A recent think tank study described Sudan as the most vulnerable country in the world; it should not be a stretch to think of the Children of Sudan as among the world’s most medically vulnerable children.

Bump Into a Killer Parasite
Sleeping sickness is one of those unheard of diseases that impact many in Sudan. Known to the medical types as Melarsoprol it was discovered 70 years ago. Doctors Without Borders say “500,000 people are currently infected and the disease kills over 65,000 people annually that are known. Sleeping Sickness threatens 60 million people, but only 7% have access to adequate medical diagnosis and treatment.” Humans get sleeping sickness through the bite of a fly. The parasite enters the bloodstream and lymph nodes where it multiplies causing fever, weakness, sweating, pain in the joints, and stiffness. Over time, it reaches the brain causing seizures, madness, and finally coma and death. Those infected sometimes develop symptoms immediately; in others they do not show up for years. “However, they do become carriers of the disease, and whenever they are bitten by a tsetse fly, the insect picks up the parasite and spreads it to the next fly-bite victim.” This is mainly a disease of poor villagers in isolated settings. Death, in some villages, has reached as high as 50% of the community.
This is particularly sad because with medical treatment sleeping sickness is curable.

Another parasitic disease that unless you studied tropical medicine in Med school you have probably not heard of is leishmaniasis. Doctors Without Borders tell us; “The disease principally affects poor communities in isolated regions, often as devastating epidemics. In Sudan, where civil war had caused a flood of internal refugees, an epidemic of visceral leishmaniasis lasted from 1984 to 1994 and claimed more than 100,000 lives in the Western Upper Nile province, a third of the population of the affected area.” Visceral leishmaniasis, also known as kala azar (Hindi for "black fever") is the most severe of over 20 varieties. “Over 90 percent of visceral leshmaniasis cases occur in five countries: Bangladesh, Brazil, India, Nepal, and Sudan. The parasite is transmitted by the bite of certain types of sand flies, which live principally in forest areas in sub-tropical and tropical climates. Both animals and humans can act as the parasite's reservoir: the sand fly picks up the parasite by biting a host and then transmits it to another” (DWB).

Indiscriminant Sex
So far AIDS has not impacted Sudan like other sub-Saharan African states. Probably because the war kept people away, but now thousands of people will be returning to Sudan from other AIDS impacted African countries. The concern of many is that these returning refugees will bring the AIDS crisis to Sudan. The statistics that I have seen claim that only about 50,000 people in Sudan currently have AIDS. Compare that to Uganda with 1,000,000 AIDS sufferers and to Kenya where 2,100,000 are currently infected. The vast majority of refugees who will return to Sudan are living in these two countries. Around the world 43,000,000 have already died of AIDS and 45,000,000 are currently infected.

The Biggest Killer of Them All
According to the World Health Organization, a child dies of malaria every 30 seconds, it kills 1-2 million people each year and threatens 40% of the world's population and is endemic in more than 100 countries worldwide, with 300-500 million new cases occurring every year and more than 90% of them in sub-Saharan Africa. Malaria is caused by the plasmodium parasite and is transmitted by mosquitoes. Its symptoms are high fever, headache, and joint pain and severe malaria can result in coma and death. One of the big problems with treating malaria is its ability to develop resistance to medicines after they have been in use for a while, therefore the development of new medicines to continue to defeat the disease is imperative. Sudan has many people who fall sick with malaria each year and many who die from it. The medications that treat malaria are not available to most villagers in Sudan.

Violence Everywhere You Turn
There are so many contributing factors to death by violence in Sudan. Just think about living in a country where civil war or the threat of civil war has been the reality since 1956. War has caused the deaths of millions of Sudanese. It has created health and mental health issues in millions more. Not only is war a major contributor to the violence but polygamy is the seedbed for family violence. Husbands against wives, wives against wives, children against the children of other mothers and all the possible combinations of these groups. Men coming home from years of violence in the war don’t easily leave that out of their home life.

No Longevity Extenders
If you are a typical Sudanese the ravages of old age will begin to impact you before you are 50; whereas if you are an American you are almost 70 before your health begins to significantly decline due to old age. There is no such thing as geriatric medicine in Sudan. The best the aged Sudanese can hope for is that they have a loving son or daughter who can help them through the final stages of life.

No Doctors And No Medicine
How many people do you know who have suffered an injury or sickness so severe that they would have died without a doctor or proper medication? Think about it; work accidents, automobile accidents, heart attacks, high blood pressure, asthma, tuberculosis, infections, cholera and on and on. But there is no doctor, there is no pharmacy, no drug has been developed to treat your particular disease because it only occurs among the poorest in undeveloped nations. Sudan has one doctor for every 11,167 people; Contrast that with the United States which has one doctor for every 266 people. Realize that most of the doctors in Sudan are in the north.

Sudan is definitely in a huge medical crisis that is not likely to go away for years to come. Any medical aid that can be provided to these suffering people will help and is most welcomed. Most NGO’s, churches and individuals must look at this huge problem as something that they can’t resolve but that they can dramatically impact one life at a time.

As a small church our resources are very limited, sometimes I find myself daydreaming about what I could do in Sudan if I had more money to do it. We have made the choice to do what we can with what we have and we have made a difference in many lives. On one of our teams we took a doctor and two nurses who saw around 1,000 patients in a week. It was chaotic at times, and was definitely a learning experience for us. One patient that the medical team saved was a small baby that would surely have died without medical assistance. On another occasion one of our nurses saw a patient who was so severely dehydrated along with other conditions that he was on the verge of death. She put an IV in him and drove him an hour and a half in the night to the hospital and saved his life.

On one of our recent teams we had a nurse who taught college and secondary school students an AIDS awareness class. We wrote and distributed 15,000 AIDS brochures to young people. One young man had contracted one of those deadly parasites that we talked about above. The doctors told him that there was no medicine available but if he didn’t get to Uganda where he could find the right medicine he would die. He came to our meetings for prayer and was healed. Do whatever you can do to help. Your individual contribution may seem small to you but as it joins with the efforts of others it can make a big impact.

Sources: Doctors Without Borders, World Health Organization, Washington Post, International Medical Corps, US Census Bureau