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Sudan

Sudan: Patients double at health clinic

The health clinic in Garsila is finding it hard to cope with an influx of patients. There are not enough staff and not enough drugs to treat the sick.

By Charlotte Brudenell, ACT/Caritas

Garsila, West Darfur, July 25, 2006-Deba primary health care clinic, run by ACT/Caritas, is now the only place in Garsila where people can access free health care.

At eight in the morning, quiet queues trace along the clinic's two buildings and more people gather under the awning that spans between them. Women in colourful tobs with babies in their arms and children by their sides, and men and boys dressed in white all sit patiently waiting for the clinic to open. The clinic offers medical consultations, immunisations, mother and child healthcare, first aid and a short stay ward.

Hawa arrived at the clinic at 6am. "If this clinic was not here, I would stay at home and the baby would die," she says. Hawa's 13-month-old baby boy is suffering from dysentery. Without treatment, her son will die within a few days.

"It is difficult for people to go to the hospital for treatment because at the hospital it is necessary to pay, so patients are coming here instead," says Ibrahim Moussa Ibrahim ,the Medical Assistant at Deba clinic.

For the 20,000 internally displaced people living in the camps around Garsila town, with no means of earning a living, paying for health care is simply impossible. Deba clinic is their only option.

"Before the war we were farmers. We could sell our seeds to pay for medical treatment, but we lost everything when our village was attacked. Now we are completely dependant on humanitarian assistance," says Hawa sadly.

Since May, when the hospital in Garsila lost some international funding, there has been a dramatic increase in the number of patients at Deba clinic.

The hospital had previously been able to provide free healthcare. But with the funding crisis, the hospital started charging patients again, as is customary in Sudan. There is no free health care or public health insurance system.

Deba clinic offers a primary healthcare service, so severe cases are referred to the hospital. However, time and again the clinic sees patients returning to the clinic, even more ill. The patients say they did not go to the hospital, since they would not be able to pay the hospital fees.

If people do go to the hospital, they often go too late, deterred by the expense. As a result, there has been an increase in the numbers of deaths of children under five at the hospital.

Even those that have not been displaced by the conflict find it difficult to pay the hospital's fees. Patients must cover all costs, from seeing a doctor, to medication, to the hospital bed occupied.

Now people from the local community and the refugee camps are all attending Deba clinic. The number of patients has doubled from 60-70 patients per day to 130, far exceeding the recommended humanitarian standard of 50 patients per medical consultant*.

The clinic desperately needs more staff, but there is a chronic shortage of trained staff. Alfred Amule, the clinic supervisor at Deba, asked the local hospital to second staff to the clinic, yet the hospital itself does not have enough staff. There are only two doctors in the entire hospital.

The staff at the clinic are working overtime. But with the increase in patients there is now a shortfall in drugs, especially life-saving medicines to treat diarrhoea, fevers, infections, and even diseases such as malaria. Due to demand, supplies that should last one month are now running out in less than two weeks.

The clinic has a limited budget. "We have to tell patients to go to the pharmacy to obtain the necessary medication, but few do because they simply cannot pay for their prescriptions," explains Dr. Amule. "We need extra funds to be able to respond fully to this new level of need."

For the whole Garsila area, only the hospital and clinic provide healthcare.

Yet the future of the clinic is uncertain. The government is meant to take over management of the clinic next year. However, limited funds and staff may force the government to close the clinic.

If the clinic closes, it could trigger a major health crisis. For the moment, working at maximum capacity, the free healthcare at Deba clinic is a life-line to thousands.

* Sphere Humanitarian Charter and Minimum Standards in Disaster Response.

Action by Churches Together International (ACT) and Caritas Internationalis (CI) are working together in a joint response to the Darfur crisis.

ACT International is a global alliance of churches and related agencies working to save lives and support communities in emergencies worldwide. Caritas Internationalis is a confederation of 162 Catholic relief, development, and social service organizations present in 200 countries and territories.

For further information, please contact:

ACT Communications Officer Callie Long (mobile/cell phone +41 79 358 3171) or ACT Information Officer Stephen Padre (mobile/cell phone +41 79 681 1868) or Caritas Internationalis Media Officer Nancy McNally (+39 06 698 79 752 / mcnally@caritas.va)