South Sudan: the challenges for child survival when disease strikes

Conflict, hunger, cholera, and now an outbreak of kala azar –  it seems that South Sudan has had an extraordinary number of public health emergencies this year. Its fragile health system has been struggling to cope with one calamity after another.

What is kala azar?

Properly known as visceral leishmaniasis, kala azar or  black fever is the world’s second-biggest parasitic killer, and there are no effective measures for prevention (apart from trying to avoid sandfly bites) and little in the way of reliable treatment.

This latest outbreak is in the remote north-eastern counties, where there has also been fighting. It could easily overwhelm local health systems, which are already weak.

Save the Children and other international agencies have been trying to treat young children for common illnesses such as pneumonia, diarrhoea and malaria. This new disease will make that much harder.

A fragile public health system

If this disease keeps recurring in South Sudan – and it does – that’s no surprise. Insufficient financing, inadequate numbers of health workers, lack of essential drugs and supplies and weak community health and surveillance systems all ensure that easily preventable illnesses that have been considerably controlled in other parts of east Africa break out here, again and again.

The longer-term solution lies in strengthening the state and county health systems. It is imperative that the outbreak is contained before it spills over into other parts of South Sudan or beyond its borders.

There’s an opportunity here for all parties to work together to ensure universal access to the basic services that should be available to every community.

A crying need for government support

While international and local humanitarian agencies can provide critical support in this regard, stewardship from the government is essential and will ensure lasting changes that will benefit children.

I’m in South Sudan this week to support our child survival efforts here.

Save the Children has been implementing the Integrated Community Case Management (ICCM) programme across the country over the past decade, training and supporting community volunteers to manage common childhood illnesses such as pneumonia, diarrhoea and malaria.

This is a crucial moment for ICCM in South Sudan. Despite the programme’s impressive history and increasing maturity, it is dependent on external funding and support from international partners.

Financial limitations notwithstanding, the South Sudanese government needs to really own ICCM and integrate it effectively as part of the mainstream county health system across the country.

It is reassuring to see that the Ministry of Health is moving in the right direction, but this needs to happen as fast as possible, despite the difficulties presented by continuing conflict and frequent outbreaks of disease.

That will at least help to resolve the latter problem, even if it cannot, regrettably, help solve the former.