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Cablegate: West Darfur Health Situation Update

VZCZCXRO1069
OO RUEHROV RUEHTRO
DE RUEHKH #0234/01 0420902
ZNR UUUUU ZZH
O R 110900Z FEB 10
FM AMEMBASSY KHARTOUM
TO RUEHC/SECSTATE WASHDC IMMEDIATE 0163
INFO IGAD COLLECTIVE
UN SECURITY COUNCIL COLLECTIVE
RHMFISS/CJTF HOA

UNCLAS SECTION 01 OF 02 KHARTOUM 000234

SIPDIS
NSC FOR MGAVIN
LETIM
DEPT PLS PASS USAID FOR AFR/SUDAN
ADDIS ABABA ALSO FOR USAU
GENEVA FOR NKYLOH
UN ROME FOR HSPANOS
NEW YORK FOR DMERCADO

E.O. 12958: N/A
TAGS: EAID PREF PGOV PHUM SOCI SMIG UN SU
SUBJECT: WEST DARFUR HEALTH SITUATION UPDATE

1. (U) Summary: Following the March 2009 non-governmental
organizations (NGO) expulsions, the West Darfur State Ministry of
Health (SMoH) and several national and international NGOs took over
affected clinic facilities and continue to provide care. The SMoH
has worked considerably to preserve coverage, although facilities
have not yet achieved ministry standards for care. The U.N. World
Health Organization (WHO) remains concerned about lack of services
available to populations in rebel-held areas, where the SMoH lacks
access. End summary.

-----------------------------------
HEALTH CARE COVERAGE IN WEST DARFUR
-----------------------------------

2. (U) In a February 2 meeting with staff from USAID's Office of U.S.
Foreign Disaster Assistance (USAID/OFDA), WHO West Darfur staff
reported on the status of health coverage in West Darfur and
potential future health concerns. WHO reported that the March 2009
international NGO expulsions and national organization dissolutions
affected three major West Darfur health partners, Mdcins Sans
Frontiers/France, Save the Children/U.S. and the Sudanese NGO Sudan
Social Development Organization (SUDO).

3. (U) Since March 2009, the SMoH has committed substantial resources
to responding to the health needs of communities previously served by
the expelled NGOs, according to WHO West Darfur. The SMoH, with WHO
support, and remaining medical NGOs have continued services to all of
the 18 affected clinics except one, whose population receives
services through a nearby, larger clinic. NGOs currently operate
some expelled organizations' clinics, and the SMoH has taken over
most of the other facilities. Several health facilities are now
being jointly operated by the SMoH and NGO partners. The SMoH and
NGOs have assumed responsibility for hospital facilities, with WHO
drug provision; hospital facilities in Mornei and Zalingei towns are
operating normally.

4. (U) WHO noted no concern with services provided though the
international NGOs operating in West Darfur-Norwegian Church Aid and
Concern-or the Sudanese Red Crescent. International NGO-managed
clinics report adequate medical staff and resources. NGO-run clinics
are currently operating in Habila, Foro Baranga, Zalingei, and
Nertiti localities. Most national NGOs, however, face considerable
challenges, including financial and human resource limitations,
limiting the organizations' ability to provide consistent services.

5. (U) In SMoH-managed clinics, services often do not meet ministry
standards for primary health care centers (PHCs), particularly in the
range of services available, due to the lack of trained medical
professionals and occasional drug shortages. While Sudanese
standards mandate the presence of a medical doctor and two medical
assistants for each clinic, many PHCs are currently operating with
only one medical assistant. The SMoH faces considerable difficulty
identifying medical doctors willing to work in rural area PHCs,
despite Khartoum's assurance to USAID staff that Sudanese doctors are
available to cover Darfur's medical needs. International NGOs have
fewer difficulties hiring medical doctors due to higher incentives
available to seconded staff. WHO West Darfur staff expressed hope
that the SMoH will continue to strive to achieve service standards
for rural communities.

6. (U) West Darfur WHO staff commended SMoH support for communicable
disease surveillance, including through the provision of
communications equipment to report cases and trends.

---------------------------
REMAINING HUMANITARIAN NEED
---------------------------

7. (U) In the rebel-held area of Kutum in Nertiti locality, where the
SMoH cannot provide services, WHO has arranged with local authorities
to support salaries for medical staff working in the PHC, but noted
that the clinic requires additional financial support to remain
viable.

8. (U) In a February 2 meeting with USAID staff, WHO noted concerns
related to access to rebel-held areas, particularly in Jebel Marra
and Jebel Moon. Neither SMoH nor WHO staff can access the area to
provide vaccinations or regular health care. In addition,
populations crossing the border from Chad have recently brought
whooping cough and measles into Sudan. Sudanese refugees and

KHARTOUM 00000234 002 OF 002


Chadians living in Chad often receive fewer vaccinations against
these diseases than West Darfur residents, according to WHO.
WHO/Sudan plans to work with WHO/Chad to try to raise immunization
rates and decrease the risk of communicable disease spread.

9. (U) WHO staff highlighted recent discussions regarding forming a
health academy to train medical staff from West Darfur, which could
improve the SMoH's capacity to hire qualified staff for remote
locations.

10. (U) Comment: While West Darfur authorities and national NGOs
have replaced some health services in almost all clinic locations
that operated prior to the March 2009 NGO expulsions, much work
remains to be done to raise the quality and expand the spectrum of
services to meet Ministry of Health standards. WHO has actively
supported efforts to maintain health supplies and secondary medical
care, but improving human resources capacity will require additional
SMoH attention and government budgetary commitment to service
provision. End comment.
WHITEHEAD

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