The Director-General of the World Health Organization (WHO), Lee Jong-wook, said on 2 June 2004 that “death and disease spiral upwards when there is inadequate food, unsafe water, improper sanitation and shelter, widespread violence, lack of public health inputs like vaccinations and insufficient access to medical care”. His statement accurately describes the current situation in Darfur, in the Sudan.
The Darfur region is a wide and semi-desert area comprising three States, with a population of about 6.7 million, and is geographically isolated and often neglected by the central government in Khartoum. As of 1 June, 2.2 million inhabitants had been affected by ongoing violence in the area, where the Janjaweed militia attacked and killed thousands.
The UN Security Council expressed its concern regarding reports of violations of human rights and international humanitarian law, which include indiscriminate attacks consisting of killing, rape, pillage of livestock, destruction of property such as water sources, and forced displacement.
Some 1.3 million inhabitants are now internally displaced, with 125,000 additional refugees, mainly women and children, crossing the border and fleeing into Chad and building makeshift shelters. Some 81,000 of these refugees are being provided with oil and beans by the World Food Programme. Hundreds of thousands more are at risk of dying in the coming months.
Since September 2003, WHO has been working to upgrade and increase its presence in Darfur. However resources and funds contributed by donor Governments were limited. Only $3.6 million of the $5.4 million necessary to upgrade health services have been donated, despite appeals from the United Nations, non-governmental organizations (NGOs) and donor field staff based in Darfur. Of the needed reserves $1.3 million came from the WHO internal operating funds and this insufficient capacity has further worsened the situation.
To make matters worse, recruitment of international health professionals has been considerably unsuccessful, and it has become increasingly difficult to keep recruits from leaving soon after they arrive in Darfur. The United Nations and other donors called for an additional $236 million to assist victims of violence. The United States said it would add $188.5 million during the next 18 months to the $100 million it had already donated since early last year; however, it was not clear how much would be forthcoming. The European Union pledged $12 million and Canada $4.4 million.
WHO, in collaboration with the Sudan’s Ministry of Health and the United Nations Children’s Fund (UNICEF), has trained 52 surveillance officers to contribute to an early warning system for monitoring and responding to outbreaks of cholera, dysentery and malaria. It has also begun a comprehensive measles and poliomyelitis vaccination and vitamin-A supplementation operation that will target 2.15 million children between the ages of nine months and 15 years. Also, 172 environmental health officers have been trained to make sure that vector control, waste disposal and health promotion measures are in place.
In order to help WHO, the Sudanese Government has tried to facilitate the jobs of aid workers by issuing visas to all humanitarian workers within 48 hours of application, eliminating the need for travel permits, and aiding the importation of equipment for humanitarian purposes. Complicating the crisis is the imminent rainy season in the region and the constant cross-border raids by the Sudanese militia in which refugees are attacked and livestocks are stolen. The transfer of refugees from the insecure Chadian border to safer locations well within Chad has been hindered because roads have become impassable due to rain.
Although the Sudan agreed to the N’Djamena [Chad] humanitarian ceasefire agreement of 8 April 2004, in which it pledged to neutralize and disarm the militia and that there would be no further violence or abuse against civilians, especially women and children, the Janjaweed militia is still active. Early last year, fighting broke out between the Government and two rebel groups—the Sudan Liberation Army (SLA) and later the Justice and Equality Movement. It was an ethnically-based rebellion that has been built on long-standing but previously contained tribal rivalries, with the Zaghawas, Masaalit and Fur tribes being the main targets. The Government responded by creating and arming the militia to counter the rebels. However, after the ceasefire agreement, the Janjaweed militia, instead of disbanding, started terrorizing the inhabitants of Darfur.
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