Lower Juba: A marginalised people in a neglected country

Basic healthcare Lower Juba

Project objective: To provide basic health and emergency response capacity for the populations in the Lower and Middle Juba Valley while advocating on behalf of, and being near, the population.

Activities: Inpatient care for paediatric, medical and maternity cases; delivery including emergency obstetric care; therapeutic and supplementary feeding; (mainly obstetric) surgery; outpatient curative and preventative services; provision of additional sources of safe drinking water and protection of existing drinking water sources.

In the Lower Juba region, MSF has provided basic healthcare since 2003. With seven international and 100 Somali staff, MSF works from its base in Marere village and also runs a supplementary feeding programme in Jilib town. The activities of the Marere Hospital are complemented by outreach activities.

Twice a year, Lower Juba experiences food shortages, so MSF has included a nutritional component in the project. The food shortages particularly affect the Bantu ethnic group, which makes up a large percentage of the Juba Valley population. The Bantu people are also socially vulnerable as they are not part of the Somali clan system.

MSF provided 34,000 outpatient consultations in Lower Juba in 2006. The year also saw 988 inpatient admissions and 920 admissions in the nutritional therapeutic programme and more than 2,800 in the supplementary feeding programme in Marere and the nearby village of Jilib.

In November, heavy rains caused flooding of the Juba and Shabelle rivers, cutting off most of the 50 villages in the area (the villages have between 50 to 600 households). MSF sent medical teams by boat to the isolated villages.

Somali medical teams with stocks were posted in several villages, as the receding waters might have made them completely unreachable due to roads being washed away. During this time the outreach teams performed 919 consultations, and provided relief goods. In addition MSF opened a clinic in Marere village during the flooding which carried out 1,088 consultations.

In the past year the Marere project has also suffered from regular evacuations of international staff due to ongoing insecurity, but MSF’s Somali staff were able to successfully continue activities.

In March and April 2007, MSF treated over 240 cases of cholera. In April an operation theatre was opened, mainly for obstetric surgery. Since it opened over ten major surgeries have been completed.