VZCZCXRO1349
PP RUEHGI RUEHMA RUEHROV
DE RUEHKH #0251/01 0501551
ZNR UUUUU ZZH
P 191551Z FEB 07
FM AMEMBASSY KHARTOUM
TO RUEHC/SECSTATE WASHDC PRIORITY 6173
INFO RUCNFUR/DARFUR COLLECTIVE PRIORITY
RUEHRN/USMISSION UN ROME

UNCLAS SECTION 01 OF 03 KHARTOUM 000251 
 
SIPDIS 
 
AIDAC 
SIPDIS 
 
STATE FOR AF/SPG, PRM, AND ALSO PASS USAID/W 
USAID FOR DCHA SUDAN TEAM, AFR/SP 
NAIROBI FOR USAID/DCHA/OFDA, USAID/REDSO, AND FAS 
GENEVA FOR NKYLOH 
NAIROBI FOR SFO 
NSC FOR PMARCHAM, MMAGAN, AND TSHORTLEY 
ADDIS ABABA FOR USAU AND FOR REFCOORD 
USUN FOR TMALY 
BRUSSELS FOR PLERNER 
 
E.O. 12958:  N/A 
TAGS: EAID PREF PGOV PHUM SOCI SU
SUBJECT:  SUDAN - BLUE NILE STATE - HEALTH CARE FOR RETURNING 
REFUGEES AND GOLD MINING ISSUES 
 
KHARTOUM 00000251  001.2 OF 003 
 
 
------------------- 
Summary and Comment 
------------------- 
 
¶1.  The USAID Senior Humanitarian Advisor (SHA), accompanied by the 
Blue Nile State Minister of Health and the Dean of the Academy for 
Health Sciences, visited the Chali Way Station to consider options 
to improve working and living conditions for health care providers. 
The group also visited the ruins of three buildings on the hospital 
grounds in Baw that will house the first class of health science 
students after renovation.  A UN Mission in Sudan (UNMIS) military 
observer reported a dispute in a Blue Nile State community over the 
exploitation of gold deposits by internally displaced persons (IDPs) 
living in the community.  End summary and comment. 
 
--------------------------------------------- ---------- 
Health Care for Returning Refugees in Chali Way Station 
--------------------------------------------- ---------- 
 
¶2.  From January 6 to 10, 2007, the SHA, the Blue Nile State 
Minister of Health--a member of the Sudan People's Liberation 
Movement (SPLM)--and the Dean of the Academy for Health Services, 
assessed existing arrangements for health services delivery at the 
Chali Way Station.  The site serves as the main reception area for 
Sudanese refugees returning from Ethiopia.  Returning IDPs from the 
northern part of the state also re-group in Chali before traveling 
to their respective villages in the southern county of Kurmuk. 
 
¶3.  Chali lies 53 km southwest of Kurmuk town in southern Blue Nile 
State and is one of four administrative centers in Kurmuk County. 
The dirt track leading to Chali offers only enough space for one 
vehicle to travel at a time.  The way station is located next to the 
ruins of the former residential buildings for health staff, a 
church, a mosque, and an elementary and secondary school.  All 
buildings except for the mosque are severely damaged and are 
reportedly not worthy of rehabilitation.  The Uduqh ethnic group is 
dominant in Chali; they suffered great losses when Sudanese Armed 
Forces attacked Chali in April 1987 in retaliation for suspected 
Sudan People's Liberation Army support !Qd4er the attack,!Th*comi5nity flEd!Do 
EwhiopmA(a~d {qEn vHe vk,lngmw 1 Yezq@mQQjvrmms~d~w'ae@eamtC(ens| bgel4l98iN,@hy,$4Qj4&Asw h&QQQJaaunQe.j5N biflqjbTul swtom*qgymQmp5rQ+taUQGxump>b&&MjQHB4Q^JEl Qxdc!Qyi+WCQxQOd4 kw substantial, which would allow water harvesting with 
hafirs, according to the UN World Food Program (WFP) and World 
Vision field staff. 
 
¶5.  Beginning in February, refugee returns will resume with convoys 
of more than 500 persons each arriving every eight days.  A total of 
14,500 refugees and 15,000 returning in-state IDPs will be processed 
through this way station. 
 
¶6.  The State Minister of Health wants to improve the operational 
and working conditions for the refugee repatriation period. 
According to the minister, immediate needs include several 
prefabricated buildings and equipment to establish a proper 
pharmacy, administration, consultation, inpatient wards, and staff 
quarters.  The State Ministry of Health (SMOH) has identified and 
selected staff and placed them on the SMOH payroll.  The total 
catchment area is currently between 3,000 and 4,000 persons and is 
expected to increase to between 7,000 and 10,000 persons. 
 
--------------------------------------------- --- 
Decentralized Academy for Health Sciences in Baw 
--------------------------------------------- --- 
 
¶7.  Baw County lies between Ed Damazin and Geissan localities and is 
dominated by the Ingessena ethnic group, considered the most 
disadvantaged and under-educated group in the state.  The SMOH plans 
to establish the Academy for Health Sciences at a hospital complex 
in Baw that has several buildings.  Students will follow their 
academic course while working part-time in the hospital for 
practical experience.  They will be considered state employees under 
training and will receive a stipend, in addition to room and board 
at the hospital.  Two dilapidated buildings need rehabilitation to 
 
KHARTOUM 00000251  002.2 OF 003 
 
 
serve as student accommodations.  A third similar building could 
serve as accommodation for teachers after rehabilitation. 
 
¶8.  The main purpose of setting up a Health Sciences Academy in Baw 
County is to avoid a concentration of opportunities in Ed Damazin, 
the state capital, where graduates tend to remain and avoid 
returning to their home communities.  Students must be residents of 
Baw County, secondary school graduates, younger than 30 years old, 
and have no severe handicaps.  Tribal affiliation is not a 
determining factor in the admission process.  The academy has 
selected the first 90 students, who will begin their programs in 
March 2007. 
 
------------------------------ 
Alluvial Gold Mining in Aljoro 
------------------------------ 
 
¶9.  UNMIS military observers report that tension has developed 
around the gold deposit in Aljoro, Baw County.  The resident 
population is aware of the gold and its value but does not have the 
technical expertise to extract it.  In contrast, IDPs from Kurmuk, 
who are temporarily living in Aljoro, possess the technical skills 
but do not own the land containing the precious metal.  The 
residents objected to the IDPs' attempted extraction of gold.  The 
land owners maintain their rights, while the IDPs argue that the 
gold is worthless to the residents if they remain unable to extract 
it.  The situation could possibly be resolved through a negotiated 
settlement, based on an agreement outlining how income generated 
from gold extraction would be shared between the residents and the 
IDPs.  This agreement assumes that the Comprehensive Peace Agreement 
(CPA) allows for such wealth sharing.  Alternatively, residents 
could compensate IDPs for transferring their skills to the 
community. 
 
------------------------------- 
Conclusions and Recommendations 
------------------------------- 
 
¶10.  The recommendations below are offered with the understanding 
that there are neither legal prohibitions nor policy considerations 
opposing such interventions.  USAID will obtain a legal opinion and 
clearance from a policy perspective as part of considering any 
interventions: 
 
A) Chali Way Station:  USAID should consider possibilities to 
support the Blue Nile State Government in its effort to take on its 
basic responsibility of rendering health services.  A temporary 
facility to provide a space for consultations and in-patient wards, 
and to adequately house health staff on three-month rotations are 
needed in Chali.  The World Bank has included Blue Nile State in its 
Decentralized Health System Development Project valued at USD 23 
million; however, contracting for the first phase alone will not be 
complete until July 2007.  By this time, the Office of the UN High 
Commissioner for Refugees (UNHCR) hopes to have repatriated the 
majority of the refugees from Ethiopia.  The USAID Three Areas 
Program Manager and UNHCR are aware of the SMOH's interest and 
suggested that the SHA investigate the situation in Chali. 
 
B) Chali:  USAID should encourage WFP and World Vision to assess the 
food security situation in Chali now, approximately six months after 
the resettlement rations have been consumed.  In addition, USAID 
should encourage these agencies to consider building hafirs for 
water harvesting under a food-for-work scheme.  Representatives of 
both agencies in Ed Damazin showed interest in the concept during a 
debriefing by the SHA. 
 
C) Baw:  USAID should assess the SMOH plan, in conjunction with 
their implementing contractor.  By supporting this plan, USAID can 
encourage the decentralization of health training and the provision 
of underserved localities with a functioning hospital as a practical 
training ground.  Currently, the SMOH is supporting the start of 
classes and providing temporary accommodations for the 
employee-students.  Assistance with the rehabilitation of the 
housing units would be a significant contribution to the academy. 
 
D) Aljoro:  USAID should assess the situation in Aljoro and 
determine options available to the community, based on the 
provisions of the CPA and the interest of the community.  With 
outside help, this community may obtain a solution to their conflict 
by either sharing the wealth from alluvial gold mining or by 
 
KHARTOUM 00000251  003.2 OF 003 
 
 
compensating the IDPs for skills transfer to the community.  In 
addition, all parties to the discussion should consider the 
environmental impact of any project. 
 
HUME