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