Malaria in South Sudan After almost two decades of civil war, on July 9, 2011, Southern Sudan seceded from Sudan to become its own nation. However, the joy of independence and its corresponding peace have been tempered by the destruction and loss of life caused by the civil war. An estimated 2 million people died in the civil war, with thousands of children orphaned. 4 million people were displaced from their homes, health facilities were leveled, and potable water supplies were destroyed during the civil war. The lack of health care, clean water, and growing poverty remained at the top of the biggest issues that people of South Sudan are facing every day. In the village of Aweil, South Sudan, there are no hospitals, running water, or transportation and poverty continues to grow. South Sudan is one of the world poorest and under-developed nations that is lacking of proper infrastructure with few hospitals or health centers in its main cities. Malaria Parasite Many people in South Sudan are dying from malaria due to lack of medical care and continuation of poverty. There are no clinics or hospitals available in the villages and people have to go to the nearest town. Because there is no mass transportation, people have to walk for hours and hours to go to the nearest hospital in town. The ones who do not have money don’t even bother to leave home, rather they died and their loves one who are unable to do anything to save them, just watching them take their final breath. People like the one in my village have to walk for 7 hours to go to the closely clinic or hospital. Some of them make it to the clinic while the ones who are critically ill die on the way before reaching the clinic or hospital. Because of the poverty in all villages, the majority of people cannot afford to buy medicines for either themselves or love one. Those who are sick and unable to walk to a clinic remain and die in the village from malaria. The most common malaria parasite in South Sudan is plasmodium falciparum, which is said to be the most deadly one that kills people if drugs are not available. Malaria has many long term effects in many villages of South Sudan due to poor individuals, communities, and economic burden. Many families have limited resources that could allow them to pay for treatment of their love one. They are also facing the burden of caring for an ill family member as result of the cycle of poverty that is hard to escape. The fact that it is a disease caused by parasites, it can be spread through blood transfusions, dirty syringes, and from mother to unborn child; mosquitoes are the most common cause of transmission. For instance, when a mosquito bites one person who already has malaria, the parasite automatically infects that particular mosquito which allows it to pass on to the next person who more likely get bitten by the same mosquito. Although malaria can be treated, the people most at risk often do not have ready access to health care, which means that severe illness, complications, and death are more likely to occur. The fact that it is transmitted from person to person is the biggest reason why it is killing so many people in South Sudan right now. When one person get infected from malaria and he or she doesn’t receive immediately treatment put other people at a high risk of attracting malaria. South Sudan is a tropical and subtropical region where malaria is widely prevalent. While clinics and medical supplies are needed most, bed nets can also be used to help protect people from mosquito bites while sleeping. Solution Building a clinic and providing medical supplies will not only solve some of the health issues but it will save many lives and prevent more malaria breakouts that most South Sudanese citizens have been dealing with for decades. Building a clinic will also eliminate the fact that people have to walk long distance to the nearest clinic or hospital and stop spread of malaria. No one will have to die on the way to the clinic as usual. Many parents will be able to let their children attend school without the fear of health conditions. Unfortunately, there are no doctors and nurses on site as a result of lacking of the clinic and medical supplies; however, they will come if there is available clinic and medical supplies. In addition to that, building a well will help people and prevent them from attracting other diseases they obtain from drinking dirty water. The comprehensive sets of solution to combat malaria are: Early testing The first step toward treating malaria is the timely testing or the Rapid-Diagnostic Test, also known as (RDT), which is used to confirm malaria cases in remote areas where malaria is very common. The Rapid-Diagnostic Test allows doctors and nurse to make sure that people get the right treatment when necessary. The test also indicates the level and stage of malaria infections within the human body, which helps doctors and nurses determine the type of treatment that particular patient need. For instance, stages 1 & 2 can be treated by giving pills while stages 3 and 4 require more involved treatment, including several doses of injections. Early testing will provide an early detection of malaria diagnoses in the human body; malaria can be easily treated in its early stages. The Rapid-Diagnostic Test is very useful in confirming and identifying malaria infections in remote areas like South Sudan where technology is very uncommon. Treatment The second step is the actual treatment, which is called the Artemisinin-Based Combination Therapies or (ACT), which are the frontline treatments for malaria. ACT is a therapy combination of different medications used by doctors and nurses to treat the malaria parasite, which is said to be the most deadly one. Other commodities like mosquito nets, insecticides and different anti-malarial drugs are used for treatment. A person receiving treatment can be cured within one to three days period. Protection The third is to help people protect themselves from mosquito, which is the root cause of malaria, by providing them with mosquito nets. The long-lasting insecticide treated bed nets (LLIN) can prevent malaria by creating a protective barrier against mosquitoes for people at night, which is when transmissions occur most of the time. The insecticide-treated mosquito net usually hangs over the sleeping areas to protect those who are sleeping under it by preventing mosquitoes to enter. One net can cover two people at once. According to the World Health Organization, (WHO) widespread use of ITNs can reduce child mortality by 20%. The new technology of LLINs eliminates the need for re-treatment and keeps the nets effective for up to 5 years (WHO). Additionally, insecticide spraying is another solution in terms of protection from malaria. Insecticide spraying is an indoor residual spraying that is used on the inside walls of homes to help kill mosquitoes. It kills the adult mosquitoes before they can actually transmit malaria parasites from one person to another person. And last but not least, the clinic will need additional doctors and nurses to work closely with families and communities to educate and provide knowledge on how to protect themselves from malaria through the recognition of early symptoms and stages. Educating families and communities will help improve their knowledge on the prevention, recognition and appropriate treatment, which is the key success to defeat and control malaria. One of the reasons why medical clinic is so crucial is because the Medecins Sans Frontiers (MSF) Doctors without Borders is present in South Sudan and is willing to treat and train people in remote areas that are devastated by malaria. However, they are only going to locations with existing medical clinics and supplies. Therefore, building a medical clinic will bring Doctors without Borders to Aweil East to treat people and also train the local doctors and nurses who will be operating the clinic. Doctors without Borders are currently operating under the Medecins Sans Frontiers (MSF) which is located in Aweil Town. Our medical clinic is located in Aweil East in TiitChok Mareng Village, which is 7 hours away by foot from Aweil Town. MSF is an independent international medical humanitarian organization that provides emergency medical assistance to people in crisis around the world. MSF share the same goal with the Deng-Foundation which is why it is an appropriate organization to collaborate for assistance with the proposed clinic. “MSF is an international, independent, medical humanitarian organization that delivers emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from health care in more than 60 countries around the world. MSF employs more than 3,000 South Sudanese staff and more than 300 international staff to respond to a wide range of medical emergencies and provide free and high-quality health care to people in need in locations across South Sudan(MSF)”. This showed that MSF will be the right organization to work with in achieving our medical clinic goals and mission. MSF’s humanitarian response in South Sudan has been successful in many locations and it remains strongly committed to help the people of South Sudan. Therefore, MSF will come and assist if we build a medical clinic in our village. It’s Personal Building a medical clinic in South Sudan is something very personal to me. I have lost most of my family to malaria including my mother and just recently my older brother. My brother was sick and because there were no hospitals, clinics or medical facilities in our village, we had to travel for a long period of time to get to a clinic. My brother passed away by the time we finally made it to the clinic. I never forget the moment I watched him die while holding his hand. I am living with that moment every single day and it will never go away. I have cried so many times on so many occasions because I completely feel lost without the people I love. The anger, pain and devastation from losing my family continues to destroy me inside and building a medical clinic in my village is the only solution I see. I know I will never bring my family back but I can save other families in my village. I have declared a war against malaria and I want to win this war. I need you to help me win this war against malaria. We can win and defeat malaria through building a medical clinic and providing medical supplies in my village where a malaria outbreak is taking place. Please donate now. Your donation is a step toward victory and toward defeating malaria in my village of Aweil East, South Sudan. This is a mission that can be achieved and I am not resting until it is accomplished.

The Deng Foundation is a humanitarian organization assisting the people of South Sudan in developing the medical and educational infrastructure necessary to assure continued peace and to provide opportunities for economic advancement.