South Sudan and coronavirus: health system at risk of collapse

South Sudan was the last African country to report positive cases from COVID-19. Born from independence from Sudan in July 2011, it is one of the poorest countries in the world, with 7 million people still in need of humanitarian assistance due to the cumulative effects of years conflicts, chronic vulnerabilities and fragile or, even worse, non-existent essential services.


In South Sudan, women and children continue to be the most affected by the fatigue of survival: every 100,000 women who give birth, 800 die during childbirth, and one in ten children do not reach the age of 5.

Hunger has been a constant and deeply rooted threat for too long across the country. A condition that over the years has forced almost 4 million people to flee their homes, looking for a better place. We talk about Internally displaced people and refugees who, with a threat such as that of the pandemic, risk falling ill and getting infected in times and ways rapid and uncontrollable. Among the contagions recorded in the country, some occurred right inside the protection centers of Juba and Malakal, which host 30,000 and 110,000 internally displaced people respectively.

In recent days, South Sudan has returned to cover the headlines of international newspapers, there is talk of politics and society, pacts and signed peace. The new agreement was signed between President Salva Kiir Mayardit and his deputy Riek Machar Teny, former head of the Sudan People’s Liberation Army-In Opposition (SPLA-IO) movement. The president published the list of governors, which obviously created chaos, especially in the state of Jonglei, the only state entrusted to the opposition party to the government and theater of most violent incidents between different communities.

“In Jonglei – explains Stefano Antichi, INTERSOS South Sudan Head of Mission – INTERSOS has a strong presence, characterized by targeted humanitarian interventions to protect the most vulnerable groups”.

“The spread of COVID-19 occurs in a twisted scenario, where clashes between the different communities (Murle, Dinka and Nuer) continue to make the territory insecure and unstable”, Stefano says, “The country is facing the double threat of COVID-19 and an increase in violence that threatens to fail both attempts at reconciliation in the fragile peace process and the precautionary measures taken by the government to contain the spread of the virus. This measures can themselves become the cause of side effects related to the subsistence of the population. In fact, most families live with occasional jobs and get food in daily uncertainty. By limiting the possibility of movement, it also becomes difficult to eat. Furthermore, we are in the rainy season and the floods are making the situation of the troubled African country even more difficult.”

To date, we can count 1892 confirmed cases of COVID-19 and 34 deaths, despite the fact that the government has immediately launched a good awareness campaign on the danger of the epidemic (also remembering the dramatic experience of the Ebola epidemic). What is missing, however, in a country like South Sudan, is an efficient health system capable of dealing with a pandemic emergency. There is a very limited number of fans, respirators and even beds in the only ‘equipped’ medical assistance facility in the country, in the capital Juba. At the moment the swabs are carried out only in the capital and this makes the real number of positive cases in the area unclear.

“Our work continues constantly,” says Stefano, “we have been present in South Sudan since 2006, we have assisted the most vulnerable people in the worst years of the internal conflict and it will not be COVID-19 to interrupt our activities. We have adapted all our activities in the area, giving a strong signal to our beneficiaries of presence and availability”.

Through awareness and information campaigns, INTERSOS tries to make people living in local communities in the areas of Upper Nile, Unity, Jonglei, Western, Eastern Equatoria and Central Equatoria aware of the risk of the pandemic. “The movement limitation required an adaptation of the projects in the field to leave nothing pending. Like the projects dedicated to psychosocial support for those who have suffered trauma in the past or live in conditions of extreme fragility. We continue to listen to those people carrying out house-to-house, door-to-door activities, leaving no one behind”.

The South Sudanese people are facing the risk of COVID-19 spreading with detachment. This happens when you are used to fear, to live perpetually on alert, to diseases, to contagion. “This is a people that has always known dangers such as malaria, yellow fever, ebola. Those who have lost a child due to other diseases that have plagued the country for years, will not be frightened by the pandemic,” Stefano says.

The violence that takes place in the states of Jonglei, Unity, Lakes, Warrap and Western Equatoria – in which hundreds of civilians have been killed, as many women and children kidnapped and over 60,000 displaced people – can no longer be ignored while there is a pandemic circulating.

The United Nations also issued a warning on the emergency situation. The Special Representative of the UN Secretary General, David Shearer Briefing, during the Security Council on South Sudan said: “Yes, people will die from the virus, as in any other part of the world. But the real threat to the people of South Sudan lies in the collapse of the already fragile health system. This could result in the loss of many other lives – a tragedy that can be prevented.”

Preventing a tragedy. For South Sudan, time is an essential dimension and intervening now on the safety of people and an unstable health system can make a difference in terms of saved lives.



Flavia Melillo
Flavia Melillo