Fieldset
Welcome to South Sudan: The "humanitarian capital"

What would you expect from South Sudan, the “newest” country in the world? Czech epidemiologist Tereza Kaplanova shares her thoughts on arriving in the conflict-stricken country for her first assignment with Médecins Sans Frontières / Doctors Without Borders (MSF).

Welcome to South Sudan, the newest country in the world.

When we say the word "new", we usually imagine something modern, something functioning, something shiny, maybe even gift-wrapped!

Welcome to South Sudan, the newest country in the world…

A country where life expectancy is 56 years. Where the maternal mortality rate is one of the highest in the world and children under 15 make up more than 40% of the population. Where the literacy rate is 27% and the unemployment rate hits 88%.

After what became Africa’s longest-running civil war, South Sudan gained independence in 2011. However, a new conflict broke out in late 2013 amid a power struggle between ruling factions. Welcome to the newest country in the world.

Expectations

So, what did I expect before coming to South Sudan? I didn't expect anything. And I'm not sure whether what I have seen so far is worse or better than that. 

I didn't even think there were so many World Food Program planes in the entire world. Welcome to South Sudan, the humanitarian capital."

After arriving in the capital Juba, I was actually surprised at the low number of people with guns in the streets, just a few officials guarding the public places. Instead, people were smiling and clapping and cheering as I did my morning jog around the block.

I needed to keep reminding myself that this is the same country where children are forcibly recruited as soldiers, women are facing sexual violence and where I heard a number of aid workers have been taken hostage in one of the states. The same country where I have heard of local people being robbed, threatened and injured in the one month since I have been here. 

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Old Fangak market. The small rural village has become a refuge for thousands of people fleeing fighting along the Nile since 2014.
Old Fangak market. The small rural village has become a refuge for thousands of people fleeing fighting along the Nile since 2014.

With an average inflation rate of over 120%, the government lacks resources and ordinary people struggle to afford food. I personally witnessed how the exchange rate increased by 30% from one week to another.

No wonder that my shopping, consisting of coffee, yoghurt, cereals, a small pack of peanuts, soap and olive oil, came to a total of over 40 US dollars. If you are a fan of shrimp, be prepared to pay 60 USD for a frozen bag of 400g.

Welcome to South Sudan, a country where the economy collapsed seven years ago.

The humanitarian capital

When you drive around Juba, you see banners produced jointly by several NGOs advertising education with their slogan: "I never miss a day in school... accessible and equitable education to all."

Juba airport is a parade for humanitarian planes and helicopters, I didn't even think there were so many World Food Program planes in the entire world. Welcome to South Sudan, the humanitarian capital.

MSF first started working in South Sudan 35 years ago. In 2017, MSF's expenditure for South Sudan was over 75 million Euros. We haven't been able to leave. Some of our projects have been running for several years, even decades. We have found ourselves stuck in the middle of a chronic emergency. 

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Fatma and her six-month-old daughter receive a health check.
Fatma and her six-month-old daughter receive a health check.

During my first visit to our project in Doro, a town in Maban county, in the north of the country, I witnessed how MSF provides healthcare to a refugee camp of nearly 60,000 people, while also running a service for the local community in the nearby town. Across the two sites, our staff see more than 3,000 patients and support more than 50 women to give birth each week.

Most of the patient consultations relate to malaria, respiratory tract infections and diarrhoea, but the team also treat some patients for scorpion stings and snakebites, tuberculosis, meningitis and many other diseases that I have previously only read about in textbooks. 

The South Sudanese team

I had no expectations when arriving in South Sudan...

I certainly did not expect that my south Sudanese colleagues would be the main source of my day-to-day motivation. I quickly learned to adapt to their handshake culture, and in return for every handshake I always receive a big smile.

Now I have seen what a chronic humanitarian crisis looks like."

My South Sudanese colleagues are so keen to learn and share their knowledge.

They have probably explained how their department's data collection and reporting works to many other international staff before me, yet they patiently explain it again. And they patiently listen when I inform them that the patient register will again slightly change, carefully spelling out how they will need to count the number of patients and record them on the tally sheet. 

Tough questions

I had no expectations when arriving in South Sudan...

I didn't know that each year, malaria exceeds the epidemic threshold. I didn't think that peaks in malnutrition would be justified as “seasonal” and dismissed by the humanitarian community. I couldn't envisage what it practically means for humanitarian funding to be cut. 

I had no expectations when arriving in South Sudan, but now I have seen what a chronic humanitarian crisis looks like.

It has been decades since the start of the South Sudanese conflict. The newspaper headlines keep repeating themselves. The food crises are hitting the country year by year. The World Food Program planes continue departing from the airport one after another.

And I keep asking myself: Am I doing enough? Are we doing enough? Are you doing enough?