SUDAN: Durable solutions elusive as southern IDPs return and ...

p.21:
"In addition to the increased violence and displacement, large-scale outbreaks of diseases such
as malaria or visceral leishmaniasis (kala-azar) remain common in Southern Sudan.
[…]
Kala-azar [a neglected tropical disease, contracted by the bite of a sand fly] thrives in poor,
remote, and unstable areas, where there is extremely limited access to healthcare, so while
outbreaks are seasonal in Sudan and are not directly linked to the violence, the current outbreak
highlights the already precarious medical humanitarian situation facing the population of Southern
Sudan."
The lack of rapid response
MSF argues that there is a lack of rapid response that would meet the emergency needs of the
population. The reason lies in the donor funding in Southern Sudan:” The primary objectives of
donors and the UN have been based on efforts to support the CPA. As a result, Southern Sudan
is addressed as a ‘post-conflict’ context and the focus on longer term development is
disproportionate to that on immediate humanitarian aid.” Consequently, "[m]ost NGOs in
Southern Sudan have a strict development agenda and funding sources that are unable to allow
for a rapid response to the emergency needs of the population" (MSF, December 2009, p.12). In
view of escalating violence across Southern Sudan, both inter-tribal as well as LRA attacks, more
attention has to be given to the immediate humanitarian needs of the population. Development
aid as it is in Southern Sudan "has serious flaws and it is not wired to meet the growing
emergency nature of the Southern Sudan context" (MSF, December 2009, p.30).
NGOs deliver 85 per cent of health-care services
It is also noteworthy that NGOs deliver up to 85 per cent of primary health-care services in
Southern Sudan and pay the salaries of three quarters of the health staff (NGO coalition, 2010,
p.24; MSF, December 2009, p.5). A recent OECD study on delivery of public services in Southern
Sudan notes that there had been almost no formal government in the south during the war (Nort-
South war). Consequently, “Southern Sudan was starting from a situation of extreme poverty and
virtually non-existent normal government institutions” (OECD, 2009, p.81). The entire public
service, including personnel and system has to be built virtually from the scratch. Therefore in the
health sector service delivery is still primarily undertaken by NGOs.
GoSS ability to take on the delivery of services is furthermore hindered by the fact that in five
years (since the signing of the CPA in 2005) the South Sudan Multi-Donor Trust Fund (MDTF),
administered by the World Bank and funded by donor countries, spent only a third of its money
(Guardian, 18 February 2010). It was anticipated that the fund would play a leading role in
contracting third parties to deliver government services for at least two years of the interim period
and that its role would be phased out as GoSS’s capacity increased. But the complex rules
imposed by the World Bank on the GoSS requiring up to 62 steps to procure anything, led to
delays and frustration. GoSS lacked the capacity to manage lengthy procurement and contracting
procedures (Guardian, 18 February 2010; OECD, 2009, pp.79-83, 146-147). According to the
GoSS "a government which is contracting out services because it lacks internal capacity is
unlikely to have the capacity to manage complex process for contracting-out" (presentation by
Ministry of Finance and Economic Planning in OECD, 2009, p.147).
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