Human Rights: Displacement and Global Health: Mohammed Seifeldin Hamad Abdalla

Department of Community Medicine

By: Mohammed Seifeldin Hamad Abdalla 6 th year Medical Student Supervised By: Prof. Mohammed Ali Awad Elkareem

Introduction

They have been forced from their homes for many of the same reasons as refugees, but have not crossed an international border.

Often persecuted or under attack by their own governments, they are frequently in a more desperate situation than refugees.

They also outnumber refugees two to one.

No international agency has a formal mandate to aid them. But they are increasingly at the forefront of the humanitarian agenda. They are sometimes called ‘internal refugees’, but are more often known as internally displaced people.

Sudan has experienced the worst population displacement in the world: six million internally displaced persons (IDPs) out of a population of 39 million Sudanese.

Two million of the internally displaced persons live in official IDP camps, squatter areas or relocation sites in and outside Khartoum.

Large numbers live in poor hygiene, sanitation, and nutritional supply, they miss the essential needs for a healthy life.

They are in real need for the participation of NGOs, at least for provision of continuous healthy water supply, food, and health education in order to obtain health for themselves and their children.

Objectives

General objectives:

To study the role of NGOs in provision of healthcare services in IDP camps, Khartoum State October 2007.

Specific objectives:

To compare between the role of National and International NGO’s.

To evaluate the provision of PHC services and free curative services.

To asses the degree of qualification of curative service providers.

To identify the number of patients (customers) attending the clinic daily and the number of population targeted by the services.

To determine the provision of nutrition.

Methodology

Study design:

Descriptive comparative study design was used.

Study area:

Heath centers in the four official IDP camps in Khartoum State (El Salaam, Wad el Beshir, Mayo, and Jebel Awlia).

Study Population:

National and International NGOs health centers in the four official IDP camps in Khartoum State. (17 Health centers 10 National 7 International)

Sample Size:

15 Health centers

8 from National NGOs ( 53.3% )

7 from International NGOs ( 46.7% )

Chart Showing Sample Distribution

Data collection method:

The data was collected by interview using a questionnaire.

D ata processing and analysis:

The data was transformed in to a master sheet, entered, and then analyzed using a computer software SPSS version 13.0

Table 1: Average number of the population targeted by National and International NGO ’ s Health Centers. * P Value = 0.179 (Statistically Insignificant) Total Target Population >10.000 5000-10.000 <5000 8 0 5 3 Count National NGO 100.0% .0% 62.5% 37.5% % within NGO 7 3 2 2 Count International 100.0% 42.9% 28.6% 28.6% % within NGO 15 3 7 5 Count Total 100.0% 20.0% 46.7% 33.3% % within NGO

Table 2: Average number of beneficiaries per day at National and International NGO ’ s Health Centers. * P Value = 0.2 (Statistically Insignificant) Total Beneficiaries Per Day >30 15-30 <15 8 1 4 3 Count National NGO 100.0% 12.5% 50.0% 37.5% % within NGO 7 3 4 0 Count International 100.0% 42.9% 57.1% .0% % within NGO 15 4 8 3 Count Total 100.0% 26.7% 53.3% 20.0% % within NGO

Table 3: Cost of service provided at National and International NGO ’ s Health Centers. * P Value = 0.27 (Statistically Insignificant) Total Service Fees <1 SDG 1 SDG >1 SDG 8 4 2 2 Count National NGO 100.0% 50.0% 25.0% 25.0% % within NGO 7 1 5 1 Count International 100.0% 14.3% 71.4% 14.3% % within NGO 15 5 7 3 Count Total 100.0% 33.3% 46.7% 20.0% % within NGO

Table 4: Qualification of health providers at National and International NGO ’ s Health Centers. Total Qualification of Health Providers Medical assistant 8 8 Count National NGO 100.0% 100.0% % within NGO 7 7 Count International 100.0% 100.0% % within NGO 15 15 Count Total 100.0% 100.0% % within NGO

Table 5: Qualification of Antenatal Care providers at National and International NGO ’ s Health Centers. * P Value = 0.123 (Statistically Insignificant) Total Qualification of Antenatal Care Providers Health Visitor Mid wife 8 5 3 Count National NGO 100.0% 62.5% 37.5% % within NGO 7 7 0 Count International 100.0% 100.0% .0% % within NGO 15 12 3 Count Total 100.0% 80.0% 20.0% % within NGO

Table 6: Qualification of Lab service provider at National and International NGO ’ s Health Centers. * P Value = 0.23 (Statistically Insignificant) Total Qualification of Lab Service Providers Lab Assistant Technician 8 6 2 Count National NGO 100.0% 75.0% 25.0% % within NGO 7 3 4 Count International 100.0% 42.9% 57.1% % within NGO 15 9 6 Count Total 100.0% 60.0% 40.0% % within NGO

Table 7: Lab investigations provided at National and International NGO ’ s Health Centers * P Value = 0.5 (Statistically Insignificant) Total Lab Investigations Provided Routine and Specific Investigations Routine Investigations 8 1 7 Count National NGO 100.0% 12.5% 87.5% % within NGO 7 0 7 Count International 100.0% .0% 100.0% % within NGO 15 1 14 Count Total 100.0% 6.7% 93.3% % within NGO

Table 8: Provision of Essential Drugs at National and International NGO ’ S Health Centers * P Value = 0.267 (Statistically Insignificant) Total Provision of Essential Drugs No Yes 8 2 6 Count National NGO 100.0% 25.0% 75.0% % within NGO 7 0 7 Count International 100.0% .0% 100.0% % within NGO 15 2 13 Count Total 100.0% 13.3% 86.7% % within NGO

Table 9: Provision of Food at National and International NGO ’ s Health Centers * P Value = 0.595 (Statistically Insignificant) Total Provision of Food No Yes 8 4 4 Count National NGO 100.0% 50.0% 50.0% % within NGO 7 3 4 Count International 100.0% 42.9% 57.1% % within NGO 15 7 8 Count Total 100.0% 46.7% 53.3% % within NGO

Table 10: Provision of Immunization Services at National and International NGO ’ s Health Centers Total Immunization Yes 8 8 Count National NGO 100.0% 100.0% % within NGO 7 7 Count International 100.0% 100.0% % within NGO 15 15 Count Total 100.0% 100.0% % within NGO

Table 11: Provision of Family Planning Services at National and International Health Centers * P Value = 0.73 (Statistically Insignificant) Total Family Planning Services No Yes 8 1 7 Count National NGO 100.0% 12.5% 87.5% % within NGO 7 1 6 Count International 100.0% 14.3% 85.7% % within NGO 15 2 13 Count Total 100.0% 13.3% 86.7% % within NGO

Table 12: Provision of Health Education Activities at National and International NGO ’ s Health Centers Total Health Education Activities Yes 8 8 Count National NGO 100.0% 100.0% % within NGO 7 7 Count International 100.0% 100.0% % within NGO 15 15 Count Total 100.0% 100.0% % within NGO

Table 13: Provision of Antenatal Care Services at National and International NGO ’ s Health Centers. Total Antenatal Care Services Yes 8 8 Count National NGO 100.0% 100.0% % within NGO 7 7 Count International 100.0% 100.0% % within NGO 15 15 Count Total 100.0% 100.0% % within NGO

Conclusions

NGOs play a very important role in the provision of health care in the IDP camps.

There was no significant difference between National and International NGO’s in the provision of health care services.

The centers targeted a very large population of the people in the camp and the service is provided for a small amount of money.

The health centers have poorly qualified health providers in the clinical.

The Health centers provide adequate PHC services and food is also offered by most centers.

The labs are poorly equipped as they only offer routine investigations.

Recommendations

The Government should grant and facilitate the free passage of humanitarian assistance and allow international humanitarian agencies rapid and unhindered access to all areas affected by displacement.

It should also cooperate with International and National organizations when national capacity is insufficient.

NGOs should continue pressing for access and meeting the essential needs of IDP populations through a coordinated response, and they should also provide adequate and predictable funding for their humanitarian programs.