Other Coutries Other Customs

A transcultural view on the problems of humanitarian aid in the crisis regions of Sudan und Niger

Ueckermnde, June 23, 2011 Martina Lutz

- medical emergency care in crisis regions - little burocracy - fast response teams - teams usually cosist of 2 doctors, 2 nurses or paramedics and a coordinator

Sudan - Darfur
- over 25 years of civil war - military and mercenaries attack villages - arabic vs. African population - peace agreement in 2006, situation got worse since

- refugee camps with up to 50,000 people - most families have lived there for years - medical care, food, schooling etc. supplied by aid agencies but: - frequent attacks by government troops and rebels - repeated compulsory evacuation of the camps

schooling provided by unicef

Basic Problems
- strictly islamic country (Sharia) - government tries to drive aid agencies out of the country - Sheiks (heads of families) have absolute power - no privacy - 100+ patients per day

- poor hygiene (sand, insects, no clean facilities available) - poor compliance - poor understanding of health issues

- no time and space for recovery - circumstances of life don't allow people to care well for themselves and their children

Trachoma (often leading to blindness) due to constant exposition to sun/wind/sand and infected wounds/wound healing deficits are common problems in the refugee camps.

Help at any cost?

- Ali, 10 years old - leg injury that led to osteomyelitis - sent to Germany for treatment - surgery, 2 months in a german hospital - 3 months of surgical outpatient treatment - lived with a german family, got designer clothes, watch, walkman... - came back to Sudan with our team

Ali
- sudanesian extended family living in a hut - can read, no other schooling after coming home: - feels superior to the rest of the family - frequent visits to humedica home after 3 months: - integration still impossilbe, mostly isolated from friends and family - disappointed, resignated - reinfection due to another injury (self harm?)

Excursion: distribution of donated clothes

In the heart of the Sahelian-Zone: Niger

- drought and hunger - poor hygiene - repeated plagues - one of the highest fertility rates in the world - polygamy

Fallacious Beauty:

- Malaria - Typhus - Parasites (Shistosomiasis, Filariasis, Echonococcosis etc.)

Primary problem: malnutrition and infections

4 year old girl with severe malnutrition on a baby scale

Trying to feed a malnutritioned Baby via nasogastric tube.

It's like death just walked through this room and took them with him.

Mattress in the sand and improvised IVs

Emergency Health Kit by WHO - basic medical kit for a population of 10,000 people for 3 months - distributed to all aid agencies in the world. Advantage: easy adjusting to new work environments for medical personnel

- modular system with basic equipment plus special modules e.g. for malaria, PEP

Clinic day in the desert

Tuareg proud and quiet

- nomads and horse people - islamic with rich indigenous culture, believes in the spirit world - stay away from other people - don't enter the clinic without being asked. If not approached and invited they just sit outside in a certain distance from the clinic and wait, for days if neccessary - don't speak much

Well-nutritioned mother and child from a rich family.

Feeding medicine to a baby

Checking for malaria

Comfortable accomodation for the team members...

Thank you for your attention!