During times of conflict, access to healthcare is sometimes one of the first basic needs to go unmet. The consequences of humanitarian crises include severe disruptions to healthcare, such as acute shortages in the healthcare workforce and inadequate health infrastructure.
The displacement caused by conflict can be further exacerbated by the fallout of the climate crisis. South Sudan ranks as one of the five countries most vulnerable to extreme weather events due to climatic changes. The country has seen increased flooding and drought, and with flooding comes increased transmission of water-borne infections such as hepatitis E and cholera, as well as vector-borne diseases like malaria.
The result? Patient care is deeply fragmented and, for many people, inadequate. For those living with disabilities, it is sometimes non-existent.
Barriers to seeking help
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The isolating nature of disabilities can dramatically hinder access to vital care. In an effort to address this, Malaria Consortium was involved in the Boma Health Initiative, a nationwide community health programme set up by the Ministry of Health in South Sudan. The programme sought to reach individuals living in remote areas by delivering health interventions activities at the boma (village) level. This entailed training boma health workers: people within the community who could provide healthcare within their boma, in the form of health promotion, disease prevention and primary healthcare delivery. The outputs of the project were continued under the Health Pooled Fund, which has now been replaced by the Health Sector Transformation Project. Under this more recent initiative, Malaria Consortium is continuing to distribute drugs and medical supplies to health facilities and boma health workers, as well as supporting the recruitment, training, resourcing and supervision of boma health workers.
One of the activities we carried out was the distribution of hundreds of walking aids to people with visual impairments. These individuals often struggle to access and use health services because of stigma and discrimination, and the fact that they usually need someone to accompany them to medical facilities. We trained boma health workers to identify and assess people with disabilities to refer them to health facilities for the most appropriate support.
Creating equal access for all
Through the programme, Alet, who is blind and lives in Aweil South county in Northern Bahr el Ghazal state, received a walking aid, which helped her to participate in society more. “The community members can identify me and provide me with assistance as they would clearly see that I am blind,” she said.
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Caption: Alet Wel Chiec with her walking aid
For Gabriel, who is also blind, the walking stick meant he could comfortably move and walk around, without fear of cars or motorbikes not seeing him. He also describes receiving more support from his community members, who offer him help when they see the white cane. Gabriel notes that a lack of family support meant that he may not have been aware of the existence of the service — but the boma health workers’ strategy was crucial for getting him the care he needed.
Caption: Gabriel Machol Kuot, pictured with his walking aid
A disability can be both physically isolating as well as emotionally and mentally isolating. This was true for Alet. “We’re social beings, and we are not meant to live in isolation. Community is critical for us to thrive, especially for someone with mental illness who is already experiencing the common symptoms of loneliness and isolation,” she says.
In countries like South Sudan, where the scars of conflict and displacement run deep, the importance of delivering accessible health services to historically marginalised individuals cannot be overstated. Creating community-driven, equitable health initiatives, such as those delivered by Malaria Consortium through the Boma Health Initiative, is imperative to confronting the deeply isolating nature of these conditions.
By working with communities to destigmatise health conditions, and encourage community support and care-seeking, we can ensure these issues don’t go undetected and unsupported.
