By Unni Karunakara

March 19, 2013 - This year marks 30 years since Médecins Sans Frontières (MSF) began providing medical care in the area that now makes up South Sudan. Our first project was in Yei in Central Equatoria in 1983, where we delivered healthcare to the local population and refugees fleeing the civil war in Uganda. Coincidentally, my first visit to South Sudan as a doctor with MSF was also to Yei, 13 years ago.

It was a great privilege to visit the Republic of South Sudan last week, as MSF International President. It is clear to me that, 30 years on, MSF, as an emergency medical-humanitarian organisation, still has a vital contribution to make. As the country begins to build a health system from scratch, people are continuing to face one emergency after another – displacement, violence, natural disasters, disease outbreaks, malnutrition. While the Ministry of Health and development organisations focus on essential long-term system-building, significant, immediate health needs still have to be addressed. There remains a clear need for donors and aid organisations to invest in strengthening emergency response capacity, which is too often inadequate or delayed.

MSF’s focus is on this hands-on provision of lifesaving health services to the most vulnerable communities. Significantly, the country’s independence has not brought a downsizing of our operations here. Instead, our commitment has grown, and the last 20 months have seen a substantial scale-up in our activities.

In 2012, our teams conducted 702,000 outpatient consultations, compared with 387,000 the previous year. This is not only due to the huge refugee emergency response in Unity and Upper Nile states, but also to the flooding and serious malaria outbreak that affected great swathes of the country last year. Notably, in 2012, we treated 141,000 patients for malaria, compared to 52,000 the year before. With the number of refugees expected to increase this year, we are working hard to strengthen our over-stretched capacities.

South Sudan is in the top three of more than 70 MSF programmes worldwide in terms of staff numbers and project expenditure. Right now, MSF has more than 3,000 South Sudanese and 350 international staff working across 14 projects to deliver free, high quality healthcare to vulnerable communities in some of the most remote, logistically difficult circumstances I have seen.

Whether it is treating a patient for kala azar in Leer, ensuring a woman can safely give birth in Yambio, operating on a gunshot victim in Nasir, or providing tuberculosis treatment in Agok, what I am struck by is the diverse range of medical activities carried out by our teams and the very different contexts in which they provide them. We are also now integrating the treatment of complicated diseases like HIV/AIDS and drug-resistant tuberculosis into a number of our regular programmes.

In recent days I have visited our teams in Yida refugee camp in Unity state, and in Pibor and Nyirol counties in Jonglei state, to see first-hand the immense health needs of people in these areas. Seeing for myself the dearth of other health services in these parts of Jonglei brought home the urgent need for all armed groups to respect the safety of patients and the neutrality of medical facilities and staff. Without this respect, thousands of people are left without healthcare, just when they need it most.

During the last three decades, MSF has not only been committed to providing medical care to people in South Sudan, but also to bearing witness to their suffering. MSF’s medical work has always been complemented by our efforts to draw attention to people whose suffering is ignored by the rest of the world. As the nature of our work here adapts to the changing needs in the country, we will endeavour to continue to bring the need for humanitarian response in South Sudan to the world’s attention.

MSF’s purpose is to bring healthcare to communities affected by conflict, displacement, natural disasters, disease outbreaks, or extreme lack of access to medical services. We have been doing so here for the past 30 years and we are committed to persisting in our efforts to care for people who are hard-to-reach and hard-to-treat in South Sudan.

Dr Unni Karunakara, International President of Médecins Sans Frontières, visited South Sudan from 3 – 8 March. MSF has been working in the area that now constitutes South Sudan since 1983 and currently has 14 projects in seven states as well as one in the Transitional Area of Abyei.