CARE-supported clinics remain open and provide essential health care despite escalating violence in South Sudan


The CARE-supported Primary Health Care Clinic in Twic East remains open despite the escalating violence which has spread to half of Sudan's 10 states over the past weeks. “The clinic is treating anyone who can reach the facility,” said County Health Director James Magok on Tuesday, December 24. “I collected wounded, three of them ... Those who are wounded come from Bor into Panyagor now.”

Bor, about 108 kilometres south of Panyagor and the clinic, is the state capital of Jonglei, one of South Sudan’s most troubled states. Bor has been the scene of intense fighting in recent days, with at least 17,000 people taking refuge at the United Nations base there.

“We are providing first aid, because that is what they need. The whole clinic is open. There are three emergency rooms because of the needs. But community members are worried, they are afraid to come. It is only those who are seriously ill who come to the clinic,” said Magok adding, “We are all working. All 16 health facilities are working in Twic East.”

Asked if women were accessing the clinic’s maternity centre, Magok said, “For the past two days they haven’t come; they are worried. Only those who have difficulties to give birth and those who are severely sick are with us now. The women, they come in the morning for medication and they walk back. People don’t know when they might be attacked.”

The normally busy clinic was almost empty early afternoon on Tuesday. On an average day they attend to 150 patients. Eighty percent are cases of malaria and most cases involve children, followed by women and then men. The clinic also routinely treats many cases of diarrhoea, upper respiratory infection and pneumonia, especially children who are ill.

Even before the current upsurge in violence, South Sudan had one of the highest maternal and infant mortality rates in the world.

During a recent interview, Twic East County Commissioner Dau Akoi Jurkuch called CARE “the mother organization” in the county. “CARE has been here since 1998 and is supporting the health sector. We seconded the staff to CARE” and CARE helps train and manage them, he said. “Nurses, community health workers, lab technicians, and midwives or TBAs – traditional birth assistants; the most important health workers are the ones seconded to CARE. They are the best trained nurses and technicians and support staff,” said Akoi.

He also said the organization’s peace building efforts in Twic East are important. So far the area has avoided most of the violence that has brought pain and havoc to many areas of the country.

“CARE has coordinated a number of workshops promoting peace, with participation of women and youths and civil society organizations,” said Akoi. “It definitely is very important. When you come out from the war most people are traumatized. So when you are doing a peace building workshop it is like providing counselling to the community.”

CARE has been working closely with the county for 15 years and supporting its health system for the past nine years. CARE supports a total of 29 clinics in Jonglei. The health program is complimented by separate multi-sector development projects that include water and sanitation, livelihoods and food security components. CARE also encourages women’s participation and economic empowerment by showing them how to set up and manage their own Village Savings & Loan Associations in Twic East, as well as in Upper Nile and Unity states.

The most recent addition to our programming in Jonglei is an initiative to prevent gender-based violence, and we also handed over 65 shelters for vulnerable families in Bor in November.

We are assessing our response to the current crisis, in addition to continuing our on-going programs where possible.

We are concerned that the insecurity makes it even more difficult for women to access health care services, putting mothers and children at even greater risk.  We urge all parties in the fighting to end the violence and ensure the protection of civilians. In times of conflict, women and girls are particularly at risk. It is crucial that acts of sexual and gender-based violence are prevented.

Learn more about CARE's work in South Sudan and how you can help >