Badru Mulumba
12 June 2008
Nairobi — William Madeng prances up and down across a garden of maize seedlings, trying to avoid swarms of people making a beeline for him.
Mr Madeng is a lead volunteer trying to distribute mosquito nets to more than two million people, but on D-Day, at a time when he should have concluded the exercise; his head has more questions than answers.
"There's a conflict and the people are all coming here," says Mr Madeng, telling of tribal fighting in a county in this State in April, which left at least 200 people dead, and displacing thousands more.
"These IDPs have a problem: what can I do to them?"
Ms Marcie Cook, the Southern Sudan Director for Population Services International, tells him to tell the people that the nets would be taken to the county from where they originate.
"They can't agree," Mr Madeng says. "They can't accept." In that case, Ms Cook says, the IDPs need to wait until everyone who has registered has received a net.
"Tell them there are enough nets; that's not a problem," Ms Cook says. "But for purposes of accountability, we need to first give those who did register."
And how long should they wait, asks Mr Madeng.
"No more than one month," replies Ms Cook.
In bust and jolts, a massive insecticide-treated mosquito net distribution exercise, that would see at least one mosquito net per three people to every household under an ambitious program stretching five years, has started in Southern Sudan.
Even if Southern Sudan is not the first to distribute nets in Africa, the enormous task is much more complicated than elsewhere.
"Nobody really had an idea of what that entails in southern Sudan and nobody had done it anywhere before," Marcie Cook, country director of Population services International, contracted, in April 2007, by Southern Sudan to distribute nets, says.
Compared to other countries, there are more challenges.
"The biggest one is no idea what the population is," Ms Cook says.
"It's a huge country, no roads. In Uganda you can get anywhere within twenty four hours. You can't get everywhere in southern Sudan in twenty four hours."
Ms Cook says the Government required a plan to distribute bed nets to combat malaria.
The states where the plan would be implemented were decided in November and December.
Ms Cook said Warrap and Western Bahr el-Gazal had the lowest distribution of insecticide treated nets, the highest number of children under 5 years suffering fever in the previous two weeks, and the highest percentage of people seeking malaria treatment in the past 24 hours.
Also, she says, Warrap had the most population. "So we started with Warrap," says Cook, even as she agrees that the exact number of people is not known.
The day the mosquito nets were distributed, thousands of people swarmed distribution points, spending hours under the blistering heat, waiting.
"If you see a bunch of people waiting for mosquito nets you know there are nine other states waiting for nets," Cook says. "The reality is you can't give nets to every one in southern Sudan."
The agency would do a coverage and retention survey in October to see how the communities have used the nets.
In Warrap, the state where the exercise kicked off in April, the situation is particularly dire, and that was the reason the state was chosen as the first stop in an ambitious mosquito net distribution exercise ever embarked upon by the three-year government of Southern Sudan.
"The case management is very week because our health facilities are ill-equipped," says Dr Raphael Mawien, the director general of Health Services in the state.
Non Governmental Organizations run the few health facilities in the state. But these, too, have no drugs, Dr Mawien says.
"People are still using chloroquine," Dr Mawien says, adding that the drugs are not effective here. "It's available all over the market."
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