In South Sudan, vaccines overshadowed by pressing needs

The UNICEF immunization campaign team arrived last month in a small motorboat in the flooded village of Wernyol, not far from the capital of South Sudan, and met elders under a tree on a small parcel of dry land.

The team went through a point-by-point fact sheet on the coronavirus and vaccine, hoping to anticipate what they assumed was a flurry of questions from elders about the shooting and its side effects.

But above all, what the ancients wanted to know was: when will the rains stop?

In recent years, it sometimes feels like the rain is the only thing some South Sudanese have ever experienced. The result is the worst flooding in parts of South Sudan in six decades, affecting about a third of the country.

For most of the 11 million inhabitants of this landlocked country in Central and East Africa, one of the poorest countries on the planet, the coronavirus pandemic is not at the top of the list of problems.

Many people fled Wernyol and other villages in Jonglei State, while those who remain lost their crops, livestock and homes. As fish are almost the only food available, malnutrition is rampant, as is disease.

In Pawel, another submerged village hours from a river that only a few years ago was a road, village chief James Kuir Bior, 50, was a bit skeptical with UN officials. on how the coronavirus vaccine compared to all the other village needs.

“We need medicine and nets,” Bior said as a thin layer of cloud above heralded even more rain. “Now all we can think of is how to get out of this flood.”

The villagers recognize the pandemic as a threat. Maybe not very urgent.

“We heard that people were dying,” Mr. Bior said, “but we didn’t see anyone sick here.” And besides, he said, “When you’re hungry you don’t think about anything else – you have to feed your stomach first.”

In any case, the issue of vaccines was moot for these villages until the floodwaters receded. The nearest airstrip was submerged under several meters of water, so the shipment of Johnson & Johnson plans destined for the area was blocked in Juba, the capital. The airstrip finally reopened in mid-November and vaccination is expected to start on Friday, November 26.

South Sudan, the world’s newest nation, was born struggling and full of hope, but little seems to have changed since the day in 2011 when its people voted to secede from Sudan. The decade that followed was marked by political conflicts and humanitarian crises.

Last month, I spent nearly a week traveling with a UN team to assess flood damage and prepare for vaccine deployment in the region, much of which nowadays only accessible by canoe. and in a small motor boat.

In Pawel, about a dozen men gathered to discuss the imminent arrival of the vaccine, the elders listening with semi-attentiveness to a team from the United Nations relief agency led by Dau Deng, 41. Young men nearby were playing chess, even less interested, as the temperature hovered around 100 degrees.

It was like that in a lot of places we went.

A virus born halfway around the world, even one that has killed millions of people, could not compete with the threat at home.

David Ayiik Deng Riak, a project officer with Community in Need Aid, a local organization, said the disease is no stranger to the region. “Malaria is the main parasitic disease in this region,” he said, “followed by respiratory infection and then of course by parasitic worms.”

The floods made everything worse. It is now common to see people going to hospitals with water-borne illnesses like dysentery, giardia, hepatitis and schistosomiasis. “Because people stay in the water all day,” Riak said.

Although testing is rare, there is little evidence that South Sudan has a major Covid problem.

“What children die from is malaria, diarrheal diseases, respiratory infections,” said Yves Willemot, communications manager at UNICEF. “We have one in 10 children who die before the age of 5, and they don’t die from COVID-19,” he said.

South Sudan is currently administering some 152,000 doses of the Johnson & Johnson vaccine donated by the United States through COVAX, the global distribution program. This is the third batch of vaccine the country is receiving, and the Ministry of Health, supported by various UN agencies, is training vaccinators and grappling with the logistical hurdles of distribution.

When the first batch of vaccine arrived in South Sudan in March, there was so little distribution capacity that the government decided to donate half of it to neighboring Kenya so that it was not wasted. A second batch of the AstraZeneca-University of Oxford vaccine arrived on August 31, but was due to expire a month later. Despite the tight window, officials say, everything was used up.

Now a third batch is in the country, this time the Johnson & Johnson vaccine, which only requires one injection instead of two.

The vaccine isn’t the only thing to have reached South Sudan. The same is true of some of the unfounded rumors about it that are circulating in many parts of the world. In Pawel, a village elder directly raised one of the concerns.

“Will we be able to do our homework as men?” asked John Majak Deu, 58, as some of the young chess players finally looked up and laughed. “Some of our sons, these people in the United States, have told us this vaccine is not good. It will cause infertility.

UN workers assured him that infertility is not a side effect of the vaccine.

But there seems to be less hesitation in other areas.

In South Sudan’s capital, Juba, there was a constant flow of people to vaccination sites across the city in October.

At one site, Gurey’s primary health care center, Johnson Gaga, 22, had little use for rumors in his neighborhood that the vaccine spreads to the liver and causes death within a year. He wanted to be vaccinated so that he could continue his studies abroad, in Uganda.

“If you don’t have a vaccine. he said, “They won’t let us in.

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