Lessons From Post-Conflict Sudan: Sing Songs, Build Health


By Kamayani Bali Mahabal

20 December, 2012

The team of health activists that is working in post-conflict South Sudan. Dr Hiba Salih (in the pink head cover) is a physician from North Sudan who has worked for three years in post-conflict sites in South Sudan.

Thunderbay, Canada (Women’s Feature Service) – South Sudan has one of the highest maternal mortality rates in the world; a young girl in South Sudan is three times more likely to die during pregnancy or childbirth than to reach Grade Eight. So how can change be ushered in under such adverse circumstances?

This was one of the themes at a recent international public health conference, held in Thunderbay, Canada, which was hosted by the Women Health Task Force (WHTF) and focused generally on the theme of reducing maternal and newborn mortality. It was attended by 850 delegates from 50 countries.

WHTF, incidentally, has a very interesting history. According to WHTF founder member, Professor Judy Lewis, who is Director, Global Health Education and Professor, Departments of Community Medicine and Pediatrics, University of Connecticut School of Medicine, it was formed in 2002 with support of Global Health Education, Training and Service as a part of an international health network. Its significance lay in south-south collaboration to improve education and health outcomes for women. The group unites experts working on women’s health and higher education with members from different regions and countries around the world. The WHTF is also an active and growing forum for the exchange of ideas and the development of strategies and resources for women’s health.

The recent conference showcased the impact of this exchange of ideas very clearly, especially with regard to the situation in South Sudan. It brought to the fore voices like that of Dr Khalifa Elmusharaf, Head of the Reproductive and Child Health Research Unit at the University of Medical Sciences & Technology, Khartoum, the capital of Sudan. “I started to work in South Sudan in 2010 with motivated and inspired post-graduates students. Together, we launched ‘Rebuilding Reproductive & Child Health System in Post Conflict Settings Initiative’, an intervention that aimed to rebuild reproductive and child health systems in a post-conflict setting by getting a better understanding of local contexts and cultures. This helped us design culture oriented interventions that improved the demand side of health delivery and empowered women to stay healthy, make the right health decisions and act on those decisions,” elaborated Dr Elmusharaf.

Sudan is a country that witnessed a bloody civil war that has raged for the past 50 years, with the more developed north of the country pitted against the south. This was a war that affected eight million with an estimated two million killed and about four million displaced from their homes.

In was against this background that Dr Hiba Salih, a physician from North Sudan, who actually worked for three years in post-conflict sites in South Sudan, could make a difference. “In the past, Sudan’s health interventions had a top to bottom approach. They did not involve local communities. What made the situation even more difficult was that the traditional modes and methods prevalent in North Sudan were completely different from those existing in the south. We inverted the pyramid and adopted a bottom-up strategy,” revealed Dr Salih.

This posed a communications challenge. The task before Dr Salih was to take local traditions and use them in untraditional ways in the advocacy for health. She pointed to a poster she had brought, “It doesn’t matter if you cannot speak Arabic. The fact is 62 per cent of the population in South Sudan is in any case illiterate, so posters like this one has had to cross the literacy divide. The central message of this poster is: ‘We are strong and united, let’s work together for primary health care of women and encourage the husband to take care of his wife and child’.”

Working in post-conflict areas with very limited resources forced Dr Salih and her team to keep their minds open. “The idea was really to connect with the community in order to empower them. So you are forced to think untraditionally and adopt local ways. The people will help you understand their context; they will share their indigenous knowledge with you. But it is ultimately up to you to choose the ways you can identify and utilise local resources for maximum impact. When you do this, you have better chances of creating sustainable solutions, which is always a big challenge in post-conflict areas,” she observed.

So what did Dr Salih and her team do? They started by empowering 15 illiterate women in 15 different villages through simple games. “Women were lined up and told to hold on to one rope. Each woman was then asked to pull a part of the rope and in this way the rest of the group moved closer to her. This was to demonstrate that networks mattered within the community. Anything that happened to any one of them affected not just the whole family but the community,” Dr Salih explained.

Since the team also wanted to understand the daily realities of these women’s lives, it came up with a novel way of getting women to document their own lives. Each woman was handed over a disposable camera for a week and asked them to take photographs relevant to their lives. Later they had to explain why they took a particular picture. Said Dr Salih, “In this way, we got a deeper understanding of their beliefs and attitudes, as well as their lives.”

Slowly, through this process the women were able to identify the important issues in their community which were adversely affecting their health. Over time, they were able to help in designing tools to address the issues that had affected them.

“It was amazing. Not only did we train them they taught us something as well. I remember this song they composed, ‘La la la ya baba yoo, ma tadogo mama yoo, Mama heya hamlana, shelo mashakil betaaki dah (no, no daddy, don’t hit mommy/ Mommy is pregnant, please don’t fight with her)’. These illiterate women had identified domestic violence as a health issue. They wanted to change their community, and even neighbouring villages, through songs,” revealed Dr Salih.

The sustainability aspect also came through. When the team first started, it comprised seven physicians who trained 15 women. Within less than a year, after about six visits, more than 55 men and women wanted to be trained. Remarked Dr Salih, “We trained the trainers and that was how we were able to have a multiple impact.”

Lewis of WHTF saw this as a good example of how participatory research as well as the development of songs and other communication tools for low literacy communities could be used to improve women’s health all over the world – including in the global north.

Women’s Feature Service began in 1978 as an UNESCO-UNFPA initiative. Until 1991, it was a project of Inter Press Service (IPS) Third World News Agency. The only international women’s news/features syndicate, Women’s Feature Service produces features and opinions on development from a gender perspective. http://www.wfsnews.org/

(© Women’s Feature Service)


Sudan using protests ‘to silence dissenters’, same as India

Rights group report urges Sudan to end the violent crackdown on anti-government protesters and journalists.

Last Modified: 27 Jun 2012 10:09


Omar al-Bashir, Sudan’s president, has said the protests against high prices is the work of “a few agitators” [AFP]

Security forces have arrested scores of protesters, opposition members, and journalists, beat people in detention, and used rubber bullets and live ammunition to break up protests that began on June 16, Human Rights Watch said in a report released on Tuesday.

Sudan should end the crackdown on peaceful protesters, release people who have been detained, and allow journalists to report freely on the events, the report added.

“Sudan is using these protests as an excuse to use violence and intimidation to silence dissenters,” said Daniel Bekele, Africa director at Human Rights Watch.

“Authorities should call off their security forces and vigilantes, end the violence immediately, and respect the right of the people to protest peacefully.”

“Arresting all suspected opponents to stifle dissent is abusive and illegal,” Bekele said.

“Authorities need to charge or release these detainees immediately, allow people to voice their opinions peacefully, and let the media work freely.”

The protests began on June 16 at Khartoum University in response to government austerity measures and price increases, and they had spread to dozens of other locations in Khartoum, and other towns across Sudan, with protesters calling for the end of the current government.

US condemnations

Meanwhile, the US have condemned the crackdown on Sudan protests,”Sudan’s economic crisis cannot be solved by arresting and mistreating protesters,” said State Department spokeswoman Victoria Nuland.

“There have been reports of protestors being beaten, imprisoned and severely mistreated while in government custody.

We call for the immediate release of those detained for peaceful protest,” she added in a statement.

The National Security and Intelligence Services (NISS) on Tuesday deported Salma El Wardany, an Egyptian female correspondent of Bloomberg News in Khartoum, and briefly detained prominent Sudanese blogger Maha El Sanousi.

“They ordered me to leave,”  Salma El Wardany, an Egyptian, told AFP by telephone as she awaited a flight from the Khartoum airport.

Sudan has lost billions of dollars in oil receipts since South Sudan gained independence last July, taking with it about 75 per cent of Sudanese crude production. The north has been left struggling for revenue, plagued by inflation, and with a severe shortage of dollars to pay for imports.

The landlocked South depended on the north’s pipeline and port to export its crude, but Khartoum and Juba could not agree on how much South Sudan should pay to use the infrastructure.

Sudan’s already depleted oil revenues shrank by a further 20 per cent after its main Heglig oil field was damaged and shut down in fighting with invading South Sudanese troops in April, international economists have estimated.

Even before the easing of fuel subsidies, the cost of basic consumer goods had doubled over the past year.

Bashir, an army officer who seized power in 1989, called the protests small and not comparable to the “Arab Spring” uprisings against regional strongmen over the past year.

He blamed anti-government protests on the work of “a few agitators” in a speech late Sunday.

But a demonstrator told AFP the current unrest is unprecedented. “Right now, this is first time since 1989 we have these protests in most cities,” he said, asking not to be identified by name.

There have been calls on social networks for a mass nationwide protest on June 29.


UN adopts historic ‘land grab’ guidelines

Man next to a pile of hay
In recent years large-scale acquisitions of farmland in developing countries have caused concern
11 May 2012 Last updated at 15:23 GMT,  BBC NEWS

The United Nations has adopted global guidelines for rich countries buying land in developing nations.

The voluntary rules call on governments to protect the rights of indigenous peoples who use the land.

It is estimated that 200m hectares, an area eight times the size of Britain, has been bought or leased over the past decade, much of it in Africa and Asia.

But aid agencies warn it will be very difficult to ensure the guidelines are implemented everywhere.

AFP quoted Clara Jamart from Oxfam as saying this was just a first step and urging caution.

“Governments have no obligation to apply these measures,” she said.

There has been growing concern about so-called land grabs, when foreign governments or companies buy large areas of land to farm.

In Africa countries such as Ethiopia, South Sudan, Democratic Republic of Congo and Sierra Leone have all signed major land deals with foreign investors.

Responsible investment

It is hoped this new agreement will secure access to land, fisheries and forests for millions of poor people who have historically used the land.

The document took three years to draw up and calls on governments to be transparent about land deals, consult local communities and defend women’s rights to own land.

It also emphasises the responsibility of businesses and multinational corporations to respect human rights when they move in to an area.

Problems can arise because in many parts of Africa local farmers, herders and gatherers do not have any formal documents for the land they use, which is often owned by the state.

Authorities often argue that big international deals bring investment and new technology to a region, benefiting local people.

But this is not always the reality and human rights organisations have highlighted cases where tens of thousands of people have been forcibly removed from their ancestral homelands to make way for foreign investors.


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