‘runaway bag’ for medical care when a person escapes
In south Sudan, millions have been fleeing violence since the civil war began in December 2013. The United Nations says it is the world’s largest refugee crisis.
Health workers are running.
How do they lean towards civilian demand in permanent flight? Doctors without borders is testing a new strategy: out-of-control packages.
This is a backpack made of tarpaulin, which weighs about 12.5 pounds at full packaging. What’s in it? Antibiotics and painkillers, anti-malarial drugs (and rapid detection), bandage wound materials, oral rehydration solution, water purification tag and a pen and a record of items have been issued. “Doctors without borders (Medecins sans frontieres), a single bag can provide adequate supplies, can be in about two weeks treatment of 50 to 70 people, because the organization in French. If a mass evacuation occurs, the idea is to require local staff to carry their luggage.
In the early stages of development, medecins sans frontieres believed that some luggage should be equipped with satellite phones and solar panels charged. Then workers realized that packages with high-tech equipment might look like members of an armed group. So medecins sans frontieres gave up the idea.
These packages are also designed to be generic: they are black, with a small MSF logo on the back. Doctors without borders does not want people to wear them as targets for both sides of the conflict.
The idea of escaping the package comes from the organization’s displaced units, a team in Nairobi that supports “failed missions”. They are talking to doctors without borders in south Sudan, where they are putting biogas bags on board as mobile clinics in the swamp.
“We are running late,” said Anna santos, head of the department of displaced persons, referring to the government’s offensive in south Sudan on the Nile in January 2016.
This is a market in the town of Wau Shilluk. It was a chaotic atmosphere. “People don’t have the opportunity to go home and take what they have, they just grab their kids and run out of town,” said Philippe Carr, a communications consultant with MSF. Some rushed into the surrounding jungle, while others sought safety in the northern villages. Doctors without borders’ hospital was evacuated and looted, now known as “just a shell of a building,” carr said.
Mr. Santos said 30, 000 people who fled Wau Shilluk were unable to get health care for at least two weeks. They hardly ever go far. Even the healthiest people are at risk of dehydration. They may hurt their feet. They can catch mosquitoes along the way. During the dry season, they may turn to stagnant swamp water and try to drink water. Santos wants to create “very specific conditions if you walk in this environment for two weeks”.
Even without health risks, hiking is dangerous. Mr. Santos said some of the fleeing civilians were robbed and attacked, and her team received a report of a bag of weapons.
Amnesty international records that in addition to houses being looted and burned by internal elders, government forces are firing people behind them as they try to escape.
Santos didn’t know how fast the first thought of the out-of-control bag would come into use in February. By April, fighting between the government and opposition forces had led to about 25,000 people fleeing the town of kodok, and thousands of people had been relocated three months after leaving the city. Santos said 29 health workers, each carrying a runaway bag, followed the fleeing population.
Ten out-of-control bags are being prepared in a small village in abouk. It was the main destination for the evacuation of kodok in April. But in May, the lack of food and water, in addition to nearby fighting, left some 20,000 people fleeing the country to neighboring Sudan. This fall, the sound of gunfire was heard near the 12-bed Aburoc medical facility of MSF.
Thomas quinn, director of the Johns Hopkins center for global health, believes that out-of-control packages are a useful idea. He likens it to a doctor’s bag, but with more space. He says the backpack keeps the weapons free, so the medical staff can help as many patients as possible: “when you move quickly, nothing can help you move faster than a backpack.”
Not every aid group thinks bags are the solution. This is a different approach from the international medical team, says Jill John Kall, senior health consultant at IMC. The IMC requires its local or foreign staff to wait for vehicles on all points along the route that the population may be moving along the route to seek safety. Health workers often treat dehydration, diarrhea and other diseases common among displaced people. Sometimes, local people open hospitals to medical staff so that they can serve people. Still, John carr agrees: “it is very important to monitor people who are displaced, and they become more vulnerable every time they are displaced.”
Medecins sans frontieres does not claim that its out-of-control bags can help the entire population. It also eliminates kinks based on early feedback from two people carrying out of control bags. They followed the flow of people across the border into Sudan. An out-of-control bag company reported that he gave five people oral rehydration solutions, but wanted the backpack to include asthma medications.
Doctors without borders’ medical coordinator in south Sudan, aziz harona, says the new bag made by Mr. Abrukh about a month ago has been improved. “In order to reduce the weight of the bag, we have removed some items, such as fluid infusion from intravenous fluids,” said Harouna. The change reduced the load. As an alternative, there are more oral rehydration solutions, which do not require trained health workers to manage it.
The group says that when a helicopter or mobile patrol is not a choice, the bag is a way to contact people. “In this case, we measure our impact, not the number of people we help, but how we can potentially save our personal journey,” santos said. Medecins sans frontieres is considering putting out of control bags in volatile parts of Latin America.
Mr. Santos said people fleeing violence don’t necessarily think about the medical supplies they need to escape. They were scared. But if they know that health workers along the way are carrying the bags, she says, “this will give them the power to do this extra step.”