Thread on my latest story for @AJEnglish on the dire state of #Sudan's health-care sector. In many ways, the rapid deterioration of an already struggling sector captures the ramifications of Sudan's coup.
aljazeera.com
aljazeera.com
1/ The health-care sector in Sudan was already reeling from years of privatization policies under former dictator Omar al-Bashir. Those policies effectively saw Bashir era cronies pocket public health-care funds, while setting up private clinics that few could afford.
2/ Even then, most Sudanese preferred to seek medical treatment abroad if they could afford to. The public-health care sector improved somewhat during the brief democratic transition. However, the adoption of IMF-advised austerity measures made medications unaffordable for most.
3/ Now the coup has compounded the challenges. Former health-ministry officials told me that most donor assistance was supposed to come from the World Bank Global Fund and Gavi, a public-private alliance aimed to supply vaccines to the global south. #Sudan
4/But like all development assistance, that money was halted as a result of the coup and for good reasons. Former health-care officials and advisors warn that if money was restored to the ministry, then it would be almost certainly stolen by the junta and Bashir era cronies.
5/The solution, which one former advisor to the ministry proposed, was to start channelling money to health clinics and hospitals directly after determining that they have a fiscal responsible staff. #Sudan
6/This solution also has limits since a number of hospital managers and directors have been fired by state governors appointed by the junta since the coup. They are looking to settle scores or simply impose their own loyalists in the sector.
7/ Nevertheless, the pause in funding has had major ramifications. Public hospitals are supposed to be supplied by the health ministry with medical supplies such as gloves, anaesthetics, and syringes.
8/ Since the coup, nearly all of these supplies have been halted. Public hospitals have been forced to purchase medications and equipment from an unregulated black market, yet doctors can't know whether the supplies they buy are safe or effective.
9/ In fact, doctors told me that anaesthetics often wear off far earlier than they're supposed to. This means that people who take spinal anaesthetics can suddenly feel unfathomable pain in the middle of an operation. Other patients have begun to wake up on the operating table.
10/ When this happens, doctors quickly administer double or sometimes triple the dosage to numb the patient or knock them back to sleep. This harrowing story is indicative of just how dire the situation is in public hospitals.
11/With the sector starving for cash, #Sudan 's junta has decided to raise money for health-care by placing the financial burden on the poorest people.
12/On February 19, a decree required patients in public-hospitals to pay at least 7,000 Sudanese pounds to simply admit themselves in the hospital. That's about a 5,000 percent increase. Tests for Malaria and x-rays and operational costs have also skyrocketed.
13/These prices are outrageous for most citizens, let alone the poorest. Many people don't make more than 15 to 30 thousand Sudanese pounds. Others make much less as they struggle to find work as day laborers. This decree is effectively a continuation of Bashir's policies.
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One more point that I need to stress: As the junta places the burden of paying for public services like health-care on the poor, high-ranking generals continue to monopolize the nation's wealth through shadowy private companies (RSF) or hundreds of state companies (military).
If the junta really wanted to help its people, it could hand over its companies to civilian officials and shift money from its bloated defense budget to health-care and education. Instead, they are paying for tear-gas and bullets to fire on protesters in the streets. #Sudan
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