Sudan has constantly suffered from rampant ethnic conflicts, and its citizens have hardly enjoyed the pleasure of its independence gained in 1956. The war between Muslims and non-Muslims in the country caused the deaths of more than two million people (Collins, 2008). Essentially, non-Muslims had dominated the northern economy, and the military regimes that favored Islamic-oriented governments became furious and began the conflicts. It is noteworthy that the continued civil wars did not give the citizens a chance to farm; thus, famine and famine-related diseases struck the region and caused severe harm to the citizens. In 2003, another conflict in Darfur displaced millions of people and the unlucky ones died. The entire scenario is quite devastating, but in 2005, the peacekeeping troops and international relief agencies employed efforts to stabilize the situation. I chose to study the republic of Sudan to evaluate the level of success of the current government and the international agencies to keep peace and address healthcare issues in the country.
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Sudan lies on the southern part of Egypt along the western part of the Red sea. It was the largest country in Africa until 2011 when it split into two countries, North and South Sudan. The country’s capital city, Khartoum, is the largest metropolitan area that grows at a rampant speed. It hosts about 7 million people including displaced people from the southern war zones (Collins, 2008).
Sudan has a population of about 39.1 million people, which is a significant increase from 34.8 million people in 2013. About 66% of the Sudanese live in rural areas whereas the urban population comprises of 33.2% of the population. Islam is the commonest religion amongst the Sudanese, where, 70% of the Sudanese are Arabs. Children under fifteen years of age formulate 41% of the population. Young adults, 15-24 years, comprise of 20% of the population while 31% of the Sudanese are aged between 25 and 54 years (Badr, Mohamed, Afzal, & Bile, 2013). The life expectancy of the Sudanese is quite low, as only 4% of the population is above the age of 55 years. Although the infant mortality rates are significantly high, the high fertility rates cover up for the deaths, and Sudan’s population will continue rising.
Sudan has an authoritarian regime type of government, where, an alliance of the military and the National Congress Party (NCP) runs the government. Omar al-Bashir received an appointment as president in 1993, and within three years, an election confirmed him as the president of the republic of Sudan. The president transformed Sudan into an Islamic authoritarian single party state; however, the 2005 constitution approved the bicameral National Legislature as the official Sudanese parliament. The legal system in Sudan relies on the Islamic law and the common English law, where, the Islamic law affects all Sudanese regardless of their religion (Smith, 2011). Citizens have a right to elect their leaders once they attain 17 years, but in 2010, Omar al-Bashir intimidated the pro-democracy activists and won the presidential election in a highly chaotic manner.
In the recent past, Sudan has recorded an improvement in its economy following the huge profits that it gains from its oil reserves. Agriculture was the main source of income for the Sudanese, but ever since the country began exploiting its oil reserves, there is a great improvement of the general economy. Currently, agriculture contributes about 39% of the country’s Gross Domestic Product (GDP), and it provides employment to 80% of the people in the workforce (Verhoeven, 2011). The International Monetary Fund (IMF) is employing efforts to enable Sudan to make great macroeconomic policies. The efforts might enable the country to maintain international relationships, increase its exports, and enhance its GDP growth rates.
State of Health
The State of health in Sudan has some deficient given the numerous cases of population movement and displacement. Civil conflict, drought, floods, desertification, high illiteracy rates, and low population awareness of health issues are the major issues affecting the state of health of the Sudanese. Apparently, there is low public health spending, as the government spends only 5% of its budgetary amount on healthcare (Klaassen, 2007).
Sudan is one of the African nations that still beliefs in old traditions that may be valid or invalid. Enlightened Sudanese seek for modern healthcare services, while those without access to modern healthcare services cling to traditional cultures and herbal medicine. Sudanese have a culture of sharing prescription drugs without minding about the adverse effects that might arise. In the villages, traditional herbalists make a living by healing simple ailments such as burns and headaches using particular herbs. Moreover, the rural regions have traditional healers, who communicate with the spirits to heal sickness associated with the malevolent spell casted through “evil eyes.”
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Healthcare System and Delivery
Governmental Health-Related Agencies: A three-tiered healthcare system comprising of the federal government, the state, and the local government addresses health matters. The federal government formulates national policies while the state oversees the formulation of the policies. On the other hand, the local government takes the responsibility of implementing the healthcare policies at district level.
Healthcare Personnel: Sudan has an enormous problem when it comes to the healthcare personnel. The instability of the country has caused more than 60% of the registered physicians to leave their country and work elsewhere (Oxtoby, 2008). The worst situation is that the remnants leave the rural areas to work in Khartoum due to the attractive packages. The government has done little to retain trained healthcare providers in the underserved rural areas. There is evidence of disproportional production in the health care providers, as the entire rural region has less than 40 physicians and about 650 nurses. Essentially, one skilled doctor and nine qualified nurses have to respond to the healthcare needs of 200000 people (Klaassen, 2007). In some cases, some healthcare providers have to work before completing their training. There is a high employee turnover after the first few years of working because of the harsh working conditions.
Nursing Education System and Accrediting Organizations: The Nursing Education System in Sudan purposes to produce competent nurses with efficient nursing knowledge and practical skills. The World Health Organization (WHO) designed a nursing program to coach students to become graduate diploma nurses. The ministry of health enhanced the program, and it established a high nursing college in collaboration with the ministry of higher education. Currently, the University of Khartoum offers students with a degree in nursing in its faculty of nursing sciences. Students can choose to take a three years course to obtain a diploma in nursing, and another two years bridging program to upgrade their diploma. They can also choose to pursue a four-year course to obtain a Bachelor of Science in Nursing or take a five-year course to obtain an honor Bachelor of Science in Nursing.
Nursing Associations: Sudan Nursing Association is a young society that aims at promoting and providing excellent nursing services while protecting the rights of the nurses. The association aims at ensuring that the nursing role in Sudan is at par with the international standards. In spite of the difficulties that the nurses encounter in their daily errands, the association purposes to comply with the needs of the Sudanese, while at the same time adhering to the medical values, embracing integrity, transparency, cooperation, and ethical values.
From the discussions, it is evident that Sudan resembles a young nation that has awakened to realize the harm that the unstable government has caused to the physical and mental health of the citizens. The government of Sudan has resolved to rehabilitate and develop the health sector to save the dying citizens. The national government developed a 25-year long-term plan to rebuild the health system through fair financing (Oxtoby, 2008). Currently, the government priorities the promotion of healthy lifestyles, development of human resources in the healthcare sector, adoption of advanced technology, and assurance of quality and equally distributed healthcare services.
It is evident that there are insufficient skilled nurses; therefore, the nurses working in Sudan will have to work extra hard to address the health situation in the country. The nurses can play a great part in addressing the health priorities by fighting for enhanced working conditions. The Sudan Nursing Association should struggle to strengthen the coordination and accountability of all the medical funds in the country (Badr et al., 2013). A salary increment, for example, will play a great role in encouraging students to pursue a course in nursing and in reducing the nurses’ turnover rates.
As evident from the discussions, the health situation in Sudan is wanting. Sudanese are dying because of poor governance that causes qualified healthcare providers to leave the country. The efforts by international relief agencies are commendable; however, it would be wise to employ efforts to bring down the tyrant president of the Republic of Sudan. Sudan can only achieve the 25-year plan to rebuild the health system if it manages to overthrow president Omar al-Bashir, and embark on peace, reconciliation, and reorganization of all systems in the country.
Badr, E., Mohamed, N. A., Afzal, M., & Bile, K. (2013). Strengthening human resources for health through information, coordination, and accountability mechanisms: The case of the Sudan. Bulletin of the World Health Organization, 91(11), 868-873.
Collins, R.O. (2008). A history of modern Sudan. Cambridge: Cambridge University Press.
Klaassen, W. C. (2007). Obstacles to healthcare: A nurse’s experience in Sudan. Urologic Nursing, 27(5), 391-400.
Oxtoby, K. (2008). Working in the Sudan. Nursing Times, 104(45), 18-19.
Smith, S. W. (2011). Sudan: In a procrustean bed with crisis. International Negotiation, 16(1), 169-189.
Verhoeven, H. (2011). Climate change, conflict, and development in Sudan: Global Neo-Malthusian narratives and local power struggles. Development & Change, 42(3), 679-707.