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South Sudan - Health and safety
Please note There has been a serious deterioration in security in South Sudan since these pages were compiled, and some of the practical information here will now be out of date. In particular, many areas are currently not safe to travel. You are advised to contact your embassy and local agents prior to travelling.
With Dr Felicity Nicholson. For up-to-date information on health issues across Africa, click here.
South Sudan has one of the poorest health systems in the world: less than a decade ago there were just four hospitals and three surgeons in the entire country. Life expectancy for both men and women is about 62 years and South Sudan’s infant mortality (defined as children dying before their first birthday) is the 19th worst in the world. Doctors and nurses are in desperately short supply, and those hospitals and clinics that do exist are underequipped and lacking in drugs. They are frequently without water and electricity as well. If you fall seriously ill or have an accident in South Sudan, you will need to arrange MedEvac to Nairobi or Kampala for treatment. For this reason, comprehensive travel insurance is imperative. Do not get on a plane without it.
Your GP or a specialised travel clinic will be able to check your immunisation status and advise you of any additional inoculations you may need. You should make an appointment at least six weeks before you intend to travel, as some vaccinations require you to have a series of injections over a protracted period. If you are travelling with children under 16 then at least eight weeks is needed to complete some courses. Visitors to South Sudan are advised to make sure they have up-to-date protection against tetanus, polio and diphtheria (now given as an all-in-one vaccine), typhoid, hepatitis A and yellow fever. Immunisations against meningococcal meningitis, hepatitis B and rabies are also highly recommended.
Travel clinics and health information
A full list of current travel clinic websites worldwide is available on www.istm.org. For other journey preparation information, consult www.travelhealthpro.org.uk (UK) or http://wwwnc.cdc.gov/travel/ (US). Information about various medications may be found on www.netdoctor.co.uk/travel. All advice found online should be used in conjunction with expert advice received prior to or during travel.
South Sudan is not a safe country in which to travel. The UK’s Foreign and Commonwealth Office (FCO) advises against all travel within 40km of the border with the Republic of Sudan and to all but essential travel to Wau. Armed clashes between the army and civilians are a regular occurrence, and there is an ongoing threat of cross-border raids. The Lord’s Resistance Army (LRA) is thought to have been responsible for a number of attacks on villages in Western Equatoria in 2010, which resulted in a small number of fatalities. Crime levels are increasing in Juba as the city grows. Consular departments have recently recorded a number of incidents in which foreigners were mugged, including by assailants on the back of motorcycles, and they advise against going out alone, particularly at night. There is a high security presence comprising police, soldiers and private security contractors, though these typically cause more of an irritation than a danger. Survival guides typically tell you what to do once you’re neck-deep in the brown stuff . This isn’t a smart position to be in. Avoiding getting into trouble in the first place is infinitely preferable, and preparation is the key. Using reliable information sources, establish where you’re going, how you’re going to get there and how you’re going to get back and impart this information to someone you trust. Always have a plan B. Keep your eyes and ears open and be flexible: choosing to change your plan in light of new information is much better than being forced to change it on the hop when circumstances conspire against you. Also, listen to your gut: evolution has given you the ‘hunch’ for a reason.
Traditional Sudanese families are very much divided along gender lines, and this influences everything from the tasks people do to who they meet with, where they sit in the home, and what they eat. Whilst foreign women are often considered ‘honorary men’ and may be given the option to move between these male- and female-dominated spheres, foreign men are unlikely to be able to do so.
The vast majority of women travellers have favourable impressions of the country, and it is generally considered safe for single women. The threat of crime and physical harassment are relatively low, particularly compared with neighbouring countries, and South Sudanese (both men and women) will often go out of their way to help a woman travelling on her own. That said, you should take the usual precautions: travel with a companion wherever possible, make sure that you are not out late at night, and dress in a manner that does not attract undue attention. If you feel uncomfortable in a situation, leave quickly and if possible head for a well-populated place: cafés, hotels and bus stations are ideal.
One area that does have potential pitfalls for women is the cheapest end of the accommodation market. Lokandas are based on communal sleeping arrangements, so the arrival of a female traveller (even one with a male companion) can sometimes provide managers with a headache as they wonder where they are going to put you.
Most tend to have smaller separate rooms that you will be offered, though if none are available you may be turned away. Women travellers should be sure to bring sufficient supplies of oral contraceptives, tampons, sanitary towels and any other personal items with them as these are unlikely to be available locally. You may also consider packing anti-thrush tablets or cream as fungal infections are particularly common (and uncomfortable) in South Sudan’s humid climate.
Homosexuality is illegal in South Sudan and the lesbian, gay, bisexual and transgender (LGBT) community faces serious and continued discrimination. In 2008, the interim Government of Southern Sudan adopted its own penal code, which prohibits ‘carnal intercourse against the order of nature’. Consensual sex between two men carries a penalty of up to ten years. According to President Salva Kiir, speaking to Dutch radio in 2010, homosexuality is not in the ‘character’ of Southern Sudanese people, it does not exist in the country, and if anyone tries to import it, it will always be condemned. As you might imagine, the president is sadly not alone in holding these views, and homosexuals in South Sudan must be exceptionally discreet in order to preserve their lives and liberty. There are no public LGBT organisations and no gay scene. If you are travelling in South Sudan with a same-sex partner you are strongly advised to refrain from public displays of affection (although two men holding hands is seen as perfectly normal and acceptable) and to be circumspect when discussing your relationship with others. In general it is better to leave them with the impression that you are simply travelling with a friend.