Perched on her pregnant mother’s lap, two-year-old Nawal turns, scratches her face and lets out a dry cough.
Nawal is waiting for treatment at the World Vision clinic – the only health centre in Duma camp, one of Darfur’s settlements for 14,000 displaced and war-scarred people.
On a typical day, up to 80 patients, mostly women and children under five, gather here and wait for the small group of World Vision healthcare professionals and community volunteers to open the doors.
The clinic’s three bamboo structures encompass a registration room, an examination and vaccination room, and a pharmacy and maternity room.
They tend to the patients in just five hours and close shop to make it back to Nyala, the capital of South Darfur, 40km away, in good time.
Until two years ago, the clinic opened for eight hours a day every day. But banditry and two armed attacks on the clinic staff at their nearby team house forced World Vision to relocate them to Nyala.
Now, the seven-member team drives the treacherous Nyala–Duma road three times a week to save lives and meet the health needs of Duma’s residents.
“We are the only aid organisation operating in the area. We have to assist these people,” said Jalal Adam, the pharmacist.
Basic medical services are few and far between across South Darfur, no doubt exacerbated by the recent forced departure of several aid agencies that provided healthcare to the region’s war-affected population.
Duma is one of four settlements in South Darfur where World Vision is the sole provider of primary healthcare.
“We have nowhere else to go,” says Nawal’s mother, 22-year-old Husseina Mohammed, who has been displaced for four years.
“Once I am here, I know my baby will be fine,” she says, as she waits to get treatment.
“She’s been coughing for two days,” she says of Nawal, who sees a doctor and is diagnosed with a respiratory infection then receives medication.
Husseina’s first child died two years ago after suffering diarrhoea. The pain of losing her baby always nudges her to bring Nawal to the World Vision clinic at the slightest hint of ill-health.
Nawal and Husseina are just two of the patients for whom the clinic is the only primary healthcare option. They come seeking treatment for a number of ailments, including malaria, respiratory illnesses, diarrheoa and reproductive complications.
The clinic’s life-saving function is not only hamstrung by its staff members’ security concerns, but also funding constraints. It lacks a test laboratory so diagnoses are made on the strength of symptoms. Patients often wait under the scorching sun because space is at a premium inside. The clinic’s structures are semi-permanent and are susceptible to damage by the elements.
But for the residents of Duma, it is infinitely better than any other option they have available to them; a makeshift store that sells a collection of drugs over the counter, or an expensive and difficult emergency journey to the district hospital in Nyala.
World Vision also distributes monthly food rations to people most in need in Duma, has rehabilitated a primary school for more than 1,000 boys and girls, distributes seeds and tools to support small-scale farming in the camp, and has constructed water hand pumps, a water distribution system and more than 100 latrines in the settlement.