South Sudanese children treated at refugee health centers

YUMBE, UGANDA — The civil war in South Sudan has been raging for over four years, with no real sign of it ending anytime soon. Over 2 million South Sudanese people have been displaced because of the conflict, the majority of them children.

Because of Uganda’s close proximity and generous refugee policies, almost half of those displaced people have now settled on the land just south of the South Sudan/Ugandan border. Dozens of refugee “settlements” dot the landscape of the northern districts of Arua, Yumbe and Moyo.

While the NGOs supervising these settlements do the best work they can, resources and manpower still strain to keep up with the refugees’ needs, especially when it comes to healthcare. The health centers there constantly overflow with people—young, old, boys, girls, men and women.

This photo story takes a closer look at some of the more than 1 million children driven to Uganda, and their experiences with the healthcare system in these enormous settlements.

Two South Sudanese teenagers, Deborah (left) and Naomi (right), wait patiently in line to see a doctor in the Zone 1 central health center at the Bidi Bidi refugee settlement, located in the Yumbe district of northern Uganda. There were nearly 300,000 South Sudanese refugees in Bidi Bidi as of May 2017 and over 62 percent of those are children below 17 years old. (Nick Trombola | The Media School)

A RMF (Real Medicine Foundation) worker takes a blood sample from a boy, Frederic, as the other children in line watch. Refugees are only required to test for malaria and tuberculosis (TB) at the day 1 health screenings, but can voluntarily test for other illnesses like HIV at subsequent visits. Twenty one children have HIV at Bidi Bidi; all of them contracted the virus during childbirth. (Nick Trombola | The Media School)

A girl with tuberculosis lies underneath her blanket at the Yinka health center in the Imvepi refugee settlement, about 1 hour south of Bidi Bidi. Imvepi hosts a little over 100,000 refugees, which is less than half as many as Bidi Bidi, but health centers are still frequently full of people and patients. Aside from malaria, TB is one of the most common afflictions in the settlements. (Nick Trombola | The Media School)

Children with bedridden parents must frequently wait as their mothers recover from or receive treatment for their various illnesses. They do what they can to pass the time, from playing hide & seek in between the bed rows to playing with the unused medical equipment the ward aides give to them. (Nick Trombola | The Media School)

Two boys sit together patiently at the Zone 1 central health center. Along with many other children in and around the center, these boys sat alone on their own bench as they waited, no parents or other guardians anywhere to be seen. Many children often make their way from South Sudan to Uganda on their own due to the nature of the conflict. In Bidi Bidi alone there are more than 30,000 unaccompanied minors. (Nick Trombola | The Media School)

The main entrance to the Zone 1 central health center. Mothers carefully swaddle their babies and toddlers on their backs in order to walk long distances in relative comfort. For a refugee living on the outskirts of the settlement, it can sometimes take several hours to reach a health center by foot. (Nick Trombola | The Media School)

A UNHCR/ RMF worker surveys a group of new mothers about what they or their children need at the Zone 1 central health center. Refugees can seek treatment at the health centers for everything from HIV to syphilis, but the most common illnesses, especially those affecting children, are malaria and malnutrition. (Nick Trombola | The Media School)

A malnourished child sits in his mother’s lap in a ward at the Zone 1 central health center in Bidi Bidi. Malnourishment is one of the most common ailments in Bidi Bidi due to declining food rations and a lack of diversity of essential vitamins. This child in particular is suffering through weight loss and muscle weakness due to the malady. (Nick Trombola | The Media School)

A toddler sits outside the Yinka health center in Imvepi with his caretaker, his stomach bloated from retention of water, a tell-tale sign of malnourishment in children. His mother is in bed recovering inside the center, so  Margaret, one of the health center aid workers, watches him as he roams around the building. (Nick Trombola | The Media School)

A new mother sits with her baby in the maternity ward of the Zone 1 central health center in Bidi Bidi. The woman did not speak English, but the ward aid workers said she had given birth just a few hours before this photo was taken. All new mothers and babies are monitored for HIV, and this woman’s son will be vaccinated against diseases like measles and TB over the next few weeks. (Nick Trombola | The Media School)