Since the first recorded case of COVID-19 in Sudan on 13 March 2020, 195 people have lost their lives, with more than 4,300 cases recorded.
The virus does not discriminate — many migrants, returnees and those forcibly displaced are at heightened risk due to already existing vulnerabilities.
Sudan is home to around 1.4 million migrants from the region, many of whom are living in difficult conditions, exacerbated by the spread of the virus. Since 2017, nearly 2,700 Sudanese have been provided with Voluntary Humanitarian Return and Assisted Voluntary Return and Reintegration assistance under the EU-IOM Joint Initiative for Migrant Protection and Reintegration (the EU-IOM-Joint Initiative) and are now re-establishing their lives with support from the programme.
The pandemic has created unprecedented challenges for the struggling health system in Sudan, especially given the high cost of medical treatment in a lower-middle income country where 47% of the population live below the poverty line. Sudan has an excessive burden of communicable diseases such as malaria, tuberculosis, and schistosomiasis.
In July 2019, the EU-IOM Joint Initiative signed an agreement with the country’s National Health Insurance Fund (NHIF), allowing more than 2,000 Sudanese returning from Libya, Egypt, Niger and Chad, among other countries, and their families to have medical coverage that assists in cushioning them against prohibitive medical bills.
The migrants assisted to return by the EU-IOM Joint Initiative are registered from the moment they arrive at the airport to receive national health insurance. To date, 1,010 returnees and their families have been registered with NHIF. Soon after receiving their NHIF cards, they can consult a medical doctor, for any condition.
The project is helping vulnerable people who otherwise would not have access to health care, and is now a lifeline for many, especially as the pandemic spreads. Health insurance has been included in the reintegration process, in addition to economic, psychosocial and other social support tailored to the needs of the returnees.
Prior to partnering with NHIF, the EU-IOM Joint Initiative was funding medical screenings and referring targeted returnees to medical service providers and covering their medical fees, but systematic access to primary healthcare has been missing. The partnership is meant to rectify this by improving access to primary healthcare for those benefiting from the programme.
“We do appreciate, with a great deal of pleasure, the fruitful partnership with IOM that yields a successful and unique experience of offering the returnees and their families financial risk protection against the escalating cost of medical care services,” says Dr. Almoghirah Alamin, the Director of the General Population Department NHIF Coverage. “From our part we will exert all effort in order to keep this partnership sustainable, productive and effective.”
The NHIF covers services such as medical examinations, laboratory tests, and ultrasonography. Also included is the prescription of drugs, along with surgical and obstetrical operations, psychological and social analysis for patients, and referrals to better health care facilities. This makes a big difference to the physical and psychological well-being of returnees at a time when they are rebuilding their lives.
Among those benefiting from the programme is Gihan Esmat who returned from Libya in 2019. She has had medical coverage for over a month and is now able to access better healthcare for herself and her family, including her father. “I feel relieved knowing that my family will have the needed medical support especially amid these difficult times,” says the 38-year-old.
Gihan was living with her family in Libya until her eldest son passed away. It was then that she decided to return to Sudan with assistance from the EU-IOM Joint Initiative. In Sudan, her two sons were provided with support to continue their education, while Gihan decided to open a bakery as part of her reintegration assistance. The bakery now provides her with an income along with work opportunities for one of her sons and two women from the community.
“I use the national health insurance to do check-ups and mostly to receive medicine,” says Yahia, another NHIF recipient. Returning from Libya at the end of 2019, Yahia received cover soon after.
Like Gihan, he is taking precautions against COVID-19, but NHIF is giving him one less thing to worry about — he does not fear medical bills for any tests or even hospitalisation, should this be necessary for any condition. “With the current lockdown and restrictions, thankfully pharmacies are still open, and I am still able to get the medication I need,” Yahia adds.
IOM National Programme Coordinator in Sudan, Reem Eldwwari, says: “Healthcare is among one of the main issues faced by returning migrants and both the physical and psychological well-being of returnees are crucial to rebuilding their lives with dignity.”
She adds: “The National Health Insurance and IOM are supporting the provision of health coverage not only for returnees but also their families, as well as assisting their reintegration process in their community to ensure that they return in a safe and dignified way.”
About the EU-IOM Joint Initiative
Launched in December 2016 with the support of the European Union (EU) Emergency Trust Fund for Africa, the programme brings together 26 African countries of the Sahel and Lake Chad region, the Horn of Africa, and North Africa, the EU and IOM around the goal of ensuring migration is safer, more informed and better governed for both migrants and their communities.
Story by: Yasir Elbakri and Wilson Johwa