Hearts of Angels for Health

During the last 22 years, Southern Sudan has been embroiled in a devastating civil conflict leading to the internal displacement and international migration of over 4 million men, women and children. The conflict has complex roots in political, religious, ethnic and regional differences and continue to affect Sudanese communities even after they have left the Sudan.

The conflict in Sudan has posed serious health challenges for Southern Sudanese including physical injury and death from preventable disease to loss of basic health care, water and food, and severe trauma. Around 500,000 Southern Sudanese are living under refugee status in a country of asylum, including 70,000 in the U.S.

Hearts of Angels for Health-Sudan (HAH-S) is committed to addressing the key health care needs of Southern Sudanese men, women and youth in both Sudan and in the diaspora. Currently, we are focused on Washington State, USA which is home to approximately 700-1000 Southern Sudanese with plans to expand to other areas in which Southern Sudanese reside. Our programs address two key health care needs; that of 1) reproductive health including prevention of HIV/AIDS and Sexually Transmitted Infections (STI) and gender based violence, and 2) conflict resolution and trauma recovery.

Reproductive Health and HIV/AIDS and Sexually Transmitted Infections in the Sudanese community

Sexually transmitted infections rage during war-time; in part due to increased mobility and migration; the loss of connections between family members and the rise of casual sexual relations, the militarization of the country, and sadly the use of rape as a weapon of war. Those who are infected with HIV are often unaware because of the long incubation period in which few or no symptoms may be present. Refugees also have difficulty accessing testing and treatment services in the refugee camps, and once in the US, those above the age of 18 face significant language barriers and difficulties accessing public health education and services. Consequently, many HIV infected individuals are unaware of their status.

Located in Seattle, Washington, HAH-S is currently focusing its operations within the city and the entire King County area. King County has recently identified the foreign born African community as a priority for HIV education due to the rising rate of HIV+ infections in this group. While in 1995, foreign-born Africans comprised 10% of cases in African/African American communities, by 2003, foreign-born Africans represented 40% of ALL reported cases in King County. The Sudanese community is identified as the 3rd largest HIV+ population of Africans (Ethiopian is first, followed by Kenya then Sudan, Ivory Coast, Somali Republic and Tanzania). Despite this serious problem, the issue of HIV/AIDS remains largely unspoken of and unaddressed.

Refugee women who have heightened vulnerability also face significant barriers to care and advocacy services. Their feelings of isolation and lack of awareness of legal protections, their fear of police and insecure socio-economic status combined with the upsetting of their traditional gender roles and responsibilities, may lead to conflict in domestic situations. Addressing intimate partner violence is thus, a key area of concern for HAH-S. Sadly, the importance of this work has been highlighted by the recent fatal incidences of domestic violence that occurred in the Seattle area in 2005 and 2006, and which lead to the deaths of 2 Sudanese women by their partners.

Southern Sudanese men, women and youth in the US often arrive in the country without access to resources, isolated and disconnected from a social safety net of family friends, and without experience dealing with the public health care services available here. This is frequently compounded by difficulties with the language, geographic isolation, and lack of financial resources to access health insurance. These problems, in connection with the issue of stigma in the community around STIs and domestic violence mean that very few men and women seek voluntary testing for STIs, including HIV/AIDS, are able to access education and products around birth control, and seek help when experiencing domestic abuse.

Sexually transmitted infections, unintended pregnancy, and domestic violence are all connected problems and as such we have chosen to address them holistically in our work. HAH-S is addressing these needs by conducting workshops in the community on reproductive health including HIV/AIDS and STI prevention, gender based violence and life skill development, and will train a core group of adult and youth HIV/AIDS peer educators.

In 2008, we are concentrating our work on King County with plans to expand to other areas of the West Coast and the Northeast where Southern Sudanese people reside.

The need for trauma recovery and conflict resolution in the Southern Sudanese Communities

Sudan's violent history and the subsequent relocation of Sudanese immigrants to the U.S. and other countries have amplified the challenges Sudanese face in coping with life and society on a daily basis.

Many of those people affected by the war in Sudan are deeply traumatized by the conflict, loss of family and friends, violence and dislocation. Trauma is deeply rooted in ongoing conflicts that continue once Sudanese men and women resettle in a new home. Such trauma often lies unaddressed and unrecognized. Yet it has significant psychological, physical and emotional implications for health and well-being and limits the ability of Sudanese men and women to make peace and move forward to build a stronger and united community.

The strain of living in a foreign land and culture also exacerbate problems of internal conflict. Sudanese men and women argue that it is especially difficult to resettle in the US, which places importance on issues very alien to the Sudanese. Specifically, the Sudanese importance on family, community accountability and interdependence are replaced with American ideals of independence and individualism. This heavy focus on individualism places enormous burden and stress on the new refugee as the Sudanese individual is forced to fend for him or herself in an often-alienating culture.

Conflicts within the Southern Sudanese community is, sadly, also quite common. Conflict between different political party members, between men and women from different regions and different families and even between family members – a fact which was sadly highlighted in 2005 and 2006 when two Sudanese women were killed by their partners, one of whom also killed himself.

These incidences of overt violence are not uncommon in the community as youth violence, interpersonal violence, and other forms of inter-community conflict are a significant challenge facing the Sudanese community in the U.S. Such conflict remains a key barrier in attempts to build community based economic, health, educational and entrepreneurial support networks. Addressing the fundamental problems of pervasive poverty and key health care and educational needs in the community have proven extremely difficult to resolve because of these internal conflicts and divisions.

HAH-S recognizes the importance of addressing trauma recovery and conflict resolution and is in the process of defining these frameworks and programs. Please check back for more updates as these critical components are worked out.