Sudan - With vision and versatility, Medair's Sudan staff travel to remote regions to access their beneficiaries, contending with unpredictable weather, the threat of insecurity, and many different kinds of terrain.

Medair's mandate is to bring life-saving assistance to some of the most vulnerable communities in the world. Unfortunately, one of the very reasons that such communities are vulnerable is because of their geographical location: they are often isolated and hard to reach. The scale this challenge presents is perhaps nowhere more evident than in Sudan, the largest country in Africa. Here, vast swathes of country have no tarmac roads; annual rains turn flat plains into swamps and sandy wadis into raging torrents; rocky hills and deep rivers provide obvious barriers; while bandits, insecurity, and landmines present less visible ones.

NGOs and Four-Wheel Drives

In many parts of the world, aid agencies are synonymous with white four-wheel drives, and this is certainly the case in Medair's project in the Nuba Mountains region of Southern Kordofan.

"This is a vast area, with a scattered population and there are no tarmac roads providing access to the communities we support," explains Edwin Visser, Medair's Project Coordinator in Southern Kordofan. "Whether it is supplying drugs to clinics or assessing locations for water projects, everything needs to be done with a four-wheel drive vehicle."

The terrain is indeed demanding, with rocky tracks that can rapidly wear down even the best-maintained vehicles. In the wet season, journey times are dramatically increased, and some areas become completely inaccessible.

"We are cut off from the rest of the world for six or seven months every year," says Adam Hassan a community leader. "So, we are reliant on medicines and other supplies that are brought in during the rest of the year."

Alternate Transport Required in West Darfur.

However, in the conflict-torn region of Darfur, aid agencies have virtually ceased using four-wheel drives, because of general insecurity and the number of carjackings directed at humanitarian workers.

"In 2004, Medair could travel to rural areas in West Darfur by four-wheel drives for a week at a time, supporting clinics, rehabilitating hand pumps, and delivering non-food items. However, as road travel became impossible due to insecurity, we had to find a way to continue supporting the 18 locations outside of El Geneina in which Medair works."

Fortunately, the United Nations Humanitarian Air Service is now providing regular helicopter service to many of these rural locations. Journeys which once took hours, or even days, now take just a few minutes, and villages that were almost unknown in the past are now featured on flight manifests, and even on airline baggage tags.

However, once Medair staff arrive by air (landing on a helipad that is often a square of stones on the outskirts of the settlement), they are then faced with the challenge of how to travel around the different project sites, which may still be some distance away. Walking may be the only option, although this is tiring under the hot sun, and limits the supplies that can be carried. Further solutions are sometimes needed, and travel often abruptly changes from modern to the traditional.

"When I last visited Um Shaleya, a donkey cart was waiting at the helipad to take me to the clinic," says Anne Reitsema. "Although transport by donkey is slower than by vehicle, it is a nice way to get to know the village and greet the people."

Risks with Air Travel

During the long years of civil war in Southern Sudan, flying in from Lokichoggio in Northern Kenya was the only way to reach many war-affected communities in areas such as Upper Nile. As well as being costly, this was reliant on the weather, with dirt airstrips at risk of becoming wet and unlandable due to sudden rains. Once on the ground, Medair's staff were often limited to areas that they could reach on foot, due to the lack of alternative transport. Fortunately, the onset of peace is starting to present new travel opportunities, especially for communities along the White Nile.

"Most airstrips in this area are dirt, and hence unreliable, and the few roads and tracks are either extremely bumpy or mined," says Lynus Ebenyo, Medair's Loki Base Manager and Flights Coordinator. "However, the White Nile provides an excellent transport route."

Water Travel by Boat or by Foot

Medair now operates a fleet of four boats. These boats enable staff and supplies to travel in less than four hours from Medair's logistics base in Malakal, the capital of Upper Nile State, to our project location in Melut 140 kilometres away.

"This is an ideal set-up for our emergency response teams who operate in Upper Nile area," says Willem van Amerongen, Malakal Base Manager. "Using boats allows us to quickly reach the most vulnerable."

Local authorities and other NGOs also see the benefit of using these boats and Medair is frequently asked if they could rent their boats to them. Unfortunately for them, the boats are most of the time fully engaged by Medair to transport staff and patients.

Sadly, some areas cannot even be reached by boat, if the water is too shallow or there are too many branches and grasses in the way. Medair staff are so committed to reaching the most vulnerable that they will travel for hours by foot through swamps, mud, and floodwaters, as one of our teams did last summer. Isolated communities are often very surprised to see "white people" (kawatja's/mzungu's) walking through the bush to reach them.

"Medair is a very committed organisation," said local resident Eg Chol Deng last summer. "They care about people, and act fast."

Despite the numerous obstacles that climate, geography, and insecurity may present, we continue to find ways to access those in the world who need us most. This is the case with our work in Sudan, where transportation is a constant challenge. However, we have risen to the challenge with determination, finding versatile ways to reach the most isolated and vulnerable - from bumpy four-wheel drives to snake-infested swamp walks; and from noisy helicopter trips to quiet donkey carts waiting below.

** Names of beneficiaries have been changed.

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Medair is an international non-governmental organization (NGO), with its operational headquarters based in Switzerland. It has worked in Sudan since 1995.

In the northern states of Sudan, Medair provides access to primary health care, and water & sanitation for up to 200,000 conflict-affected persons in West Darfur; works with war-displaced people in Khartoum; and supports access to primary health care, and safe water & sanitation in the Nuba Mountains area of Southern Kordofan. In Southern Sudan, Medair provides emergency medical and water assistance for outbreaks, large people movements, and nutritional emergencies in a number of locations across the region, as well as improving access to primary health care and safe water sources in Upper Nile.

These activities receive financial support from the Swiss Agency for Development and Cooperation (SDC), the Humanitarian Aid Department of the European Commission (ECHO), the Department for International Development (DFID), UNICEF, the Swedish Government (SIDA), the Office of U.S. Foreign Disaster Assistance (OFDA), BSF (DFID - British Government and Worldbank), the Dutch Ministry of Foreign Affairs (BuZa), TearFund New Zealand, ERF (Emergency Response Fund/UNDP administrated by OCHA), CHF (the United Nation 'Common Humanitarian Fund for Sudan). Medair's life-saving activities are dependent upon private financial support. To contribute to this work, please visit www.medair.org (Sudan section.)

Flight services are provided by the United Nations Humanitarian Air Service (UNHAS) and Mission Aviation Fellowship (MAF).