"This is your disease"

Findings from the research project

A new report documents findings from a research project investigating understandings of COVID-19 and public health in South Sudan, as well as the way that COVID-19 has interacted with the struggles and strategies of local and national NGOs and local government.

Drawing on ethnographic and qualitative research in sites across South Sudan, the team conducted consultations with nearly 100 people in urban and rural areas working for local and national NGOs, as well as local communities, authorities and former staff. 

Findings are presented in a full research report and are also summarised, along with recommendations, in an accompanying policy brief.

The research was funded by the UK Foreign, Commonwealth and Development Office and published by the London School of Economics and Political Science in June 2021. 

Research findings

The research makes the following key arguments:

• In the first year of the global COVID-19 pandemic, there have been fluctuating public debates and personal fears in South Sudan about whether COVID-19 is really a concern. South Sudanese have had many recent experiences dealing with deadly disease outbreaks, and COVID-19 has been analysed through established systems of local epidemiological knowledge. Yet, this virus has proved particularly puzzling. COVID-19 symptoms, even when fatal, do not allow a clear diagnosis in the absence of testing. Testing has largely been non-existent in most of South Sudan. Therefore, many people describe COVID-19 as a global concern but not as something that was happening locally.   
• The limited visibility of the virus in many local communities was juxtaposed with disruptive restrictions on social and economic life, and a pivoting of attention and resources to COVID-19, at a time of multiple, competing crises. COVID-19 seemed to matter not because all lives were at risk, but because it threatened the richest and most powerful, in South Sudan and globally. COVID-19 restrictions became indicative of the concerns of the foreign and powerful taking precedence over the many other pressing and deadly crises facing South Sudanese people. This has undermined people’s trust in public health advice. 
• The first year of the pandemic happened when there were no appointed local government commissioners or state governors in government controlled areas. The complexity and vacuums in local government significantly impacted their ability to respond to the pandemic. Local authorities lacked funds, and sometimes also lacked the formal authority to make clear-cut decisions to apply COVID-19 regulations. At the same time, throughout South Sudan, local authorities did become involved in awareness campaigns and enforcing restrictions, especially over long- distance movements and large gatherings. Furthermore, many other actors including chiefs, international organisations, and South Sudanese NGOs took on leadership roles in the response to COVID-19. Even in the absence of state and local government leadership, there was government and governance.
• From voluntary initiatives and adapted programming to large-scale, externally-funded responses, South Sudanese NGOs have played an important role in responding to the pandemic, and were amongst those authorities who helped fill any vacuums in the absence of local government leadership. However, despite early optimism that the pandemic would add momentum to the ‘localisation’ agenda, there is limited evidence of this in South Sudan. Instead, over the first year of the pandemic, postponed and cancelled projects, combined with rising costs and economic crisis, led to staff cuts and struggles to stay afloat. Trust in aid workers was also affected, sometimes because of fears that they would be bringing the virus, and other times because of frustration at the focus on COVID-19 ahead of other pressing concerns. 

Overall, the research explores themes of trust and mistrust felt in relation to the COVID-19 response, and how the global pandemic took precedence over many other pressing crises facing South Sudanese people. The findings call for more holistic, integrated, and localised responses to disease outbreaks. 

Research team

The research team was led by Alice Robinson, Naomi Pendle, Peter Justin and Linda Ahimbisibwe, and included Chot Biel, Latjor Dang, Benjamin Dut Dut Tong, Chuol Gew, Rose Mabu, Ngot Mou, and Umba Peter.

Read the full project report: 'This is your disease': Dynamics of local authority and NGO responses to COVID-19 in South Sudan.

Read the policy brief: attention of donors, international and national organisations and government relating to COVID-19.