Paper short abstract:

Diverse actors have tried to tackle sleeping sickness in Southern Sudan. The absence of a central authority hampered learning and planning in disease control work, tasks that were further complicated by fluctuations in the dominant actor types during different phases of the conflict.

Paper long abstract:

This paper explores how a range of actors have tried to control Human African Trypanosomiasis (HAT; commonly known as sleeping sickness) in Southern Sudan between 1955 and 2005. In this period, Southern Sudan experienced two prolonged civil wars, interspersed by a period of post-conflict reconstruction. Over this period of conflict and calm, the types of actors and modes of engaging in humanitarian work changed considerably. Today, the region is one of the most impoverished and weakly governed in the world.

HAT control in Southern Sudan is a case study in tackling an infectious disease in highly adverse circumstances. We explore this history through extensive archival research and interviews. We argue that the absence of either a capable government or dominant external actor to organise and coordinate had profound consequences. Without either a clear evidence base or a shared understanding of previous strategies, actors were prone to adopting idiosyncratic methods that reflected their own organisational priorities. For instance, recurring debates over both competing disease control techniques and the viability of eliminating HAT entirely were clouded by problematic interpretations of the past.

Ultimately, these successive cycles of forgetting and highly selective remembering of past projects highlight the limitations of twentieth century humanitarianism. It is a truism that development, humanitarian, and global health organisations often fail to learn from the past: the case of HAT in Southern Sudan exemplifies that tendency, as well as the broader difficulties of coordinating external actors with diverse methods and motivations.