Introduction: Globally about 463 million people are living with diabetes mellitus (DM) which is estimated to rise to 700 million by 2045; 80% are in middle and low-income countries. Recent studies have shown that body mass index (BMI) was one of the significant predictors, along with nephropathy and retinopathy, of diabetic foot ulcers (DFU).Objective: To assess the association between BMI and DFU in Wad Medani town, Gezira state, Sudan.Method: The study was based on primary data obtained via a cross sectional random sample of 400 patients with DM presenting at Aldarga Diabetic Centre in Wad Medani. The data collection tool was a structured questionnaire designed in English and translated into Arabic for the field survey. Data were analysed with SPSS version 20, using frequency tables and chi-square tests.Results: Of the 400 participants, 208 were diagnosed with foot ulcer. There was a statistically significant association between BMI and DFU. A total of 134 (56%) of the 239 overweight patients had diabetic foot ulcers compared to 74 (46%) of the 161 who were not overweight (p=0.04).Conclusion: The result suggests a significant association between BMI and DFU at our Diabetic Centre.
全球约有4.63亿人患有糖尿病(DM)，预计到2045年将增加到7亿;80%在中低收入国家。最近的研究表明，身体质量指数(BMI)与肾病和视网膜病变一起是糖尿病足溃疡(DFU)的重要预测因素之一。目的:探讨苏丹Gezira州Wad Medani镇BMI与DFU之间的关系。方法:该研究基于在Wad Medani Aldarga糖尿病中心就诊的400名糖尿病患者的横断面随机样本获得的原始数据。数据收集工具是一份用英文设计并翻译成阿拉伯文的结构化问卷，用于实地调查。使用SPSS version 20对数据进行分析，采用频率表和卡方检验。结果:在400名参与者中，208人被诊断为足部溃疡。BMI与DFU之间存在统计学上的显著相关性。239名超重患者中有134名(56%)患有糖尿病足溃疡，而161名非超重患者中有74名(46%)患有糖尿病足溃疡(p=0.04)。结论:本研究结果提示BMI与糖尿病中心DFU之间存在显著关联。
{"title":"The association between body mass index and foot ulcer among patients with diabetes mellitus, Wad Medani, Sudan","authors":"A. Eltilib","doi":"10.4314/ssmj.v14i4.4","DOIUrl":"https://doi.org/10.4314/ssmj.v14i4.4","url":null,"abstract":"Introduction: Globally about 463 million people are living with diabetes mellitus (DM) which is estimated to rise to 700 million by 2045; 80% are in middle and low-income countries. Recent studies have shown that body mass index (BMI) was one of the significant predictors, along with nephropathy and retinopathy, of diabetic foot ulcers (DFU).Objective: To assess the association between BMI and DFU in Wad Medani town, Gezira state, Sudan.Method: The study was based on primary data obtained via a cross sectional random sample of 400 patients with DM presenting at Aldarga Diabetic Centre in Wad Medani. The data collection tool was a structured questionnaire designed in English and translated into Arabic for the field survey. Data were analysed with SPSS version 20, using frequency tables and chi-square tests.Results: Of the 400 participants, 208 were diagnosed with foot ulcer. There was a statistically significant association between BMI and DFU. A total of 134 (56%) of the 239 overweight patients had diabetic foot ulcers compared to 74 (46%) of the 161 who were not overweight (p=0.04).Conclusion: The result suggests a significant association between BMI and DFU at our Diabetic Centre.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48920335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obehi O. Osadolor, A. Osadolor, U. Otakhoigbogie, Owens O. Osadolor
Tobacco use is a serious public health problem with smoking as the most common method of consuming tobacco. It is a major preventable cause of premature morbidity and mortality. The prevalence of tobacco smoking varies from country to country. It creates a huge economic burden on the individuals who consume it and on the healthcare system. The current approach toward the management of tobacco smoking addiction revolves around a combination of education, counselling, and pharmacotherapy. Dental professionals, such as dentists and dental therapists/hygienists have a special role in identifying smokers: odour and teeth stains are obvious revealing signs. Dentists are well placed in tobacco smoking cessation as they provide preventive and curative services on a regular basis. The regularity of visits by patients to dental clinics offer valuable contacts for dental health professionals to initiate and strengthen tobacco cessation measures. Dentists are in a unique position to motivate and assist their patients to quit tobacco use and smoking.
{"title":"Tobacco smoking: the role of dental health professionals","authors":"Obehi O. Osadolor, A. Osadolor, U. Otakhoigbogie, Owens O. Osadolor","doi":"10.4314/ssmj.v14i4.6","DOIUrl":"https://doi.org/10.4314/ssmj.v14i4.6","url":null,"abstract":"Tobacco use is a serious public health problem with smoking as the most common method of consuming tobacco. It is a major preventable cause of premature morbidity and mortality. The prevalence of tobacco smoking varies from country to country. It creates a huge economic burden on the individuals who consume it and on the healthcare system. The current approach toward the management of tobacco smoking addiction revolves around a combination of education, counselling, and pharmacotherapy. Dental professionals, such as dentists and dental therapists/hygienists have a special role in identifying smokers: odour and teeth stains are obvious revealing signs. Dentists are well placed in tobacco smoking cessation as they provide preventive and curative services on a regular basis. The regularity of visits by patients to dental clinics offer valuable contacts for dental health professionals to initiate and strengthen tobacco cessation measures. Dentists are in a unique position to motivate and assist their patients to quit tobacco use and smoking.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49184484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Ectopic pregnancy, a pregnancy in which the embryo implants outside the endometrial cavity, is an important cause of maternal mortality, especially in developing countries. It can be managed medically using methotrexate. In Ethiopia, limited evidence exists regarding the treatment outcome of this approach.Methods: This retrospective study was conducted based on medical records of ectopic pregnancies managed medically using methotrexate. The data of women who had unruptured ectopic pregnancy and who were managed medically in the study period at St. Paul’s Hospital Millennium Medical College were included. Data were extracted from patients’ medical records and analysed using SPSS software.Results: During the 5-year period 2015 to 2019, 81 women with unruptured ectopic pregnancy were managed medically using methotrexate with 93.8% (n=76) success. Methotrexate was administered intramuscularly to all patients in either single dose or multiple doses. Five out of the 81 patients underwent surgical intervention for either ectopic rupture or persistent ectopic mass. There were no fatal complications.Conclusion: Methotrexate is a successful and safe alternative to surgical management of unruptured ectopic pregnancy in our settings. It should be given a trial in patients who meet the selection criteria in a setting ready for emergency surgical intervention and blood transfusions.
{"title":"Ectopic pregnancy managed medically at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia","authors":"Jok Thikuiy Gang, Sisay Kirba Kea, Samson Gebremedhin","doi":"10.4314/SSMJ.V14I3.4","DOIUrl":"https://doi.org/10.4314/SSMJ.V14I3.4","url":null,"abstract":"Background: Ectopic pregnancy, a pregnancy in which the embryo implants outside the endometrial cavity, is an important cause of maternal mortality, especially in developing countries. It can be managed medically using methotrexate. In Ethiopia, limited evidence exists regarding the treatment outcome of this approach.Methods: This retrospective study was conducted based on medical records of ectopic pregnancies managed medically using methotrexate. The data of women who had unruptured ectopic pregnancy and who were managed medically in the study period at St. Paul’s Hospital Millennium Medical College were included. Data were extracted from patients’ medical records and analysed using SPSS software.Results: During the 5-year period 2015 to 2019, 81 women with unruptured ectopic pregnancy were managed medically using methotrexate with 93.8% (n=76) success. Methotrexate was administered intramuscularly to all patients in either single dose or multiple doses. Five out of the 81 patients underwent surgical intervention for either ectopic rupture or persistent ectopic mass. There were no fatal complications.Conclusion: Methotrexate is a successful and safe alternative to surgical management of unruptured ectopic pregnancy in our settings. It should be given a trial in patients who meet the selection criteria in a setting ready for emergency surgical intervention and blood transfusions.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"14 1","pages":"85-88"},"PeriodicalIF":0.0,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48897456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stop killing healthcare workers in South Sudan","authors":"E. Kenyi","doi":"10.4314/SSMJ.V14I3.1","DOIUrl":"https://doi.org/10.4314/SSMJ.V14I3.1","url":null,"abstract":"","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"14 1","pages":"70-70"},"PeriodicalIF":0.0,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48127501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-24DOI: 10.5871/BACAD/9780197266953.003.0011
Brendan Bromwich
The natural resources and conflict discourse has been instrumentalised by commentators on Darfur as a means of disputing the relative significance of conflict at national and local levels. The significance of natural resources is played down by those wishing to focus on government culpability for violence but emphasised by those focussing on local peacebuilding and a strategy of constructive engagement with the government. Mindful of this disputed context, we review an institutional perspective on natural resources and peacebuilding. We find that Darfur is undergoing a contested and traumatised institutional bricolage relating to natural resources, livelihoods and ethnicity. Institutional bricolage therefore provides a frame in which peacebuilding relating to the environment can be analysed. A comparative neglect of these issues by international actors is aligned with conflict framings which focus on national conflict dynamics and international relations at the expense of Darfur’s own protracted political contest.
{"title":"Natural Resources, Conflict and Peacebuilding in Darfur","authors":"Brendan Bromwich","doi":"10.5871/BACAD/9780197266953.003.0011","DOIUrl":"https://doi.org/10.5871/BACAD/9780197266953.003.0011","url":null,"abstract":"The natural resources and conflict discourse has been instrumentalised by commentators on Darfur as a means of disputing the relative significance of conflict at national and local levels. The significance of natural resources is played down by those wishing to focus on government culpability for violence but emphasised by those focussing on local peacebuilding and a strategy of constructive engagement with the government. Mindful of this disputed context, we review an institutional perspective on natural resources and peacebuilding. We find that Darfur is undergoing a contested and traumatised institutional bricolage relating to natural resources, livelihoods and ethnicity. Institutional bricolage therefore provides a frame in which peacebuilding relating to the environment can be analysed. A comparative neglect of these issues by international actors is aligned with conflict framings which focus on national conflict dynamics and international relations at the expense of Darfur’s own protracted political contest.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"478 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72433993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-24DOI: 10.5871/BACAD/9780197266953.003.0007
E. Thomas
Sudan’s 2005 Comprehensive Peace Agreement (CPA) came at a time when oil revenues had transformed Sudan’s economy, and it recognized that regional inequalities in development needed to be redressed for peace to be sustainable. The government used fiscal policy to address these inequalities, transferring significant amounts of the central government’s oil rents to state governments. It was mostly spent on wages for government officials, and the evidence reviewed here suggests that it did little to redress Sudan’s stark regional inequalities. This chapter argues that the CPA’s fiscal arrangements alone could not address the land crises that underlie the violence and stagnation in the Sudan’s deeply polarized peripheral states: that would require ambitious plans to draw the productive energies of the periphery into the national economy, centred on Khartoum.
{"title":"Fiscal Policy and Sudan’s 2005 Comprehensive Peace Agreement","authors":"E. Thomas","doi":"10.5871/BACAD/9780197266953.003.0007","DOIUrl":"https://doi.org/10.5871/BACAD/9780197266953.003.0007","url":null,"abstract":"Sudan’s 2005 Comprehensive Peace Agreement (CPA) came at a time when oil revenues had transformed Sudan’s economy, and it recognized that regional inequalities in development needed to be redressed for peace to be sustainable. The government used fiscal policy to address these inequalities, transferring significant amounts of the central government’s oil rents to state governments. It was mostly spent on wages for government officials, and the evidence reviewed here suggests that it did little to redress Sudan’s stark regional inequalities. This chapter argues that the CPA’s fiscal arrangements alone could not address the land crises that underlie the violence and stagnation in the Sudan’s deeply polarized peripheral states: that would require ambitious plans to draw the productive energies of the periphery into the national economy, centred on Khartoum.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88855270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-24DOI: 10.5871/BACAD/9780197266953.003.0003
W. James
Why did Sudan’s Comprehensive Peace Agreement of 2005 leave a situation of intensifying conflict, rather than peace along the new international border between Sudan and South Sudan, following South Sudan’s independence in 2011? This chapter tries to answer that question by examining how different understandings of peace affected what was actually done in the CPA negotiations and implementation with reference to border communities, specifically those in Blue Nile State, one of the ‘Three Areas’ treated separately in the peace negotiations and in the final draft of the CPA. I argue that the CPA failed to acknowledge the international dimensions of the Sudanese civil war from 1983 onwards, specifically the politics of shifting relations with Ethiopia. The process of peace-making took place mainly at the elite level of local and international leaders, speaking in very general terms of the Sudanese ‘north’ as a whole, distinct from ‘the south’. The discourse promoted by IGAD itself rested on the assumption that the problem lay between these two entities. The professional peace-makers did not take sufficiently seriously the issues affecting local communities in the transitional zones, especially those who had endured twenty years of living on the shifting front lines of military conflict.
{"title":"Making Peace on Paper Only","authors":"W. James","doi":"10.5871/BACAD/9780197266953.003.0003","DOIUrl":"https://doi.org/10.5871/BACAD/9780197266953.003.0003","url":null,"abstract":"Why did Sudan’s Comprehensive Peace Agreement of 2005 leave a situation of intensifying conflict, rather than peace along the new international border between Sudan and South Sudan, following South Sudan’s independence in 2011? This chapter tries to answer that question by examining how different understandings of peace affected what was actually done in the CPA negotiations and implementation with reference to border communities, specifically those in Blue Nile State, one of the ‘Three Areas’ treated separately in the peace negotiations and in the final draft of the CPA. I argue that the CPA failed to acknowledge the international dimensions of the Sudanese civil war from 1983 onwards, specifically the politics of shifting relations with Ethiopia. The process of peace-making took place mainly at the elite level of local and international leaders, speaking in very general terms of the Sudanese ‘north’ as a whole, distinct from ‘the south’. The discourse promoted by IGAD itself rested on the assumption that the problem lay between these two entities. The professional peace-makers did not take sufficiently seriously the issues affecting local communities in the transitional zones, especially those who had endured twenty years of living on the shifting front lines of military conflict.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80215834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-24DOI: 10.5871/bacad/9780197266953.003.0016
M. Schomerus, Anouk S. Rigterink
South Sudan’s peace agreements offer two versions of justice: The Comprehensive Peace Agreement includes justice as a description of a better future with more equality. The Agreement for the Resolution of the Conflict in the Republic of South Sudan focuses on justice as individual criminal accountability for war crimes. However, the South Sudanese demand for justice combines and goes beyond these two conceptions of justice. Using structured and open-ended interviews conducted in January 2014, the chapter argues that justice is used to describe holistic accountability. This means accountability is understood not as individual accountability for crimes, but additionally as holding leaders formally to account for failing to deliver socio-economic justice and equality, as evoked by the spirit of the CPA. It is a request of sorts to bring leaders to justice for their lack of collective social and economic responsibility in a system where elections do not function as a way to hold leaders to account.
{"title":"South Sudan’s Long Crisis of Justice","authors":"M. Schomerus, Anouk S. Rigterink","doi":"10.5871/bacad/9780197266953.003.0016","DOIUrl":"https://doi.org/10.5871/bacad/9780197266953.003.0016","url":null,"abstract":"South Sudan’s peace agreements offer two versions of justice: The Comprehensive Peace Agreement includes justice as a description of a better future with more equality. The Agreement for the Resolution of the Conflict in the Republic of South Sudan focuses on justice as individual criminal accountability for war crimes. However, the South Sudanese demand for justice combines and goes beyond these two conceptions of justice. Using structured and open-ended interviews conducted in January 2014, the chapter argues that justice is used to describe holistic accountability. This means accountability is understood not as individual accountability for crimes, but additionally as holding leaders formally to account for failing to deliver socio-economic justice and equality, as evoked by the spirit of the CPA. It is a request of sorts to bring leaders to justice for their lack of collective social and economic responsibility in a system where elections do not function as a way to hold leaders to account.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85772192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-24DOI: 10.5871/BACAD/9780197266953.003.0013
R. Marsden
This chapter provides a practitioner’s perspective on the negotiations leading to the 2011 Doha Document for Peace in Darfur (DDPD) and its aftermath. It explains how international actors constrained peace in Darfur by framing Sudan’s conflicts on a north/south axis; by repeating past mistakes in mediation; and by focusing too much on clashes between government and rebel forces when the main threat to civilians came increasingly from government forces and proxy militias. It argues that international actors often pursued approaches that were at odds with each other and should have put more weight behind democratisation. It shows how the Bashir regime used the DDPD to provide cover for its pursuit of a military solution and manipulated implementation to strengthen its grip in Darfur. It also shows how some lessons from past experience are still valid as a new phase in Sudan’s peace process gets underway.
{"title":"Peacemaking in Darfur and the Doha Process","authors":"R. Marsden","doi":"10.5871/BACAD/9780197266953.003.0013","DOIUrl":"https://doi.org/10.5871/BACAD/9780197266953.003.0013","url":null,"abstract":"This chapter provides a practitioner’s perspective on the negotiations leading to the 2011 Doha Document for Peace in Darfur (DDPD) and its aftermath. It explains how international actors constrained peace in Darfur by framing Sudan’s conflicts on a north/south axis; by repeating past mistakes in mediation; and by focusing too much on clashes between government and rebel forces when the main threat to civilians came increasingly from government forces and proxy militias. It argues that international actors often pursued approaches that were at odds with each other and should have put more weight behind democratisation. It shows how the Bashir regime used the DDPD to provide cover for its pursuit of a military solution and manipulated implementation to strengthen its grip in Darfur. It also shows how some lessons from past experience are still valid as a new phase in Sudan’s peace process gets underway.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85721269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-24DOI: 10.5871/bacad/9780197266953.003.0017
A. de Waal
This chapter draws upon the contributions to this volume and adds additional reflections on peacemaking in Sudan and South Sudan, to draw out some patterns and general conclusions. It frames the analysis within the theories of change implicit in international and domestic Sudanese approaches to peacemaking. The principal argument is that peace processes should be seen as an extension of politics, characterized by strategic ambiguity, pursuing parallel tracks, and positioning for future opportunities that cannot be identified in advance. By contrast, international peacemakers’ theories of change are structured to achieve a singular unified settlement, or to pursue external interests. Sudanese/South Sudanese civic actors’ strategies go beyond ‘inclusion’ to agenda setting and generating coalitions for change. These differences are illustrated with reference to how the Comprehensive Peace Agreement managed its core issues (economy and security) and its marginal or excluded issues (Abyei, the ‘two areas’ and Darfur).
{"title":"Concluding Reflections","authors":"A. de Waal","doi":"10.5871/bacad/9780197266953.003.0017","DOIUrl":"https://doi.org/10.5871/bacad/9780197266953.003.0017","url":null,"abstract":"This chapter draws upon the contributions to this volume and adds additional reflections on peacemaking in Sudan and South Sudan, to draw out some patterns and general conclusions. It frames the analysis within the theories of change implicit in international and domestic Sudanese approaches to peacemaking. The principal argument is that peace processes should be seen as an extension of politics, characterized by strategic ambiguity, pursuing parallel tracks, and positioning for future opportunities that cannot be identified in advance. By contrast, international peacemakers’ theories of change are structured to achieve a singular unified settlement, or to pursue external interests. Sudanese/South Sudanese civic actors’ strategies go beyond ‘inclusion’ to agenda setting and generating coalitions for change. These differences are illustrated with reference to how the Comprehensive Peace Agreement managed its core issues (economy and security) and its marginal or excluded issues (Abyei, the ‘two areas’ and Darfur).","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86161760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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