who south sudan weekly report. issue 2 2013€¦ · lks 254 0 36.51 0.00 lks 58 0 8.34 0.00 nbgz 0...

South Sudan Emergency humanitarian situation report

Issue 2 07 January – 13 January 2013

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HIGHGLIGHTS

Humanitarian Situation

� WHO supported the State Ministry of Health (SMOH), Northern Bahr el Ghazal state with the investigation and verification of suspected Viral Haemorrhagic Fever cases in Awiel Prison.

� Supported the SMOH, Unity state with provision of assistance to the displaced population in Panyijar County.

� Participated in a rapid health assessment in Tonj

East county following cattle raids that led to population displacement and fatalities.

� Conducted a peer review team meeting to define priorities for the first round of the Common Humanitarian Fund for 2013,

� Supported Mariallou hospital with emergency

drugs and supplies to support the management of causalities resulting from a cattle raid in the two counties of Tonj East and Tonj North.

� Supported the state to install 6 solar fridges in Warrap State.

� Continued supporting Upper Nile state with the mass immunization of refugees against Cholera in Upper Nile state.

� Three thousand five hundred (3500) people were reportedly displaced during this week from Paweng and Mariallou Payams of Tonj East and Tonj North Counties in Warrap state, (Tonj East and Tonj North County reports). This follows an attack by cattle raiders in Padulek, Mangan, and Wun-Cum, Padukiir and Rumkuac in Paweng Payam, Tonj East County and Machar Lou village in Mariallou Payam, Tonj North. During the raid 17 people were killed, 18 injured and 2500 cattle looted. Those injured were referred to Mariallou Hospital and currently receiving treatment in the hospital.

� Hepatitis E remains a challenge in Doro,Jamam, Batil and Gendrassa Camp. A total of 959 cases were reported

in the camps in this reporting week with 11 associated fatalities. Over 1120,000 refugees are registered and

settled in the mentioned camps.

� An estimated 6,000 people remained displaced in Northern Bahr el Ghazal state, in the areas of Jaac,Warcum, Makeranei,Jarkol and are in need of humanitarian assistance.

� Tension remained high in Rumbek center as interethnic conflict and fighting erupted and a considerable number of fatalities and injured recorded. Assessments are yet to verify the estimated number of persons displaced in the area.A barge carrying 1,260 returnees arrived in Juba from Renk in Upper Nile State this week. The majority of returnees are headed for the Greater Equatoria region as their final destination. During the past week, aid agencies tracked 1,026 returnees heading to their final destinations across South Sudan.

Source: UNOCHA

PUBLIC HEALTH CONCERNS

Health Situation

� A total of six suspected meningitis cases

period. Disease surveillance and case detection

measles were reported in Gendrassa

populations is a risk factor for the transmission of

� During this reporting period, five suspected AFP cases were reported in the states of Western Bahr el Ghazal

state, Northern Bahr el Ghazal,Eastern Equatoria and

� Health partners are concerned of

Northern Bahr el Ghazal. The sanitation situation continues to

transport assistant to Rummit camp.

� Hepatitis E remained a challenge in Batil and Gendrassa Camp. In the

reported in the camps with 11 associated fatalities. Over 400 cases were recorded in week two

Communicable Diseases

� In this reporting

period, a total of 224

(22.5%) of health

facilities sent in

weekly reports with a

completeness rate of

23% and timelines

rate of 5%. Unity

state was the best

performing state with

74% as compared to

Central Equatoria

State with 1%. The

reporting rates were

affected by the

retreat for the

surveillance team isin

AFFECTED POPULATION Total target for health

Newly Internally Displaced Persons

Refugees in South Sudan

Returnees from Sudan

People in need of humanitarian support

0%

50%

100%

150%

Ra

te%

South Sudan Emergency humanitarian situation reportIssue 2 07 January – 13 January 2013

PUBLIC HEALTH CONCERNS

A total of six suspected meningitis cases were reported in the refugee camps in Unity and Upper

Disease surveillance and case detection were strengthened in the camps following the reports

Gendrassa camp in Maban county. Population displacement and concentrated

for the transmission of these two diseases.

During this reporting period, five suspected AFP cases were reported in the states of Western Bahr el Ghazal

Bahr el Ghazal,Eastern Equatoria and Jonglei States.

f the deteriorating conditions of returnees in Muduany transit site in Aweil,

anitation situation continues to deteriorate as the population

transport assistant to Rummit camp.

E remained a challenge in Batil and Gendrassa Camp. In the last two weeks, a total of 959 cases were


2,900,000

200,000

350,000

125,000

4,600,000

CES EES Jonglei Lakes NBeG Unity UNS WBeG

States

Fig 1: Comparison of Average Timeleness and Completeness of

Surveillance Reports by State on Week 02, South Sudan

Timeleness

Completeness

Emergency humanitarian situation report

2

reported in the refugee camps in Unity and Upper Nile state this

following the reports. Cases of

. Population displacement and concentrated

During this reporting period, five suspected AFP cases were reported in the states of Western Bahr el Ghazal

conditions of returnees in Muduany transit site in Aweil,

population awaits onward

last two weeks, a total of 959 cases were


WBeG WES Warrap

Fig 1: Comparison of Average Timeleness and Completeness of



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the eastern county of Kajokeji. Despite that, no new outbreaks were reported in South Sudan this reporting

period. The states of Jonglei, Northern Bahr el Ghazal and Western Equatorial performed poorly

� A total of 15,504 health events were reported form the states this reporting period. Malaria accounted for the

largest number of events at 10,943, accounting for 70% and being the leading cause of morbidity, this was

followed by Acute Watery Diarrhea (AWD) accounting for 22%

� The table below summarizes the incidence rates across the states for AWD, BD, Malaria and Measles

AWD BD

State C D IR CFR State C D IR CFR

WES 0 0 0 0.00 WES 0 0 0 0.00

EES 431 0 47.57 0.00 EES 213 0 23.5 0.00

CES 16 0 1.45 0.00 CES 14 0 1.27 0.00

JNG 0 0 0 0.00 JNG 0 0 0 0.00

WRP 519 1 53.34 0.19 WRP 80 0 8.22 0.00

LKS 254 0 36.51 0.00 LKS 58 0 8.34 0.00

NBGZ 0 0 0 0.00 NBGZ 0 0 0 0.00

WBGZ 156 0 46.79 0.00 WBGZ 39 0 11.7 0.00

UNS 1461 4 151.5 0.27 UNS 503 0 52.2 0.00

UNITY 645 0 110.1 0.00 UNITY 148 0 25.3 0.00

TOTAL 3482 5 42.15 0.14 TOTAL 1055 0 12.8 0.00

Malaria Measles

State C D IR CFR State C D IR CFR

WES 0 0 0 0.00 WES 0 0 0 0.00

EES 2513 5 277.3 0.20 EES 0 0 0 0.00

CES 66 0 5.98 0.00 CES 0 0 0 0.00

JNG 0 0 0 0.00 JNG 0 0 0 0.00

WRP 1789 0 183.9 0.00 WRP 0 0 0 0.00

LKS 712 0 102.3 0.00 LKS 0 0 0 0.00

NBGZ 0 0 0 0.00 NBGZ 0 0 0 0.00

WBGZ 440 0 132 0.00 WBGZ 0 0 0 0.00

UNS 3903 5 404.7 0.13 UNS 0 0 0 0.00

UNITY 1520 0 259.5 0.00 UNITY 3 0 0.51 0.00

TOTAL 10943 10 132.5 0.09 TOTAL 3 0 0.04 0.00

Hepatitis E outbreak

The first Acute Jaundice Syndrome case was recorded from Jamam camp in July 2012 and the first Hepatitis E Virus

case was confirmed in Jamam in the 2nd week of August 2012. Hepatitis E Virus outbreak was declared by the

Ministry of Health in early September 2012. In the subsequent weeks and months, the outbreak spread to Gendrasa



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and Batil all within Maban county. Since then, cases have continued to be reported in the camps ofJamam,

Gendrassa and Batil in Maban County. The table below shows the number of cases reported as of week one of 2013.

In week two, over 400 cases have been reported and this is despite efforts by the combined efforts from the WASH

and health sectors

Acute Jaundice Syndrome Case Fatality Proportion by Refugee Camp as of week 1 2013) (Source –

UNHCR/MoH

Camp Pop# # AJS # Deaths CFR (%)

Jamam 15,000 883 21 2.4

Gendrasa 14,500 286 2 0.7

Yusuf Batil 37,500 1418 40 2.8

Doro 44,500 4 1 33.3

111500 2,591 64 2.5

� The figure below shows the epi-Curve of Acute Jaundice Syndrome cases in Maban Refugee camps,

Upper Nile, n=2590

� In response to the current Hepatitis E situation, a gap analysis was undertaken and a Water, Sanitation and Hygiene (WASH) outbreak control strategy put in place in all the camps. All the three components of WASH i.e, Water, Sanitation and Hygiene Promotion were considered with particular emphasis on the sanitation and hygiene promotion components. In Doro Camp, where no cases were detected by end of 2012, a total of 22 suspected cases were detected, 18 of them in the previous week. Most of those detected with Hepatitis E are relatives of cases of refugees visiting relative and or friends in Doro refugees visiting Batil. All cases reported during this period are coming from the same villages of Ingasana and JumJum.

� In this reporting period, five suspected AFP cases were reported. One was reported from Wau county in

Northern Bahr el Ghazal and another from Warrap state. These were investigated and samples collected and

sent to Juba for onward transmission to Nairobi for further investigations. . The other three were reported from

Equatorial state, one from Gogrial west in Warrap state and one from Pochalla in Jonglei state. The WHO

together with the state ministry of health state teams are investigating and following up with the cases. South

Sudan is in the pre-certification period to be declared Polio free.

0

100

200

300

20 25 30 35 40 45 50

He

p E

ca

ses

Epi week 2012 and 2013(week2)



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Response � During this reporting period, WHO and other humanitarian organizations started delivering aid to 4,000 people

displaced due the conflict in Panyiajar, Unity State. Those displaced were a result of cattle-raiding in Panyiajar County on 6 December, resulting in the death of four people. The insecurity in the area delayed the delivery of humanitarian aid to those affected.

� Following the interagency assessment in Awiel east county,Jakakor and Makeranei, it was established by the

assessment team that a total of 1,500 persons were displaced. Following this incident, WHO supported the state ministry of health to revive a mobile clinic to respond to the health needs of the population while ensuring, adequate medical supplies were available for the population. A total 3 basic unit kits were dispatched to the the affected area worth treating 3,000 persons for three months. Disease surveillance was also enhanced in the area.

� A barge carrying 1,260 returnees arrived Juba from Renk in Upper Nile State during this time. A combined team

of the State Ministry of Health and WHO immunized a total of 227 children. Sixty seven percent (67%) of those

immunized received the measles vaccine. Emergency measles vaccination is one of the most critical strategies

of combating measles outbreaks in emergency settings. In addition, WHO donated essential drugs (ACT and anti

malarial) and other sentential drugs to IOM to support returnees at the Malakal way station. These included; two

basic unit kits and one anti malarial. WHO also donated Primary Health Care kits and one truma kit to

INTERSOS in Malakal to facilitate the ongoing treatment of returnee in the state.

� In order to strengthen maternal health at the state levels, WHO in collaboration with the State Ministry of Health

and UNICEF participated in the Training of Trainers training for the upcoming Maternal and Neonatal Tetenus

campaign. A total of 40 participants from all the counties in Warrap state were. The training was organised with

the aim of refreshing the participant’s knowledge and skills so that they further train MNT vaccinators within their

respective Counties.

� As a way of supporting the state strengthen routine Expanded Programme on Immunization at the state level, WHO provided logistical and technical support by providing a Cold Chain Technician to install solar fridges in Warrap State. A total of 6 solar fridges were installed in the health facilities of Lurcuk, Mariallou, Yik Ador Lietnhom Ajiep Thur Nyoor.

WHO staff participates in the supervision of the Cholera vaccination exercise in Maban

county, Upper Niles state. Photo: WHO

A planed chattered by WHO delivers medical supplies to Upper Nile state to

support the response of emergencies in the state Photo: WHO/Pauline Ajello



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� The organization continued supporting Maban county health department with the vaccination exercise of host communities’ aganist cholera. The agency will continue to provide support supervision of the exercise to ensure the intended target is reached 160,000 (refugees and Host) people are targeted with the cholera vaccine as a preventive measure in addition to other preventive measures being conducted by other partners like health promotion and education messages. Its hope that the vaccine will help the host community and those in the refugee camp lower the risk of getting contracting cholera.

Coordination

� During this reporting period, WHO together with the Central Ministry of Health and the State Ministry of Health,

participated in the assessment of a suspected ebola case in a community hospital in Juba. This follows reports of

suspicious death had occurred at South Sudan Modern Clinic in Juba, with symptoms of Ebola. With the

assistance of WHO, members of the national rapid response team were mobilized to establish facts as the body

of the deceased was taken home. The team established that the deceased does not fit the standard case

definition and is unlikely to be a Viral Hemorrhagic Fever case; despite these, the attendants were advised to

ensure very minimal contact with the body since the diagnosis was still unclear. Blood specimens were collected

and sent to the reference laboratory in Nairobi for further analysis. The team continued to monitor health workers

and other family members.

� In addition, following reports of suspected Viral Hemorrhagic Fever (VHF) in CES state, an emergency

coordination meeting was held in Kajo Keji County health department. During the meeting, strategies on how to

support the state ministry of health with the management of cases and burial at the community level were

discussed. It was agreed that the support of WHO, the team intensifies disease surveillance and rapidly assess

all reported cases at the border. Over 6 cases of suspected VHF have been recorded in the county in the last

two months.

� To strengthen the preparedness skills of health workers in Upper Nile state, WHO conducted a training for 20

participants health workers including State Surveillance Officers, County Health Department staff, Laboratory

technicians and nurses from eight counties of Upper Nile state. The training aimed at enhancing the capacity of

health workers in proper preparedness during outbreaks mainly in the area of conducting prompt medical

investigations. As we approach the meningitis season, it is hoped that the health workers will utilize the acquired

skills to respond to and detect any potential outbreaks early enough

� During this period, WHO supported the central ministry of health to conduct an emergency meeting to design a

response plan for the rising numbers of wounded people resulting from bombardments in Kiir. Those wounded

are being treated in Raja hospital. Reports obtained from the hospital indicate an overwhelming numbers of

wounded patients in comparison to the hospitals capacity and available medical supplies. A meeting was held at

the state ministry of health and it was agreed that WHO supports the ministry of health by chattering a flight to

deliver Trauma kits and supplies to help the health workers provide care to the injured.

WHO staff conducts a training of health workers in Maban county. Photo: WHO Vaccination of returnees at the point of arrival at Juba Bridge in South Sudan Photo:WHO



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� In Unity State, WHO and MOH conducted a risk assessment following reports of increasing numbers of ant

rabies cases in Abeinom county. The team established that 31 dog bites had been recorded in the last one

month. A combined strategy of Ministry of Animal industry and Fisheries, FAO,MOH and WHO was put in place

to respond to the increasing numbers of dog bite in the abeinom-agok corridle. WHO will provide case

management protocols, surveillance tools and guidelines and rabies vaccines to support the response.

� During this reporting week, WHO in collaboration with the state ministry of health conducted an assessment to

Raja to assess the health impact of the bombardment that happened a week ago. During the assessment, the

team met with the Commissioner and other health partners. It was agreed that all partners support health

interventions for the causalities and support the county health department cover the much needed gaps. IMC

plans to deploy a surgeon to support the causalities, IMC is supporting the county health department with fuel

and a nurse while WHO is supporting by providing emergency medical supplies and the major and minor surgical

kits.

� Following the reports of an estimated displacement of over 1,000 to 3,500 persons after a cattle raid in Tonj East and Tonj North counties, WHO in collaboration with other partners among them, the State Relief and Rehabilitation Commission , UNOCHA, SMOH, WHO, WFP, WVI, UNMISS, UNHCR, NRC, IOM, UNICEF & CCM visited Tonj East County to verify and identify needs of conflict affected People in the area. The team visited Kuelcuk Primary Health Care Unit, Paliang Primary Health Care Unit, Paweng Primary Health Care Centre and Mariallou hospital to conduct an assessment of the health facilities and hospital to meet the health needs of the victims given their proximity to the attacked villages. The teams established that an estimated 1000 persons are in need of food and non-food items following the attack although no evidence of displaced camps were seen. In response CCM transported the wounded patients to Mariallou hospital while WHO in collaboration with State Ministry of Health (SMOH) delivered trauma, basic health kits among other kits including antibiotics to Mariallou hospital.

� Following the displacement of an estimated 1,000 people, mostly children and women due to a cattle-raid in Tonj

East and North counties in Warrap , it has been established by the assessment team those displaced are in

urgent need of food, livelihood support and medical assistance.

� The lack of basic facilities and services at the new site in Rumtiit, Awiel center is also of particular concern to aid

organizations. The available water point at the site can only provide for approximately 100 families out of the 500

expected to settle in the new site. Aid agencies have boosted the current water point to improve coverage and

are mobilizing support to drill additional boreholes as a long term solution. A mobile clinic was recently provided

to attend to the health needs of the returnees..

Planned Activities

� Emergency Health Assessment mission to Jaac and Warchum,Northern Bahr El Ghazal

� Health assessment for reported cases of measles in Kapoeta East County

� Conduct refresher training of the state Rapid Response Team in Western Bahr el Ghazal and Unity states. The Rapid Response Team support with the containment of potential emergencies.

Health Needs/Gaps & Challenges

Health Assessments

For more information contact:

WHO Country Office:Dr Abdi Aden Mohamed, Head of Office WHO South South, [email protected] Or Ms Pauline Ajello, Communication Officer. [email protected] WHO Regional Office for the Eastern Mediterranean: [email protected] Website: www.who.int\emro\eha

who south sudan weekly report. issue 2 2013€¦ · lks 254 0 36.51 0.00 lks 58 0 8.34 0.00 nbgz 0...

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