Southern Sudan: maintaining basic health services in the wake of the referendum
The referendum was completed with only sporadic clashes reported in some areas, especially in and around Abyei Region and Upper Nile State. The required 60%-of-voters turnout has reportedly been reached. Abyei, where the referendum still needs to be held, remains the key area of contention.
Since September 2010, almost 182 500 Southerners have returned from North Sudan, most of them settling in Unity, Upper Nile, North Bahr el Ghazal and Warrap States. As many as 500 000 are expected to return before next July. The Government of South Sudan (GoSS) does not have the capacity to integrate them all in such a short time. so far the GoSS has established mechanisms to register people, transfer them to their desired destination, allocate land to them (with support from UNDP) and provide them with basic services including health services. There is pressure on the international community to ensure equitable provision of aid in order not to create inequities between host communities and returnees.
Challenges in the health sector include shortages of vaccines in some areas, particularly in Malakal (Upper Nile) and facilities to store emergency and medical supplies, inadequate shelter and water sources in some transit points and lack of mobile medical teams to serve the rising returnee population in Lakes, Warrap, Upper Nile and North Bahr el Ghazal States.
Regarding communicable diseases, nine suspected cases of yellow fever have been reported in Eastern Equatoria (5) and Central Equatoria State (4). Currently, 1300 patients are receiving treatment for visceral leishmaniasis (Kala azar) in 18 treatment centres in the greater Upper Nile region. Overall, 9837 patients have been treated since the beginning of the outbreak. Furthermore, 71 measles cases (CFR 4%) have been recorded in Mayom County (Unity): most cases were returnees and 95% of them were not vaccinated.
In Juba, the Health Cluster continues to focus its work according to the contingency plan for the post-referendum period. The main emergency needs under consideration:
- the delivery of basic health services for affected populations, especially in Warrap and North Bahr el Ghazal States, need to be maintained;
- the MoH and WHO are developing a response strategy and preparedness plan for yellow fever. The GoSS/MoH has 60 000 doses of yellow fever vaccines;
- in Awiel Town (North Bahr el Ghazal), the International Rescue Committee (IRC) is supporting the State MoH to implement primary health care services in transit camps by providing mobile clinics;
- In Warrap State, World Vision International is supporting the management of common illnesses and malnutrition for returnees in transit camps.
- WHO, MEDAIR, MSF-Swiss and the Coordinating Committee of the Organizations for Voluntary Service (COSV) are supporting the State MoH maintain the Kala azar treatment centres in Upper Nile State.
- in Malakal (Upper Nile), ICRC, WHO and the State MoH conducted a joint training exercise for emergencies, mass casualty response and disease surveillance for participants from five of the seven prioritized counties (Malakal, Fashoda, Melut, Manyo & Panyikang).