Humanitarian Health Action

South Sudan conflict-related crisis - Health situation report no. 4 - 16 November 2009

Additional emergency health kits and trauma kits are urgently needed.

HIGHLIGHTS

  • WHO and health authorities from the Government of Southern Sudan and Central Equatoria State investigated the upsurge of malaria cases and deaths in Juba County.
  • Suspected cases of Influenza-like illnesses were reported in Juba.
  • More than 500 Kala azar patients are being treated in health facilities in Malakal, Old Fangak, Pibor, Rom, Melut and elsewhere.
  • WHO and the Ministry of Health of the Government of Southern Sudan (MoH/GoSS) donated 800 kg of medicines and assorted medical supplies to the Old Fangak health facility to combat the Kala azar outbreak.
  • Acute watery diarrhea (AWD) cases are increasing across Southern Sudan.
  • Overall security continues to be precarious.

HEALTH IMPACT

  • More than 500 Kala azar patients are under treatment in different health facilities in Malakal, Old Fangak, Pibor, Rom, Melut and elsewhere.
  • Suspected malaria cases are still on the rise. 8401 cases of malaria with 10 deaths were reported in week 44 (26 Oct – 1 Nov), with most cases and deaths reported from Juba.
  • More than 26, 000 internally displaced persons (IDPs) in Maridi, Ibba, Mundri and Yei counties are in acute need of health services.
  • In week 44 (26 Oct – 1 Nov), seven cases of neonatal tetanus were reported from Alsabah Children Hospital in Juba, Central Equatoria State (CES).
  • In week 44 (26 Oct – 1 Nov), one suspected measles case was reported in Wau, Northern Bahr El Ghazal (NBEG) State.
  • Two suspected cases of influenza-like illness were reported in Juba. Both cases tested negative for the pandemic (H1N1) 2009 influenza virus.

HEALTH SECTOR RESPONSE

  • Médecins sans Frontières (MSF)-Spain is now supporting the Yambio Hospital (operation theater and pediatric ward only), which is the closest referral hospital to Ezo county, following an agreement with the State Ministry of Health (SMoH).
  • MSF-Spain also agreed to support the Naandi Primary Healthcare Centre (PHCC) in Ezo county, train medical staff, and provide medicines and supplies.
  • ACROSS and MSF-Belgium conducted an accelerated vaccination campaign for infants in Nyori settlement (Yei county) for tuberculosis, polio, and diphtheria, pertussis and tetanus (DPT). They also vaccinated women of childbearing age against tetanus.
  • More than 500 Kala azar patients are being treated in health facilities in Malakal, Old Fangak, Pibor, Rom, Melut and elsewhere. Most cases have been reported from Old Fangak PHCC.
  • In week 45 (1–7 Nov) Malakal Teaching Hospital admitted 22 new patients suffering from Kala azar and discharged nine patients. Currently 80 patients are being treated in Malakal Teaching Hospital, 427 in Old Fangak PHCC, and 25 in an MSF-Belgium-supported health facility. Admission figures during the past two months show that 39% of patients were children under five and 49% were children aged between five and 17. So far more than 40 deaths have been recorded at the Malakal Teaching Hospital, Old Fangak and other health facilities due to Kala azar.
  • During the week 44 (26 Oct – 1 Nov), seven cases of neonatal tetanus were reported from Al-Sabah Children Hospital in Juba. The Central Equatoria Response Team is currently investigating in order to reconfirm these cases.

WHO RESPONSE

  • In light of increasing number of malaria cases and deaths in the past few weeks in Central Equatoria State, WHO supported an investigation mission at two Juba hospitals (Al-Sabah and Juba Teaching Hospitals). The mission, also including the Ministry of Health for the Government of Southern Sudan (GoSS) and Central Equatoria State MoH, recommended that:
    • Training on severe malaria case management for all health providers in Juba Teaching and Alsabah Hospitals should be considered.
    • Improve data management for both the hospitals.
    • Computers and training should be provided.
    • The same investigation should be carried out at community level and other health facilities in the Juba area.
    • Al-Sabah Hospital must be included in county level surveillance activities.
  • WHO signed an agreement and provided seed funds to the international NGO Action Africa Help to scale up health services for IDPs in Maridi, Ibba, Mundri and Yei counties.
  • WHO provided technical assistance to an investigation of two suspected cases of influenza-like illnesses reported in Juba. Both cases tested negative for pandemic (H1N1) 2009. The investigation was led by the CES surveillance team and also supported by the MoH/GoSS.
  • In response to the Kala azar outbreak in Upper Nile state, WHO and MoH/GoSS donated 800 kg of medicines and assorted medical supplies to the Old Fangak PHCC.
  • WHO is fully supporting the coordination of Kala Azar outbreak response activities through Malakal Office.

NEEDS

  • IOM reported gaps in referring HIV/AIDS patients to the nearest hospital in Ezo town, which is 100 km away.
  • HIV-positive individuals living in refugee and displaced camps need improved access to antiretroviral therapy.
  • A follow up measles and tetanus campaigns are needed to mitigate against measles and tetanus outbreaks.
  • Additional emergency health kits and trauma kits are urgently needed.
  • The capacity of referral hospitals needs to be improved. Most of the state referral hospitals do not have capacity to treat wounded patients. These patients are referred to Juba Teaching Hospital, which has its own limitations in terms of supplies and treatment.
  • An ambulance is urgently needed for referral services of patients to nearby hospitals in Nzara County, Western Equatoria State (WES).
  • The Ezo PHCC, which is MSF-supported, urgently needs medical supplies and an ambulance to transport patients referred to other facilities.
  • The PHC centres in Lainya and Bereka need more medical supplies.
  • Immunization campaigns in all IDP and refugee camps in Jonglei and WES should be supported and organized if and when security improves.
  • Health service providers need to be trained on case management of epidemic-prone diseases.
  • Training of health providers on Kala Azar diagnosis and case management in Upper Nile and Jonglei States.
  • More Kala Azar treatment centers should be established in Khorfluss and nearby payams. Disease surveillance for common communicable diseases should be strengthened.
  • The WASH sector needs to be better coordinated in order to improve the availability of safe drinking water and sanitation.
For further information please contact:

Dr Abdi Aden Mohamed
Head of Office
WHO Southern Sudan Office
E-mail: mohameda@nbo.emro.who.int
Tel: + (249) 927 361 440

Mr Irshad Shaikh
Emergency Preparedness and Humanitarian Action
WHO Regional Office for the Eastern Mediterranean
E-mail: shaikhi@emro.who.int
Tel : +20 2 2276 5525
Mobile: +20 1 0173 3924

Mr Jukka Sailas
External Relations
Health Action in Crises
WHO Geneva
E-mail: sailasj@who.int

Mr Paul Garwood
Communications Officer
Health Action in Crises
WHO Geneva
E-mail: garwoodp@who.int
Tel: +41 22 791 3462
Mobile: +41 79 475 5546

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