Humanitarian Health Action

South Sudan conflict-related crisis - Health situation report no. 1 - 2 September 2009

Latest information on South Sudan conflict-related crisis health situation.

OVERVIEW

  • The Lord's Resistance Army (LRA) is continuing its campaign of terror in Western Equatoria State (WES), Southern Sudan: looting and ransacking homes, churches and health facilities, stealing food, killing innocent civilians and abducting young girls and boys. Many women and children have experienced or witnessed atrocities including rape, looting and abductions.
  • LRA attacks have intensified in recent weeks, causing mass displacements. According to recent reports, over 80 000 people have been displaced in WES and Central Equatoria State (CES) since December 2008. Along with another 16 000 refugees from the Democratic Republic of the Congo (DRC), most internally displaced people (IDPs) have settled in camps in Yambio and Yei counties.
  • Ezo County, which borders DRC and Central African Republic, has been the site of repeated attacks in recent months. During the latest attack on Ezo and neighbouring counties on 13 August, the LRA looted and burned local houses and churches, ransacked health facilities, killed and wounded civilians and abducted ten young girls. LRA militia also looted all available food donated by WFP and other humanitarian agencies. The total number of people displaced following the recent attacks in Ezo is unclear. Many IDPs are still hiding in the jungle due to persistent fear of LRA attacks, while most displaced are now living in camps organized by local authorities or host communities.
  • There is a high risk of epidemic-prone disease outbreaks in areas affected by the conflict. Health facilities have been badly damaged and many health care workers are among the displaced. Moreover, the precarious security is preventing many people from reaching the few health facilities that are still functioning. In the last two weeks, over 400 cases of malaria and 100 cases of watery diarrhoea, mostly among children and women, have been reported from Ezo County.
  • All humanitarian workers have been evacuated following the latest Ezo attack, and all humanitarian activities remain suspended for security reasons. The current humanitarian situation in Ezo is unknown due to delays in the undertaking of an inter-agency assessment mission, which finally arrived on site 2 September.

HEALTH IMPACT

  • Ezo County remains inaccessible to humanitarian workers since the most recent LRA attacks of 12 August. Surveillance officers are on the ground in Ezo but their movements are limited, making it impossible for them to ascertain the scale of health needs in Ezo. However, they have reported an increase in the number of cases of malaria due to the fact that many IDPs have stayed in the jungle for days without proper shelter or mosquito nets. Most IDPs have no resources and are in urgent need of food, safe drinking water, clothing, shelter and health care.
  • The humanitarian situation remains serious. Local churches have asked for emergency supplies of food, safe drinking water and medicines. The severe shortage of food may lead to malnutrition in children and pregnant women. Many health care workers were among the displaced, and very few health facilities are operational.
  • National Immunization Days scheduled to take place in August were not conducted due to the insecurity.
  • Yambio hospital - the closest referral hospital to Ezo country - has an acute lack of medical supplies and no money to pay staff salaries or running costs. The NGO that previously supported the hospital withdrew from the area in June 2009.

HEALTH SECTOR RESPONSE

  • On 27 August, the Governor of WES convened a meeting of all UN and non-UN Agencies in Yambio to discuss the humanitarian needs of IDPs and refugees and the continuing insecurity in Ezo county. The Governor asked for urgent medical supplies for health facilities in the affected areas and assistance to improve the availability of clean drinking water and sanitation.
  • WHO met with the State Ministry of Health to discuss ways to respond to health needs in Ezo and deliver badly needed medical supplies. The need for a rapid assessment of health needs was also discussed; WHO travelled to Ezo County on 2 September as part of an inter-agency assessment mission, the findings of which are expected shortly.
  • The State Ministry of Health requested WHO to support the expansion of basic health services in Ezo and surrounding areas through mobile health clinics. The services offered by the mobile clinics will include treatment for common illnesses, assistance to pregnant women and the provision of free medicines for certain ailments.
  • Forty plastic slabs were dispatched by UNICEF to the International Organization for Migration (IOM) in Tambura to support construction of sanitation facilities to benefit IDPs within the Namutina Payam community in Western Equatoria State. The facilities will provide safe excreta disposal for an estimated 300 households.

WHO RESPONSE

  • WHO has donated:
    • one Inter-Agency Emergency Health kit (containing enough medicines and supplies to treat 10 000 people for three months)
    • one Inter-Agency Diarrhoeal Disease kit (containing enough medicines to treat 100 severe cases of diarrhoea, 400 moderate cases of diarrhoea and 200 Shigella dysentery cases).
    • 2000 adult doses and 3000 children’s doses of artemisinin-based combination therapy (ACT).
  • WHO has assigned a senior medical officer to Yambio to support the humanitarian response.
  • WHO is supporting disease surveillance activities in all WES counties. WHO is planning to: 1) train health care workers in affected areas on the case management of common illnesses including treatment for malaria, diarrhoea and skin diseases, using the integrated management of child illness approach; 2) support measles and polio immunization campaigns targeting IDPs in Ezo County and surrounding areas; 3) donate medical supplies and provide technical support to Yambio hospital.

NEEDS

  • Improve basic health care services and expand their accessibility to both IDPs and host communities.
  • To conduct National Immunization Days in Ezo County once security improves in the area.
  • Build capacity of health workers in the diagnosis and treatment of common illnesses including malaria, URTI, measles, diarrhoea, and other infectious diseases.
  • Enhance health centres by increasing their health capacities at IDP sites.
  • Provide additional medicines (antibiotics, treatments for skin diseases, vitamins and anti-helmenthics), medical supplies and equipment to health facilities, including Yambio hospital.
  • Support an immunization campaign including measles, polio and other preventable communicable diseases.
  • Strengthen disease surveillance to control the spread of common communicable diseases such as malaria, acute watery diarrhoea and measles.
  • Provide financial and technical support to Yambio Civil Hospital.
  • Monitor malnutrition rates among children.
For further information please contact

WHO Southern Sudan Office
Dr Abdi Aden Mohamed
Head of Office
e-mail: mohameda@nbo.emro.who.int
Tel: + (249) 927 361440

WHO Regional Office for the Eastern Mediterranean
Dr Irshad Shaikh
Emergency and Humanitarian Action Regional Adviser
e-mail: shaikhi@emro.who.int
tel.+202 276 5525
mobile: +2010 173 3924

WHO headquarters
Mr Jukka Sailas
External Relations
Health Action in Crises
e-mail: sailasj@who.int
tel. +41 22 791 4778
mobile: +41 79 475 5501

Mr Paul Garwood
Communications Officer
Health Action in Crises
e-mail: garwoodp@who.int
tel. +41 22 791 3462
mobile: +41 79 475 5546

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