Humanitarian Health Action

South Sudan conflict-related crisis - Health situation report no. 3 - 9 November 2009

Additional emergency health kits and trauma kits are urgently needed. The capacity of referral hospitals needs to be improved.

HIGHLIGHTS

  • Yambio Hospital is in dire need of medical supplies and funds to cover running costs.
  • Ambulances are needed to strengthen the referral system in Ezo and Nzara counties.
  • The International Organization for Migration (IOM) has sent medicines to Tambura for mobile clinics in Ezo.
  • Cases of Kala azar are still being reported in Upper Nile State. WHO is donating medical supplies to combat the outbreak.
  • Malaria cases and deaths are on the rise in Juba county and elsewhere.
  • Overall security continues to be precarious.

HEALTH IMPACT

  • The Kala azar outbreak is continuing in Upper Nile State. Malakal Teaching Hospital, Old Fangak health facility and other health centres have reported an increase in the number of cases of the disease.
  • There has also been an increase in the number of malaria cases and deaths in Juba county and elsewhere. The Ministry of Health of the Government of South Sudan (MoHGoSS) and WHO are investigating.
  • Internally displaced persons (IDPs) in Maridi, Ibba, Mundri and Yei counties are in acute need of health services.
  • One suspected meningitis case was reported in Tonj South (Warrap State).
  • A measles outbreak alert was reported from Panyijar county (Unity State).

HEALTH SECTOR RESPONSE

  • 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 following the departure of the NGO Diocese of Torit. The State Ministry of Health (SMoH) does not have the capacity to manage or support the hospital; UN agencies and NGOs are providing the necessary assistance. WHO is discussing potential further support with partners.
  • Médecins sans Frontières (MSF) and World Vision International (WVI) have signed a memorandum of understanding for the handover of primary health care services, WVI is now running the Makpandu PHC centre full time. The centre is staffed by a clinical officer, two nurses, two midwives and community health workers.
  • The number of referrals to Yambio and Nzara hospitals has dropped to 14 in the past week. The UNHCR/WVI ambulance has been used to transport patients from the refugee camp to these hospitals. UNHCR and WVI have also provided food, accommodation and essential drugs for critically ill patients.
  • ACROSS and MSF-Belgium have carried out an accelerated BCG, OPV and DPT vaccination campaign in Nyori settlement (Yei county) for infants. During the campaign, they also vaccinated women of childbearing age against tetanus.
  • There has been an increase in the number of Kala azar cases reported from Upper Nile and Jonglei States. Health partners operating in these states are gearing up to respond, and have held coordination meetings in Juba and Malakal. The SMoH in Upper Nile State and WHO are coordinating the overall response. Malakal Teaching Hospital has admitted 65 patients suffering from the disease. Children account for a significant proportion of the outbreak: admission figures over the past two months show that 42% of patients were children under five and 47% were children aged between five and 17. There has been a total of 10 deaths at the hospital. While weekly admission figures have dropped from the peak of 25 new admissions recorded in week 43 (18-24 October), they remain significantly higher than the original eight cases per week reported in September.
  • IOM has sent a medical doctor to Tambura to do a rapid assessment of health interventions, and has dispatched 87 kg of medicines to Tambura for mobile clinics in Ezo.

WHO RESPONSE

  • One measles outbreak alert was reported from Panyijar county. The state surveillance officer, together with WHO, investigated and confirmed 13 cases of measles, most of which were in children under five in Mayom payam. The SMoH and health partners are organizing the outbreak response.
  • 11 524 cases of malaria with 23 deaths were reported this week, with most cases and deaths reported from Juba (CES) and Warrap State. The MoH/GoSS and WHO are in contact with the SMoH and the county health authority to investigate the outbreak and identify ways to improve case management, vector control and surveillance in all health facilities.
  • 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.
  • The State surveillance officer in Warrap state, together with WHO, is investigating the meningitis case reported from Tonj county. The result of the investigation will be made known shortly.
  • In response to the Kala azar outbreak in Upper Nile state, WHO is planning to donate 800 kg of medicines and assorted medical supplies to the Old Fangak health facility next week.

NEEDS

  • 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.
  • The Ezo PHC centre (MSF-supported) urgently needs medical supplies and an ambulance to transport patients referred to other facilities.
  • An ambulance is urgently needed for referral services of patients in nearby hospitals in Nzara county (Western Equatoria State (WES)).
  • The PHC centres in Lainya and Bereka need more medical supplies.
  • HIV-positive individuals living in camps need improved access to antiretroviral therapy.
  • Immunization campaigns in all IDP and refugee camps should be organized if and when security improves in Jonglei and WES.
  • Health service providers need to be trained on the management and control of disease outbreaks.
  • 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:

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

WHO Regional Office for the Eastern Mediterranean
Mr 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

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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