Republic of

CHOLERA RESPONSE UPDATES AS OF 12-August-2017

Coordination of cholera response Overall coordination of the cholera response at the national level is coordinated by the National cholera taskforce that meets weekly on Wednesdays from 2pm in the WHO conference hall in . In addition, the cholera coordination meeting in Juba Teaching hospital convenes on Monday starting 11am and Friday starting 9am in the Postgraduate School.

At the sub-national level, cholera taskforce committees are coordinating the cholera response in East and Yirol West, Nyirol, Uror, East, South, Kapoeta North, and Kapoeta East. Other non-affected states have also initiated cholera preparedness meetings in Aweil, Torit, Wau, Yambio, and .

Across the border in Sudan, the week 27, 2017 joint situation report by the Federal Ministry of Health and WHO showed that 15 out of the 18 states have been affected by acute watery diarrhoea with active transmission reported in Kassala, Blue Nile, River Nile, Gezira, Senar, Khartoum, Gedarif, Northern, White Nile, South Kordofan, North Kordofan, West Kordofan, North Darfur and East Darfur. All the states bordering South Sudan are affected. This therefore calls for enhanced preparedness in Renk, Western Bank of the Nile, Pariang, Abiemnhom, Abyei, Aweil East, Aweil North, and Raja counties.

To enhance cross-border surveillance and response, cross-border meetings are planned starting with the South Sudan, Uganda, and Kenya meeting that is planned for next month in Nimule.

Surveillance and case management updates

New cholera alerts

Berteth County (formerly Pibor): In Maruwa (Boma Payam), 17 people reported dead of suspected cholera between 7th and 9th August, 2017. WHO is working with the field teams and also in collaboration with MSF to conduct an assessment of the situation in the area.

Raja County: In Katta, several people reported of severe dehydration and vomiting in the past week. An assessment team from Raja Project and ALIMA deployed to conduct investigation failed to reach the area because of insecurity on the road leading to Katta. The CHD and health partners in the area are planning for another deployment to the area.

Akobo West County: In Wechjal and Boung, eight (8) suspect cholera cases were reported between 5th and 10th August. Nile Hope with support from WHO is conducting investigation and assessment of the situation.

General cholera trends There is a general declining trends in cholera cases in the country over the past three weeks. The number of counties with active transmission remains at 10 namely; Kapoeta South, Kapoeta East, Kapoeta North, Tonj East, Yirol East, Yirol East, Nyirol, Ayod, Duk and Juba. However, Kapoeta South reported an increase in cases over the week with Kapoeta town reporting more cases.

Similar declining trend is being reported in the Tonj East with transmission reported to have plummeted in Paweng and Makuach. However, a new hotspot has emerged in Marial lou, in Tonj North where suspect cholera cases have been reported. A cholera treatment unit has been established to manage cases.

Low level transmission continues to be reported in Yirol East and Yirol West; in Uror (Pieri), and Nyirol (Lankien). In Juba, transmission in Don Bosco IDP camp is controlled following the first round of oral cholera vaccination from 3rd to 6th July 2017. Sporadic transmission continues from widespread areas including Gondokoro, Shirkat, Lologo, Gudele 2, Rock City, Kor William, and Nyakuron.

Cholera response updates and field missions At least 50 cholera treatment facilities including cholera treatment centers and units; and oral rehydration points are currently operational in the areas with active cholera transmission. In Juba, HLSS has been supported by Unicef to establish 9 ORP sites in Al Sabbah hospital; Gurei; Kator; Lologo; Gumbo; Don Bosco, Kor Woliang, Nesitu, and Nyakuron.

In Tonj East, there are currently seven (7) cholera treatment facilities (4-CTUs and 3-ORPs) The four CTUs are located in Makuac, Mapara, Paweng and Paliang payams while the ORPs are in Ager bac, Aliet and Aper num. Four more ORPs are proposed to be sited at Marial Lou where cholera has been confirmed, Wunbol, Gol guk and Pagour. One more CTU has been established in response to the case upsurge in Marial Lou.

A total of 15 cholera treatment facilities have been set up in Kapoeta state, with Kapoeta South having 1CTC, 1CTU, and 1 ORP; Kapoeta East having 3CTUs and 3 ORPs; and Kapoeta North having 1 CTC and 5 ORPs.

With support from UNICEF, a total of 16 cholera beds were delivered to Kapoeta State Hospital CTC (10 beds); Napotpot (3beds); and Narus (3beds). Due to the shortage of cholera kits, UNICEF is planning to deliver case management and WASH kits to support the cholera response activities in Kapoeta state.

Tab.1: Cholera treatment facilities in highly active transmission counties

Cholera treatment facilities by type Total State County CTC CTU ORP

Kapoeta North 1 0 5 6

Kapoeta Kapoeta South 1 1 1 3

Kapoeta East 0 3 3 6

Tonj Tonj East 0 5 3 8

Jubek Juba 1 0 9 10 Total 3 9 21 33

Oral cholera vaccination Vaccination campaign in the four priority counties including Kapoeta North, Kapoeta South, Kapoeta East and Tonj East is now in a mop up stage. The vaccination campaign started on the 29th July, 2017 to the 4th August, 2017 in the Kapoeta state while in Tonj East the campaign started on the 5th August, 2017 and ended on the 12th August, 2017. A total of 500, 010 doses were deployed to cover a target of 500,000 people across the four counties. This brings the total OCV doses secured from ICG/GTFCC since the beginning of 2017 to 1,544,150.

A total of 611,564 doses have been deployed during the first round and 161,321 doses deployed during the second round. Cholera cases have significantly reduced in areas, especially in sites where the OCV campaign have been conducted so far in 2017.

Since the beginning of 2017, cholera vaccines have been deployed in Leer, Bor PoC, Town, PoC, Mingkaman IDP settlement, Aburoc IDPs, Bentiu/Rubkona Town, Ayod (Pagil, Tar, Jiech, Karmun, Padek, and Kandak), Juba (Don Bosco IDPs), Kapoeta North, Kapoeta South, Kapoeta East and Tonj East and surrounding payams.( Ref. Tab.2) The next phase of the campaign will target the remaining four prioritized counties including Juba, Akobo/Uror, Lankien and Panyijiar with a target population of 395,940.

An additional two million doses of oral cholera vaccines are required to mitigate the risk of cholera in high risk areas and to interrupt transmission in the areas with ongoing transmission. W.H.O is in the final stages of securing these additional doses to complement the ongoing cholera response.

Table 2: Doses of Oral Cholera Vaccines deployed in 2017 by site Target First round Second round No Site pop. # vacc. %cov. # vacc. %cov. Drop Vacc. Dates Partner out 1 Leer 44,731 30,772 69 - - - 22-Feb-17 MedAir, WHO,UNICEF 2 Malakal Town 16,500 10,499 64 - - - 18-22 May MSF-E, WHO,UNICEF 3 Bor PoC 2,265 1,926 85 1,885 83 - 3-4 Apr/ HLSS, 26-29 Apr WHO,UNICEF 4 Mingkaman 111,278 68,512 62 42,296 38 - 12-26 May MedAir, 10-21 Jun WHO,UNICEF 5 Ayod Tar 19,400 15,649 81 - - - 9-22 May MedAir, WHO,UNICEF 6 Ayod Pagil 4,850 3,943 81 - - - 9-22 May MedAir, WHO,UNICEF 7 Bentiu PoC 112,924 72,514 64 77,603 69 - 5-10 May IOM, WHO, UNICEF 8 Rabkona &Bentiu 35,204 31,908 91 38,387 109 - 20-23 Jun IOM, WHO, town UNICEF 9 Aburoj IDPs 11,640 10,723 92 - - 20-22 May MSF-E, WHO,UNICEF Ayod (Jiech, 10 Karmun,Padek 15,000 11,140 74 - - - 22-25 Jun IOM, CMD, &Kandak) WHO, UNICEF MSF-H, 11 Juba Don Bosco IDPs 5,940 3,909 66 1150 19 - 3-6 Jul; 24- WHO,UNICEF 27 Jul WHO, 12 Tonj East 189,058 160,862 85 - - - 6-12 Aug UNICEF, IOM,CCM, THESO 13 Kapoeta North 141,520 44,438 31 - - - 29 Jul-4-Aug WHO, UNICEF, SCI 14 Kapoeta South 97,000 78,469 81 29 Jul-4-Aug WHO,UNICEF, ARC 15 Kapoeta East 97,000 66,300 68 29 Jul-4-Aug WHO, UNICEF, SCI Total doses deployed 2017 904,310 611,564 68 161,321 42

Fig.1: First Round OCV Vaccination Coverage in Four priority counties, 2017

Target Coverage % Coverage

1,000,000 90.0 85.1 350,069 900,000 80.9 80.0

800,000 70.0 68.4 66.7 700,000 60.0 600,000 50.0 500,000

40.0 Target/Coverage

400,000 160,862 %Coverage 31.4 30.0 300,000 44438 66,300 524,578 200,000 78,469 20.0 100,000 189,058 10.0 141,520 97,000 97,000 0 0.0 Kap-N Kap-S Kap-E Tonj-E Total Counties

A total of 350,069 out of a target of 524,578 across the four counties were vaccinated, representing 67% of the target population vaccinated. Kapoeta South and Tonj East recorded slightly above 80%, that is, 80.9% and 84.7% respectively. Coverage for Kapoeta North was very low at just 31.4%. Partners will have to

remobilize and also re-strategize and conduct a vigorous mop-up in the area. Similarly, Kapoeta East may

have to also conduct mop-up exercise before the second round is rolled out.

Kap= Kapoeta North, South, East and Tonj East

Laboratory updates A total 662 samples of cholera have been tested of which 41.8% (277) have been confirmed positive for Vibrio cholerae.

Tab.3: Laboratory statistics

Culture results State (County) Cumulative New positives in week 31 Positive Cumulative Negative Total tested Central 0 0 5 5 Jonglei-Duk 0 7 5 12 Jonglei-Bor South 0 6 3 9 Jonglei-Lankien 0 4 3 7 Jubek-Juba 19 113 144 257 Terekeka 0 2 0 2 Eastern - Mingkaman 0 44 52 96 Eastern Lakes – Yirol West 0 3 0 3 Eastern Lakes – Yirol East 0 4 6 10 Imatong 0 7 1 8 Fangak – Fangak 0 18 42 60 Fangak – Ayod 0 1 2 3 Wau 0 0 6 6 Boma 0 0 3 3 Northern Liech – Rubkona 0 32 76 108 Northern Liech – Mayom 0 1 3 4 Southern Liech – Leer 0 2 0 2 Southern Liech - Panyijiar 0 1 0 1 Southern Liech – Mayendit 0 4 6 10 Fashoda – , Aburoc 0 3 5 8 Central Upper Nile (Pigi) 0 3 5 8 Central Upper Nile (Malakal) 0 1 11 12 Kapoeta (Kapoeta South) 0 4 2 6 Kapoeta (Kapoeta East) 0 4 0 4 Kapoeta () 1 2 0 2 (Tonj East) 0 3 3 6 Torit 0 0 2 2 Renk (Geiger) 0 1 0 1 Total tested 20 277 385 662

WASH CLUSTER RESPONSE UPDATES

Note: WASH Cluster partners to send their Cholera response updates by Friday 4pm every week at [email protected] and [email protected]

WASH Cluster Key Cholera Response updates: 7th-12th August, 2017

Nine (9) WASH Cluster partners namely Help, RUWASSA, CCOSS, CAFOD, MEDAIR, ADA, CRS, NH reported in the prescribed WASH Cluster Cholera weekly reporting matrix

Locations with ongoing WASH Partners Ongoing actions with number of population reached with Cholera Gaps and recommended action outbreak and hot spots present interventions (Payam level) - A cumulative total of 97 boreholes have been worked on, (Kapoeta North – 41 repaired and 0 rehabilitated, Kapoeta South – 43 repaired and 13 rehabilitated), benefitting approximately 48,500 individuals. - House to house visits for hygiene promotion carried out in Kapoeta North (Najie, Chumakori, Lokwamor, Lomeyen, Paringa and Nakwa) - Kapoeta case management, Kapoeta South and Kapoeta South (Napetait, Nanaknak and Kapoeta town), reaching surveillance & OCV working (Nakwasingira, Napetait, 14,570 individuals (3,472 men, 4,791 women and 6,307 children) Nanaknak, Kapoeta group meeting: Wednesday during the week. th town) and IOM 9 Augu12 2017 (10h – 11h - Mass campaigns held in Nanaknak on 5th August, reaching Kapoeta North AM); approximately 312 individuals (42 men, 121 women and 149 children) (Lomeyen, Najie, - Kapoeta WASH cluster - Hygiene promotion messages and demonstration for use of Pur and Paringa, Lokwamor, meeting: Friday 11th August other WASH NFIs passed during WASH NFIs distribution for Napetait, Chumakori and Nakwa) 2017 (1.30PM – 3h PM) Narekedae, Nakicho and Lopala. This reached approximately 1,653

individuals (127 men, 687 women and 839 children) - Kapoeta Cholera taskforce Focal Point: David - The hygiene promotion activities passed messages on safe disposal of meeting (with the Governor): Kinyua human waste, proper handwashing with soap and running water at all Friday 11th August 2017 (3h – Project Officer – WASH critical times, safe water chain and handling, good health seeking 5h PM) (EPnR) behavior for cholera and mobilization for OCV. IOM South Sudan - Distribution of WASH NFIs to 1,611 HH (9,666 individuals) in Cell: +211 920 083 201 Narekedae (419 HH), Nakicho (169 HH), Napetait (513 HH) and Lopala +211 915 776 520 CINA (510 HH). Each HH received; 1 collapsible jerrican, 1 bucket with lid, +211 954 355 494 (Machi 1, Machi 2) 100 satchets of Pur, 1 filter cloth and 4 bars of soap. Skype: david.kinyua37 [email protected] - 2,456 Individual (women: 839, Men: 534, Boys:569, Girls:514) reached

in 829 HH.

- For last week; 1,456 Individual (Women:588, Men:341, Boys:264, Girls:263) reached in 668 HH.

Kapoeta East IRW/UNICEF IRW/UNICEF (Nadapal, Narus, (Nadapal, Narus, - 1 borehole repaired in Narus town. Napotpot, Loyolo, Napotpot) - 3 boxes (75 bars) of washing soaps were distributed to 75 lactating Mogos, Natinga/New mothers representing 75 households in Nadapal boma. Site, Lolim, Lopua, - 1,265 aquatabs, 5 strips per household, were distributed to 253 Katodori) households, subsequently 1,516 beneficiaries across Nadapal town. - 200 sachets of ORS were delivered to the Nadapal PHCU as they could Focal Point: David only serve 40 households/ or 240 beneficiaries, way below the number Kinyua of households in the area. The ill-feeling residents will benefit from the Project Officer – WASH supply. (EPnR) - 10 boxes/ or 250 bars of soaps have been supplied and distributed to IOM South Sudan some lactating mothers, covering 250 households or 1,489 Cell: +211 920 083 201 beneficiaries across Napotpot and Lokuma boma, Katodori Payam. +211 915 776 520 +211 954 355 494 Rural Action Against Hunger (RAAH) Skype: david.kinyua37 - Identification of NFIs beneficiaries of Lolim and Lopua, so far 315 HHS [email protected] identified using Child Headed Household (CHH), Female Headed RAAH Household (FHH), Disabled and elderly as selection criteria. (Lolim, Lopua) - Hygiene promotion activities in the two location of Lolim and Lopua. The topic this week was food hygiene. In light of the plans, the following achievements were realized 1336 HHS reached with routine Hygiene promotion messaging. A total of 1810 individuals reached. Of these individuals 734 are Women, 316 Men 485 Girls and 275 Boys respectively. SI (Solidarites’ International) - SI was proposed to intervene Suspected cholera cases in Ngauro and way forward: in Ngauro. The team on - Started assessment in Ngauro, with possibility of response next week. ground will confirm whether - SSRC already has 74 contracted volunteers on ground for their normal they will respond activities. SSRC are in negotiation with UNICEF for a PCA, which will - Partners suggested that areas SI include cholera response. in Budi, especially Ngauro, be Budi County (Ngauro) (Ngauro) - 08 suspected cases of cholera reported in Ngauro, with 2 cases RDT considered for vaccination positive (Though not culture). - There is still need for SI to intervene even in the presence of SSRC since proper confirmation for SSRC to respond is not obtained Yirol (Lakes) - HELP PAH PAH and CCOSS Pulling out this - CCOSS - Handing over WASH tools to county water department ( Yali and week leaving a big gap in all areas HELP – WASH Focal - Caritas Abang) they were operating in. Point - PAH - Finished distribution of NFIs to 3360 HHs with 27386 individuals; The remaining partners (Help, Bernard James: - CHADO Khap 1060 HH with 8201 individuals, Wunthou 1000HHs with 9103 HACO, and Chado) will try [email protected] - HACO individuals, Mangar 720 HHs with 5700 individuals, Mageer 580 HHs covering up the gaps but still we with 4382 individuals. urge more support from WASH - Trained WUCs for 11 Boreholes partners to help the remaining - Will be pulling out of Yirol this week agencies in covering the gaps as CCOSS the disease (cholera) is not yet - Daily hygiene promotion in Pankar-Arou-nyel, Adior, Malek, Nyang, declared out of the location. Shambe, Langmatot, Thonabutkok, guthorm and Yirol town is ongoing with 5350 men, 5731 women, 5097 Girls, 4319 Boys reached with hygiene key massages with 1796 HHs visited. - In Social mobilization, 334 men, 536 women, 4107 Girl, 369 Boys were mobilized in both Yirol east and west. - Carried assessment of the repaired Bore holes and repaired two. - Will be pulling out by this week on the 15th August HELP - Weekly cleaning campaigns in Yirol main market. - Conducted cholera mass campaign targeting women, men and school children in Midinyin with 750 individual reached with key hygiene and cholera massages(Men 98, Women 189, Boys 245 Girls 268) - Continuous mobilization of HHs for latrine construction. - CLTS mobilization in Amethic, Wunthou, Lekakudu and Billiny villages is ongoing. - Continues with key Cholera Hygiene promotion messages in Yirol town through focus group discussion, in markets and other gathering places with 7487 individuals reached (men 916, women 2487, Boys 1503, Girls 2581) - 687 HHs (4122) individuals reached with key hygiene massages in Yirol town - Continues with hygiene and cholera prevention awareness sessions in 12 OTP facilities( in Yirol west; Aluakluak, Pandit, Anuol, Wouwou, Agany and in Yirol east; Lekakudu, Billiny, Achigor, Amethic, Khap, Pagarau and Thonabutkok) with 7652 individuals reached (Men 942, Women 3905, Boys 1219, Girls 1586) - Provision of soap for jerry can cleaning campaigns in the water points with distribution of Aqua tabs as well. Caritas - Distributed Hygiene Kits to two primary school each with 120 kits per school, Pagarau, Nyan primary school , Nyang-jok primary school in Adior and Mamer Primary school in Billing - Formed 24 WUC for 24 boreholes to be rehabilitated. - Hygiene promotion activities is ongoing in all the areas of operation. - Planned to conduct WUC training - Planed distribution of remaining NFIs HACO - Hygiene promotion activities is continuous in the following areas Liepliep, Billiny, Bunagany and Bunmager. - Jerrican cleaning on going in water points with provision of soap for washing water containers - Plans HH registration in Tinapal and Rianteng for proper intervention. - Distributed soap and Aqua Tabs to 300 HHs in Billiny, Bungany, and Liepliep with 1600 Individuals. CHADO - C4D programs is continues for Nutrition, hygiene, malaria, education and routine immunization reaching 1606 HHs with estimated 4939 beneficiaries with 11 case identified and referred on cholera with 2 deaths reported - Reached 49 sessions in primary school with estimated 12,332 school children - Conducted 57 community meetings with 2559 individual - Reached 46 market sessions with 1608 estimated individuals reached - Reached 136 water point intervention with 1980 estimated individuals - Jerrican cleaning campaigns ongoing with provision of soap for washing water containers and distribution of Aqua Tabs. - Community sensitization/awareness.

- CRS-focal point - Reached 395HHs (3,054 individuals (1370 males and 1684 females) DUk- - PAH with hygiene messages through house to house hygiene sensitization. - Reached 2705 beneficiaries with hygiene messages through mass Ageer, Padiet, and campaign. Dong-chak and Payuel, - Distributed 2,100 strips of aqua taps to 210 HH - Distributed 2500 bar of soaps to 2500 HH poktap, Payuel and Patuenoi WASH Cholera Focal bomas in Ageer and Payuel Payam(330 M and 2170 F) individuals Point: received the soap Kuany Ayiik - Distributed 5 gumboots were distributed to 5 CHPs (4 F and 1 M) in [email protected] Poktap during the time of distribution of soap. Asrat, Abayneh: - Disinfected 5 stances of latrines and 81 infected HH [email protected] Juba PAH - PAH conducting Cholera response activities in Joppa, Walangwalang, - Many local partners are Solidarite Newsite. willing but do not have Mariana Matoso; International, - SI conducting WASH Cholera response in Hai Gudele 1, Rock City and funding. UNICEF and other [email protected] SSRC donors requested for support. Hai Gumbo. k UNICEF/ THESO/ - Urban WASH technical NSDO - THESO conducting Cholera response in UN house with support from working group meeting every Medair UNICEF. week to strengthen Juba - Medair Karire 1 and 2 in Rejaf Payam, Don Bosco IDP camp, Gumbo, response. Next meeting on Lologo 2, Khor William. In Kator they are responding in Atlabara, 18th August at 11 am at Kator, Lologo 1, Kelibala, Suksita, Jeber Shukar UNICEF - Water quality monitoring to - NSDO a national NGO supported by UNICEF is working in schools and be the focus of WASH hospital in Munuki, Northern Bari and Kator in the following partners. neighborhoods:

Joppa Block 2 , Joppa Block 4, Home Dove Primary , Gurie Block 1, Jebel Yesua Block 5, Rock city, St. Peters Gudele , Hai Tarawa , Al Sabah Children Hospital, Peace Secondary School, Orphanage Primary School, Home Dove Primary SOCIAL MOBILISATION UPDATES

Social Mobilization, Communication and Hygiene Promotion Reporting Format (Date: 7th -12th August, 2017….)

Locations with ongoing Partners present Ongoing Action with number of population reached with Gaps and recommended action outbreak and hot spots ( Cholera interventions Payam level)

Tonj East: Most affected - CCM, THESO, UNICEF, - No Report shared Makuac, Paliang, Paweng WHO and SMOH Payam, Tonj South and Marial-Lou-Tonj North. () Kapoeta ( EEQ) SSRC, ARC, Singaita FM - One Radio talk show done by ARC and SSRC on - cholera vaccination and cholera prevention - Senitization of 4567 women at ‘Kapoeta south at the GFD distribution Site on the five step of cholera prevention - 231 HH & 652 individual in Kapoeta town have been reach with cholera prevention messages.

Torit, Nimule (EES) Health Link, SSRC, AMREF - NFR - and Radio stations

Jonglei (Duk, Bor and Twic - CDNF, SMoH, CHDs - UNICEF supported partner CDNF continue with East community engagement activities which include household visits with critical demonstrations, community meetings, water-point and market awareness, school and cattle camps intervention in areas of Bor, Duk and Twic East,. - - From 3rd – 8th Aug, 2017, CDNF social mobilizers reached total 2,194 HHs and 7,787 Individuals through 70 trained volunteers social mobilizers/home health promoters) educating community on social and behavior change intervention on cholera control and diarrheal disease prevention - A total of 11 schools and 2347 pupils benefited from school-based interventions on cholera awareness session carryout by social mobilizers at different schools in Bor,Twic east and Duk counties - In hard to reach villages of Bor, Twic east and Duk counties, the social mobilizers conducted 10 water point sessions reached total of 479 people including water vendors with Cholera and diarrheal disease educative messages including demonstration on proper water treatment and storage - Social mobilizers conducted 7 market sessions and reached 354 individuals including food vendors in the mentioned counties of Jonglei - In the same period, the social mobilizers also conducted 6 community meetings and attended 376 people inclusive of community leaders which comprise of local chiefs, religious leaders and women and youth leaders at different payams of Bor, Twic east and Duk counties.

- Mass media intervention: cholera key messages and radio spots are continuously being broadcasted on Mingkaman100 FM, and Radio Jonglei 95.9FM, 6 times daily in Dinka, English and Arabic reaching population in remote locations and villages lifesaving messages on cholera prevention and control Religious engagement: Social mobilizers reached people with effective cholera messages in over 23 churches during Sunday in the counties of Bor, reaching 11,500 individuals,Twic east, and Duk 2017 and cattle visited Akobo, Old Fangak, (Jonglei) Nile Hope, FCDI - 91 trained social mobilizers engaged by FCDI - reached 2,9372households and 7,401 individuals, reached with cholera messages - The social mobilizers conducted 12 sessions of awareness in schools and reached 2847 pupils with cholera messages in schools - In the same week, the social mobilizers had conducted 14 community meetings and reach 180 local leaders with cholera messages, and sensitize to advocate for cholera control and prevention in their communities - In the reporting week FCDI social mobilizers conducted 15 markets awareness sessions and reached 785 people including food vendors with cholera messages - The social mobilizers conducted 12 water points session and reach 472 water vendors with messages on water treatment and safe water storage to avoid cholera diseases at house hold levels - Over 5,007 people were reached by social mobilizers through public announcements inclusive of health education through churches and health facilities - Find action picture attached below Rubkona, Bentiu town and UNIDO, Nile Hope, - No updates shared - POC IRC, Mercy Corps Upper Nile: Fashoda County, - - Cholera social mobilization, hygiene promotion and - Panyikang Population communication is ongoing in Abrounc IDP settlement Displace in Abrounc: Most where Cholera intervention has been ongoing. UNICEF affected Abronuc IDP supported partner SCPD continue with community settlement. (Upper Nile State) engagement activities which include household visits with critical hygiene education messages, Cholera prevention messages, community meetings with local authority, Focus group discussion, Training for community leaders. (365H/H reached in home visits with 215 Female H/H visited and 150Male H/H and with 15 Child Headed House Holds (CH/H). with 2,935 people reached; with 1720 Female reached and,1215 male reached); 25 social mobilizers and 10 chiefs engaged during the campaign - - - Upper Nile (Maban, Renk and Mobile Threatre - Melut Social Mobilizers had conducted 3 hygiene - Increased the awareness in the MelutTown) Team/CHD promotions sessions in Dimtoma two Pri school P 3 27 community boys, 24 girls and with women group 12 Women. - Lack of mean of transport to far areas - Cholera prevention awareness campaign were - Rain season affected some plan conducted in Dimtoma 1 & 2 through house to house activities were 63 girls, 83 boys, 45 women 21 men - Lack of social mobilizers materials such - One Sessions on cholera prevention was conducted in gums-boot, rain-coats during time for Melut Hospital were 18 girls, 12 boys, men 08 women their work when it is raining 21. - One session on hygiene messages was conducted in Dimtoma 2 CFS were demonstration of hand washing was show to children

- Social mobilizers in Renk had conducted one meeting with local community leaders in Hai Masira on cholera messages to also reached other unreached population in their community with the same messages were 5 men and 4 women attached during the sessions in Hai Masira.

- Renk social mobilizers had conducted four (4) a day sessions on hygiene promotion in Abayok, Hai Salam, Hai Sora, Hai buron in Renk town were 46 women, 69 boys 73 girls 16 men.

- Renk Social Mobilizers had conducted 4 sessions per days on cholera prevention on their daily activities were they meet through hoses to house or community meeting were they following population were reached 57 women, 23 102, boys 126 girls.

- They had also conducted one session in Comboni Primary school in class 2 on cholera prevention messages 38 boys, 32 girls

- Renk social Mobilizers had conducted 2 Focus Group Discussions with women group in Hai Thoray and Monydeng areas on cholera prevention messages with women group were 19 women attached the session and benefited. Yirol East(Eastern Lakes), - SSRC, from 4 to 11 - SSRC have conducted household visits, 480, Gaps: distributions of 6,720 water purify, ORS 960, soap 640, Thonabutkok and Pangrew cases referred 6.

- CHADO have conducted household visits, community meetings, water-points and market awareness sessions, and schools in seven payams of Yirol East County i.e. Adior, Nyang centre, and Yali, Lekakedu, Tin-agau, Pagarau and Malek payams. Weekly summary - Households reached are 927 - Esimated number of people reached 5547 - Numebr of Cases identified are 01 - Number of Cases referred are 01 - Number of schools reached are 33 - Nunver of pupils reached are 6770 - Number of community meetings conducted are 35 - Estimated number of people reached are 654 - Number of Market sessions conducted are 34 - Estimate number of people reached are 762 - Number of water point sessions done are 91 - Estimate number of people at WPI are 902

Awerial ( Eastern Lakes) - - CHADO have conducted household visits, community Gaps: Mingkaman, Alel, Dor, Puluk, meetings, water-points and market awareness - Poor phone network in most of Bunangok, Nile, Magok, sessions, schools and cattle camps interventions in the the payams to transmit daily social Abuyong six payams of Awerial county i.e. Nile, Puluk, mobilization activities Bunangok, Abuyong, Alel and Magok - Inaccessibility due to heavy rain Weekly summary - Households reached are 712 - Estimated number of people reached are 2684 - No of Cases identified 0 - No of Cases referred 0 - Number of schools reached are 23 - Number of pupils reached are 2101 - Number of community meetings conducted are 34 - Estimated number of people reached are 708 - Number of Market sessions conducted are 46 - Estimated number of people reached are 420 - Number of water point sessions done are 116 - Estimated of people at WPI are 961 - Number of Cattle camps Intervention are 19 - Estimated No of people reached are 639 Yirol West (Eastern Lakes), - CHADO, SSRC and CHD - CHADO have conducted household visits, community - Poor phone network in most of the Abang Payam, Anuol Payam meetings, water-points and market awareness payams to transmit daily social Yirol Centre (Town), Geng- sessions and schools in six out of seven payams of Yirol mobilization activities Geng Payam, Geer Payam, West county i.e. Yirol center, Abang, Aluak-luak, Geer, Aluak Luak Payam, Mapuordit Geng-geng and Mapuordit payams. Aluol payam has - Inaccessibility due to rain Payam been inaccessible due to very poor network both road and communication. Weekly summary - Number of Households reached are 679 - Estimate number of people reached is 1719 - Number of Cases identified are 10 - Number of Cases referred are 10 - Number of schools reached are 16 - Number of pupils reached are 5562 - Number of community meetings conducted are 3622 - Estimate number of people reached are 605 - Number of Market sessions conducted are 12 - Estimate number of people reached are 493 - Number of W.P.I sessions done are 48 - Estimate of people at WPI are 637 Juba (Don Bosco, Gumbo, - MoH, SMoH-Jubek, - A total of 14 FM stations continue with airing of radio Gurei, Kator, Kor William, SSRC, HealthLink spots and talk-shows in Juba and Yei. As of 4-11 Lologo, Nesitu, POC, Ghabat South Sudan, Radio August, 2017, 840 times radio jingles have been and Nyakuron) Stations, Telecom broadcasted reaching over 2 million people across the Companies, THESO- country. POC - This week, street announcement of cholera messages has been ongoing through Five (5) Public Address Systems (PAs) in five main areas of the City namely; Rajaf, Kator, Juba, Munuki and Nyar-kenyi/Northern Bari.The PAs conducts 5 hours announcements per day (3 hr morning and 2hrs evening) and will be ongoing for a period of 60 days.

- THESO is also conducting hygiene promotion and megaphone announcements in Juba POC - Ministry of Health, WHO and UNICEF in collaboration with Vivacell Telecom Company have re-activated Cholera hotline (1144) which currently respond to all calls as well as educating callers on cholera response and preventive measures.

Health Link have started intensifying community engagement activities in different localities of their nine Oral Rehydration Points across the city The activities including follow-up of cases, household visits, community meetings, water-points and market awareness sessions, schools and cattle camps interventions in the four counties of Juba i.e Rajaf, Juba, Nyarkenyi and Lokiliri Weekly summary - A total of 125 frontline workers trained on clinical management of cholera, WASH and community mobilization. The health workers who have been deployed in the nine ORPs include clinical officers, Nurses, sprayers and social mobilizers - 5 trained mobilizers in Gurei reached the following; - 508 households (3882 individuals) - 4 schools reached with total of 1164 pupils and teachers educated on cholera - 3 community meetings conducted reaching 570 people including local chiefs and religious leaders - 2 Market sessions conducted reaching 598 people including food vendors