Republic of

CHOLERA RESPONSE UPDATES AS OF 8 SEPTEMBER 2017

Coordination of cholera response The National cholera task force is coordinating the overall cholera response. The task force meetings convene weekly on Wednesdays from 2 pm in the WHO conference hall in . Also, the cholera coordination meeting in Juba Teaching hospital holds on Monday starting 11 am in the Postgraduate School.

Surveillance and case management updates

Cholera alerts There were no new alerts reported during the week. However, two alerts, one in Boma and the other in Kata (Raja county) remain unverified and/or confirmed. The initial cases in Boma originated from Maruo, Labarab Payam on 7 August 2017. At least 48 suspect cholera cases including three deaths have been line listed as of 31 August 2017. One sample tested culture negative for Vibrio cholerae on 21 August 2017. The last case was admitted in Boma Civil Hospital on 31 August 2017. In Kata, Raja county, a cluster of suspect cholera cases was reported during the week of 7 August 2017 by ALIMA, an implementing agency. Alert verification is pending due to security concerns.

General cholera trends Cholera transmission is on the decline countrywide. In the last four weeks [weeks 33-36], cholera cases dropped from at least 132 cases in week 33 of 2017 to at least 6 cases in week 36 of 2017.

During the last four weeks [week 33-36, 2017], cholera transmission was reported in three counties [Budi, Juba, and Nyirol]. During this period [week 33-36, 2017], a total of 462 cases including 52 deaths of cholera were reported. The majority of the cases were reported from Budi [421 cases including 52 deaths] while the rest were reported from Juba [40 cases] and Nyirol [1 case]. During the corresponding period of 2016 [weeks 33-36, 2016], 781 cholera cases were reported from six counties [Awerial, Bor, Duk, Juba, , and Terekeka].

Budi remains the most affected county currently with a total of 289 cases including 40 deaths (CFR 13.8%) reported during the last four weeks [weeks 33-36, 2017]. A cumulative of 421 cases including 52 deaths [CFR 12.4%] have been reported in Budi since week 29, 2017. The cases have been reported from at least 8 payams with the most affected being Ngauro (286 cases & 7 deaths]; Napak (47 cases & 27 deaths), Kimotong (22 cases & 12 deaths); and Loriyok payam [18 cases & 3deaths]. Napak and Kimotong payams have the highest CFR (>50%), highlighting the need to improve access to timely and appropriate cholera case management.

1 All the deaths reported in the two payams [Napak and Kimotong] occurred in the community.

The outbreak in Budi started on 28 July 2017 with the initial transmission occurring among gold- miners in Ngauro. Cordaid and the CHD are supporting management in Ngauro CTU, Kimotong CTU, Kimotong PHCC, Vaka ORP, Nagishot PHCC, and Kakilai PHCC in . In addition to the case management, surveillance, and WASH interventions, a microplan is being developed for a cholera vaccination campaign in Budi.

In Juba, 40 cases have been reported from the nine HLSS managed ORPs in the last four weeks [week 33-36]. As the trend has been in the recent weeks, the areas actively reporting cases in Juba include Rejaf, Kator, and Juba Town. Also, sporadic cases continue to be reported from UN House PoC with three cholera RDT positive cases reported in week 36. A total of 31 cholera cases have been line listed in UN House PoC since 4 June 2017.

Cholera response updates The overall response to cholera in South Sudan is coordinated by the national taskforce that is Chaired by MoH with support from WHO, Unicef, and partners (Health and WASH clusters).

The oral cholera vaccine working group meeting was held in Juba on 8 September 2017. The meeting was informed that 396,940 doses of oral cholera vaccines are slated to arrive in Juba on 13 September 2017. The vaccines will be used for the first round vaccination campaigns in parts of Juba, Akobo/Uror, Lankien and Panyijiar. Due to limited access in Panyijiar, the meeting resolved that the campaign is delayed till the end of the rainy season. In the same way, the campaigns in Akobo/Uror will be deferred. The campaign in Juba will proceed as planned with MSF-CH implementing the first round campaign in select high-risk neighborhoods while MSF-E committed to implement the second round in the same locations. The other locations in Juba will be vaccinated subsequently using staff from Jubek state MoH.

WHO continues to support the overall coordination of cholera preparedness and response activities as co-chair of the cholera taskforce. WHO is also coordinating the deployment of oral cholera vaccines to complement the current response in South Sudan. WHO is also supporting the surveillance and laboratory activities though collation of cholera data, compilation of the cholera situation report, provision of cholera investigation kits, specimen transportation, and support to the microbiology laboratory for timely culture testing. WHO is also supporting the deployment of rapid response teams to augment the response in areas with active transmission.

UNICEF continues to provide supplies for medical management of cholera cases at both community and facility levels in the affected areas. As part of cholera case management, UNICEF supported 46 oral rehydration points (ORPs), 15 cholera treatment units (CTUs) and two cholera treatment centers (CTCs) through partners in key cholera hotspots where more than 30 Diarrhea Disease Kits have been distributed in 2017. During the reporting period, UNICEF provided cholera supplies( drugs, WASH/Hygiene kits) for the response in Budi county through CORDAID. UNICEF has prepositioned cholera supplies in all field offices and supported the development of cholera contingency plans in hot spot counties. Cholera and Log/WASH consultants have been recruited to strengthen response especially case management and Infection prevention and control in treatment sites.

2 Table 1: Doses of oral cholera vaccines deployed in 2017 by site Firs round Second round Target % % No Site populatio No No Dates Partners coverag coverag n vaccinated vaccinated e e 1 Leer (one round) 44731 30,772 69% 0% 22/02/2017 MedAir, WHO, UNICEF Malakal Town (one 2 16500 10,499 64% 0% 18-24Mar2017 MSF-E, WHO, UNICEF round) 3-4Apr2017; 2nd 3 Bor PoC 2265 1,926 85% 1,885 83% HLSS, WHO, UNICEF Rnd 26-29Apr2017 26Apr-5May2017; 4 Mingkaman 111,278 68,512 62% 42,296 38% 2nd Rnd: 12-26May MedAir, WHO, UNICEF & 10-21Jun 5 Ayod Tar (one round) 19,400 15,649 81% 0% 9-22May MedAir, WHO, UNICEF 6 Ayod Pagil (one round) 4,850 3,943 81% 0% 9-22May2017 MedAir, WHO, UNICEF

7 Bentiu PoC 112,924 72,514 64% 77,603 69% 5-10May2017 IOM, WHO, Unicef Rubkona & Bentiu 8 35204 31,908 91% 38,388 109% 19-23 Jun 2017 & 11- IOM, WHO, Unicef towns 15 Jul 2017 Aburoj IDPs (one 9 11,640 10,723 92% 0% 20-22May2017 MSF-E, WHO, UNICEF round) Ayod (Jiech, Karmun, 20-26 Jun 2017 & 18- 10 Padek, Kandak) (one 18,550 13,756 74% 9,337 50% IOM, CMD, WHO, UNICEF 23 Jul 2017 round) 3-6 Jul 2017; 24-27 MSF-CH; WHO, UNICEF, 11 Juba Don Bosco IDPs 5,940 4,536 76% 3,309 56% Jul 2017 HLSS 12 Tonj East (one round) 189,058 160,862 85% 6-10 Aug 2017 IOM, WHO, Unicef North (one 29 Jul-4Aug 2017 & 13 141,520 73,323 52% SCI, WHO, UNICEF round) 17-25Aug 2017 Kapoeta South (one 14 97,000 78,863 81% 29 Jul-4Aug 2017 ARC, WHO, UNICEF round) Kapoeta East (one 15 97,000 85,058 88% 29 Jul-4Aug 2017 ARC, WHO, UNICEF round) Total doses deployed 907,860 662,844 73% 172,818 19% in 2017

Oral cholera vaccination As part of the ongoing cholera response, cholera vaccines have been deployed to complement cholera response in several high-risk populations and locations. These areas include Leer, Bor PoC, Malakal Town, Bentiu PoC, Mingkaman IDP settlement, Aburoc IDPs, Bentiu/Rubkona Town, Ayod (Pagil, Tar, Jiech, Karmun, Padek, and Kandak), Juba (Don Bosco IDPs), Tonj East and Marial Lou payam, Kapoeta North, Kapoeta South, and Kapoeta North. Out of the 1,044,150 doses secured by WHO in 2017, a total of 835 662 doses have been deployed (see Table 1). There is no transmission in all the locations that have deployed OCV.

Preparations are underway to deploy 395,940 doses of oral cholera vaccines for vaccination in Juba, Lankien, Akobo and other areas in Jonglei, and Panyijiar. In addition, the oral cholera vaccine working group has given a go-ahead for the shipment of 896,360 doses to cover second round campaigns in Kapoeta South, Kapoeta North, Kapoeta East, Juba, Akobo/Uror, Lankien, and Panyijiar. Arrangements are underway to update the micro plans for the second round campaigns in Kapoeta North, Kapoeta East, Kapoeta South, and Tonj East counties. A separate microplan is being developed to facilitate vaccination in Budi county.

Communication for development (C4D) UNICEF continues to mobilize pastoralist communities in Eastern Lakes, Jonglei, Unity and with cholera prevention and control messages reaching 24 cattle camps with a cumulative population of more than 2,500 people. Since end June 2017, total of 1,073 trained social mobilizers and hygiene promoters have been deployed and have reached over 72,000

3 households. Mobilizers also reached around 49,000 school children and teachers in 147 schools. About 17,600 people including community leaders and food and water vendors were reached with messages through community meetings, water-point and market sessions. UNICEF continues to work with 11 implementing partners to conduct community engagement activities including household visits with critical demonstrations, community meetings, water- point and market awareness activities and schools and cattle camps interventions in all the cholera hotspot locations. As part of efforts to prevent cholera in Imatong, county, UNICEF through its partner, Health Link, a total of 100 hygiene promoters were trained reaching 3,574 people ( Female 2,170 & Male 1404) with hygiene promotion messages and 492 provided with wash soap to prevent the spread of acute watery diarrhea.

During this reporting period, UNICEF supported cholera awareness campaigns through 21 radio stations in Juba, Yei, Kapoeta, Torit, Bentiu, Tonj, Bor and Mingkaman, where active transmission is ongoing. This includes, broadcasting of five to ten radio jingles with cholera messages per day, with a total of 27 talk shows and 24 interviews, reaching approximately 1.8 million people (listenership data of 21 radio stations) with cholera prevention messages during the reporting period

Water, sanitation and hygiene (WASH) UNICEF and implementing partners continue to respond to the ongoing cholera epidemic through the provision of basic WASH services. The primary focus of the cholera response is on safe household water treatment and storage through distribution of Aquatabs© or PUR© water treatment products and hygiene promotion so as to interrupt the cycle of infection. Rehabilitation of broken hand pumps, and distribution of WASH NFIs, such as soap, buckets and jerry cans for safe water storage are also undertaken to ensure the continuum of WASH services in the affected/at risk communities. A total of 16 WASH partners that are supported by UNICEF and six (6) WASH Cluster partners with the capacity to conduct rapid mobile responses are currently providing essential WASH services for the cholera response.

UNICEF has prepositioned WASH cholera supplies in most affected areas and is supplying all WASH partners through the core pipeline to support the ongoing response. UNICEF has provided safe drinking water to an estimated 221,660 people in cholera affected areas through the rehabilitation of 153 boreholes hand pumps, drilling 19 new boreholes. 3,300 people were provided with access to safe sanitation through construction of 66 latrine stances. Through surveillance activities, 10,460 households received water treatment products to ensure safe drinking water in cholera affected communities. Additional 17,252 households also benefited from distributions of WASH NFIs (soap, buckets, Jerry cans etc.), and additional 20, 1965 people also reached with key hygiene and cholera messages. To strengthen the capacity of WASH partners, UNICEF conducted a training on cholera prevention and containment, which was attended by 29 participants from 19 WASH partner organizations.

Table 2: Cholera culture test results Jun 2016 - Sept 2017 Week 36 Cumulative (2016-2017) County Positive Positive Negative Total tested Abyei 1 1 Akobo 2 2 Awerial 55 63 118

4 Week 36 Cumulative (2016-2017) County Positive Positive Negative Total tested Ayod 2 6 8 Bor 4 4 8 Budi 1 2 1 3 Duk 11 6 17 Fangak 28 50 78 Fashoda 7 14 21 Juba 11 240 249 489 Kapoeta 8 8 East Kodok 1 2 3 Lankien 3 1 4 Leer 9 13 22 Magwi 7 1 8 Malakal 2 21 23 Mayendit 4 6 10 Mayom 4 7 11 Panyijar 1 1 Pibor 5 5 Pigi 2 4 6 Renk 2 2 Rubkona 30 91 121 Terekeka 2 2 Tonj East 8 8 16 Torit 5 5 Uror 2 2 Wau 6 6 Yirol East 6 8 15 Yirol 4 4 West (blank) 1 1 Kapoeta 12 12 24 South Nyirol 3 1 4 Adior 4 4 8 Total 463 592 1,056 tested

5 WASH CLUSTER RESPONSE UPDATES

WASH Cluster Key Cholera Response updates

Reporting period: 4 – 9 September 2017 Locations with ongoing WASH Partners Ongoing Action with number of population reached with Gaps and recommended outbreak and hot spots Cholera interventions action present

Kapoeta South (Nakwasingira, CMD CMD Napetait, Nanaknak, Kapoeta (Nakwasingira, - Recruited 19 Hygiene promoters for Kapoeta South town) and Napetait, - Health Education and awareness at HHS, distribution of Aqua tabs and Jerri can Kapoeta North (Lomeyen, Nanaknak, Kapoeta cleaning at water points is ongoing in Kapoeta town ( Rai A &B and Palakal A& Najie, Paringa, Lokwamor, town, Lomeyen, B and Market) Chumakori and Nakwa) Najie, Paringa, - In Nanaknak 19 boys, 250 women, 75 girls and 40 men reached Lokwamor, - In Napetait Aqua tabs distributed to HHs, 25 men, 80 women, 40 girls and 30 Chumakori and boys. Nakwa) - In Kapoeta town; jerry can cleaning up campaigns 1003 people reached at water points; HHs (200men, 83 boys, 88 girls and 104 women - Recruited 08 pump mechanics and 06 masons - Next week plan - Meeting with mayor on the sanitation activities in town

CINA CINA WASH supplies needed. On (Machi 1, Machi 2) - Hygiene promotion ongoing in 19 Bomas, total number of 2400 HH reached as Monday supplies stock, will be well as 8506 individuals reached with messages (2,240 women, 1955 girls, 1957 checked and share with the men & 2,356 boys) partner

Kapoeta East IRW/UNICEF IRW/UNICEF (Nadapal, Narus, Napotpot, (Nadapal, Narus, - Hygiene promotion is ongoing in the area with 20 HP in the community Loyoro) Napotpot) - WASH NFIs distributed in Lokuma and Nadapal (Soap 25bars, Aqua tabs 620, Materials for cleaning 160 kits) number of HHs reached 805 and people 3360 (Girls 1222, boys 968, women 761 & men 409)

6 Locations with ongoing WASH Partners Ongoing Action with number of population reached with Gaps and recommended outbreak and hot spots Cholera interventions action present

Kapoeta East RAAH Rural Action Against Hunger (RAAH) (Lolim, Lopua) - 705 HHs received WASH NIFS and 2,293 individual benefited in Loolim ( Aqua tabs, Pur, soap and filter cloth) - 1370 HHs and 2376 individual reached with hygiene promotion messages (866 women, 502 girls & 414 boys).

Budi County (Ngauro) SI SI (Solidarites’ International) (Ngauro) - Repaired 03 BHs (now 04 hand pumps functional) and trained 06 pump mechanics - Constructed 05 stances of latrines 01 in CTU and 4 outside - Constructed 02 bathing shelters in CTU - Drainage dug in water points - Hygiene promotion is ongoing where 10 hygiene promoters in Ngauro and 09 in Vaka - Started registeration for NFIs distribution current estimate 1800 HHs (Ngauro) and 2000HHs (Vaka)

Kapoeta East (Narus, Nadapal, INTERSOS - Recruited 0f 04 Hygiene promoters’ officers done Lokale & Newsita) - Mobilization of HP is ongoing

Kapoeta North IOM - IOM reached 804 beneficiaries with WASH NFI distribution in Lomeyen and Paringa - IOM rehabilitated additional three boreholes in Lomeyen and Chumakori,

Duk CRS - 211 HH (1,727 beneficiaries) were reached with hygiene messages at house to house visiting in Poktap and Payuel. - 459 beneficiaries were reached with hygiene messages at mass campaign in both Poktap and Payuel - 4 stances were disinfected in Poktap Boma and 19 HH were disinfected at Households Visiting. - 86 HH (428F and 356M beneficiaries) received hygiene messages at house to house visiting in Padiet. - 815 beneficiaries were reached with hygiene messages at mass campaign in Padiet. - 360 HH (967 F and 802 M beneficiaries) were reached and received hygiene messages through house to house visit in Pajut.

7 Locations with ongoing WASH Partners Ongoing Action with number of population reached with Gaps and recommended outbreak and hot spots Cholera interventions action present

- 85 HH and 15 stances were disinfected in Pajut. - 743 Beneficiaries receive hygiene messages in pajut Boma. - 280 Jerrycans/buckets were cleaned and disinfected in Pajut.

Awerial- Lakes state CRS - Conducted hygiene promotion messaging at house hold in Awerial (HH 356, Individual 3778, M 1674, F 2104). - Mass jerry cans cleaning was carried out on four water points in Mingkaman sector 4, 12 bar soaps used cleaning 300 jerry cans, 200 stripes of Aqua-tabs distributed. - 12 public latrines of 75 stances were disinfected in site sector 4 & 5Mingkaman. - Jointed hygiene promotion messaging was conducted in collaboration with LRRP WASH in Kalthok Boma in-line with distribution of some NFIs (25 pcs of soaps, 200 strips of aqua-tabs and 2 sachets for water treatment at the household level) - Identified latrines in Awerial for decommissioning and now in the process of hiring causals to conduct the exercise Mayom IOM IOM reached 4294 beneficiaries by household visits in Kuerbone IOM rehabilitated six boreholes in Kuerbone and Wangbuor

Juba (Rejaf and Munuki) SI Sherikat – school sessions, public awareness campaign, household visits targeting 3263 people Gudele 1 (blocks 4- 9) household visits – 4344 people Rock City – school sessions and household visits targeting total of 978 people

8 SOCIAL MOBILISATION UPDATES

Social Mobilization, Communication and Hygiene Promotion Reporting Format (1 -8 September, 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, A total of 72 community mobilizers continued to actively Makuach, Paliang, Paweng UNICEF, WHO and work with the communities and households in Tonj East Payam, Tonj South and SMOH (Romic) & Tonj North (Marial lou) Marial-Lou-Tonj North. During house to house visit, a total of 4,026 households (Warrap) (20,130 people) were reached with cholera and immunization messages, Kapoeta (EEQ) SSRC, ARC, Singaita FM • 3 Community sensitization meeting were done on the - five step of cholera prevention. • Radio talk on personal hygiene and washing hand with soap • 3465 women were sensitized during General food distribution in Rewoto. Torit, Nimule (EES) Health Link, SSRC, Radio - 12 jingles 4 talk done on Radio Emmanuel 89 FM on the - stations role of community leader to support cholera prevention and promote hygiene in community Bor, Twic East, Duk and CDNF - Pibor UNICEF supported partner CDNF continue with 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.

In week of 31st Aug – 8th Sept 2017,

80 CDNF social mobilizers reached total of 1,462 HHs and 7,366 Individuals through house to house mobilization for

9 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) community on social and behavior change intervention on cholera control and diarrheal disease prevention

In Pibor total of 1050 households and 6300 individuals has been reached with cholera messages by 30 trained social mobilizers

A total of 5 schools and 1730 pupils benefited from school- based interventions on cholera awareness session carryout by social mobilizers at different schools in Bor, Twic east, Duk and Pibor counties

In hard to reach villages of Pibor, Bor, Twic east, Duk, and Pochalla counties, the social mobilizers conducted 27 water point sessions reached total of 810 people including water vendors with Cholera and diarrheal disease educative messages including demonstration on r water treatment and proper storage

Social mobilizers conducted 15 market awareness sessions and reached 2250 individuals including food vendors in the mentioned counties

In the same period, the social mobilizers also conducted 21 community meetings and attended by 420 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, Pibor, Pochalla counties.

10 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) 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 with lifesaving messages on cholera prevention and control

Religious engagement: During religious services Social mobilizers reached people with effective cholera messages in over 105 churches in the counties of Bor, Pibor, Duk, Twic east, Pibor and Pochalla reaching population with lifesaving messages on cholera control and prevention.

In Pochalla county 24 CDNF social mobilizers benefit from orientation on IPC training on cholera prevention and control facilitated by UNICEF C4D officer Akobo, Nyirol and Uror Nile Hope, UNICEF supported partner Nile hope continue with - 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 Akobo, Nyirol, and Uror counties

In the week 31st August – 8th Sept,2017 - 115 social mobilizers reached 4,230 HH and individual 21,150 peoples benefited on cholera and immunization messages - They have identified 19 cases during their house to house visits

11 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) - 33 schools were visited and 14,307 students were reached on cholera prevention in Akobo, Uror and Nyirol - 36 communities meeting were conducted and 7,886 Communities members have attended the meeting - 27 sessions were held in markets and 8,344 peoples reached on sensitization messages of cholera in various counties of Akobo Uror and Nyirol - 39 sessions were held on water points and 19,459 were reached on Health education messages - 45 session of church engagement were conducted and 15,890 were reached on hygiene and sanitation messages. - 6 public announcements were done and 13,774 peoples benefited on integration of cholera prevention and immunization awareness in Akobo, Uror and Nyirol counties respectively

Akobo, Old Fangak, Ayod, FCDI No report shared - Pigi, Nyirol, Uror Juba Health link, SMoH A total of 45 trained community mobilizers has been actively - Gurei, Kator, Lologo, and CHD working Gurei, Kator, Lologo, Gumbo, Nesitu Gumbo, Nesitu No case was reported and referred during the reporting week During the house to house visit, a total of 929 households (5,849 people) were reached with cholera messages. WASH and Health supplies distributed during the reporting period includes 1,042 ORS and 707 chlorine taps

As part of Mass media, a total of 14 FM stations continue with airing of radio spots and talk-shows in Juba and Yei.

12 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) As of 2-8 September, 2017, 980 times radio jingles have been broadcasted reaching over 2 million people across the country.

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; Rejaf, Kator, Juba, Munuki and Nyar-kenyi/Northern Bari. The PAs conduct 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.

Rubkona, Bentiu town and UNIDO, Nile Hope, - - POC IRC, Mercy Corps Upper Nile (Maban, Melut Mobile Theater UNICEF supported partner MTT and health partners in - and Renk) Team and CHD Melut in conjunction with CHD had meet and arranged the upcoming measles campaign as MTT had be given a role of social mobilization.

13 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) • Cholera prevention awareness campaign were conducted in Dimtoma 1 & 2 through house to house were 22 girls,27 boys, 23 women 15 men • One Sessions on cholera prevention was conducted in Melut Hospital were 17 girls, 09 boys, men 05 women 16 • Three (3) session awareness on key messages, access to clean water, good sanitation, and hygiene that play a key role in the good health practices and wider community development in the community total number of people reached in Dimtoma 1 women centers, Melut town and Dimtoma 68 boys, 31 girls 18 men, 29 women

• Melut Social Mobilizers had conducted 2 hygiene promotions sessions in Dimtoma Primary School P 4 p 5, A & B 53 boys, 42 girls • In Maban, two (2) session awareness on key messages, access to clean water, good sanitation, and hygiene that play a key role in the good health practices and wider community development in the community, conducted in Hai Dum, News site were, 51 boys, 44 girls, 12 men, 43 women Six (6) sessions on cholera prevention awareness conducted in areas of Hai Khartoum, Hai Kurmuk, through house to house campaign were 59 girls,52 boys, 31 women 16 men • One Cholera public campaign awareness was conducted in Ban Kuman, 47 boys, 41 girls, 28 women, 15 men were attended the campaign.

14 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) • In Renk MTT and health partners in Renk in conjunction with CHD had meet and arranged the upcoming measles campaign as MTT had be given a role of social mobilization. In which MTT had already identified all social Mobilizers for the campaign. • MTT team had conducted a monthly meeting with local community leaders on the progress and ways for forward of the hygiene promotion and cholera prevention awareness conducted in Kwai were 6 men, 8 women attended the meeting • Four (4) sessions awareness on key messages, access to clean water, good sanitation, and hygiene that play a key role in the good health practices and wider community development in the community, conducted in Kwai, Mondydeng were, 38 boys ,33 girls, 17 men, 41 women • Four (4) Sessions on cholera prevention awareness was conducted in Nyiik, kiitwut, Mondeng, Kwai were 62 girls, 74 boys, 18 men 31 women 16 • One session on cholera prevention was conducted in Dawa Evening Primary school in class 4 & 5 on cholera prevention messages 48 boys, 29 girls Yirol East (Eastern Lakes), - SSRC, CHADO/ CHD - CHADO have conducted household visits, Adior Payam, Malek Payam, community meetings, water-points and market Lekakedu Payam, Yali awareness sessions, and schools in the six payams of Payam, Pagarau Payam, Yirol East County i.e. Adior, Nyang center, and Yali, Tin-agau Payam, Nyang Lekakedu, Tin-agau, Pagarau and Malek payams. (Lakes) Weekly summary Households reached are 891 Estimated number of people reached are 3210

15 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) No Cases identified 0 No Cases referred 0 Number of schools reached are 0 Number of pupils reached are 0 Number of community meetings conducted are 56 Estimated number of people reached are 2202 Number of Market sessions conducted are 49 Estimated number of people reached are 2439 Number of W.P.I sessions done are 221 Estimated of people at WPI are 1002

Awerial (Eastern Lakes) - - CHADO have conducted household visits, Mingkaman, Alel, Dor, community meetings, water-points and market Puluk, Bunangok, Nile, awareness sessions, schools and cattle camps Magok, Abuyong interventions in the six payams of Awerial county i.e. Nile, Puluk, Bunangok, Abuyong, Alel, Magok and Dor

Weekly summary Households reached are 1198 Estimated number of people reached are 3801 No Cases identified 0 No Cases referred 0 Number of schools reached are 0 Number of pupils reached are 0 Number of community meetings conducted are 63 Estimated number of people reached are 973 Number of Market sessions conducted are 82

16 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) Estimated number of people reached are 973 Number of W.P.I sessions done are 78 Estimated of people at WPI are 766 Number of Cattle Camps Intervention are 0 Estimated No of people reached are 0

Still in Yirol East, SSRC cover 500 house hold with health education, demonstration of ORS, Pur, and Homemade ORS. Also cleanup campaign was done in Yirol town. Distribution of 1000 ORS, 7000 PuR, 500 soap, that was for two weeks from 28 August to 8 Sept 2017. Yirol West (Eastern Lakes), - CHADO, SSRC and CHADO have conducted household visits, community - Abang Payam, Anuol Payam CHD meetings, water-points and market awareness sessions Yirol Centre (Town), Geng- and schools in six out of seven payams of Yirol West Geng Payam, Geer Payam, county i.e. Yirol center, Abang, Anuol, Aluak-luak, Geer, Aluak Luak Payam, Geng-geng and Mapuordit payams. Mapuordit Payam Weekly summary Number of Households reached are 763 Estimate number of people reached is 2546 No Cases identified 0 No Cases referred 0 Number of schools reached are 0 Number of pupils reached are 0 Number of community meetings conducted are 66 Estimate number of people reached are 786 Number of Market sessions conducted are 50 Estimate number of people reached are 1492 Number of W.P.I sessions done are 127

17 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) Estimate of people at WPI are 987

Public awareness campaign in ban Kuman (Maban) Cholera session in Kiitwut in (Renk)

Cholera session in Kwai in (Renk) Cholera session conducted to children in Melut town

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Hygiene session with CFS children Prevention message awareness in Melut

Contacts Dr. Mathew Tut Dr. Joseph F. Wamala Director, Emergency Preparedness and Response Epidemiologist Ministry of Health, Ministerial ComplexJuba, Republic of South Sudan World Health Organization Email: [email protected] Ministerial Complex Juba, Republic of South Sudan Email: [email protected]

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