WORLD HEALTH ORGANIZATION SOUTH | WEEKLY REPORT | WK 2 | 10 - 16 JANUARY 2011

WEEKLY HEALTH UPDATE

10 - 16 JANUARY 2011 | WEEK 2 Photo: © Harish Murthi/ WHO

RETURNEE UPDATE IN SOUTH SUDAN BY STATE HIGHLIGHTS | WEEK 2

• The overall situation in southern Sudan – both security and political – has remained relatively calm.

• Voting at polling stations in all ten states is ongoing in an organized and peaceful manner; however, sporadic incidents of clashes have been reported in some areas, especially in-and-around the Abiyei region and Upper

UNITY: 47,679 Nile State.

NORTH BAHR EL GHAZAL: 39,760^ • The number of returnees entering southern Sudan is : 35,558^ observed to be steadily increasing, with a vast majority : 24,390 settling into areas bordering north Sudan –concentrated : 16,107 mainly in , Upper Nile, North Bahr el Ghazal and WEST BAHR EL GHAZAL: 8,766 Warrap State. JONGLEI: 5,230 : 2,742 182,446* RETURNEES HAVE BEEN : 1,427 REGISTERED ACROSS SOUTH SUDAN : 787

*SOURCE: IOM/ UN OCHA: Contains only verified IOM data. Figures as of 11 January 2011 ^ Unverified case-loads according to IOM (Upper Nile 2,045 and NBeG 1,166) SOUTH SUDAN | WEEKLY REPORT | WK 2 | 10 - 16 JANUARY 2011 WORLD HEALTH ORGANIZATION

PUBLIC HEALTH CONCERNS

• Nine suspected cases of Yellow fever (AJS) have been reported in Eastern Equatoria (5 suspected cases) and Central Equatoria State (4 suspected cases). Investigation has been carried out and specimens have been sent for laboratory analysis.

• In Upper Nile State, the Nasir Hospital has reported six cases of AJS (Acute Jaundice Syndrome), with the death of two pregnant women. Initial results tested positive for hepatitis E; however, more samples have been taken to confirm the diagnosis. The condition of the remaining patients is closely being monitored by WHO, the State Ministry of Health and MSF Holland. Photos: © WHO South Sudan • Currently, the number of patients receiving treatment for kala azar stands at 1300 cases, spread-out across 18 treatment centers in the region. The new KA treatment center in Renk has managed to contain the previously reported surge at the Melut PHCC – most of these cases were military families from northern Photo: © Harish Murthi/ WHO , who have since then been re-posted to Renk.

The current cumulative analysis of the YTD data indicate:

1 9,837 patients have been treated, of which 9,090 (92%) were primary KA patients; 4,092 (42%) were children un- der-five; 3,354 (34%) were aged between 5-17; and 2,391 (24%) were over the age of 17 – the total number of male patients stands at 5,319 (59%).

2 4,627 (47%) patients were treated at the Old Fangak KA treatment centre, and the remaining 5,210 were treated at other facilities.

3 Patient exit data and figures for treatment outcome from the Old Fangak Treatment Centre are currently unavail- able. Data from other treatment centres are projected in the following figures: • 3,922 (87%) patients have been discharged/cured;

• 273 (6%) of deaths were facility-specific rates, ranging from 1-15%; and 195 (4%) were treatment defaulters. Photo: © Allen Mpairwe/ WHO Photo: © David Gough/IRIN

2 Continued next page >> HIGHLIGHTS OF WEEK 35 (Continued)

WORLD HEALTH ORGANIZATION SOUTH SUDAN | WEEKLY REPORT | WK 2 | 10 - 16 JANUARY 2011

• A total of 71 cases of measles (CFR 4%) have been line listed in , Unity state. This follows confirmation of four cases of measles reported in the previous week. Majority of the cases are returnees, and 95% of reported cases had no history of vaccination – the SMOH, WHO, UNICEF, Medair and MSF-Swiss are responding to the situation to contain the measles outbreak.

• In Warrap State, suspected cases of measles are still being reported in Town, where the majority of returnee population is stranded in transit camps. The SMoH is closely coordinating vaccination campaigns in partnership with WHO,UNICEF, GOAL, MSF Belgium and County Health Departments.

• In North Bahr el Ghazal State, no major health events have been reported, and routine vaccination activities continue to be Photos: © WHO South Sudan conducted at the Madauny and Apada returnee transit camps – both camps are located in Aweil Town. Photo: © Harish Murthi/ WHO HEALTH CLUSTER RESPONSE

In , a Health Cluster Coordination Meeting was held to discuss issues related to the ongoing health emergency response being conducted across southern Sudan. The main focus of discussion was the contingency plan for the post-referendum period; and the following highlights were deliberated upon:

• The implementation of action-points agreed by members of the Health Cluster need to be maintained, especially in Warrap and North Bahr el Ghazal State; and channels for information exchange and activity updates covering contingency plans need to be effectively coordinated, particularly activities pertaining to the delivery of basic health services for affected populations.

Continued next page >> 3 SOUTH SUDAN | WEEKLY REPORT | WK 2 | 10 - 16 JANUARY 2011 WORLD HEALTH ORGANIZATION

• A response strategy and preparedness plan for Yellow fever is currently being developed by the MoH and WHO. Currently the Government of South Sudan (GoSS) has 60,000 doses of Yellow Fever vaccines.

• In North Bahr el Ghazal State, IRC is supporting the State Ministry of Health in Awiel Town to implement PHC services in transit camps by providing mobile clinics.

• In Warrap State, WVI is supporting the management of common illness and MUAC screening for the returnees in transit camps, particularly at the Block 14 transit camp in Kuajok Town.

• Kala azar Treatment Centers in Upper Nile State are being supported by WHO, MEDAIR, MSF-Swiss and COSV in partnership with the State Ministry of Health.

• In response to seven new suspected cases of kala azar in Kakita Hospital, Eastern Equatoria State, WHO has dispatched test kits and drugs for the treatment of Leishamaniasis. This effort is being conducted in conjunction with the State Ministry of Health (EES) and County Health Departments (Kapoeta East).

• In Upper Nile State, MSF Holland is supporting three teams – each composed of 6 members – to provide services in transit camps located Town. These teams include 2 Nutrition Screeners, 2 Vaccinators, one Malaria Control and one Social Mobilization Specialist. Mostafah/ WHO Photo: © Yahia • ICRC, WHO and the State Ministry of Health conducted a joint training exercise for emergencies, mass casualty response and disease surveillance. The training was conducted in Malakal Town, and was attended by participants from five of 7 prioritized Counties (Malakal, Fashoda, Melut, Manyo & Panyikang). Mostafa/ WHO Photo: © Yahia

4 WORLD HEALTH ORGANIZATION SOUTH SUDAN | WEEKLY REPORT | WK 2 | 10 - 16 JANUARY 2011

CHALLENGES

• Shortage of Vaccines is reported in some states, particularly in Malakal, Upper Nile State – UNICEF is currently responding to this fill this gap.

• Some transit points still have inadequate shelter and water sources.

• More mobile medical teams are needed to respond to the increasing returnee population in Lakes, Warrap, Upper Nile and North Bahr el Ghazal State.

• Shortage of facilities to store emergency and medical supplies is reported in some states.

• Human resource capacity from the supply-side of the Government of South Sudan (GoSS), needs to be urgently addressed – an assessment conducted to evaluate the in-service pool of health

workers has reflected to be inadequate, especially on the ground. Photo: © Harish Murthi/ WHO

RECOMENDATIONS

• A strong coordination mechanism needs to be maintained at all levels of emergency and health response, to ensure effective delivery of humanitarian services and information sharing among health partners.

• Acceleration and routine vaccination targeted towards returnees and host communities needs to be scaled-up.

• Documentation of health and medical response needs to be maintained on a regular basis; and channels of communication with stakeholders needs to be enhanced, especially in Warrap, Unity, Upper Nile and North Bahr el Ghazal State

• Disease surveillance and response capacity needs to be further supported and closely monitored for the potential outbreak of infectious diseases. Mostafa/ WHO Photo: © Yahia

5 Photo: © Harish Murthi/ WHO Photo: © Peter Martell/IRIN

Report prepared by: Editorial Supervision:

Harish Murthi Dr. Allan Mpairwe Communication Officer Technical Officer/ EHA WHO South Sudan Office WHO South Sudan Office Email: [email protected]