On 15 May 2014, South Sudan's Ministry of Health declared a cholera outbreak in Juba, Central Equatoria State, after 18 suspected cholera cases and one death had been reported (Govt, 15 May 2014).
The National Cholera Task Force was mobilized, with UNICEF leading the WASH and Social Mobilization and Health Education working groups, while WHO is the lead for Case Management and Surveillance (UNICEF, 19 May 2014).
By 25 May, 586 cases including 22 deaths had been reported since the onset of the outbreak on 24 Apr (WHO, 25 May 2014).
By 11 Aug, the number of cases had increased to 5,697, including 123 deaths. Overall new cholera cases reduced from 825 in week 28 to 121 in week 32. (WHO, 15 Aug 2014)
By 12 Oct, a total of 6,141 cholera cases including 139 deaths had been reported. Overall, cholera was on the decline countrywide, with only two new cases reported in week 41. (WHO, 12 Oct 2014)
By the end of October, cholera had resurfaced in Eastern Equatoria's Lopa-Lafon County where new cases and deaths were reported, raising the cumulative number to 6,260 cases and 157 deaths (WHO, 31 Oct 2014).
No new cases were reported from week 47 onward. As of 14 Dec, the cumulative total stood at 6,421 cases including 167 deaths (CFR 2.60%) from five states and 16 counties. (Govt/WHO, 14 Dec 2014) According to WHO, the outbreak has subsided, but recurring outbreaks remain a concern and reflect the need for sustained prevention and control activities while addressing the underlying causes by ensuring consistent access to clean water. (WHO, 30 Nov 2014)
Forced recruitment and other grave child violations continue. Last week, 89 children were forcibly recruited from Wau Shiluk, however, it is believed that the number may be much higher. Some witnesses have noted that at least some of these children are receiving military training. Reports of forced recruitment in other parts of the country were also received this week and UNICEF and partners are now working to verify the number of children who may have been forcibly recruited and to advocate for their release.
Protracted violence in Unity and Upper Nile states results in displacement, casualties, and property destruction
Humanitarian agencies continue efforts to improve food security with the delivery of emergency food assistance
Health organizations confirm a cholera outbreak in Eastern Equatoria State
The humanitarian situation remains fluid and unpredictable with the health response concentrated in the Protection of Civilians (PoC) sites.
WHO prepositioned 42 metric tonnes of life saving drugs in the 10 states. The supplies are adequate to treat 208,400 people.
WHO participated in a rapid health assessment in Jal Payam, Jonglei State to assess the humanitarian needs of the affected population.
(IDP CAMPS AND SETTLEMENTS)
9 – 15 February, 2015
￼ - Completeness for weekly reporting in week 07 of 2015 was 81% compared to 93% for the corresponding week of 2014.
- Malaria, ARI, AWD, ABD and suspect measles are the top causes of morbidity among IDPs.
During week 07 of 2015, ARI was the top cause of morbidity among IDPs and registered a proportionate morbidity of 18% and incidence of 62 cases per 10,000 population.
The Ministry says a total of 43 cases have been reported to the Cholera Treatment Center.
A rapid response team has increased surveillance. Hygiene promoters have also been trained and equipped with health education messages.
The Director General for preventive health services, Dr. John Rumunu, says that the main challenges faced by the team include access to affected areas, poor communication networks and weak health infrastructure.
When Margaret Dudu, a 30-year old mother of two, visited her mother in Gumbo on the outskirts of Juba, she intended to stay for a few days then return home and resume her life.
In 2015, thanks to the funds acquired from ECHO and the Common Humanitarian Fund PAH has the chance to carry out immediate aid activities in communities affected by natural disasters, conflicts and sudden outbreaks of cholera.
In 2014 the Emergency Response Team (ERT) carried out a total of 10 interventions, two of which took place in regions affected by outbreaks of cholera epidemics – Ikwotos and Juba, and two in UN IDP camps – Bor and Bentiu.
2014 in review
Médecins Sans Frontières’ teams were quick to respond to people’s needs in South Sudan after the onset of fighting in Juba in December 2013. The organization immediately started dispatching medical supplies and personnel to launch emergency response activities in critically affected locations. From 13 regular projects, MSF’s activities soon expanded to more than 20 projects in 9 states, to provide free healthcare to the most vulnerable people affected by the conflict.
When violence erupted in South Sudan at the end of 2013, tens of thousands of people fleeing the conflict sought refuge in United Nations bases positioned around the country in the hope that peacekeepers stationed there would protect them. The bases were quickly overwhelmed, with families crammed together with little or no access to safe water or sanitation.
Then the rainy season approached, increasing the risk of water-borne diseases, in particular cholera, which is endemic to the country – with the potential for explosive outbreaks in the congested camps.
Completeness for weekly reporting in week 06 of 2015 was 87% compared to 100% for the corresponding week of 2014.
Malaria, ARI, AWD, ABD and suspect measles are the top causes of morbidity among IDPs.
During week 06 of 2015, malaria was the top cause of morbidity among IDPs and registered a proportionate morbidity of 22% and incidence of 77 cases per 10,000 population.
Four new suspect measles cases were reported from Bentiu (1), Renk (2) and Duk (1).
Fighting in Cueibet County, Lakes State resulted in 36 deaths and 55 casualties.
Humanitarian partners are supporting the management of the wounded.
A shortage of blood and blood products has been reported across the conflict-affected states. There is need to step up campaigns that encourage voluntary, non-remunerated blood donations by the public.
Completeness for weekly reporting in week 51 of 2014 was 96% compared to 100% for the corresponding week of 2013.
Malaria, ARI, AWD, ABD, and suspect measles are the top causes of morbidity among IDPs with children under five years being more affected than persons five years and above.
During week 51 of 2014, malaria registered the highest proportionate morbidity of 16.4% and incidence of 44 cases per 10,000 population.
Special points of interest:
o WES and Lakes had the highest completeness and timeliness respectively this epi-week 49.
o Total consultations reached 68,966 with 26,696 under 5 years and mortality of 15 recorded across the 10 states with seven (7) cases in the < 5 years age group.
o Thirteen (13) suspected Measles cases occurred in <5 years this week most in Aweriel (6)_LKS.
o No case of suspected Meningitis occurred for <5 yrs this week.
In 2014, with the generous support of our donors, UNICEF and partners have reached 880,000 conflict-affected children with essential, life-saving services. In 2015, UNICEF will appeal for US$ 165.6 million to expand services for 1.7 million children, with a focus on reaching the hardest to reach children and improving the quality and sustainability of services while leveraging opportunities to improve the dire situation for children across the country.
Completenes for wekly reporting decreased from 92% to 89% while timelines decreased from 50% to 3% in wek 49 when compared to wek 48.
During wek 49, ARI surpased malaria as the main cause of morbidity among IDPs with Malakal PoC having the highest ARI incidence folowed by Bentiu, Kodok, Awerial and Ogod.
During wek 49, Malakal PoC had the highest incidence for ARI, malaria, AWD and ABD.
Five suspect measles cases were reported from Lankien during wek 49.
Completeness for weekly reporting increased from 89% to 96% while timeliness increased from 3% to 49% in week 50 when compared to week 49.
During week 50, malaria re-emerged as the main cause of morbidity among IDPs with Malakal PoC having the highest malaria incidence folowed by Lankien, Renk, Tongping, and UN House.
During week 50, Malakal PoC had the highest incidence for Malaria and AWD while Bentiu had the highest ARI incidence and Akoka had the highest ABD incidence.