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)
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.
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.
In this issue: The health response to the crises in South Sudan and Pakistan. WHO marks the one year anniversary of super-typhoon Haiyan
Fighting in Cueibet County, Lakes State resulted in 21 deaths and 5 casualties.
Humanitarian partners are treating the wounded.
Seven suspected meningits deaths were reported in Longochuk County, Uper Nile State in November. A verifcation exercise was conducted.
Visceral Leishmaniasis (kala-azar) cases and deaths rose to 7,204 and 19 (CFR2.76%) respectively.
To date health partners have conducted 4,056,047 medical interventions since December 2013.
More than 3.4 milion children under-5 years were vacinated against polio during the National Immunisation Days (NID) in November, surpasing the 3.2 milion target. Meanwhile, the final round of NIDs for 2014 tok place from 2 to 5 December.
The first round of a polio immunisation campaign targeting children under-15 years in the thre conflict-afected states of Jonglei, Unity and Uper Nile began on 5 December.
• One year after the conflict began, children are still under daily threat in South Sudan. Over 1.9 million people, over half of whom are children, have fled their homes. The health system has been weakened, with outbreaks of polio, cholera and kala-azar reported. 400,000 children have been forced out of school and an increase in grave child rights violations were recorded over past years.
● Partners finalized the planning process for 2015. The Humanitarian Response Plan for 2015 seeks $1.8 billion to assist 4.1 million people.
● Fighting continued to be reported in Fangak, Jonglei State, displacing thousands of people to different locations.
● Tuberculosis, HIV and AIDS were the most common causes of death during the month of November in displacement and Protection of Civilian sites.
● Fourth round of nationwide polio immunization campaign reached 2,431,388 out of the targeted 3.3 million children.
Snapshot 3–9 December
Philippines: Category 5 Typhoon Hagupit, locally known as Ruby, made landfall on 6 December over the town of Dolores in Eastern Samar province (Eastern Philippines). At least 49 of 81 provinces are potentially at high risk. The typhoon is moving very slowly, potentially subjecting each community in the path of the typhoon to high winds and torrential rainfall for much longer. 1.1 million people are affected.
Fighting continued to be reported in Fangak, Jonglei State, displacing an unverified number of people to different locations.
Polio vaccination campaign for children under 15 years old continued in Jonglei, Lakes and Unity states
More than 5,000 children are accessing education in Bentiu PoC, Unity State.
Refugees receiving education
Mosquito nets distributed to refugees in Yida since January
IDP families who received UNHCR NFIs since January
Semi-permanent shelters constructed for Sudanese refugees
Population of concern
A total of 1,594,208 million
USD 424,282,355 million requested
• Relative calm provided UNICEF and partners the opportunity to assess and begin an immediate response to the needs of IDPs in Bentiu town. Of 129 children screened for malnutrition, 2.3 per cent were suffering from severe acute malnutrition (SAM) and 10.1 per cent from moderate acute malnutrition (MAM). Children identified with malnutrition were referred for treatment.
Niger: 10,000 refugees arrived in Diffa region from Damasack, Nigeria. Most were fleeing forced recruitment by Boko Haram, and some unaccompanied children were reported. More than 105,000 people have arrived from Nigeria since May 2013, and the rate is increasing. The newly displaced are in a critical situation, and Diffa faces serious gaps in service provision.
AN OVERVIEW OF THE CRISIS
• Life-threatening needs driven by the conflict are made worse by extreme poverty and some of the world’s lowest levels of development indicators.
• Needs are most acute in areas with active hostilities or large numbers of people displaced.
• Chronic needs such as severe food insecurity, high rates of malnutrition, vulnerability to disease outbreaks and exposure to gender-based violence are also present in other parts of the country.
Eight suspected Guinea Worm Disease cases were reported in Malakal PoC in the last two months and are being investigated.
A cumulative total of 274 Acute Flacid Paralysis (AFP) cases have ben reported since January 2014.
Visceral Leishmaniasis (kala-azar) cases and deaths rose to 6,854 and 190 (CFR 2.8%) respectively.
By Chiran Livera, IFRC and Marial Mayom, South Sudan Red Cross
Providing clean water is essential during a cholera outbreak as it helps stop the spread of the disease through contaminated food and water. This is always done alongside promoting good hygiene and sanitation practices. During a recent cholera outbreak in South Sudan, the International Federation of Red Cross and Red Crescent Societies did just that, deploying a water and sanitation Emergency Response Unit to support activities being implemented by the South Sudan Red Cross.
Displacement increased by 1.4 million in region
The number of people displaced in the region has increased by 14 per cent in the last six months. By the end of September 2014, the total number of people displaced was 11,433,752 in Burundi, (eastern) Democratic Republic of the Congo (DRC), Djibouti, Eritrea, Ethiopia, Kenya, Rwanda, Somalia, South Sudan, Sudan, Tanzania, and Uganda. Of the total displaced population, 2,467,547 are refugees while 8,966,205 are internally displaced persons (IDPs) and people severely affected by conflict.