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).
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.
● Calm returned in the Protection of Civilians (PoC) sites in Malakal, enabling partners to resume aid operations this week.
● Tensions remained high in the northern states of Jonglei, Unity and Upper Nile, where sporadic fighting has been reported.
● The third round of the nationwide polio immunization campaign reached 3,431,592 children aged 0 to 59 months, according to preliminary reports.
● The 16 Days of Activism against Gender Based Violence campaign was launched in some part of the country.
Médecins Sans Frontières/Doctors Without Borders (MSF) has more than 3,300 local staff and 350 international staff working in South Sudan. MSF is also running programmes to provide healthcare to the South Sudanese refugees in neighbouring countries as part of its response to the humanitarian crisis.
- The present report is submitted pursuant to Security Council resolution 2155 (2014), by which the Council extended the mandate of the United Nations Mission in South Sudan (UNMISS) until 30 November and requested that I report on the implementation of the Mission’s mandate every 60 days. The report provides an update to my previous report (S/2014/708), dated 30 September 2014, covering developments from 24 September to 24 November.
UN Assistant Secretary-General for Humanitarian Affairs, Kyung-wha Kang, concluded a three-day mission to South Sudan, calling on all parties to the conflict to respect their ceasefire commitments, and urged for more international support to enable humanitarians to scale-up and expand critical aid operations.
The security situation in the Protection of Civilians (PoC) sites in Malakal remained relatively calm, as community elders engaged the warring youth in a bid to defuse the tensions.
An immunisation campaign targeting more than 3.2 million children in all 10 states has been successfully completed in seven states. Efforts are underway to immunise children in the three conflict-affected states of Jonglei, Unity and Upper Nile.
Clashes in Malakal, raise concerns as gunshot wounds and other weapon-related injuries are the leading cause of mortality, accounting for 23% of deaths in the Protection of Civilian (PoC) site.
The deteriorating situation in Malakal Protection of Civilian (PoC) site is of great concern with the provision of humanitarian assistance significantly disrupted. Over the past weeks, insecurity has increased, with humanitarian staff threatened and assaulted when delivering services in the PoC, greatly affecting the provision of WASH, education and child protection services in the site.
Snapshot 12–18 November
Ethiopia: Waters have begun to recede from Leitchuor refugee camp in Gambella, but few refugees have returned to the camps so far, where alarming rates of severe malnutrition persist: 5.7% in Leitchuor, 7.8% in Kule, and 10% in Tierkidi. In SNNPR, flooding was reported, while in Oromia, water trucking has begun for populations affected by drought.
On 9 November, the Inter-Governmental Authority on Development (IGAD) facilitated the recommitment to the implementation of the Cessation of Hostilities Agreement of 23 January.
Escalating inter-communal tensions between the youth in the Protection of Civilians (PoC) sites in Malakal, Upper Nile State, continued to disrupt humanitarian operations.