Public health risk assessment and interventions: Conflict and humanitarian crisis in South Sudan
Since its independence, the Republic of South Sudan has experienced internal conflict which has begun to deteriorate into a civil war. On 15 December 2013, there was an armed confrontation in the presidential palace in Juba between army officers loyal to President Salva Kiir and soldiers backing his ex‐deputy Riek Machar. There are reports that thousands have been killed in the civil unrest and tens of thousands displaced along ethnic lines, leading to the current humanitarian crisis.
As of 10 January 2014, the number of people reported displaced by the crisis in South Sudan was up to 201 000, including 60 000 sheltering in ten UN peacekeeping bases. Seven of the ten States are affected by the current wave of armed violence with the most affected being Jonglei, Unity and Upper Nile Sates.
The number of people who need life‐saving assistance such as health care and protection is deemed to continue to increase and the UN foresees a further increase in population displacement (up to 400 000 displaced) in the following weeks.
Priority populations are: children under five years of age, women who are pregnant or of childbearing age, people vulnerable to violence and sexual or gender‐based violence (SGBV).
Principal health issues:
a. Wounds and injuries as a direct result of violence.
b. High burden of communicable diseases such as malaria, pneumonia, and diarrhoea (the top three causes of childhood death).
c. Risk of disease outbreaks related to lack of safe water, poor sanitation and hygiene, overcrowding, and poor vaccination coverage.
d. Malnutrition: especially in infants and young children, leading to increased and more severe disease.
e. Reproductive health (especially complications of pregnancy, safe delivery and acute newborn care).
f. Sexual and gender based violence and sexually transmitted diseases g. Mental health and psychosocial conditions h. Poor access to health services due to attacks on patients, health care workers, and health facilities, and severe shortages of health staff.
i. Major disruption in medicines supply chain, including for treatment of trauma, obstetric care, infectious diseases such as malaria, tuberculosis, leprosies, and chronic conditions.
j. Poor infection prevention and control in health care facilities.