- Days of torrential rains in last days of July 2008 has brought one of the worst floods in years to the Northern Bahr El Ghazal State (NBGS), mostly Aweil centre, Aweil East, Aweil West and Aweil North counties.

- Flooding has overstretched the capacity of existing health services in NBEG to respond to the emerging health needs of the flood affected population. Emergency health conditions continue to be a serious challenge with health service coverage in the flood affected areas being very low before the onset of the flood. Very few health facilities are functioning in the flood affected areas and many others do not have supplies.

Coordination and Collaboration

On August 4th, 2008, the Ministry of Health received the information on increased cases of acute watery diarrhea and malaria in Aweil town and other counties due to the on-going floods. In consultation with health partners and WHO, the MOH-GoSS dispatched a technical team to investigate the reported outbreak in NBGS. The team conducted the following activities:

- Training of trainers on surveillance, cholera/malaria case management, infection control and health education targeting key health personnel.

- Technical assistance to State Surveillance officer on ways to improve the surveillance network and placing active case findings within Aweil town.

- Medical supplies and Information, Education & Communication (IEC) materials were delivered to SMOH, and assisted the distribution of these medical supplies donated by MOH-GoSS and WHO to health facilities in the affected communities (one diarrhoea kit, one emergency health kit, 1,000 insecticide treated nets (ITNs), 96,000 waterguards, 30,000 doses of Anti malaria (ACT+SP) drugs, anti snake venom, anti rabies, tetanus immunoglobulin, ringer lactates and ORS).

- 11 stool specimens were collected for bacteriological analysis.

- Assessed different water sources and sanitation level in Aweil town and surrounding areas.

- Surveillance tools and cholera & malaria treatment guidelines were distributed to health facilities in collaboration with State Surveillance officers.

- WHO/MoH-GoSS are closely monitoring the situation with the support of UNOCH;

Water & Sanitation

- Majority of the State residents are drinking water from the river and very few boreholes are available.

- The floods have damaged or contaminated various water sources in the state.

- Inadequate safe drinking water in most of the flood affected villages.

- Very few houses have latrines and people do not use latrine and tend to defecate outside.

- MSF-F is currently providing safe drinking water to displaced people in Maper Akot camp.

- UNICEF, Midair and other organizations are in the process of assessing the current water situation in the flood affected areas and address the needs.

Flood Affected Areas and Population Estimates

According to SRCC assessment, affected areas include:

- Aweil Town (Naivasha, Malan Awel, Block 9/10, Hain Torch and Hai Salama).

- Aweil East (Mayum Akot, Akuem, Peth, Adoor, Hong Thok)

- Aweil West (Aweet, Wedwil).

- Aweil North (Wathok, Mayam Ulem and Wenalel).

- In Aweil town, most displaced people were moved to Maper Akit which is highland.

Estimated displaced people in Aweil town (based on SRCC assessment):

- 5,292 households were affected in Aweil town

- 22,424 individuals were initial affected

- 2, 788 individuals are presently at Maper Akot camp.

-  Many other displaced people have moved along the railway road and the main road to Wau.

- Displaced people in Aweil East, West and North counties are still unknown due to continuing difficulties associated with lack of land-access to the affected localities and shortage of boats to cross the river or transport relief.

Disease Outbreak

- Since July 29th until August 10th, 85 cases of acute watery diarrhea were recorded in Maper Akot CTU, Akuem CTU and Wathok CTU. 95% of cases were adults and 80% of them were females.

- Maper Akot CTU and Wathok CTU were supported and managed by MSF-F and they received over 70% of cases. Maper Akot CTU is serving the Aweil town, Aweil east and other locations.

- The case fatality rate from all three centres was 14%. However, there were other deaths reported by the communities in Aweet, Wathaleel and Akuem, since they were not confirmed, it was decided to exclude from the surveillance data. fuirthermore, WHO is planning to preposition additional medicines & supplies in other flood prone States which are Jongeli, Upper Nile, Lakes and Warrap.