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South Sudan

Fadéla Chaib, WHO Spokesperson press briefing notes on the health situation in South Sudan

Briefer: Fadéla Chaib, WHO Spokesperson

WHO is concerned about the overall health needs of the people of South Sudan, especially the Internally Displaced People (IDPs) in Juba, Wau and other States as a result of the recent hostilities.

Coupled with the conflict, the country is battling threats to health due to outbreaks. This includes an ongoing cholera outbreak as well as measles and malaria cases. Limited access to health care services, safe water and sanitation, combined with poor hygiene practices, facilitates the spread of diseases such as malaria and measles, as well as acute diarrhoeal disease including cholera.

As of 30 July, a total of 586 cholera cases including 21 deaths have been reported nationwide. The majority of these have been recorded in Juba County, where an average of 35 new admissions is being recorded daily.

Nearly 30% of health facilities are not functional. Health workers are affected by both conflict and the current economic situation. Thus access to basic health services is severely restricted. Health facilities remain closed in large parts of South Sudan, especially in Wau.

In order to ensure that those affected have continued access to healthcare, a combination of mobile and fixed health units have been established in Juba.

Urgent funding is needed to respond to rising needs. WHO requires US$ 17.5 million of this total amount for 2016, of which US$ 4.3 million (25%) has so far been received. Without urgent funding, WHO and partners will not be able to implement most of the planned interventions.

WHO Response

WHO strategy aims to help not only the thousands who are living in IDP camps, but also the millions of people in the country who are currently deprived of basic life-saving health services. Donating medical supplies to treat the injured

WHO has delivered essential medicines and supplies to South Sudan, including surgical and intravenous infusions kits to save the lives of injured patients. On 16 July 2016, WHO provided anti-malarial, cholera and malaria testing kits, surgical and delivery kits, and tents to partners to Wau Teaching Hospital, and to Level-2 and Daniel Comboni Hospitals.

In response to the food security crisis, WHO has sent newly designed kits containing supplies for the medical management of severe acute malnutrition in children. Further supplies are on their way.

WHO has sent newly designed kits containing supplies for the medical management of severe acute malnutrition (SAM) in children.

Cholera

The case fatality rate for the current outbreak is high, which is likely to be a result of problems of access to health care. Currently, only the Juba Teaching Hospital has been designated as a Cholera Treatment Centre (CTC). At least 100 additional beds are needed to support the cholera response in the hospital.

Given the limited spaces at Juba Teaching Hospital to accommodate an increasing number of cases, preparations are underway to open a rehabilitation and stabilization centre at Al Sabah Children’s Hospital.

To increase access to oral rehydration therapy in Juba, 11 oral rehydration points have been set up in high transmission locations including: Nyakuron, Munuki, Gurei, Gumbo, Kator, Lologo, Mahad, Gorom, Al Sabah, Khor William, and El Giada.

Rapid response teams have been deployed to investigate new cholera alerts in Juba, Terekeka, Duk, and Malakal. WHO, together with the Ministry of Health and partners, is conducting an Oral Cholera Vaccination campaign that will initially target more than 14 000 people at the UNMISS Tongping transit IDP site, EL Giada, Gorom, and UN House PoC.

WHO, UNICEF and the MOH have developed cholera education materials for distribution in hotspots and for community engagement purposes. Messages are being aired on radio.

The risk of further spread of diseases is a major concern. With the coming rains, an increase in malaria and water-borne diseases is likely. WHO expects medical needs to increase in an already challenging environment.

Malnutrition

The nutrition situation in the country remains precarious; UNICEF estimates that about 600 000 children under-5 years are acutely malnourished.

WHO has introduced the first ever drug module kit for the management of Severe Acute Malnutrition and Medical Complications in children. The kit contains the most essential and basic medicine for the treatment of children with severe acute malnutrition and medical conditions.

The kit is a key strategy to support stabilization centres to manage Severe Acute Malnutrition (SAM) or Malnourished Children (MC), strengthening capacity to deliver effective and immediate nutrition and health response. The kits also provide a stop-gap measure for hospitals experiencing stock-outs of medicines.

Malaria

Since June 2016, South Sudan has reported 3316 case of malaria in Wau, Western Bahr El Ghazal State.

Malaria is the number one cause of morbidity in the country accounting for 54% and 39% of consultations in non-conflict affected states and IDP sites respectively. In recent weeks, malaria trends in Bentiu PoC and Northern Bahr el Ghazal have exceeded expected levels. WHO has despatched antimalarial drugs.

Measles

As of mid- July, 1564 suspected cases of measles haven reported with at least 17 deaths. Since the beginning of 2016, measles outbreaks have been confirmed in 12 counties. Most of the measles cases have been reported in camps for internally displaced people where families live in overcrowded conditions and many children are malnourished. WHO, with support from UNICEF and other partners, has vaccinated 13 029 people. A countrywide follow-up measles campaign is planned for November 2016.

WHO staff in South Sudan are working hard under difficult circumstances to reach affected populations with essential medical care and services. Nearly 100 staff members remain in the country to provide WHO support in various States.

What is Cholera?

Cholera is an acute intestinal infection caused by ingestion of food or water that has been contaminated with the bacterium Vibrio cholerae. It has a short incubation period, ranging from two hours to five days. Symptoms include copious, painless, watery diarrhoea that can quickly lead to severe dehydration and death if treatment is not promptly given.

Cholera is a virulent disease that affects both children and adults. Unlike other diarrhoeal diseases, it can kill healthy adults within hours. Individuals with lower immunity, such as malnourished children or people living with HIV, are at greater risk of death if infected by cholera.

Cholera prevention consists primarily of providing clean water and proper sanitation to populations who do not have access to basic services.

Strengthening surveillance and early warning is important to detect the first cases in an outbreak and to put in place control measures.

The risk of spread of cholera remains high in South Sudan due to increased population movement, crowded living conditions in camps which have inadequate basic services, low sanitation coverage, poor hygiene practices, malnutrition, food insecurity and anticipated flooding.

Visit the WHO website on South Sudan: http://www.who.int/emergencies/south-sudan/en/