UNICEF South Sudan Cholera Situation Report, 31 August 2017

Report
from UN Children's Fund
Published on 31 Aug 2017

Highlights

• Malnutrition rates remain high as South Sudan approaches the end of the lean season, with the number of people targeted for humanitarian assistance in 2017 having increased from 5.8 million to 6.2 million as per the mid-year review of the Humanitarian Response Plan (HRP). UNICEF dispatched US$ 2.3 million worth of nutrition supplies in August to address the current critical situation.

• The month of August has seen high levels of insecurity in the country, with fighting reported in all states of Greater Upper Nile and Greater Equatoria leading to population displacement. UNICEF is providing support to internally displaced populations through static programmes, outreach and the Integrated Rapid Response Mechanism (IRRM).

• Following high incidence of cholera in the first half of 2017, the number of reported cholera cases has been on the decline in the month of August. As at 20 August, 15,882 cholera cases and 274 cholera-related deaths have been reported in 2017, with a case fatality rate of 1.7 per cent. UNICEF and partners continue to provide critical cholera prevention and response in key hotspots across the country.

Situation Overview & Humanitarian Needs

The security situation and humanitarian context remained unstable during the month of August, with intense clashes recorded in Upper Nile State and fighting reported in Greater Equatoria, Jonglei and Lakes states. Displaced populations continue to cross the border into neighbouring countries, with the number of South Sudanese refugees in Uganda now having passed one million people, out of a total of 1.97 million South Sudanese refugees in the region. Children and women constitute an estimated 85 per cent of the refugee population. Overall, the number of people targeted for humanitarian assistance in 2017 has increased from 5.8 million to 6.2 million, with needs constantly rising as humanitarian actors continue to stretch their limited resources to provide necessary assistance. The nutrition situation in the country remains critical as the country approaches the end of the lean season.

Following the mid-year review of the South Sudan Humanitarian Response Plan (HRP), the most significant changes will be in the Food Security and Livelihoods sector, which has increased the number of people targeted by partners from 4.8 million to 5.7 million in light of the most recent Integrated Phase Classification (IPC) results that found six million people to be food insecure.
Five SMART surveys conducted during the reporting period showed global acute malnutrition (GAM) rates above the World Health Organization (WHO) 15 per cent emergency threshold in the counties of Aweil Centre, Northern Bahr el Ghazal (23.3 per cent); Malakal, Upper Nile (15.2 per cent); Bor South, Jonglei (16.1 per cent); and Kapoeta North (17.3 per cent) and Kapoeta South (16.9 per cent), Eastern Equatoria. A significant deterioration of the nutrition situation in Malakal Protection of Civilians (PoC) site, Kapoeta North and Kapoeta South was noted during the lean season (April – July) as compared to the same season in 2016. Outbreaks of acute watery diarrhoea and cholera have been attributed to the high GAM rates in Kapoeta North and South. The crude mortality rate in Kapoeta South was found to be above the emergency threshold of two deaths per 10,000 people per day, which is mainly attributed to cholera-related deaths.

The trend in the number of cholera cases reported in the past four weeks has been on the decline, with only 102 cases reported in the first week of August compared to 219 cases in the first week of July. Active transmission is currently ongoing in Eastern Equatoria (Kapoeta South, Kapoeta East and Kapoeta North), Warrap (Tonj East), Lakes (Yirol East and Yirol West), Jonglei (Nyirol, Ayod and Duk) and Central Equatoria (Juba). As of 20 August 2017, 15,882 cholera cases and 274 cholera-related deaths have been reported, with a case fatality rate of 1.7 per cent. Since the beginning of the current outbreak in June 2016, South Sudan has seen more than 19,846 cases of cholera and 355 deaths. Six new cases of measles were reported in August, with total of 1,025 measles cases and 24 deaths recoded in 2017 (case fatality rate at 2.3 per cent).