Sudan Situation Report, 18 Sep 2019 [EN/AR]
As of 19th September 2019, Blue Nile and Sennar states of Sudan reported 124 suspected cholera cases with seven deaths reported.
According to the Ministry of Health, the states that have the highest risks of cholera outbreak are:
White Nile, Gedaref, Sennar, Kassala and Khartoum states.
Humanitarian partners have provided approximately 146,000 people with improved access to safe water and sanitation in Blue Nile.
The Sudan Humanitarian Fund (SHF) is allocating $7.6 million for the cholera and flood response under its Reserve for Emergencies envelope.
Response and Funding to Mitigate Cholera Outbreak in Blue Nile
As of 19th September 2019, localities in Blue Nile and Sennar States reported a total of 124 suspected cholera cases with seven deaths according to Sudan's Federal Ministry of Health and WHO. In Blue Nile the currently affected localities are: El Roseries (73 cases), Wad Amahi (2 case), and Damazin (25 cases), Bau (1 case). In Sennar state the affected localities are: Abu Houjar (15 cases), Singa (2 cases) and El Souki (6 cases). The current case fatality rate (CFR) in Sudan is 5.6 percent. With proper treatment, the case fatality rate for cholera should remain below 1 per cent.
The immediate actions taken by FMoH and health sector partners indicate that the current outbreak in Blue Nile State can be classified as an early detection and response scenario. In this scenario, there is a much better opportunity to prevent new cholera cases, avert deaths and save time and resources spent on overall response, if the response is sustained and there is immediate funding for it.
Currently, resource mobilization for cholera response in Sudan and preparedness in high risk states is a major challenge. The SHF is allocating $7.6 million under its Reserve for Emergencies envelope across all sectors
AWD and cholera response
The FMoH and WHO are working together to strengthen disease surveillance, provide medical treatment for patients, distribute laboratory supplies, monitor water quality and chlorinate public water supplies, and promote health education and hygiene among affected as well as at-risk communities. Two cholera treatment centres are serving patients in Blue Nile, and a dedicated isolation centre has been established for cholera case management.
FMoH, WHO and UNICEF have already provided acute watery diarrhoea (AWD) kits—enough to treat 300 people—with three additional kits in the pipeline. In addition, IV fluids (Ringer lactate)and oral rehydration therapy supplies have already been providedfor treatment of the patients. UNICEF is supporting eight Oral rehydration therapy points (ORT), to ensure the timely access of affected people to lifesaving rehydration. The timely clearance and movement of supplies will be critical to an effective response.
The State Ministry of Health (SMoH) in Blue Nile in partnership with UNICEF is supporting water chlorination activities and hygiene awareness in AWD-affected areas of Blue Nile at household levels.
Additional rapid response activities include house-to-house visits by nearly 700 community mobilisers, providing families with information about how to protect themselves by cleaning and storing drinking water safely, good hygiene and hand washing practices, keeping food safe, and on how to handle a sick family member.
Water chlorination activities are underway at eight water sources connected to the urban water network in both Ed Damazine and El Roseries towns. In addition, several open water sources have been chlorinated through volunteers who are working actively at the intake area and other open sources. The volunteers managed to chlorinate 1,340 donkey carts and 5,200 jerrycans at water sources. New water sources have been installed to provide better water service to people in affected areas, with over 146,000 people now having improved access to safe water and sanitation in Blue Nile alone.To monitor and contain the outbreak, WHO has surged a team of public health experts to Blue Nile State; other international experts will soon follow.
Community Engagement and Prevention
Efforts to implement a communication strategy at the national level and in Blue Nile to empower the community are being ramped up. The health promotion department in SMoH and humanitarian partners are carrying out advocacy campaigns to raise awareness and promote prevention activities. UNICEF’s Communication for Development C4DSection is training 1,400 volunteers in seven states. The training is focusing on the integrated strategy for water related diseases and long-term impact on behavioural change.
In Blue Nile, four mobile cinema shows reaching 370 people were staged, five theatre shows reaching 1,420 people,and 16 health awareness messages were broadcast through radio. The total number of beneficiaries from radio messages represent 75 per cent of the state population (873,750). In addition, 22 public sessions were conducted reaching 465 people and informational materials were distributed to 51,135 people.
WHO commends the new Government of Sudan with regard to transparency and full implementation of the international health security measures and protocols—a critical step to containing the disease.