Sudan

WHO Country Office in Sudan: Darfur Weekly Progress Report, 5 - 11 Jun 2005

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Mortality Survey Highlights

Up to June 12, the amount of clusters finalized reached 75%: 100% in North Darfur and 65% in West Darfur and 60% in South Darfur.

Because of the deteriorating security situation in South Darfur, the interview teams have encountered problems accessing the previously selected clusters.

It is expected that the interviews and data processing will be completed by the end of June, depending on the security situation.

Outbreak information

Strong seasonal transmission of Bloody Diarrhoea is still continuing: a significant increase in reported case incidence from West Darfur has been reported, while incidence has marginally decreased in North and South Darfur.

12 new cases of clinically diagnosed measles were detected this week, mostly from South Darfur. Preparations are ongoing for the follow-up mass measles vaccination campaign in Greater Darfur, between WHO, UNICEF and the Federal Ministry of Health (FMoH).

Active case finding as well as case-based surveillance efforts have been intensified in West Darfur following detection of six new cases of suspected meningococcal meningitis in four camps of West Darfur for the first time during the last 22 weeks. The outbreak situation in Saraf Omra camp in North Darfur and Abu Suroj camp in West Darfur are showing signs of stabilization following vaccination campaign as well as other public health response packages.

There has been a marginal decrease of attack rate from Hepatitis E this week from Greater Darfur.

WHO tasks and programmes

Improved access to hospital care and referral systems

North Darfur

Rational Use of Drugs

The urgent drugs list from El Fasher Teaching Hospital that was requested is expected during the next week.

Rehabilitation of hospitals

Two more wells have been rehabilitated at El Fasher Teaching Hospital, while the rehabilitation of the septic tanks continues.

The Sudanese Red Crescent is building a new room for the waste disposal at El Fasher Teaching Hospital.

South Darfur

Rational Use of Drugs Action point

WHO is planning to set up a separate pharmacy for WHO drugs/supplies at Nyala Teaching hospital, as well as to directly hire a pharmacist and two assistants to carry out the necessary technical activities to ensure waiver free availability of drugs and other medical supplies for IDPs.

A dialogue between the health partners and the hospital's authorities on the assurance of waiver treatment for IDPs will be instigated.

Communicable disease control and surveillance & outbreak response

North Darfur

Hepatitis E

A slight increase in the number of cases of acute jaundice syndrome has been reported.

Meningitis

A total of four cases of suspected meningitis were reported, but not as yet laboratory confirmed.

Action point

An action plan for the improvement of basic laboratory services in El Fasher hospital is under discussion with the Federal Ministry of Health (FMoH).

Because of an expected increase in malaria cases in the coming wet season, WHO is following up on the distribution of Insecticide Treated Nets (ITNs) and Long-lasting Insecticide Nets (LLINs) to the most vulnerable population, in close collaboration with UNICEF.

West Darfur

Meningitis

One case of suspected meningococcal meningitis was reported from Abu Suroj IDP Camp in West Darfur, three weeks after the localized vaccination campaign which was organized by FMoH in collaboration with WHO and the NGO Medair. Because of security issues, the vaccination coverage achieved was 64%. Enhanced surveillance and close vigilance for active case finding are still continuing in the camp.

Action point

WHO is following up on two cases of suspected meningitis in Mukjar area through an intensified case-based surveillance system in order to detect any epidemiological link between these new cases and other confirmed cases reported from West Darfur.

South Darfur

Measles

Seven new cases of clinically diagnosed measles with no related death were reported from South Darfur. The majority of these clinically diagnosed cases were found to be clustered in El Seref camp

Action point

WHO, UNICEF and FMoH are planning a Follow-Up Immunization campaign in whole of Darfur in order to stop transmission of measles virus. In the meantime, efforts have been directed towards appropriate case management as well as strengthening routine immunization for measles in all the IDP camps in Greater Darfur.

Improved access to primary health care and environmental health

North Darfur

Access to Primary Health Care

The assessment of Reproductive Health (RH) services is continuing during the coming week in Tabit, Galab and Shangil Tobayi and Tawila. Agencies contributing to the assessment are the State Ministry of Health (SMoH), WHO, UNICEF and the NGOs IRC, SRC and Malteser.

Training on psychological counseling for 20 community health workers who will deal with Gender Based Violence (GBV) and HIV/AIDS has started. This training program is organized and conducted jointly by SMoH, WHO and UNFPA.

The NGO IRC has established a community base group for follow up on psychosocial care of post sexual violence survivors in Zam Zam Camp and will be initiating the same program in Abu Shoak soon.

A second group of medical assistants of El Fasher Hospital has completed the crash training on Standard Case Management of Integrated Management of Childhood Illness (IMCI). A total of 40 medical assistants are now trained by facilitators of FMoH and SMoH. At last, the 20 selected Primary Health Care facilities in IDP camps and El Fasher town count with the skills able to prevent and treat the 5 major killer diseases (malaria, malnutrition, ARI, diarrhea and measles) among children below 5 years of age.

West Darfur

Environmental health

The cleaning-up campaign for El Geneina town and surrounding IDP camps has been postponed until further notice. Preparations for the campaign are still ongoing and increased participation from the NGO community is being offered. The NGO Medair will coordinate the initiative, in close collaboration with SMoH, WHO, UNICEF, other NGOs and the locality.

South Darfur

Access to Primary Health Care

Another 19 medical assistants and two medical doctors from Kalma and Otash IDP camps were trained on IMCI in Nyala.

A three-day training on "clinical management of rape survivors" was carried out for 23 medical doctors from 11 IDP camps around Nyala. The training was facilitated by UNFPA in collaboration with WHO and SMoH. The training module used was the revised edition of the WHO Guidelines on "Clinical Management of Rape Survivors".

Environmental health

To control houseflies, filth flies and mosquitoes in Kalma IDP camp, a second round of spraying with deltamethrin inside human dwellings, shops, restaurants, animal shade, garbage and latrines was launched on the 31st of May. The activity is planned for 15 days.

Results of chemical and bacteriological analysis of water samples collected from 22 water points and 43 households in Kass IDP camp indicate that a number of samples had a high concentration level of Fluoride, that 5 water points were contaminated with faecal coli as well as 23 out of 43 samples collected at household level. Three samples had residual chlorine.

Malaria control activities in Kass IDP camps and host communities will be carried out soon as a joint initiative between the Water and Environmental Sanitation department (WES) through supply of insecticide (WES); and the NGOs Oxfam through the provision of ITNs/LLINs and IRC through the payment of incentives for spray operators. The IRC agreed to take the lead.

Further information:

Sacha Bootsma, Communication Officer
bootsmas@sud.emro.who.int