UNICEF Uganda Humanitarian Situation Report - August 2019

Report
from UN Children's Fund
Published on 31 Aug 2019

Highlights

  • According to the Office of the Prime Minister (OPM) and UNHCR, over 7,500 new refugees arrived in Uganda in August from South Sudan, Democratic Republic of the Congo (DRC), and Burundi, bringing Uganda’s total refugee and asylum-seeking population to 1.33 million.

  • UNICEF continues to provide basic medicines and services to refugee and host communities that includes; vitamin A supplements to over 27,000 children and Child Friendly Spaces (CFS) for nearly 900 children.

  • Uganda experienced a new cholera outbreak in Nakivale refugee settlement, Isingiro district, which resulted in one death. UNICEF has distributed critical supplies to help curb transmission during the outbreak.

  • On 29 August, an imported case of Ebola Virus Disease (EVD) was confirmed in Kasese district. A 9-year old girl was identified at the point of entry and died on 30 August. The risk of importation of EVD cases from the DRC remains high, due to a highly mobile population across the porous border with Uganda.

  • UNICEF continues to intensify risk communication and social mobilization activities, as well as interventions on Infection Prevention and Control (IPC) through WASH, child protection, and nutrition. UNICEF and partners reached an additional 577,000 people through direct interpersonal engagement during house-to-house visits and community meetings in 10 high-risk districts.

Situation Overview and Humanitarian Needs

Refugees
Uganda continues to host the largest number of refugees in Africa, with over 1.33 million refugees and asylum-seekers within its borders, according to UNHCR and the Office of the Prime Minister (OPM). Nearly 843,000 are from South Sudan, 376,000 from the Democratic Republic of the Congo (DRC), 43,000 from Burundi, and nearly 70,000 from Somalia, Rwanda, and other nearby countries. Sixty-one per cent of Uganda’s refugee population—or over 812,000 persons—are children. The average daily influx in August included 26 persons from South Sudan and 191 from the DRC, compared to July arrivals of 30 and 209 respectively. A site assessment by OPM and UNHCR is being finalized to determine the capacity of settlements to absorb new refugees amidst reports that some settlements are nearing full capacity.

Disease Outbreaks Ebola Outbreak:
Uganda remains at high risk for the importation of EVD cases from the DRC due to the frequent movement of people across borders due to trade, family ties, fleeing violence, and in the case of EVD, an increasing number of contacts either seeking treatment in Uganda or escaping contact-tracing. On 12 August, a male patient who had been admitted to a border health facility in Uganda was confirmed positive for EVD upon his return to the DRC. He recovered in Butembo. On 29 August, an imported EVD case was reported in Uganda involving a 9-year-old girl from the DRC who was detected during routine screening at Mpondwe Point of Entry (POE) and referred for management at the Bwera Ebola Treatment Unit (ETU) in Kasese, where she died on 30 August. Upon request from the DRC, the body of the girl and five contacts were repatriated.
On 29-30 August, the MoH organized the After-Action Review (AAR) for the 6th EVD outbreak experienced in Kasese district in June. The AAR aimed to evaluate the performance of the different EVD response pillars, while identifying gaps and lessons learned to inform future preparedness and response activities in Uganda. The review was supported by WHO Regional Office for Africa, UNICEF Eastern and Southern Africa Regional Office, and Centers for Disease Control and Prevention (CDC).
Overall, the AAR confirmed a coordinated response that enabled rapid containment of EVD transmission in Uganda.
Identified gaps and recommendations for action will be elaborated in the final report.

Cholera Outbreaks: In August, Uganda experienced a new cholera outbreak in Nakivale refugee settlement, Isingiro district.
On 7 August, the 19-year old male index case was admitted into care with acute watery diarrhea, later confirmed as cholera, and died the following day. As of 27 August, a total of 104 cumulative suspected and confirmed cases were identified. The drivers of the outbreak are associated with poor water, sanitation and hygiene (WASH) services, low access to clean water and latrines, and limited surveillance for easy detection and response. The Ministry of Health (MoH) and District Local Governments (DLG) in districts recently affected by outbreaks (Isingiro, Bududa, Kyegegwa and Kisoro) have intensified health education for hygiene promotion, with an emphasis on hand-washing, using safe water, and strengthened coordination

Measles Outbreaks: Uganda continues to experience a generalised measles outbreak driven by sub-optimal community mobilisation for vaccinations along with sporadic stock-outs of measles vaccines at the district level. Between January and August, over 16,200 cases and 51 deaths have been reported, with 1,214 cases and 1 death registered in August.

Malaria: In August, the MoH reported a significant increase in malaria cases in Uganda. Based on the latest HMIS data available, the total number of recorded cases in July 2019 (1,731,701) increased by more than 80 per cent compared to the same month in 2018 (948,136). Malaria admissions have also increased by over 80 per cent from 46,539 in July 2018 to 84,993 in July 2019. Malaria in pregnancy admissions have increased by 44 per cent from 5,957 in July 2018 to 8,576 in July 2019. Malaria-related deaths increased more than twofold from 284 deaths in July 2018 to 710 deaths in July 2019. Over 70 per cent of these deaths occurred in children under 5 years of age.