HIGHLIGHTS WHO South Sudan staff transfer patients from a plane in to awaiting ambulance. The patients were evacuated from jonglei state to Juba Teaching hospital. In week 34, WHO: Supported the central ministry of health and the state ministry of health, Jonglei state to evacuate victims of inter tribal conflict to Juba Teaching hospital, Malakal and Bor hospitals. Conducted mass immunization of returnees from north Sudan Supported training of health and community health workers from different states on AFP surveillance.
1. Public health issues A total of forty seven new suspected measles cases were reported during the reporting week, the majority of which are from Western Bahr el Ghazal (WBGS), Northern Bahr el Ghazal (NBGS) and Warrap States. Blood specimens were collected for further investigation and shall be forwarded to reference laboratory in Nairobi. There were reported rumours of acute jaundice syndrome from WBGS. Two new suspected cases of cutaneous anthrax and one suspected case of intestinal anthrax were also reported during the week from WBGS. 2 AFP cases were notified from Unity, one was from Leer and another from Myadit 2. Security situation The security situation in the country was generally tense during this week following inter tribal clashes in Jonglei state in which over 350 people were killed and hundred others seriously wounded. 3. Coordination and emergency preparedness and Response During the week: 1. A total of 1552 individuals were reported to have arrived to WBGS from Khartoum. These returnees are currently being acaccommodated in one of the big stores. 365 HHs with 1167 individuals were verified as returnees during the reporting period. 2. WHO continued working closely with the state ministry of health to coordinate health services to the returnees by providing them with drugs. 3. In Lakes states, sixty one households containing two hundred and four individuals are confirmed to have remained in the Rumbek Centre way station while the rest continued to
Wau. No morbidity & mortality report have been received from organizations working in lakes state this week. 4. WHO lead the assessment team for the medical evacuation of victims of inter tribal clashes in Uror county in Jonglei state. 5. In Warrap state, WHO participated in the interagency coordination meeting during which health partners were briefed of all health activities conducted by the organization at the state level and on the preparations on the measles follow up campaign that is planned for in the coming weeks. 4. Communicable diseases. Disease surveillance update During the week: 1. A total of 21 576 new suspected malaria cases were recorded across South Sudan during this week with many health facilities still recording increased number of cases. Of the 21,576 cases, forty percent were children below five years and sixty percent adults. The majority of the cases were recorded in Central Equatoria State, Western Equatoria State, Warrap and NBGS. WHO together with MoH and other partners are responding to the malaria outbreak in the states and counties by sending additional anti-malaria drugs, testing kits, treated mosquito nets and other required support. Accordingly to the Pharmaceutical department, there is severe shortage of anti-malaria drug in the country, however, MoH- RoSS and WHO avails emergency stock which will be sent to high risk states mainly those hosting more returnees or displaced people. In the mean time, WHO has been requested to procure emergency anti-malaria drugs and testing kits that will assist in addressing the ongoing malaria outbreak and the reported gaps from now until December 2011 and beyond. 2. Nine suspected meningitis cases, all of them adults were reported in Mvolo county. Investigations by the state rapid response team is ongoing. So far, no Cerebral Spinal Fluid has been collected but the situation is closely being monitored.
3. Fifty seven new suspected cases of measles with no death were recorded across south Sudan, mainly in the states bordering north Sudan. The states that reported an increase in numbers include; NBeG, WBeG, Unity and Warrap States where thousands of returnees and displaced people are settled in temporary camps Eighty percent of all the new cases were children below five years with no history of measles vaccination. In response to the increased incidence of measles, WHO is currently supporting the state health authorities and partners to implement measles vaccination campaigns targeting all children below five years. 4. One hundred and forty one new cases, 14(Relapse/PKDL) and 2 deaths of Kalaazar were reported from 16 out of the 24 facilities with 715 patients in 16 treatment centers. There is an increased vulnerability to infection due to mass movement following pockets of insecurity and influx of returnees from the north with low immunity. There is a false cumulative decline in the number of cases this week compared to same period last year as shown in graph above caused due to under reporting and limited movement by the kala azar patients resulting from insecurity. Old Fanga hosted almost 50% of all the Kala-azar cases this week. 5. WHO supported EPI outreach activities in Ju-River and Wau counties. During the outreach 1457 children were vaccinated against Measles and 565 received OPV-3 and DPT-3
5. Capacity Building 1. During the week, WHO supported the sensitization and orientation of thirty three county level health cluster partners and seventeen teachers and students from a secondary school in Kuajok town in Warrap state on AFP case definition, detection and reporting. While in WBGS, sensitization of 9 medical doctors on AFP surveillance from Wau hospital was conducted. A polio team member gives measles and OPV vaccine to a returnee child in Wau recently. 2. In Western Equatoria state, a training of sixty eight community health workers, field assistants, EPI supervisor, cold chain assistant, vaccinators and IDSR personnel on AFP surveillance & EPI related topics was conducted. The trainings took place in Nzara, EZo & Tambura Counties. 3. In Lakes states, four health facilities were visited from which five nurses were sensitized on AFP surveillance. The facilities visited include: Diakonie Primary Health Care Centre (PHCC), Rumbek hospital, Maeelser& Across P H C C in Rumbek and Yirol West Counties. 4. In Juba Teaching Hospital, the programme conducted an active case search in, Alsaba Children Hospitals& 3 PHCC in Nyokuron, Gurea and Usratuna and an advocacy meeting conducted for 7-Peadiatric Nurses & 3 Medical Assistants.
6. Plan for next week During the week, the program plans to; 1. Continue monitoring kala-azar trends and advocate for the timely submission of the weekly/monthly reports. 2. Continue holding coordination meetings with all partners to monitor, evaluate and address challenges facing the program. 3. Strengthen kala-azar data base and case based findings as essential tools to analyze and compare different variable of statistic significant, and 4. Monitor the malaria situation and advocate for the availability of more mosquito nets and drugs to high risk states. 7. Acknowledgments: The progress achieved by WHO/EHA South Sudan was made possible through contributions from the following partners: For further information, please contact: Dr. Allan Mpairwe, Emergency Cocoordinator, Email: mpairwea@nbo.emro.who.int or Ms Pauline Ajello, Communication Officer, Email: ajellop@nbo.emro.who.int