Emergency Preparedness & Humanitarian Action (EHA) Week 29, 16-22 July 2011 WHO and partners are preparing response activities as heavy rains threaten many parts of Darfur. Photo here shows rainwater in Kalma IDP camp, South Darfur. A total of 21 suspected cases of Acute Jaundice Syndrome (AJS) were reported from the 3 states of Darfur. There were 14 suspected Measles cases reported between 9 and 15 July from South Darfur. In Red Sea State, 22 suspected cases of Measles were reported from Port Sudan and Haya localities. Kassala State reported 3 suspected cases of Measles from the localities of Nahre Atbara and Rural Kassala. During the week, 3 deaths were reported from east Sudan due to severe Malaria and Kalaazar. In Blue Nile State, there was an increase in the number of cases during the week. Preparations are underway for the acute watery diarrhoea season in Darfur, East Sudan, South Kordofan and Blue Nile. During the week, WASH sector conducted meetings to look into the status of the diseases related to environmental health and deliberated on the preparations and plans for prevention and control measures. In South Darfur, a 2-day training course was conducted in Gereida targeting 30 hygiene promoters and community members on environmental health related diseases prevention and control. Forty (40) midwives from the localities of El Geneina and Garsilla will be inducted as part of the reproductive health support to West Darfur. In North Darfur, WHO continues its support to Zamzam emergency life saving activities including support for 5 fixed clinics and 3 mobile clinics providing health services to 136 000 old and new IDPs in the camp. In East Sudan, WHO and Kassala SMOH conducted a joint supportive supervisory mission at the health facilities in Telkuk localities, a relatively inaccessible area previously affected by conflict, and has been prone to drought. WHO s Emergency Preparedness and Humanitarian Action (EHA) in Sudan is funded by: Government of Finland
Page 2 Week 29 In West Darfur, a series of health sector meetings were conducted during the week to discuss preparations for the acute watery diarrhoea season. While WASH sector also held meetings to look into the status of the diseases related to environmental health and deliberated on the preparations and plans for prevention and control measures. In South Darfur, a 2-day training course was conducted in Gereida targeting 30 hygiene promoters and community members on environmental health related diseases prevention and control. The training focused on risk factors related to EH related diseases and ways of blocking the rotes of transmission through environmental measures focusing on diarrheal diseases and vector borne diseases. WHO briefed the UK Minister for Africa on the health situation in the Red Sea State during the Minister s visit to the State. Issues shared and discussed during the monthly UN agencies meeting were disease patterns in East Sudan and major activities of WHO including the supplies provided, the training of health workers and supportive supervisions conducted. During the monitoring and supervisory visit in the OPD department of El Fasher Teaching Hospital in North Darfur observed were overcrowding of patients and shortage of essential medicines, medical equipment and proper hygiene and sanitation. In response, WHO donated essential drugs including consumables estimated to cover 2000 IDPs. To enhance capacity of health staff of the hospital to guard themselves against Nosocomial infection prevention, WHO and the preventive medicine department of State Ministry of Health is planning to conduct a training workshop on infection prevention targeting 30 health staff from the hospital including those working in the outpatient department.
Page 3 Week 29 From 9 to 15 July, 87.3% of the total sentinel sites reported through EWARS. A total of 52 384 consultations were recorded during the week from 2 661 418 population under surveillance. A total of 21 suspected cases of Acute Jaundice Syndrome (AJS) were reported from the 3 states of Darfur (9 cases from South Darfur, 2 cases from West Darfur and 10 cases from North Darfur) compared to the 19 cases reported in the previous week. There were 14 suspected Measles cases reported between 9 and 15 July from Nyala North, Netiga, Edd Elfirsan and Abukarinka in South Darfur. In Red Sea State, 22 suspected cases of Measles were reported from Port Sudan and Haya localities compared to 7 suspected cases reported the previous week. WHO in collaboration with the Ministry of Health is preparing to conduct vaccination campaigns targeting children in affected areas of RSS. During the week, 3 deaths were reported from east Sudan. Two of these deaths were reported from Gedaref State, and were due to severe malaria and Kalaazar, and one death reported from Kassala State was due to severe malaria. In Blue Nile state, Malaria showed an increasing trend compared to what was reported last week. However, this is the same pattern which was reported in the same period in 2010, but to a lesser degree. Malaria attack rates reported this week in BNS varied in different localities. Geissan locality has reported the highest attack rate. Incidence rate (IR) per 10000 population of ARI, Bloody Diarrhoea & Malaria reported in Darfur from week 25 to week 28, 2011. Incidence rate (IR) per 10,000 populations of common diseases reported in East Sudan, week 25 to week 28, 2011. State D i s - ease S o u t h Darfur W e s t Darfur N o r t h Darfur Incidence Rate W 25 W 26 W 27 W 28 ARI 9.8 13.6 10.4 9.9 BD 3.4 5.1 4.2 3.5 MAL 3.6 8.5 5.7 5 ARI 19.2 16.6 19.7 14.8 BD 4.8 4.7 5.7 4.6 MAL 6 4.5 6.6 5.2 ARI 38 38 38 48.3 BD 2.1 2.1 2.1 2.1 MAL 2.9 2.9 2.9 2.7 State Kassala Gedaref Red Sea Disease Incidence Rate W 25 W 26 W 27 W 28 MAL 11.37 9.35 11.60 14.50 TB 0.10 0.10 0.11 0.09 Typhoid F. 0.40 0.2 0.28 0.42 BD 1.60 2.0 2.25 2.10 Bilharzias 0.30 0.3 0.60 0.47 MAL 13.7 5.01 14.80 13.98 TB 0.04 0.05 0.07 0.08 Typhoid F. 0.87 1.08 0.96 0.91 Kala-Azar 0.22 0.15 0.19 0.22 BD 4.37 5.01 5.07 4.73 Viral H. 0.02 0.02 0.01 0.01 MAL 2.70 2.06 1.91 1.81 Viral H. 0.07 0.06 0,04 0.06 BD 0.90 0.49 0.55 0.44 (DF) 0.01 0.0 0.01 0.00
Page 4 Week 29 After completing the midwifery course, 40 midwives from El Geneina and Garsilla in West Darfur will undergo orientation/induction sessions before deployment to health facilities in different villages in the State. Capacity building support including training of midwives is imperative in West Darfur s reproductive health programme. In North Darfur, WHO continues its support to Zamzam emergency life saving activities including support for 5 fixed clinics and 3 mobile clinics providing health services to 136 000 old and new IDPs in the camp. WHO supports the SMoH mobile clinic in Gabr AlGhanam village in North Darfur. The clinic is providing services to more than 13 000 people who arrived in the area in search of gold through gold panning, or the manual technique of sorting gold from sand and gravel. To improve and strengthen the skills of healthcare providers in areas of diagnosis, management and understanding the epidemiological nature of leishmaniasis disease, WHO conducted a training workshop targeting 50 health staff from SMoH and INGOs working in Zamzam IDP camp. Leishmaniasis is a common disease in North Darfur State. The last entomological survey revealed that acacia trees and crackly mate which provide enriched environment for sand flies are thriving inside Zamzam. In East Sudan, WHO and Kassala SMOH conducted a joint supportive supervisory mission at the health facilities in Telkuk localities, a relatively inaccessible area previously affected by conflict, and has been prone to drought. The facilities visited were Twaiet and Telkuk rural hospitals and one of the gaps identified was the inadequate documentation and analysis of surveillance data. As response, SMoH will provide standard registers for documentation of reports. In Blue Nile State, WHO with SMoH conducted a 4-day training programmes from 18 to 21 July on comprehensive curriculum with a focus on primary health care in emergencies, targeting 28 medical assistants. In total, 90 PHC cadres have been targeted for the same training course.
Page 5 Week 29 In West Darfur, WHO conducted a monitoring visit to Geneina teaching hospital s renal dialysis unit and found that there are five working machines at the unit, and the hospital has established an infection prevention protocol and use safety tools. This was part of the follow-on activity of the training on infection control conducted last week. During the visit, WHO provided with surgical gloves as it reported shortage and stock-outs of this essential item. WHO donated assorted drugs, consumable items and medical supplies to Bendsi rural hospital in Southeast corridor. The hospital is providing invaluable health services especially for internally displace people and conflictaffected populations in the area. The donated items are estimated to cover 1000 Patients. The Qatar Red Crescent Society has been supporting the hospital, and the hospital s location is known to be inaccessible during the rainy season. provide free health services for IDPs and conflict affected people. Donation was as well made to El Fasher Maternity Hospital with essential drugs, laboratory reagents, consumables and medical items, sufficient to cover 1 500 patients for 1 month. WHO is collaborating with and supporting SMOH/Sudan National Aids Programme in North Darfur. WHO is securing funds to cover the running costs of the VCT/ART center at El Fasher teaching hospital. The centre is providing anonymous counselling and testing, HIV care, support and treatment for all HIV positive clients. The center sees an average of 120 clients every month. To assess the laboratory services provided at the EdDaein Rural Hospital in South Darfur, a 4-day monitoring visit was conducted by WHO and MoH laboratory directorate. The laboratory and the blood bank is run by six laboratory technicians, technical capacity for investigations provision is limited due to unavailability of some instruments and reagents. Adequate blood bank services are provided but currently the laboratory needs donation chair. There is also a need to build capacity of staff on infection prevention and quality control. WHO will support SMoH in building capacity and provision of infection prevention tools. In North Darfur, WHO supported El Tina rural Hospital with essential drugs, laboratory reagents, consumables and medical items. The donated drugs are estimated to cover 500 patients for 1 month. The hospital is continuing to
EHA Sudan Highlights Page 6 In West Darfur, WHO supported a 4 day training on water quality and chlorination techniques targeting 25 environmental health officers and volunteers from El Genena. Participants included staff working with field partners including MedAir, CRS, WES and SMoH in addition to the owners of the wells in Genena locality. Meanwhile, the opening ceremony of the 3-day training programme for 23 Youth of Nyouro returnees village on water sanitation diseases, protection and public health was arranged by Islamic Relief Agency (ISRA) in collaboration with SMoH. The mobile clinic of ISRA is supported by WHO with supplies and human resources through seconded staff - medical doctor and medical assistant. In South Darfur, water quality control activities were conducted in Tulus and a total of 35 samples were collected from sources and analyzed for simple water quality. Results showed standard free residual chlorine in all tested samples ranging between 0.2 0.5 mg/l. In El Deain, 19 water samples were taken from El neem, Khor Omer and El Deain hospital where the residual chlorine was found between 0.2 0.5 mg/l (normal level) in 14 samples including from the hospital and PHC clinic, while the other 4 samples were found below the standard level. In Nyala, sanitary inspection was done for 20 different water sources (dug wells, hand pumps and boreholes). Risk analysis of these sources indicated urgent action priority for 2 boreholes, 1 hand pump and 1 open dug well. Other 13 samples indicated high action priority and 3 required low action priority. Feedback will be shared with State Water Corporation, WES and private wells union to step up remedial actions within specified time and the surveillance team will conduct follow up visits. Vector surveys were conducted in Nyala and El Deain stations where the average adult mosquito density was found 0.1 / room in Nyala and zero in El Deain. Vector control measures targeting mosquito breeding sites are ongoing in Nyala and the IDP camps around the localities of Kass, El Deain including El neem in addition to Buram, Tulus and Al wihda. During the week, a total of 3 632 breeding sites were inspected and treated with temphos insecticide. Among these sites,226 sites were found with anopheles breeding. WHO organized a monthly North Darfur water quality committee meeting to highlight main activities, challenges, and constraints in El Fasher and IDP camps specifically Zamzam camp where high number of other diarrheal cases and acute jaundice syndrome have been reported. During the week, there is a shortage of water due to lack of fuel supply to run water pumps. The issue has been shared with OCHA and SMoH, and which will hopefully be raised with HAC. In North Darfur, 494 samples were collected for bacteriological and chemical analysis. Based on results, chlorination activities were conducted. Likewise the committee also agreed on increasing the capacity of water quality facilities and improvement in reporting system at different levels. WHO supported the 5-day vector spraying campaign at Zamzam A covering 5 400 private and communal latrines and other breeding sites. Dissemination of hygiene messages was integrated in the campaign. In Port Sudan, chlorination of 3927 tons of drinking water from 267 tankers was conducted, while1083 houses were covered by house to house chlorination. For further information please contact: Dr. Iman Shankiti EHA Coordinator WHO Sudan shankitii@sud.emro.who.int Mrs. Christina Banluta Communications and Advocacy Officer, WHO Sudan banlutac@sud.emro.who.int