Blue Nile State In relation to the separation of southern Sudan from northern Sudan and the rainy season the preparedness for response activities of the Health Sector in Blue Nile State has been updated. The exercise identified the key partners, available resources, capacities, ongoing preparations as well as the gaps that need to be urgently filled to ensure provision of basic health and surgical services, in case the overall situation worsens. The surveillance system of Blue Nile State has been strengthened since the start of the year. In week 24 (11-17 June 2011), 94.1% of the sentinel sites reported on time with 14 923 consultations recorded. Malaria remains the leading cause of consultations, followed by bloody diarrhoea, and acute typhoid fever. Please refer to the table below on the comparison of incidence rate of malaria and bloody diarrhoea over the last 4 weeks. Comparison of Incidence rate (IR) per 10,000 populations of Malaria and Bloody Diarrhoea reported in Blue Nile state, week 21 to week 24, 2011. Disease Incidence Rate/10000 population W21 W22 W23 W24 Malaria 29.9 35.3 39.3 31.4 Bloody Diarrhea 4.7 4.3 4.45 6.9
Sudan map, June 2011 Courtesy of OCHA For malaria, children less than five years contributed 19% to the whole disease proportions while those above five years old contributed around 17%. These figures confirmed that children less five years of age are the most vulnerable age group and thus need urgent attention. South Kordofan The security situation in South Kordofan remains tense and volatile. Sporadic fighting has continued in South Kordofan while bombing incidents around Kadugli town were also reported over the last few days. As of 7 July, around 23 000 population are still displaced and are currently hosted by communities in the localities of Heiba, Talodi, Kadugli, Um Dorain, Al Reief, Al Shargi, Keilak, Rashad, Dilling, El Goz, and El Obeid. Between 1 and 6 July, the total number of consultations recorded in the 4 newly established health clinics in Kadugli is 1 196. Acute Respiratory Tract Infection (ARI) is considered the main cause of morbidity and represents 21% (246) of the total number of consultations, followed by diarrheal cases with 13%, malaria cases with 13%, and eye infection 6%. Page 2
BLUE NILE STATE UPDATES Preparedness activities are ongoing in localities which border South Sudan. This is in anticipation of any conflict or any unforeseen events that might erupt as a result from the North and South Sudan separation or the rainy season. Health partners, capacities, activities, and gaps have already been identified and summarized below. In Kurmuk locality, WHO and UNICEF are closely working with the State Ministry of Health, GOAL and Samaritan s Purse (SP). GOAL is running 14 health facilities (HF) (primary health care centres and primary healthcare units) while SP is supporting secondary health care facility. This is the only hospital apart from Damazine teaching hospital that can perform general anesthesia, and the hospital has a blood bank. In collaboration with Sudanese Red Crescent Society (SRCS), WHO trained 25 volunteers on basic first aid services. WHO has also supported other training courses/sessions e.g. outbreak investigation, disease surveillance and reporting and standard case management. Additionally, WHO has an existing agreement with the SMOH to support mobile clinics if and when the needs arise. This agreement was initiated in January 2011 during the referendum. The UN s health agency also supports logistical needs to strengthen Rapid Response Teams for communicable disease rumour investigation. Moreover, UNICEF has propositioned stocks in this area. SP is providing services in the locality and is supporting secondary health care. WHO has supported SP with 2 trauma kits and medical supplies. There is 1 medical doctor in Kurmuk hospital with capacity to provide basic health and surgical services. The main gap that faces facilities in the whole state is the shortage of health cadres especially nursing staff and running cost for facilities. Another urgent issue that the sector needs to consider is the area s inaccessibility during the rainy season. In case of the worst case scenario, access is better through South Sudan, and will require strong coordination. Starting 7 July 2011, UNMIS will pull out its forces from this area. As a result, safe zones which were earlier planned to protect vulnerable population will no longer exist. In Kurmuk, GOAL is well funded and has not indicated any programmatic gaps unless the situation worsens. GOAL has pre-positioned medical supplies in its 14 HFs. In Altadamon locality, the State Ministry of Health (SMOH) is running all HFs in the locality. SRCS has trained volunteers who could stabilize emergency conditions and refer patients to hospitals. With WHO s support, SRCS has also trained 25 volunteers on basic first aid services. The locality has one hospital with medical doctor and an ambulance. The hospital has a new operating theatre. Since early this year and part of pre- and post-referendum preparedness WHO has an existing agreement with the SMOH to support mobile clinics if the need arises. The hospital in Altadamon cannot perform general anesthesia and has no blood bank. Cases have to be referred to Damazine. Meanwhile, the MOH medical doctor in this area has been trained to handle/ manage mass casualty. As of January this year, 10 000 nomads arrived from Upper Nile and are currently settled in Altadamon and Bau localities with poor primary health services. Like the other border localities, Altadamon is inaccessible during rainy season. In Bau locality, SMOH is running all health facilities in the locality. SRCS has trained volunteers, who could stabilize emergency conditions and refer patients to hospitals. In addition, World Vision International (WVI) is supporting 2 health facilities in Bau locality. With regards to human resources, the MOH medical doctor in this area has been trained in dealing with mass casualty, and the training course was part of the referendum preparedness. WHO has an existing agreement with the SMOH to support mobile clinics in this area if the need arises. This agreement was initiated in January during the referendum. Page 3
Gaps in the provision of health services have been identified. The area is inaccessible or gets completely cut off during rainy season. The hospital in Bau cannot perform general anesthesia and has no blood bank hence all critical cases have to be referred to Damazine. Bindis, an agricultural area on the South Sudan border, is a hot spot. There is no agreement on its border and issues could be similar to Abyei, but with no tribal conflicts reported. In Geissan locality, SMOH is running all HFs in the locality. SRCS has trained volunteers, who could stabilize emergency conditions and refer patients to hospitals. WVI is supporting the health clinic in Khor Adar village/ Geissan. In collaboration with WHO, SRCS has trained 25 volunteers in basic first aid services. However, there is an absence of implementing partners in many areas in Geissan. According tothe latest assessment there will be a shortage of essential and life saving drugs if the number of casualty increases. WHO will fill the gaps (WVI has buffer stocks in Kurmuk and Chalet). Regarding the secondary healthcare facility in Geissan, it cannot perform general anesthesia and has no blood bank hence all complicated cases have to be sent to Damazine. In Damazine locality, SMoH is running all HFs in the locality. As part of the preparedness activities, SRCS has trained volunteers who could stabilize emergency cases and refer patients to nearest hospitals. Damazine s State hospital has a blood bank and the MOH medical doctor in this area has been trained to handle/manage mass casualty. In collaboration with WHO, SRCS has trained 25 volunteers on basic first aid services. UNICEF has also prepositioned drugs with SMOH in Damazine and has a buffer stock available in its warehouse. Sufficient stocks and supplies are available in the hospital and MOH. It is expected that once conflict arises in Kurmuk, Bau and Tadamon, the main town of Damazine will face an influx of displaced population. In Roseires locality, SMOH is running all health facilities in the locality and SRCS has trained volunteers who could stabilize emergency conditions and refer patients to hospitals. So far SRCS together with WHO has trained 25 volunteers in basic first aid services. Additionally, WHO has an existing agreement with the SMOH to support mobile clinics in this area if and when the need arises. Roseires has no secondary health care services available, and all cases need to be referred to the health facilities in Damazine. SOUTH KORDOFAN UPDATES Four (4) health clinics are established by SRCS in Kadugli town to provide basic health services to returnees and displaced population. WHO is supporting SRCS with the required emergency medical drugs/supplies, and is providing financial support for the clinics operational costs. WHO and UNICEF are supporting SMoH with needed emergency medical drugs/supplies in addition to financial support for operational costs for its 31 health facilities and 4 mobile clinics in Elreef Alsharqi, Keilak, Rashad, and Talodi localities. From these facilities, the leading causes of medical consultations are acute respiratory infections, ARI represented 24% (1 457), malaria 21% (1 269) and diahhreal cases represented 18% (1054). Pancare is providing mobile clinic services in Alkweek (Alreef Alsharqi locality) and Dobaibat (Alqoz locality). WHO and Unicef are supporting Pancare with emergency medical drugs and consumables. So far, WHO supported Pancare with life saving drugs sufficient to cover the needs of 5 000 population for one month. An inter-sectoral survey has been completed. Data is still being processed and report will be shared with all partners as soon as it becomes available. Page 4
Nine (9) health partners will share a limited allocation of USD1.5million from the 2011 Common Humanitarian Fund (CHF) for Sudan after deliberations and review of the Technical Review Group. Selected priority projects will contribute towards achieving the overall Humanitarian Work Plan for Sudan s objectives by supporting life saving activities during emergencies to displaced populations that restricted access to health services, helping improve access to maternal and reproductive services, and strengthening of preparedness and response capacity to disease outbreaks. Health partners with high priority projects and which reported critical gaps in their funding have been considered for this second round of allocation. This allocation has targeted critical funding gaps in the three Darfur states and Blue Nile. For more information contact: Dr Anshu BANERJEE WHO Representative in Sudan +249912130308 banerjeea@sud.emro.who.int Dr Iman SHANKITI EHA Coordinator +249912502286 shankitii@sud.emro.who.int Dr Shahwaliullah SIDDIQI Health Sector Coordinator +249912174681 siddiqi@sud.emro.who.int Mrs Christina BANLUTA Communications Officer +249-923-971588 banlutac@sud.emro.who.int
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