WHO SOUTHERN SUDAN HEALTH UPDATE April 2004

Transcription

1 WHO SOUTHERN SUDAN HEALTH UPDATE April 2004 HIGHLIGHTS Over Ninety Health Workers in Five Counties Trained on Disease Surveillance and EWARN Southern Sudan participates at the Eastern Mediterranean Inter-country Meeting on Emerging and Re-emerging Diseases WHO South Sudan Office Sends one Sudanese Doctor to be Trained on Surgical Management of Buruli Ulcers in Ghana Polio program begins annual AFP training for all field staff 1.0. DISEASE SURVEILLANCE AND EARLY WARNING AND RESPONSE NETWORK (EWARN) 1.1. Training and orientation on EWARN Strengthening local capacity for surveillance and response continues to be the main area that WHO and its EWARN partners continue to support in southern Sudan. As part of this effort, training on disease surveillance and EWARN for health workers, and orientation of community leaders and members on EWARN were carried out in 5 locations. Fig. 1: Kala Azar patient from eastern Upper Nile WHO and agencies working in Kala Azar endemic areas are predicting an upsurge in cases of the disease Training of health workers WHO, ARC, DOT, ZOA, ADRA, GOAL, SMC, CARE, MEDAIR and CHDs in the respective counties of Magwi, Juba, Terekeka, Bor North, Bor South and Turalei jointly organized a one-week EWARN training on strengthening surveillance and response for Sudanese health workers in 5 locations. The training focused on basic surveillance, detection, alerting, verification and response techniques to epidemic-prone, emerging and new diseases. Selected outbreak conditions, case examples, and formats and guidelines were discussed. Moreover, video films on VHF, diarrheal diseases and Buruli ulcer (BU) were used to facilitate discussion sessions. A total of 91 Sudanese health workers and 5 PHC

2 supervisors from 16 health NGOs participated in the trainings. Three more trainings are to be conducted in Ikotos, Kiechkuon and Luanyaker locations before the end of May Community-level EWARN orientation A total of 142 community leaders and members from five counties participated in EWARN orientation and trainings on outbreak detection and reporting. The trainings were organized in Nimule, Katigiri, Turalei, Mabior and Padak, in collaboration with partner NGOs and counterparts. The participants were oriented on how to recognize and alert on suspected outbreaks. The orientation used case examples from outbreaks that occurred in the areas in the last five years, including cholera, meningococcal meningitis, measles, and dysentery. These community orientations were carried out as part of capacity building and network for EWARN A Sudanese surgeon leaves for Buruli ulcer training in Ghana WHO South Sudan in collaboration with the Global Buruli ulcer Initiative has sent Dr. Yatta Lori Lugor to Ghana for a two-weeks training on surgical management of Buruli ulcers. Dr. Logor works for the Diocese of Tambura/Yambio as a general surgeon in Yambio Civil Hospital. This training is part of WHO s effort to respond to the Buruli ulcer outbreak in Mabia and Nzara. On his return from Ghana, Dr. Yatta will head the task force on BU in Western Equatoria. He will also train health workers in both Tambura and Yambio hospitals on BU management and control and will be in charge of surgical management of BU cases in the region TB & Leprosy Control WHO organizes TB workshop The WHO Office for South Sudan, in collaboration with the SPLM Health Secretariat, organized a tuberculosis workshop from the 1 st to 2 nd April 2004 at New Stanley Hotel, Nairobi, to develop draft Tuberculosis Control and Policy Guidelines. The objectives of the workshop were to develop a draft TB Policy and Strategy for South Sudan which will guide the stakeholders in managing TB in South Sudan, review the current treatment guidelines in South Sudan and to develop comprehensive TB recording, monitoring and reporting materials for South Sudan. The workshop drew representatives from The Health Secretariat and NGOs treating tuberculosis in South Sudan. These included Medair, CCM, COSV, Malteser, MSF- Belgium, MSF-France, MSF-Holland and WHO itself. They all presented their experiences with Tuberculosis management in South Sudan. Though ZOA did not attend the workshop, it sent a presentation, which was presented by WHO. An outline of a draft TB policy and guidelines was presented for comments and integration. The Health Secretariat and the NGOs appreciated the steps taken by WHO for drafting the policy document. The participants felt that it was crucial to develop an effective South Sudan Tuberculosis Policy and urged WHO to continue work on draft two of the policy document for presentation in yet another meeting of the stakeholders for discussion. The need to expand DOTS activities in South Sudan was stressed by all participants. These activities can be expanded not only through the global funds but also by encouraging new NGOs to participate in the program Joint S. Sudan and Somalia Leprosy workshop held In order to enlighten health oriented NGOs on the importance of leprosy elimination in South Sudan, the WHO office for South Sudan, organized a leprosy educational workshop on Saturday the 17 th April 2004 at its Offices in Gigiri, Nairobi. The main aim of the leprosytraining workshop was to strengthen the MDT activities in treatment of leprosy in South Sudan. The objectives were to strengthen the capacity of the NGOs Coordinators and to

3 sensitize them on how to identify and diagnose leprosy early, effectively treat leprosy cases, properly record and monitor leprosy cases and to supervise and report on leprosy elimination program. This meeting was organized jointly with the WHO Somalia Office in Nairobi and was attended by Leprosy NGO Coordinators working in both Somalia and South Sudan, and African Medical Research Foundation (AMREF) representatives. Dr. Myo Thet Htoon-WHO Leprosy Officer in Geneva, Dr. Hashim El Wagie -Communicable Disease Officer for Somalia and Dr. Abdullahi Ahmed- Head of Office for WHO South Sudan jointly facilitated the workshop. The meeting drew up recommendations that will enhance the activities of leprosy elimination in both countries. Fig. 2: A rare skin disease - monkey pox in an elderly lady 1.3. Preparedness, Detection and Response Forecasting and preparedness Based on experiences and health data from the previous years, it is forecasted that an up-surge in cases of visceral leishmaniasis (Kala Azar) is likely in Upper Nile region of southern Sudan. In the last few years, outbreaks/upsurge of the disease tend to peak in July. Health NGOs and agencies working in these areas are advised to increase their surveillance and preparedness for such an eventuality. However, the security situation in the area is a cause of concern. Most of the area is rated as security level three and four and the situation is likely to deteriorate. This may interfere with response efforts. Those responsible for security need to work hard to improve the situation. We may again be faced with a similar situation like last year when an assessment mission was delayed for three months because of flooding Detection, verification and response

4 A total of seven alerts on suspected disease outbreaks were received and followed-up. Rumors of measles outbreak continue to top the list of reported outbreaks. This month rumors of measles outbreaks were reported from four new locations in South Sudan. A number of cases of dog bites were reported from Rumbek and Turallei. One suspected case of rabies died in Turalei following a bite by a dog. WHO and the concerned NGO responded with case management and anti-rabies vaccination. It must be stressed here that WHO will not afford to provide anti-rabies to all the increased cases of dog bites in the region. Every year around this time WHO- EWARN receives reports of dog bites from various locations in South Sudan. NGOs working in South Sudan are reminded that it is advisable to keep some stock of antirabies vaccines in their health facilities Southern Sudan participates at the Eastern Mediterranean Inter-country Meeting on Emerging and Re-emerging Infectious Diseases emerging health risks and develop plans of concerted efforts to control emerging infectious diseases in member states. During the three days WHO presented position papers on EID, and member states presented their progress reports. The keynote address was presented by the Lebanese Minister of Public Health (read on his behalf by the director of the Ministry). At the end of the three days the meeting came to the conclusion that communicable diseases are still the leading cause of morbidity and mortality in the Region. Surveillance is the corner stone for planning, monitoring and evaluation of any prevention and control strategy. The meeting made nine recommendations (that included the need for a high political commitment to support surveillance and response to EID) to help countries in the region develop national disease surveillance systems. A three-days inter-country meeting on emerging and re-emerging infectious diseases for the Eastern Mediterranean region was held in Beirut, Lebanon from April 6 8, South Sudan was represented by WHO South Sudan. Over 60 participants representing 23 countries from the region, HQ and other institutions attended the meeting. The meeting was organized by WHO EMRO for the purpose of: 1) promoting communicable disease surveillance and response activities for emerging disease in the region; 2) sharing of experience among countries in the region; 3) identify

5 Table 1. Summary update of verified outbreaks, April Outbreak disease/syndrome Measles Location/Onset Source and date of update Khormus, Magwi (EEQ) DOT Ikotos, Torit (EEQ) Kwajok, Gogrial (BGZ) Malual-kon, Awiel East (BGZ) NCA SRRC MSF-F Reported cases/deaths/actions taken 25 cases 1 death Area is inaccessible due to LRA activities 23 cases 9death case management (Not new outbreak. Follow-up cases) 178 cases 22 death case management Vaccines 7 cases No death case management Food poisoning Dog s Bite Suspected Rabies Akon, Gogrial (BGZ) First week of April 2004 Padak, South Bor (UNL) Turalei, Twic (BGZ) Rumbek, Lakes (BGZ) MSF-F Medair WHO GOAL WHO cases No death Alert case management 24 cases case management Lab support 5cases 1death. Case management & vaccines 3 cases. Reporting case management & vaccines