Republic of South Sudan

Transcription

1 Republic of South Sudan CHOLERA RESPONSE UPDATES AS OF 1 SEPTEMBER 2017 Coordination of cholera response The National cholera task force is coordinating the overall cholera response. The task force meetings convene weekly on Wednesdays from 2 pm in the WHO conference hall in Juba. Also, the cholera coordination meeting in Juba Teaching hospital holds on Monday starting 11 am in the Postgraduate School. Surveillance and case management updates Cholera alerts Nyinbouli, Aweil West: On 28 August 2017, six suspect cholera deaths were reported in Nyinbouli, Ayat West Payam, Aweil West County. A verification mission by the CHD on 29 August 2017 showed that four of the deaths were due to malaria (following tests at Nyinbouli PHCC), one was a snake bite death, and the other was a maternal death due to postpartum hemorrhage. Boma: The initial cases originated from Maruo, Labarab Payam, Boma County on 7 August At least 48 suspect cholera cases including three deaths have been line listed as of 28 August One sample tested culture negative for Vibrio cholerae on 21 August Verification and response activities initiated in response to the alert. Cases are being managed at Boma Civil Hospital. Cholera confirmation is still pending. Katta, Raja county: A cluster of suspect cholera cases reported in Katta during the week of 7 August 2017 by ALIMA, an implementing agency. Verification is still pending due to security concerns. Narus county: Three suspect cholera cases including one community death were reported from Narus. Two of the suspect cholera cases involved a mother and her 21-month daughter from Narus village. They were both treated and discharged from Narus CDOT CTU. The third alert involved a community death from Lopua village; the verification is underway. Kikilai, Lotukei, Budi county: Three suspect cholera cases from Lotukei payam were admitted in Kikilai PHCC on 28 August 2017; two of the cases were RDT positive for cholera. Also, cholera alerts have been investigated in Loriyok (Camp 15) and Kuduk Boma. At least 20 cholera cases including two deaths have been line listed in Kimotong payam while in Ngauro, at least 153 cases including 6 deaths have been line listed. 1

2 General cholera trends Cholera transmission is on the decline countrywide A countrywide. In the last four weeks [weeks 31-34], cholera cases have dropped from at least 145 cases in week 31 of 2017 to at least 39 cases in week 34 of During the last four weeks [week 31-34, 2017], at least five counties [Budi, Juba, Kapoeta East, Kapoeta South, and Nyirol] have registered cholera transmission. Juba and Budi counties accounted for the majority of the cholera cases reported in week 34 of During week 34, Budi county reported a total of 29 cases from Kimatong payam (13 cases), Ngauro payam reported 13 cases (compared to 40 cases including one death in week 33), and Lotukei payam reported 3 cases. The outbreak in Budi started on 28 July 2017 with the initial transmission occurring among gold-miners in Ngauro. Budi county has reported a cumulative of at least 159 cases including eight deaths since 28 July Cordaid and the CHD are supporting management in Ngauro CTU, Kimotong CTU, Kimotong PHCC, Vaka ORP, Nagishot PHCC, and Kakilai PHCC in Budi county. In Juba, 102 cases have been reported from the nine HLSS managed ORPs in the last four weeks [week 31-34]. The areas actively reporting cases in Juba include Rejaf, Kator, and Juba Town. Also, sporadic cases continue to be reported from UN House PoC with three cholera RDT positive cases reported in week 34. A total of 28 cholera cases have been line listed in UN House PoC since 4 June In Kapoeta East and Kapoeta South, the number of new cholera cases reduced from 14 cases in week 32 to no cases in week 34. The implementing agency (ARC) has scaled-down on case management response activities with only Kapoeta Hospital CTC and Narus CTU remaining open to receive and manage cholera cases. Cholera response updates The weekly EP&R/cholera task force meeting was held in Juba on 30 August 2017 to review the cholera situation and response updates. WHO continues to support the overall coordination of cholera preparedness and response activities as co-chair of the cholera taskforce. WHO is also coordinating the deployment of oral cholera vaccines to complement the current response in South Sudan. WHO is also supporting the surveillance and laboratory activities though collation of cholera data, compilation of the cholera situation report, and provision of cholera investigation kits. WHO is also supporting the deployment of rapid response teams to areas with active transmission. During the week, alerts were verified in Nyinbouli, Aweil West; Kimatong, Budi; and Lotukei, Budi county. The investigations were undertaken by the CHDs working in collaboration with partners CORDAID. The cholera suspect cases in Nyinbouli were ruled out while in Lotukei, three cholera (2 cholera RDT positive) were identified. In Kimatong, at least 13 cholera cases have been line listed. In Kapoeta South and Kapoeta East, ARC has scaled-down on case management activities with the two remaining cholera treatment facilities [Kapoeta Hospital CTC and Narus CTU] being handed over to SMoH/CHD. In addition, the ARC team managed to travel to Jie and Mogos to 2

3 retrieve the oral cholera vaccine campaign results from the two sites. UNICEF continues to provide supplies for medical management of cholera cases at both community and facility levels in the affected areas. As part of cholera case management, UNICEF supported 46 oral rehydration points (ORPs), 15 cholera treatment units (CTUs) and two cholera treatment centers (CTCs) through partners in key cholera hotspots in nine counties across five states with 8,764 cases so far in 2017 were treated using the supplies provided by UNICEF and more than 30 Diarrhea Disease Kits have been distributed in 2017 with 2 DDK distributed in the reporting period. UNICEF has prepositioned cholera supplies in all field offices and supported the development of cholera contingency plans in hot spot counties. Cholera and Log/WASH consultants have been recruited to strengthen response especially case management and Infection prevention and control in treatment sites. Table 1: Doses of oral cholera vaccines deployed in 2017 by site No No vaccinated % coverag e No vaccinated % coverag e 1 Leer (one round) ,772 69% 0% 22/02/2017 MedAir, WHO, UNICEF 2 Site Malakal Town (one round) ,499 64% 0% 18-24Mar2017 MSF-E, WHO, UNICEF 3 Bor PoC ,926 85% 1,885 83% 3-4Apr2017; 2nd Rnd 26-29Apr2017 HLSS, WHO, UNICEF 4 Mingkaman 111,278 68,512 62% 42,296 38% 26Apr-5May2017; 2nd Rnd: 12-26May & 10-21Jun MedAir, WHO, UNICEF 5 Ayod Tar (one round) 19,400 15,649 81% 0% 9-22May MedAir, WHO, UNICEF 6 Ayod Pagil (one round) 4,850 3,943 81% 0% 9-22May2017 MedAir, WHO, UNICEF 7 Bentiu PoC 112,924 72,514 64% 77,603 69% 5-10May2017 IOM, WHO, Unicef Rubkona & Bentiu 8 towns Aburoj IDPs (one 9 round) Ayod (Jiech, Karmun, 10 Padek, Kandak) (one round) ,908 91% 38, % Jun 2017 & Jul 2017 IOM, WHO, Unicef 11,640 10,723 92% 0% 20-22May2017 MSF-E, WHO, UNICEF 18,550 13,756 74% 9,337 50% 11 Juba Don Bosco IDPs 5,940 4,536 76% 3,309 56% Jun 2017 & Jul Jul 2017; Jul 2017 IOM, CMD, WHO, UNICEF MSF-CH; WHO, UNICEF, HLSS 12 Tonj East (one round) 189, ,862 85% 6-10 Aug 2017 IOM, WHO, Unicef Kapoeta North (one 13 round) Kapoeta South (one 14 round) Kapoeta East (one 15 round) Total doses deployed in 2017 Target populatio n Firs round 141,520 73,323 52% Second round 29 Jul-4Aug 2017 & 17-25Aug 2017 SCI, WHO, UNICEF 97,000 78,863 81% 29 Jul-4Aug 2017 ARC, WHO, UNICEF 97,000 85,058 88% 29 Jul-4Aug 2017 ARC, WHO, UNICEF 907, ,844 73% 172,818 19% Partners Oral cholera vaccination As part of the ongoing cholera response, cholera vaccines have been deployed to complement cholera response in several high-risk populations and locations. These areas include Leer, Bor PoC, Malakal Town, Bentiu PoC, Mingkaman IDP settlement, Aburoc IDPs, Bentiu/Rubkona Town, Ayod (Pagil, Tar, Jiech, Karmun, Padek, and Kandak), Juba (Don Bosco IDPs), Tonj East and Marial Lou payam, Kapoeta North, Kapoeta South, and Kapoeta North. Out of the 1,044,150 doses secured by WHO in 2017, a total of doses have been deployed (see Table 1). There is either no transmission or negligible transmission in all the locations that have deployed OCV. Dates 3

4 Preparations are underway to deploy 395,940 doses of oral cholera vaccines for vaccination in Juba, Lankien, Akobo and other areas in Jonglei, and Panyijiar. In addition, the oral cholera vaccine working group has given a go-ahead for the shipment of 896,360 doses to cover second round campaigns in Kapoeta South, Kapoeta North, Kapoeta East, Juba, Akobo/Uror, Lankien, and Panyijiar. Arrangements are underway to update the micro plans for the second round campaigns in Kapoeta North, Kapoeta East, Kapoeta South, and Tonj East counties. Communication for development (C4D) UNICEF continues to mobilize pastoralist communities in Eastern Lakes, Jonglei, Unity and Eastern Equatoria with cholera prevention and control messages reaching 24 cattle camps with a cumulative population of more than 2,500 people. Since end June 2017, total of 1,073 trained social mobilizers and hygiene promoters have been deployed and have reached over 72,000 households. Mobilizers also reached around 49,000 school children and teachers in 147 schools. About 17,600 people including community leaders and food and water vendors were reached with messages through community meetings, water-point and market sessions. UNICEF continues to work with 11 implementing partners to conduct community engagement activities including household visits with critical demonstrations, community meetings, waterpoint and market awareness activities and schools and cattle camps interventions in all the cholera hotspot locations. During this reporting period, UNICEF supported cholera awareness campaigns through 21 radio stations in Juba, Yei, Kapoeta, Torit, Bentiu, Tonj, Bor and Mingkaman, where active transmission is ongoing. This includes, broadcasting of five to ten radio jingles with cholera messages per day, with a total of 27 talk shows and 24 interviews, reaching approximately 1.8 million people (listenership data of 21 radio stations) with cholera prevention messages during the reporting period Water, sanitation and hygiene (WASH) UNICEF and implementing partners continue to respond to the ongoing cholera epidemic through the provision of basic WASH services. The primary focus of the cholera response is on safe household water treatment and storage through distribution of Aquatabs or PUR water treatment products and hygiene promotion so as to interrupt the cycle of infection. Rehabilitation of broken hand pumps, and distribution of WASH NFIs, such as soap, buckets and jerry cans for safe water storage are also undertaken to ensure the continuum of WASH services in the affected/at risk communities. A total of 16 WASH partners that are supported by UNICEF and six (6) WASH Cluster partners with the capacity to conduct rapid mobile responses are currently providing essential WASH services for the cholera response. UNICEF has prepositioned WASH cholera supplies in most affected areas and is supplying all WASH partners through the core pipeline to support the ongoing response. UNICEF has provided safe drinking water to an estimated 221,660 people in cholera affected areas through the rehabilitation of 153 boreholes hand pumps, drilling 19 new boreholes. 3,300 people were provided with access to safe sanitation through construction of 66 latrine stances. Through surveillance activities, 10,460 households received water treatment products to ensure safe drinking water in cholera affected communities. Additional 17,252 households also benefited from distributions of WASH NFIs (soap, buckets, Jerry cans etc.), and additional 20, 1965 people also reached with key hygiene and cholera messages. To strengthen the capacity of WASH 4

5 partners, UNICEF conducted a training on cholera prevention and containment, which was attended by 29 participants from 19 WASH partner organizations. Table 2: Cholera culture test results Jun Aug 2017 County Positive Negative (blank) Total tested Abyei 1 1 Akobo 2 2 Awerial Ayod Bor Budi 1 1 Duk Fangak Fashoda Juba Kapoeta East 8 8 Kodok Lankien Leer Magwi Malakal Mayendit Mayom Panyijiar 1 1 Pibor 5 5 Pigi Renk 2 2 Rubkona Terekeka 2 2 Tonj East Torit 5 5 Uror 2 2 Wau 6 6 Yirol East Yirol West 4 4 (blank) 1 1 Kapoeta South Nyirol Adior Total tested ,040 5

6 WASH CLUSTER RESPONSE UPDATES WASH Cluster Key Cholera Response updates Reporting period: 28 August 3 September 2017 Locations with ongoing WASH present Partners Ongoing Action with number of population reached with Gaps and recommended action Kapoeta South, Kapoeta North, Kapoeta East IOM- WASH Focal Point IOM IOM reached 3053 beneficiaries by household visits in Lomeyen IOM rehabilitated additional six boreholes in Paringa and Chumakori, IOM and SI withdrawing from the locations across Kapoetas, ongoing handovers and partner meeting, CMD and INTERSOS preparing the response Budi SI SI responding in Ngauro INTESOS planning to respond in Kiamatong Duk Ageer and Payuel Padiet, Pagak and Dong-chak Payam CRS Sensitized communities on hygiene promotion and rehabilitation of boreholes in both Payam of Ageer/Payuel and its villages (Poktap, Weerajack, Garach, Themeropiny, Kiirhom, Thonpiny, Jual, Wutbany and Patuenoi and Payuel) 192 HH (1,727 beneficiaries) were reached with hygiene messages at house to house visiting. 257 beneficiaries were reached with hygiene messages at mass campaign in both Poktap and Payuel 6 latrine stances were disinfected in poktap Boma. 55 HH (459 beneficiaries) received hygiene messages at house to house visiting. 608 beneficiaries were reached with hygiene messages at mass campaign. There is need for supply of working gears (Masks, raincoats and aprons). There is need for supply of working gears (Masks, Gumboots, raincoats, aprons and gloves) 6

7 Locations with ongoing WASH present Partners Ongoing Action with number of population reached with Gaps and recommended action Panyang Pajut, Patuet, Turu, Kuergach, Kuerliet, Pamaidiang, Mananyang 237 HH (1,645 beneficiaries) were reached and received hygiene messages through house to house visit. One borehole rehabilitated (Kuerliet borehole) There is need for supply of working gears (Masks, Gumboots, raincoats, aprons and gloves) Padiet PAH Training of water user's committee (62 participants) Water Quality Monitoring - bacteriological testing (12 samples) Water Storage container distribution (jerry cans, PUR, filet cloth and soap) 18,296 beneficiaries Distribution of latrine digging tools (10 sets) 6 Hand washing facilities constructed in schools 8 Hand washing facilities constructed in health facilities Hygiene promotion messaging - Household Visits and public campaigns (43,873 beneficiaries reached) Mayom IOM IOM reached 6947 beneficiaries by household visits in Kuerbone IOM rehabilitated six boreholes in Kuerbone and Wangkei Yirol PAH 8 Handpumps rehabilitated Distribution (jerry cans, PUR, buckets, filter cloth, soap) 27,386 beneficiaries Hygiene promotion messaging - Household Visits (29,464 beneficiaries) Latrine construction in Health Facilities (4 stances) Training for community leaders (20 participants) Construction of CTU's shelter at 2 health facilities Distribution of latrine cleaning facilities to 9 institutions 5 Hand washing facilities constructed in schools 5 Hand washing facilities constructed in health facilities Distribution of latrine digging tools (25 sets) 7

8 SOCIAL MOBILISATION UPDATES Social Mobilization, Communication and Hygiene Promotion Reporting Format (28 August-1 September, 2017) Locations with ongoing (Payam level) Partners present Ongoing Action with number of population reached with Gaps and recommended action Tonj East: Most affected Makuac, Paliang, Paweng Payam, Tonj South and Marial-Lou-Tonj North. (Warrap) Bor, Twic East, Duk and Pibor - CCM, THESO, UNICEF, WHO and SMOH CDNF 5 new suspected cholera cases were identified in Romic and referred to the treatment site. A total of 75 community mobilizers continued to actively work with the communities and households in Tonj East (Romic) & Tonj North (Marial lou) During house to house visit, a total of 1760 households (7347 people) were reached with cholera and immunization messages, A total of 2421 school children in 7 schools participated in cholera prevention education session. During 9 community meetings 1,131 people received cholera prevention and control messages A total of 43 people in 1 market places were exposed with cholera prevention and control strategies. As part of cattle camp strategy, 417 nomadic population were reached in 7 cattle camps visited by social mobilizers. And 6 water-points sessions conducted reaching 40 water vendors who were educated on cholera prevention strategies including water treatment and household water safety practices during outreach sessions. Also 105 assorted cholera posters were displayed in public places. UNICEF supported partner CDNF continue with community engagement activities which include household visits with critical demonstrations, community meetings, water-point - 8

9 Locations with ongoing (Payam level) Partners present Ongoing Action with number of population reached with Gaps and recommended action and market awareness, school and cattle camps intervention in areas of Bor, Duk and Twic East. In counties of Bor, Twic east and Duk, from 24th Aug 1st Sept 2017, CDNF conducted social mobilization activities and reached the total 1,675 HHs and 8,587 Individuals through 70 trained volunteers social mobilizers/home health promoters) educating community on social and behavior change intervention on integrated cholera control diarrheal disease prevention. Another total of 9 schools and 1,646 pupils benefited from school-based interventions on integrated cholera awareness sessions carryout by social mobilizers at different schools, Bor, Twic east and Duk counties In this period, the social mobilizers conducted 8 community meetings at different payams of Bor, Twic east and Duk counties, number of reached 388 people inclusive of community leaders which comprise of local chiefs, religious leaders and women and youth leaders. Social mobilizers conducted 7 awareness sessions at market places and 296 individuals through market sessions including food vendors in the mentioned counties of Duk, Twic east and Bor. 9

10 Locations with ongoing (Payam level) Partners present Ongoing Action with number of population reached with Gaps and recommended action In villages of Bor, Twic east and Duk counties, CDNF social mobilizers conducted 4 water point sessions and reached total of 175 people including water vendors with cholera and diarrheal disease messages. Mass media intervention: cholera key messages and radio spots are being broadcasted on Mingkaman100 FM, and Radio Jonglei 95.9FM, 6 times daily in Dinka, English and Arabic reaching population in remote locations and villages with lifesaving messages on cholera prevention and control Religious engagement: Trained CDNF Social mobilizers reached people with effective cholera messages in over 11 churches during religious prayers services in the counties of Bor, Twic east, and Duk, Pibor Pibor, Lekuangole, Verteth and gumuruk Nile Hope, FCDI CDNF conducted orientation meeting with county Community Social mobilizers and Supervisor on Thursday 28 th Aug 2017 in Bor county In Payam of Pibor, Lekuangole, Verteth and Gumuruk, from 24 Aug 1st Sept 2017, CDNF conducted social mobilization activities and reached the total 428 HHs and 2,841 Individuals through 23 trained volunteers social mobilizers/home health promoters) educating community on social and behavior change intervention on integrated cholera control diarrheal disease prevention. - 10

11 Locations with ongoing (Payam level) Partners present Ongoing Action with number of population reached with Gaps and recommended action A total of 10 schools and 534 pupils benefited from school-based interventions on integrated cholera awareness sessions carryout by social mobilizers at different schools, Pibor, Lekuangole, Verteth and Gumuruk Payams In the same period, the social mobilizers conducted 6 community meetings at payams of Pibor, Lekuangole, Verteth and Gumuruk, reached 954 people inclusive of community leaders which comprise of local chiefs, religious leaders and women and youth leaders Again CDNF Social mobilizers in Pibor conducted 5 awareness sessions and reached 794 individuals through market interventions including food vendors in the mentioned counties of Boma. In hard to reach villages of Pibor, Lekuangole, Verteth and Gumuruk payams, CDNF social mobilizers conducted 8 water point sessions rand reached total of 643 people including water vendors with Cholera and diarrheal disease messages Akobo, Old Fangak, Ayod, Pigi, Nyirol, Uror Juba Gurei, Kator, Lologo, Gumbo, Nesitu FCDI No report shared - Health link, SMoH and CHD A total of 43 trained community mobilizers has been actively working Gurei, Kator, Lologo, Gumbo, Nesitu No case was reported and referred during the reporting week During the house to house visit, a total of 4,712 people from 15,582 households were reached with cholera messages. - 11

12 Locations with ongoing (Payam level) Partners present Ongoing Action with number of population reached with Gaps and recommended action WASH and Health supplies distributed during the reporting period includes 4,572 ORS and 604 chlorine taps As part of Mass media, a total of 14 FM stations continue with airing of radio spots and talk-shows in Juba and Yei. As of 28 August-1 September, 2017, 840 times radio jingles have been broadcasted reaching over 2 million people across the country. This week, street announcement of cholera messages has been ongoing through Five (5) Public Address Systems (PAs) in five main areas of the City namely; Rajaf, Kator, Juba, Munuki and Nyar-kenyi/Northern Bari. The PAs conducts 5 hours announcements per day (3hr morning and 2hrs evening) and will be ongoing for a period of 60 days. THESO is also conducting hygiene promotion and megaphone announcements in Juba POC Ministry of Health, WHO and UNICEF in collaboration with Vivacell Telecom Company have re-activated 12

13 Locations with ongoing (Payam level) Partners present Ongoing Action with number of population reached with Gaps and recommended action Cholera hotline (1144) which currently respond to all calls as well as educating callers on cholera response and preventive measures. Rubkona, Bentiu town and POC Upper Nile (Maban) Yirol East (Eastern Lakes), Adior Payam, Malek Payam, Lekakedu Payam, Yali Payam, Pagarau Payam, Tin-agau Payam, Nyang (Lakes) Awerial (Eastern Lakes) Mingkaman, Alel, Dor, Puluk, Bunangok, Nile, Magok, Abuyong UNIDO, Nile Hope, IRC, Mercy Corps - No report shared - Mobile Theatre - No report shared - Team - SSRC, CHADO/ CHD No report shared - No report shared Yirol West (Eastern Lakes), Abang Payam, Anuol Payam Yirol Centre (Town), Geng- Geng Payam, Geer Payam, Aluak Luak Payam, Mapuordit Payam - CHADO, SSRC and CHD No report shared - 13

14 OCV Campaign: MoH, American Refugee Committee (ARC) and WHO team in Mogos cattle Camp 02/AUGUST/2017 Kapoeta East Contacts Dr. Mathew Tut Director, Emergency Preparedness and Response Ministry of Health, Ministerial Complex Juba, Republic of South Sudan Dr. Joseph F. Wamala Epidemiologist World Health Organization Ministerial Complex Juba, Republic of South Sudan 14