Republic of South Sudan

Transcription

1 Republic of South Sudan CHOLERA RESPONSE UPDATES AS OF 25 AUGUST 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 and Friday starting 9 am in the Postgraduate School. Surveillance and case management updates Cholera alerts Boma: The initial cases originated from Maruo, Labarab Payam, Boma County on 7 August At least 40 suspect cholera cases have been line listed as of 23 August One sample tested culture negative for Vibrio cholerae on 21 August Verification and response activities initiated in response to the alert. 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. General cholera trends Cholera transmission is on the decline countrywide A countrywide. In the last four weeks, cholera cases have dropped from at least 169 cases in week 30 of 2017 to at least 31 cases in week 33 of During the last four weeks (week 30-33, 2017), at least six counties [Budi, Juba, Kapoeta East, Kapoeta South, Mayom, and Nyirol] have registered cholera transmission. Juba and Budi counties account for the majority of the cholera cases reported currently. Ngauro payam in Budi County reported 40 cases including one death in week 33, 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 have established two CTUs (Ngauro and Nagishot) and one ORP (Vaka) to facilitate case management. In Juba, a cumulative of at least 272 cases including four deaths have been reported from the nine HLSS managed ORPs. The areas actively reporting cases in Juba include Lologo, Kor William, and Gurei. 1

2 In Kapoeta East and Kapoeta South, the number of new cholera cases reduced from 14 cases in week 32 to four cases in week 33. All the four cases reported in week 33 originated from Kapoeta South. As a result, the implementing agency (ARC) is scaling-down on case management response activities. Cholera response updates and field missions The weekly EP&R/cholera task force meeting was held in Juba on 23 August 2017 to review the cholera situation and response updates. The cholera task force meeting in Kapoeta took place the same day [23 Aug 2017] to assess the cholera status and results from the first round of OCV campaigns, and plans for the second round of OCV. The WHO mobile medical team is deployed to Kapoeta to support the cholera response in Kapoeta and Budi. From August 2017, a joint CHD and Cordaid team conducted a verification mission to Nagishot. The mission was intended to establish cholera response interventions in Nagishot following the escalation of suspect cases from the area. The initial cases originated from miners returning from Ngauro gold mines. The team helped local authorities to establish a cholera treatment unit in Nagishot. At least 24 cholera cases including four deaths have occurred in Nagishot since 1 August In Kapoeta North, SCI working with the CHD completed the OCV first round mop up campaigns on 21 August The initial campaigns were interrupted by security concerns. The campaign reached 73,323 (52%) individuals aged one year and above in Kapoeta North. In Kapoeta East and South, ARC has finally completed the mop-up campaigns and compiled the data from the first round of OCV campaigns in the two Counties. The administrative coverage data from the first round OCV campaigns show that 78,863 (81%) and 66,300 (68%) individuals one year and above were reached in Kapoeta South and Kapoeta East respectively. However, data from two sites, Mogos and Jie in Kapoeta East is pending due to security concerns. Since the beginning of 2017, UNICEF has provided supplies to Cholera Treatment Centers (CTCs), Cholera Treatment Units (CTUs) and Oral Rehydration Points (ORPs) in affected communities. So far UNICEF has distributed 30 Diarrheal disease kits (DKK) and 100 cholera beds to ORPs/CTU/CTCs for effective treatment of suspected cholera cases. As part of cholera case management, the number of UNICEF supported ORPs increased from 37 to 46 with 9 additional ORPs in Juba, while 15 CTUs and two CTCs in key cholera hotspots in nine counties across five states are still supported. In response to the outbreak in Mayom and Budi counties, UNICEF is also providing cholera supplies to the health partners supporting the health response in the two counties. UNICEF supported other partners and MOH in OCV campaigns with vaccine management, management and social mobilization as well as trainings at the state and county levels during the Oral Cholera Vaccine Campaign in Kapoeta North, South and East. UNICEF together with WFP and other health partner is exploring the feasibility of conducting OCV vaccinations during Rapid Response Mechanism (RRM) missions in selected hard-to-reach areas that are at high risk of cholera outbreaks. 2

3 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. Preparations are underway to deploy 396,000 doses of oral cholera vaccines for vaccination in Juba, Lankien, Akobo and other areas in Jonglei, 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 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. Through State Ministries of Health and partners, UNICEF has been raising mass awareness in public places including POCs and IDP sites through street announcements, traditional performances and drama shows. Further, World Health Organization and UNICEF in collaboration with Vivacell Telecom Company have re-activated Cholera hotline (1144) respond to all calls as well as give basic education on cholera preventive measures. 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. 3

4 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% Table 2: Cholera culture test results Jun Aug Apr2017; 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 66,300 68% 29 Jul-4Aug 2017 ARC, WHO, UNICEF 907, ,086 71% 172,818 19% County Positive Negative (blank) Total tested Abyei 1 1 Akobo 1 1 Awerial Ayod Bor Budi 1 1 Duk Fangak Fashoda Juba Kapoeta East 4 4 Leer Magwi Malakal Manyendit Mayom Panyijar 1 1 Pibor 4 4 Pigi Renk 1 1 Rubkona Terekeka 2 2 Tonj East Torit 3 3 Uror 1 1 Wau 6 6 Yirol East Yirol West 2 2 (blank) Kapoeta South Nyirol Total tested Dates Partners 4

5 WASH CLUSTER RESPONSE UPDATES WASH Cluster Key Cholera Response updates Reporting period: August, 2017 Highlights 1. At least 122, 401 people reached with WASH Cholera response during the reporting period. 2. No reports from Tonj East by UNICEF. 3. Partners in Juba (NRC, PAH, SI) requested to report. Locations with ongoing WASH present Partners Ongoing Action with number of population reached with Cholera interventions Gaps and recommended action Kapoeta South, Kapoeta North, Kapoeta East IOM WASH Focal Point IOM, CINA, SSRC, IRW/UNICEF - IOM reached 5692 people during the week with WASH Cholera response. In Kapoeta town, Longelya and Pwata. - No reports from CINA this week - South Sudan Red Cross reached 4424 people with Cholera activities in Kapoeta Town. - CMD plans to implement WASH project in Kapoeta for 8 months - IRW/UNICEF: 7655 people reached with the Cholera response in Katodari and Narus during the reporting week. - Rural Action against Hunger (RAAH) reports are due. - Intersos will be implemented WASH project in Kapoeta East for 9 months; - Need a partner in North Kapoeta as IOM plans to mobilize their team elsewhere. - CMD will be taking over IOMs response in Kapoeta South as they plan to mobilize there team to another location Meetings and engagements: - Kapoeta case management, surveillance & OCV working group meeting: Wednesday 9 th Augu (10h 11h AM); 5

6 Locations with ongoing WASH present Partners Ongoing Action with number of population reached with Cholera interventions Gaps and recommended action - Kapoeta WASH cluster meeting: Friday 11 th August 2017 (1.30PM 3h PM) - Kapoeta Cholera taskforce meeting (with the Governor): Friday 11 th August 2017 (3h 5h PM) Budi County (Ngauro) SI (Ngauro) - Solidarités International conducted the assessment and started the response with Hygiene promotion and hand pump rehabilitation. Duk CRS- WASH Focal Point Uror and Akobo East Nile Hope WASH Focal Point CRS - CRS sensitize the community 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) - CRS sensitize the community on hygiene promotion and rehabilitation of boreholes (Pajut, Patuet, Turu, Kuergach, Kuerliet, Pamaidiang, Mananyang.) - PAH continuing the cholera response. Nile Hope - Nile hope is continuing with preparedness and response activities Awerial- Lakes state RUWASSA WASH Focal Point CRS, HELP RUWASSA, RUWASSA - House to house hygiene promotion carried out in site 0 Section 1, 2, 3, 6, 7 and 8 with total 5,293 beneficiaries reached through house to house visit of 785 households (341 men, 1,393 females and 3,559 children). - During jerry can cleaning with soap attended by 2,899 individual s men =262, women= 1,218 and children=1,419 participated with 5,086 Jerry cans were cleaned with soap in 17 water point - Distribution of WASH NFs during House to house hygiene promotion, water point monitoring (jerry can cleaning), schools visits and Outreached with 129 Bars of soap,25 Collapsible jerry cans 20 liters,2,018 strips of Aqutabs. - Completed construction of 50 HHs latrines and 50 on progress and materials distributed - Bad roads due to rainy season CRS Mingkaman; Duony-Gok, Dor school Primary School 6

7 Locations with ongoing WASH present Partners Ongoing Action with number of population reached with Cholera interventions Gaps and recommended action - Carry out environmental cleanliness in all targeted schools. - All three targeted schools break for holidays till first week of September - Daily inspection of pupil s hygiene was administered throughout the week by matron/patron. - Two additional school hygiene club members in Dor and Dor primary school head teacher have excavated their latrine at household level. HELP Mingkaman - Completed decommissioning of 30 communal latrines in site 1 and site 3. - Completed construction of 15 household latrines I site 1 and 3. - Recruitment of hygiene promoters on progress for 30 HPs. Yirol (Lakes) HELP WASH Focal Point - HELP - Caritas - CHADO - HACO HELP - Weekly cleaning campaigns in Yirol main market. - Continuous mobilization of HHs for latrine construction. - CLTS mobilization is ongoing in Amethic, Wunthou, Lekakudu and Billiny villages. - Continues with key Cholera Hygiene promotion messages in Yirol town through focus group discussion, in markets and other gathering places with 5528 individuals reached (men 729, women 1704, Boys 1054, Girls 2041) HHs (5329) individuals reached with key hygiene massages in Yirol town - Continues with hygiene and cholera prevention awareness sessions in 12 OTP facilities ( in Yirol west; Aluakluak, Pandit, Anuol, Wouwou, Agany and in Yirol east; Lekakudu, Billiny, Achigor, Amethic, Khap, Pagarau and Thonabutkok) with 5395 individuals reached (Men 621, Women 2364, Boys 1114, Girls 1298) - Provision of soap for jerry can cleaning campaigns in the water points with distribution of Aqua tabs as well. Caritas - Not available in meeting to share updates HACO - Hygiene promotion activities is continuous in the following areas Liepliep, Billiny, Bunagany and Bunmager. All the partners to share their updates on weekly bases for clear monitoring, coordination and support through the Cluster. 7

8 Locations with ongoing WASH present Partners Ongoing Action with number of population reached with Cholera interventions Gaps and recommended action Mayom - IOM - Samaritan Purse Juba Oxfam WASH Focal Point - Medair - THESO - UNICEF - Conducted hygiene campaign I cherich with 325 boys and 98 girls with 5 teachers, tinagau with 382 boys, 104 girls and 6 teachers - Mass campaign in Pagarau with 439 women, 191 men, mass campaign in tinagau with 83 Women and 114 men. - Jerrican cleaning on going in water points with provision of soap for washing water containers CHADO - C4D programs is continues for Nutrition, hygiene, malaria, education and routine immunization reaching 965 HHs with estimated 5380 beneficiaries with 11 case identified and referred on cholera with 2 deaths reported - Reached 6 sessions in primary school with estimated 6395 school children - Conducted 10 community meetings with 2327 individual - Reached 6 market sessions with 1296 estimated individuals reached - Reached 92 water point intervention with 2274 estimated individuals - Jerrican cleaning campaigns ongoing with provision of soap for washing water containers and distribution of Aqua Tabs. - Community sensitization/awareness. - IOM reached people during the reporting period in Kuerbuone and Mankien - Samaritan Purse reached 1200 in Mankein - Medair reached 5239 people in Kator and 10, 341 people in Rejaf Payam - THESO supported by UNICEF reached in Northern Bari ( including UN House POC) - Nile Hope reached about 5933 people with Cholera response in POC3. - Gifted Hands with UNICEF support reached 2371 people in Norther Bari All partners are requested to share the report. 8

9 SOCIAL MOBILISATION UPDATES Highlights of the week 1. A total of 38,916 people / 8,215 HHs from the cholera outbreak hotspots were exposed to cholera prevention strategies through house to house visits. 2. A total of 16,111 school children in 39 schools, also received cholera prevention education during school based interventions. 3. A total of 8,555 leaders and members from 65 communities were sensitized on important hygiene and sanitation practices to prevent and control cholera. 4. During 55 market outreach sessions, a total of 8,444 people among them food vendors received hygiene and sanitation messages to prevent and control cholera. 5. A total of 14,730 people reached through 6 rounds of street announcements with messages on how to prevent and control cholera. 6. A total of 1,273 people from hard to reach areas and cattle camps received cholera prevention messages including critical demonstrations in 167 water points. 7. Radio continues to complement the community and household interventions by resounding lifesaving messages in local languages, Arabic as well as English. 8. Partnership with religious leaders continues to stand out in Jonglei activity report with over 47 churches receiving cholera prevention messages during the worship gatherings. 9. No major challenge gap was reported ORS and 380 chlorine taps were reported as distributed. Social Mobilization, Communication and Hygiene Promotion Reporting Format (Date: 27 August 2017) Locations with ongoing Partners present Ongoing Action with number of population reached with Cholera interventions Tonj East: Most affected Makuac, Paliang, Paweng Payam, Tonj South and Marial-Lou-Tonj North. (Warrap) - CCM, THESO, UNICEF, WHO and SMOH 2 new suspected cholera cases from Ageer bac ORP & Paliang CTUs A total of 45 community mobilizers continued to actively work with the communities and households in Tonj East & Tonj North (Marial lou) A total of 32 case were identify and referred. During house to house visit, a total of 4624 people from 1167 HH were reached through cholera and immunization messages, Gaps and recommended action 9

10 Locations with ongoing Partners present Ongoing Action with number of population reached with Cholera interventions Gaps and recommended action Bor, Twic East, Duk and Pibor CDNF A total of 1567 school children in 10 schools participated in cholera prevention education session. During 9 community meetings 1,131 people received cholera prevention and control messages A total of 6218 people in 8 market places were exposed with cholera prevention and control strategies As part of cattle camp strategy, 197 nomadic population and water vendors were exposed to cholera prevention strategies including water treatment and household water safety practices during outreach sessions conducted in 16 water points. During the reporting period CDNF, an implementing partner of UNICEF continued to implement community engagement activities which include household visits with critical demonstrations, community meetings, water-point and market awareness outreaches, school and cattle camps intervention in areas of Bor, Duk and Twic East, Pibor and Pochalla through 100 trained volunteers social mobilizers/home health promoters). The following are key activities carried out by the implementing partner: - A total of 9,098 people from 2,353HHs educating community on social and behavior change intervention on cholera control and diarrheal disease prevention A total 4,730 school children from 14 schools in Bor, Twic East, Duk and Pibor counties participated in school-based interventions on cholera prevention education sessions As part of cattle camp strategy, 537 nomadic population and water vendors were exposed to cholera prevention strategies including water treatment and household water safety practices during outreach sessions conducted in 16 water points. 10

11 Locations with ongoing Partners present Ongoing Action with number of population reached with Cholera interventions Gaps and recommended action Pibor, Lekuangole, Verteth and Gumuruk Akobo, Old Fangak, Ayod, Pigi, Nyirol, Uror Nile Hope, FCDI FCDI A total of 1,038 food vendors operating in 18 market places, participated in good food and personal hygiene practices to prevent and control cholera. A total of 1,427 community leaders inclusive of community leaders which comprise of local chiefs, religious leaders and women and youth leaders received cholera prevention and control messages during 18 community meetings. Mingkaman and 95.9FM radios continue to complement the community and HH outreach efforts by resounding key lifesaving messages on cholera prevention and control. Over 47 churches in the counties of Bor, Pibor, Duk, Twic east, and Pochalla delivered lifesaving messages on cholera control and prevention during their religious services. A total of 104 community mobilizers continue to actively work with the communities and households of Pibor, Lekuangole, Verteth, and Gumuruk. During house to house visit a total of 32 case were identify and referred. During house to house visit, a total of 17,400 people from 3,480 HH were reached through cholera and immunization messages, A total of 6,890 school children participated in cholera prevention education session in Akobo, Uror and Nyirol. During 17 community meetings 5,812 people received cholera prevention and control messages A total of 6218 people in 8 market places of Akobo, Uror and Nyirol were exposed with cholera prevention and control strategies Over 14,500 people in Akobo, Uror and Nyirol counties were exposed to cholera prevention and immunization messages through 3 rounds of public announcements. A total of 91 trained community mobilizers continue to actively work with the communities and households

12 Locations with ongoing Partners present Ongoing Action with number of population reached with Cholera interventions Gaps and recommended action Juba Gurei, Kator, Lologo, Gumbo, Nesitu Health link During house to house visit, 3082 people from 474 HH were reached through cholera and immunization messages, A total of 2,924 school children from 15 schools participated in cholera prevention education sessions. As part of cattle camp strategy, 539 nomadic population and water vendors were exposed to cholera prevention strategies including water treatment and household water safety practices during outreach sessions conducted in 13 water points. During 17 community meetings 185 community leaders from previously restricted areas received cholera prevention and control messages. A total of 863 people in 23 market places were exposed with cholera prevention and control strategies Over 230 people were exposed to cholera prevention and immunization messages through 3 rounds of public announcements. A total of 42 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 741 households were reached with cholera messages. WASH supplies distributed during the reporting period includes 1958 ORS and 380 chlorine taps - 12

13 OCV Campaign mop-up: Save the Children International (SCI) team in cattle Camp 21/08/2017 Kapoeta North OCV Campaign mop-up: Final MOP UP campaign in Najia Payam 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 13