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Cholera returns to South Sudan

Davis Mugume and Gale Julius
Hundreds of cases of cholera have been confirmed in South Sudan. Health and humanitarian agencies warn of a potential epidemic and have set up emergency treatment centres across the country.
1.08.2016  |  Juba, South Sudan
Kiir Thon Ajak receiving cholera treatment at the Juba Teaching Hospital, July 27, 2016. (photo: The Niles | Gale Julius)
Kiir Thon Ajak receiving cholera treatment at the Juba Teaching Hospital, July 27, 2016. (photo: The Niles | Gale Julius)

At least 21 people have died because of a cholera outbreak in South Sudan. The Ministry of Health announced a suspected outbreak of the water-borne illness on July 18 and the World Health Organization (WHO) confirmed the outbreak on July 25 after 77 percent of samples taken to the national public health laboratory tested positive for cholera. WHO cites at least 522 cases of the disease in Jubek-Juba County alone. Cases have also been confirmed in Jonglei and Terekeka.

“We are noticing that the number of new cases is increasing significantly,” Tim Irwin, a spokesman for UNICEF in South Sudan, told The Niles. “For example last week we had 46 new cases, while yesterday (Wednesday, July 27) alone we had 35 cases.”

#SouthSudan | #Juba – At least 522 cases and 17 people have died because of a cholera outbreak in South Sudan, according...

Posted by theniles.org on Monday, 1 August 2016

WHO, Médecins Sans Frontières (MSF), UNICEF and other humanitarian agencies have set up emergency treatment facilities known as Oral Rehydration Points (ORPs) in several states as a preventive measure. ORPs are up-and-running in the following hospitals, according to Dr. Usman Abdulmumini, WHO South Sudan Country Director: Gurei, Kator, Lologo, Gumbo, Munuki, Gorom, Khor Williams and al-Geida. Other treatment points have been established at al-Sabbah Children’s Hospital and Juba Teaching Hospital.


“Treatment starts at home”

At the ORPs, dozens of health workers, known as hygiene promoters, teach patients and their families about better hygiene practices. MSF’s Emergency Coordinator Anja Wolz says people can avoid cholera by making sure that the water they drink is clean and safe. “Cholera can kill, but with early medical care people have a very good chance of survival,” Wolz told The Niles.

Also read:
Juba’s deadly water
by Francis Michael
Parasites, disease and even death are risks of drinking water from the Nile in South Sudan’s capital.


“We want to make sure people know that if they have watery diarrhoea more than three times in one day then they may have cholera. With early diagnosis and treatment, people have a very good chance of survival. Treatment starts at home – people should drink Oral Rehydration Solution and then seek medical care as quickly as possible,” added Wolz.

Cholera is an acute water-borne diarrhoeal disease caused by an infection in the intestines that can kill a healthy adult in a matter of hours. Symptoms include chronic diarrhoea, extreme dehydration and kidney failure.


500 cholera deaths since 2011

MSF says it will vaccinate 14,000 people against cholera in Juba alone. More than 2,300 had been vaccinated in Jubek State by July 27, according to Wolz.

Health agencies continue to prepare for a further spread of the outbreak, yet several factors hamper their efforts to isolate the disease. With no proper sanitation facilities in some South Sudanese homes, the risks of a cholera epidemic remain high.

Juba Teaching Hospital Medical Director Dr. Marik Issac said people who drink water directly from the river are also vulnerable to cholera infection. More than 500 people have died of cholera in South Sudan since 2011, according to the WHO.

Kiir Thon Ajak, a soldier in the South Sudan national army, survived because he was administered emergency treatment just in time at Juba Teaching Hospital last week. He had been rushed to the key medical facility unconscious after losing large quantities of liquid from his body.

“Now the vomiting has stopped and I’m able to move after receiving help,” said Ajak, recovering in his hospital bed.

#SouthSudan | #Cholera – One issue that health workers are encountering is that many people in the #Juba area are afraid...

Posted by theniles.org on Monday, 1 August 2016


Patients afraid to visit ORPs

One issue that health workers are encountering is that many people in the Juba area are afraid to leave their homes to visit the emergency treatment centres. South Sudan’s capital remains tense following clashes earlier this month between government and opposition forces, which left hundreds dead. “People should not fear coming to hospital when they fall sick,” Ajak told The Niles. “You cannot run way from sickness. I’m only okay now because I came to hospital.”

Health experts say they are monitoring the situation on a daily basis. “Every day we meet, we look at the data and if there are new areas emerging we set up oral rehydration centres in that area,” Dr. Wamala Joseph Francis, an epidemiologist working in South Sudan, told The Niles. Dr. Francis emphasised that patients with cholera symptoms should seek treatment as soon as possible.


IPD sites at risk

Health agencies are targeting what they regard as high-risk areas or places that are prone to contamination such as sites for internally displaced people.

A spokesman for UNICEF South Sudan said experts in the field are working overtime to prevent an outbreak in crowded areas, such as UN Protection of Civilian (PoC) sites for citizens displaced by the recent waves of fighting.

“We have teams out there to help educate communities who are at risk of contracting cholera. So we hope through social mobilisation and integrated emergency services, we can stop the spread of cholera,” says James Timothy Irwin, a spokesman for UNICEF South Sudan.


Rains a concern

Experts say the forthcoming rainy season could worsen conditions. “The risk of further spread of disease is a major concern.

With the coming rains, it is realistic to expect an increase in malaria and water-borne diseases,” says WHO’s Country Director, Dr. Abdulmumini. “Consequently, we can expect medical needs to increase in an environment where WHO and partners are already working hard to keep up with existing health needs.”

Also read: 
Rainfall, lakes and boreholes
by Charlton Doki
Quick facts about where water is found, how it is used, and why it is such a problematic topic in South Sudan.

 

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