Sudan Health Highlights
An overview of Emergency Preparedness
and Humanitarian Action (EHA) activities
Weeks 20-21 of 2013 | 18-31 May 2013

Inaccessibility due to security issues has been a major concern in North Darfur particularly in conflict-affected areas of
Jebel Amir namely Elseraif town, Kebkabya and Saraf Omra. The situation has posed threats to health service delivery.
Recently, cases of suspected acute jaundice syndrome (AJS) and measles were reported from Elseraif area, and
emergency response was not immediately carried out due to security issues.

Acquiring permits to transport medicines and supplies to Kaguro, Sarafaya, SagElnaam, Abudeleg, and Kobe Athar has
been an a major issue in the delivery of health services.

In West Darfur, three separate training courses on water-borne diseases, water safety, as well as water quality testing
were conducted in Geneina and Zalengei. Some 56 health workers and volunteers were trained by facilitators from the
State Ministry of Health (SMoH) and the World Health Organization (WHO).

In South and East Darfur, access to some localities particularly those within Jebel Marra has been a concern for
organizations working in the area. To urgently cover gaps in health services, WHO has been working closely with SMoH
and health partners.

To strengthen disease surveillance system in the eastern States, WHO in collaboration with the Ministries of Health
launched the mapping survey of 321 sentinel sites.

Between 13 May and 30 May, 33 suspected cases of Dengue Fever with one death were reported from Port Sudan
Locality (ten cases) and Sawakin (23 cases) in Red Sea State.

From 1 January 2013 up to 31 May 2013, a total of 317 suspected meningitis cases including 14 deaths were reported
from all Sudan States.
WHO’s Emergency Preparedness and Humanitarian Action (EHA) in Sudan is funded by:
Government of Finland
Communicable diseases surveillance and response
Dengue Fever in Red Sea State
Between 13 May and 30 May, 33 suspected cases of Dengue Fever with one death were reported from Port Sudan Locality (ten cases) and Sawakin (23 cases) in Red Sea State. 54.5% of the reported cases were within the age group of
15-29 years and 27.2% within the group of 30-44 years. Blood samples from all suspected cases were collected for
rapid testing. Twelve of the cases were found positive for Dengue Fever. WHO continues to provide technical support
and supplies to support the MoH contingency plans along the lines of disease surveillance, case management, vector
control and coordination to mobilize partners to support SMOH and to closely monitoring the outbreak containment
activities.
Meningitis Update
From the first week of January 2013 up to the last week of May 2013, a total of 317 suspected meningitis cases
including 14 deaths were reported from all Sudan States (except East Darfur, Northern and Red Sea state) including 14
deaths (case fatality rate of 4.4%). Of these cases, 66% of the reported cases were males and 34% were females. 47%
of the reported cases are in the age group 1-4 years and 20.2% were in 5-14years of age. A total of 179 cerebro-spinal
fluid (CSF) were collected and analysed at the National Public Health Laboratory. Only ten of the samples yielded positive results (8 Streptococcus pnumonae, 1 Heamophilus influenza and 1 Neisseria meningitides, W135). The one case
of W135 was reported from South Darfur. So far this season no alert or epidemiological threshold was reached in any of
the pre-determined epidemiological sectors.
EWARS Reporting
From 25 May to 31 May 2013, 76% of the sentinel
site reported to the early warning alert and response
system (EWARS) in Greater Darfur. The benchmark for
timely reporting, in order to periodically monitor the
quality of the surveillance performance of EWARS,
has been set at 85%, please see figure . Around 40
613 consultations were recorded from 2378146
reported populations under surveillance.
Incidence rate (IR) per 10000 population of ARI, Bloody Diarrhoea
& Malaria reported in Greater Darfur, W 19 to W 22, 2013.
State
South
Darfur
West
Darfur
North
Darfur
D i s ease
Incidence Rate
W 19 W 20 W 21 W 22
ARI
BD
MAL
ARI
BD
MAL
ARI
BD
MAL
12
4.4
2.9
28.4
3.8
3.7
19.1
1.7
3
18.1
4
3.1
24.2
3.8
4.5
16
1
2
12.5
3
2.7
23.3
3.0
4.9
18.4
0.9
1.8
12.5
3.3
3.3
24.6
3.6
3.8
21.1
1.3
2.3
Diseases of Public Health Importance



Acute Respiratory Infections (ARI), Bloody Diarrhoea
(BD), Clinical Malaria (MAL), were the leading causes
of morbidity in Darfur from 25 to 31 May 2013.
During the week, 200 cases of acute jaundice
syndrome (AJS) were reported: one case South
Darfur, four cases from West Darfur, and 195 cases
from North Darfur. The total number was in addition
to the one hundred cases reported last week.
No case of suspected measles was reported this
week. Through EWARS, four deaths were reported
from Greater Darfur and were attributed to ARI
(1 fatality), MAL (fatality), injury (1 fatality) and other
causes (1 fatality).
Communicable diseases surveillance and response
Disease morbidity in East Sudan
Please refer to table below comparing incidence rate/10000 population in
the eastern states (Gedarif, Kassala and Red Sea). 2
Comparison of incidence rate (IR) per 10,000 populations of common diseases reported in East Sudan, W 19 to W 22, 2013.
State
Kassala
Gedarif
Red Sea
Disease
MAL
TB
Typhoid F.
BD
Bilharzias
MAL
TB
Typhoid F.
Kala-Azar
BD
Viral H.
MAL
Viral H.
BD
Measles
W 19
9.8
0.3
0.2
1.4
0.6
8.8
0.0
1.4
0.1
2.5
0.0
1.9
0.0
0.8
0.1
Incidence Rate
W 20
W 21
12.4
11.5
0.2
0.2
0.3
0.2
1.1
1.2
0.9
1.0
7.7
8.8
0.1
0.1
1.4
1.4
0.2
0.1
2.1
2.4
0.0
0.0
1.9
1.7
0.0
0.0
0.8
0.9
0.0
0.0
W 22
9.3
0.2
0.3
1.6
0.8
9.3
0.1
1.3
0.1
2.5
0.0
1.7
0.0
0.8
0.0
Coordination
In North Darfur, WHO and health sector partners assessed and monitored the health situation of communities in Jebel
Marra. Gaps in environmental health services in Elserief were identified. More than1.5 tons of medicines and medical
supplies including laboratory reagents were airlifted by UNAMID flight to health facilities in Elserief and Saraf Omra.
Moreover, improvements of health infrastructure, laboratory services, healthcare waste management, as well as logistical
needs were concerns addressed by health sector partners including MoH, WHO, UNFPA, ICRC and UNAMID.
In West Darfur, the implementation of cleaning campaign in Geneina town and verification of measles cases reported from
Kulbus, as well as the rainy season’s early preparedness plan were the main issues agencies working for health looked into
and prioritized in their respective organization’s plan of action.
In South Darfur, Care International Switzerland (CIS) agreed to take over the operations of the Saudi Red Crescent Authority
(SRCA)-supported clinic in Al Salam camp to help fill the gap in health service delivery in one of Nyala’s most populated
camps.
Primary healthcare

As tribal conflicts continued, major international nongovernment organizations temporarily suspended provision of
services to communities in Jebel Amir in North Darfur.
However, WHO ensured that organizations working in conflictaffected areas have sufficient essential medicines to provide
minimum primary healthcare services, when they would
resume providing health services in the affected areas.

Eighty five community health volunteers from Mallet locality
who were earlier trained by SMoH and WHO participated in a
five-day campaign. Health volunteers disseminated messages
in their communities on communicable diseases and preventive measures, as well as issues on mother and child health.

In South Darfur, WHO conducted a two-day training
programme on rational use of drugs targeting 20 medical assistants from Umlabasa town and the surrounding villages.
The course conducted in collaboration with SMoH, covered
topics such as drug cycle management, supervision and monitoring of the rational use of drugs (RDU), key concepts of RDU,
essential medicines, as well as lessons learnt from Sudan experience.
Newly displaced population temporarily settling at
Alzahraa School in Nyala, South Darfur as they listen
to a community health promotion volunteer. Health
promotion activities in camps are complemented by
films shown through mobile video equipment.
Secondary healthcare

In North Darfur, WHO provided support to the renal dialysis unit in El Fasher Teaching Hospital by donating medical
supplies to support the unit’s daily operations, providing dialysis services to at least 20 patients per week, 60% of
whom are internally displaced persons.

WHO provided the health facility inside Shalla prison with essential medicines and supplies. Around 30 patients are
being attended by the prison’s clinic daily.

In West Darfur, WHO provided medicines and consumable items to cover requirements of 100 patients of the Geneina
teaching hospital’ pediatric ward for at least two weeks.

On 28 May 2013, WHO handed over a donation of equipment and furniture for the Dakar Halal Family Health Center
built near Nyala, South Darfur.

Strengthening of Nyala teaching hospital’s referral system has been supported by WHO, along technical guidance, facilitation, as well as provision of required essential medicines and surgical supplies.

Nyala’s Renal Dialysis Centre received medicines and supplies sufficient for one month.
Environmental health

Between 21 and 28 May, WHO and MoH conducted a supervisory mission in Elseraif town in North Darfur. The mission’s
tasks were: monitor water quality from various water sources, assess the health care waste management in health facilities, as well as observe the main vector breeding sites in town. These were the major findings:

There is a need to strengthen water chlorination activities in different sources of water in Elseraif town. Results
of the bacteriological analysis of 19 samples collected from different sources showed that eleven or 58% of
the total samples collected were unfit for human consumption. Two hand pumps and nine hand dug wells were
contaminated.

A four-day chlorination of water sources was prioritized by a team of 12 environmental health workers comprising of ten operators and two supervisors from MoH.

During these four days, 20 samples from different households were tested for free residual chlorine (FRC) and
the results showed that levels were within WHO standards.

The medical waste disposal system at the clinics is functioning properly; however, the hospital’s medical
waste disposal system needs support.

On a weekly basis, garbage collection campaigns have been conducted by youth groups in and around the
market, as well as ensuring that dead animals have been properly disposed.

Many areas in Elseraif were observed as main breeding sites for malaria vectors, in addition to scattered open
defection areas. Once unattended, the situation will increase the probability of vector borne disease outbreaks
during the rainy season.

In West Darfur, three separate training sessions on water borne diseases, water safety, and water quality testing were
conducted. In El Geneina, two sessions were attended by 36 participants, while one session was conducted in Zalinglie
with 20 participants. The training programme was aimed to build capacity of the technical staff at MoH, as well as to
institute the monitoring of water quality in the State, and to facilitate the establishment of water quality data base.

Along with laboratory items, WHO donated reagents for bacteriological tests to the MoH and Islamic Relief in Central
Darfur State. The donation included membrane filters, absorbent pad dispenser, DPD1 + DPD3, PH meter, sample cup,
Petri dishes, vacuum pump, and Agar media to facilitate the monitoring of water quality in high risk areas of Central
Darfur state.

Two workshops were conducted in South and East Darfur targeting 80 community volunteers in Kass and Eldeain. The
workshops focused on awareness raising on public health and environment hazards around communities/
neighbourhood and provided information on hazards and sound management practices for preventive environmental
health interventions.

A mass vector control campaign was conducted in South Darfur, due to increased density of house flies in the new arrival areas and the observed deterioration of the living environment in camps. The vector campaign covered camps in El
neem, Derije, Ottash and El Zahra school targeting the adult flies and breeding sites. El Salam camp was not included
due to security reasons.

In Kassala State, health promotion campaign was successfully conducted in Nhri Atbara locality to reduce the incidence
rate of vector transmitted diseases to low level through dissemination of health messages, particularly on safe drinking
water, solid waste treatment, food safety and vector control.
For further information please contact:
Dr. Iman Shankiti
EHA Coordinator | WHO Sudan
[email protected]
Mrs. Christina Banluta
Communications Officer | WHO Sudan
[email protected]
For more information visit http://www.emro.who.int/countries/sdn/