27 May 2014 - The number of suspected cholera cases in Juba has risen to over 670 with 23 deaths, leading health officials to double their estimates of people who could contract the disease.
“Because of the current caseload … we went back and recalculated the estimate,” UNICEF Senior Emergency Specialist Abdulkadir Musse said at a Juba press briefing. “In two weeks’ time, the number of cases – it’s very high.”
The national Ministry of Health and World Health Organization (WHO) had expected 1 per cent of the population – about 5,000 people -- would show cholera symptoms, but that had now been revised to 2 per cent, Mr. Musse said.
The majority of suspected cases were in Juba, but the disease was now in danger of spreading to other states, said World Health Organization Acting Officer-in-Charge Dr. Abdinaisir Abubakar.
“There is a risk of the outbreak spreading to other surrounding counties and villages if community interventions are not rigorously conducted,” Dr. Abubakar said.
Interventions include identifying cases quickly and bringing them to the Cholera Treatment Centre (CTC) at Juba Teaching Hospital, he said. Of the 23 people who had died, 13 had passed away in hospital and nine in communities where they lacked treatment.
To make facilities more accessible, Medecins Sans Frontiers-Belgium had just opened another CTC in Juba and health partners planned to establish additional ones, said UNICEF’s Dr. Musse.
“That is one of the reasons patients are dying,” he said. “Because people are arriving at the CTC in a severely dehydrated state. We need to take the CTCs closer to the communities.”
Dr. Abubakar said Juba had been free of the waterborne disease since 2007, but living conditions had recently worsened due to conflict in the county, including overcrowding in internally displaced persons (IDP) camps as well; as poor water, sanitation and general hygiene.
“Most people who have contracted cholera drank untreated water from the River Nile and ate un-hygienically prepared food from markets/roadside vendors,” he said. Other risks included poor latrine use and personal hygiene, open defecation and improper handling of dead bodies.
Responding to poor IDP camp conditions before the outbreak, WHO carried out mass cholera vaccination campaigns, originally in Juba with its more than 18,000 displaced, Dr. Abubakar said. It has now moved to other states with IDPs, with a final campaign ongoing in Bentiu, Unity State.
To decongest Juba displaced camps and reduce the cholera risk, UNMISS Spokesperson Ariane Quentier said IDPs from the mission’s Tomping site would be gradually moved to a new one on higher ground with better drainage.
The site, funded by the Chinese and located on land provided by the government, would be inaugurated on 28 May.
A new site was ready in Bentiu and others were being constructed or improved in Bor, Jonglei, and Malakal, Upper Nile, she added.
UNICEF’s response to the outbreak had been to coordinate hygiene in the areas of health, water and sanitation as well as social messaging, Dr. Musse said.
The agency had helped establish the hospital CTC, provided tents, oral hydration solutions, protective gear, water chlorination soap, hand washing buckets, vaccines and diarrhoeal kits, he said.
Stressing the need to spread messages about safe hygiene, Dr. Musse said the agency had also trained over 175 community volunteers in 18 communities and social mobilizers to carry out house-to-house awareness raising.