UNDECLARED CHOLERA EPIDEMIC CONTINUES IN JUBA

UNCLAS KHARTOUM 000478

SIPDIS

SIPDIS

E.O. 12958: N/A
TAGS: EAID SOCI TBIO SU
SUBJECT: UNDECLARED CHOLERA EPIDEMIC CONTINUES IN JUBA

REF: Khartoum 445


1. SUMMARY: The office of the UN Humanitarian
Coordinator for Southern Sudan confirmed on February 20
that WHO has cultured six positive cholera infections,
the tripwire for declaring an epidemic. The GoSS,
however, has thus far not officially declared an
emergency, and the UN and other bodies fear the spread of
the disease to other towns less capable of dealing with
an epidemic. The UN has undertaken preventive measures
in Juba. Other diseases have been identified in other
areas of Southern Sudan, and still others are lurking in
the wings. The lack of capacity in the GoSS Health
Ministry has become painfully obvious. End Summary.

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The Epidemic and Where it Might Spread
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2. The acting UN Humanitarian Coordinator (UNHC) told CG
on February 20 that more than fifty people had died in
the ongoing epidemic (reftel),and that the WHO has
positively identified enough confirmed cases to
categorize the disease as a cholera epidemic. For
uncertain reasons, the GoSS has been reluctant do declare
an emergency or publicize the dangers of the epidemic
spreading to other towns. The UNHC said that there have
been additional recorded deaths in Yei, from whence the
disease reached Juba, but that NGOs there report that for
the most part the disease has run its course.


3. The present concern is the further spread of the
epidemic from Yei to Maridi and from Juba to Torit.
Traders from Yei were among the first cases hospitalized
in Juba. The NGO capacity in Maridi is sufficient to
provide some bulwark against a runaway epidemic, but
there is not capacity to speak of in Torit. The arrival
of cholera there could trigger a widespread, high
mortality event. The UNHC said that some of the
unexpected downsides of peace vis a vis health had been
the rapid increase of urban populations and greater
access between towns by road.

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Preventive Measures Underway
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4. The various task forces in Juba have taken various
measures to check the spread. They have used the town
crier service, yellow taxis with loudspeakers mounted on
the roof, to spread word of the epidemic and describe
countermeasures. They are seeking access to radio for
public health announcements, although this medium reaches
fewer, is unreliable, and is subject to the Minister's
review. The UN has established a refrigerated
containerized morgue to hold bodies between the time of
death until burial, to prevent the body touching common
in local culture. The NGOs have set up additional
isolation wards, and when one child transported to Bor on
a barge was identified as ill, additional barge trips
were postponed and the child was successfully isolated in
a clinic on Bor. The task forces would like to begin
treating water in other vulnerable locales with chlorine
now, as a precaution, and are seeking GoSS approval.

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Worse Ahead?
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5. Cholera is not the only disease of concern. Experts
have confirmed outbreaks of whooping cough in Bahr el
Jebel and measles in Western Equatoria. Within a few
weeks, when the seasonal dust storms begin, the annual
cycle of viral meningitis is also expected to hit. This
airborne disease has traditionally had a high mortality
rate and, unlike cholera, leaves many of those that
survive with serious permanent disabilities. The
inability of the GoSS Ministry of Health to address
decisively an epidemic in urban centers where health care
exists exposes is vulnerability to take many effective
measures against disease in outlying rural areas.

HUME