Health officials in South Sudan have been preparing for potential outbreaks of cholera, an infectious disease causing diarrhea and vomiting. They are training community health workers how to spot the disease.

Cholera spreads mainly through drinking water that is contaminated by the feces of infected persons, so emergency health officials in South Sudan are coordinating with sanitation providers to try to improve sanitation and water services, as well as boost community awareness of sanitation issues. 

The Health Cluster, a coordinating body of different aid organizations, said in a regular bulletin published Thursday that health organizations are on the lookout for cholera cases. However, four suspected cases of cholera reported at Tongping camp have tested negative.

Nonetheless, the aid groups have convened emergency meetings to address a potential cholera outbreak, together with the Water and Sanitation (WASH) cluster. This working group discussed “joint health and hygiene promotion activities, a harmonized training package for community health workers, and safe water and sanitation situation in the IDP camps,” says the update.

MSF has already established a cholera treatment centre at Tongping IDP camp in Juba. “Preventive messages on cholera were disseminated to the community. Partners continue to put in place contingency measures to respond to the likelihood of epidemics of diarrhoeal disease in the upcoming rainy season,” reads the bulletin.

Likewise, in the UN House camp, the World Health Organization trained 16 community health workers on disease surveillance and management of diarrhoeal diseases including cholera.

Health officials have also met in Bentiu together with sanitation officials to discuss cholera preparedness and plans for scaling up hygiene promotion and provision of safe water. Another concern is “availability of medicines and medical supplies for management of a potential cholera outbreak.” 

Cholera vaccination campaign has been targeting IDPs in Mingkaman, Awerial County and in Tongping camp. In total, 54,208 people were vaccinated in the second round of the campaign. Normally the vaccine is given in two doses, making it more complicated for this vaccine to be used in conflict situations where mass populations movements can occur. 

In Tongping IDP camp the second round of the Oral Cholera Vaccine (OCV) mass vaccination re-commenced on the 25 March 2014; 1,432 persons (298 persons for the first time) were vaccinated bringing the cumulative total number vaccinated to 13,443 out of which 2,388 received the vaccine for the first time.

Other outbreaks of diarrheal disease are also a concern for the health organizations. There was a “substantial increase in bloody diarrhoea amongst IDPs in Bentiu, with 80 cases reported recently within a one week period."

Measles, STIs risk

Outbreaks of measles killed at least 85 people in South Sudan since the beginning of the year. Suspected cases of measles continue to be reported from Bentiu, Lankien, Nasir, Tongping, Yida, and Yuai IDP camps. 

In spite of vaccination campaigns, population movements mean that the risk of measles outbreaks remains, according to health organizations. The Ministry of Health has planned to conduct a nationwide mass measles campaigns in April, starting with the seven least conflict-affected states.

According to health workers, sexually transmitted infections are also becoming a ‘major concern’ because of suspected rates of infection among youths in the camps. But patients are reluctant to seek treatment because of fear of stigmatization.

Photo: An MSF worker holds a baby during the launch of a cholera vaccination campaign in Juba, 22 February 2014 (AFP/Charles Lomodong)