Registring people at cholera vaccination campaign at UNMISS Tomping IDP camp in Juba. Here Trina (medical advisor) shows the team how to best do this.
On December 15, 2013 fighting broke out in Juba and quickly spread to multiple locations across South Sudan. As a result of the fighting, thousands of IDPs fled into various âsafeâ sites including the UN MISS base in Tomping and the UN MISS base in Juba 3 also known as UN House. Sites were not well planned and the thousands of IDPs are now living within congested sites, with limited water supply, poor sanitation, and with current high rates of acute watery diarrhea and a measles outbreak.
Discussion began in January to determine if the risk of a cholera outbreak was significant enough such that the risk outweighs the logistic and financial costs that are incurred with such a response. Partners including MoH, WHO, UNICEF, MSF, and Medair met with the
Emergency Preparedness and Response team and agreed that the gravity of the risk and the appalling conditions in the camp necessitated a quick response. WASH partners have focused on cholera prevention activities including provision of clean water, construction of latrines, and hygiene promotion. Teams have worked non-stop, but the risk of cholera remains and the congestion of the camp is feared to create widespread attack rates and death should an outbreak occur.
On January 30th, the WASH cluster reported that hand washing campaigns started, improving the facilities and use in the toilets at the UNMISS Tomping site.
Awareness sessions regarding safe water, hand washing and safe food consumption have also begun. There is still a need to create space for additional latrines and bathing areas. Similar sessions on personal hygiene, hand washing, use of latrines, waste management and jerry can cleaning have begun at the UN House, targeting adults and children.
IDPâs at the UNMISS Tomping site remain inside the site due to ongoing safety concerns for the population outside of the site. The host population surrounding the UNMISS Tomping site are removed geographically as the UNMISS site is adjacent to the airport on one side and the IDP site is located within the inner portion of the UNMISS base.
As a result of the identified need and risk, Medair agreed to lead teams to carry out a mass oral cholera vaccination campaign in both UN MISS Tomping and Juba 3/UN House.
The total population for the UNMISS Tomping site is 20,498 (source: IOM registration). The target population for this location is 19,883 (97% of total). IN UN House, the total population is noted to be around 12,501. The target for this population is 12, 126. Vaccines will be provided to all children and adults over 1 year of age, excluding pregnant women.
Conditions for IDPs in UNMISS sited are disturbing with limited water supplies, appalling sanitation conditions, and extreme congestion. With Cholera being endemic and the possibility of carriers within the UNMISS base, the technical working group have determined to carry out a mass oral cholera vaccination campaign to aid in the prevention of a cholera outbreak.
Medair will identify IDPs within the sites, provide training on vaccine administration, and establish vaccination sites in both locations. Vaccinations would initially be carried out in Tomping and then the following week Juba 3/UN House will be covered. A week break will then ensure to allow the teams to reorganize and plan for the second round of vaccinations creating at least 14 days between dose 1 and 2.
Each IDP vaccinated will receive a cholera vaccination card. Cards will enable teams to identify who has received two doses of OCV during the campaign. With the influx of people, Medair will carry out 3 rounds of vaccination to ensure that those present only at the second round will receive their second dose. If possible, soap will be distributed to those IDPs who maintain their OCV cards to promote hygiene and encourage IDPs to come for the second dose. Each person vaccinated will also have the 5th digit on their right hand dipped in gentian violet as means of verifying those who have received a vaccine.
Together with the local camp authorities Medair will identify local IDPs to assist in the campaign. Training will be carried out over 1-2 days depending on the needs identified for vaccinators, registrars and mobilisers. Training will include key mobilization messages, methods for vaccination, vaccination techniques, waste management, and record keeping.
The vaccination team will record the number of vaccinations performed using a cholera tally sheet format. The Medair team leader will collect the tally sheets and used vials at the end of each day. Vaccine utilization rates will be calculated and recorded. All stationary supplies including tally sheets, pens, and clip boards will be provided by Medair. Utilization rates will be reported in the final report after concluding the campaign.
Vaccines will be provided by WHO in Geneva. Cold chain facilities will be provided by the MoH/ UNICEF and Medair in Juba, Central Equatoria State. Depending on the length of time required for the campaign, Medair may be required to exchange ice packs midway through the campaign to ensure maintenance of the cold chain. Exchange will be done with ice packs from the cold chain at Medair. All other consumables needed such as tally sheets will be provided by Medair.
Medair will facilitate and coordinate the vaccination campaign, will supervise the vaccination teams and coordinate the maintenance of supplies and the cold chain.
Medair will give incentives for the vaccination campaign based on incentives provided by the MoH and UNICEF in the initial vaccination campaign in Tomping site. Day labour for technical staff is set at 40SSP per day the equivalent of a little over $10 USD per day.
UN humanitarians said on Tuesday they allocated 125 million U.S. dollars for underfunded relief operations in 14 countries worldwide.
UN Under-Secretary-General for Humanitarian Affairs Martin Griffiths, who is also the UN’s relief chief, authorized the allocation from the Central Emergency Response Fund (CERF) for operations in Africa, Asia, the Americas and the Middle East, said the UN Office for the Coordination of Humanitarian Affairs (OCHA).
This year’s global humanitarian funding requirements have shot past 55 billion dollars and is less than 30 percent funded, according to OCHA.
“It is a cruel reality that in many humanitarian operations, aid agencies are scraping along with very little funding right at a time when people’s needs compel them to scale up,” Griffiths said. “Thanks to the generosity of a vast range of donors, we can count on CERF to fill some of the gaps. Lives are saved as a result. But we need individual donors to step up as well — this is a fund by all and for all.”
OCHA said the funding supports 250 million people affected by conflict, the climate impact, natural disasters, disease outbreaks, displacement and other crises.
“With this additional funding, CERF has allocated a record 270 million dollars so far this year through its Underfunded Emergencies window,” OCHA said. “This is the largest annual amount ever allocated, to the highest number of countries, a reflection of skyrocketing humanitarian needs.”
The CERF allocation, OCHA said, will help scale up humanitarian assistance in some of the world’s most protracted and neglected crises: Afghanistan and Yemen (20 million dollars each), Burkina Faso and Myanmar (9 million dollars each), Haiti and Mali (8 million dollars each) and will also support refugee operations in Bangladesh (8 million dollars) and Uganda (6 million dollars).
OCHA said funds also will go to Venezuela (8 million dollars), the Central African Republic and Mozambique (6.5 million dollars each), Cameroon and the Occupied Palestinian Territories (6 million dollars each), and Malawi (4 million dollars).