OCHA: Humanitarian Bulletin Sudan Issue 32 | 3 – 9 August 2015
Poor nutrition levels across Sudan
According to the UN Children’s Agency (UNICEF), in Sudan some 2 million children under age five suffer from chronic malnutrition. The Sudan National S3M survey conducted in 2013 revealed that 128 of the total 184 localities in the country have astunting rate classified as “high”—above 30 per cent. Moreover, there are pockets of very high stunting rates, found mostly in the eastern states of Red Sea, Kassala and Gedaref, with the highest being Gedaref at 73 per cent. A further 1 million children in Sudan under age five suffer from acute malnutrition resulting in an average global acute malnutrition (GAM) rate of 16.3 per cent, which is above the 15 per cent threshold that constitutes a critical emergency. In several localities across the country, however, the GAM rate is alarmingly higher. In Red Sea State, localities have GAM rates as high as 46.7 per cent (Toker locality) and 37.4 per cent (Agig locality). Among the Darfur states, the poorest nutrition levels are observed in North Darfur, where four localities have GAM rates above 25 per cent (El Sireaf, Ailliet, Dar El Salam, and Kalimendo).
Of the 1 million children who suffer from acute malnutrition, some 550,000 are severely malnourished and at risk of death.[Note: this is a shockingly high figure, and the first time that I know of the OCHA has made it public—most children suffering from SAM outside a hospital or treatment center will die—ER]. Of Sudan’s 184 localities, 53 have severe acute malnutrition (SAM) rates that are classified as very critical (above 3 per cent). The highest SAM rates measured are above 20 per cent, and are found in three localities in South Darfur and Red Sea. Most of the children with SAM are found in North Darfur, El Gezira, South Darfur, Khartoum and Gedaref. These five states carry 51 per cent of the national SAM burden.
[Noting some gains to mollify Khartoum, OCHA goes on to note—ER] child mortality remains very high and the situation of children remains critical. According to UNICEF, the key drivers of this poor situation are the high incidence of communicable diseases amongst children—particularly diarrhoea, measles, pneumonia and malaria—and lack of access to basic services such as quality health care and safe water and sanitation facilities. Socio-cultural beliefs and practices as well as ongoing conflict and displacement and food insecurity continue to fuel and exacerbate the situation. Furthermore, with the start of the lean season all feeding centres for severely malnourished children are experiencing an increasing number of children identified for treatment, leading to overcrowding in hospitals.
States with GAM rates above the emergency threshold of 15% (click on this link—most of Darfur is included in the map—ER)
WFP nutrition interventions facing shortage of supplementary food stocks
World Food Programme (WFP) nutrition interventions are constrained by a lack of funding and difficulties in importing nutrition supplements (supercereals) due to genetically modified organism (GMO) regulations in Sudan. WFP is working closely with the National Bio-Safety Council to address the government’s zero tolerance for GMO in specialized food to resolve the issue. These constraints have significantly impacted the timeliness of WFP’s food supply, and the near depleted stocks of supercereals will not be enough to sustain treatment programmes for more than 150,000 acutely malnourished children and pregnant or lactating women in need. WFP hopes to mitigate the impact of these shortfalls by locally procuring some quantities of supercereals. WFP will also continue to appeal for more funding for its nutrition interventions. In the meantime, WFP will continue to use the limited quantities of supercereals and Plumpy Nut nutrition supplements while further prioritizing its emergency blanket supplementary feeding programme (eBSFP) and treatment programmes for moderate acute malnutrition.
East Darfur: Stabilisation centre in Ed Daein operating beyond capacity
The international NGO Tearfund reported a high number of malnourished children in the stabilisation centre in Ed Daein, East Darfur, forcing each bed to be shared by two children. The centre has a capacity of 21 children, but as of 5 August 42 children had been admitted. As an interim solution, a veranda has been converted into an extension of the stabilisation centre to accommodate additional patients. The ongoing lean season is posing a challenge to the nutrition programme, as is WFP’s shortage of supplementary food. Current stocks in Ed Daein will run out by 15 August.
Measles outbreak: 2,896 cases including 43 deaths
According to the MoH, 2,896 confirmed and 4,545 suspected measles cases, including 43 deaths, have been reported in Sudan as of 26 July 2015. The outbreak started in December 2014 and has affected 61 localities across all 18 states. The majority of cases (72 per cent) have been among children under 15 years, with the highest number of cases reported in the states of West Darfur (666), Kassala (516) and Red Sea (432). The highest number of deaths (14) was reported in East Darfur.
Aid organisations continue to respond to the outbreak in their areas of operation. Response measures include health awareness sessions, case detection, ensuring proper case management and providing daily reports. According to the MoH, insufficient funds are hampering the implementation of a country-wide immunization campaign putting some 16.5 million children between six months and 15 years at risk of the disease.UNICEF supported the MoH in the procurement of approximately 9.6 million doses of vaccines targeting 7.9 million children between 6 months and 15 years in 96 affected and high-risk localities through a three-phased campaign. As of the end of June, the MoH—with the support from UNICEF and the World Health Organization (WHO)—has vaccinated a total of 6.3 million of the targeted children, about 79 per cent. However, this number only represents 38 per cent of the 16.5 million children of the same age group in the country. Children living in inaccessible areas of Blue Nile and South Kordofan States and parts of the Jebel Marra remain out of reach by measles vaccination campaigns, and many have not received routine immunizations since 2011. This not only leaves these children at heightened risk, but also increases the vulnerability of children throughout the country as such extensive gaps in coverage ensure the sustainability and continued spread of the disease in Sudan.
Furthermore, there is growing concern about the new andincreasing number of measles cases, as well as reported deaths, especially in the Darfur and River Nile states. Further investigations have revealed that the majority of deaths are associated with underlying malnutrition, highlighting the need for more comprehensive case management. In order to achieve community immunity, the MoH has requested partners to support fund raising efforts for a national catch up campaign for all children below the age of 15 years. An additional US$5 million is required to procure the much needed doses of measles vaccines, scale up social mobilization interventions and support relevant operational costs required to undertake a comprehensive national catch up measles vaccination campaign.
Heavy rains and floods affecting delivery of aid
Although most of the country has experienced a late onset of the rainy season, heavy rainfall and flooding has already started to damage roads and affect the delivery of aid in parts of Darfur. Disruptions in the timely provision of humanitarian assistance to those in need increase the vulnerability of thousands of households during the lean season—the period when food insecurity of vulnerable household is usually at its highest.
West Darfur: Heavy rains affect access to parts of West and Central Darfur According to aid organisations in West Darfur, heavy rains have damaged roads and filled many of the wadis (seasonal riverbeds) in West Darfur, making access to parts of the state and to parts of Central Darfur difficult for humanitarian actors. In particular, poor roads are hindering movement of staff and relief supplies within West Darfur and to locations in Central Darfur, including Mukjar, Wadi Sali and Um Dukhun localities. However, some partners, including WFP and UNICEF, already pre-positioned food and nutrition supplies to last at least three months in these hard-to-access locations. The overflowing wadis also heighten the risk of drowning. According to the African Union—United Nations Mission in Darfur (UNAMID), at least three deaths due to drowning have been reported in El Geneina, West Darfur.
South Darfur, mission to assess needs of returnees in Gereida postponed
In South Darfur, an inter-agency assessment mission to return villages in Gereida locality was postponed until after the rainy season due to inaccessible roads. In June, WFP reported that 11,634 displaced people from Gereida IDP camps had either returned to their home areas or indicated their willingness to return. WFP had already classified the needs of the displaced people who intend to return based on information gathered during a recent camp profiling exercise. These needs included income-generating activities, Food for Assets and Food for Work programmes, education kits, support for newly constructed schools, and healthcare, as well as water, sanitation and hygiene services.
FEWS NET: 4 million people in Sudan face stressed and crisis levels of food insecurity
According to the latest Famine Early Warning Systems Network (FWES NET) Food Security Outlook Report July-December 2015, as of July an estimated 4 million people in Sudan face Stressed (IPC Phase 2) and Crisis (IPC Phase 3) levels of acute food insecurity. Most of these people are in conflict-affected areas of Darfur, South Kordofan, West Kordofan, and Blue Nile states, with additional pockets of Stressed (Phase 2) populations in drought- prone areas of Red Sea, North Kordofan, North Darfur and Kassala states. About 65 per cent of the current food insecure population is in Darfur and 14 percent in South Kordofan. Crisis (Phase 3) levels of food insecurity is mainly among displaced people in areas controlled by the Sudan People’s Liberation Movement – North (SPLM-N) in South Kordofan and among people in Darfur displaced within the last six months due to conflict. Displaced people in Darfur facing Stressed (Phase 2) levels of food insecurity are only able to maintain this level with the support of humanitarian assistance.
Cumulative seasonal rainfall has been below average in the main agricultural production areas, particularly in the east and across parts of Darfur. The May – July rainfall has been below average across parts of Darfur and North Kordofan and 100 to 200 mm below average along the eastern border, particularly in Kassala and Gadaref states. The below average rainfall has disrupted land preparation and delayed planting in most rain-fed area. In addition to this, recent fuel shortages in some parts of the country have disrupted land preparation, also resulting in significant delays in planting in rain-fed areas, according to FEWS NET.