Doro refugee settlement in Maban’s Country of South Sudan provides living accommodation for more than 46,000 refugees. The camp is overcrowded. Prior to education by foreign assistance organizations, sanitation practices were nearly non-existent. In the developing world, these conditions amount to a recipe for disease, epidemic, and death.
Beginning in late 2011, refugees began fleeing violent conditions in the Blue Nile State, and by July of 2012, approximately 110,000 refugees had settled at the Doro camp in South Sudan. Around this time, Mother Nature settled along with them by way of heavy flooding and rains. The severe weather conditions and refugee congestion caused mortality rates to skyrocket. The UNCHR and the World Health Organization stepped in to assist with refugee health. It began with a large number of Acute Jauncide Syndrome (AJS), followed by fatalities.
Officials researched the jaundice and found that the outcomes of AJS represented several diseases, particularly the Hepatitis E Virus (HEV). HEV, a fecal-oral disease, is contracted and spread through contaminated food and water. Unfortunately, there is a long HEV incubation period, which makes matters worse because transmission can occur for weeks before symptoms occur. Along with the initial AJS symptom, severely ill refugees endured confusion, agitation, and coma.
According to UNHCR spokesman Adrian Edwards, “The risk of infection is high in densely populated settings, such as refugee camps.” Edwards explained how flooding and poor sanitation intensify the spread, and how women and children are at the highest risk.
Realizing outbreak control measures in refugee camps is extremely challenging. Supplying water, sanitation, and hygiene interventions does not happen overnight. Since late 2011, however, there have been significant changes.
According to a press release written on October 28, 2013, there has been significant preventative measures administered by the UNHCR and other organizations. Adan Ilmi, UNHCR Head of Office in Maban described these measures: “Today, water access for refugee across all camps is at 22 liters per person, which means sufficient quantities of water to cover an individual’s daily personal and domestic needs.
The epidemic of Hepatitis E cases peaked in the summer of 2012 with 50 to 80 cases per week. Today, due to educating refugees and implementing hygiene routines, the numbers have decreased to 16 cases per week.
Evalyne Nyasani, Water Sanitation and Health (WASH) Specialist with UNICEF explains, “Now that the messages on good hygiene practices have been disseminated and understood, agencies are working to ensure that things like hand washing become second nature and a daily part of refugees’ lives.” By promoting hygiene practices and teaching refugees the importance of simple measures such as hand washing, UNHCR hopes to continue to decrease the cases of HEV in Doro and other affected refugee camps in the region.
– Laura Reinacher
Sources: UNHCR, Voice of America News, Center for Disease Control and Prevention
Photo: Copenhagen Consensus