July 05, 2012

Alarming Mortality Rates Indicate Worsening Crisis

Mortality rates are nearly double the emergency threshold in a refugee camp in South Sudan’s Upper Nile State.



South Sudan 2012 © Shannon Jensen

Children wade through the water and mud at Jamam refugee camp, where heavy rains and flooding have worsened what was already a dire lack of potable, clean water.

JUBA, SOUTH SUDAN/NEW YORK, JULY 5, 2012—Preliminary studies reveal mortality rates nearly double the emergency threshold in a refugee camp in South Sudan’s Upper Nile State, currently home to a quarter of the roughly 120,000 refugees who have fled Sudan’s Blue Nile State since late last year, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) warned today.

The death rates were derived from rapid epidemiological surveys carried out in the Jamam refugee camp in Maban County prior to the onset of heavy seasonal rains that have flooded the camp and gravely expanded the risk of illness for the already weakened refugees. All agencies involved in the relief effort, led by the United Nations High Commission for Refugees (UNHCR), must find better options for the people living in Jamam camp, one of three refugee camps in the area. Failure to do so will almost certainly lead to more misery and deaths.

“These people have fled terrible violence in Sudan and lost family members during their arduous journeys for safety, and now they are sitting exposed in refugee camps on a flood plain and dying from preventable diseases due to horrific living conditions,” said Tara Newell, MSF emergency coordinator in Jamam. 

Having arrived with stories of violence and harrowing conditions in Blue Nile, refugees in Upper Nile State, in many cases already ill, have arrived in a place that is uniquely unsuited to accommodate more than one hundred thousand refugees.

A baked mud wasteland in the dry season, and a mostly swampy flood plain in the rainy season, there are few islands of dry ground and it is extremely difficult to locate sites to drill boreholes for suitable water. The refugees have been met with inadequate shelter and sanitation facilities and far less than the standard minimum quantity of clean water. Rising floodwater is worsening the crisis. 

After heavy rains the majority of Jamam camp became flooded the night of June 26. Latrines have overflowed, contaminating standing water. There is a general shortage of potable water. Many camp residents sleep in wet clothes under soaked blankets, leaving them vulnerable to hypothermia.

Over the last two weeks, MSF medical teams in Jamam have treated at least 2,500 people for diarrheal diseases, respiratory diseases, malaria, and malnutrition. As the rains increase, more and more people are falling ill, especially from malaria and hypothermia. Young children are the most vulnerable.

“Our clinic is already filled with children suffering from pneumonia, diarrhea, and malnutrition,” said Dr. Erna Rijnierse, working with MSF in Jamam. “If they stay in these sorts of conditions, there could well be profoundly distressing consequences.”

Preliminary medical data gathered by MSF in Jamam Camp during the week of June 18, before the onset of consistent heavy rains, revealed a mortality rate among children of 2.8 per 10,000 per day, above the emergency threshold of 2/10,000 per day. The crude, or overall, mortality rate was registered at 1.8, while the emergency threshold is set at one. At the Jamam camp alone, almost three children are dying per day. Sixty-five percent of deaths were reportedly due to diarrhea.

The rains will also further exacerbate unhygienic conditions in the camps, creating ideal conditions for the further spread of disease. The soaked earth is already making transport to all the refugee camps in the area exceedingly difficult. To meet the immediate lifesaving needs of the refugees, roads and airstrips must be improved to transport aid personnel and heavy equipment, in order to meet the needs of the highly vulnerable, exhausted population.

“The living conditions in Jamam are simply unacceptable” said Newell. “What’s needed is for all agencies involved, led by the UNHCR, to join together to come up with a solution that can remove these refugees from the health risks associated with the dire living conditions in the camp. We have to proceed with a great sense of urgency.”

MSF has been providing aid to refugees in Upper Nile State since November 2011, operating field hospitals, mobile clinics, intensive therapeutic feeding centers, and measles vaccination campaigns. MSF teams provide more than 6,000 consultations per week for the refugees in Upper Nile State. The organization is also distributing basic survival items (like plastic sheeting, blankets and jerrycans), operating water and rehydration points, monitoring mortality and morbidity levels among newly arrived refugees, and providing emergency assistance to people moving from the border and between camps.