VZCZCXRO1282
OO RUEHROV
DE RUEHKH #0478 0541612
ZNR UUUUU ZZH
O 231612Z FEB 06
FM AMEMBASSY KHARTOUM
TO RUEHC/SECSTATE WASHDC IMMEDIATE 1609
INFO RUCNIAD/IGAD COLLECTIVE
RUEHGI/AMEMBASSY BANGUI 0017

UNCLAS KHARTOUM 000478 
 
SIPDIS 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: EAID SOCI TBIO SU
SUBJECT:  UNDECLARED CHOLERA EPIDEMIC CONTINUES IN JUBA 
 
REF: Khartoum 445 
 
¶1.  SUMMARY:  The office of the UN Humanitarian 
Coordinator for Southern Sudan confirmed on February 20 
that WHO has cultured six positive cholera infections, 
the tripwire for declaring an epidemic.  The GoSS, 
however, has thus far not officially declared an 
emergency, and the UN and other bodies fear the spread of 
the disease to other towns less capable of dealing with 
an epidemic.  The UN has undertaken preventive measures 
in Juba.  Other diseases have been identified in other 
areas of Southern Sudan, and still others are lurking in 
the wings.  The lack of capacity in the GoSS Health 
Ministry has become painfully obvious.  End Summary. 
 
-------------------------------------- 
The Epidemic and Where it Might Spread 
-------------------------------------- 
 
¶2.  The acting UN Humanitarian Coordinator (UNHC) told CG 
on February 20 that more than fifty people had died in 
the ongoing epidemic (reftel), and that the WHO has 
positively identified enough confirmed cases to 
categorize the disease as a cholera epidemic.  For 
uncertain reasons, the GoSS has been reluctant do declare 
an emergency or publicize the dangers of the epidemic 
spreading to other towns.  The UNHC said that there have 
been additional recorded deaths in Yei, from whence the 
disease reached Juba, but that NGOs there report that for 
the most part the disease has run its course. 
 
¶3.  The present concern is the further spread of the 
epidemic from Yei to Maridi and from Juba to Torit. 
Traders from Yei were among the first cases hospitalized 
in Juba.  The NGO capacity in Maridi is sufficient to 
provide some bulwark against a runaway epidemic, but 
there is not capacity to speak of in Torit.  The arrival 
of cholera there could trigger a widespread, high 
mortality event.  The UNHC said that some of the 
unexpected downsides of peace vis a vis health had been 
the rapid increase of urban populations and greater 
access between towns by road. 
 
---------------------------- 
Preventive Measures Underway 
---------------------------- 
 
¶4.  The various task forces in Juba have taken various 
measures to check the spread.  They have used the town 
crier service, yellow taxis with loudspeakers mounted on 
the roof, to spread word of the epidemic and describe 
countermeasures.  They are seeking access to radio for 
public health announcements, although this medium reaches 
fewer, is unreliable, and is subject to the Minister's 
review.  The UN has established a refrigerated 
containerized morgue to hold bodies between the time of 
death until burial, to prevent the body touching common 
in local culture.  The NGOs have set up additional 
isolation wards, and when one child transported to Bor on 
a barge was identified as ill, additional barge trips 
were postponed and the child was successfully isolated in 
a clinic on Bor.  The task forces would like to begin 
treating water in other vulnerable locales with chlorine 
now, as a precaution, and are seeking GoSS approval. 
 
------------- 
Worse Ahead? 
------------- 
 
¶5.  Cholera is not the only disease of concern.  Experts 
have confirmed outbreaks of whooping cough in Bahr el 
Jebel and measles in Western Equatoria.  Within a few 
weeks, when the seasonal dust storms begin, the annual 
cycle of viral meningitis is also expected to hit.  This 
airborne disease has traditionally had a high mortality 
rate and, unlike cholera, leaves many of those that 
survive with serious permanent disabilities.  The 
inability of the GoSS Ministry of Health to address 
decisively an epidemic in urban centers where health care 
exists exposes is vulnerability to take many effective 
measures against disease in outlying rural areas. 
 
HUME