COVID 19 EMERGENCY - Supporting Preparedness and Response Actions against COVID19 Outbreak in South Sudan

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Project location: SOUTH SUDAN
Project start date: July 2020 - Project end date: October 2020
Project number: 2020-025
Beneficiary: CUAMM Medici con l\'Africa

According to the last issued South Sudan COVID19 Weekly Situation Report, the number of confirmed cases in the Country, updated at the 14th of June 2020, has reached 1755, with 58 recoveries and 30 deaths.

Immediately after the notification of the first cases in Africa, South Sudan Government has established the National Task Force for COVID19 emergency and this has adopted quite strict prevention and containment measures, similar to those chosen by European Countries and aligned to international recommendations. In spite of all this, risk perception has remained quite low, and people reluctance in adopting preventive behaviours is being exacerbated by an increasing collective refusal of COVID19 threat, based on the spreading stigmatization and on the fear of mobility and activities limitations imposed to those found or suspected to be a case. This is likely to favor wider community transmission and makes hard any kind of containment attempts, as contact tracing and quarantine, as well as home-based isolation of confirmed/suspected asymptomatic and mild patients. For those requiring medical attendance, the health system is not ready to offer the due care, while ensuring health staff safety and avoiding Hospitals and Health Centers to become the core of new infections; medical equipment and personal protection devices lack is the main problem to deal with, coupled with the insufficient number of qualified personnel and poor infrastructures, especially WASH ones. South Sudan COVID19 National Task Force is requesting for a specific case management strategy, tailored on the national peculiar context, being fully aware of all limitations impeding the careful application of the generally recommended measures.

Doctors with Africa CUAMM keeps working in all the 13 Counties it is based in, committed to both basic and emergency health and nutrition services regular provision and to COVID19 preparedness and response. As per its usual approach, Doctors with Africa CUAMM contribution against COVID19 is designed over the three levels of care. At community level, CUAMM aims to train the 1300 village-based health and nutrition volunteers on how to inform people about infection prevention, recognition and handling and on how to safely provide the routine domiciliary care for common diseases and malnutrition. 

At PHC facilities, WASH component is being strengthening, with hand washing points made available for both health staff and patients and cleaning materials being provided in bigger quantities. Patients in flow and waiting time/spaces are being regulated, to guarantee the due physical distancing and to facilitate the prompt identification and separation of suspected cases. 

All Hospitals have organized a proper triage system at Out Patients Department and Services, for crowding limitation, physical distancing facilitation and timely identification of suspected cases. Isolation Units are being setting up for the admission and symptomatic treatment of suspected/confirmed cases with medical complications. Hospital staff is being trained on COVID19 prevention, identification and management, while personal protection equipment stock is being constituted. Infection Prevention and Control measures are being enhanced, with particular focus on hand washing, environmental cleaning and waste management.

All these steps are being moved with reference to National guidelines and to Doctors with Africa CUAMM strategy. CUAMM field staff is part of State and County COVID19 Task Forces, providing technical support in the adaptation and implementation of international and national orientations.

For sustaining such comprehensive and multi-level response, without neglecting nor scaling down regular services, CUAMM is trying to mobilize different donors for cash and in-kind contribution. In this framework, CUAMM is asking for extraordinary support to the Nando and Elsa Peretti Foundation to narrow one of the identified gaps, related to transport means.

The Ministry of Health orientation is asymptomatic/mild COVID19 suspected/confirmed cases to be isolated at home and be referred to Hospitals only if developing medical complications. Similarly, people who have been in contact with a suspected/confirmed COVID19 case are advised to remain at their place, with the local health authority being in charge of sending an investigation team to confirm the contact and to assess the quarantine conditions are in place at concerned persons domicile. However, Hospitals and State authorities are missing the vehicles for referrals and investigation team deployment. 

In response to the Covid-19 emergency, the Nando and Elsa Peretti Foundation has awarded a grant to Doctors with Africa CUAMM to allow for the purchase of a vehicle to be dedicated to the transport of COVID19 suspected/confirmed cases. This will allow Rumbek State Hospital to keep running the regular referral system and therefore to keep facilitating people access to emergency services, in particular for women and children. NaEPF funds cover about the 50% of vehicle costs, the balance being covered by CUAMM with its own resources.

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