South Sudan: RMF UNICEF Malnutrition Treatment and Prevention Program Jonglei State

An Update on Cholera: July-November 2018

December 05, 2018

Deanna Boulard

Children greet RMF’s team in Jonglei State

Children greet RMF’s team in Jonglei State

RMF’s Presence in Jonglei State


In December 2014, RMF South Sudan entered into a partnership with UNICEF and the South Sudan Ministry of Health to bring our expertise in malnutrition treatment, education, and outreach to one of the hardest hit areas of South Sudan, Jonglei State. This initiative is designed to ensure that all children under 5 with severe acute malnutrition (SAM) are reached with a package of integrated nutrition services in the counties of Jonglei State assigned to RMF by UNICEF: Ayod and Boma. In January 2015, RMF launched the Malnutrition Program, and implementation started in early March 2015.

In March 2016, RMF integrated a Targeted Supplementary Feeding Program (TSFP) through the United Nations World Food Program (WFP) into the existing nutrition programs to ensure provision of comprehensive nutrition services. The TSFP is bridging the gap experienced by RMF in the first year of nutrition services; this ensures children under 5 with moderate acute malnutrition (MAM) and pregnant and lactating women (PLW) are reached with nutrition services. In 2017 alone, 62,488 children under 5 years of age were screened or signs of acute malnutrition and 1,728 children with severe acute malnutrition (SAM) were identified and treated.

Progress Made as Outbreak Ends

Vigilence Still Needed

On February 7, 2017, South Sudan announced the end of its longest and deadliest cholera outbreak. According to the World Health Organization, there had been more than 21,000 cases of suspected cholera and 436 deaths reported since the outbreak was declared on June 18, 2016. In Ayod County—the envisioned location for RMF’s proposed project and the area where we are implementing the nutrition program supported by UNICEF and WFP— 3,856 cholera cases and 39 deaths were reported between June 2016 and November 2017 according to the OCHA. However, due to the armed conflict, lack of health infrastructure, and nomadic nature of the populations of concern, we believe the actual numbers of cholera cases and deaths are likely much higher.

In the fight against cholera in South Sudan, WHO reports that during 2017, over 885,000 higher-risk people received a first round of cholera immunization and almost 500,000 received a second round of the vaccine. These immunizations and the end of the outbreak are positive developments that must be built upon.

In their July 19, 2018 report, WHO acknowledges that cholera “continues to be a public health threat to children, women, and other vulnerable groups in South Sudan.” The organization acquired 562,000 oral cholera vaccine doses this year and has been implementing vaccination campaigns to lower the risk of another outbreak. UNICEF, likewise, continues to implement cholera vaccination campaigns, and as of September 30, 2018, observed that there have been no reported cases of cholera during the year. However, in many locations, including the remote villages where RMF works in Ayod County, the lack of health and WASH infrastructure means that populations remain highly vulnerable to cholera.

RMF’s Work with Communities

Incorporating Prevention, Testing, and Treatment

RMF remains vigilant and well positioned to implement a cholera prevention and treatment program in remote areas of Ayod County, where our national and local staff have earned the trust of communities and continue to work daily with malnourished children under 5 years of age and pregnant and lactating women. With funding, RMF will be able to quickly and effectively integrate cholera prevention, testing, and treatment measures into our existing facilities and programs.