UNICEF SOUTH SUDAN COUNTRY OFFICE
Rapid Response Team Report
Location : Jonglie State/Duk Padiet/Ayueldit (N07.43.25.66//E031.19.45.55)
Date of the Mission: 18-26 July 2014
1 / Name & Title of UNICEF Team Leader / RRM - Gary Silliker - UNICEF (CANADEM)
2 / Names & Titles (with org/depart/section) of other members of the team / Technical staff:
Health - Simon Dada - UNICEF
Education - Christine Akello - CMD
Child Protection -Trine Utne - UNICEF
Nutrition - Kibrom Tesfaselassie - UNICEF
WASH - Augustino Maluk- UNICEF
MRE/CP - Jok William Deng - CINA
3 / Sites visited / Restricted to Ayueldit
Information and Data collected
4 / General Information / Provide the following general information about the mission site
Total Population registered: 3,200 (WFP confirmed)
Number of Households: 2,000 (WFP confirmed)
Total number of children under five = 514
Humanitarian Situation and needs:The population hide themselves in the bush and returned only after the rebels left the area. This Padiet Payam consist of four Bomas namely Ayneldit (aka Ayueldit), Bongjok, Doruk and Papat. This mission covered three Bomas (all except Papat as none of the population there has returned). This Payam is under full control of Government. The community were fully dependentupon livestock to support their families. IRNA was not conducted in this Payam before; this mission has been organized based on the Government Commissioner request to UN agencies and NGOs for verification and intervention.
5 / Name and contact of NGO partners in the field (existing, capacity, type of presence, ongoing programmes and services in place, staff capacity, logistics+storage capacity etc.) / Provide name and contact details of the partners in the field (as described)
  • Yohannes Desta, WFP Team Leader
  • Gedion , WFP Air Operator
  • Mayiik Deng , RRC Supervisor for Duk County
  • Gabriella , Field Security Officer , WFP
  • Chaplain Michael Modi , ICT Assistant
  • Gatluak Nyang , Deputy RRC Supervisor
  • Peter Chol Push , Hygiene Promoter trained by UNICEF in Ayuel Dit
  • Jok Abraham , CINA Child Protection Officer
Christian Mission for Development (CMD).
Email:
Tel: +211-922-211-444, +211-927-262-266
CMD has a State Office in Bor with constant visits to Duk. CMD’s Education project which was funded by CHF ended in the month of June 2014. The CMD Food Security project also funded by CHF will be starting in August 2014
John Due Foundation (Nutrition Partner)
1. Joh Deng Abot Clinic Manager
2. Jacob Mayen Gach, Nutrition Assistance
3. Galuak Niyang, Nutrition Assistance
There have been no ongoing programmes since the crisis began. JDF has joined the RRM team from Twic East where they have been displaced. They are capable ofoperating the OTP if enough nutrition workers are assigned soon, however there isno storage capacity and all commodities are stored in a school.
6 / Name and contact of active (1) Youth-serving (2) Youth-led Organizations / Provide name(s) and contacts details of the partners in the field (as described)
  • Simon Mayik - County RRC
Phone number: (Thuraya): +8821655581831
  • Gatluak Nyang – Padiet Payam Administrator

7 / Name and contact of authorities met, including in Health Centers, Schools etc. / Provide name and contact details of the authorities met (as described)
  • Duk County Commissioner - Elijah Mochnhom Wuor
Email:
Tel: +8821655534912
Immediate Response Provided and Follow up Actions
8 / Nutrition
Situation Overview and Humanitarian needs: / Provide a brief situation analysis and list down the critical humanitarian needs related to Nutrition
All social services has been hampered in Duk County severely since the crisis.The hospital, PHCC, PHCU, schools and other infrastructure were burned out. Currently, no social services being provided. However, there are people displaced to Twic East county, Panyagor HQ, and settled in Pawel Payam three Cattle camp (IDPs). The estimated population figure of this Cattle Camp (IDPs) is 18,583 individual (confirmed by RRC). WFP/CRS and SMC are providing food and health services respectively. JDF has planned to establish OTP/TSFP with the support of UNICEF and WFP soon in Panyagor for Duk IDPs.
JDF had a nutrition programme (OTP) in Duk county prior to the conflict. Following the conflict in December, the nutrition program was suspended as all houses including the hospital and other health facilities are burned out, supplies had been looted and staff safety not guaranteed. UNICEF mobilized JDF to join RRM mission and resume OTP service. Nutrition supplies such as RUTF, retinol, anthropometric equipment and other essential drugs have been sent to the site.
Immediate Response/Results: / Summary of key interventions and results including challenges and how they were overcome
Immediate Response/Results:
  • A total of 391 children 6 – 59 months were screened for malnutrition using MUAC; among this 9 children (4.3%) were found with SAM. Following after all MAM children (with MUAC measurement >11.5 - <12.5 cm) were measuring for their weight and height, 8 children additional children were found with SAM, hence, a total of 17 children (4.3%) with SAM were admitted in OTP. See the table below for details:
Children 6-59 months age
MUAC / M / F / Total / Rate using MUAC only (%) / Rate both MUAC & WHZ (%)
<11.5cm (SAM) / 7 / 2 / 9 / 2.3 / 4.3
>11.5 - <12.5cm (MAM) / 15 / 16 / 31 / 7.9
>12.5 (Normal) / 182 / 169 / 351 / 89.8
Total / 204 / 187 / 391
  • As shown in the table below, total of 216 pregnant and breastfeeding mothers were screened using MUAC.
Pregnant and breastfeeding mothers
MUAC / Pregnant Mothers / breastfeeding mothers / Total / Rate by MUAC (%)
<18.0cm (SAM) / 0 / 0 / 0 / 0
>18.0 - <21.0cm (MAM) / 5 / 12 / 17 / 7.8%
>21.0 (Normal) / 88 / 111 / 199 / 92%
Total / 93 / 123 / 216
  • 187 female and 204 male children 6-59 months age received Vitamin A supplementation.
  • 176 male and 187 female children 1-5 years received deworming tablets.
  • Health/Nutrition/WASH education: Key messages on immunization, IYCF, hygiene and CLTS conveyed to all adults estimated above 2,500 individuals.
  • Blanket supplementary feeding for children 6-59 months were provided by WFP for one month ration.
Follow up Actions required:
  • JDF will follow up and maintain the quality OTP programme and IYCF promotion in the site,
  • Identify a permanent OTP room and store for nutrition supply (RUTF) in collaboration with County Commissioner,
As per table above, above 25 percent categorized as MAM based on MUAC were later categorized as SAM based on WHZ admission criteria, hence recommended to encourage all nutrition colleagues to check WHZ for all MAM children (MUAC 11.5 - <12.5 cm) in order to avoid missed opportunities
Provide data against the following indicators and mention the source of information in the end
391 / # of children 6-59 months screened for malnutrition (MUAC)
9 / # of children 6-59 months with SAM
31 / # of children 6-59 months with MAM
17 / # of new SAM cases referred for treatment (OTP + SC)
# of children 6-59 months in the affected areas who received the recommended dose of multi-micronutrient supplement
216 / # of pregnant and lactating women screened for malnutrition
# of pregnant and lactating women referred for treatment
# of pregnant and lactating women receiving multi micronutrient supplement (or iron and folic acid)
216 / # of pregnant and lactating women reached with key IYCF messages
(insert other indicator)
(insert other indicator)
Source of information: RRM mission
Follow up Actions required: / What key actions are required and by whom?
  • JDF will follow up and maintain the quality OTP programme and IYCF promotion in the site
  • JDF will identify a permanent OTP room and store for nutrition supply (RUTF) in collaboration with County Commissioner,

PCAs: / Please note any expected changes to PCAs (new PCAs, amendments)
New PCA is being signed between JDF and UNICEF.
9 / Health
Situation Overview and Humanitarian needs: / Provide a brief situation analysis and list down the critical humanitarian needs related to Health
According to the 2008 population census, Duk county had a population of 65,588 which could possibly be more by the time of the crisis, owing to natural growth (3%) over the past 6years. In the advent of the conflict that broke out last December, the majority of the population fled to the neighbouring Twic East County and beyond. However, some communities hid in the bushes for over three months and returned to concentrate in Ayuel Dit, 14km from Duk Padiet after the government troops recaptured the latter. During the mission, WFP registered a population of only 3,200 of which 391 are children under five years. Most of the registered population, were single households (number of households =2000).
Prior to the conflict, the county of Duk was served by a hospital and primary health care centre run by indigenous health NGOs (NNGOs). The NNGOs include; the Sudan Medical Care, John Dau Foundation JDF), and Duk Lost Boys Clinic services. The expanse of Duk County was rendered devoid of health services after the conflict. Health facilities and available supplies were burnt or looted. Health care providers fled either internally to neighbouring counties, Bor town and as far as Juba or to the neighbouring countries Like Kenya, and Uganda.
Left without health care for half a year, communicable diseases were common within the IDP community. Top conditions noted and treated included acute respiratory tract infections, malaria and diarrheal diseases. Fortunately, there no reports of vaccine preventable disease outbreaks.
There were 93 pregnant women and 123 lactating mothers registered and attended to but there are no facilities to manage any complications during pregnancy, labour or postpartum. There was no information on mothers enrolled on PMTCT prior to the conflict. However, absence of the PMTCT services in the community alone, is an indication for concern
Immediate Response/Results: / Summary of key interventions and results including challenges and how they were overcome
<5 / ≥5 / Total
M / F / M / F / M / F
Treatment of common illness
Total consultations / 20 / 23 / 39 / 86 / 59 / 109
Total consultations not disaggregated by sex / 39 / 53 / 92
Malaria / 6 / 3 / 18 / 32 / 24 / 35
Diarrheal disease / 1 / 4 / 4 / 8 / 5 / 12
Vaccinations / 0 / 0
OPV / 218 / 196 / 218 / 196
Measles Vaccine / 234 / 131 / 234 / 131
Provide data against the following indicators and mention the source of information in the end
414 (under 5) / # of children 6mo-15y vaccinated for measles
365 (under 5) / # of children 6mo-15y vaccinated for polio
391 (187M/204F) / # of children 6-59 months receiving vitamin A supplement in the past 6 months
363 (176M/187F) / # of children 12 - 59 months receiving de-worming medication
None (93 Screened once during mission) / # of pregnant women attending at least ANC 1
None / # of pregnant women attending ANC counselled and tested
2,000 (received at least one net) / # of households receiving 2 ITNs
(insert other indicator)
(insert other indicator)
*source of information:
Follow up Actions required: / What key actions are required and by whom?
  • Initiate discussion for creating a PCA with Sudan Medical Care (SMC) and JDF to continue providing health services in Duk
  • Arrange a follow up mission to Ayuel Dit to replenish supplies, and provide maternal neonatal, and child health services

PCAs: / Please note any expected changes to PCAs (new PCAs, amendments)
JDF is already negotiating PCA with UNICEF so it would be strategic to piggyback on such an arrangement to include health services in the package. Sudan Medical Care (SMC) and JDF could continue providing health services in Duk County until the humanitarian situation stabilizes
10 / WASH
Situation Overview and Humanitarian needs: / Provide a brief situation analysis and list down the critical humanitarian needs related to WASH
  1. Water Supply System in Duk Padiet (Ayuel Dit, Dorouk and Boungjok):
  • There are many sources of water in those three Bomas (Ayuel Dit, Dorouk and Boungjok) includingboreholes, rivers and swamping areas around the river Nile, with some of the water sources such as river and swamping areas contaminated or possible sources of contamination.
  • 16 Borehole that are functional in those three Bomas are generating or yielding good amount of water over 11,000 to 13,000 litres per day.
Sanitation Status in Duk Padiet:
  • The sanitation status in Duk Padiet is very poor as there are no latrines being used in the area apart from 1 latrine with 4 stances stationed in Ayuel Dit Primary School; people continue Open Defecation in the bush and around residential areas.
Hygiene Promotion in Duk Padiet:
  • There was no serious cases of diarrhoea reported so far among the people in Duk Padiet which is a good indicator that people are drinking safe water from the borehole.Most of the cases reported among children and women was Malaria and other Respiratory Infections among children under five.

Immediate Response/Results: / Summary of key interventions and results including challenges and how they were overcome
  • One Person has been trained on water treatment, Cholera, Immunization messages, Exclusive Breastfeeding, CLTS basics and the use of mosquito Nets, Hence the person managed to sensitize the above mentioned communities over 3,000 people in local languages (Dinka and Nuer) using flipcharts and water treatment demo.
  • 3,010 people have been reached with hygiene promotion messages and demonstration on how to treat water with PUR, handwashing with soap, the importance of latrine use, the effects of open defecation and the relationship between flies and diarrhoea.
  • 3,010 people have been reached with simple Community Lead Total Sanitation basics on how to bury their faeces/wastes after defecation exercises and they were positive to change their behaviour. Twenty people asked about how to control flies who plays the role of spreading diarrhoea cases, and they were sensitized on Cholera as a disease and the root causes of diarrhoea as well.
  • 3,010 people have been reached with handwashing with soap messages and demonstrations after visiting the toilet and other circumstances related to washing with soap.
  • 920 households reached with WASH supplies including buckets, soap and FLOC

Provide data against the following indicators and mention the source of information in the end
# of target population provided with access to water as per agreed standards (7.5-15 litres of water per person per day)
# of target population provided access to appropriate sanitation facilities (as per Sphere Standards)
3,010 / # of people reached with hygiene promotion messages
920 / # of households received WASH supplies
Please list supplies received:
Buckets, soap, FLOC
(insert other indicator)
(insert other indicator)
source of information: ------
Follow up
Actions required / What key actions are required and by whom?
  • Follow up mission by UNICEF staff member recommended, including additional supply delivery

PCAs: / Please note any expected changes to PCAs (new PCAs, amendments)
N/A
11 / Child Protection
Situation Overview and Humanitarian needs: / Provide a brief situation analysis and list down the critical humanitarian needs related to CP
Expected number of people for registration was around 30,000. The turn out was around 6,000. Information given by people who came for registration was that most people are at the riverside both for security and because there is food.
Immediate Response/Results: / Summary of key interventions and results including challenges and how they were overcome
Follow up on-going for FTR forms filled and missing children forms filled for tracing.
Provide data against the following indicators and mention the source of information in the end
0 / # of UASC identified
0 / # of UASC registered
9 missing children
3 FTR, including 7 children / # of registered UASC receiving Family Tracing and Reunification services and family-based care or an appropriate alternative care services
0 / # of children benefitting from CFS activities
(insert other indicator)
(insert other indicator)
source of information: local population that registered
Follow up Actions required: / What key actions are required and by whom?
  • Maybe conduct RRM at the riverside since it seems most people from the community are there.
  • Find a partner to carry out child protection activities
  • If we can find a partner, maybe they can establish TLS and CFS at the riverside where the majority of the population resides as a psychosocial support mechanism.

PCAs: / Please note any expected changes to PCAs (new PCAs, amendments)
Currently we don’t have a partner for child protection in the area. Education have partnered up withCMD. When the population return to the area and schools are up and running we might talk to them and see if they can make a proposal for child protection.
12
: / Education
Situation Overview and Humanitarian needs: / Provide a brief situation analysis and list down the critical humanitarian needs related to Education
There are a total of 25,000 children in the payam as reported by the county education director for both host community and IDPs but this could not be confirmed by the team
There are nine open air schools and one permanent school (Pajiek PS) i
i)There was no clear data on the child population except for rough estimate by an Education representative of Ayueldit Primary School estimating to 22,500 children in the entire county according to the data before the crisis
ii)There are a total of 25 schools in Duk County, 9 schools have structures.
iii)9 schools in Greater Duk, 4 schools with structures and 5 open air schools with no latrines, office or store.
iv)There are no schools operating at the moment due to displacement caused by the crisis that began in mid-December, 2013 except Koyom Primary school by the river side with approximately 150 students served by 3 teachers as volunteers. About 90% boys and 10% girls. This was not verified due to insecurity in the area
v)1 school is reported destroyed by fire Padiet Payam school except that all the schools with structures are occupied by solders and displaced members of the community
vi)Before the emergency there were a total 110 teachers in entire Duk Ccounty, currently there are about 30 teachers including IDP teachers (8 female and 22 male).
vii)4 schools have a functional borehole; Ayueldit, Amiel, Duk Padiet and Dong Chak Primary according to the Education representative, the rest of the schools do not have boreholes nearby.
viii)Teacher are reluctant to resume teaching due to lack of incentives they chose to look for a means of livelihood.
ix)Education Partner in Duk is mainly CMD supported by CHF
Immediate Response/Results: / Summary of key interventions and results including challenges and how they were overcome
  • Sensitization of the community on the importance of Education for children and Youth. Over 1,500 people were reached.

Provide data against the following indicators and mention the source of information in the end
30 / # of students registered (pre-school, primary, etc)*
0 / # of pre-school children received supplies*
0 / # of primary school children received supplies
No rehabilitation done during RRM / # of classrooms established/rehabilitated
No TLC established / # of TLCs established
No data was present / # of schools (in locations where schools are available) /Incl. Alternative Learning Centre
(insert other indicator)
(insert other indicator)
source of information: Information was received from representative of Director of Education, Mr Gabriel Deng
Follow up Actions required / What key actions are required and by whom?
  • Construct temporary learning spaces for the schools with no structures
  • Work closely with local authorities to encourage community and soldiers to vacate schools.
  • Mobilize community in churches, market places to send there children to schools
  • Assure teachers to support learning with possible incentives through PCA supported by UNICEF
  • Distribute learning materials, chairs and tables to the open schools
  • Provide files for scheme of work and registers
  • Work closely with WASH cluster to rehabilitate non functional boreholes, provide water tanks in schools and jerry cans, buckets and water purification tablets in schools.

PCAs: / Please note any expected changes to PCAs (new PCAs, amendments)
N/A
14 / Summary of WFP response /
  • All population above 3,200 received WFP dry ration for one month duration.
  • Blanket supplementary feeding for children 6-59 months were provided by WFP for one month ration.

Additional Information collected from the mission
15 / Limitations of the mission / Education:
  • There are no teachers in Duk County. Teachers are said to have moved to Twic East and Bor due to the Insecurity and in pursuit of rewarding employment opportunities.
Child Protection
  • Limited number came for registration.
  • No possibility to move around in the area to see people in the villages.
Nutrition:
  • Lack of infrastructure for operating nutrition services and store for supplies; all supplies are kept in the school with no proper door.

16 / Recommendations (specific) / Education:
  • Provision of Teacher Incentives which would attract teachers back to their duty stations
  • Provide training on psychosocial support teachers.
  • Establishment of ECD classes and orientation training to teachers on ECD.
  • Need to conduct mass awareness campaigns on need for girl child Education to reduce on early marriages.
.
Child Protection:Look at opportunity to go to the riverside since information from the community say there is where most people are staying.
Nutrition:
  • To strengthen the nutrition workers capacity and conduct joint regular supervision by JDF and County Health Department to improve and maintain the OTP service.
  • Provision or building a store for OTP supply (RUTF) by County Commissioner.
.
17 / Lessons Learned / Nutrition: Ensure that County Commissioner has prepared one appropriate room for OTP and keep nutrition supply before the mission is occurred. If this is impossible, RO should be raised once the team is in the ground and estimate the required amount for specific duration.
18 / Suggested follow-up mission: date

Summary of Key Indicators: