Emergency Health Response to Curb Outbreak and Spread of Hepatitis E Virus in Bentiu Internally Displaced Persons Camp, Rubkona County, Unity State The spread and risk of exposure to HEV in the Bentiu IDP Camp could increase exponentially unless urgent measures are put in place to curb the spread of the virus which has seen a sharp incline of cases in recent years. World Relief (WR) is therefore proposing an emergency HEV intervention to curb the spread and risk of exposure to HEV. Through this project, WR intends to reach 54,500 (both directly and indirectly) camp residents with messaging on HEV mode spread, sources and risks associated with the disease. The project also intends to vaccinate 1,500 people with the HEV vaccine, mainly pregnant women, and train 24 staff and volunteers on disease surveillance and outbreak response. To enhance knowledge about HEV, the project will conduct an epidemiological and environmental assessment through an external consultant. The study will be done in collaboration with WHO to ensure standard procedures are followed for reliable results and are in line with health cluster strategies. The study will focus on the identification of the source of infection, mode of spread other risk factors. The report will be shared to the health cluster for validation and adoption. 
The spread of HEV caseloads has been on the steady rise in the Bentiu IDP Camp. A recent survey conducted by MSF in August 2021 demonstrates a 192% increase in positive cases between August 2019 and August 2021. Pregnant women were especially shown to be at a greater risk of contracting HEV than other camp residents. One major factor in the spread of HEV is poor access to water, sanitation and hygiene (WASH) facilities, and poor access to services could be linked to political developments witnessed in the country over the past few years. With the re-establishment of the Revitalized Transitional Government of National Unity and strengthened peace efforts in most parts of the country, the UN has been slowly handing over UN-led facilities to local governments for control and management of key services. Thusly, the former Bentiu PoC was transitioned to the local Rubkona government and became an IDP Camp in March 2021. With this transition came also a reduction in key services from UN agencies and other humanitarian actors including health services.
World Relief is a primary health actor within the Bentiu IDP Camp who since 2015 has provided residents with emergency health services in sectors 1, 2 and 5. WR is particularly suited to intervene in such a response as its existing resources and experience will be leveraged for this intervention, including two primary health care centers (PHCCs) and one primary health care unit (PHCU). The proposed intervention targets residents of sectors 1, 2, 3 and 5 through OPD consultations and treatment services, routine HEV immunization, disease surveillance, outbreak prevention and awareness raising activities. 
Throughout the implementation, the project will strive to improve evidence-based program intervention. WR will collect program data through assessments and surveys, analyse and share monthly reports, as well as an end of project report to all relevant stakeholder. WR will analyse IDSR data to track the HEV progression in the 6 month period which will assist WR adjust programming on outbreak response as needed. WR will also ensure satisfaction of beneficiaries by creating mechanisms of accountability to the affected populations. WR will implement compliant feedback mechanism at each service delivery point, and information collected will be used for service improvement and scale up program activities. WR will also coordinate and collaboration with UN agencies, other health partners, relevant Government Ministries and the local community/stakeholders. WR will collaborate with IRC to ensure other sectors within the IDP camp are covered. WR will also collaborate with MSF who are conducting mass vaccination. WR will still targeted pregnant mothers who present themselves at the ANC.