Emergency health and nutrition response to Ethiopian refugees The on-going armed conflict between Ethiopian National Defense Forces (ENDF) and Tigray People’s Liberation Front (TPLF) has resulted in an influx of refugees from Ethiopia’s Tigray region to Kassala, Gedaref and Blue Nile states of Sudan. 

According to UNHCR, as of Dec 12, 2020, a total of 50,045 refugees (57 percent men and 43 percent women) have arrived in Sudan since early November 2020. Of these, 45 percent are children (lt17 years) 51 percent are adults (18-59 years) and 4 percent are elderly (gt60 years). The refugees are relocated to two main refugee camps: Um Rakuba and Village 8, after crossing the border at one of the three main crossing points, namely Hamdayet in Kassala and Lugdi and Abderafi in Gedaref. A total of 14,898 refugees have been relocated to Um Rakuba camp. 

The influx of refugees has placed additional strains on the government of Sudan which is already struggling to meet the needs of its own people due to the deteriorating economic situation leading to hyper-inflation COVID-19 pandemic and recent massive floods. In Gedaref alone, more than 35,000 people were affected by the recent floods, which were the worst in three decades. The hosting states and communities simply do not have the resources or capacity to provide critical support, including life-saving health and nutrition services, to the refugees. For example, even before the influx of refugees, only 15 percent of the essential medicines required were available at the health facilities in the country. 

On Nov 16, 2020, Mercy Corps in close coordination with Gedaref State Ministry of Health (SMoH), the Commissioner of Refugees (COR), UNHCR, and SHF launched its emergency health interventions in the public-sector’s primary healthcare center (PHCC) in Um Rakuba camp to address the critical health needs of refugees from the Tigray region of Ethiopia. Mercy Corps has deployed its own staff and supports the SMoH staff to provide first aid/emergency care and out-patient management of communicable and non-communicable diseases. Mercy Corps is also supporting the SMoH in providing essential medicines and non-medical supplies to the facility. The average number of people seeking healthcare from the PHCC ranges from 100 – 120 per day and this is expected to rise as more refugees arrive in the camp. The common diseases are diarrhea (gastro-enteritis), upper respiratory tract infection, and malaria. At least eight people living with HIV/AIDs have voluntarily identified themselves  . So far we haven’t seen any COVID-19 case, but this may be due to the lack of testing facilities at the PHCC. Patients suspected to have TB or diagnosed with TB in the past and admitting it are part of the referral plan and will be referred to TB dispensaries in Gedaref. With regard to the antiretroviral drugs Mercy Corps, in coordination with SMoH, is in contact with the HIV center in Gedaref. All patients with HIV (so far 8 patients) registered with PHCC will be provided by antiretroviral medicines by the HIV center in Gedaref.

Mercy Corps proposes to support the SMoH to deliver a standard minimum package of primary health care and nutrition services. This will include, out-patient management of common illnesses, maternal and child health, sexual and reproductive health, expanded program of immunization (EPI), and nutrition services. Mercy Corps will support SMoH to carry-out Infection Prevention and Control (IPC) for COVID-19, and ensure regular supply of essential medical and non-medical supplies to the Um Rakuba PHCC. 

All activities will be carried- out in line with COVID-19 specific guidance provided by SMoH and WHO. Mercy Corps will support the local referral system by providing the PHCC in Um Rakuba with transportation options, and will help to strengthen the existing surveillance and disease outbreak control by providing timely information to the SMoH.