Sudan conflict – Situation in refugee-hosting countries, Multi-country External Situation Report #7, covering the reporting period November 2024

Industry Overview - The ongoing conflict in Sudan has driven a large influx of refugees into surrounding countries, including Chad, South Sudan, Egypt, Libya, Ethiopia, and the Central African Republic [1] - Nearly 12.0 million people have been displaced, with almost 2.5 million displaced into neighboring countries [2] - The report focuses on the health situation and WHO's regional response in refugee-hosting countries, excluding Sudan itself [3] Chad - Chad is at the center of the Sudan refugee crisis, with over 935,000 Sudanese refugees/asylum seekers entering since April 2023 [5] - Refugees live in formal and informal camps across nine health districts, facing challenges in accessing essential health services due to difficult physical access, limited medical supplies, and a lack of health workers [5] - Health concerns include chickenpox, malaria, acute jaundice syndrome, hepatitis E, and measles, with significant case numbers reported across various districts [7] Ethiopia - Ethiopia has received over 179,700 refugees and returnees from Sudan as of November 2024, with concerns over insecurity, shortages of supplies, and inadequate water and latrine facilities [25] - Malaria cases are increasing among both refugees and host communities in the Amhara region [25] - Health services are provided by Health Cluster partners, local health facilities, and mobile health and nutrition teams [27] South Sudan - South Sudan has received over 886,000 refugees and returnees since April 2023, with the majority crossing through the Wunthow (Joda) point of entry [84] - The ongoing cholera outbreak is linked to the influx of returnees and refugees, with 1,427 cases and 14 deaths reported between September and December 2024 [84] - WHO has shipped 22 metric tons of cholera kits and four tents to Malakal, providing resources to treat 2,200 individuals [85] Egypt - Egypt has received 1.2 million new arrivals from Sudan as of November 2024, with 569,629 Sudanese registered with UNHCR [95] - WHO Egypt has provided coverage for 2,261 health services for Sudanese refugees, including management of injuries, renal dialysis, and caesarean sections [96] - Despite being certified malaria-free, Egypt has reported 20 malaria cases among Sudanese refugees in 2024 [96] Libya - As of November 2024, 125,020 health certificates have been issued, predominantly to adult male Sudanese refugees, indicating a rapid increase in refugee influx to southern Libya [97] Central African Republic - As of November 2024, six affected districts have reported at least one outbreak, with an ongoing hepatitis E epidemic affecting Vakaga [63] - A total of 239 suspected cases of hepatitis E have been reported, with 84 laboratory-confirmed cases and five deaths [64] Operational Challenges - Key challenges include resource mobilization gaps, inadequate early warning and response systems, limited health service delivery, health worker shortages, and insecurity [68] - The funding gap significantly hampers operations, with limited availability of water and supplies increasing the risk of outbreaks such as cholera and hepatitis E [68] Next Steps - Continued support for health emergency preparedness and response, including surveillance, rapid response teams, WASH, and case management [69] - Financial and logistical support to restock drug supplies, diagnostic kits, and IPC/WASH supplies at points of entry [69] - Capacity building of health workers and EMTs at health facilities and points of entry serving host communities and refugees [69]