UNHCR steps up measures to rein in Hepatitis E among South Sudanese refugees in Ethiopia

Briefing Notes, 8 August 2014

This is a summary of what was said by UNHCR spokesperson Ariane Rummery to whom quoted text may be attributed at the press briefing, on 8 August 2014, at the Palais des Nations in Geneva.

The liver disease Hepatitis E that has spread across South Sudan over the last two years has now appeared in three border camps that house some 150,000 South Sudanese refugees in Ethiopia.

The UN refugee agency has worked swiftly with the Ethiopian government, the World Health Organization, the refugees themselves, and other partners to contain the disease. As a result, we are seeing a decline in infections even though, unfortunately, 13 refugees have died from Hepatitis E since April.

Hepatitis E is caused by a virus and is spread mainly by consuming contaminated water and food. For this reason, we have been working to improve sanitation in the camps and increase the amount and availability of safe drinking water.

Our key message is for refugees simply to keep their hands clean. In the camps, Médecins Sans Frontières France, has distributed 80,000 bars of soap donated by UNICEF in the camps to encourage better hygiene. In addition, we are telling refugees not to defecate in the open and are building more latrines. We are also telling refugees not to let animals defecate close to their homes.

The refugees know Hepatitis E as "Yellow Eyes" so we are sharing the message: "If you have yellow eyes, go to the clinic." Getting early medical treatment is essential.

Since April, there have been 367 cases of Hepatitis E in Leichuor, Kule and Tierkidi camps, which are all located in the Gambella region of western Ethiopia, bordering South Sudan. Laboratories in Addis Ababa and Nairobi confirmed that the virus is related to the Hepatitis E outbreak reported in neighboring South Sudan. Six more cases were reported in the refugee hosting communities of Itang and Nyin-yan.

Hepatitis E hits people between the ages of 15 and 40 hardest. In the three camps where we see refugees with Hepatitis E, a large majority are young people aged 12-40. Hepatitis E is particularly dangerous for pregnant women; as many as 20 to 25 percent of pregnant women who contract the disease may die. A pregnant woman was among the 13 refugees who have died.

Ethiopia is home to 247,554 South Sudanese refugees, including more than 185,000 who have fled since fighting broke out in mid-December last year.

In other neighboring African countries that host South Sudanese refugees, medical staff are screening all refugees as they arrive to find out whether they are or have been sick. If needed, they are further examined to see if they may have Hepatitis E or cholera, which has also been sweeping South Sudan since 15 May. In addition, UNHCR and partners have also stockpiled medicine, medical supplies, and water treatment supplies as a normal precaution.

For more information on this topic, please contact:

  • In Geneva, Ariane Rummery on mobile +41 79 200 7617
  • In Ethiopia, Kisut Gebre Egziabher on mobile +25 19 11 20 89 01
  • In Kenya, Kitty McKinsey on mobile +254 735 337 608



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Public Health

The health of refugees and other displaced people is a priority for UNHCR.

Health crisis in South Sudan

There are roughly 105,000 refugees in South Sudan's Maban County. Many are at serious health risk. UNHCR and its partners are working vigorously to prevent and contain the outbreak of malaria and several water-borne diseases.

Most of the refugees, especially children and the elderly, arrived at the camps in a weakened condition. The on-going rains tend to make things worse, as puddles become incubation areas for malaria-bearing mosquitoes. Moderately malnourished children and elderly can easily become severely malnourished if they catch so much as a cold.

The problems are hardest felt in Maban County's Yusuf Batil camp, where as many as 15 per cent of the children under 5 are severely malnourished.

UNHCR and its partners are doing everything possible to prevent and combat illness. In Yusuf Batil camp, 200 community health workers go from home to home looking educating refugees about basic hygene such as hand washing and identifying ill people as they go. Such nutritional foods as Plumpy'nut are being supplied to children who need them. A hospital dedicated to the treatment of cholera has been established. Mosquito nets have been distributed throughout the camps in order to prevent malaria.

Health crisis in South Sudan

Bonga Camp, Ethiopia

Bonga camp is located in the troubled Gambella region of western Ethiopia. But it remains untouched by the ethnic conflicts that have torn nearby Gambella town and Fugnido camp in the last year.

For Bonga's 17,000 Sudanese refugees, life goes on despite rumblings in the region. Refugee children continue with school and play while their parents make ends meet by supplementing UNHCR assistance with self-reliance projects.

Cultural life is not forgotten, with tribal ceremonies by the Uduk majority. Other ethnic communities – Shuluks, Nubas and Equatorians – are welcome too, judging by how well hundreds of newcomers have settled in after their transfer from Fugnido camp in late 2002.

Bonga Camp, Ethiopia

Southerners on the move before Sudanese vote

Ahead of South Sudan's landmark January 9, 2011 referendum on independence, tens of thousands of southern Sudanese in the North packed their belongings and made the long trek south. UNHCR set up way stations at key points along the route to provide food and shelter to the travellers during their arduous journey. Several reports of rapes and attacks on travellers reinforced the need for these reception centres, where women, children and people living with disabilities can spend the night. UNHCR has made contingency plans in the event of mass displacement after the vote, including the stockpiling of shelter and basic provisions for up to 50,000 people.

Southerners on the move before Sudanese vote

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