Sudan - 10 December 2021

UNFPA is deeply concerned about the excess maternal mortality associated with recent outbreaks of communicable diseases in North Darfur State. 31 maternal deaths were reported during November 2021 in Al Fashir, Zamzam and Dar Alsalam localities - an alarming contrast to the 68 total maternal deaths reported in the whole of North Darfur State between January and October 2021. Maternal deaths reported during November shared common features of fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain and jaundice before passing away. Differential diagnosis of the condition suggests a possibility of hepatitis E, dengue fever, and malaria which are prevalent in the area. Initial assessments indicate limited access to clean drinking water in the affected areas. 

Hepatitis E is commonly transmitted through the consumption of contaminated drinking water, while Malaria and Dengue Fever are spread through mosquitoes. Maternal death surveillance reports identify Malaria as the leading indirect cause of maternal death in Sudan. Moreover,  hepatitis E is known to have a fulminant impact on pregnant women. According to the World Health Organization, up to 20–25% of pregnant women can die if they get hepatitis E in the third trimester. This rate is expected to increase in the affected areas in Sudan given the fragile health system and limited access to life-saving services.

Access to clean drinking water, early detection of the disease and the early identification and treatment of any symptoms and comorbidities of pregnant women are key to mitigate potential risks and avert preventable maternal deaths.  

Together with other UN agencies, UNFPA is supporting the rapid response and outbreak investigation to the affected areas in close coordination with the State Ministry of Health and civil society partners. A rapid response team was deployed to the villages of Abuzriga, Abuduail-A, Abudulai-B and Hillat Yousif in Dar Alsalam locality - some of the most heavily affected places - to conduct an investigation into the outbreak, identify pregnant women and perform health promotion activities. 100 pregnant women were provided with clean delivery kits and mosquito bed nets. 

UNFPA’s planned response for the excess maternal mortality associated with the outbreak of communicable disease in North Darfur includes the following: 

Support the outbreak investigation and intensify efforts on maternal death surveillance and multisectoral response.

The deployment of mobile clinics to the affected areas. 

Supporting house-to-house visits for surveillance of active cases and health promotion, including the identification of pregnant women in the affected locations, distribution of mosquito bed nets and clean delivery kits and working with the WASH sector to support the distribution of chlorine tablets and other household infection prevention supplies. 

Prepositioning emergency sexual and reproductive health supplies to support the nearest referral hospital, Al Fashir Teaching Hospital, for the treatment of complicated pregnancies diagnosed with hepatitis E.

The deployment of additional staff to emergency obstetric and neonatal care (EmONC) facilities.