PRESS BRIEFING BY THE UNITED NATIONS INFORMATION SERVICE

31 September 2023

Sudan: Cholera, Dengue and Other Concurrent Outbreaks

Ni’ma Saeed Abid, Sudan Representative, World Health Organization (WHO), said the conflict in Sudan had been actively ongoing for seven months, with devastating impact on people’s lives, health and wellbeing across the entire country. 5.9 million people had been newly displaced since April, with more than 1.2 million of them seeking refuge in neighbouring countries and 4.6 million displaced within the country. This, coupled with more than three million displaced before the current crisis, made Sudan the largest crisis of internal displacement in the world.

The health system in Sudan was stretched to breaking point, as capacities declined in the face of mounting needs due to disease outbreaks, malnutrition and rising cases of untreated non-communicable diseases such as diabetes, hypertension, cancer, chronic respiratory diseases and chronic renal failure. Access to health care continued to be limited due to insecurity, displacement and shortages of medicines and medical supplies – placing millions of Sudanese at risk of severe illness or death from preventable and treatable causes.

70 to 80 per cent of health facilities were non-functional in conflict hotspots, and in areas not directly affected by the conflict, health facilities were overwhelmed with patients. Health care workers had not been paid for nearly seven months. Attacks on health care were continuing. As of today, WHO had verified 60 attacks on health care since the start of the conflict, leading to 34 deaths and 38 injuries, further impacting availability of health care.

Conflict and the ensuing mass displacement had driven the population further into a state of wide-spread malnutrition, with the lives of children hanging in the balance. Cholera, measles, dengue and malaria were circulating in several states. A combination of any of these diseases with malnutrition could be lethal.

Cholera outbreaks in Sudan were not a surprise, given the situation in the country. Outbreaks of cholera had now been declared in three states across Sudan - Gedaref, Khartoum and South Kordofan - with suspected cases also reported in Al Jazirah and Kassal. It was rapidly spreading due to the favourable conditions of poor water, sanitation and hygiene, displacement and weak health services. A total of 1,962 suspected cholera cases had been reported as of last week, with 30 lab-confirmed cases and 72 associated deaths as of 27 October 2023. More than 3.1 million people were estimated to be at risk of cholera until the end of December 2023. The Federal Ministry of Health had launched a multi-sectoral response to the cholera outbreak, bringing all health partners on board, including WHO.

WHO had identified these four diseases as threats one year ago. It had stockpiled drugs and essential supplies for the treatment of cholera patients and was fully supporting a number of cholera treatment centres and units in Gedaref and Al Jazirah states with supplies, financial support for operational and fuel costs, and staffing. It was training rapid response teams and covering their deployment cost into affected localities, strengthening surveillance through training and operational support, and training doctors and nurses in cholera case management and infection prevention and control.

WHO facilitated the shipment of samples to the Public Health Laboratory in Port Sudan, which it had upgraded with equipment, supplies and training to function as a national referencing lab in place of the National Public Health Laboratory in Khartoum, which had been occupied since the start of the conflict. The samples were not only limited to cholera but included measles, dengue and polio samples, which were further sent by road to Ministry of Health laboratories in Cairo.

WHO was coordinating with partners to strengthen water, sanitation and hygiene as a backbone of cholera prevention and response. WHO was engaged in water quality monitoring of water sources in localities and the United Nations Children's Fund (UNICEF) was providing water treatment supplies. It was also working with communities to increase awareness of the risks and put in place measures to prevent further spread of cholera, such as treatment of drinking water.

WHO was getting ready to receive oral cholera vaccines from the International Coordination Group on Vaccine Provision (ICG) Secretariat. WHO was conducting a campaign targeting persons older than one year in six localities of Gedaref. Similar requests for Aj Jazirah and Khartoum states were under review.

In response to questions, Dr. Abid said WHO was focusing on community engagement to promote decontamination of water. There were cases in neighbouring countries, including Ethiopia, and there was a possibility of further expansion. The health care system was at a breaking point. The number of children with acute malnutrition had increased during the recent period.

There was a global supply shortage of cholera vaccines, and priority was given to countries with conflict. Distribution was focused on vulnerable groups such as internally displaced persons. The vaccine was an effective tool, but it needed to be accompanied by various other interventions.

Millions of children and nursing mothers were malnourished. Admissions to hospitals this year for malnourishment were almost four or five-fold compared to last year. Two or three children were being put on the same hospital bed for treatment for malnutrition.

Gaza Crisis Update

James Elder for the United Nations Children's Fund (UNICEF) said that from the earliest days of the unprecedented hostilities in the Gaza Strip, UNICEF had called for an immediate humanitarian ceasefire, for the aid to flow and for children abducted to be released. It had pleaded for the killing of children to stop.

Its fears of the reported numbers of children killed growing rapidly were realised in just a fortnight. The numbers were appalling; reportedly, more than 3,450 children had been killed. Staggeringly, this number rose significantly every day.

Gaza had become a graveyard for thousands of children. It was a living hell for everyone else.

The more than one million children of Gaza also had a water crisis. Gaza’s water production capacity was at a mere five per cent of its usual daily output. Child deaths, particularly infants, due to dehydration was a growing threat. A UNICEF staff member in Gaza, Nesma, who lived and worked in Gaza, who had two children, four-year-old Talia and seven-year-old Zain, said, “It breaks my heart to see children around me strive for a cup of clean water and cannot find it. Zain keeps asking for regular water.” Salty, unsafe water was the only option right now. It was making Zain and many other children sick.

When the fighting stopped, the cost to children and their communities would be borne out for generations to come. Before this latest escalation, more than 800,000 children in Gaza – three quarters of its entire child population – were identified as needing mental health and psychosocial support. Four-year-old Talia was showing severe symptoms of stress and fear, and was now self-harming, ripping her hair off and scratching her thighs until they bled. Her mother said, “I don’t have the luxury to think about my children’s mental health. I keep telling myself, “Nesma, keep them alive.” And when all of this ends, I will provide them with mental support and medical care.”

On behalf of Talia, Zain and the 1.1 million children in Gaza, UNICEF was calling for an immediate humanitarian ceasefire, and for all access crossings into Gaza to be opened for the safe, sustained, and unimpeded access of humanitarian aid, including water, food, medical supplies and fuel. If there was no ceasefire, no water, no medicine and no release of abducted children, even greater horrors would be afflicted on innocent children.

In response to questions, Mr. Elder said children were dying because there were situations where they did not have the medical care they needed after being impacted by the bombardment. Some children’s lives could have been saved. Without humanitarian access, the deaths from the attacks could be the tip of the iceberg. The number of deaths could increase exponentially if hospitals ran out of power and there was no access to medicines. Currently, 940 children were missing.

Gaza was one of the most densely populated places on earth. Secretary-General António Guterres had called on authorities to rescind the order to relocate to the south. The bombardment was gut-wrenching, and the number of casualties was rising by the minute. UNICEF believed that a humanitarian ceasefire was key. Such a ceasefire would keep innocent children safe. The age of the children made no difference; the grief that parents felt when they lost them was the same.

UNICEF had eight trucks that crossed the border into Gaza yesterday. It had sent 25 trucks since the start of the conflict. It was not able to deliver fuel. There were many full trucks at the border that were unable to get into Gaza. Humanitarian organisations were extremely frustrated that they were unable to send in basic supplies needed for human survival.

There were two million people in dire need of water in Gaza. 55 per cent of water facilities needed repair. Desalination plants were damaged or had no fuel. People in Gaza had no way of accessing the amount of water they needed.

On the context of the recent looting of warehouses, Rolando Gómez, Chief of the Press and External Relations Section at the United Nations Information Service (UNIS) in Geneva said Commissioner-General Philippe Lazzarini of the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) had issued a statement saying that “people were scared, frustrated and desperate”.

The United Nations Secretary-General António Guterres was recently in Nepal, where he held a press conference with the Prime Minister. He extended condolences to families of the 10 Nepali students killed in the terrorist attacks by Hamas in Israel on 7 October and extended best wishes for the safe return of Bipin Joshi, who was missing. He repeated his utter condemnation of the appalling attacks perpetrated by Hamas. There was no justification, ever, for the killing, injuring and abduction of civilians. He reiterated his appeal for an immediate humanitarian ceasefire, the unconditional release of all hostages, and the delivery of a sustained humanitarian relief at a scale that would meet the needs of the people of Gaza.

Christian Lindmeier for the World Health Organization (WHO) said WHO joined the call for an immediate humanitarian ceasefire. Fuel was necessary to get water out of the ground and to desalinate it. Fuel was also vital for ambulances and hospitals to operate, and for various other purposes to support lives amid the humanitarian catastrophe.

There were 130 premature infants that were dependant on incubators, of which 61 per cent were in the north. There were 50,000 pregnant women and an average of 180 births per day. 350,000 people had non-communicable diseases. 1,000 people needed kidney dialysis. All of this could not happen without supplies and electricity. This was an imminent public health catastrophe.

There had been over 200 attacks on health care in the occupied Palestinian territory: 118 in the West Bank and 82 in the Gaza Strip. 491 people were killed in these attacks, including 16 on-duty health workers. 28 ambulances had been damaged or destroyed, and 36 health facilities had been affected. 12 hospitals out of the 35 were not functional anymore.

34 trucks with medical supplies had entered Gaza, including eight from WHO and others from the Egyptian Ministry of Health, UNICEF and the International Federation of Red Cross and Red Crescent Societies (IFRC). The eight WHO trucks delivered supplies to cover the health needs of more than 300,000 people, including trauma care and treatment for chronic conditions. WHO had also delivered 51 pallets of life-saving medical supplies and surgical equipment to the Al-Shifa Hospital in Gaza City. WHO medicines and health supplies had also been delivered to four key hospitals in the south and to the Palestine Red Crescent Society for distribution to its health facilities and ambulance crews.

Hospitals were at 180 per cent capacity and it was practically impossible to keep them operating normally. There were not enough supplies. People needed much more. UN organisations could deliver the necessary supplies, but they needed access. Hospitals should never be a target and should never be used for military purposes.

Jens Laerke for the Office for the Coordination of Humanitarian Affairs (OCHA) said Martin Griffiths, United Nations Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, was in east Jerusalem. He said that what families were facing was beyond devastating. When an eight-year-old said that “she didn’t want to die”, it was hard not to feel helpless. Families were living in agony, not knowing if their loved ones were alive. It was unbearable to think about children buried under rubble with very little possibility of getting them out. OCHA was releasing flash updates on the situation in Gaza. United Nations organisations did not depend on parties to the conflict to buy fuel but needed authorisation to distribute it in conflict areas.

6,179 residential buildings and 16,441 housing units had been destroyed. There were also over 11,000 severely damaged housing units. As a result, 27,000 families were on the streets. Many displaced people had gone to UNRWA schools, which were designated emergency shelters. Nearly 672,000 people were sheltering in 150 UNRWA facilities. These shelters were at over three times their capacity. Some families were sheltering with other family members in small apartments. There were reports of such families living in cramped apartments being bombed.

Mr. Griffiths had met with Israeli officials and had spoken with people in Gaza. He would also have meetings with Palestinian officials. OCHA was doing its best to negotiate delivery of aid. Large amounts of fuel needed to come in. The current siege needed to end. Mr. Griffith’s priorities were to protect civilians, free the hostages, allow the delivery of fuel and supplies at scale and promote respect for international humanitarian law.

It was not possible to say the number of trucks that were needed as OCHA did not have a full picture of the current needs. 100 trucks per day was a base-level need. OCHA hoped to be able to scale up to 1,000 trucks per day. 26 trucks went through Rafah crossing yesterday. OCHA hoped that more trucks would go in today. Since 21 October, 123 trucks had crossed the Rafah crossing.

Elizabeth Throssell for the Office of the United Nations High Commissioner for Human Rights (OHCHR), said there was a need for constant care to spare the civilian population. Hospitals were protected buildings under international humanitarian law. The use of hospitals by military groups and the use of patients as human shields amounted to a war crime. All combatants needed to comply with international humanitarian law. Attacks on hospitals converted to military bases also needed to comply with international norms and principles of proportionality. Collective punishment was also a violation of international law. OHCHR currently could not verify claims of Gaza hospitals being used for military purposes. Medical units’ special protection needed to be respected at all times.

Responding to questions, Ms. Throssell said OHCHR was aware of reports of the killing of a number of Palestinian journalists. These reports were deeply concerning. Journalists were civilians and should not be targeted. Military personnel who targeted journalists needed to be held to account.

Israeli forces had carried out daily arrests of Palestinians in the West Bank on the basis of political affiliation. Between 8 and 30 October, 1,680 Palestinians on the West Bank, including East Jerusalem, had been arrested. The number of reported arrests was very concerning. As of 23 October, Israeli police said that they had arrested 170 Palestinians in East Jerusalem over incitement on social media platforms. It was estimated that more than 6,000 Palestinians were being held in Israeli prisons on security charges, of whom more than 1,600 were in administrative detention.

It was prohibited to use military methods that failed to distinguish between civilian and military objects. The use of incendiary weapons against fighters was prohibited if there were more humanitarian means available.

Ukraine: Report into 5 October Attack on Funeral Reception in Hroza

Elizabeth Throssell for the Office of the United Nations High Commissioner for Human Rights (OHCHR), said that on 5 October, a missile struck a café in the small village of Hroza in eastern Ukraine, killing 59 people attending a funeral reception. It was one of the deadliest single incidents for civilians since February 2022.

Today, OHCHR was publishing a report into the events of 5 October that concluded that there were reasonable grounds to believe that the missile was launched by Russian armed forces, and that there was no indication of military personnel or any other legitimate military targets at or adjacent to the café at the time of the attack.

The report was based on information collected and verified by the Human Rights Monitoring Mission in Ukraine (HRMMU), who carried out two fact-finding missions to Hroza on 7 and 10 October. HRMMU inspected the site of the blast and interviewed 35 people, including local residents, witnesses, two survivors, medical staff and morgue employees.

Those killed – 36 women, 22 men and an eight-year-old boy - were all civilians, attending the reception after the funeral and re-burial of a local man who was a member of the Ukrainian armed forces. The blast completely destroyed the café and a small shop.

The report detailed the devastating impact of the missile strike on Hroza, with 15 families losing two or more family members. One man, Volodymyr, said he could not believe his wife, his son and daughter-in-law were gone.

“I cannot sleep, I cannot eat…I walk around in hope to see my wife showing up from somewhere,” he said. Another resident recounted how her daughter’s friend could only be identified by her manicure when rescue workers discovered her hand. For many others, identification relied on DNA tests of bodily remains.

The report said that the Russian armed forces either failed to do everything feasible to verify that the target was a military objective, or deliberately targeted civilians or civilian objects, which in either case would be in violation of international humanitarian law.

OHCHR urged the Russian Federation to conduct a full and transparent investigation to hold those responsible to account and to take measures to prevent similar attacks from happening in the future. It also called on the Russian Federation to provide access to effective remedy, including appropriate reparations, for victims and families.

Bangladesh Protests

Elizabeth Throssell for the Office of the United Nations High Commissioner for Human Rights (OHCHR), said OHCHR was deeply concerned by a series of violent incidents during ongoing protests in Bangladesh. As the country headed towards elections, it called on all political actors to make clear that such violence was unacceptable and to avoid any statements or actions that could constitute incitement to violence.

As of this morning, at least 11 people had died in connection with the protests in many parts of the country. Among the dead were two policemen, six opposition party staff members and two bystanders.

On 28 October, opposition protesters allegedly attacked the residences of the Chief Justice and other judges, and approximately 30 journalists were assaulted by protesters and masked individuals riding on motorcycles, who were thought to have been ruling party supporters.

In responding to the protests, police had reportedly attacked protesters with rods, batons, rubber bullets and sound grenades. They had also raided the homes of opposition activists across the country, indiscriminately arresting and detaining hundreds, including the activists’ family members. OHCHR urged the police to ensure that force is only used when strictly necessary and, if so, in full compliance with the principles of legality, precaution and proportionality.

On 30 October, the head of the opposition BNP, Mirza Fakhrul Islam Alamgir, was arrested and charged under the Explosive Substances Act in connection with the alleged arson attack on the Chief Justice’s residence. He remained in detention. Several other senior opposition leaders were reported to have gone into hiding for fear of arrest.

OHCHR urged the Government to observe the greatest restraint to curb political tensions at this critical time, and to take steps to ensure that human rights are fully upheld, for all Bangladeshis, before, during and after the elections.

Rolando Gómez, Chief of the Press and External Relations Section at the United Nations Information Service (UNIS) in Geneva said that the UN Secretary-General had also expressed deep concern about the reports of violence at political rallies in Bangladesh. The number of people who had died had sadly risen to 11, and numerous people had been injured. He called on all parties to refrain from violence, any excessive use of force and arbitrary detention, and also stressed the need to respect the right of freedom of expression and peaceful assembly.

Post-Earthquake Situation in Afghanistan

Stephen Rodriques, Resident Representative in Afghanistan, United Nations Development Programme (UNDP), said the situation in the western province of Afghanistan was catastrophic three weeks after the earthquakes. Approximately 21,500 homes had been destroyed, more than 1,500 people had died in the earthquakes and more than 150,000 people were directly affected.

The survivors were living in tents. There were many aftershocks, so people did not want to go back to what remained of their houses. They needed water, health care, food and proper shelter. Winter was coming, and temperatures were dropping, which made things worse.

90 per cent of victims were women and children. Due to social norms and restrictions, they were trapped inside their houses when the earthquakes hit. Many were left with no means to survive. The needs of women needed to be properly factored into planning for the future.

The immediate needs were shelter, food, water and cash. UNDP was operating cash-for-work programmes for rubble clearing operations. It had also set up women-led community kitchens to cook and serve hot meals for thousands of people daily. Over 6,000 individuals had received warm meals so far. But that was not enough.

UNDP was appealing for 25 million United States dollars (USD) to support its comprehensive recovery plan. This was part of a larger Herat Earthquake Response Plan developed by the UN humanitarian country team, which needed 93.6 million USD to assist 114,000 people who were most in need during the winter. For the time being, UNDP had repurposed 3.15 million USD from its own resources for immediate relief. However, this was not enough to meet the huge demand for recovery and rebuilding.

Around 314 million USD of damage was done to this impoverished region by the earthquakes. It would take at least a year to rebuild. The programme for reconstruction would focus on rebuilding essential basic infrastructure such as schools, health centres, irrigation and water systems.

Afghanistan was competing for attention amidst all the other global crises. This disaster had come on top of many other challenges that Afghanistan had been facing for decades, such as conflict, poverty, food insecurity and displacement. Afghanistan had been through four decades of conflict. The country now had a very high number of people living below the poverty line. 15 million people out of the 40 million population were food insecure. The situation was the worst man-made crisis for a decade. Around 85 per cent of the population needed to live on less than one dollar per day. Almost every third Afghan had no access to basic food, health care and income security.

The international community needed to not lose sight of Afghanistan and the needs of its people.

Announcements

Rolando Gómez, Chief of the Press and External Relations Section at the United Nations Information Service (UNIS) in Geneva, said the United Nations Secretary-General António, in a video message issued from the Mount Everest region, noted that Nepal had lost close to one-third of its ice in the last thirty years. He said that the glaciers were retreating, but we could not.  He stressed that we must end the fossil fuel age, and we must act now to protect people on the frontlines. Upon departing Nepal, he called on the international community to show effective solidarity to protect communities. The Secretary-General would depart Nepal for to London where he will attend the AI Safety Summit 2023.

The International Telecommunication Union (ITU) would hold a press conference on Thursday, 2 November at 10:30 a.m. to preview the “ITU World Radiocommunication Conference 2023 (WRC-23)”. Speaking would be Joanne Wilson, Deputy to the Director, ITU Radiocommunication Bureau.

The World Health Organization (WHO) and World Meteorological Organization (WMO) would also hold a press conference on Thursday, 2 November at 12 p.m. to mark the release of the State of Climate Services for Health report. Speaking would be Professor Petteri Taalas, WMO Secretary-General; Dr. Maria Neira, Director, Department of Environment, Climate Change and Health, WHO; and Dr. Joy Shumake-Guillemot, joint WMO-WHO Office on Climate and Health.

The World Intellectual Property Organization (WIPO) would hold a virtual press conference on Thursday, 2 November 2023 at 3 p.m. to announce the release of the World Intellectual Property Indicators report, which showed global intellectual property (IP) statistics from countries across the globe. The embargo on the report expired on Monday, November 6, 2023, at 10:30 a.m. Speaking from would be Marco Aleman, Deputy Director General, IP and Innovation Ecosystems Sector, and Carsten Fink, Chief Economist.

The United Nations Human Rights Committee would hold a press conference on Friday, 3 November at 2 p.m. to present findings on Iran, Kuwait, Republic of Korea, Trinidad and Tobago, the United States of America and Venezuela. Speaking would be Committee Vice Chair José Manuel Santos Pais and Committee members Carlos Gómez Martínez and Hélène Tigroudja.

The Human Rights Committee would have tomorrow morning a public meeting to hear the presentation of the progress reports on follow-up to concluding observations and follow-up to views. It would close its 139th session next Friday at 5 p.m. and issue its concluding observations on the reports of the six countries reviewed during the session: Iran, Venezuela, Kuwait, the United States, Trinidad and Tobago and the Republic of Korea.

The Committee Against Torture, which opened yesterday its 78th session (30 October-24 November, Palais Wilson), was beginning this morning the review of the report of Burundi. This session, it would review the reports of Burundi, Costa Rica, Kiribati, Denmark and Egypt, Slovenia.

Today was World Cities Day. In his message for the day, the Secretary-General said cities were engines of economic growth and innovation that held the key to achieving the 2030 Agenda and Sustainable Development Goals. They were on the frontline of today’s complex challenges, from the climate crisis to growing inequalities and political polarisation. He called for resolve to work together for urban areas, which were beacons of sustainability, resilience and prosperity for all.

Tomorrow, 1 November at 3:30 p.m. in the United Nations Office at Geneva (UNOG) press briefing room, UNOG Director-General Tatiana Valovaya and Services Industriels de Genève (SIG) Director General Christian Brunier would sign the “Ambition Negawatt Vision” Charter. The signing would express UNOG’s ambition to increase its clean energy production capacity and achieve significant energy savings.

RG Announcements:

Read the list of meetings covered prepared by François Nassiet

Press conferences

24 – 31 October

Global Media and Information Literacy Week

31 October

World Cities Day

02 November

International Day to End Impunity for Crimes against Journalists

TOPICS

WHO Christian Lindmeier (PR) with Dr. Nima Saeed ABID, WHO Sudan Representative (From Port Sudan)

• Sudan – Cholera, Dengue and other concurrent outbreaks”

UNICEF James Elder (Zoom)

• Widespread grave violations being committed against children, and the rising threats of unsafe water and trauma in Gaza

OHCHR Elizabeth Throssell (PR)

• Ukraine: Report into 5 October attack on funeral reception in Hroza
• Bangladesh protests

UNDP Sarah Bel (Zoom) with Stephen Rodriques, Resident Representative in Afghanistan (From Kabul)

• Update on the situation post-earthquakes

Listening / available for questions but not briefing:

FAO KiJung Min (Zoom

IFRC Tommaso Della Longa (Zoom)

OCHA Jens Laerke (PR)

OSE Jenifer Fenton (PR)

UNCTAD Catherine Huissoud (Zoom)

UNHCR Shabia Mantoo (Zoom)

Not available:

ILO, WMO, WTO

No reply:

HRC, ICRC, IOM, ITC, ITU, UNECE, UN-HABITAT, UNITAID, UNOPS, WFP, WIPO