gezira state emergency Profile

Saving Lives..
Protecting Health
gezira state
Emergency Profile
1st Edition 2014
Gezira ESP
1
Gezira State Administrative Map
2
Gezira ESP
Table of Contents
1. Executive Summary............................................................................................................... 7
1.a Context .............................................................................................................................................................................. 7
1.b Risk profile........................................................................................................................................................................ 7
1.c Priority needs ................................................................................................................................................................. 9
2. Hazard Profile ......................................................................................................................10
2.a Major Hazards.............................................................................................................................................................. 10
2.b Impacts of Past Disasters...................................................................................................................................... 11
2.c Current situation........................................................................................................................................................ 12
3. Public Health Profile ...........................................................................................................13
3.a Epidemiological profile: prevalent diseases and their seasonal peak...................................... 13
3.b Leading causes of morbidity and mortality ............................................................................................ 14
3.c Public health indicators......................................................................................................................................... 15
3.d Environmental Health ........................................................................................................................................... 18
3.e Administrative structure of health system & level of care............................................................... 23
4. EPR structure, Policies, and Public Health Guidelines ..................................................25
4.a Operational structure of state disaster management system....................................................... 25
4.b Policies available....................................................................................................................................................... 25
4.c Public health guidelines ..................................................................................................................................... 25
4.d Emergency Preparedness and Response plan, program ............................................................... 25
5. Health Sector Partners existing in the state ...................................................................26
5.a National entities ........................................................................................................................................................ 26
5.b International / UN agencies............................................................................................................................... 26
5.c Private sector .............................................................................................................................................................. 26
6. EPR Contacts / Focal Points ................................................................................................27
7. References.............................................................................................................................28
7.a National links................................................................................................................................................................ 28
7.b Other references....................................................................................................................................................... 28
Annexes......................................................................................................................................29
1. General State information...................................................................................................................................... 29
2. Administration: administrative divisions, governance.......................................................................... 34
3. Economic Situation.................................................................................................................................................... 34
4. Basic Education............................................................................................................................................................. 35
5. Demography: ................................................................................................................................................................ 36
6. Socio-cultural profile: languages, ethnicity, religion, cultural practices.................................... 36
Gezira ESP
3
ABBREVIATIONS
AWD
CBS
CFR
CSOs
ECP
EHA
EPR
ESP
FAO
FHC
FHU
FMoH
HIV/AIDS
NGOs
PHC
RVF
SHHS
SMoH
SRCS
WHO
4
Gezira ESP
Acute Watery Dirhoea
Central Bureau of Statistics
case fatality rate
Civil Society Organizations
Emergency Country Profile
Emergency and Humanitarian Action
Emergency Preparedness and response
Emergency State Profile
Food and Agriculture Organization
Family Health Center
Family Health Unit
Federal Ministry of Health
Human Immunodeficiency Virus
Non Governmental Organizations
Primary health Care
Rift Valley Fever
Sudan Household Health Survey
State Ministry of Health
Sudanese Red Crescent Society
World Health Organization
ACKNOWLEDGEMENT
This version of the Gezira-Emergency State Profile (ESP) is the output of participations
of several individuals from: the Emergency Department, FMoH Sudan, Gezira SMoH
Emergency personnel, and other health partners such as WHO and Civil Defense.
The data has been collected by Suha Almahbob and Lena Mohamed Osman and written by
Ms. Lena Mohamed Osman. The maps have been generated by Ms. Hala Mohammed (GIS
officer, EHA). The first draft is reviewed and updated by Dr. Nassma Mohieldeen (Deputy
Head of Information Unit) and Dr. Mahmoud Ali (the Head of Information Unit, EHA). The
final draft is reviewed by Mrs. Somia Okoued (EHA Director, FMoH).
Gezira ESP
5
PROCESS
This document has been prepared through the following processes:
-The Information section at National EHA Department has compiled the information and
data using the original Sudan-ECP template.
-The template has then been tailored to state context and the information was verified
and completed by a visit to the Gezira State.
-The first draft has been circulated to the SMoH and the FMoH, Sudan to review and
correct the data.
-The final draft has then been submitted to FMoH for final approval and the endorsement
has been done in a workshop attended by Director Generals of SMoH and State EHA
Coordinators.
N.B
This document is a living document and the state has to update it regularly (at least
annually) and/or as soon as new source of information becomes available and/or the
situation evolves in the state.
6
Gezira ESP
1. Executive Summary
1.a Context
Gazira State is located at the middle of Sudan between Latitudes13-15 N, and Longitudes
34-32.5 E. The State’s area is about 27,549 square Kilometers while the total population is
about 3, 734,320 according to 2008 census . The state is bordering Khartoum State to the
north, Sinnar state to the south, White Nile State to the west and Gedarif State to the east.
Administratively, it divided into eight localities namely: Wad Madani alkubra, Al kamleen, El
Hasaheisa ,Um Algora ,East ALgazira, South ALgazira, Alqurashi and El Managil. The region
has benefited from the Gezira Scheme, a program to foster cotton farming begun in 1925.
At that time the Sennar Dam and numerous irrigation canals were built, Al gazirah became
the Sudan›s major agricultural region with more than 2.5 million acres (10,000 km²) under
cultivation that makes the state exposed to water associated borne diseases like malaria,
acute watery diarrhea and Schistosomiasis particularly during and after rainy season where
environment becomes suitable. The geographical location of the state makes it a center for
the highways’ network leading to high incidents of traffic accidents, for instance: Red sea,
Kassala, Khartoum highway road)(1).
1.b Risk profile
1- Health-related risks
Most of the state population works in agriculture while others herd Livestock. The presence
of Elgenaid Sugar Factory and a number of textile and food oil factories has resulted in
severe negative impacts on population health even though they have socioeconomic
values. This situation put a huge challenge on Ministry of Health to provide effective health
services to its population. Nevertheless, the state suffers from high burden of endemics
(malaria, schistosomiasis) and frequent epidemics mainly coming due to the deterioration
of environmental sanitation as well as agricultural related activities. Source: HMIS Report
2012.
2- Water-related risks
Improved sources of drinking water are piped water (into dwelling, yard or plot), public
tap/standpipe, tube well/borehole, protected well, and rainwater collection. 79.2% of state
population using improved drinking water source (SHHS 2010). The coverage is between
54%- 96% in urban to 60-90% in rural areas. The state suffers from insufficient drinking
water especially in the western part of Al Managil and Um Algora localities and some parts
of Al Hasaheisa locality like Abogota administrative unit. Groundwater is the main source
of drinking water in majority of state areas while there is only one purification plant in Wad
Madani city. Likewise, the water pipe systems are considered old, corroded and near to
the surface make them exposed to mix up with sewage system especially when there is
network breakdown during rainy season.
(1) Source: Epidemiology Department-SMOH
Gezira ESP
7
3- Education-related risks
Gezira state faces many challenges regarding education. One of the main problems is the
incomplete coverage and access to school particularly basic education. Students in some
villages walk so long distances to reach schools and during their home journey they play
in water drains and stagnant canals where there is high density of Schistosoma. As a result,
Bilharziasis is considered the commonest public health problem around the state following
Malaria.
Crowded schools due to shortage of classes make the student susceptible to spread of
infectious diseases like meningitis. Moreover, there are many of co-education schools
that might lead to certain unexpected behaviors .On the other hand, some schools lack
sufficient drinking water sources as well as latrine facilities. Furthermore, some schools are
built near to car roads that threaten the life of many students. Source: School health-SMOH.
4- Livelihood-related risks
The state has benefited from the Gezira Scheme. The scheme contributes about 58, 46, 23,
and 12 percent of the total cotton, wheat, groundnut and Sorghum production in Sudan
respectively. A program to foster cotton farming is begun in 1925. At that time, Sennar
Dam and numerous irrigation canals were built. Gezira state became the Sudan›s major
agricultural region with more than 2.5 million acres (10,000 km²) under cultivation. The
initial development project was semi-private, but the government nationalized it in 1950.
Cotton production increased in the 1970s but by 1990s increased wheat production has
supplanted a third of the land formerly seeded with cotton. Cotton productivity in Gezira
scheme is low and fluctuating from one year to another. It was 4.4 pound per acre before
2005 and now it is 3.8 pound per acre. Durra productivity also becomes lower which is from
1.2 pound per acre before 2005 to 0.9 pound per acre. All these factors together led to
decrease the economic value of Gezira scheme and decrease the income of farmer that, in
turn, led to increased unemployment level, low food security, and encouraged migration to
urban areas.
8
Gezira ESP
1.c Priority needs
Table (1): State Priorities
Issues
Health care and treatment
Priorities
Increase coverage by basic PHC
package & application of total quality system
Affordability& sustainability of basic medicine with reasonable
cost
Reduce child & Maternal mortality
Limit the spread of communicable diseases and the
implementation of early warning systems to prevent epidemics
Capacity building
Majority of health services in large cities and rural areas are
critically understaffed
Capacity Building for human resource for health and link it with
population and geographical location.
Water and sanitation (Poor sanitation;
its impact on communities and the
environment)
Confirm safety of water & food and establish effective system for
waste disposal at locality level
Community participation
Raise community awareness & participation for their health
promotion & to prevent them from communicable and noncommunicable diseases
Source: HMIS report, 2012
Gezira ESP
9
2. Hazard Profile
2.a Major Hazards
The followings are the major hazards in the state with their potential scale on population
Table (2): The Major Hazards:
Hazard trend
Vulnerability (Risk\impact)
Potential scale
Disease
outbreak
Increase in mortality and
morbidity
Flood
Loss of assets and property
damage
AWD 0.09% of population
Schistosomiasis 0.8% of population
RVF 0.0007 of population
Malaria 10-22% of population
Flood of Al- Rahd River (2012)& Blue Nile River
Agriculture
hazard
Crop damage ,Insect pests
pest and now a day fruit flies constitute an enormous
threat to fruits and vegetables
670 tons of lentils and cinnamon Were examined in
addition to 273 tons of cottonseed genetically axis and
9300 tons of wheat seed and cleared 38 empty container
for export
Drowning
Loss of life
117 victims*
Fire
Loss of belongings
334 HHs*
* Civil Defence, 2012
10
Gezira ESP
Figure (1): Gezira State Flood Map, 2013
2.b Impacts of Past Disasters
Gezira state has affected by many disasters in which include, diseases outbreaks, heavy
rains, and flash floods. these hazards and disaster collectively leads to destruction of
buildings, crops losing, loss of human and animals life and loss of health and educational
facilities, the most common disaster is spared of upper respiratory infection due to spread
grasshoppers affected 2582 person with 11 die ,in November 2007 the state affected by Rift
Valley Fever (RVF) with 402 people get sick &164 die Gazira state is endemic by Malaria ,
Schistosomiasis & typhoid below table show number of cases per year.
Table (3): Number of Cases of Endemic Diseases 2008-2012
Disease
Malaria
Schistosomiasis
Typhoid
Dysentery
TB
2008
175026
4603
14485
15571
1648
2009
222082
5841
21123
16865
1615
2010
185385
5856
27013
15015
1519
2011
225348
6644
41498
15417
1590
2012
269748
5014
42055
18065
1337
2013
323343
0
40408
16762
1128
Source: Epidemiology Department-SMoH
Gezira ESP
11
2.c Current situation
Gazira state hosts the most two bigger agricultural projects; Algezira and Alrahad irrigation
schemes as well as other smaller projects like Zaid alkhair & ALgenaid projects that can
create breeding grounds & increases opportunities for vector- borne diseases.
Non-rational use of pesticides and fertilizers, many industrial establishments do not follow
the law and drain untreated waste water into the river, sewage is dumped into the Nile
as a result of lack of sanitation and waste water treatment, all these have led to economic
and health hazards especially the spread of water and food-borne pathogens that become
endemic all over the state.
Overall, human activities have affected the River Nile. When the River Nile is affected, all of
the plants, animals, and humans that depend on the river are also negatively affected.
12
Gezira ESP
3. Public Health Profile
3.a Epidemiological profile: prevalent diseases and their
seasonal peak
Gazira state suffering from many endemic and epidemic disease mainly come from the
presence of irrigation schemes & deterioration of environmental sanitation, malaria
number one in top five of disease with typhoid, hepatitis &Tuberculoses. There is disease
related to some season like meningitis & hemorrhagic fever. In 2007 the state witnessed
outbreaks of (RVF).
Schistosomiasis which is associated to Gezira scheme is still a problem even though the
state made unprecedented efforts to eliminate it .increase number of seasonal worker and
lowering percentage of adequate sanitation make state vulnerable to many disease and
give chance to entrance of new disease to state.
Figure (2): Seasonality of Major Past Events – Gezira state
Rift Valley Fever
Gezira ESP
13
3.b Leading causes of morbidity and mortality
The figures below illustrate the major communicable diseases in the states in 2008-2012
Figure (3): Major Communicable Diseases’ Frequency per HF
Source: Epidemiology Department, sMOH, 2011
Figure (4): Leading Causes of Mortality, 2012
Source: statistic Department, sMOH, 2012
14
Gezira ESP
3.c Public health indicators
According to the SHHS (2010), Estimates of the neonatal, post-neonatal, infant, child and
under-five mortality rates by background characteristics are presented .which provides
estimates of child mortality by socioeconomic and demographic characteristics. There is
some difference between the probabilities of dying among males and females. Infant and
under-5 mortality rates are lowest in Gezira compare to the figures for Blue Nile region
are about 60 percent higher than the national average. The SHHS2 findings indicate that
mortality rates are higher for males than females. There are also significant differences in
mortality in terms of educational and wealth levels of households, where mortality levels
are lowest among children whose mothers have secondary and higher education and
among children of mothers from households in the richest quintile these high levels of
child mortality and morbidity can be partly attributed to a number of wide-spread bad
hygiene practices: open defecation, improper use and maintenance of latrines, lack of
hand washing, and unhygienic water collection, water storage, food storage and food
preparation.
According to the health authorities, current health facilities fulfill national standards in
terms of size and coverage, but not in terms of capacity and quality of services (such as
availability of well trained medical Personnel and adequate equipment). Furthermore,
accessibility to health units is rendered difficult by the absence of roads and ambulance
services.
Figure (5): Comparative Child Health Indicators
Source: SHHS, 2010
Gezira ESP
15
Table (4): The estimated status of some selected indicators as in 2009-2010
Indicator
Birth Rate
Estimated Status in 2010
30.9
Crude mortality rate
16.3
Infant Mortality Rate
Under 5 Mortality Rate
Maternal Mortality Rate
Immunization Coverage
Malnutrition Rate
Prevalent diseases
39 per 1.000
53 per 1.000
185 per 100.000
EPI standard immunization
3.4%
Malaria, Diarrhoeal diseases,
Typhoid fever, Dysentery,
Schistosomiasis
37.8
Prevalent Poverty
Source
Population and housing
census,2008 analysis report Gezira
state
Population and housing
census,2008 analysis report Gezira
state
HHS 2010
HHS 2010
HHS 2010
EPI, SMOH
SHHS 2010
Epidemiology department, SMOH
Population and housing census,
2008 analysis report Gezira state
Health Personnel / Service
Table (5): Human and Physical Resources indicators Rate (R) per population
Indicator
Population: Hospital
Population: doctors
Population: Hospital Bed
Rate (per 100000 population )
2
45
107
Source: HMIS, SMOH
Table (6): Number of Health Facilities in the State:
Hospital
76
Source: HMIS, SMOH, 2012
16
Gezira ESP
Health centre
352
Health unit
516
Total
944
Figure (6): Health Facility Distribution in Gezira State, 2013
Gezira ESP
17
Table (7): Health Personnel per Locality
Medical staff
AlGezira AlKamlin Al
East
Hasaheisa
Um
Algora
Wad Madni
Alkobra
South
Al
Total
AlGazera Managil
Specialist
16
14
23
4
133
10
54
254
MO
51
57
91
15
372
41
84
711
Health assistant cader
Nurse
62
395
81
304
134
422
37
66
292
512
138
332
139
324
883
2375
Technical personal
Pharmacists
29
10
46
5
91
10
18
2
92
95
140
1
7
13
423
136
Registrar
0
0
10
0
95
0
0
105
Dentist
4
5
4
0
16
2
6
37
Public health officer
Public health
Assistant Public health
Nutrition officer
Nutrition Counselling
14
19
4
4
16
33
28
22
6
13
16
24
20
8
37
4
5
5
3
7
27
42
37
11
48
19
25
23
5
38
18
34
58
5
10
131
177
169
42
169
Health visitor
Assistant Health visitor
Legal mid wife
3
2
203
9
1
130
8
6
248
4
1
92
11
4
148
8
6
296
5
2
354
48
22
1471
Source: HMIS, SMOH, Annual Statistics Report, 2012
3.d Environmental Health
Water and Sanitation
Improved sources of drinking water are piped water (into dwelling, yard or plot), public
tap/standpipe, tube well/borehole, protected well, and rainwater collection. Public house
connection and tap/stand-pipe are the main source of drinking water in urban and per
-urban areas especially while protected wells are widely used in rural areas and urban
centres as well.
Water Yards:
Deep and cased boreholes equipped with electrical submersible pumps and elevated
storage tank and distribution system. In recent year, driven low yielding reciprocation
pumps have been replaced by electrical submersible pumps and generating sets for
groundwater development in rural areas. Water yards can provide enough water for both
human and animal consumption.
Hand Pumps:
Hand pumps very popular in areas where ground water is not available in enough
quantities especially in basement complex areas in west and east of Gezira state. Hand
pumpsare characterized by the following:
- Suits the fragile ecological conditions and the scattered villages and provides water even
in crystalline rock areas.
- Low cost, simple and easy to install, operate and maintain by communities
- Provides safe water and prevents surface contamination.
18
Gezira ESP
Slow Sand Filters:
Slow sand filters are common in areas of limited groundwater like western and eastern part
of the state. These techniques are very common in areas of Elfao Agricultural project and
Elmanagil Agricultural extension. They are useful in improving surface water quality.
Most of the slow sand filter work without the step of disinfectioned by chlorination, the
cornerstone in this type of filter the sod imitation of water.
Haffirs:
Although haffirs in general don’t provide safe domestic water as they are subject to surface
contamination, but they make up an important water source for livestock. Haffirs water
quality, for domestic use, can be improved through fencing and installation of slow sand
filters.
Water Purification Plants:
Urban centers along the Nile system used to depend on river water. Wad Medani and
among few town were established water purification plants as main source of water.
Hand Dug Wells:
Hand dug wells are sallow well and range of 3 to 20 meters depth , basically used to
provide water for livestock in some areas but the number of hand dug is diminishing over
the time due to the contaminated nature of their low yields.
Status of Water Facilities:
Gezira State has 2,350 water sources, the fully functioning facilities producing about 67%
of total water supply, whereas the balance is from partially functioning water sources.
However, this assessment indicated that only 40% of total facilities were functioning with
full capacity and 40% partially working, whereas 20% of these facilities were not operational
at the time of assessment as indicated in the table below.
Gezira ESP
19
Figure (7): Water Sources Distribution in Gezira
Table (8): Safe Water Production in the State according to the functionality of the
Installed Sources:
Type
No of
sources
Fully
functional
Urban
Rural
Total
171
2,179
2,350
54
871
925
Water
Production
m³
27,648
62,755
90,403
Partially
functional
92
856
948
Water
Production
m3
23,552
20,545
44,097
Total m3
Population
served
51,200
83,300
134,500
682,975
2,892,305
3,575,280
l/c/d
75
19
In the urban areas situation is far better than in the rural areas, where person consumption
estimated at 75 l/c/d, as indicated in the above table.
20
Gezira ESP
Table (9): Comparative Water and Sanitation Statistics, 2010
% use improved
% using sanitary % of those who using improved
State
sources of water
means (latrines) water and Sanitary means
Gezira
79.2
34.4
32.1
Sinnar
60.7
17.3
13.2
Blue Nile
39.9
5.3
2.7
Sudan
60.5
27.1
20.8
Source: SHHS 2010
According to SHHS 2010 results, Gezira state is among those with good water and
sanitation status compared to other neighboring states and the country average even
though the sanitation indicators need more work to cope with population demands.
Table (10): Water Source per Locality
Locality
Wells
Hand
pump
Al Hasaheisa
AlKamlin
South AlGazera
Al Managil
Wad Madni Alkobra
AlGezira East
Um Algora
Total
560
249
418
480
157
527
140
2531
150
76
201
35
4
39
505
Haffirs
Sand
Filters
Integrated water
purification Station
60
51
7
118
2
1
1
4
5
6
5
16
Source: Environmental Health Department, SMOH, 2012
Water
purification
station
2
1
1
4
Gezira ESP
Total
664
256
782
442
135
509
199
2987
21
Table (11): Use of Improved Water Sources
Percent distribution of household population according to main source of drinking water and
percentage of household population using improved drinking water sources, Sudan, 2010
Main sources of drinking water
(Unimproved sources)
Total
Number of household members
Missing
Other
Bottled water
Transported by tankers/ carts from
unimproved source
Transported by tankers/ carts from
improved source
Unfiltered (river, stream, dam, hafir, lake,
pond, canal or rain) water
Unprotected spring
Unprotected well
Bottled water
Filtered(river,streamdam, hafir, lake, pond,
canal or rain water
Protected spring
Protected/covered well
Water yard/hand pump
Public tap / standpipe
Piped into compound yard or plot
Piped into dwelling
State
Percentage using improved drinking water source [1]
Main sources of drinking water
(Improved sources)
Gezira 17.0 50.0 9.7 1.5 .2 0.0
0.8
0.0 .1 0.0 1.5
18.4
0.6
White
Nile
22.2 .1 7.5 .0 0.0
0.5
0.0 .8 0.0 8.9
25.8
24.3 0.1 1.6 0.0 100.0 38.5 4391
Sinnar 11.3 23.5 7.6 17.9 .0 0.0
0.3
0.0 .0 2.3 3.3
21.7
10.8 0.0 1.1 0.1 100.0 60.7 3474
0.5
0.0 4.8 3.2 22.8
14.1
13.8 0.0 1.4 0.0 100.0 39.9 3018
Blue
Nile
8.2
1.8
10.3 0.8 26.5 .0 0.0
0.0 0.1 0.0 100.0 79.2 12569
Sanitation Services coverage (urban, rural, emergency)
Access to safe excreta disposal in Gezira estimated at 34.4% according to the SHHS,
compared to 27% Sudan users’ o improved sanitation facilities. Many localities didn’t reach
this level. Still there is a big gab in sanitation especially in schools, public institutions and
market places in rurals and urban areas. The state should give top priorities in their plans
to bridge these gaps.Since Gezira State is characterized by largest agricultural scheme
in Africa and liable for spreading water related diseases., the issue of sanitation must
be addressed probably, through proper waste treatment systems especially in big town
to reduce health risks associated with on sight sanitation, such as pollution of surface
water and groundwater protection. It also assists in enhancing sustainable soil fertility by
controlling the natural nutrients and use of retreated water in agricultural and industrial
usage, however, as indicated above access to both improved water sources and adequate
sanitation in El Gezira is 34.4% according to the SHHS2010
22
Gezira ESP
Table (12): Types of Sanitation Facilities
Percent distribution of household population according to type of toilet facility used by the
household, Sudan, 2010
Improved sanitation facility
Unimproved sanitation facility
Number of household members
Total
No facility, Bush, Field
Missing
Other
Hanging toilet, Hanging latrine
Bucket
Pit latrine without slab / Open pit
Flush to somewhere else
Composting toilet
Pit latrine with slab
Ventilated Improved Pit latrine (VIP)
Flush to unknown place / Not sure /
DK where
Flush to pit (latrine)
Flush to septic tank
Flush to piped sewer system
State
Gezira
0.1
1.2 0.4
0.0
10.0 33.6 0.2 0.0 16.1 0.0 0.1
2.8 0.0
35.6 100.0 12569
White
Nile
0.0
5.5 2.5
0.0
7.1
12.3 1.0 0.2 36.0 0.0 0.1
1.3 0.0
34.0 100.0 4391
Sinnar
0.0
1.0 2.0
0.1
7.0
12.4 0.3 1.6 29.3 0.0 0.0
1.0 0.2
45.1 100.0 3474
Blue
Nile
0.0
1.5 0.7
0.2
0.3
3.0
0.7 0.0
30.1 100.0 3018
0.3 1.4 61.7 0.0 0.0
3.e Administrative structure of health system & level of
care
The two-layer health system is comprised of State Ministry of Health (SMoH) and Locality
Health Management Authorities. However, this system is not fully functional. SMoH is
responsible for adopting and implementing policy, strategic and detailed health planning,
and programming and project formulation. This level also has direct responsibility to
organize and supervise the health services in the state and support local health authorities.
A local health authority is based on locality/county health system approach, which
emphasizes the primary health care. However, there is a dichotomy in the administration
of health services at locality level. The lower level health facilities, i.e. Family Health
Units (dressing stations, dispensaries) and Family Health Centers are the management
responsibility of the locality, while technically being under SMoH. The rural hospitals, on the
other hand, are the responsibility of the SMoH(1).
(1) ECP Sudan document, 2010
Gezira ESP
23
Table (13): Levels of care vs. Population Standard
Level of Care
Administrative Unit
Health Facility
Population Coverage in 1000
Tertiary Level
State
State Hospital /
Specialized Hospital
State’s Population
Secondary Level
State/Locality
State/Rural hospital
Primary/First Level
Locality
Urban FHC and rural FHC
First Contact
Administrative unit
FHU
24
Gezira ESP
250 for SH
100 for RH
- 50 for UFHC
- 20 for RFHC
5 kilometres radius
4. Emergency Preparedness & Response (EPR)
Structure, Policies, and Public Health Guidelines
4.a Operational Structure of Disaster Management
system
At state level, the higher emergency committee, which is chaired by the governor (Wali)
and membered by the Civil Defense (as secretariat) and state line ministries including
SMoH, is responsible for coordinating disaster management efforts and mobilizing
resources for response activities. On the other hand, the health emergency technical
committee, which is chaired by the Director General of SMoH and membered by EHA
department (Secretariat) and other SMoH’s departments, is responsible for coordinating
health activities during emergencies. Similarly, the health emergency coordination
committee is chaired by the Director General of SMoH, EHA as secretariat, and membership
of health sector partners. This committee is effectively coordinating the fund raising
and intersectorial activities among different health partners to guarantee efficiency and
avoidance of duplication.
4.b Policies Available
• Public Health Act, 2008
• IHR, 2005
• National Emergency Policy
• National Health Sector Strategic Plan (2012-2016)
• EHA Policy, 2014
• Health Emergency and Disaster Risk Management Strategy for Sudan (2013- 2016)
4.c Public Health Guidelines
• National Guidelines for Rainy Season Emergency Preparedness & Response Planning
• Emergency Information Management Guidelines and SOPs
• Environmental Health Guidelines During Emergency
• Nutrition Guidelines During Emergency
• Others:
- WHO Emergency Guidelines
- Sphere Standards
4.d Emergency Preparedness and Response Plan, Program
• Federal & States’ Annual EHA Plan
• Federal & States’ Rainy Season Preparedness Plan
• National Health Emergency Response Plan, 2014
• Hospital Disaster Plans
• Health Partners Related-EPR Plans, WHO, UNICEF…
• Community Preparedness Program, SRCS
Gezira ESP
25
5. Health Sector Partners existing in the state
5.a National entities
Civil defence, Ministry of Infrastructure, ministry of agriculture, ministry of education ,Public
Water Corporation, localities, police, ,Local committees
5.b International/UN agencies
There is no UN or international organizations working in Gezira state
5.c Private sector
Red crescent - Islamic Relief Organization- Ithar charity organization
26
Gezira ESP
6. EPR Contacts / Focal Points
Name
Designation
Address
Dr. Ahmed Albasher
DG
Ministry of health 0912320012
Dr. Abass Suliman
Head of preventive medicine
Ministry of health 0123451385
Mr. Tai Alla Ali Tai Ali Al
Head of Epidemiology &
emergency
Ministry of health 0123451386
Mr. Abudria Ahmed Abudria Head of environmental Unit
Dr. Omer ALtai
Head of Planning &
development Unit
Telephone and Email
Ministry of health 0123451392
Ministry of health 0123451382
Mr. Abd Elrhman Ali Hamad Head of statistic & information Ministry of health 0123451383
Dr. Amal Mohamed Babikir
Director of Circulating drug
Ministry of health 0123244441
Dr. Nazar Mohamed
ALgadal
Head of Curative medicine
Ministry of health 0123061980
Mr. ALnaeer Moubark
Director of school health
Ministry of health 0123451368
Dr. Rufaeda ALamin
Mansour
Director of PHC
Ministry of health 0123451361
Dr. Tareg Abass ALajwa
Director of ambulance
Ministry of health 0123451342
Mr. Abomedeen Omer
Director of health promotion
Ministry of health 0123451347
Dr. Ahmed Altayeb
Director of Malaria
Ministry of health 0123451389
Mr. Fath Alrahman
Director of improve
Environment & Water
Public Water
Corporation
0122936278
Director of Red crescent
Red crescent
0122828735
Director Central Bureau of
Statistics
Central Bureau of 0912387768
Statistics
[email protected]
Mr. Osama Mohamed
Osman
Mr. Awad allseed abdula
adam
Gezira ESP
27
7. References
7.a National links
SMoH, Ministry of Agriculture, Civil defence, CBS
7.b Other references
Red Crescent
28
Gezira ESP
Annexes
1. General State information
1.1 Geography: location, borders, capital, area
Gazira State is located in the middle of Sudan between Latitudes13-15 north, and
Longitudes 34-32.5 east. The State’s area is 27,549 square Kilometres 3.734.323 of
population according to2008 censes . From the North, it is bordered to north by Khartoum
State, to the south by Sinnar state, to the west by White Nile State and to the east by
Gedarif State. Administratively, it divided into seven localities namely: (Wad Madani alkubra
, Al kamleen, El Hasaheisa ,Um Algora , Sharg ALgazira,Ganob ALGazira, El Managil) with
39Adminstrative unit,state become Crossroads of high way Traffic (port Sudan)(wad
madani- El Hasaheisa –al Khartoum)( wad madani- El Managil), read sea State, Khartoum
State, Kassala State) Resulting in the exposure of citizens to road traffic accidents.
Wad Medani is the capital city of Gaziera located in the West site of the Blue Nile about
200 km from south of Khartoum. Is strategically located intersect with roads, railway, east
and west and north and south, also represents the second largest city in Sudan after
Khartoum. All these advantages the city has attracted huge numbers of migrants and
displaced persons and asylum-lasting work and seasonal work of the various tribes of the
Sudan.
1.2 Topography
Most of the state surface is a flat plain and there are some hills in some eastern and
southern parts of state, Most of the state areas are located within the mudflats stretching
from the mid-Sudan until the Upper Nile.
Generally the surface of state hails towards north in towards the riverbeds and foremost of
which is the Blue Nile and AL Rahad River. Blue Nile, one of the most important features of
the state surface is characterized by its course, speed in water, and high percentage of silt in
its water.
Gezira ESP
29
Figure (1): Gezira state Elevation Map
1.3 Hydrology
Groundwater resources:
Water in Gezira State generally occurs in Gezira, Nubian and basement aquifers. Ahmed,
2004 indicated that 90% of Gezira water supply from the Gezira aquifer, while about 10%
is from Nubian sandstone aquifers. The Blue Nile is the main sources of groundwater
recharge.
Water in this aquifer occurs under water table and semi confined conditions, the Blue
Nile is the main sources of groundwater recharge for this aquifer. The black cotton soil has
negative impact on groundwater recharge it not support percolation of water down wards.
The upper aquifers providing water supply for shallow wells penetrating up to 45 meters,
while deep Gezira aquifer is providing water supply for relatively deep wells penetrating up
to 90 meters and the average aquifer thickness is 30 m.
Groundwater quality recorded at present of good quality except in some locations and
pockets. Hardness of water is generally high but within the acceptable limits.
30
Gezira ESP
1.4 Climate
We find the temperature of the month of July to September does not exceed the
17degrees in winter to 37 in the summer. ranging from 37 degrees to22degre centgrate.
In dry summer , the maximum temperature may reach 42 degree centigrade as always
happens in the months of April, May that temperature fit the summer crops, which means
grain types& do not fit winter crops that need low temperature, and often find that the
disparity warming be very large and may reach 13 degree cent grate in summer time in
which we find that the thermal contrast in the winter period does not exceed 8 degree.
Average relative humidity in the dry season ranges from 23% to 44 %, while in the autumn
could reach the relative humidity to 94% and between July and until the month of
September of each year humidity varies from 60% and even 84%, usually its peak in August
where the relative humidity is above sixty as in 94-95-96-2006-2007-2008 years. .
Table (1): Total precipitation in the Gezira State in Season 2012/2013 compared to
the previous last two seasons (mm)
Season
Locality
2011/2010
2012/2011
2013/2012
Um Elgura
272.4
231.5
369.5
East Gezira
242.4
118.2
346.2
Managil
292.5
146.4
403
South Gezira
255.3
245.1
447.2
MedaniELkubra
253.8
150.8
343.7
Hassahisa
270.5
152.5
315.2
Kamlin
93
38
126
El qurashi
0
0
0
Average
240
154.6
335.8
Gezira ESP
31
1.5 Soils
Soil prevailing in the state is a Mud plain
Figure (2): Distribution of Soil Units in Gezira state
1.6 Vegetation and land use
Gzira State Considered the first agricultural state in Sudan, by virtue of its natural potential
and their infrastructure in field of agricultural production , where the state space of 27.545
square kilometers representing 6.57 million feddans an are arable land is 91% that equal
to approximately 6 million feddans currently an exploit it about 2.5 million feddans (Gzira
irrigated project 2.2 million feddans , ALRahad project 233 thousand feddans , Sugar
Aljunied 44 thousand feddans, AlteftishaAlasher53 thousand feddans, Alhelalya 6 thousand
s, Albraiab project 6 thousand feddans ). 1.5 million feddans are rain-fed , and another
estimated 1.5 million Feddans of pastures and 407 thousand acres of forest.
32
Gezira ESP
Table (2): Lands by Feddans
Locality
feddans
East Gezira
700000
Managil
300000
Um Elgura
35000
South Gezira
80000
MedaniELkubra
20000
Hassahisa
20000
Kamlin
0
Elqurashi
0
Total
1155000
Figure (3): Land Cover Map, Gezira state
Gezira ESP
33
2. Administration: administrative divisions, governance
Gazira state divided into seven localities namely: (Wad Madani alkubra , Al kamleen, El
Hasaheisa ,Um Algora , Sharg ALgazira,,Ganoub ALgazira, El Managil & El qurashi) with 41
Adminstrative units.
Table (3): Localities and Administrative units
No.
State localities
1
Population
Total
Male
Female
El Gezira East
217,795
245,359
463154
2
ElKamlin
201,488
200,442
401930
3
El Hasaheisa
291,544
314,845
606389
4
Um Algora
104,101
114,377
218478
5
Wad Madni AlkObra
213,429
210,434
423863
6
South AlJazeera
265,078
290,172
555250
7
El Managil
430,895
475,321
906216
8
El Qurashi
0
0
0
1,724,330
1,850,950
3575280
TOTAL
3. Economic Situation
3.1 Gezira Scheme
It is the oldest agricultural scheme in Sudan established in 1925 as the biggest irrigated
farm in the world in an area of 2.1 million feddans. The scheme extends through Gezira
and Sennar states and irrigated by flowing irrigation. The scheme depends on small-farm
ownership (Hawashat) with an area ranging between 15 to 40 feddans.
The scheme contributes by 65% of the country’s cotton production, and about 70%
of wheat production, 15% of groundnuts, 12% of sorghum, in addition to 70 thousand
feddans cultivated by horticultural products, forest and fodders. Moreover, there are around
2 million cattle’s and goats in the area of the scheme.
The Scheme provides great opportunities for investment in agricultural industries, weaving
and spinning, grain mils, edible oils and food industry.
In 2005 a new Act for Gezira Scheme was issued as part of the privatization policy.
Gezira scheme act for 2005:
Taking into account the unique situation of the scheme regarding its ownership;
(government, administration and farmers) and coping with the declared privatization policy
in addition to the need for institutional reformation, the Gezira Scheme Act was issued in
34
Gezira ESP
2005. The act asserts that the infrastructures of the scheme are considered to be part of
the national resources; that the integrity of the scheme land and its agricultural aims are
to be emphasized, and that the scheme administrative unity - which includes agricultural,
irrigation, research and agricultural and industrial elements-, should constitute the essential
factors and basic components. Moreover, it ensures the necessity of the comprehensive
sponsorship of the state. The Act states the right of farmers’ participation in decision making
with regard to agricultural activities, options of crops, financing, marketing, commerce
and investment. The farmers own the land through a lease contract with the government
renewed every 40 years to settle duplication of ownership of the scheme and to unify the
ownership system
Agriculture constraints facing the State:
- The credit for cash crop is not available
- The inputs for rain-fed is unavailable.
3.2 Poverty
According to SHHS2 data shows that the majority of the households in Sudan rely on
the market as the main food source, though the proportion of households that rely on
own production of food items and those who rely on the market vary among States,
The proportion of households which rely on own production of Sorghum in state is
21%& Households with poor food consumption score 0.9 that mean households had an
acceptable food consumption score in Gezira 96.3 percent
3.3 Industry
Gezira state industry composed of small business (Sweet Factory, Traditional oils factory.
Cotton gin…etc)there is number of deferent factories in state : ( Factory of textile ,
Factory of oils and soap, Biscuit factory, Pepsi-Cola factory) in general the main economic
problems/challenges facing the State:
- The collapsed of the main agriculture projects in the state ( Elgezira and Elrahad irrigation
scheme ).
4. Basic Education
The education sector in the state has shown some improvement in recent years.
Table (4): Improvements in Basic Education between 2010 and 2011
2011
2012
% increase
Institutions
1977
2062
2.1
Pupils
694223
720452
1.9
Teachers
23605
24327
1.5
Source: Ministry of Education, 5 years plan, 2012
Gezira ESP
35
Table (5): Improvements in Enrolment in Basic Education between 2010 and 2012
2010
2011
2012
Number of student in primary schools
677967
694223
720452
Males
356103
365665
371992
Females
321864
328558
348460
Source: Ministry of Education, Gezira state, 2012
5. Demography:
The total population of Gezira state is 3, 734,323 (Census 2008). Out of total population
urban are 19.1% while rural are 80.4%.
Table (6): Population by Locality (Census 2008)
State localities
Population
Total
Male
Female
El Gezira East
217,795
245,359
463154
ElKamlin
201,488
200,442
401930
El Hasaheisa
291,544
314,845
606389
Um Algora
104,101
114,377
218478
Wad Madni AlkObra
213,429
210,434
423863
South AlJazeera
265,078
290,172
555250
El Managil
430,895
475,321
906216
El qurashi
0
0
0
1,724,330
1,850,950
3575280
TOTAL
6. Socio-cultural profile: languages, ethnicity, religion,
cultural practices
Many Arab tribes live in Gezira state such as Koahla , Alhlaween , Kenana , Refaah ,
Allarkeen. Such tribes had emigrated from old time looking for pasture and water. After the
establishment of the ALgazira project, other tribes came from the north and west of Sudan
and West Africa.
In terms of language , these tribes divided into tribes speaking Arabic as a mother tongue ,
including: (Aldjaleen and Alshawiga, Rizeigat and Altaisha) and tribes take Arabic as second
language namely: (Aldnaqlh , mahass and Zaghawa), and the tribes of West Africa namely
( Hausa, Albrgo).
36
Gezira ESP

Download Report