Where?
Programme Laascaanood-1 will take place in the outskirts of Laascaanood, a city pertaining to the Sool region, Somalia. This region, currently disputed between Somaliland, Puntland and the Kathumo State, was scouted by the Sool-3 Mission Work Group in 1997, 1999, 2006 and 2007.
Why?
- Acute food insecurity and high levels of acute malnutrition, particularly in children.
- Inadequate and poor quality basic services.
- Emergent epidemic in the Sool area.
- Human rights violations against civilians.
- Minor displacement related to current conflicts. Predicted raise over 10%-30% in following months.
When?
[MISSION CALENDAR STILL NOT CLOSED] - CONTACT MCF CONTINENTAL ASSETS FOR FURTHER INFORMATION
Mission Dossier: Puntland and Laascaanood
The humanitarian situation in Puntland, situated in the North-Eastern corner of Somalia, improved recently with the cessation of most combats in the area. However, it recently worsened anew by the arrival of internally displaced people affected by conflict and the sporadic fighting between Puntland and the Somaliland army.
Laascaanood (also called Las Anod or Laas Caanood), capital city of Sool, has become a necessary stop for IDPs trying to escape from the ongoing combats by traversing the region, which is subject to an unresolved boundary dispute with Somaliland. Current local conflict, inter and intra-clan clashes and banditry persist in rural areas of the region, and there have been reports of major military Somaliland operations in the area.
This, combined with other, preexisting humanitarian problems that affect all of Somalian territory, leave vulnerable groups (IDPs, the urban destitute and poor residents) in an even more exposed situation, that will certainly result in further infringements of their human rights.
Finally, a recent outbreak of a new infectious entity, Rupert's disease, that might quickly become epidemic have reached the MCF Mission Watch. This entity, known by local inhabitants as the "Sour" disease or "the Milking Maggot" disease has been deemed a priority by Mission Watch. If infected IDPs are treated or administered preventive measures before they enter Puntland or Somaliland, we will be preventing the spread of a dangerous epidemic and potentially saving thousands of lives.
If you wish to know more about the Sour disease, refer to the Mission Watch Report below these lines.
TECHNICAL INFORMATION
Mission Work Group
The Opal-1 Mission Work Group is the only dedicated MWG assigned to this programme. This group is composed of:
- Six Executive Members.
- Thirteen Trained Volunteers on yearly rotation.
- Thirty-one Volunteers on yearly rotation.
- Three Health and Prevention Specialists.1
- Four Infrastructures and Development Specialists.2
- Three Rescue and Intervention (Security) Specialists.
And is equipped with:
- Three adapted transport and utility semitrailers.
- Three dedicated MSU.3
- Six pickup trucks and two four wheel drive vehicles of different make.
- Non-disposable medical equipment and gear.
- Two months' worth of medical supplies, including disposable and normal-abnormal materials, adjusted to predicted rate of activity.
- Two crops-per-inhabitant worth of normal-abnormal Myrmidon Crop seeds.
- Three full body bio-hazard protective suits.
- Bio-hazard gear.
- Training material (bibliography, practice material; normal-abnormal assets related in complete equipment manifest).
Abnormal Assets
Three abnormal assets have been deployed with the Opal-1 Mission Work Group:
- Third Vesta Donation, to provide fast structural development to the area and provide local headquarters and medical facilities for the Work Group.
- First CETRes Donation, to warrant a continuous supply of clean, drinkable water to both MCF facilities and IDP camps in the area.
- Fifth Global Occult Coalition Donation, to ensure rapid and discreet deployment of TVD-pre-synthesized facilities and other large loads.
Mission Watch Additional Report - HEALTH CONCERN : "THE SOUR"
Of Concern: HEALTH CONCERN, EMERGENT DISEASE, INFECTIOUS DISEASE, POSSIBLY ABNORMAL, Africa, human contagion, REGIONAL, EPIDEMIC, treatable, LETHAL.
Concern Summary: Conclusions of an article about the Rupertine disease. Written by Dr. Sarah Desjeux, Health and Prevention Field Executive member.
The Sour is an emergent epidemic first identified in IDP camps in Niger, where UN-OCHA work clusters first encountered it. MCF personnel from the Ruperts-1 Work Group established a local Research-Health Programme with the approval of local authorities and African Union4, GOC5 and UN-OCHA6 support. It has been repeatedly called since 'the Rupertine' or 'Rupert's disease" by the local media and scientific bulletins emitted from both GOC and MCF internal editorials, but in truth it should be called by the names the affected communities have given it, as they are much more descriptive.
The Sour, also called the Milking Maggots disease, is caused by a virus which can be caught from infected humans. It is transmitted mostly through skin contact. It has been theorized that its etiologic agent, a virus possibly pertaining to the Herpesviridae family, is capable of surviving in contaminated water by infecting Giardia lamblia, a very common free-life protozoan. This makes clean water supply a priority for any Mission dispatched to areas affected by it, and immensely complicates Concern management.
When they woke me up, I was sure I had gotten blind because of that car that hit me, but then they said I had been down with the Sour. I had been playing with my brothers in the brook a couple of days before, and at first I thought we were just fine.
One day, I woke up seeing all those dead people around, like corpses, only covered with white writings, and they chanted 'drink, drink the maggots' milk, so they can feed their ilk' all the time. One of them looked like my mother, I thought she was my mother; my brothers were like them, too, so I run and got run by a car. My legs were bleeding a lot, but it did not hurt, so I run away from them.
I hid for a while, I do not know for how long. I started to bleed white from my legs, and I got thirsty, so I did as the chanting said and I drank it. I also ate the maggots. It tasted bad, like milk gone bad, but at the same time it was good, felt good.
Later, it started to hurt, so I went out and looked for help. The only person I found in the village was a tall stranger, a man from MCF. The man told me to stop running, to calm down, and gave something for my pain, then took me here, to the clinic.
They say I will be fine, but other people in the village are sick now, and I'm afraid my mother and brothers got the Sour too. I do not care if they lose their legs too, I just want to see them.
Daouda was one of the many children from a small village near Arlit, Niger, affected by the Third Sour Outbreak. While the village is now defunct, more than thirty percent of its population was safely evacuated and treated by the Geraldine-2 Mission Work Group.
The Sour doesn't have early onset symptoms. However, after an incubation period of ten to twelve days after infection, all patients will suddenly suffer from acute psychotic disorders which mainly involve psychotic clinical and radically altered behavior. They will be followed by a secondary phase in which self-inflicted injuries and/or severe trauma due to reckless demeanor are frequent.
A key symptom present in Sour patients is that most injuries occurred during this period will not heal nor bleed, releasing instead a pus-like white substance of a slightly floral smell and, reportedly, very sour taste. This usually dehydrates the subject, who quickly enters a state of passivity and delirium that may be accompanied by fever. Blood analysis has confirmed the presence of the likely etiologic agent in the bloodstream, but no satisfactory explanation for the apparent transmutation it undergoes when exiting the blood vessels due to traumatic injury larger than a pinprick.
It is infrequent, but not exceptional, to find small worm-like tumors in the edges of injuries suffered by the subjects; these characteristic growths give the Sour its other name, the Milking Maggot disease.
Normally, these symptoms should subside in ten to thirteen weeks of natural development, provided the patient survives the behavioral alteration phase. After this, normal healing processes resumes; however, chronic pain and/or general loss of health are frequent after the illness has run its course, due to major scarification and internal injuries — it is frequent to find injuries so complicated and/or extensive that normal healing processes cannot handle them.
Currently, early diagnosis of this disease is considered difficult even with access to laboratory conditions. Focus on contagion prevention measures and isolation of known patients should be absolute priorities to all Work Groups.
However, the agent has proven to be sensitive to a combined treatment of generic Aciclovir and Prometerine — see attached field manuals for dosage and viable administration routes, necessary material for the inoculation and possible alter-scientific uses —, and may be used as primary prevention, entirely stopping the development of the disease with an estimated 98% efficacy. Finally, if properly addressed and treated, the infection can be stopped in its early stages; actually, when combined with isolation and support measures to counteract the loss of fluids, even patients in deteriorated phases may survive!
To sum it up, the Sour has proven to be a highly infectious process, a dangerous threat to human life and an extremely distressing phenomenon to behold, both for relatives of its victims, first responders and NGO workers. The Manna Charitable Foundation possesses the means, the experience and the on-site assets to respond to this health concern in a comprehensive, complete capacity.
With a new possible outbreak in Sool, we stand on the brink of a potentially catastrophic deterioration in the state of humanitarian concerns of the area and the permanent destabilization of its already suffering societies. I, with the full support of my team, motion that we intervene immediately.
Dr. Sarah "Opal" Desjeux is a forty-nine years old Health and Prevention Field Executive member and has worked as such for thirty-one years, making her one of the most veteran field workers in the Manna Charitable Foundation. She worked as a volunteer for three years and has been a Mission Work Group Operation Leader for ten.
Programme Priority: Medium-High. All deployed personnel must be on the lookout for new outbreaks. Mission Watch will elevate Programme Priority accordingly to increases in rate of infection and mortality rates or new clinical presentations.
Safety Concerns: Strictly restricted to trained volunteers, specialists and Executive members. Engage only in optimal gear and deployment conditions. If detected, warn a) Mission Watch, b) Mission Branch Health and Prevention Directorate, c) the pertinent Continental Branch Secretariat and d) the UN-OCHA.