Health Cluster Bulletin May to August 2019 MAY TO AUGST 2019 Capacity building on health emergency operations centre of Ministry of Health and Sports
The simulation exercise of National Health Emergency Operations Centre at Naypyitaw on 8 August 2019. Photo: WHO
Health Emergency Operations Centre conducted in Naypyidaw with the support out the respective roles and (HEOC) is a physical location for from Public Health England and WHO: responsibilities during the simulation coordination of information and 5 - 6 August 2019: Training on Incident exercise. resources to support incident Management System management activities. HEOC integrates 7 August 2019: Training on Health The Functional Exercise was the first traditional health services into an Emergency Operations Centre exercise conducted utilizing and testing emergency management model. HEOC is 8 August 2019: Functional Command Post the existing HEOC Plan. The exercise was an essential platform for Incident Exercise on HEOC using the scenario of a conducted from three different locations Management System in emergency pandemic influenza. in Naypyidaw: one acting as National preparedness and response regarding HEOC, another as State/Regional HEOC, health. Public Health England, and Central and the last as Exercise Controller. The Epidemiology Unit and Disaster & Public event was followed by a debriefing Ministry of Health and Sports (MoHS) has Health Emergency Response Division session with senior officials from MoHS developed the National Health (DPHERD) of MoHS, Myanmar facilitated on 9 August 2019. The recommendations Emergency Operations Centre Plan with the whole event successfully in from the event will be implemented by technical support from WHO during 2019. collaboration with WHO Health MoHS in due course in order to further National HEOC Plan is a critical Emergency Programme team. Focal strengthen health emergency component of the National All-hazards persons from central, state and region preparedness and response capacities. Emergency Preparedness and Response levels of MoHS, and WHO actively Plan. participated. The participants used and For more information, please contact: followed National HEOC Plan as well as Dr. Kyaw Khine San, Disaster and Public Health From 5 to 8 August 2019, a series of National Pandemic Influenza Emergency Response Division, Department of Public Health, Ministry of Health and Sports capacity building activities on HEOC were Preparedness & Response Plan to carry (DPHERD), [email protected] Safeguarding health care from attacks In 2012, World Health Assembly Resolution 65.20 The vision of the initiative is that essential equipped with knowledge and resources; was adopted, which requested WHO to provide life-saving health services must be provided to • parties to conflict understand and uphold leadership at the global level in collecting and emergency-affected populations unhindered by their responsibilities under International reporting information on attacks on health care. any form of violence or obstruction. Ultimately, Humanitarian Law; WHO subsequently created the Attacks on Health WHO seeks to ensure that: • health care delivery is not disrupted by Care initiative to systematically collect to advocate • health workers everywhere can provide attacks; and for the end of, and to promote best practices for health care in a safe and protected • all forms of violence against health care stop. safeguarding health care from attacks. environment; For more information: http://bit.ly/2k90h7S • health workers are protected, resilient and Health Cluster Bulletin—Issue 2 2019 || Page 1 of 6
Health Cluster Myanmar WHO humanitarian assistance in Myanmar
Upon request from MoHS, flood response is further complemented through mobilizing US$ 160,000 from WHO South East Asia Regional Health Emergency Fund. The fund enabled the expansion of mobile clinic emergency health care provision to the widened flood affected areas, procurement of anti-snake venom and items needed for provision of safe drinking water.
The MoHS mobile clinic in Kyaikmayaw township, Mon State on 22 August 2019. Photo: WHO For more information, please contact: Dr. Win Bo, WHO, Myanmar, [email protected] WHO continues to strengthen public Nations in Myanmar mobilized the health emergency risk management in Central Emergency Response Fund Myanmar in collaboration with Ministry (CERF). For the latest updates from WHO Myanmar, of Health and Sports (MoHS). An international expert provided technical The CERF funded WHO project titled assistance to develop the MoHS Health “Provision of life-saving health care Emergency Operation Centre (HEOC) services to the new displaced people and concept of operations in May 2019. host communities arising from the This was a follow-up visit from July armed conflict in Rakhine State” 2018 to build the capacity of HEOC. facilitated delivery of life-saving primary Furthermore, HEOC plan validation health care services to the affected exercise & orientation sessions on populations in Mrauk U, Kyauktaw, please refer to our newsletters: Incident Management System and Ponnagyun, Rathedaung and Buthidaung http://bit.ly/2YvVCg6 and factsheets: http://bit.ly/2P4FH5j HEOC to MoHS focal persons were townships through MoHS mobile clinics conducted resulting to concrete starting 2 May 2019 up to six months. recommendations for the all-hazards Total amount of CERF fund is plan improvement. US$135,997.
CERF funded mobile clinics in armed-conflict affected townships of In the midst of the Monsoon season, Rakhine State WHO supported the flood response by An upsurge of fighting between the providing essential medicines and Myanmar Military and the Arakan Army medical supplies to all affected areas. Preventing measles, rubella, polio: http://bit.ly/2RxCxsp and in early 2019 resulted to new This is in addition to operational prevention polio: http://bit.ly/38kp7WD displacements, and compounded the support for MoHS mobile clinics to humanitarian situation, in Rakhine State. provide essential health services to the To address these new needs, the United flood-affected population.
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Health Cluster Myanmar Strengthening collaboration with WASH cluster in Kachin State management of AWD with the support from received timely AWD treatment while WHO. The joint AWD preparedness and health education was provided to nearby response plan of Kachin Health and WASH communities. Cluster is developed to strengthen the coordination and collaboration between WASH Cluster contributed with water the two clusters using existing technical quality testing, chlorination and safe documents. water supply. The presence of E. coli, water insufficiency and poor personnel Health (SHD & WHO) and WASH Cluster, On-site meeting to respond diarrhea incidents, On 25th April 2019, WASH Cluster partner hygiene practices were major concerns. 26 April 2019. Photo: Kachin SHD provided information of diarrhea cases at Pa Two new cases were reported on 26th La Na IDP camps 1 and 2 in Myitkyina. April 2019 followed by no new cases in Acute Watery Diarrhea (AWD) could Kachin SHD, Special Disease Control Unit, the following weeks. This was an endanger thousands of lives especially WHO Myanmar and Myitkyina Township example of effective and timely within overcrowded population areas Health Department conducted investigation collaboration between the two clusters. like the internally displaced population and responses on 25-26 April 2019, followed (IDP) camps in Kachin State. State Health by continuous health service provision as For more information, please contact: Dr. Aye Thein, Kachin State Health Department, Department (SHD) is strengthening routine activity. With about 2,[email protected] collaboration with WASH Cluster in the population in the two camps, 14 patients
Capacity building and implementation of health care services in Rakhine State The following are key accomplishments • Facilitated the Access to Health Fund by the Rakhine State Health Department: board monitoring participated by MoHS • Conducting mobile health care activity focal persons Dr. Thandar Lwin and in Myo Thu Gyi rural health Centre in Dr. Myint Myint Than, and focal person Maungdaw township on 4 May 2019 from Embassy of Switzerland, British using a mobile car donated by Union Embassy, Embassy of Sweden, and Enterprise for Humanitarian assistance, Embassy of United States of America on Resettlement and Development. 3-5 June 2019. The monitoring team conducted the meeting in Sittwe Special mobile health clinic from state health General Hospital and visited to department in Maungdaw, 04 May 2019. Thet Kel Pyin, Darpaing and Photo: Rakhine SHD Kyauktan subCentre. • Conducting opening ceremony of Department, one in Pauktaw township Toungup township hospital on 10 June and three in Kyauktaw township on 2019. 09 July 2019. • Conducting district level training for • Implementation of school feeding prevention of mother to child programme in nine townships with the • Participation of 23 assistant surgeons transmission of HIV for basic health support of World Food Programme, and nurses to the post-abortion care staff on 18 June 2019. with plan to extend in Sittwe, Thantwe, training in Yangon Central Women • Conducting advocacy meeting and and Gwa townships. School meal Hospital on 6-10 May 2019. training for gender-based violence for programme is conducted in two • Conducting state level advocacy northern Rakhine State on townships. workshop on sanitation campaign and 22-24 June 2019. • Revitalization of the routine Health hygiene practice in Rakhine state was • Conducting community-based Infant Management Information System, done on 22 May 2019. This was and Young Child Feeding training in which is currently impacted by internet followed by activities of community Pauktaw and Ramree townships on access issues in some townships of based environmental health and 1-10 July and 18-27 July 2019, Rakhine State starting 22 June 2019, to sanitation activities in Sittwe, Pauktaw respectively. be conducted as soon as possible. and Minbya townships. • Handover of four new subcenters by • Conducting Training of Trainers for German Society for International For more information, please contact: Dr. Sai WIn Zaw Hlaing, Rakhine State Health Psychological First Aid in Sittwe for all Cooperation to the State Health Department, [email protected] 17 townships on 26-27 May 2019. Health Cluster Bulletin—Issue 2 2019 || Page 3 of 6
Health Cluster Myanmar Pilot direct acting antiviral for hepatitis C virus treatment & care model among people who inject drugs in hard-to-reach areas in Myanmar Myanmar is confronted with a HIV/AIDS, 412 screened for HCV and HIV, 358 hepatitis and drug use syndemic. There is (86.8%) were HCV RNA positive. an estimated 93,000 people who inject Of all completed treatment, 81.4% drugs (PWID), and among them, HIV achieved sustained virologic response. prevalence is up to 61.4%, Hepatitis C or HCV treatment was perceived as an HCV positivity rate of 87.9%, and HCV/ important incentive to seek other HIV co-infection of 25%. treatment and self-reported health seeking behavior increased significant- With USAID HIV/AIDS Flagship (UHF) - ly. U.S. President's Emergency Plan for AIDS Relief (PEPFAR) funding, Asian Harm In conclusion, the treatment of and Reduction Network (AHRN) assessed the adherence to oral DAA regimens is effect of HCV treatment among PWID in effective. In the absence of blanket HCV remote areas in Myanmar. Participants Patient living with Hep C consulting medical doctor at treatment, appropriate reach and harm were screened with SD Bioline HCV AHRN clinic, Waingmaw Township, Kachin State, reduction coverage is needed, notably Antibody and confirmation by GeneXpert. 25 May 2019. Photo: AHRN needle syringe programme and MMT to All HCV Ribonucleic acid (RNA) positive mitigate transmission and reinfection of patients were enrolled in a compreh patients, of which 110 were on HCV. ensive HCV treatment model of care: methadone maintenance therapy (MMT), addressing psycho-social, clinical and were initiated on 12 weeks Sofosbuvir For more information, please contact: Murdo Bijl, AHRN (Asian Harm Reduction Network), drug dependency needs. All eligible and Velpatasvir treatment. Of a total of [email protected] Safe hospitals save lives in disaster Health services should be reliable and Emergency Medical Team (UK-EMT) to continue running when a disaster increase effective internal circulation and strikes. Safe hospital initiative was interoperability in the aftermath of Mass initiated by WHO to implement measures Casualty Incidents (MCI). to improve safety in health facilities and to strengthen their capacity to respond Such activities are vital for healthcare to disaster. In Myanmar, Safe Hospital facilities to be more prepared and safe Project is one of the efforts carried out by during disaster. The project is also Humanity & Inclusion (HI), funded by promoting participation of charity ECHO and Luxembourg’s Ministry of ambulance providers both in Yangon and Foreign Affairs, in the frame of the Mandalay to support the two hospitals in Myanmar Consortium for Community MCI. For the last trimester of 2019, the Resilience. project will focus on improving personnel’s awareness of the Medical Incident command and control in mass casualty Since early 2018, HI has been supporting Countermeasures plan and to test it incident by HI and UKEMT for hospital's staffs in Yangon General Hospital and Mandalay through a hospital wide drill. Mandalay General Hospital, 5 March 2019. General Hospital update the hospital’s Photo: SHI-HI Mass Casualty Management Plan and For more information, please contact: Incident Command and Control system in Dr. Pyae Phyo Aung, HI (Humanity & Inclusion), collaboration with UK Government's [email protected] Supporting essential health and nutrition services for Kachin IDPs (ESPI) Project in seven townships in conduct project advocacy and Kachin State, in partnership with the coordination. Shortly after, CPI held a Kachin Development Group (KDG) and 10-day training in Myitkyina to build the Kachin Back Pack Health Worker Team capacity of 20 KaBPHWT staff to (KaBPHWT). implement an Integrated Package of Health Services (IPHS). The ESPI project aims to 1) to increase access to integrated In mid-May, CPI conducted a second health services in emergency settings 10-day IPHS training for 35 basic health through locally accessible service staff providing services in IDP camps in Capacity building training for Kachin Backpack providers, and non-government controlled areas. In Health Worker Team, Myitkyina Township, 2) to strengthen the availability and June, CPI began to distribute essential Kachin State, 22 April 2019. Photo: CPI quality of health services by building medicines to IDPs through KDG and the capacity of community-based KaBPHWT. With support from the Myanmar providers. Humanitarian Fund, Community Partners For more information, please contact: International (CPI) is implementing the In April, CPI met with Kachin Chit Su Wai Aung, CPI (Community Partners International), [email protected] Essential Health and Nutrition Service Independence Organisation Health Provision of Internally Displaced Persons Department representatives in Laiza to Health Cluster Bulletin—Issue 2 2019 || Page 4 of 6
Health Cluster Myanmar In communities torn apart by armed conflict, youth centres nurture health, values and well-being Millions of young people in Myanmar are are already mothers. This is higher than profoundly affected by armed conflict in the national adolescent fertility rate of 33 different areas of the country. (2014 Myanmar Population and Housing Census). Accurate and reliable To reach young people in information allows them to make non-government controlled areas, where informed decision and gives them the international organizations have limited confidence to make choices that they will access, UNFPA partners with local not regret. For those young people, the organizations. UNFPA’s youth friendly Young people at UNFPA supported youth Centres, Centres are not only a place for fun in the spaces in Je Yang, Mai Ja Yang and non -government controlled areas, Kachin State, midst of protracted conflict, but also a Woi Chyai are managed by Health 24 April 2019. Photo: UNFPA place to learn about their bodies and Poverty Action and Kachin Women rights. Association. The Centres are dedicated reproductive health and rights, youth to providing young people with learn how to protect their bodies and For more information, please contact: Mollie Fair, knowledge about their bodies, relation- minds from harmful practices. UNFPA (United Nations Population Fund), [email protected] ships and health. Through awareness sessions about adolescent sexual and In Kachin, 37 out of 1,000 teenage girls
Filling the gap of primary health care services in vulnerable areas, Kachin State Basic training for Community Health Worker is part of Reaching Equitable Access to health through Local empowerment Project of Myanmar Health Assistant Association which was planned to organize in first semester of 2019.
General Objectives of this training are increasing coverage area in provision of health services for communicable disease control activities, improving health knowledge on Malaria, Tuberculosis through health education session in Closing Ceremony of CHW Basic Training at Bhamo District Hospital, Kachin State, communities and awareness raising as well. In order to avoid overlapping 23 June 2019. Photo: MHAA volunteers, District Health Department Training on 23rd June 2019 and awarded discussed with Basic Health Staff, local Myanmar Health Assistant Association the outstanding CHW on the basis of authorities and implementing partners. supported the cost of nineteen pre -post mark, and gave certificates to Community Health Workers must submit Community Health Workers including six each CHWs. the monthly report to the Public Health persons from camps for 28 days training Supervisor II who will then supervise the that held in meeting hall of District Health For more information, please contact: Aung Myo Community Health Workers with Department of Bhamo. Finally, DHD held Khaing, MHAA (Myanmar Health Assistant checklists quarterly. the closing ceremony of CHW Basic Association), [email protected] HIV prevention by Premiere Urgence International we provided specialized health care for patients with sexually transmitted infections. In 2005 we added HIV prevention: behavior change communication, condom distribution, testing & opportunistic infections. In 2007 we developed a prevention, care & treatment programme for HIV starting with 900 antiretroviral therapy with support from Global Fund. Until 2018 the programme covered 6,359 people. In 2011 Reproductive Health & WASH programmes were implemented in Dala & Seikgyi plus mobile services in 2016.
Our current programme provides HIV Nutrition programme at Bhamo, Kachin State, 1 May 2017. Photo: PUI prevention in fixed & mobile education, counseling, defaulter tracing, nutrition & Premiere Urgence International (PUI) Between 2001 & 2018 we had offices in psychosocial support and often case started working in Myanmar in 1984 as Yangon, Kayin, Rakhine, Kachin, Sagaing, management. We are starting a WASH in Aide Medical International training health Wa & Lashio implementing primary; clinics and schools programme in workers, doctors &nurses. Dala WASH & emergency (Nargis, floods, etc); government and non-government Health programmes started in 2001 & Maternal, Newborn and Child Health; HIV controlled areas in Southeast Myanmar. expanded to South Yangon townships prevention & treatment; water, Dala, Thanlyin, Twantay, Seikgyyi, sanitation and health (WASH); For more information, please contact: Josh, PUI (Première Urgence Internationale), Kawhmu & Kuchangone. livelihoods. Since 2003 in South Yangon [email protected] Health Cluster Bulletin—Issue 2 2019 || Page 5 of 6
Health Cluster Myanmar Early warning, alert and response system, Rakhine State
EWARS summary 2017 2018 Jul 2019
EWARS reporting 11 9 13 organizations weekly reports 3,058 4,307 1,259 received reporting sites 357 263 167 total 219,742 299,132 91,037 consultations verified cases 344 172 27
Health Cluster Work Plan 2019
Activity Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Bimonthly National Health Cluster meetings NPT YGN NPT YGN NPT YGN Formation of Working Group Health Cluster Terms of Reference 3Ws (Who does What, Where) – ad hoc Public Health Situational Analysis extended extended extended extended extended Health Cluster Strategy deferred deferred deferred deferred Emergency Response Plan updating
(includes Contingency planning for monsoon season) extended Health Cluster website extended extended extended extended extended Health Cluster Bulletins extended Contact list updating Mailing list updating
Health in Complex Humanitarian Emergencies Training MHF second standard allocation extended Cluster Coordination Performance Monitoring extended extended Humanitarian Response Plan 2019 monitoring Humanitarian Needs Overview 2020 Humanitarian Response Plan 2020
Humanitarian Response Plan 2019, (60) Myanmar Health Cluster Participated Organizations, by type, by location Health Cluster funding status (1) National authorities (13) National NGOs (24) International NGOs people targeted , HRP 931,051 National; Rakhine; Kachin; 1 National; Rakhine; Kachin; 1 National; Rakhine; Kachin; 1 people targeted, supplemental 63,774 (7) UN Agencies Kachin; Shan N; 1 National; Rakhine; Shan N; 2 HRP National; Rakhine; Kachin; 3 National; Rakhine; 2 National; Kachin; Shan N; 1 requested, HRP 32.6m US$ National; Rakhine; Shan N; 1 Rakhine; 1 Kachin; Shan N; 1 requested, supplemental HRP 1,1m US$ National; Rakhine; 1 Kachin; 8 National; Rakhine; 3 National; 1 (5) Others/Observers National; Kachin; 4 funded 3.4m US$ Rakhine; 1 National; Rakhine; Kachin; 2 National; 4 coverage (%) 10.0% (9) Donors National; Rakhine; Kachin; 1 Rakhine; 3 National; 9 National; Rakhine; 1 Kachin; 5 National; 1 (1) IGOs in National Health
For more information on Health Cluster activities, please contact:
Dr Kyaw Khine San, [email protected] Dr Allison Gocotano, [email protected] Programme Manager/Assistant Director Disaster & WHE Technical Officer, Health Cluster Coor- Public Health Emergency Response Division, MoHS dinator, WHO Country Office for Myanmar
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