TYPHOON YOLANDA HEALTH

ISSUE #7

DECEMBER 11, 2013 Photo: WHO/Frainisco Guerrero WHO/Frainisco Photo:

HIGHGLIGHTS

 As of 10 December 2013, the National Risk Reduction Management Council (NDRRMC) of the reported 5 786 deaths, 27 022 injured, and 1 779 missing. A total of 11 241 237 people have been affected, 4 006 747 are displaced, and 103 604 are in 386 evacuation centers.

 Top 5 health events reported via SPEED from Region 6 (Capiz, Aklan, Antique and Iloilo) on 9 Dec 2013 were acute respiratory infection, wounds, high blood pressure, fever, and animal bites. Alerts were noted for tetanus and acute haemorrhagic fever in Cabatuan and Iloilo City.

 The number of evacuation centres is declining as people begin rebuilding their homes and schools are cleared to permit classes to begin.

 To date, 1068 of 9297 health facilities in the affected regions have been assessed. Among assessed facilities there has been substantial damage. Many of the remaining facilities will not be assessed as they are outside the Yolanda Corridor and assumed to not be damaged.

 The routine immunization programs in region VIII will begin soon; stocks and cold chain are now being re-established.

Inside this bulletin:  Public health risks, needs, and gaps

 Affected population and areas

 Main public health concerns  Health cluster action

TYPHOON YOLANDA HEALTH CLUSTER BULLETIN 1 December 11, 2013

AFFECTED POPULATION AND AREAS

As of 10 December 2013, the National Disaster Risk Reduction Management Council (NDRRMC) of the Philippines reported 5 786 deaths, 27022 injured, and 1 779 missing. A total of 11 241 237 people have been affected, 4 006 747 are displaced, and 103604 are in 386 evacuation centers (Table 1).

AFFECTED POPULATION (NDRRMC, 10 December 2013) Number of af- % of total pop- Number of % of inter- fected popula- ulation of the Displaced nally dis- tion area* Population placed

Region IV A 27 076 0.2 - - Region IV B 467 050 17 1 960 0.07 Region V 656 239 23.7 - - Region VI 2 829 806 39.8 2 414 276 33.83 Region VII 2 898 027 42.6 258 484 4.30 Region VIII 4 271 816 104.2 1 340 381 31.93 Region X 19 592 0.5 - - Region XI 5 000 0.1 - - Caraga 66 631 2.7 22 - Total 11 241 237 23.8 4 006 747 9.27 Humanitarian Case Load ac- 12 900 000 29.84% cording to Flash Appeal Source: Situation report #58 NDRRMC as of 10 December, 2013

The number of evacuation centres them eligible to receive assistance gratory movement. is declining. According to OCHA in the neighborhood where they The oil spill clean up in Estancia, people are leaving centers as had lived prior to the typhoon. Iloilo is reported to be improving. shelter materials from aid organi- Japan has dispatched an oil clean- zations or salvaging become avail- Local Government is constructing ing expert team, at the Govern- able. The reopening of schools temporary relocation centers, each ment’s request. that previously hosted evacuation housing 28 families, in , Palo inLeyte; Basey, Marabat in centers has been a factor for this UNICEF has put out a reminder Samar; Guiuan, Hernani and Gi- decline. Many affected people asking people to look for and as- porlos in Eastern Samar. The goal have begun returning to the sites sist unattended children. of their former homes. Some stay is to build 375 by Christmas. This with others in affected areas or will provide housing for 52,500 urban centres such as and persons. DTM seeks to track con- Manila. Others have moved to ditions at these sites for the provi- temporary relocation centers sion of services. where tent cities and wooden pa- Migration outflow desks are still vilions are being erected. The De- operating at the ports and airport. partment of Social Welfare and About 500 people per day leave Development (DSWD) has provid- the affected areas, approaching ed each departing IDP with a normal levels of pre– typhoon mi- Family Assistance Card, making

TYPHOON YOLANDA HEALTH CLUSTER BULLETIN 2 December 11, 2013

PUBLIC HEALTH RISKS, NEEDS, AND GAPS Public Health Concerns ble for a few weeks as the De- Department of Health is con- The DOH sighted the top causes partment of Health is still accu- cerned by the potential increase in of referred cases from 11 Novem- mulating and correcting infor- illnesses with cold weather occur- ber to 5 December 2013 at the mation day by day. Among those ring in some affected regions. Villamor Air Base in Tacloban health facilities that have been Health programmes do not yet were wounds, fracture, acute gas- have sufficient programming for assessed 402 have been found Elderly men and women. troenteritis, pneumonia and post- to be partially damaged and a The Cebu cluster raised concerns exposure prophylaxis for Leptospi- further 188 have been complete- about unattended injuries, in- rosis. ly destroyed. creased risk for sexual violence, petty crimes, trauma and stress. Health facilities Essential health services To date, 1068 of 9297 health All six facilities for diagnosing mul- Morbidity facilities in the affected regions tidrug resistant TB in the affected Top 5 health events reported via have been registered as as- areas are functioning. One TB- SPEED from Region 6 (Capiz, sessed. Among those facilities Directly Observed Therapy (DOTS) treatment facility was de- Aklan, Antique and Iloilo) on 9 Dec there has been substantial dam- mand as non-functional and the age. Many of the remaining facili- 2013 were acute respiratory infec- DOH is awaiting assessments on tion, open wounds and bruises, ties will not be assessed as they a further 15. Fourteen TB micro- high blood pressure, fever and are outside the Yolanda Corridor scopic sites are not functioning animal bites. Alerts were noted for or are otherwise assumed to not yet, and 15 TB-labs, mostly in Bo- hol, are yet to confirm their status. tetanus and acute haemorrhagic be damaged. Full information on Please refer to maps. fever in Cabatuan and Iloilo City. damages will not likely be availa-

TYPHOON YOLANDA HEALTH CLUSTER BULLETIN 3 December 11, 2013

TYPHOON YOLANDA HEALTH CLUSTER BULLETIN 4 December 11, 2013

HEALTH CLUSTER ACTION

Health Cluster coordination general health of the communities teams are functioning with basic The Department of Health is the seems fair. However, there was type 1 services, 7 teams function- lead of the Health Cluster, with psychological trauma in some of ing with more sophisticated type 2 WHO as co-lead. the children, especially around the services and 2 teams with special- coastal areas. There was limited ty type 3 services. Seventy-two of As of December 4, the DOH damaged to homes in all places the 85 FMTs are in Region VIII. downgraded the situation from Code Red to Code Blue. This except for Sicaba where an esti- downgrade indicates that activities mated 50% of homes were dam- FMTs that wish to donate equip- are returning to normal. aged and 30% were destroyed. ment and supplies to local ser- Aid has been received by the vices are requested to coordinate with the DOH in doing so. Assessment Sicaba community from some

UK Naval Ship HMS ILLUSTRI- NGOs. A guidance note from the DOH on OUS team conducted an assess- the entry and exit strategy of ment of Cadiz City, Cardiz Viejo Response FMTs can be found at: and Sicaba on Negros Island, re- Health Care Services gion VI. They found that most are- Eighty-five registered Foreign http:// www.philippineconsulate.com.au/ as had been well prepared for the Medical Teams (FMT) and 148 disaster and sustained little disrup- surgical-and-medical-missions-to- local medical teams were in the the-phl.html tion. The medical facilities func- affected areas as of 9 December tioning were not disrupted and the (refer to maps). Seventy-five of the

TYPHOON YOLANDA HEALTH CLUSTER BULLETIN 5 December 11, 2013

TYPHOON YOLANDA HEALTH CLUSTER BULLETIN 6 December 11, 2013

Eastern Samar cluster reports Vaccination and cold chain Surveillance and communicable that health teams have provided The mass vaccination campaign disease control services at evacuation centres. has been completed in Tacloban, The quality of SPEED data is im- As of 9 December Medical Guiuan, Borongan, and Palo. It will proving. The Provincial Health Of- Team International (MTI) relocated continue in Tanuan, Tolosa, as fices on the ground are strength- their team to Tacloban and transi- well as coastal communities south ening their surveillance systems tioned their activities to MSF. of Tacloban. Routine immunization with more facilities reporting with programs will be re-established SPEED and additional facilities Cebu cluster reported that in Leyte soon through prepositioning transitioning over to PISDR. Cur- stocks and the reestablishment of rently 50% of teams operating and Samar, FMTs were accompa- the cold chain. The total number of within Tacloban are reporting reg- nied by construction crews in- children vaccinated as of 10 De- ularly. However, there are still sig- stalling temporary roofs to dam- cember is 14 478 for polio,14 521 nificant challenges in getting con- aged health facilities. for measles and 10 808 were pro- firmatory laboratory samples test- vided vitamin A. ed. The WHO is obtaining rapid diagnostic tests for dengue. With Vector control Eastern Samar cluster reported an increase in confirmed dengue A dengue expert from MSF is that in Guiuan the Expanded Pro- cases, teams are preparing for working with the DOH on vector gram on Immunization (EPI) team possible outbreaks. control. will map availability of vaccines

and Oxytocin at health facilities. FMT’s are requested to input into In the Philippines media the DOH SPEED to provide better surveil- Assistant Secretary Eric Tayag Cold Ccain assessment has been lance coverage of the affected warned about a possible spike in completed in Roxas, Iloilo, Cebu areas. dengue cases in typhoon-affected and Aklan, with assessments on- areas. Mosquito control operations going in Tacloban and in Eastern and distribution of mosquito nets Samar. has been indicated to take place.

Table 2: Summary of SPEED Reporting in Typhoon Yolanda affected Areas6 – 10 Dec 2013

Region Provinces Municipalities Health Facilities and (#) (#) Reporting Sites (#) VI 4 58 69 VII 1 1 2 VII 3 14 26

Reproductive Health Water, Sanitation and Hygiene Tacloban City in Leyte and 10 mu- UNFPA has provided reproductive (WASH) and Environmental nicipalities in Eastern Samar in- health kits to referral facilities in Health cluding Hernani and Guiuan tested Roxas City (Capiz), Estancia A water purifying unit was de- positive for fecal coliforms or E.coli (Iloilo) and Guiuan (Eastern Sa- lievered to Palompon District bacteria. Residents are being mar). The kits provide clean deliv- Hospital in Ormoc. urged to chlorinate or boil their ery, family planning services, . treatment for STIs and medical The DOH reported that the water management of sexual violence supply in Leyte has been sufficient Disability Inclusion for the estimated needs of 10,000 since 15 November 2013.In The current focus of the disability people for 3 months and for the Busuanga town water is function- and rehabilitation stakeholder management of miscarriage and al. However, in Coron they have meetings has been how to ad- suture of vaginal tears for 30,000 implemented a rationing system. dress the specific health, rehabili- people for 3 months. In Roxas, Capiz, Metro Roxas Wa- tation and assistive device needs ter District and Municipal Water of people with serious injuries and OCHA also reported that repro- District has resumed services, but disabilities. There were many ductive health kits have been dis- water supply remains limited. For- people with disabilities living in the tributed to three key Rural Health ty percent of municipal water dis- most affected areas and the vul- Units in Leyte, each able to serve tricts in Antique and 70% in Iloilo nerability of people with disability 30,000 people. Rural health mis- are operational. is particularly apparent in disaster sions were conducted in Tacloban The Department of Health (DOH) situations. There were also many City to provide pre/post-natal, is reporting that water samples people who sustained serious inju- health promotion and family plan- taken from November 27 to 30 ries during the typhoon, many of ning services. from Sta. Fe, Tanauan, and these people are now in health

TYPHOON YOLANDA HEALTH CLUSTER BULLETIN 7 December 11, 2013

facilities in Manila, Cebu and ples Organizations (DPOs) Tacloban, those with spinal cord and Community Based Reha- Cebu cluster reported that a psy- injuries, amputations, serious frac- bilitation (CBR) organizations. chosocial tent will be established tures and traumatic brain injuries  Communicate with health facil- in the temporary relocation site in are initial priority. The current ities to ensure discharge plan- Cebu. They are also in the pro- WHO Disability and Rehabilitation ning for people with serious response will complement Protec- injuries and ensure linkages cess of developing a TOT for tion Cluster activities. These in- are made on discharge with MHPSS of teachers. DepEd has clude: local community service pro- been invited to the Cebu MHPSS  Develop database of people viders. cluster for further planning and with serious injury (SCI, Am- counselling of schoolchildren. putations, TBI and serious Mental Health and Psychosocial fractures) future follow-up/ Support (MHPSS) tracking. Most of these people WHO trained 30 people in Psycho- Planning are currently still in hospital logical First Aid (PFA) on 5 De- A semi-final version of the Strate- facilities in Manila, Cebu and cember. Trainees included NGOs, gic Response Plan has been pub- the Field Hospitals set up by DSWD, DOH, Department of Edu- lished and is being reviewed. FMTs. cation (DepEd) and Philippine Red WHO has received 19 plans from  Map stakeholders able to Cross Society. 16 partners, with half of the pro- meet the specific health, reha- grams running for a full year and bilitation and assistive device Partner’s implantation of PFA pro- the remaining will last 6-7 months. needs of disabled people. This grams will be further established is occurring through networks once all information on MHPSS including the Disabled Peo- 4W is received.

FUNDING STATUS OF ACTION PLAN

As of 11 December 2013, OCHA has updated the action plan, which is now at is 28% funded for the health sector (table 4).

Table 4 FUNDING STATUS OF ACTION PLAN FOR HEALTH (US$) Project Appealing Amount Funding % Covered Agency Required Merlin & Save the Children Essential Health Save the chil- Services for Preventing Excess Mortality and dren Morbidity in affected Popu- lation 4707706 800000 17% Ensuring Access to Reproductive Health UNFPA 15% Services in the Aftermath of Typhoon Haiyan 10000000 1499518 Provision of emergency health services to WHO typhoon affected populations 15000000 10749603 72% Immediate assistance to injured and vulner- HI able persons affected by Haiyan typhoon in Philippines 240000 179063 0% Emergency Health care, public health and IOM referral initiatives for displaced and affected persons ‘on the move and their vulnerable host communities’ 1810511 0 0% Provision of life-saving interventions for UNICEF health to children 0-59 months affected by Typhoon Haiyan emergency 19000569 182041 1% Provision of quality medicines and develop- IHP ing resilience in the supply chain to avoid gaps by strengthening the department of health medicines stock management sys- tems 806000 0 0% Prevent increase in maternal, neonatal and Plan child mortality post disaster through ensuring continuity of services for these more vulner- able groups 3960422 0 0%

TYPHOON YOLANDA HEALTH CLUSTER BULLETIN 8 December 11, 2013

Promoting mental health and psychosocial IMC wellbeing of populations affected by Typhoon Haiyan 727961 0 0% Ensuring the health needs of older people in HelpAge Inter- Typhoon Haiyan national 465000 0 0% Health care support for Typhoon Haiyan af- IMC fected populations 3865225 0 0% Enhancing coordination within and outside the WHO health sector 1816100 0 0% Surveillance, outbreak prevention and vac- WHO cination 3929850 0 0% Local health system recovery for social and WHO economic protection 4061800 0 0% Delivery of essential health services to meet WHO the immediate health needs of the affected population 3524500 0 0% Typhoon Haiyan emergency health response WV Philippines 400000 400000 100% Health assistance for disaster affected com- RI munities of inland Leyte and coastal Baran- gays of Tacloban municipalities of Tacloban City, Jaro, San Miguel and Carigara 955500 0 0% Provision of emergency medical assistance to MDM France affected population of the Typhoon Haiyan 2700000 0 0% Saving Women’s lives in Typhoon affected Saude em provinces through reproduction health Protugues 1150800 0 0% Restoration of basic health package within AAI Concepcion Municipal Health Office area 310000 0 0% Sub total for health 79431944 13810225 17% http://fts.unocha.org/reports/daily/ocha_R32_A1043___11_December_2013_(03_00).pdf

Major WHO donors: Australia, Canada, Norway, Japan, the United Kingdom and the UN Central Emergen- cy Response Fund (CERF), Russian Federation, Sweden and the United States of America, and from the European Commission and Civil Protection (ECHO).

TYPHOON YOLANDA HEALTH CLUSTER BULLETIN 9 December 11, 2013

Health Cluster Partners PUI France, Samaritan 119 Korea, SC, SCDN, Solidarities Interna- National- Manila: tional, Spanish Red Cross, TGCFI, RTR hospital, UNDAC, UNDP, AECID, Americares, Australian UNFPA, UNICEF, USAID, US Aid, CDN- DART, CFSI, Child- OFDA, Vodafone foundation, Fund, DFID, DOH, FPOP, Handi- WFP, WHO, WISAR, World cap International, HuMa, IFRC, IHP-UK, ILO, IMC, IOM, IRC, Vision. ISAR-Germany, JICA,MERLIN,

MDM, MSF, National Bureau of Investigation , PHE, Philippines Sub-national- Cebu: Red Cross, Relief International, AmeriCares, ASB Germany, Plan International, Project Hope, PU-AMI, SCI, UNFPA, UNICEF, Canadian Emergency Response USAid, US Forces, WHO, World Unit, Canadian Medical Assis- Vision. tance Teams, CFSI, ChildFund, DOH, Embassy of Israel, Eversly

Child Sanitarium, GOAL, ICRC, Sub-national- Tacloban: IFRC, International Medical Corps, JICA, MDM, Med Japan, Merlin, AECID, ACF, ACTED, Action MSF, NYC Medics, PNA, Samari- PompiersUzgenceInlanaVionus, tan Purse, SC, SCI, Spanish Red ARC, ASEAN, ASYA SAR/KYM, Cross, Saint Anthony Mother and B-FAST, AUs, BomberosUnidos Child Hospital, Talisay District SP, Care, Christian Aid, DFID, Hospital, UNICEF; Vicente Sotto DOH, ECHO, Emergency.LU, Er- Memorial Medical Centre, WHO icsson Response, EUCPT, First

Relief Fund, First Response Ra- dio, Fuel Relief Fund, German Sub-national- Roxas: Embassy, German Red Cross, ACF, Action Aid International, Globalmedic, GOAL, Good Neigh- Canada DFAT, Child Fund, bours Intl., Good People Intl., CRWRC, DoH, GOAL, IOM, Ja- HUMEDICA,IFRC, International pan Heart Foundation, Philippine Disaster Relief, Internews, IOM, Rural Reconstruction Movement, IsraAid, JICA, KIHI, KOICA, Leg- MSF-Swiss, NETHOPE, Save the er Foundation, Miral Welfare Children, UNDAC, UNICEF, Welt Foundation, MSF/F, OCHA, Hunger Hilfe, WFP, WHO, World Oxfam, Philippine Red Cross, Vision International PompiersHumanitaires France,

Health Cluster Contacts

National- Manila: [email protected]

Sub-national- Tacloban: [email protected]; [email protected]

TYPHOON YOLANDA HEALTH CLUSTER BULLETIN 10 December 11, 2013