HEALTH CLUSTER Situation Report No 14 • The / Typhoon Bopha (Pablo)

A. Cluster Details 1. Lead Organization: Department of Health / World Health Organization

2. Cluster Website:

3. Focal Point Contact Details: Dr Gerardo P Medina Technical Officer Emergency and Humanitarian Action WHO Mobile # 0908 863 3163 Landline 02 528 9765 Email: [email protected]

B. Reporting Period 1. Report Number: HC SitRepNo. 14

2. Report Date: 4 February 2013

3. Time Period Covered: 28 January to 3 February 2013

C. Humanitarian Needs

 From the DOH Health Emergency Alert Reporting System (HEARS) Update as of 4 February 2013: There are at least 1,146 deaths, 2,956 injured, and 834 still missing due to TY Pablo. There is no change in figures from the previous report  Some 100,527 individuals or 19,301 households in the Boston-- area are in need of permanent accessible health services, including some 14,803 children aged below 5 years, while currently served by mobile teams and other interim arrangements. Access to health services by residents of Caraga, Oriental (36,464 individuals/ 6,855 families/ 4,970 children aged below 5 years) has somehow improved with the repair of the San Jose Bridge connecting Caraga to Mati City. The Manurigao Bridge between Caraga and Baganga remains unpassable.  Medical missions conducted by cluster partners show about 63% of patients consulting are females, about 21% are aged below 5 years of age, and around 9% are aged 60 years or older.  Top health conditions prompting consultation reported via SPEED include acute respiratory infections, high blood pressure fever, acute watery diarrhea, and wounds and bruises. Partners likewise report other reasons for consultation which include myalgia, hyperacidity, UTI, skin disease, peripheral neuoropathy and post traumatic stress. Health conditions reported via SPEED warranting special attention include suspected acute hemorrhagic fever, suspected measles, acute malnutrition, acute flaccid paralysis, and suspected tetanus infection.  Supporting local health officials on implementation of Minimum Initial Service Package on Reproductive health (including Adolescent Sexual and Reproductive Health) is highly required.  There is an urgent need for provision of pre-natal, post-natal check-up and supply of dignity kits for pregnant and lactating women, with special consideration for teenage mothers in affected communities

D. Humanitarian Response

Coordination and Information Management:  Cluster coordination continues to be decentralized at the local government unit level. o In Compostela Valley, province-level cluster meetings for health and MHPSS clusters are being undertaken weekly. o In , health clusters have been organized locally specifically in the three municipalities, namely – Boston, Baganga, and Cateel. Local/municipal health clusters meet regularly for updates and concerns. Quad- cluster meetings (Health, MHPSS, Nutrition, and WASH) have been scheduled once a week with health partner clusters (including NGOs/INGOs) to discuss issues and concerns. MHPSS cluster has just been locally organized. A weekly meeting schedule is set for providers and partners to consolidate data. A standardized form from DOH will be used for MHPSS reporting. Essential Health Services and Supplies  Essential health services and supplies support continue to be rendered by mobile health teams (composite teams rendering medical, MHPSS, WASH, and/or nutrition services) from the DOH central office, other DOH regional offices, DOH and LGU hospitals and health cluster partners like WHO, UNFPA, UNICEF, MERLIN, HuMA, Philippine Red Cross, Spanish Red Cross, ICRC, MSF, among others.  MERLIN teams are providing medical consultation, antenatal and postnatal care, nutrition assessment, distribution of RUSF, health/hygiene promotion, breastfeeding promotion, and measles immunization as in their priority areas of Boston, Cateel, and Baganga in Davao Oriental, serving some 1,815 patients within the reporting period and about 8,822 residents since they began operations in December. Likewise, MERLIN-supported rehabilitation of health stations were started in Barangays Baybay,Abijod, Taytayan and San Rafael in Cateel and in Barangay Cabasagan in Boston.  Humanitarian Medical Assistance (HuMA) from Japan in its last week of operations has provided medical services to some 302 patients in two barangays of Baganga, for a total of 3,692 patients cared for in its month-long stay in Compostela Valley and Davao Oriental. Some 760 boxes of assorted medicines were likewise turned over to the DOH by HuMA prior to their disengagement.  UNICEF has completed distribution of a total of 24 IEHK basic units to the municipalities of Laak (7 kits), Montevista (6 kits), (6 kits), (5 kits).  On 30 and 31 January 2013, UNFPA in partnership with Compostela Valley Provincial Hospital, Provincial Health Office, MSWDO, Filipinay and Family Planning Organisation of Philippines conducted two RH medical missions – one in Barangay Casoon, Monkayo and another in Barangay Panag, New Bataan, Compostela Valley Province serving a total of 111 pregnant and 112 lactating women with pre/post-natal check-up, FP counseling and services, health information sessions and hygiene kits distribution respectively. Barangay Casoon in Monkayo is one of the most remote areas in the Province and this was the first medical mission in that barangay so far.  In Boston, Davao Oriental, UNFPA and partners conducted an RH medical mission in Barangay Simulao and distributed hygiene kits in Barangay Caatihan. A total of 199 pregnant and lactating women received pre/post-natal services and attended health information sessions in Simulao, while 265 women of reproductive age in Caatihan received RH hygiene kits. The missions were conducted in partnership with FPOP, Merlin, Child Alert, UNHCR, and WHO. The two barangays are remote, hard-to-reach places inhabited by indigenous people.  MSF had some 511 consultations from five barangays of Cateel, four barangays of Baganga, and one barangay in Boston for the reporting week.  Since December, the Philippine Red Cross, supported by partners like the Spanish Red Cross and the ICRC, has provided health services to some 5,417 patients through its Emergency Health Station, mobile clinics, mobile x-ray, and ambulance conduction in New Bataan, Compostela, Monkayo, and Baganga. Its health and hygiene promotion activities have likewise reached some 11,618 individuals in Davao Oriental and Compostela Valley. Disease Surveillance  WHO conducted a week-long assessment on the needs, capacities, gaps, and constraints related to disease surveillance at the DOH-CHD XI, key DOH hospitals and in Compostela Valley Province.  Surveillance in Post Extreme Emergencies and Disasters (SPEED) disease surveillance system reports have consistently come in from New Bataan in Compostela Valley and Baganga, Boston, and Cateel in Davao Oriental with the participation of partners like MERLIN, HuMA, and MSF. Regular paper-based reporting are being undertaken in Compostela, Monkayo, Montevista, and Laak.  Reports of health conditions with outbreak potential continue to be verified by the DOH regional office, supported by the DOH National Epidemiology Center. PHO of Davao Oriental has deployed additional personnel to for disease surveillance in Boston, Cateel, and Baganga.

E. Gaps & Constraints

 Damaged, nonfunctional health facilities with typhoon-affected health workers continue to hamper health service delivery. o Cateel District Hospital is still undergoing construction. Doctors and nurses from DRH and SPMC (rotating weekly) temporarily augment the working staff in the hospital. It continues to exceed its licensed bed capacity of 15 beds with daily ward census reaching up to 25 patient admissions. The hospital is in need of some basic medical supplies and medicines (e.g. RBS kits, cannula, microset, insulin). o A stabilization center for malnourished children with medical complications has been suggested. The suggested area is at Cateel District Hospital but due to the damaged hospital infrastructure, it may not be possible yet. o Midwives have been already stationed back in their respective Barangay Health Stations but limited health services have been rendered due to lack of supplies and equipment. o There is still a limited number of health staff to provide reproductive health services . o Some BHS are being utilized for other purpose, eg military base of operations  Medical services and data reporting from BHS (including SPEED reporting) are highly dependent on NGOs/INGOs providing medical health services per barangay. Not all barangays have been reached by mobile medical teams due to damage infrastructure and weather constraints.  MHPSS cluster needs to be strengthened further at the local level. A number of MHPSS providers themselves haven’t received any debriefing yet.  Intermittent internet connection (eg in Baganga RHU) and mobile phone signal (eg in Monkayo and Laak) affect disease surveillance reporting.  Some organizations rendering mobile health services are ending their tour of duty.