Health Action in Crises (WHO/HAC) Highlights - No 34: Monday, 8 November 2004

The WHO/HQ Department for Health Action in Crises aims to produce a running note on select current issues at weekly intervals. This note—which is by no means exhaustive— is designed for internal use and does not reflect the official position of WHO.

SUDAN - Darfur Crisis - Assessments and events: • Throughout the Darfur, clinically diagnosed malaria still accounts for most mortality and morbidity reported through the WHO-instigated Early Warning and Response Network (EWARN). • In North Darfur, preparations have begun for the 21 November polio campaign. Service provision agreements have been established between WHO, UNICEF, and NGOs for certain Sudan Liberation Army (SLA) areas. • A gap analysis in West Darfur has highlighted a chronic shortage of health staff and facilities. ¾ Only four out of six hospitals are providing services. ¾ There is one surgeon and no paediatricians, obstetricians, gynaecologists, ophthalmologists, orthopaedic surgeons, or dentists. ¾ There is no transport (e.g., ambulances) in the health sector. • It is with great sadness that we report the death of Ministry of Health Surgeon Dr Ihab on 5 November during a hold-up on the Nyala-Kass Road, South Darfur. Actions: • In West Darfur, WHO rehabilitated the laboratory, blood bank, gynaecology, female surgical and medical wards of El Geneina State Hospital, as well as contributed a generator, electrical goods and furniture. WHO also provided inputs to six rural hospitals that—in total—serve an estimated population of 336,240. • In West Darfur, WHO donated 10,000 Rapid Diagnostic Tests (to assist in the diagnosis of malaria) and 11 Basic Emergency Kits (each meeting the needs of a population of 1,000 for a period of three months) to NGOs. • In South Darfur, WHO supported the Federal MoH and State MoH in conducting Standard Case Management training for 21 doctors at primary health care facilities. • Training of Trainers (ToT) courses were conducted for nine doctors on "child health activities in emergencies" in South Darfur. ToT courses were also carried out for 11 NGO participants on key family practices to address health problems in children aged under five. • Funding for WHO humanitarian operations in Darfur has been provided by African Development Bank (AfDB), UK's Department for International Development (DfID), the Humanitarian Aid Office of the European Commission (ECHO), and the governments of , Italy, Ireland, Norway and United States. COTE D'IVOIRE Assessments and events: • As a result of recent escalated violence in Cote d'Ivoire, all UN agencies have closed their offices as of today, 8 November. Staff movement is restricted. • ICRC reported that approximately 250 persons with gun wounds were admitted to hospitals in Abidjan in the past days. Actions: • WHO is: ¾ closely monitoring the current situation, examining implications for health and preparing itself to respond to requests for assistance; ¾ participating with UN system in the review of the contingency plan for the country and in the definition of a common UN action plan; ¾ supporting the enhancement of the early warning system for the surveillance of epidemic diseases, notably poliomyelitis; ¾ seeking funds for activities in Cote d'Ivoire, and encourages a renewed focus by donors on addressing the humanitarian situation there.

Health Action in Crises 1 WHO is working with partners to address the health aspects of crises in more than 40 countries. Check the Health Action in Crises Web site for more details: http://www.who.int/disasters/

WEST BANK AND Assessments and events: • On 2 November, the UN Relief and Works Agency for Palestine in the GAZA STRIP Near East (UNRWA) Commissioner-General presented a statement to the UN Special Political and Decolonization Committee (Fourth Committee) that highlighted the challenges that UNRWA faces in the West Bank and Gaza Strip as a result of violence, curfews disclosures, and financial constraints. Actions: • WHO and the MoH carried out a Food Safety workshop from 29 October to 3 November in Ramallah. Twenty-three inspectors from the MoH and Ministry of Agriculture were trained on Hazard Analysis and Critical Control Point (HACCP) as part of a series of activities planned within the Food Safety project. Participants became familiar with modern risk management tools such as the Good Hygienic Practices (GHP) and Hazard Analysis Critical Control Point (HACCP) concepts, in line with internationally recognized standards (Codex Alimentarius). A similar training will be conducted for Gaza food inspectors in conjunction with the University of Crete (WHO Collaborating Centre). • WHO visited primary health care services in Khan Younis and Rafah districts (Gaza Strip) as part of the health baseline data collection at district level. Healthinforum and MoH are involved in this joint initiative in an effort to improve the health information system. • WHO met with representatives of the Government of Norway in order to develop a synergy between WHO’s nutrition project (aiming to strengthen the nutrition management of the MoH Nutrition Department) and the Norwegian nutrition project implemented through the MoH. • Current WHO humanitarian actions in the West Bank and Gaza Strip have been made possible by 2004 funding from USAID, AGFUND, and the Government of Norway, as well as pre-2004 funding from ECHO. IRAQ Assessments and events: • WHO is monitoring the humanitarian situation in Iraq. The spraying campaigns against Malaria and Leishmaniasis have been completed throughout Iraq, while fogging and rodent control activities are ongoing. Preventive and control activities in relation to cholera in Basra are ongoing and include the distribution of chlorine tablets and health education materials. Actions: • WHO is providing logistic and technical support to the MoH for a countrywide assessment of all Primary Health Care (PHC) centres – using assessment tools developed in partnership between WHO and MoH. • WHO supported the 1-4 November training workshop on “Results Based Management – Logical Approach to Managing Programmes”. The workshop focussed on the logical approach of implementing health programmes in Iraq and Web site on WHO activities in Iraq: was attended by 23 representatives from MoH and 14 from WHO. http://www.emro.who.int/iraq/ • WHO procured a shipment of I.V. canulas for emergency needs. The shipment arrived in Baghdad on 7 November. • WHO supported the MoH debriefing on the findings of the Independent Acute Flaccid Paralysis (AFP) Review Mission for Iraq. The meeting was attended by the senior officials from the Iraqi and Jordanian Ministries of Health and WHO, as well as focal points from Iraqi directorates of health including Erbil, Dohuk and Suleimaniyah. WHO facilitated this meeting through funding from the European Commission. • Three WHO Regional Advisors facilitated a MoH/WHO/UNICEF Expanded Programme of Immunisation Workshop from 31 October to 4 November. Thirty- two participants attended the meeting, representing MoH staff, experts from medical universities and independent national consultants. The support to this workshop was made possible through funding from the European Commission. • WHO is facilitating the participation of one MoH delegate at the meeting "International Regulations for Health", which is taking place in from 1 to 12 November.

Health Action in Crises 2 WHO is working with partners to address the health aspects of crises in more than 40 countries. Check the Health Action in Crises Web site for more details: http://www.who.int/disasters/

UGANDA Assessments and events: • According to an October 2004 study by Médecins Sans Frontières, death rates in camps for the 1.6 million people displaced by conflict in northern Uganda are far above the threshold used to classify an emergency (one death per 10,000 persons per day). The MSF study—conducted in six IDP camps in the Lira and Pader districts—found a crude mortality rate of 2.8 deaths per 10,000 people per day for the general population, with rates for children far higher. (More information: www.msf.org) • As of 3 November, there were 56 cases of cholera with three deaths in Pabbo IDP camp since the index case appeared in early October. Actions: • WHO is currently finalizing all of administrative and security procedures for the establishment of a sub-office in Gulu, which will be used as a base for emergency interventions. The WHO Gulu team will: ¾ Build capacity and improve coordination for humanitarian health assistance; ¾ Monitor disease burdens and provide early warning of epidemics through improvements to the surveillance system; ¾ Coordinate the control of communicable diseases in the camps; ¾ Support IDP communities' engagement in environmental health, health education, and HIV/AIDS awareness activities. • In response to the cholera outbreak in Gulu camp, WHO is providing technical guidelines to health stakeholders. It is also supporting the Divisional Director of Health Services (DDHS) and other health partners in establishing treatment facilities, conducting laboratory diagnosis, and coordinating social mobilization. • WHO is in urgent need of funds to upscale operations in Northern Uganda. For more information on assessed health needs and planned WHO activities, see http://www.who.int/disasters/repo/14747.pdf. For additional information, including proposals, contact: [email protected].

INTER-AGENCY INITIATIVES ¾ Côte d'Ivoire. o WHO will participate in an inter-agency meeting on 10 November in Geneva to discuss the current situation in Côte d'Ivoire, inclusive of projected humanitarian implications, planned interagency and agency responses and security arrangements. o WHO will participate in the Regional Inter-agency Contingency Planning Meeting on 12 November in Dakar, . ¾ ECHA. On 10 November, the UN Executive Committee on Humanitarian Affairs (ECHA) will discuss the protection of civilians in Darfur; the situation in Côte d’Ivoire; preparations for the Security Council Meeting in Nairobi; and the inter-agency mission to the Democratic People’s Republic of Korea (DPRK). The Representative of the Director-General for Health Action in Crises will participate. ¾ IASC-WG. Preparations are underway for the next meeting of the Inter-Agency Standing Committee (IASC) Working Group in Geneva on 22 and 23 November. Agenda items include early warning, humanitarian common services, and new humanitarian partnerships, among other topics. WHO is a member of the IASC and will participate. ¾ NGO/IASC. During the monthly NGO/IASC meeting of 10 November, Human Rights Watch will present its research, including a review of the complex dynamics in South Darfur. WHO plans to participate. ¾ occupied Palestinian territories. On 9 November, the UNICEF Representative in the occupied Palestinian territories will brief in Geneva on the situation of women and children in the occupied Palestinian territories. ¾ IASC. Preparations are underway for the next plenary session of the IASC at the level of Heads of Agency, which is scheduled to take place in Geneva on 9 December. WHO will participate. ¾ Gender. As co-chair of the IASC Gender Task Force, WHO will facilitate its 15 November meeting, during which the Task Force's 2004 Progress Report and 2005 Workplan will be discussed. ¾ Integrated missions. From 14 -16 November, the Representative of the Director-General for Health Action in Crises will participate in the conference " Integrated Missions: How can Political, Humanitarian, and Development Goals Be Integrated?" in New York. ¾ IFRC. On 23 November, WHO will attend the launch of the IFRC's 2005 Annual Appeal.

Health Action in Crises 3 WHO is working with partners to address the health aspects of crises in more than 40 countries. Check the Health Action in Crises Web site for more details: http://www.who.int/disasters/

¾ Contingency planning. WHO is participating in the 8 November meeting of the IASC Sub-Working Group on Preparedness and Contingency Planning. ¾ DAR guidelines. WHO is participating in the 8 and 9 November workshop on the draft UNHCR Development Assistance for Refugees (DAR) guidelines. ¾ Training. o The 40th UN Civil-Military Coordination training course will take place in the Dominican Republic from 14-19 November. WHO is considering participation. o WHO is planning to attend the 11th Emergency Field Coordination Training in Geneva/Vaud from 24 November to 2 December. ¾ Common services. An inter-agency meeting on UN Humanitarian Air Services (UNHAS) is scheduled for 22 November in Geneva. WHO plans to participate. ¾ IOM. The eighty-eighth Session of the Council of the International Organization for Migration will take place in Geneva from 30 November to 3 December. ¾ Nansen Award. WHO is considering nominations for the 2005 Nansen Refugee Award, which recognizes and honours the spirit and dedication of individuals who make extraordinary efforts to assist vulnerable people. SPECIAL Health in the 2005 Consolidated Appeals Process

The "CAP Compendium: Health 2005" will be released on Thursday, 11 November at 11h00 New York time, in keeping with the Secretary- General's launch of the 2005 Consolidated Appeals Process.

The Compendium features health needs and financial requirements identified through the CAP for: ; Central African Republic; Côte d'Ivoire; Chad; Chechnya and Neighbouring Republics; Democratic Republic of Congo; Republic of Congo; Eritrea; Guinea; Great Lakes; ; Uganda; West Africa; and West Bank and Gaza Strip.

Available on 11 November at www.who.int/disasters. For a hard copy, write [email protected] or External Relations, Health Action in Crises, World Health Organization, 20, Avenue Appia, CH-1211 Geneva 27, Switzerland, Fax: +41 22 791 4844

Please send any comments and corrections to [email protected].

MAP DISCLAIMER: The presentation of material on the maps contained herein does not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or areas or of its authorities, or concerning the delineation of its frontiers or boundaries. Map source: Perry Castaneda Library Map Collection, University of Texas at Austin.

Health Action in Crises 4 WHO is working with partners to address the health aspects of crises in more than 40 countries. Check the Health Action in Crises Web site for more details: http://www.who.int/disasters/