EARTHQUAKE IN Situation Report No. 2 Event Date: April 16, 2016 18:58 Date of Report: April 17, 2016 11:00

I. HIGHLIGHTS

● An earthquake of 7.8 MW struck Ecuador on April 16th at 18:58 (local time), with epicenter between the city of Pedernales and the town of Cojimes, north of the Manabí province, 170 km from ● 235 killed mainly in the cities of the province of Manabí Perdernales, Canoa, Bahía de Caraquez, Manta, Portoviejo, and Santo Domingo and 1577 injuries reported as of 11:00 am on 04-17-2016 ● The Government of Ecuador has activated the National Emergency Operation Committee and the Provincial Emergency Operations Centers ● A State of Emergency has been declared for six provinces: Manabí, Esmeraldas, Guayas, Santo Domingo and Los Ríos ● The health system has been declared on high alert ● Loss of power and communications services in the affected area ● The PAHO country office is assisting the National and health EOC with personnel ● Two experts from PAHO have been deployed to the Operations Centre established in Manta. ● The Verdi Ceballos Hospital in the Portoviejo community suffered structural and non- structural damage and is partially operational; it is providing medical care to multiple patients with polytrauma ● Chone Hospital has structural collapse, patients have been referred to other health units ● The Ecuadorian Social Security Institute’s Hospital in Manta reported multi-story collapse ● Four hospitals in Quito reported minor damages, mainly non-structural, which do not impact their operations ● The Eloy Alfaro airport in the city of Manta and Carlos Concha of the province of Esmeraldas are operating at the moment ● Damage and needs assessment is underway and more impact is expected in the next few hours ● The country has moderate to good response capacity and the major cities are operational, however, support may be required for coordination, damage assessment of health facilities, water and sanitation and information management. ● The Government has mobilized its armed forces, public works personnel, firefighters, and medical teams to all affected areas, as well as a mobile hospital to the municipality (canton) of Pedernales, the most affected area. ● Some incidents of social disruption and looting have been reported in the provinces of Manabí, Guayas and Esmeraldas

II. OVERVIEW OF THE SITUATION

● The main earthquake occurred on April 16th at 18:58pm (local time) with a magnitude of 7.8 MW and a depth of 20 km. It was preceded by another event with a magnitude of 5.0, and followed by multiple aftershocks felt especially in the epicentral area. ● The provinces of the Pacific Coast of Ecuador: Esmeraldas, Manabi, Guayas, Santo Domingo de los Tsachilas, as well as those of the andean area such as Pichincha, Azuay, Bolívar, among other areas, reported damages to homes and buildings, mainly in the cities of Manta, Portoviejo, Montecristi, Santo Domingo and Quito. In the city of Guayaquil, a pedestrian bridge fell over the Americas Avenue. In addition, it is reported that several cities in Colombia were also affected, including the city of Cali. ● The information collected so far reflects the difficulties in access and communications in certain areas. The number of the injuries and deaths is expected to increase. Media are reporting significant damage to infrastructures in the city of Pedernales based on information from the Mayor. PAHO’s staff reached the city of Pedernales less than 24 hours after the earthquake and confirmed that approximately 80% of the city is destroyed.

Health Situation:

Province of Manabí, Portoviejo Community:

The Verdi Cevallos Hospital is saturated due to increased demand for emergency care. The hospital has not suffered any structural damage but a water leak occurred after the rupture of pipes that partially flooded the ground floor of this hospital. Patients are being evacuated to a nearby hospital in Portoviejo. A mobile care center will be installed in the ECU-911 (Emergency Operations Center) located in this city. Difficulties in accessing roads and for health personnel to provide support have been reported.

Guayaquil: Damage has been reported to infrastructure in some commercial areas, fall of a pedestrian bridge, and partial damage of the ECU-911 (Emergency Operations Center). The temporary disruption in the airport ended and it is currently operational.

Pedernales: Estimated population of 50,000 people, damage to infrastructure and collapse of a large number of dwellings and several hotels have been reported. This is currently the most affected area. The health clinic is fully operational but may need staff rotation due high demand of services.

Access to Affected Regions:

Multiples roads have been The Aloag - Santo Domingo road is partially operational between 12h00 and 18h00 hours.

III. RESPONSE AND NEEDS

Health Sector Response

. The entire country’s Health Network is on high alert . The provincial emergency operations committees are collecting information and coordinating emergency assistance. . The Ministry of health is activated and coordinating with the national COE. The MoH spokesperson is Mr. Santiago Tarapues. . The Ministry of Health reported the following actions: . Mobilization of early responders in: Esmeraldas, Eloy Alfaro, Atacames, Muisne, Quininde, San Lorenzo, Rio Verde . Evacuation and referral of patients of hospitals in areas with involvement of public and private networks . Deployment of the mobile hospital “2” from Ambato to Portoviejo, with 96 officers and all medical specialties. . Deployment of a surgical mobile unit from Azuay and Chimborazo to Manta. . Mobilization of the Mobile Surgical Hospital of the armed forces from to Pedernales, for which the MSP provides specialized doctor from zone # 3 to meet the requirement of health services . Activation and air mobilization of 5 medical response teams (Emergentologists, Traumatologists and surgeons) from the zone # 9 of the MSP and 5 of the Ecuadorian Institute of Social Security (IESS) towards affected areas . Mobilization of 60 doctors of the Farmer’s Social Security to Portoviejo and Manta . Doctors of Quevedo and El Empalme the joint mobilization, to give attention to the IESS Hospital of Santo Domingo . Activation and mobilization of 3 rapid response teams – Damage and Needs Assessment from the MoH, 2 of the IESS and 4 from the Ecuadorian Red Cross, to the affected areas . Two teams of structural evaluators and personnel from hospitals and first level of care to assess the affected health facilities . Mobilization of 12 ambulances of basic and advanced life support: 1 MSP, 10 IES, 3 firefighters from Quito, 4 Ecuadorian Red Cross, and 1 firefighters Santo Domingo . Quito hospitals are being requested to prepare space and beds in order to transfer patients to Quito. . Contingency plans was activated in Quito hospitals for receipt patients referral

PAHO-WHO Actions:

. PAHO Country Office (CO) activated its emergency response planning including its internal special emergency procedures and is fully assisting the National EOC and Health EOC and working on information management.

. Special Emergency Procedures

. Two Members of the PAHO CO were deployed to the province of Manabi to perform an field assessment

. Five experts of the Regional Response Team from Washington, Panama, Colombia and Peru, were deployed to Ecuador to support Emergency Management, structural and non-structural assessment of health facilities, coordination of Emergency Medical teams, damage and needs assessment, and supplies management and logistics.

Needs:

. Due to the difficulties of access to some health facilities, additional support may be needed to transfer patients between health facilities and to major cities . Registry of persons and patients treated in health facilities. . Consolidate information on damage and needs assessment

State of the Health Network as of April 17, 2106 02:50am

Province Community Preliminary Information

Manabí Portoviejo Bahia Hospital reported walls cracks, is still functional, Verdi Cevallos Hospital is without power or communications

Manta IESS Hospital of Manta collapsed

Pedernales Significant collapse of infrastructure was reported in general, up to a 80% (preliminary data from the ECU-911 Portoviejo)

Chone Chone Hospital collapse, patients referred to private clinics

B Caraquez Collapsed Hospital (Preliminary data Source: media in which Mayor was quoted)

Esmeraldas Esmeraldas Information Pending (PI)

Atacames PI

Muisne PI

Pichincha Quito Enrique Garcés, Carlos Andrade Marín, San Francisco, and Eugenio Espejo Hospitals, reporting minor non-structural damages

Guayas Guayaquil Pedestrian Bridge collapsed on the Av.Las Americas

Note: The damage assessment is currently underway by the national authorities. Where information is marked as PI (Information Pending), this means that the country or the health counterpart has not yet been able to collect such information; it does not mean that there is no damage at this time.

IV. COORDINATION

● Operations in Portoviejo are being coordinated from the ECU-911

● PAHO Country Office (CO) is coordinating with the National and Health EOCs and has dedicated staff 24/7 for this task

● PAHO’s CO crisis committee in Ecuador and PAHO”s Emergency Operations Center are activated.

● Members of the Regional Response Team have been deployed to support Emergency Management, structural and non-structural assessment of health facilities, coordination of Emergency Medical teams, damage and needs assessment, and supplies management and logistics

● International Medical Teams coordination cell is activated and awaiting requests from the national health authorities, the OSSOC is being informed.

● Coordination with neighboring countries is being carried out and available information is shared in the event that the mobilization of international assistance is required.

● The humanitarian country team is in coordination with the national authorities who may request international assistance.in the coming hours or days.

Sources: MOH, National Situation Room, PAHO CO Ecuador; PDC, Redhum, OCHA