EPoA Operations Update Cameroon: Floods and Cholera Epidemic DREF Operation no. MDRCM020 GLIDE n° EP-2014-000121-CMR Operations update n° 1 Period covered by this update: 8 September to 5 November, 2014 Operation start date:8 September, 2014 Timeframe: 5 months (End date: 5 February 2015) Operation budget:CHF 308,136 (Initial allocation:CHF 179,304;additional allocation:CHF 128,832) N° of people being assisted: 52,380 (initial number targeted to be assisted was 26,380) Host National Society presence: 25,000 volunteers, more than 50 staff, 58 departmental branches and 250 local branches. Red Cross Red Crescent Movement partners actively involved in the operation: IFRC Other partner organizations actively involved in the operation: Ministry of Public Health, Local Administration Authorities Summary: This operations update extends the operation timeframe by an additional 2 months with an additional budget allocation of CHF 128,832 to; Reinforce public outreach / awareness-raising activities in the six localities, which were included in the EPoA (Bibemi, Figuil, Guider, Mayo-Oulo, Pitoa, and Touboro), in an effort to improve the populations’ sanitation and hygiene practices and thus combat the cholera epidemic in 12 districts (six additional districts) of the North Region of Cameroon Extend these activities into the six localities where new cases have been reported (Garoua I, Garoua II, Gashiga, Golombé, Rey Bouba and Tcholiré). The DREF budget revision will cover the training (on Epidemic Control for Volunteers (ECV) manual); and deployment of an Cameroon RC volunteers offloading NFIs in Bibemi. Photo: IFRC additional 50 volunteers and five supervisors (additional 10 volunteers and one supervisor per locality) in five existing localities (Figuil, Guider, Mayo-Oulo, Pitoa, and Touboro); as well as an additional 130 volunteers and 13 supervisors in the six localities where new cases have been reported (Garoua I, Garoua II, Gashiga, Golombe, Rey Bouba and Tcholiré. It will cover additional insurance costs; the CRC cholera focal point, the regional supervisor, a driver and a vehicle, which will be needed in the field until the end of the DREF operation. The Regional Disaster Response Team (RDRT) member, which has been deployed will also been required for one extra month (three months in total) to ensure the effective implementation of activities. The RDRT will provide support to both the MDRCM018 and MDRCM020 operations, which are being implemented concurrently in the Far North and North regions of Cameroon. In total therefore, the RDRT will be deployed for 5 months, 2 months are budgeted against MDRCM018 and 3 months are budgeted against MDRCM020 since this operation closes a month later. By February 2015, it is expected therefore that the DREF operation will have assisted an additional 26,000 people, increasing the target population to 52,380 across the 12 localities. The DREF operation will end on 5 February 2015, and a final report will be made available by 5 April, 2015 (Three months after the end of the operation). P a g e | 2 <click here for the revised budget and here for the contact details > Since 21 August, 2014, Bibemi district located 64 km from the town of Garoua (capital of the North Region of Cameroon) experienced heavy rainfall (about 180 mm of precipitation),leading to widespread flooding, which caused extensive destruction, and affected more than 250,000 people. Further to the flooding, the situation worsened, following an outbreak of cholera. From 18 to 28 August 2014, Cameroon Red Cross (CRC) volunteers carried out an assessment and identified 77 cases of cholera and 8 deaths in the 6 districts affected by the epidemic. On 8 September 2014, the IFRC allocated CHF 179,304 from the Disaster Relief & Emergency Fund (DREF) to support the CRC response to the needs of the flood affected population as well as those affected by the Cholera epidemic over a period of three months. The DREF operation was intended to support about 10 per cent (26,380 persons) of the affected population of 255,214 inhabitants in the six affected localities of Bibemi, Figuil, Guider, Mayo-Oulo, Pitoa, and Touboro. To date, over 75 per cent of the activities planned have been implemented. During the course of the DREF operation, the CRC has been able to make progress in the following areas: Shelter and Settlements: In total, 276 families, whose homes were partially damaged or destroyed by the floods have been provided with Non-Food Items (NFIs) including; blankets (552), buckets (276), jerry cans (276), kitchen sets (276), mats (552), mosquito nets (552 long lasting insecticide treated nets), and tarpaulins (552). Moreover a total of 119 women (within the 276 families) received hygiene kits. Table 1: Summary of beneficiaries assisted with NFIs drawn from villages in Bibemi NFIs Jerry Cans Tarpaulins Mosquito Blankets Hygiene Buckets Kitchen Soap Mats Nets Sets Village HHs Kits Baksa 11 22 11 11 11 5 22 22 110 22 Bandoro 14 28 14 14 14 11 28 28 140 28 Botare 7 14 7 7 7 5 14 14 70 14 Cinq Plaque 15 30 15 15 15 2 30 30 150 30 Foulbere 24 48 24 24 24 24 48 48 240 48 Ouro Kari 79 158 79 79 79 41 158 158 790 158 Lakare Lame 18 36 18 18 18 2 36 36 180 36 Lakara Louka 22 44 22 22 22 6 44 44 220 44 Mandjola 38 76 38 38 38 9 76 76 380 76 Mbella Do’Ouro 5 10 5 5 5 0 10 10 50 10 Ouro Yadji 15 30 15 15 15 2 30 30 150 30 Sabaongari 28 56 28 28 28 12 56 56 280 56 Total 276 552 276 276 276 119 552 552 2,760 552 Health and Care: In total, 100 volunteers and 10 supervisors have been trained and deployed to carry out public outreach and awareness-raising activities (signs of the disease, mode of transmission, prevention, the search for suspected cases and remedies) on cholera in the six localities. To date, the volunteers have reached 19,786 people with cholera prevention messages and up to 5,366 people have been trained on the preparation of sugar-salt rehydration solution and 80 households disinfected. Water, Sanitation and Hygiene Promotion: A total of 100 volunteers have carried out demonstrations on hand-washing and preparation of oral rehydration solution/sugar-salt solution; as well as educated the population in the six localities on home-based water treatment and storage, and carried out disinfections of P a g e | 3 latrines in collaboration with the district health authorities. As of this Operations Update, 4,268 proper hand- washing demonstration sessions have been conducted, 15 sites sanitized, 5,681 latrines identified and 766 disinfected. Moreover, 4,600 water points have been treated in households. Table 2: Cholera Situation in the North region, from 18 to 28 August 2014 Health District Number of cases Number of fatalities Bibémi 17 1 Figuil 8 0 Guider 21 0 Mayo-oulo 10 0 Pitoa 12 3 Touboro 9 4 Total 77 8 Please note that despite the activities carried out through the DREF operation, the epidemic is continuing to spread rapidly within the North region, as a result of prevailing socio-cultural practices, and unhygienic conditions. As of 5 November, 2014, 52 cases and 11 deaths were reported by the regional officer responsible for epidemics at the North Regional delegation for health in six new localities, specifically: Garoua I, Garoua II, Gashiga, Golombe, Rey Bouba and Tcholiré, which have population of 925,964. Table 3: New localities affected by cholera in the North Region as of 5 November, 2014 Health District Population Number of Number of cases deaths Garoua I 247 045 1 0 Garoua II 256 848 9 4 Gashiga 101 370 5 4 Golombé 73 072 22 2 Rey Bouba 105 503 3 1 Tcholiré 142 126 12 0 Total 925 964 52 11 In Mayo Oulo, which is close to the border with Nigeria, the increase in the number of cases is due to an influx of 1,000 Nigerian refugees, who have fled insecurity caused by the Boko Haram group. During a mid-term field assessment of the DREF operation, CRC volunteers informed the IFRC/CRC of the presence of a cholera epidemic in the localities of Dirtha and Koja (Nigeria), which situated along the border with Cameroon, and that due to the instability, no cholera prevention activities are being carried out to combat the outbreak. Furthermore, people in some localities (Guider, Pitoa and Mayo Oulo,) also remain resistant to change, and continue to practice open defecation, fish and toad breeding in wells, and drinking of river water, which is exacerbating the situation. As noted the DREF operation has enabled the mobilization of 100 volunteers and 10 supervisors to carry out public outreach / awareness-raising activities in the six localities of Bibemi, Figuil, Guider, Mayo-Oulo, Pitoa, and Touboro.However this has been recognized to be insufficient (with the exception of in Bibemi) due to the long distances between these localities and the near impassable roads in the North Region. Table 4: Cholera Situation in the North Region as at 5 November 2014 Health District Number of cases Number of deaths Bibémi 55 6 Figuil 38 0 Garoua I 1 0 Garoua II 9 4 Gashiga 5 4 Guider 71 4 P a g e | 4 Golombé 22 2 Mayo-oulo 129 7 Pitoa 22 2 Rey Bouba 3 1 Tcholiré 12 0 Touboro 9 4 Total 378 30 Table 5: Current distribution of volunteers and supervisors in the operation. Health District Number of volunteers Number of supervisors Bibémi 30 3 Figuil 10 1 Guider 20 2 Mayo-oulo 20 2 Pitoa 10 1 Touboro 10 1 Total 100 10 Additional CRC volunteers will be deployed four times a week to carry out activities to increase community awareness, specifically house-to-house visits to raise community awareness on the improved health/hygiene practices, and will use IECs (posters and flyers), which have been developed to summarise these messages.