Emergency and Humanitarian Action (EHA),

Weekly Activity Report I. General Situation a. Political, Social and Security; The UPDF military operation against LRA in Garamba forest is still ongoing. Week 4, However, the security situation in Acholi, Lango and Karamoja sub-region is calm.

th th b. Main Events of Interest/Concern for Health 19 to 25 January Regional workshop on “STOP AVIAN INFLUENZA” conducted for districts 2009 in Lango and Acholi sub-region by the Ministry of Agriculture, Animal Industries and Fisheries (MAAIF).

WHO, Dokolo DHT and officials from MoH Sleeping Sickness control Programme conducted a joint support supervision of intensified HAT control activities in WHO Lira sub-office conducted inventory of human resources for health and staff accommodation in Lango sub-region. Preliminary findings show that according to HSSP II norms, over 70% of health posts in 4 of the 5 districts are filled. district coverage is the lowest at 67.5%. On average, only about 30% of the staff has staff accommodation.

II. Analysis and Health Consequences (Health Problems and Needs of Affected Population) Malaria: Acholi, Lango and Karamoja sub-regions; The trend of malaria cases in all sub- regions in the last four weeks is similar to that of 2008 for the same epi-week.

Figure I

Highlights

Capacity building for districts in Acholi and Lango sub-regions on Avian Influenza

The epidemic outbreak of meningitis in Hoima, Masindi, Arua, Moyo Meningitis; The epidemic outbreak of Meningitis in the districts of Hoima, Masindi, and Adjumani has been Arua, Moyo and Adjumani has been contained. A total of 336 cases were registered contained. with 43 deaths (CFR 13%)

Dysentery: Acholi, Lango and Karamoja; The number of cases of dysentery reported in Karamoja sub-region in 2009 is comparable to that of 2008. In Acholi and Lango sub- regions, the number of cases of dysentery reported in 2009 is much less than that of 2008 for the same epi-week. See figure II for details. Acknowledgement Production of this weekly activity report has possible by contribution from the followings

The weekly incidence of dysentery in in 2008 is almost two times that of 2009. See figure III for details

Cholera Measles and AFP; No case reported in the week Hepatitis E: 56 new cases were registered in epi-week 4 of 2009 up from 34 cases registered in epi-week 3. The cumulative number of cases registered now is 9,473 with 152 deaths (CFR 1.62%). Kitgum district registered 53 new cases with one death. See table I and figure III below for details.

Table I

District New cases New deaths Cumulative Cumulative cases deaths

Kitgum 53 1 9,348 143 (1.5%)

Gulu & Amuru 0 0 17 (9 positive) 2 (13.3%)

Pader 3 0 105 7 (7.3%)

Lango 0 0 3 0

Total 56 1 9,473 152(1.62%)

Avian Influenza; Capacities of 2 officers from 9 of the 10 districts of Northern Uganda was built on Avian Influenza identification, investigation and procedures for referral of samples for confirmation of cases.

III. Actions a. WHO Response

Epidemic Response (Sida) . Disease surveillance; o WHO Lira sub-office supported Dokolo district with IDSR and HMIS tools (booklets) including registers, databases and carbonated weekly reporting forms o Continue to provide technical and financial support to disease surveillance in all districts in the region. Weekly epidemiological reports depicting disease trends have been shared with all the districts and partners. . Malaria; o Continue to provide support to DHO Kitgum and Pader with the ongoing 3rd round IRS activities . Measles; No new case was reported in the week. Awaits results of the samples submitted to UVRI. . Hepatitis E; WHO continues to advocate with other cluster members to continue supporting Hepatitis E response. WHO also supports weekly task force meeting in Kitgum and , cases management, community mobilization, community sensitization and disease surveillance activities. . Polio campaign; Continue to provide technical, financial and logistical support to DHO Kitgum, and Pader during the ongoing Polio campaign . HAT; WHO participated in joint support supervision with MoH to community health workers, health centres and treatment centres. The purpose of the visit was to strengthen HAT case identification, case management and referrals. Emergency Health and Nutrition Response in Karamoja (CERF) . Ongoing support to outreaches . Ongoing rehabilitation works in Lorengechora, Lolachat and Panyagara . Training of 116 VHTs is ongoing in Kotido. Additional 273 VHTs are being prepared for training in Moroto . Supported supervision of VHTs at village level in 2 sub counties in Kotido . Supported monthly meeting and supervision of VHTs in . Monthly meeting for the VHTs of Kakomongole in Nakapiripirit took places. The VHTs were provided with the record books to begin their activities Influx of refugees from DRC . WHO continues to support strengthening of EPR and IDSR, in all refugee hosting districts of western Uganda. . At national level WHO continue to support coordination of response to refugee influx b. Cluster Partner’s Response . Distribution of 230,000 ITNs provided by UNICEF is ongoing in Lango sub- region . CUAMM continues to support Oyam in implementing comprehensive maternal and child health services (staff development, EmoC, ambulance systems for referrals, immunizations, radio talk shows, support supervision). . MSF is providing health services and outreach program in some selected sub counties in Lamwo HSD in Kitgum district . AVSI is providing PMTCT services in selected health units in Kitgum district . ACF continues to run CTC and SFCS in Lira and Oyam. . MSFH, ASB and CESVI supporting Hepatitis E control activities in Pader District . IMC and FHI have received funding for hepatitis E activities for 2 and 5 sub counties respectively for 4 months. . received 14,040 blisters of Coartem from the government of Uganda for implementing HBMF. The Coartem were distributed to CBMD . Others partners include Concern, TPO Uganda, UNFPA, MSU, MTI, Medair, CPAR, World Vision, ZOA, GOAL and URCS Other partners response to refugees influx from DRC . Partners responding to the refugee crisis include; GTZ, UNHCR, AAH, URCS, AIRD, MSF-F, SCiU, Hope After Rape and CESVI IV. Comments and Conclusions Hepatitis E response activities continue to slow down. Many NGOs have suspended or reduced the intensity of the response activity due to lack of funds. The number of cases of Hepatitis E registered on weekly basis is increasing. With the onset of rainy season and the presence of risk factors such as poor access to safe water and low latrine, this increase in number of cases registered on weekly basis may continue. WHO will continue to advocate to partners and MoH to ensure that response activities continue in the emergency mode. V. Plan for Coming Week . Support hepatitis E epidemic response in Kitgum and Pader district . Support response to the influx of refugees from DRC . Providing technical and financial support in the above regions to the office of the DHOs in strengthening HMIS/IDSR . Continue to support 3rd round of IRS in Kitgum and Pader district . Support Polio vaccination campaign in Kitgum, Gulu and Pader district For further information, please contact:

Dr. Joaquim Saweka, WHO Representative Uganda: Tel. +256 41 335500, Mobile +256 752 728 257, Email: [email protected]