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Somalia Situation Report August - October 2013

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Somalia Situation Report August - October 2013 Somalia Situation Report August - October 2013 Highlights ► Joint Health and Nutrition Programme endorsed by Somali Health Authorities to improve access to affordable quality health and nutrition services for 3.4 million people. ► An investigation by WHO rules out outbreak of viral haemorrhagic fever in Mogadishu. ► No new cases of polio reported from Banadir, considered the ‘engine’ of the outbreak, since 19 July 2013. ► 1 million people affected by MSF withdrawal from Somalia. US$ 7 million still needed to run 12 essential facilities for one year. ► Two tuberculosis centres vacated by MSF in Puntland continue running with WHO’s support. ► Mass screening against malaria targets 200 000 people in Bossaso district. ► Serious gaps in emergency surgery services highlighted by WHO study. ► Three months training for 45 Lady Health Workers started in Mogadishu. ► celebrated in Mogadishu to sensitize mothers on the importance of breastfeeding. World Breastfeeding Week 2013 © WHO/Somalia/R. Vicentini A child being screened at Madina Maternal Child Health centre in Mogadishu Historic Somali Joint Health and Nutrition Programme signed Five-year plan endorsed by Somali Health Authorities to improve maternal and child health The Somali Health Authorities, along with UNFPA, UNICEF and a year die before their fifth birthday, and 30.5% of women WHO, have renewed their commitment to work together to improve of reproductive age die due to pregnancy related causes maternal and child health and to strengthen the Somali health system. The five year Joint Health and Nutrition Programme Health and nutrition services supported by the JHNP target (JHNP) was signed at WHO Office in a ceremony chaired by the 700 000 children under five and 335 000 pregnant or lactating UN Resident and Humanitarian Coordinator Philippe Lazzarini. women across Somalia. Longer term goals include improving the health and nutrition status of Somali people and contributing to an Two decades of conflict have devastated Somalia’s health overall reduction in maternal and child mortality. sector, leaving the country with some of the worst health and nutrition indicators in the world. An estimated 70 000 children The programme is led by the Somali Health Authorities with to be continued on page 2 Somalia Situation Report Aug- Oct 2013 1 support from the joint UN partners – UNFPA, UNICEF and WHO. The current donors to this US$ 236 million Programme are the The Joint Health and Nutrition Programme is United Kingdom’s Department for International Development a multi-donor and multi-partner five years programme that (DFID), the Government of Sweden, and the United States Agency is aligned to the Somalia’s Health Sector Strategic Plans for International Development (USAID). The Australian Agency (HSSPs). The JHNP is aimed at improving maternal and child for International Development (AusAID) also made a significant health and at strengthening the health systems by improving contribution and has been particularly instrumental during the quality and access to affordable quality health and nutrition inception of, and well into, the programme. The World Bank and services for 3.4 million Somalis. the Swiss agency for Development and Cooperation (SDC) are also engaged. © WHO/Somalia Joint Health and Nutrition Programme (JHNP) signing ceremony at WHO office on 4 October 2013 Outbreak of viral haemorrhagic fever ruled out by WHO investigation Confirmatory testing and entomological survey in progress On 20 September 2013, the WHO Office in Mogadishu was notified of few cases of suspected unknown fever in Mogadishu. Eight patients reportedly presented symptoms of fever and jaundice; six of them had also haemorrhagic manifestations. The notification prompted an immediate outbreak investigation by WHO staff on the ground. Initial laboratory results of blood samples from the affected cases were negative for viral infections. A WHO team of four international experts, including one entomologist, reached Nairobi within days and subsequently travelled to Mogadishu between 10 and 13 October 2013 to join WHO experts already on the ground. © WHO/Somalia WHO investigation team carrying out an entomological survey While the final results of the investigations will be available in November 2013, preliminary findings have proved that an outbreak existing vectors and guide the decision making for suitable control of viral haemorrhagic fever is to be excluded. No other cases have interventions. been detected after the initial notification, which confirms that the identified cases were isolated incidences. However, targeted Despite security challenges, the detailed investigation was surveillance will continue in selected areas. conducted in wide areas of Mogadishu. This was made possible thanks to the collaboration of partners, particularly the UN Resident Confirmatory testing is in progress, and the entomological survey and Humanitarian Coordinator, UN Department of Security and is underway in selected areas of Mogadishu, to identify the Safety and the African Union Mission to Somalia. Somalia Situation Report Aug- Oct 2013 2 Somalia experiences recurrent outbreaks of communicable diseases, particularly: polio, cholera, measles, malaria, dengue fever, whooping cough and diphtheria. The 195 sites of the Communicable diseases Surveillance and Response (CSR) network has reported over 1.4 million consultations, including about 650 000 children under the age of five, since January 2013. Between August and October 2013, the observed trend for suspected cholera is stable compared to the same period in 2012. However, the number of cases is expected to increase with the onset of the Deyr rainy season in November. Since © WHO/Somalia/ Kate Holt the beginning of the year, over 7000 cases were reported Cholera Treatment Centre supported by WHO in Banadir Hospital in Mogadishu throughout Somalia. Three outbreaks were confirmed and effectively controlled by health cluster partners in Mogadishu Suspected measles cases Augut- October 2013 (weeks 31-40) prison (Banadir), Beletweyne town (Hiraan), and Mushani village (Lower Shabelle). Suspected measles cases continue to be reported, particularly from southern and central Somalia, where access to routine Owdweyne vaccination is limited. Since January 2013, around 2700 cases have been reported from sentinel sites in the country. The risk of a large measles outbreak cannot be excluded, due to the low Legend immunization coverage. Wk 31-40 O(Zero Responding) 1 - 5 Incidences of violence have continued in southern Somalia, 5 - 10 Tayeeglow particularly in Mogadishu, Kismayo and Beletweyne. Conflict 11 - 15 15 - 148(Max) increases displacement of civilians, limiting their access to Qansax Dheere Wanla Weyn Banadir healthcare and amplifying the risk of outbreaks of cholera and Qoryooley KurtunwaareyM arka other communicable diseases, as well as hampering polio Baraawe vaccination campaigns. Jamaame Between January and October 2013, over 3800 wounded civilians have been treated at four major hospitals supported by The boundaries and names shown and the designations used on this map do not imply the expression of any WHO in Mogadishu. Another 1100 civilians were treated at the opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, main hospital in Kismayo. territory, city or area, or of its authorities, or concerning the delimitation of its frontiers of boundaries. Health situation analysis Health situation Polio outbreak response campaigns showing results No new case in Banadir since 19 July 2013 assessments concluded that the response was rapid and aggressive, with strong national leadership and international coordination. However, the assessments highlighted that there is a significant risk that the outbreak will extend beyond 6 months, due to the large number of under-vaccinated children in Somalia. Outbreak response planning should therefore continue into 2014. Meanwhile, outbreak response is continuing across Somalia. The eight nationwide immunization campaign took place between 20 and 26 October 2013, targeting all the population, including adults. A further campaign in mid-November and one Child Health Day in December (including routine immunization © WHO/Tom Morant © WHO/Tom services) are planned. IDP children in Mogadishu showing their ink-marked fingers to WHO representative Dr Ghulam Popal, after being vaccinated against polio To reduce the impact of the spread of polio into security- compromised areas, permanent vaccination posts have been The current outbreak in the Horn of Africa has reached 200 cases, set up at 299 cross-border and transit points, vaccinating more including 180 cases from Somalia. As a result of the intense than 50 000 children every week. Preliminary results of the outbreak response activities, no new cases were reported since independent monitoring conducted in 39 districts in the three 19 July 2013 in Banadir region, the epicenter of the outbreak. zones revealed high awareness of the vaccination campaigns and identified the absence of the parents as the main reason for In August 2013, three-month assessments of the polio outbreak missed children. response were conducted in all the zones of Somalia. The Somalia Situation Report Aug- Oct 2013 3 One million people affected by MSF withdrawal from Somalia Health Cluster supporting coordination to handover MSF facilities to provide quality service to the Somali population. A committee with members from the Health Authorities, Health Cluster and
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