HEALTH CLUSTER Situation Report No 13 • The / Typhoon Bopha (Pablo)

A. Cluster Details 1. Lead Organization: Department of Health / World Health Organization

2. Cluster Website:

3. Focal Point Contact Details: Dr Gerardo P Medina Technical Officer Emergency and Humanitarian Action WHO Mobile # 0908 863 3163 Landline 02 528 9765 Email: [email protected]

B. Reporting Period 1. Report Number: HC SitRepNo. 13

2. Report Date: 28 January 2013

3. Time Period Covered: 21-27 January 2013

C. Humanitarian Needs

 From the DOH Health Emergency Alert Reporting System (HEARS) Update as of 27 January 2013: There are at least 1,146 deaths, 2,956 injured, and 834 still missing. Of the 314 unidentified remains, majority are in Compostela Valley province. Majority of the 834 missing are from , Compostela Valley and General Santos City. The changes in the number of deaths and injured are a product of continuous validation and consolidation of data and ongoing search and retrieval operations. There is no change in figures from the previous report  Some 100,527 individuals or 19,301 households in the Boston-- area are in need of permanent accessible health services, including some 14,803 children aged below 5 years, while currently served by mobile teams and other interim arrangements. An additional 36,464 individuals or 6,855 families with some 4,970 children aged below 5 years are exposed to sub-optimal health services in , Oriental because of inclement weather which damaged roads and bridges making access to health services more difficult.  Medical missions conducted by cluster partners show 61% of patients consulting are females, about 24% are aged below 5 years of age, and 8% are aged 60 years or older.  Top health conditions prompting consultation include acute respiratory infections, fever, acute watery diarrhea, high blood pressure, and skin disease. Partners likewise report other reasons for consultation which include myalgia, hyperacidity, UTI, benign headache, and post traumatic stress.  Supporting local health officials on implementation of Minimum Initial Service Package on Reproductive health (including Adolescent Sexual and Reproductive Health) is highly required.  There is an urgent need for provision of pre-natal, post-natal check-up and supply of dignity kits for pregnant and lactating women, with special consideration for teenage mothers in affected communities. In the Municipality of , , wherein 10 out of 18 barangays are severely affected, around 900 pregnant and lactating women are in need of prenatal and postnatal check-up and supply of dignity kits.

D. Humanitarian Response

Coordination and Information Management:  The Health Cluster through the WHO and UNFPA provided technical assistance to the DOH at the national and regional level for their Post-Disaster Needs Assessment and Recovery Planning for Typhoon Pablo.  Cluster coordination continues to be decentralized at the local government unit level. Regular meeting municipal-level health clusters have been organized in Boston, Cateel, and Baganga. Essential Health Services and Supplies  Essential health services continue to be rendered by mobile health teams (composite teams rendering medical, MHPSS, WASH, and/or nutrition services) from the DOH central office, other DOH regional offices, DOH and LGU hospitals and health cluster partners like UNFPA, MERLIN, HuMA, IOM, MSF, CRS, and ICRC, among others.  MERLIN teams are providing medical consultation, antenatal and postnatal care, nutrition assessment, distribution of RUSF, health/hygiene promotion, breastfeeding promotion, and measles immunization as well as donating medicines and basic equipment in their priority areas of Cateel and Baganga in , serving 1,156 patients within the reporting period.  Humanitarian Medical Assistance (HuMA) from Japan has provided medical services to some 870 patients in barangays of Baganga.  International Organization for Migration (IOM) has provided 77 boxes of medicines and medical supplies to RHU/BHS in Boston, Cateel, and Baganga, Davao Oriental; , Laak, and Compostela , Compostela Valley; Veruela, , and; Lingig, Surigao Del Sur.  UNFPA in coordination with the PHO, Compostela Valley Provincial Hospital, MSWDO, PNP, and FPOP conducted an RH medical mission in Compostela, Compostela Valley where 134 women of reproductive age were provided with prenatal/postnatal care, health information sessions, family planning services, and hygiene kits.  Addressing the constraints in the referral for emergency obstetric care in the Municipality of Caraga in Davao Oriental following the damage of bridges, coordination done with Manay District Hospital as referral facility to provide ambulance service after patients have crossed the river from the area of the broken bridge. Disease Surveillance  Reports of health conditions with outbreak potential continue to be verified by the DOH regional office, supported by the DOH National Epidemiology Center. PHO of Davao Oriental has deployed additional personnel to for disease surveillance in Boston, Cateel, and Baganga.  Surveillance in Post Extreme Emergencies and Disasters (SPEED) disease surveillance system reports have consistently come in from New Bataan in Compostela Valley and Baganga, Boston, and Cateel in Davao Oriental through the participation of partners like MERLIN, HuMA, and MSF.

E. Gaps & Constraints

 Damaged, nonfunctional health facilities with typhoon-affected health workers continue to hamper health service delivery. o Cateel District Hospital is still undergoing construction. Doctors and nurses from DRH and SPMC (rotating weekly) temporarily augment the working staff in the hospital. As per information from the OIC- Chief of Hospital, the daily hospital admission census consistently exceeds the total allowed bed capacity. The hospital is licensed 15 bed capacity and it is receiving at least 16-18 admissions a day. Make shift tents are utilized to cater this demand. o Partners for nutrition are suggesting for stabilization center for malnourished children with medical complications. The suggested area is at Cateel District Hospital but due to the damaged hospital infrastructure, it may not be possible yet. o Tents utilized by the Cateel RHU to cater to OPD patients were damaged due to strong winds and heavy rains on 20 Jan 2013 o Midwives have been already stationed back in their respective Health Stations but limited health services have been rendered due to lack of supplies and equipment.  Medical services and data reporting from BHS (including SPEED reporting) are highly dependent on NGOs/INGOs providing medical health services per barangay. Not all barangays have been reached by mobile medical teams due to accessibility and weather constraints.  MHPSS groups are not yet organized locally.  Persistence of inclement weather has further affected access to health services to some barangays.  Lack of access to some affected areas due to poor infrastructure is a major constraint in reaching affected population. For instance, broken bridges connecting to the Municipality of Caraga, Davao Oriental limit the referral of pregnant women for emergency obstetric care.  Intermittent internet connection and mobile phone signal affect disease surveillance reporting.  Some organizations rendering mobile health services are ending their tour of duty.