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Health Sector Bulletin in Zango Ward of Bade LGA, Yobe State Reporting Period: 1St Till 30Th April 2018 Northeast Nigeria Humanitarian Response

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Health Sector Bulletin in Zango Ward of Bade LGA, Yobe State Reporting Period: 1St Till 30Th April 2018 Northeast Nigeria Humanitarian Response Cholera response: WHO HTR team member conducting active case search Health Sector Bulletin in Zango ward of Bade LGA, Yobe state Reporting period: 1st till 30th April 2018 Northeast Nigeria Humanitarian Response 5.4 million 5.1 million People in need target by the 1,713,771* 3.7 Million people of health care Health Sector IDps in the three States Reached in 2017*** HIGHLIGHTS Health Sector Displacement could further increase from May 45 HEALTH SECTOR PARTNERS to August, as a result of evolving conflict (HRP & NON-HRP) dynamics, including the unanticipated military HEALTH FACILITIES IN BORNO STATE** operation Last Hold, as well as other various NON- FUNCTIONING (OF TOTAL 755 environmental/seasonal patterns. The LGAs 375 (50%) ASSESSED HEALTH FACILITIES) that are most severely impacted so far include 292 (39%) FULLY DAMAGED 205 (27%) PARTIALLY DAMAGED Gwoza that has received nearly 24,000 new 253 (34%) NOT DAMAGED arrivals, and Bama, Ngala and Mobbar LGAs CUMULATIVE CONSULTATIONS that have all received between 10,000-12,000 689,509 CONSULTATIONS**** 950 REFERRALS new arrivals. Ongoing cholera outbreak in Kukawa LGA, 42,839 CONSULTATIONS THROUGH HARD TO REACH TEAMS Borno state with over 683 cases reported up to EPIDEMIOLOGICAL WEEK 16 30th April, 2018 and also in Yobe state (Bade, EARLY WARNING & ALERT RESPONSE Karasuwa, Yusufari, Busari and Jakusko) over 272 EWARS SENTINEL SITES 411 cases reported up to 30th April, 2018. 169 REPORTING SENTINEL SITES Preparedness plans for rainy season and new 34 TOTAL ALERTS RAISED***** displacements are in place but there is a dire need to mobilise additional resources as most SECTOR FUNDING, HRP 2018 of the existing drugs and stocks/supplies are HRP 2018 REQUIREMENTS $109M presently diverted to contain the cholera outbreak in Yobe state & Kukawa LGA. Health FUNDED $ 4.2 M (3.8%) is one of the least funded sector so far with UNMET REQUIREMENTS $ 105 M funding coverage of only 3.8%. https://fts.unocha.org/appeals/642/clusters * Total number of IDPs in Adamawa, Borno and Yobe States by IOM DTM XIX **MoH/WHO Borno HeRAMS September/October 2017 ***Number of health interventions provided by reporting HRP partners as of December 2017. 1 **** Cumulative number of medical consultations at the IDP camps from 2018 Epidemiological Week 1- 16. **** * The number of alerts change from week to week. Situation update Following the new military operation launched on 1st May, large number of new arrivals are to be expected in different field locations in the NE (mainly Borno). This new influx situation would be further exacerbated with the increased number of displaced people that will result from seasonal dynamics (rainy season, lean period, etc.) as well as the potential high number of refugees returning to Nigeria (up to 62,500 according to UNHCR). Locations that will likely see high levels of displacement are Damasak (Damasak LGA), Baga (Kukawa LGA), Monguno (Monguno LGA), Ngala/Gamboru (Ngala LGA), Rann (Kala Balge LGA), Dikwa (Dikwa LGA), and Banki (Bama LGA). Large scale displacement will also likely continue to Pulka and Gwoza (Gwoza LGA). Humanitarian partners have reported large scale population movements into Baga and Doro Baga, two major towns in Kukawa LGA as a result of insecurity and military activities in and around the area. Newly arrived persons also report that many more families remain in areas that are hard to reach for international humanitarian workers. Emergency conditions exacerbated by the rainy season are expected to last from June to September 2018 for the majority of locations. However, in Rann (Kala/Balge LGA), flood-related impacts could be seen through December 2018 due to the geographic terrain. For the different sectors, the level of humanitarian impact and consequences will vary. The rainy season and a potential flooding event may directly or indirectly impact the health status of conflict-affected persons. During the rainy season, potential consequences may include: an increase in risks of water-borne diseases such as cholera, malaria and hepatitis E; an increase in the number of malnutrition cases with medical complications; damage to facilities which would interrupt the delivery of critical health services; and restricted access to areas, which would compromise the delivery health supplies and affect the mobility of health workers and other human resources crucial to the delivery of health services. The Health sector will aim to enhance disease surveillance and risk assessment for a timely response to outbreaks during the rainy season, as well as to provide essential health care services to reduce the risk of morbidity and mortality. Priority preparedness and response activities include: pre-positioning of adequate health supplies and kits; immediate risk assessments in communities for the timely mitigation and response to outbreaks; vaccination/immunization of children under the age of 5 for major vaccine preventable diseases (VPDs); mental health and psycho-social support for conflict-affected persons. Vulnerable groups will be prioritised, including those who have chronic sicknesses, persons with disabilities, persons suffering from mental ailments, pregnant and lactating women, and persons with conflict-related injuries in the communities. For rainy season contingency plan, the Health sector will focus response activities particularly where there are two ongoing cholera outbreaks: one in Kukawa LGA in Borno State, and the other in Bade, Yusufari, Bursari and Karasuwa LGAs in Yobe State. A robust surveillance and outbreak response mechanism will be needed to ensure the timely detection of cases and an adequate response. Mobile health teams will be critical for preparedness and response considering the context. Demand for medicines and health supplies will increase, and therefore pre-positioning is critical. It is important to note that the State Government and Health sector partners’ capacity to respond has been overstretched with recent increased needs and, during the rainy season, this will continue to be the case. Early Warning Alert and Response System (EWARS) In Epidemiological Week 16, 2018: Number of reporting sites in week 16: A total of 169 out of 272 reporting sites (including 20 IDP camps) submitted their weekly reports. The timeliness and completeness of reporting this week were both 62% (target 80%). 2 Total number of consultations in week 16: Total consultations were 39,519 marking a 13% decrease in comparison to the previous week (n=45,177). Leading cause of morbidity and mortality in week 16: Malaria (suspected n= 10,266 and confirmed n=4,026) was the leading cause of morbidity accounting for 37% of reported cases. Acute respiratory infection, acute watery diarrhoea, maternal, and neonatal deaths accounted for 36% of deaths reported through EWARS. Number of alerts in week 16: Thirty-four (34) indicator-based alerts were generated with 82% of them verified. Morbidity Patterns . Malaria: In Epi week 16, 4,026 cases of confirmed malaria were reported through EWARS. Of the reported cases, 375 were from General Hospital in Biu, 200 were from Gamboru C MCH Clinic in Ngala, 181 were from Logumane PHC in Ngala, 145 were from 250 Housing Estate (Kofa) IDP camp clinic, and 130 were from Garubula MCH in Biu, No associated malaria death was reported. 3 4500 4000 3500 3000 2500 2000 1500 1000 500 0 w3 w6 w9 w2 w5 w8 w34 w37 w40 w43 w46 w49 w52 w12 w15 w18 w21 w24 w27 w30 w33 w36 w39 w42 w45 w48 w51 w11 w14 2016 2017 2018 under 5years 5years and above Figure 2: Trend of malaria cases by week, Borno State, week 34 2016 - 16 2018 . Acute watery diarrhea: In Epi week 16, 2,711 cases were reported through EWARS. Of the reported cases, 257 were from Herwa PHC in MMC, 237 were from Gamboru C MCH Clinic in Ngala, 137 were from Logumane PHC Clinic in Ngala, and 110 were from FHI360 Banki clinic in Bama. One associated death was reported from Chibok General Hospital in Chibok. 2500 2000 1500 1000 500 0 w9 w3 w6 w2 w5 w8 w12 w34 w37 w40 w43 w46 w49 w52 w15 w18 w21 w24 w27 w30 w33 w36 w39 w42 w45 w48 w51 w11 w14 2016 2017 2018 under 5years 5years and above Figure 3: Trend of acute watery diarrhoea cases by week, Borno State, week 34 2016 - 16 2018 . Acute respiratory infection: In Epi week 16, 5451 cases of acute respiratory infection were reported through EWARS. Of the reported cases, 532 were from Herwa PHC in MMC, 310 were from Gamboru C MCH Clinic in Ngala, 175 were from Logumane PHC in Ngala, 171 were from FHI360 Banki clinic in Bama, 168 were from Hausari MDM IDP camp clinic in Damboa, 139 were from Mogcolis IDP camp clinic in MMC, and 135 were from Jakana PHC in Konduga. There was one associated death from Kwayabura MCH in Hawul. Suspected Measles: Fifty-three (53) suspected measles cases were reported through EWARS in week 16, marking a 26% decrease in comparison to the previous week (Fig. 4). Of the reported cases, 25 were from Gajiganna MPHC in Magumeri, 7 were from General Hospital Gajiram in Nganzai, and 5 were from 4 Njimtilo PHC in Konduga. Six additional cases were reported from Kaga (4), Monguno (1), and Askira Uba (1) LGAs through IDSR*. No associated death was reported. 140 120 100 80 60 40 20 0 w3 w6 w9 w2 w5 w8 w43 w34 w37 w40 w46 w49 w52 w12 w15 w18 w21 w24 w27 w30 w33 w36 w39 w42 w45 w48 w51 w11 w14 2016 2017 2018 under 5years 5years and above Figure 4: Trend of suspected measles cases by week, Borno State, week 34 2016- 16 2018 . Suspected Yellow Fever: Five suspected yellow fever cases were reported through EWARS in week 16 from Gajiganna MPHC (3) in Magumeri, PHC clinic (1) in Gwoza, and FSP Cross Kauwa (1) in Kukawa.
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