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TYPHOON DURIAN Health Cluster Bulletin No. 2 Thursday 28 December 2006 ASSESSMENT AND MONITORING The 30 November 2006 floods and mudslide in Region V in the Philippines caused 660 deaths. As of 23 December 2006, there are still at least 20,466 displaced individuals housed in 67 different evacuation centers in the province of Albay alone. As of December 23, 2006 the morbidity and mortality in the evacuation centers in Region V is as follows: Legend: ARI- cough and colds with fever. Cough and Colds- cough and colds without fever. Diarrhea- 3 episodes of watery stools/day LBM- those that do not fit the criteria of diarrhea. Leading Causes of Consultation at EC Morbidity Mortality Municipality 01-22 December, 2006 23 December 2006 Daraga Cough and colds: 416 11 Fever: 259 Wounds: 144 3 Loose Bowel Movement: 67 8 Asthma: 65 ARI: 55 2 Diarrhea: 42 4 Mumps: 8 2 Non-neonatal tetanus: 2 0 0 Legaspi Cough and colds: 340 Fever: 88 13 Wounds: 90 9 Loose Bowel Movement 4 (LBM): 73 Asthma: 16 ARI: 224 2 Diarrhea: 70 0 Chicken pox:2 66 Leptospirosis:6 5 Non-neonatal tetanus: 1 0 Camalig Cough and colds: 177 ARI: 67 33 LBM: 20 6 Wounds:66 1 Diarrhea: 0 11 Fever: 64 0 Asthma: 12 4 3 Guinubatan Cough and Colds: 183 Acute Respiratory Infection 2 (ARI): 49 Asthma: 9 LBM: 15 Fever: 33 1 Wounds: 17 0 Diarrhea: 15 1 Pneumoniae: 2 0 Non-neonatal tetanus: 2 1 0 Malilipot Cough and colds: 20 Fever: 7 2 Wounds: 8 0 LBM:0 1 Asthma: 12 ARI: 20 0 Diarrhea: 6 0 1 0 Tabaco Cough and colds: 109 Fever: 6 1 Wounds: 30 LBM: 2 Asthma: 2 ARI: 20 Diarrhea: 29 Pneumonia: 1 Leptospirosis:1 Non-neonatal tetanus: 1 Bacacay Cough and colds: 42 Fever: 2 3 Wounds: 61 1 LBM: 7 4 Asthma: 4 ARI: 95 1 Diarrhea: 11 0 4 1 Sto. Domingo Cough and Colds: 32 ARI: 24 21 Asthma: 1 5 LBM: 1 1 Fever: 3 0 Wounds:36 5 Diarrhea: 5 5 Pneumonia: 2 1 There was 1 mortality in Guinobatan from non-neonatal tetanus from December 1 to 22. There was 1 mortality in Tabaco from leptospirosis during that period as well. Source: CHD V report HEALTH COORDINATION A meeting of the Field Health Cluster was convened on December 27, 2006, 9:00AM at the Department of Health Center for Health Development V (DOH-CHD V) Daguinsin Hall, Legazpi City. The following GOs and NGOs participated in the meeting: • Carlos Primero D. Gundran – Coordination Assistant (WHO) • Nestor Santiago- Regional director • Ingrid Magnata- Assistant Regional Director • Juancho Torres- HEMS Coordinator • Rogelio Rivera- COH BRTTH • Eric Raborar- ER Chair BRTTH • Fulbert Gillego- MHO Malilipat • Katrina Gamboa- Handicap International • Joann Manzanilla- Handicap International • Morpheus Causing-MSF • Joseph Manjares– Red Cross • Luis Mendoza- PHO Albay • Dante B. Bausa- MHO Malinao • Mary Anne Esquivel- PHO Albay • Sotera C. Copino- MHO Tiwi • Mercy Chua- MHO Daraga • Violeta Borja- PHN II Bacacay • Evelyn Zuniga- RSI Sto Domingo • Arnold Binalla- MHO Malilipot • Eddy Hew- Relief Officer Mercy Malaysia • Pepe Nebril- Field Coordinator for Disaster management UNFPA The meeting was chaired by Dr. Ingrid Magnata and was well-received and actively engaged in by the participants. The present health status was discussed and identified the top five leading causes of morbidity in evacuation camps: 1) cough and colds; 2) ARI; 3) Wounds; 4) Fever; and 5) Diarrhea. There are still 68 evacuation centers at present. Dr Magnata announced that of the 68 evacuation centers, 60% has complied with the standards of shelter set by WHO; 81% compliance with the standards of safe drinking water by WHO; 50% compliance for the standards of availability of latrines by WHO; and 94% compliance based on the waste disposal standards set by WHO. In the discussion, it was emphasized that NGO’s might help in constructing more latrines in areas where it is lacking. The problem of congestion in the evacuation centers was raised. The proposed methods on decongesting the camps are as follows: 1) to provide more classrooms in schools; 2) To provide Housing Assistance to the affected people; 3) Provide a place for Permanent Relocation. Dr Rivera of BRTTH informed us that BRTTH is a 250 bed tertiary hospital. In ideal conditions, this hospital should be manned by at least 800 personnel of which they do not have at present. The present working staff of the hospital runs in a skeleton work-force under normal conditions. There is a need to upgrade not only the structural capacity(facilities) but also the functional capacity(hospital personnel) of the hospital to cater the needs of the region under normal conditions especially now that the region is in a disaster situation. Previously, health personnel were augmented by teams from other DOH hospitals. Presently though, they are on their own. The RHU and CHO of Guinobatan and Santo Domingo asked for assistance regarding medicines for ARI and Diarrhea. To summarize, it was agreed that the needs that the priority needs at present are: 1) augmentation of Health personnel for hospitals; 2) Provision of drugs and medicines; 3) Start the early rehabilitation Phase of damaged Health Facilities. WHO Field Health Coordination Associate Dr Carlos Primero Gundran is working closely with the Department of Health Regional Office (Center for Health Development V) to support the government’s efforts in coordinating the relief and early recovery efforts in the health sector. He is based in the Operations Center of CHD V. He also attended the general assembly/coordination meeting called by the Governor Fernando Gonzales of Albay today. Two health cluster coordination meetings have also been conducted in Manila. The last one was held last 21 December 2006 at the WPRO, chaired by WHO EHA Programme Officer Dr Malou Barrameda and co-chaired by DOH-HEMS Director Dr Carmencita Banatin. The next health cluster coordination meeting in Manila is scheduled on 5 January 2006. More detailed planning for the early recovery and rehabilitation of the affected health care facilities will be one of the major topics for discussion in the next meeting. FILLING HEALTH GAPS Four New Emergency Health Kits from WHO, each of which can provide for the medical supplies and equipment needs for 10,000 population for the next three months, were received at the WHO Central Office last week. Two of the kits were received by CHD V today. WHO is in the process of procuring more supplies and equipment as requested by the DOH. MSF has provided Oral Rehydration Centers and is planning to rehabilitate Ziga hospital. They also have Cholera Kits and Staff ready for a Cholera Outbreak. Handicap international agreed to help those disabled by the typhoon by providing prosthesis, wheelchairs, and crutches, in coordination with Simon of Cyrene. They are also considering assistance they could provide for the early rehabilitation phase wherein they plan to hire local personnel. UNFPA is still finalizing their assessment for the early rehabilitation phase. International Organization for Migration has committed to provide transportation services to the roving medical teams, if needed. Mercy Malaysia is considering providing the following services if needed: Cleft palate surgery, cataract surgery, orthodontic surgery and psychosocial training. PRESERVING AND SUPPORTING Medicins Sans Frontieres committed to be on call for provision of logistics (medicines, and human resources) in the event of outbreaks/epidemics, and has also committed to rehabilitating the Zisa Memorial District Hospital. Handicapped International also committed to review their mandates to include preparations for early rehabilitation of the affected health facilities. WHO continues to coordinate closely with the DOH to provide technical advice and operational support as necessary and to help plan out the response to the health needs of the affected populations until the rehabilitation phase. Prepared by: Carlos Primero D. Gundran, MD WHO Field Coordination Associate Legaspi City, Albay, Bicol Region.

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