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Health Action − in the North Caucasus NEWSLETTER ON EMERGENCY PREPAREDNESS AND RESPONSE JULY-SEPTEMBER 2004 September 2004: Beslan, North arranged immediate provision of drugs/medical Ossetia consumables and other emergency assistance on the spot. The international community re- sponded with supplying medical material for treatment of the victims in Beslan. In the first As of 30 September, 48 people (including 24 week already several cargo planes landed at children), remained hospitalised in North Os- Beslan airport from countries as the United setia. A total of 195, in cluding 130 children States, Italy, Norway, France, Canada, Austria, are still undergoing treatment in Moscow and Germany, China, Greece, Bulgaria and Poland Rostov hospitals. Four children were sent to carrying drugs, medical consumables and in- hospitals in Germany. 1 9 people, including 7 struments, laboratory equipment, reagents, ICU children died while being hospitalised. 277 equipment, X-ray sets, ambulances etc. The deceased people, includ ing 145 children have EMERCOM of Russia and the Ministry of Health of been identified, while there still remain 52 North Ossetia are in charge of monitoring and people (26 children) who are not yet identi- distributing humanitarian aid. fied. DNA analyses are on-going. WHO, together with other international agen- cies On 1 September 2004, about 1,300 people, - assisted in the health sector coordination post mostly children, were taken hostage in school Beslan incident #1 in Beslan, North Ossetia. On September 3, -kept track of incoming donations and updated the hostage crises ended in extreme violence twice a day a list of donations with some 330 deaths (50% children) and more than 500 hospitalized initially. -provided feedback to donors -conducted initially twice daily hospital assess- Most of the victims suffered in the event in ments in Beslan and Vladikavkaz school No. 1 in Beslan received shot wounds and - held daily meetings in the Ministry of Health of burns and required immediate medical assis- North Ossetia to receive updates on patients and tance – mostly surgical and neuro-surgical. The their needs district hospital in Beslan immediately started to receive patients in most critical conditions. The - facilitated the dispatch of trauma kits and republican clinical, emergency and children hos- burns dressing modules to Beslan. pitals in Vladikavkaz carried the main burden of WHO also facilitated the Norwegian Government accepting the majority of victims. Hospitals in funded donation of material for blood safety to Rostov-upon-Don also received wounded hos- the Blood Bank in Vladikavkaz and released tages from Beslan. Patients with most severe funds to the Serbsky Institute of Forensic Psy- conditions were transported to Moscow with chiatry, Moscow, to provide posttraumatic care “Zaschita” emergency flights. to hostages and their families in the first six weeks following the event. UN agencies (UNICEF, UNHCR, WFP), ICRC, RRC and NGOs (ARD, Help, Hammer Forum, MSF, In the aftermath of the event, posttraumatic PHO, IR, CPCD, Caritas, Care, World Vision, care and psychosocial support became a major SDC/SHA), working in the North Caucasus, focus of national and international organisations 1 in Beslan and Vladikavkaz. The process to es- compliment these efforts through targeted in- tablish psychological rehabilitation centres and volvement of a larger number of mental health provide training for health staff has already professionals in qualified long-term assistance to started. population, assistance to respective specialised local health institutions (e.g. establishment of EMERCOM specialists and experts from Moscow the Republican medical-social psychological re- and Rostov, together with 50 local psychiatrists habilitation centre) and creation of independent and psychologists were providing counselling psychosocial rehabilitation units. Part of long- services as from the first day in all the four hos- term psychosocial rehabilitation is promoting pitals. In the policlinic of Beslan the counsellors peace-building activities – organization of mass saw 120-150 people daily; the Republican centre campaigns, joint festivals, conferences and other for medical-social psychological assistance of the arrangements aimed to include the people from Ministry of Health set up a hotline; specialists Chechnya, Ingushetia and North Ossetia. from the Moscow Serbsky Institute of Psychiatry provided on the spot psychiatric and psychologi- The federal government arranged for further cal assistance and organized lectures for health treatment and rehabilitation of the children and personnel. their parents; a vast number of “sanatories”, (rehabilitation institutions) throughout Russia The Serbsky Institute of Forensic Psychiatry is offered their services for these victims and their currently developing mid- and long-term pro- relatives. gramme of post-trauma counselling for affected children, their parents, teachers and health staff of North Ossetian hospitals and staff of the morgue. Local and international NGOs plan to INGUSHETIA AND CHECHNYA Demography - discussed the overall TB situation in the North Caucasus and its current problems and future According to the Danish refugee council, 46,498 perspectives Chechen IDPs (10,521 families) were registered for assistance in Ingushetia as of 31 August - analysed the efficacy of the WHO TB control 2004. Out of those 19,784 IDPs (4,336 families) and prevention programme in Ingushetia, its were registered in 177 temporary settlements, results, follow-up and monitoring activities and 26,714 IDPs (6,185 families) in private ac- commodation. - received updates of TB-related projects run by other organizations, focusing in particular on inter-organisational linkage and TB -discussed improving family and community On 2-15 August IMC held in Nazran a training awareness on TB in the NC. course on TB detection, treatment and monitor- In continuation of the TB control and prevention ing for 30 IMC and MoH representatives. The programme in Ingushetia and in agreement with training was carried out by two specialists from WHO, WFP continued providing the Republican the Central TB Research Institute in Moscow. TB hospital in Nazran with flour, oil and salt for Following this training, WHO chaired the TB co- in and out-patients. In the last three months, ordination meeting on 18 August. Responsible 8020 kg of flour, 841 litres of oil and 95 kg of officials from both Ministries of Health and other salt were distributed to about 200 patients. interested organizations 2 WHO delivered 5000 single-use test tubes to - support to individual patients: 8 in the laboratory of the Republican TB Hospital. Chechnya and 6 in Ingushetia - training: 12 organizations in Chechnya and 12 in Ingushetia Epidemiology and immunization - psychosocial rehabilitation : 9 in Chech- nya and 10 in Ingushetia. A more detailed list is available in the Nazran office of WHO. IHI organized a one-month (14 June-16 July) training for 13 doctors (specialists in anaesthe- siology, functional diagnostics, neonatology and paediatrics) from Chechnya and Ingushetia in Warsaw, Poland. From 29 July to 1 August World Vision carried UNICEF-supplied refrigerators at a medical facility out in Nalchik a training course on cardiovascu- in Groznensko-Selsky district of Chechnya lar diseases for physicians of their mobile teams, and another one on first aid for nurses. The fa- cilitators were IMC and IHI staff. One more In September, the Ministry of Health of Chech- training course, for WV gynaecologists on ob- nya vaccinated 68,737 children up to 4 years old stetrical and gynaecological care, took place on against measles. Due to shortage of vaccines 10-13 August, also in Nalchik. coverage of only 69.6% was achieved. Within the framework of its Expanded Pro- gramme of Immunization UNICEF procured Medicins du Monde (MDM) continues the im- 202 refrigerators, 142 cold boxes and 543 vac- plementation of its Surgery and Rural Medicine cine carriers for tertiary level health institutions Programmes in the Nozhai-Yurt district of Chech- in Chechnya. The equipment will be distributed nya. In August, in addition to regular delivery of to vaccination rooms in village health posts, pharmaceuticals and medical materials for a schools and selected primary health care facili- number of hospitals in Grozny, Gudermes, Urus- ties mainly in Chechnya, but also in Ingushetia. Martan, Argun, Nozhai-Yurt and Kurchaloi, MDM 194,000 disposable syringes were also distrib- supplied five operating tables, a cranioscope and uted. a trauma surgery tool kit under the Surgery pro- gramme; scheduled supplies of medicines and medical materials were carried out for three dis- Health assistance trict hospitals, two outpatient clinics and nine According to the latest WHO update, humanitar- feldsher-midwife stations under the Rural Medi- ian aid is provided in Ingushetia and Chechnya cine programme. by 25 organisations through: - health posts : 4 organisations in Chech- Agency for Rehabilitation and Development nya and 6 in Ingushetia (ARD) continues its 12 psychosocial rehabilita- - mobile medical teams: 2 organizations in tion centres in Chechnya attended by 260 chil- Chechnya and 5 in Ingushetia dren, 50 women and up to 60 adolescents. - drugs distribution: 10 organizations in Chechnya and 11 in Ingushetia; Hammer Forum donated a lung ventilation de- - equipment distribution: 7 in Chechnya vice and several heaters to children hospital N2 and 7 in Ingushetia in Grozny, laboratory equipment
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