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Health Action − in the North Caucasus NEWSLETTER ON EMERGENCY PREPAREDNESS AND RESPONSE OCTOBER-NOVEMBER 2004 Launch of the Consolidated In- • Assistance that contributes to recovery and ter-agency Appeal 2005 for rebuilding livelihoods. Chechnya and Neighbouring Re- publics The CAP 2005 reflects a shift in humanitarian action from relief aid to recovery. The humani- On 19 November in Moscow humanitarian agen- tarian community will increasingly include ele- cies working in Chechnya and neighbouring re- ments of recovery and capacity building in its publics launched the 2005 Consolidated Appeal relief programmes, especially in the health and for Chechnya and Neighbouring Republics. The education sectors, but also in the economic re- appeal is a part of global UN effort to provide covery and infrastructure sector. humanitarian assistance to 26 million people in 14 emergency situations throughout the world (With inputs from OCHA Moscow) through raising USD 1.7 billion. 24 October - UN Day in the North Caucasus The UN day in the North Caucasus was marked by a large-scale media campaign in the three republics - Chechnya, Ingushetia and North Os- setia. The campaign, aimed to raise awareness of population and governments of UN operations in the region, included: - Articles in weekly newspapers “Ingushetia” and “Serdalo” in Ingushetia, and a daily “North Os- Kasidis Rochanakorn, UNHCR Representative, Hu- setia” in North Ossetia-Alania, containing infor- manitarian Coordinator, at the CAP 2005 launch in mation about UN globally and ongoing and Moscow planned activities of UN agencies (UNICEF, The total amount of funding requested in the UNDP, WFP, FAO, WHO, UNHCR, OCHA) in the 2005 Consolidated Appeal for Chechnya and North Caucasus; Neighbouring Republics amounts to nearly US$ - Articles in bi-weekly newspapers “Molo- 60 million. These funds are expected to enable dyozhnaya Smena” and “Stolitsa Plus”, in 29 humanitarian agencies to achieve the follow- Chechnya; ing goals: - Special lessons, devoted to UN activities, given • Protection of the affected civilian population; to children in three schools in Ingushetia and in school no.6 in Beslan (North Ossetia), where • Humanitarian relief and emergency support to pupils were informed about the global character meet the most basic social and physical needs; of the United Nations, its capability to help the people all over the world in critical situations, • Support for the capacity of local government and to help the most vulnerable people on the and NGOs to provide needed public services; planet; 1 - Wide TV coverage through live inter- accommodation centre in Argun and a children’ views with UN agencies’ representatives in the psychosocial rehabilitation centre, run by the North Ossetian weekly programme “Friday”, and local NGO “SERLO” , supported by WHO. In the TV programmes on two Chechen TV companies – conversations with heads and staff of the visited Chechen State TV and Radio Broadcasting En- hospitals, the latter put special emphasis on terprise and Grozny TV. In Ingushetia, local TV continued education of medical workers, particu- aired the filmed version of school lessons, de- larly organized at the district level. voted to UN activities. On 19 November, WHO visited in Grozny the premises of the Republican maternity hospital and city polyclinic N7. On 24 November, WHO, in a joint WFP/ECHO/WHO assessment Mission to Urus- Martan and Shali districts of Chechnya, visited a central district hospital in Shali, 5 schools, a kin- dergarten and a distribution point. The central district hospital in Shali serves one of the largest districts of Chechnya with a popu- lation of 115,000 people. It has a capacity of Dr Ute Enderlein (left), Head of WHO field office in Nazran, interviewed in Argun (Chechnya) on the 350 occasion of UN day In recognition of the activities of UN in the North Caucasus, the President of the Chechen Repub- lic, Ali Alkhanov, sent a letter to the UN Resident Coordinator in Russia, Mr.Stefan Vassilev, ac- knowledging the UN concern over the hardships of Chechen people, with best wishes of success in peace-building and achieving concordance all over the world. WHO missions to Chechnya Republican maternity hospital in Grozny On 21 October, WHO visited two district hospi- tals, Gudermes children hospital, a temporary beds. Other health institutions in the district are: district hospital in Chiri-Yurt (100 beds), TB hos- pital in Shali (60 beds), seven ambulatories and a FAP. Shali district hospital bed capacity amounts to 10% of the total of Chechnya. The hospital has general medicine (65 beds), surgery (60 beds), gynecology (45 beds), maternity (60 beds), pae- diatry (45 beds), infectious (20 beds) and TB (60 beds) units. The hospital admitted 7618 patients in 2004 (fourth after Gudermes, Urus-Martan and Nad- terechny) and mortality is reported to be one of At the Gudermes Children’ hospital the highest in 2004. Shali maternal mortality 2 and perinatal mortality rates (23,6% compared The hospital has water supply and heating. Cen- to average in Russia – 12,1%) are one of the tral heating and sewage are available only for highest in the republic. the maternity ward patients. The hospital’s main The hospital TB department will be renovated problem, as reported by the administration, is from the Republican budget. Upon completion the lack of space for patients and hospital’s ser- MSF-H will assist with laboratory supplies, con- vices. Another issue requiring potential assis- struction of a new incinerator and training tance from humanitarian organizations is the courses for TB specialists. lack of diagnostic equipment. The hospital re- ceives monthly assistance from ICRC. Hospital staff regularly participates in training courses organized by ICRC, MSF-H and WHO. INGUSHETIA AND CHECHNYA Demography MSF-Holland continues its TB program in Gud- ermes and Nadterechny districts of Chechnya, According to DRC data as of 15 November 2004 which includes provision of food for patients and there were 39 931 IDPs from Chechnya in In- staff and anti-TB drugs. It was reported that the gushetia including 14 858 IDPs living in tempo- first 42 patients completed treatment and 64 rary settlements and 25 073 IDPs in the private patients are currently undergoing the 6-months sector. treatment. TB-laboratories in these districts were also equipped during the program. The TB program will be extended to the Shali district as TB soon as reconstruction works are finished there. In October, the Republican TB hospital in Nazran had 210 patients, including 131 men and 79 Epidemiology and immunization women. In October, the expert from the Central TB Re- Four cases of Congo Crimean Haemorrhagic fe- search Institute in Moscow (CTRI), was invited ver* were registered in Malgobeck district of In- by IMC to conduct the TB Control and Manage- gushetia. Three people died. The fourth person ment course cycle for 84 primary health care was hospitalised in Moscow, after medical doctors from Chechnya and Ingushetia in Naz- evacuation. WHO supported the MoH, Ingushetia ran. with funds for barrier nursing items and basic drugs and equipment. On 23-25 November, two specialists from CTRI conducted, within the framework of WHO TB *Crimean-Congo haemorrhagic fever (CCHF) Control and Prevention programme in Ingushetia is a viral haemorrhagic fever of the Nairovi- rus group. Although primarily a zoonosis, a refresher course for 25 Ingush TB specialists sporadic cases and outbreaks of CCHF affect- on the basis of the Republican TB hospital in ing humans do occur. The disease is endemic Nazran. in many countries in Africa, Europe and Asia, and during 2001, cases or outbreaks have been recorded in Kosovo, Albania, Iran, Paki- WFP provided its monthly food commodities stan, and South Africa. The disease was first described in the Crimea in 1944 and given (4590 kgs of flour, 529 liters of oil, 253 kgs of the name Crimean haemorrhagic fever. In sugar and 64 kgs of salt) in October-November 1969 it was recognized that the pathogen to 421 patients of the Republican TB hospital in causing Crimean haemorrhagic fever was the same as that responsible for an illness identi- Nazran and 18 outpatients who completed their fied in 1956 in the Congo, and linkage of the medical treatment. two place names resulted in the current name for the disease and the virus. 3 In late November food poisoning, possibly linked to diary products, was reported in two Ministry of Health of Chechnya Statistics kindergartens in Oktyabrskoe village of Prig- orodny district of North Ossetia. Nearly 200 chil- • At present there are 64 state health dren were hospitalized in local hospitals, mostly structures operational in Chechnya providing as preventive measure. Necessary tests were 6901 hospital beds. 2484 beds are available made to identify the source of gastrointestinal in the reserve. Structurally there are 21 rural infection. hospitals, 15 maternity wards (and 1 mater- nity hospital), 13 central district hospitals, 8 city hospitals, 8 dispensaries, 3 district hospi- Health assistance tals, 1 city children hospital, 1 republican clinical hospital, 1 republican children hospi- tal. Ministry of Health of Chechnya Priorities for • 99 465 people were hospitalized in 2005 January-October 2004, including 17 341 chil- • Further improvement of Chechen dren. 480 people died while hospitalized, in- health staff professional skills and their post- cluding 150 children. graduate studies; • MoH referred 7065 people including 1447 children for out-of-republic treatment. • Strengthening physical rehabilitation of state health structures using both federal • 3625 people with cancer (1047 – and republican budgets (42 state health men, 746 – women) were registered for the structures in Chechnya are included in the reporting period. Additionally, 5347 patients with active TB including 454 children were plan for physical rehabilitation in 2005); also registered. • Better prophylactic campaigns among • The birth rate in Chechnya is twice as population, including vaccine preventable much (19.1) as compared to 9.8 in Russia.

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