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. and Neighbouring Re- publics The CAP 2005 reflects a shift in humanitarian action from relief aid to recovery. The humani- On 19 November in 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, 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 , 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 , 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. communicable disease prevention and health However, infant mortality in the republic is awareness activities; still much higher than in Russia.

• Strengthening the primary health There are 16 sanitary-epidemiological • care level; stations functioning in Chechnya. 51 598

cases of infectious diseases were registered • Improvement in health indicators of during 9 months of 2004, including 35 157 socially important diseases such as TB, AIDS, children and 799 under one year old. Most STI, drug/substance abuse; frequent diseases were: acute respiratory

infections, acute intestinal infections, hepati- • Strengthening ambulance and first tis A, parotitis, and TB. aid service;

• Implementation of the Republican- funded target programs; Throughout October ICRC continued regular monthly provision of medicines and medical con- • Further development of the Center of sumables to the Republican Blood Bank in Emergency Medicine; Grozny, as well as to ten hospitals in Chechnya

(three in Grozny), one in Ingushetia, and one in • Mother and child health care. Dagestan. Also in October, ICRC donated medi- cal equipment for Shaly and Achkhoy-Martan Child district hospitals and the Republican paedi- atric hospital.

ICRC supported a doctor from Kurchaloy re- gional hospital to participate in the training

4 course on skin and venereal diseases, organized (800 – Chechnya and 750 – in Ingushetia). So by the Russian Medical Academy of Post- far, IRC staff completed schoolchildren’ observa- Graduate Education in St.Petersburg. tion of weight and height. The blood and faeces tests will be also carried out. The expected sur- vey deadline is June 2005. In October, MDM continued its two programmes in Chechnya. Within the framework of the sur- WHO donated to the Ministry of Health of gery programme the NGO procured drugs and Chechnya 350 medical books (35 different ti- medical consumables for Hospital no.9 in tles) for further distribution to state health Grozny, Central hospital in Argun and Central structures. district hospitals in Urus-Martan, Gudermes, Kurchaloi and Nozhaj-Yurt.

The ‘rural medicine programme’, designed to HIV/AIDS upgrade FAPs and ambulatories in 14 health fa- WHO conducted in November three training cilities in the Nozhai-Yurt district of Chechnya courses (3-5 Nov; 9-11 Nov; 15-17 Nov) on HIV included delivery of drugs and medical consum- consultation and child feeding in the Republican ables, as well as supervision of medical reporting AIDS centre in Grozny. Twenty-two local health of feldshers and monitoring the use of drugs. experts from various districts of Chechnya par- On 4-7 October MDM conducted a training ticipated in each training course. WHO trained course on “Rural Medicine”, with one lecturer facilitator, Dr. Taramova, acting chief specialist from France and the other one from Chechnya, on gynaecological and obstetric care of MoH of covering emergency medical assistance in rural Chechnya chaired all three sessions. areas.

A training on HIV/AIDS counseling for psycholo- IMC continues to support rural settlements in gists from the state sector and the NGOs was Chechnya and in Ingushetia, including the moni- conducted from 9 – 12 November by the WHO- toring of children less than five years of age. trained facilitator from Chechnya, Dr Khapta Ak- hmedova, in Nazran. The NGO also continues its training program on family medicine, covering medical personnel of four rural medical centers in Ingushetia and 12 In October, WHO donated medical consumables in Chechnya. (condoms, pregnancy tests, syringes, gloves) within its HIV/AIDS prevention programme to In October, IMC carried out 4 training courses the health facilities in Chechnya. on Cardiopulmonary Resuscitation (CPR) and

Basic First Aid for 37 participants from IDP set- On 15 November, ARD started a three-month tlements in Ingushetia. project on HIV/AIDS awareness and prevention in Chechnya. The project is realised jointly with MSF-F continues its work in Ingushetia (Karabu- SDC/SHA and the Republican AIDS Centre in ten lak, Nazran and Sunzha) and in Chechnya (dis- locations of ARD presence in the republic. tribution of drugs and equipment to 8 health 10,000 SDC/SHA booklets on HIV were distrib- facilities). The NGO plans to expand their work uted in Chechnya in line with this project. in Chechnya, closing one mobile brigade in In- gushetia. On 12-14 October, UNICEF conducted a semi- nar and a two-day training workshop for 44 par- IRC public health programme is focused on the ticipants from Chechnya and Ingushetia. Repre- anaemia survey among children in Ingushetia sentatives from different government structures and Chechnya. The study covers 17 schools, in- and NGOs involved in HIV/AIDS/STI (Sexually cluding 4 state schools in Grozny and 13 IRC Transmitted Infections) prevention, reproductive schools in Ingushetia or a total of 1550 children health, and other problems related to young

5 people’s health as well as several youth repre- care and prevention of mother-to-child trans- sentatives participated in the event, held in Nal- mission of HIV (PMTCT) for 25 neonatologists chik (Kabardino-Balkaria). The aim of the work- from Chechnya and Ingushetia. shop was to promote basic information tech- nologies, the establishment of Youth Information

Centres, information campaigns, youth volunteer work and peer support as the main tools in HIV/AIDS prevention. (UNICEF)

Mother and child health

On 12-16 and 18–22 October WHO held two training courses on Making Pregnancy

Safer/Promoting Effective Perinatal Care (MPS/PEPC) and Obstetrical Care in Nazran. 39 participants (chief obstetrician-gynaecologists Participants of the WHO MPS/PEPC training assess the condition of the maternity ward in Nazran from the Ministries of Health of Chechnya and Republican Hospital Ingushetia, obstetricians and midwives from

Shali, Naursky, Urus Martan and Grozny dictricts of Chechnya and Sunja and Malgobek districts of UNICEF (in cooperation with Hammer Forum Ingushetia) took part in both courses. The and the Ingush Republican Centre for Disease training aimed at: Prevention) continued its awareness-raising campaign targeting mothers and other child - providing training to obstetricians, midwives care providers in Ingushetia and Chechnya. 400 and neonatologists in Promoting Effective Peri- women living in temporary accommodation cen- natal Care according to WHO recommendations; tres (TACs) in Grozny and 240 IDP women living - identifying possible facilitators for future train- in Ingushetia, as well as 917 resident and IDP ings in Ingushetia and Chechnya and dissemina- mothers in various centres of Nazran district tion of MPS/PEPC principles; (Altievo, Gamurzievo, Plievo, and Barsuki (In- - elaborating the plan of action in implementa- gushetia) attended awareness sessions in Octo- tion of MPS/PEPC/Obstetrical Care in the two ber. Each woman attending the sessions re- republics in line with WHO recommendations. ceived a copy of UNICEF’s brochure on breast Practical sessions were conducted at the mater- feeding and a booklet on better child health nity ward of the Nazran republican hospital. care. (UNICEF) Participants received a complete set of training materials for future reference. On 25 November Hammer Forum organized a meeting with women who passed previous train- On 8-19 & 16-27 November WHO conducted ing to evaluate their skills to spread the informa- training courses on Integrated Management of tion further to other pregnant women or young Childhood Illnesses (IMCI) for 20 local MCH spe- mothers and to work with the booklet. cialists in Urus-Martan district and 20 doctors from Naur district of Chechnya through WHO prepared facilitator, Dr. Ismailova, MoH special- ist in paediatrics and WHO IMCI co-ordinator in Chechnya.

On 22-26 November WHO carried out a training course on Making Pregnancy Safer/Promoting Effective Perinatal Care (MPS/PEPC)/Neonatal

6 Mental health

Beslan Update Currently two presidential committees and a The emergency phase of the Beslan crises committee of Beslan authorities are responsi- ble for dealing with all aid and assistance that being over, there is now a growing need to effect the smooth transfer from emergency to was received and will be received for victims middle- and long term psychosocial assis- of Beslan hostage taking. One of the presi- tance to the affected population. In the af- dential committees is headed by the Prime Minister of RNO-Alania, Mr Merkulov, who is termath of the event the following parties keep currently providing psychosocial aid in accountable for the already received humani-

Beslan: tarian aid and cash, for determination of di- rect and indirect beneficiaries and its distribu- • 25 psychologists and 25 psychiatrists tion. The other committee, the “Fund of social from North Ossetia provide consultations in revival of Beslan”, lead by the Vice-chairmen the policlinic in Beslan and in , as of the Government, Mr Khatzaev, is concen- well as in teams for the still operating hot- trating on presently incoming national and line; international assistance, its coordination, • Mobile psychological and psycho- monitoring and distribution. therapeutic teams of experts from the Mos- cow based Serbsky Institute on Forensic Psy- chiatry; • Consultants from Moscow Research Care Canada opened a new psychosocial centre Institute on Psychiatry; in Nazran, Ingushetia. Two staff and six volun- teers are employed at the centre. At present • Psychologists from the NGO “Do- veriye” (Trust) working under the umbrella of monitoring activities take place to identify the the Ministry of Education and being an im- most vulnerable categories, including elderly and plementing partner of UNHCR. handicapped.

• Republican medical-psychological re- habilitation center in Vladikavkaz. International Rescue Committee (IRC) pub- The Federal government’s programme to sup- lished the first issue of the new psychosocial port provision of psychosocial aid in the area newspaper called “Sintem”. It has three pages envisages, in the first line, construction of in Russian and one page in Chechen and con- two new schools, a new hospital, two apart- tains rubrics on useful advice and recommenda- ment blocs and a psychosocial center in tions from psychologists. The edition is limited to 260 copies – 43 are meant for teachers of IRC’ Beslan. SDC agreed with the Ministry of Health of North Ossetia to set up a centre at assisted schools and 200 - for distribution the premises of the already existing in Beslan among parents. It is envisaged that other psy- recreational sports complex to receive pa- chosocial NGOs will also participate in this work tients from the Beslan community, as well as and provide their useful inputs for the newspa- to train local psychologists/psychiatrists. per.

UNICEF plans to open another centre to train school teachers in diagnosis of Post- On 29 November - 3 December WHO invited an traumatic stress disorder (PTSD) and other expert from the Moscow Research Institute of mental disturbances in children, as agreed Psychiatry (MRIP) to conduct a workshop on with the Ministry of Education. A further com- standardisation of diagnosis and treatment of plex is meant to be located on the basis of mental health in children in Nazran. Psycholo- the Vladikavkaz dermato-venereal dispensary gists from psychosocial NGOs and state facilities and is meant to be a Republican focal point from Ingushetia and Chechnya participated. for psychosocial activities with inpatient ca- pacity of about 30 beds.

7 Water and sanitation giene practices among 13,500 schoolchildren residing in the district. (UNICEF)

UNICEF implementing partner PHO continues Assistance to the disabled water provision for resident civilian population in Grozny and improvement of sanitation condi- In November-December ICRC held its regular tions in Grozny and other parts of Chechnya. In War surgery seminars in Moscow (30.11-1.12) addition to its regular activities of provision of and (6-8.12). Some 40 participants water and removal of garbage, PHO has installed came from Chechnya, Ingushetia, North Ossetia, 16 garbage containers in a temporary accom- Dagestan and locations in the South Caucasus. modation centre (TAC) at Saikhanova str. and The seminars were facilitated by two surgeons removed 10 spontaneous garbage dumps in dif- from Geneva Headquarters, one from St. Pe- ferent locations of Grozny in October. 34 hand tersburg Military Medical Academy and the chief operated water pumps were constructed in 31 traumatologist of the Ministry of Health of locations. Chechnya.

Within the framework of PHO’s awareness ac- ICRC supported a doctor from Gudermes re- tivities, the TV spot on proper use of “technical” gional hospital to participate in 4 weeks training and potable water, addressed to children, was on traumatology, organized by the Russian aired on Grozny TV. Also, around 20,000 hy- Medical Academy of Post-Graduate Education in giene awareness leaflets were distributed to Moscow. children from 52 schools and educational facili- ties. Together with this, the teachers conducted special lessons on sanitation and environmental In view of suspension after the Beslan crisis of problems. the UNICEF-supported project for the provision of prosthetic-orthotic assistance to mine/UXO UNICEF distributed 188 T-shirts (carrying mes- survivors at the Vladikavkaz Prosthetic Work- sages on the importance of safe drinking water) shop (PW), the Ministry of Interior of North Os- to these volunteers, responsible for the mainte- setia-Alania agreed to the provision of an escort nance of water distribution points. service, allowing mine/UXO-affected children from Chechnya – together with the NGO staff In the context of its hygiene education pro- accompanying them – to resume their travel into gramme targeting schoolchildren in Chechnya, the territory of North Ossetia. The training on and in cooperation with the Chechen Ministry of the production of orthopaedic footwear for four Education, UNICEF initiated the implementation specialists from Grozny’s prosthetic workshop, of hygiene education activities in schools n. 41 also suspended, has been shifted from Vladi- and n.7 in Grozny. The two schools plan to or- kavkaz to Pyatigorsk, where it resumed on 25 ganize a variety of events (performances, lec- October. (UNICEF) tures, drawing contests) to be conducted in par- allel to the sanitary and hygiene awareness CARE-Canada continues to provide individual campaign, so as to contribute to the promotion and group counselling to child mine/UXO survi- of better hygiene practices and healthy life vors and other disabled children. 15-18 styles among schoolchildren and their parents. mine/UXO child survivors are daily hosted in the (UNICEF) “Believe in Yourself” centre, established by CARE In partnership with the SES and MoE specialists in the premises of the Library for the Blind in from Grozny UNICEF organized and conducted Grozny. three training workshops on hygiene awareness and sanitary education for 75 teachers in Achkhoi-Martan District (Chechnya), who will subsequently raise the awareness on better hy-

8 Other news Health Action in the North Caucasus is a news- letter on the Disaster Preparedness and Response The European Commission has approved a €10 programme (DPR) of the World Health Organiza- million humanitarian aid package to support vic- tion Regional Office for Europe. The information is tims of the ongoing conflict in Chechnya. The compiled by the WHO Humanitarian Assistance Programme in the North Caucasus, the Russian recipients will include internally displaced per- Federation. sons (IDPs) and vulnerable groups in central and All rights are reserved by the organization. The southern Chechnya as well as IDPs in Ingushetia document may, however, be freely reviewed ab- and Dagestan. Assistance includes: food and stracted, reproduced or translated in part or whole, but not for sale or for use in conjunction with com- non-food items, medical support, shelter and mercial purposes. This newsletter is not an official water/sanitation, education, psychological assis- WHO publication. The views expressed in it do not tance and vocational training. Funds are being necessary represent the stated policy of WHO. allocated via the Directorate General for Hu- Correspondence should be addressed to: Russia Office of the WHO Special Representative manitarian Aid (ECHO) under the responsibility of the Director General in the Russian Federation of the Commissioner for Development and Hu- 28, Ostozhenka, manitarian Aid. This recent allocation has 119034 Moscow The Russian Federation pushed the total amount of ECHO’s aid to the Attn: Irina Tarakanova [[email protected]] victims of the current crisis since 1999 to ap- Tel.: (+7) 095 787 21 52/12 proximately € 147 million, making the EU the Fax: (+7) 095 787 21 19 largest donor in the region. (ECHO) Editors: Dr Corinna Reinicke [[email protected]], Irina Tarakanova [[email protected]] For more information about WHO Disaster Prepar-

edness and Response programmes, please con- tact:

List of abbreviations: Dr Gerald Rockenschaub [[email protected]]

DRC: Danish Refugee Council The "Health Action in the North Caucasus" news- EPI: Expanded Programme on Immunization letter of the Disaster Preparedness and Response FAP: Feldsher/obstetric post programme (DPR) can be found at GP: General practitioner http://www.euro.who.int/emergencies. HI: Handicap International ICRC: International Committee of the Red Cross IRC: IDPs: Internally displaced persons IMC: International Medical Corps IMSMA: International Management System for Mine Action IR: Islamic Relief IRC: International Rescue Committee MDM: Médecins du Monde MoH I: Ministry of Health of the Republic of In- gushetia MoH RF: Ministry of Health of the Russian Fed- eration MoH Ch: Ministry of Health of Chechnya MSF−B: Médecins sans Frontières-Belgium MSF−F: Médecins sans Frontières-France MSF−H: Médecins sans Frontières-Holland PHO: Polish Humanitarian Organization OCHA: United Nations Office for the Coordination of Humanitarian Affairs SARC: Saudi Red Crescent Society SDC: Swiss Agency for Development and Coop- eration SES: Sanitary Epidemiological Surveillance TAC: Temporary accommodation centre UNICEF: United Nations Children's Fund UXO: Unexploded ordnance VOM: Voice of the Mountains WHO: World Health Organization

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