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YEMEN: Health Cluster Bulletin. 2016

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YEMEN: HEALTH CLUSTER BULLETIN DECEMBER 2016 Photo credit: Qatar Red Crescent 414 health facilities Highlights operationally supported in 145 districts o From the onset of the AWD/cholera outbreak on 6 October until 20 December 406 surgical, nutrition and 2016, a cumulative number of 11,664 mobile teams in 266 districts AWD/Cholera cases and 96 deaths were reported in 152 districts. Of these, 5,739 97 general clinical and (49%) are women, while 3,947 (34%) are trauma interventions in 73 children below 5 years.* districts o The total number of confirmed measles cases in Yemen from 1 Jan to 19 December 541 child health and nutrition 2016 is 144, with 1,965 cases pending lab interventions in 323 districts confirmation.** o A number of hospitals are reporting shortages in fuel and medicines/supplies, 341 communicable disease particularly drugs for chronic illnesses interventions in 229 districts including renal dialysis solutions, medicines for kidney transplant surgeries, diabetes 607 gender and reproductive and blood pressure. health interventions in 319 o The Health Cluster and partners are working districts to adopt the Cash and Voucher program on 96 water, sanitation and a wider scale into its interventions under hygiene interventions in 77 the YHRP 2017, based on field experience districts by partners who had previously successfully implemented reproductive health services. 254 mass immunization interventions in 224 districts *WHO cholera/AWD weekly update in Yemen, 20 Dec 2016 ** Measles/Rubella Surveillance report – Week 50, 2016, WHO/MoPHP PAGE 1 Situation Overview The ongoing conflict in Yemen continues to undermine the availability of basic social services, including health services. Increasing needs for conflict-related trauma injuries, non-communicable diseases, and maternal and child health services are placing a strain on a weakened health system. Import interruptions and the closure of air and sea ports have resulted in shortages in essential medicines and medical supplies. Since September 2016, government employees, including health staff, have not been receiving regular salaries, resulting in shortages of staff reporting to work at public health facilities. On the other hand, most Yemeni citizens are not able to afford health services from the private sector. SPECIAL FEATURE: Cholera Response The AWD/cholera outbreak has affected 15 of Yemen’s 23 governorates, with Al Jawf recently reporting confirmed cholera cases. However, the danger of spread is still present, as other governorates remain at high- risk of infection transmission, due to the conflict situation, as well as population movement. From the onset of the outbreak on 6 October until 20 December 2016, a cumulative number of 11,664 AWD/cholera cases were reported, with 96 associated deaths. Of these, 157 stool samples from 741 patients tested positive for Vibrio cholera.1 The overall attack rate during Epidemiological Week 51 in 2016 (18-24 December) was 4.9 per 10,000 populations, compared to 4.3 in the previous week, indicating that the outbreak has not declined. For more information, see WHO’s latest cholera situation update. Call for NGOs to support AWD/cholera response The Integrated Health/WASH and AWD/cholera taskforce has updated the Cholera Response Plan to ensure adequate integration of interventions. OCHA Yemen has opened a funding window, the Second Reserve Allocation of the Yemen Humanitarian Pooled Fund (YHPF), calling for NGOs to apply and support the cholera response. Both clusters have finalized and shared the Gap Analysis and Standard Operating Procedures (SOPs) with OCHA to guide agencies on the geographical priorities and immediate interventions needed to be included in their proposals, based on existing needs and gaps in the 15 affected governorates. Funding is scheduled to be made available to selected agencies in early January 2017, with a project duration of three months. Health cluster AWD/cholera response activities Abs Development for Women & Children (ADO) distributed 850 hygiene kits in the two districts (Abs district of Hjah governorate and Al Luhia district of Al Hudaydah governorate. The total number of beneficiaries is 725 persons (309 male and 416 female). Additionally, 69 health education sessions were conducted in the two districts. Building Foundation for Development (BFD) reached 46,690 beneficiaries in Amran district, Amran (874 men, 410 women, 24,473 boys and 20,933 girls) through cholera health awareness activities in 50 schools targeting both students and teachers. The campaign included posting educational materials, distributing brochures, and conducting role-play activities in classrooms and during morning assembly. Khadijah Foundation for Development (KFD) reached 2,292 individuals (171 men, 234 women, 171 boys and 170 girls) by conducting 16 sessions of Focus Group Discussions, 31 sessions of counselling and distributing 330 IEC materials in Modhaikihra district (Ibb). The purpose of these activities was to raise awareness mainly on cholera, safe motherhood, and other public health related issues. In addition, 508 households (577 men, 674 women, 491 boys and 454 girls) were reached through distribution of 508 hygiene kits and 1,016 jerry cans. 1 WHO cholera/AWD weekly update in Yemen – 20 December 2016 PAGE 2 National Foundation for Development and Humanitarian Response (NFDHR) opened two cholera treatment centres in Mukayras Hospital and Sharyah Al Wafa’a Health Centre in Al Baydah governorate. The two centres are functional 24/7 and are receiving and treating all cases of AWD/cholera. Action Contre la Faim (ACF) in close collaboration with MoPHP and WHO has reached 1,041 patients with acute watery diarrheal treatment (300 men, 371 women, 217 boys and 153 girls) through Al Thowra DTC in Al Hawk District of Hodeidah Governorate. Out A physician treating a patient at the new cholera treatment of which 646 cases were treated with suspected centre in Mukayras Hospital - Photo-credit: NFDHR cholera2, the majority coming from Al Hawk, Al Hali and Al Mina districts. Dehydration status upon admission in the month of December was mild-28.8% (300), moderate-47.8% (498) and severe-23.3%. On discharge, 15% (156) patients left the treatment centre without completing full rehydration therapy, 83.7% (871) patients cured, 1.3% (14) patients were transferred to other medical facilities. Public health risks, priorities, needs and gaps The number of confirmed measles cases in Yemen from the beginning of 2016 until 19 December is 144, while the number of suspected measles cases is 3,417. The vaccination profile of the suspected cases show that zero dose cases were heavily distributed in Sa’ada, Al Jawf, Shabwa, Al Hudaydah and Amran governorates. 61% of measles cases received no vaccination. The affected age group is mainly children under 15 years, with a greater number below the age of five. Four measles outbreaks have been declared since the beginning of 2016. A number of hospitals are reporting shortages in fuel and medicines/supplies, for chronic illnesses including renal dialysis solutions, medicines for kidney transplant surgeries, diabetes and blood pressure. Health Cluster Action Coordination The second leg of the YHRP 2017, i.e., uploading of projects by humanitarian agencies on the Online Project System (OPS) has been completed on 21st December 2016. Currently, there are 78 projects uploaded under the Health Cluster, including those by UN agencies, international and local NGOs. The total amount is USD 364,657,776. The Cluster provided guidance and support to agencies during the project uploading phase. Projects submitted online are to be vetted by clusters/OCHA and the final list of projects will be published by mid-January 2017. HEALTH RESPONSE Health service delivery Abs Development for Women & Children (ADO) reached a total of 8640 people through mobile & fixed clinics providing primary health care services, including treatment of common and infectious diseases: 4285 people (689 men, 1,870 women, 844 boys and 882) girls were reached through two mobile teams in Abs district (Hajjah) and Al Luhia district (Al Hudaydah), and 4,355 people (950 men, 1829 women, 819 boy, 757 girl) were reached through two fixed clinics in Al Zuhra and Al Luhia districts (Al Hudaydah) 55 patients were referred to hospitals for tertiary care services including surgical intervention & blood transfusions. Building Foundation for Development (BFD) reached 4,372 beneficiaries (968 women, 224 men 1,585 boys and 1,595 girls) through supporting one mobile team and five health facilities in Harf Sufian and Hubor Zolima districts (Amran). The fixed and mobile teams provide epidemiological services, including Integrated Management of Childhood Illnesses (IMCI) services; nutrition services; maternal, newborn and child health 2 Suspected cholera case definition in areas with confirmed cholera case is any person with Acute Watery Diarrhea; Suspected cholera case definition in the area without confirmed cholera cases is any person with Acute Watery Diarrhea and severe dehydration with or without vomiting or any death related to AWD PAGE 3 services; and Communication for Development (C4D) services. In Mareb, BFD reached 4,560 beneficiaries (1,739 women, 260 men, 1,282 boys and 1,279 girls) through supporting two mobile teams and four health facilities in Harib and Al Abedia districts. BFD also delivered medicines, reproductive health kits and medical equipment to health facilities in the two districts. Handicap International (HI) donated specialised rehabilitation equipment for health facilities to be able to offer quality services to beneficiaries. By the end of December, HI will support the establishment of a rehabilitation unit at the inpatients department in Al Thawra hospital. On a daily basis, HI provides devices such as wheelchairs and crutches to persons with injuries and disabilities in Al Thawra hospital, Al Jumhuri hospital and the Prosthesis and Physiotherapy Centre. International Medical Corps (IMC) supported 97 health facilities in five governorates (Sana’a, Taiz, Aden, Al Dahale’e and Lahj) In addition, a total of 24 mobile teams are also being supported. IMC referred 213 people for secondary and tertiary health care in Sana'a.
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