Health Situation Report: Pakistan Floods Health Situation Issue # 9| August Report23-29, 2013 Pakistan Monsoon Floods Issue # 9 | (August 23-29, 2013)
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Health Situation Report: Pakistan floods Health Situation Issue # 9| August Report23-29, 2013 Pakistan monsoon floods Issue # 9 | (August 23-29, 2013) Highlights: According to NDMA, 1.3 million people affected, 193 persons died while 31,355 people are living in 512 relief camps in the flood affected districts. WHO has provided essential medicines support to 165,693 people through customized kits including Emergency Health kits (EHKs), Diarrheal Disease Kits (DDKs), Hygiene kits, and other supplies including anti-malarial drugs, Anti Snake Venom (ASVs), and Rapid Diagnostic kits. The medicines stock is depleting and need to be replenished. Stagnant water in the flood affected areas is posing threat for increase in malaria, dengue and other water-borne diseases Acute Watery Diarrhea (AWD) in flood affected districts of Punjab is showing increasing trend which needs vigilant monitoring. Total 25 alerts were received and appropriate measures were taken. Altogether 5 each alerts were WHO’s team visiting IDPs camp in Bhawalpur received for Measles and Scabies; 4 for Dengue fever; 2 each for AWD, ARI, CCHF, and Typhoid; while 1 alert each for AJS, (Photo: WHO Punjab) Bloody diarrhea and Rabies. Increasing trend of skin diseases have been reported from Rajanpur and Sialkot. Diphtheria cases are on the rise in Punjab. Till date, 18 cases of clinical diphtheria have been reported from which 9 of these have been reported the during current monsoon season. In Sindh, the overall proportion of Acute Diarrhea is high as compared to the previous year during the same reporting period. During the current monsoon season 15 AWD outbreaks were identified and responded but the situation needs continuous monitoring in the province. Health situation / health needs: Punjab: Stagnant water in the flood affected areas is posing a threat for increase in malaria, dengue and other water-borne diseases. Acute Watery Diarrhea (AWD) in flood affected districts of Punjab is showing increasing trend which needs vigilant monitoring. A total of 25 alerts were received and appropriate measures were taken. According to NDMA, 65 dead, 792 injured and 738,976 people were affected while 289 Relief Camps are hosting 19,406 persons in the food affected areas. The cases of dog bites and snake bites are being reported with increased numbers. 102 cases of Dengue fever cases were reported through Dengue Dashboard from flood affected districts in Punjab and 4 of these were confirmed by laboratory. Four cases of diphtheria were reported from Muzaffargarh, Lahore and Faisalabad. WHO has supplied Anti Diphtheria Serum (ADS) in these areas. Page 1 of 4 Health Situation Report: Pakistan floods Issue # 9| August 23-29, 2013 Data has been collected from 8 flood affected districts of Punjab (DG Khan, Rajanpur, Narowal, Mandi Bahauddin, Sheikhupura, Kasur, Sialkot and Vehari) from 6-28 August, 2013. Data revealed that 22,505 (18%) of the consultations reported were of Scabies followed by ARI 21,259 (17%), Diarrhea 11,360 (9%), Suspected Malaria 1,299 (1%) whereas other diseases were 54,463 (44%) of the total 123,680 consultations. Given below graph demonstrates the proportional morbidity of acute diarrhea from the flood affected districts of Punjab. Acute diarrhoea as percentage of all consultations, flood affected districts in Punjab, 6 - 26 Aug, 2013 15 10 Percentage 5 0 6-Aug 13-Aug 14-Aug 15-Aug 16-Aug 17-Aug 18-Aug 19-Aug 20-Aug 21-Aug 22-Aug 23-Aug 24-Aug 25-Aug 26-Aug 12-Aug Baluchistan: The severely affected districts are Jhalmagsi, Jaffarabad and Naseerabad. According to NDMA, 18 people have died (Khuzdar 6, Lasbela 5, Loralai 1, Jhalmagsi 1, Turbat/Kach 3). NDMA reported 64,270 persons have been affected while 4 Relief Camps are hosting a population of 4500 persons. According to Department of Health, 11 BHUs have been damaged in Jhalmagsi. The water level in Jaffarabad and Naseerabad is receding and situation is getting back to normal. 158 cases of snake bites have been reported from flood affected districts of Naseerabad and Jhalmagsi for which WHO has provided 50 Anti Snake Venom (ASV). In the flood affected areas communities are using contaminated water for all household/drinking purpose and are at risk of being affected by Diarrhea, Malaria, Typhoid, skin diseases and eye infection. Two mobile medical camps have been established at Naseerabad by PPHI. DEWS team has provided 32,000 Aqua tablets, 200 Jerry cans, 14,000 water purification sachet and 200 antibacterial soaps to IDPs of both UCs Aliabad 01 and 02. BHU Baghtail, CD Noor Muhammad Jerwar and BHU Nushki Jadeed (Jaffarabad) and Mengal kot, Sabz Ali Umrani, Qadirabad, Meerwah and Goulat Ghari (Naseerabad) are reporting higher consultations for Malaria, Diarrhea and skin diseases. DEWS team along with EHE, EM and DoH representative visited the area and investigated the cases. Majority of the cases reported are mild diarrhea due to the consumption of contaminated water. In these areas, required medicine and purification sachets were provided, health educations session were conducted and close liaison is in place with NGO partners, PPHI and Health Department to over-come the health issue. WHO-DEWS team reported, investigated and responded alerts of CCHF; Dengue, Measles; Acute Watery Diarrhea; Acute Respiratory Infections (ARI), and scabies. Data has been collected from 3 flood affected districts (Naseerabad, Jaffarabad and Jhalmagsi) from 6-28 August 2013, consultations revealed Diarrhoea 3,385 (19%), Suspected Malaria 2,498 (14%), ARI 1,323 (7%), Skin Diseases 1,066 (6%) and other diseases 7,814 (44%) of total 17,956 consultations. Following trend line illustrates the proportional morbidity of acute diarrhea from flood affected districts of Balochistan from 6th to 28th August 2013. Page 2 of 4 Health Situation Report: Pakistan floods Issue # 9| August 23-29, 2013 Acute diarrhoea as percentage of all consultations, flood affected districts in Balochistan, 6 - 28 Aug, 2013 40 30 20 Percentage 10 0 6-Aug 7-Aug 13-Aug 15-Aug 16-Aug 17-Aug 18-Aug 19-Aug 20-Aug 21-Aug 22-Aug 23-Aug 24-Aug 26-Aug 27-Aug 28-Aug 12-Aug Health response: Punjab: Save the Children in coordination with health department, is providing support through 3 Mobile Health teams to cater the immediate and essential health needs of the affected communities in 6 Union Councils including Fatehpur (Tehsil Rajanpur), Sabzani, Umerkot (Tehsil Rojhan), Harrand. Hajipur and Wah Lashari (Tehsil Jampur). Since beginning of the current response, Save the Children mobile health teams has provided 2,924 consultations along with treatment for the community members suffering from communicable and non-communicable illnesses. A total of 122 Maternal, New-born and Child health consultation have been conducted for the pregnant women and mothers in their postnatal period accompanying newly born babies. So far, Save the Children has conducted 95 health and hygiene awareness sessions for the community members for promotion of best health and hygiene practices attended by 2,002 community members. One patient was refereed to higher level of health care facility for appropriate treatment. WHO-DEWS team reported, investigated and responded to disease alerts in flood affected districts. The main diseases reported are Dengue fever, Diphtheria, Typhoid Fever, Acute Viral Hepatitis, Scabies, Acute and Bloody Diarrhea and Measles. Disease data and Alert sheet analysis is clearly indicating that Incidence of water-borne diseases (Diarrhea, AVH & Typhoid fever) and water related diseases (Dengue fever & Scabies) are on rise. Baluchistan: WHO-DEWS teams are present on ground in the flood affected districts responding to alerts/outbreaks as well as assisting health departments through medicines and other technical support. Eight medical camps in Jhalmagsi (Jhalmagsi, Gandawa, Bareeja, Kot Magsi, Saifabad and Shambani) and 5 medical camps in Jaffarabad are functional with the support of DoH & PPHI and medicines support from WHO. Five DDKs, 2 EHKs along with extra essential medicines, aqua tabs were provided in Loralai, Jaffarabad, Naseerabad, Mastung and Jhalmagsi. Environmental health items such as water filters, Aqua tablets, soups and water purification sachet were provided to DoH, districts Naseerabad and Jaffarabad. 10 chlorine color comparators were also provided to PHED. On the job training session was conducted for PHED field staffs on preparation of stock solution using of chlorine HTH70% for water tankers, using of aqua tabs and water purification sachets, Health and hygiene. Page 3 of 4 Health Situation Report: Pakistan floods Issue # 9| August 23-29, 2013 WHO’s essential medicines support and population coverage: Approximate coverage include 165,693 population with DDKs, EHKs, malarial medicines, skin preparations & other medicines for alerts & outbreaks response Province Districts Population coverage TIG ASV ORS EHK RDT DDK Primaquine Hygiene kits Anti Anti Malarial Bannu 2 1 3 10,003 DI Khan 2 1 3 10,003 KPK Swat 4 4 2,004 kohat 2 2 1,002 Narowal 2 8,143 Rawalpindi 2 1,000 Sialkot 2 8,143 Rahim yar khan 3,740 10,000 4,073 DG Khan 2 1 50,000 1,020 11,020 Punjab Rajan Pur 2 1 2,000 20,000 2,800 30 15,497 Muzaffargarh 2 50,000 3,020 20,000 4,972 DGHS Punjab 22 11,000 layyah 2 2,000 20,000 2,800 6,467 Loralai 1 1 5,000 14,671 PPHI Jhalmagsi 1 Jhalmagsi 1 2 2,000 10 18,510 DGHS Balochistan 150 150 Mastung 1 1,929 Balochistan PPHI naseerabad 1 1,200 500 Naseerabad/jaffarabad 2 2 19,000 Karachi 1 500 Hyderabad 10,000 0 DGHS Sindh 400 400 Larkana 25 25 Jacobabad 1 10 510 Sindh Matiari 16,171 Tharparkar 0 Sukkur 0 Shikarpur 0 Total 54 10 113,200 11,780 70,000 10,600 607 30 165,693 For further information, contact: Dr Fawad Khan Health Cluster Coordinator/Acting EHA Coordinator, WHO Pakistan, Email: [email protected], Cell: 0300 5018530 Mohammad Shafiq, Technical Officer – Health Cluster, WHO Pakistan Email: [email protected]; Cell: 0303 555 2270 Page 4 of 4 .