HEALTH CLUSTER BULLETIN #23 Group counselling session by IOM MHPSS staffs in Mekelle IDP sites, April & May 2021 May 2021 Photo by: IOM. Ethiopia Emergency type: Multiple Events Reporting period: 1-30 April & 1-31 May 8.7 M 2.9 M 1.6 M 220 PEOPLE IN NEED IDP TARGETED HOST TARGETED WOREDAS HIGHLIGHTS HEALTH SECTOR • The health cluster require US$48.2M to HEALTH CLUSTER 30 IMPLEMENTING support partners sustain operations in PARTNERS Tigray region for the next 8 months (From MEDICINES DELIVERED TO HEALTH May to December 2021). FACILITIES/PARTNERS • Healh cluster is targeting 2.3M out of the 751 ASSORTED MEDICAL KITS estimated 3.8M people in need of health HEALTH CLUSTER ACTIVITIES care services in Tigray. • From January to May 2021 the health 394,693 OPD CONSULTATIONS cluster reached a cumulative of total of 1,421,169 people with health IEC messages. VACCINATION VACCINATED AGAINST 9,040 MEASLES • Majority of IDPs live in host communities (over 90%),only a small number live in EWARS sites. North Shewa has 253,000 IDPs and CONFIRMED COVID-19, POLIO, YELLOW FEVER, Oromia S. zone 105,000; the IDPs need 5 food, ES/NFIs, WASH and healthcare. CHOLERA, MEASLES OUTBREAKS FUNDING $US • As of 23 May 2021, Ethiopia recorded 140 M REQUESTED 269,194 confirmed COVID 19 cases,with M % FUNDED 4,076 deaths and 228,757 recoveries. M GAP have been reported in Ethiopia. 1 Situation update The situation in the Tigray region was becoming protracted with increased humanitarian needs. Hence, the available resources in the country would be insufficient to meet the growing need to rapidly respond to the public health consequences of the conflict. Physical access to certain affected rural areas remained difficult due to pockets of conflicts and insecurity; by implication affected population in those locations were denied access to public health and other social services. Health partners providing MHNT services could not reach up to 22 woredas with those services. The conflicts were in parts of North West zone; Eastern zone (Wukro, Hawzen); Central zone; Western zone and Southern zone (Maychew - 130Kms South of Mekelle and in Samre and Gijet, 60KMs South East of Mekelle). For woredas that were becoming accessible, there was need to sustain the operations of MHNTs and the few functioning health facilities. More medical supplies were required to address the pipeline issues and to ensure that the MHNTs and hospitals do not runout of the essential supplies. A number of health facilities remained non-functional because of insecurity, health worker shortage, attacks on healthcare – for instance looting, vandalism and military occupation of some few facilities. To ascertain the motive for the vandalism and looting of some these health and/or public facilities, investigations would be required to identify the people. Development of the Northern Ethiopia Response Plan was finalized in May 2021. Health cluster require US$48.2M to support partners sustain operations in Tigray region for the next 8 months (From May to December 2021). The cluster is targeting 2.3M out of the 3.8M people in need of essensial health services. The priority objective of the cluster is to reduce avoidable morbidity and mortality among IDPs, and vulnerable conflict affected population in the Tigray region. The funds would support SGBV/MHPSS, Covid19 response, MHNT, medical supplies, referral systems (ambulances), coordination in Mekelle and shire, disease surveillance and emergency preparedness among others. According to the inter-agency assessment report in North Showa and Oromo special zones of Amhara region, from 3 to 6 May, the security situation was calm, normalcy returned to Debre Berhan, Debresina, Shoa Robit, Kemise, Artuma Fursi. Ataye town is abandoned: Burned down, no people in the town. There are 253,000 IDPs in North Shewa, 105,000 IDPs in Oromia S. zone and majority of the IDPs live in host communities (over 90%), only a small percentage are in sites. The priority needs include food, ES/NFIs, WASH and healthcare. Figure 1: HC MHNTs operating in Tigray as of 30 May 2021 2 There was suspected Cholera outbreak is in Oromia region, however no suspected Cholera cases and death were reported in week 19. A total 43 suspected measles cases without deaths were reported in week 19 in Amhara, Oromia, Gambela and Addis Ababa region. Up to 77% (33) of those cases were from Amhara region, 19% (8) were from Oromia region, 2% (1) were from Gambela and 2% (1) from Addis Ababa region. In the same week, 16 suspected Polio cases were reported. Up to 50% (8) of them were from Oromia region, 32% (5) were from Amhara region, 12% (2) were from SNNP and 6% (1) from Sidama region. As of 23 May 2021, Ethiopia had recorded a total of 269,194 confirmed COVID 19 cases with 4,076 deaths and 228,757 recoveries. Response activities continued through the national and subnational PHEOC, with partners supporting various pillars at all levels. Public Health risks, priorities, needs and gaps Health risks • With ongoing community transmission of COVID-19, Ethiopia remains at high risk of increasing caseloads and mortalities, thereby straining the health system. • Communicable disease outbreaks due to low literacy levels, poor and congested living conditions, poor WASH facilities and practices, mass gatherings and activities, and low vaccination coverage remains a huge public health concern. • Conflict and population displacement leading to increased health demands on facilities due to new and pre-existing conditions and diseases, mental health burden, sexual and gender-based violence, and other sexual and reproductive health needs outtretches existing capacities in the facilities. • Food insecurity and malnutrition, resulting from erratic rains and drought in some locations, which contribute to higher vulnerability of children and other people to infectious diseases and other disease conditions is another area of critical concern. Priorities • COVID-19 outbreak readiness and response preparation is among the top on the list. • Revitalization of the healthcare delivery system in Tigray region to cope with the increased need for healthcare services. • Delivery of essential life-saving emergency health services to vulnerable populations by ensuring sufficient quantities of quality medicines and medical supplies and availability of health workers to deliver the services. • Work with and strengthen the capacity of the existing health system by training health workers and establishing humanitarian-development linkages that would enable easy transition and ensure sustainability of the outcomes. • Enhance quality of the response through field level coordination, monitoring and support to partners with the main focus on IDP/return locations and new incidents. • Improve the collection and collation of data and information from partners, present it in the information of products and use it for decision making, resource mobilization and guiding the response. • Support joint and integrated approaches with other Clusters targeting the same locations and populations with humanitarian response to avoid duplication and maximize resource utilisation. Needs and gaps • Shortage of qualified health staff to implement the response in emergency affected locations, in an already strained health system, and partners’ inability to recruit the appropriate staff adequately. • There is need to strengthen the regular supply chain for medicines, and harmonize it with the emergency streams to reduce incidents of stock-outs at health facilities, and address delays in emergency funding. • Health facilities in many return locations were fully or partially destroyed by the conflict, floods and other causes. There is need to speedily rehabilitate, re-staff and restock these facilities. Health Cluster Action Strategy and response processes The cluster focused on ensuring availability and expansion of essential health services in Tigray and other conflict affected parts of the country. Expansion of mental health and psychosocial support servces to conflict affected populaions including survivors was also a major area of focus for the cluster. Emergency health kits were provided to North Shewa and Oromo 3 special zones of Amhara after intercommunal violence that erupted in several locations. Encouraging partner presence in North Shewa and Oromo Special Zones of Amhara region is a major concern for the cluster. Health Cluster coordination As for Tigray response, the Health cluster continued to provide leadership to the health response, partner coordination, technical and operational support in response to both Regional Health Bureau and partner efforts. In March, WHO activated a second Sub National Health Cluster coordination forum in Shire in addition to the existing one in Mekelle with participation of nine partners. The central cluster continued to participate in the coordination meetings held at Chagni (for Metekel) and Gonder. However, this participation became difficult due to overlapping committments and shortage of human resources. The health cluster continued its regular weekly virtual meetings where updates and guidance on ongoing partners’ contributions to essential health services and the emergency response in Tigray is shared. Monthly health cluster partners’ 4W and HRP for the whole country is collected and anlysed. Currently the cluster has 19 partners of which 3 are UN agencies, 13 are International NGOs, and 3 are National NGOs. These partners operate in 220 woredas in different parts of the country. Over the period, January – May 2021, the cluster reached out to a cumulative total of 1,421,169 people with IEC messages. Field Monitoring and Support The Health Cluster Public Health Officer (PHO) participated in a multisectoral assessment in North Shewa and Oromo Special Zones of Amhara region where it was noted that the needs are high on the ground but partner presence was very limited. There cluster partners have not provided emergency response to the two zones apart from emergency health kits delivered earlier through MSF E. The lessons learned through the assessment were shared with cluster partners and the ICCG. 2021 HRP dashboard Indicators Q1 April May Total 1.1.1.