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NATIONAL DEPARTMENT of HEALTH Public Health Division NATIONAL DEPARTMENT OF HEALTH Public Health Division P. O. Box 807 Phone: + (675) 301 3735/3825 WAIGANI Fax: + (675) 323 0177 National Capital District, Email: [email protected] Papua New Guinea BRIEF SUMMARY REPORT ON HEALTH SERVICE RISK ASSESSMENT TEAM VISIT TO THE HIGHLANDS DATE OF ACTIVITY: 14-18 OCTOBER 2015 A. Composition of Assessment Team 1. BACKGROUND 1.1. Introduction 1.2. Conduct of the Assessment 2. DEMOGRAPHY AND NATURE OF DROUGHT AND FROST DISASTER IN THE HIGHLANDS REGION 3. STATISTICS OF AFFECTED DISTRICT IN EACH HIGLANDS PROVINCE 4. IMPACT OF THE DROUGHT & FROST DISASTER 4.1. Coordination & Control 4.2. Health Facility Operations 4.3. Water & Sanitation 4.4. Food Security 4.5 Drugs & Supplies 4.5. Nutrition 4.6. Communication & Awareness 4.7 Schools 4.8. Population Migration 4.9. New Emerging issues 5. PARTNERS & NGOS 6 RECOMMENDATION 6.1 Short term 6.2 Long term 7 CONCLUSION Composition of team members: 1. Mr. Berry Ropa (Manager Surveillance and Emergency Response) 2. Mr. Ray Kangu (Technical Advisor, Environmental Health) 3. Mr. Gau Gau (Technical Officer, Environmental Health) 4. Mr. Ben Kapa, Technical Officer, Surveillance) 5. Mr. Willie Mark, Technical Officer, Surveillance) 6. Dr. Mathias Bauri, Public Health Officer 7. Mr. Josing Salimbi, Technical Officer (Climate Change) 8. Mr. Terence Bowasiki, (Technical Officer, Media) Place visited: WHP – PHO, Tambul District Health Centre SHP – Ialibu District Hospital, Pangia Health Centre, Imbongu District Health Centre, Mongol sub-Health Centre Hela – Magarima District Health Centre Enga – Kandep District Health Centre Simbu – Kerowagi District Health Centre Jiwaka – Minz District Health Centre, Mogol District Health Centre 1. BACKGROUND 1.1. Introduction In response to the recent drought and frost which has affected all parts of the country but more severely affecting certain districts in the Highlands Provinces, the National Disaster Drought Response Committee (NDDRC) team comprising of various National Technical Agencies were deployed to all regions of the country beginning 23rd of August, 2015. The objective of the deployment to the regions were to: (i) Assess the extent of damage to determine level of immediate and long term assistance required by the affected communities. The sectors to be assessed includes; food and water security, health issues, education and economic sectors (ii) Carry out capacity assessment on the capabilities & responsiveness of respective provincial governments to manage the effects of El-Niño (iv) Carry out awareness on drought mechanisms and strategies with the Provincial Disaster Government and affected communities (v) Assist PDC establish and strengthen existing government structures at the Provincial, District and Local Level for effective coordination of humanitarian relief operations. Following presentation of the reports, the National Disaster Drought Response Committee requested Government Agencies and various Organizations to carry out their respective organization’s preparedness and response activities. The Deputy Secretary of Health agreed for a Health Risk assessment (Health Service functionality) to be conducted in the districts worse affected in the highlands provinces. The Technical team of the National Department then visited the highlands provinces from 14- 18th of October 2015 with the purpose: 1. To visit district health facilities in the worst affected districts and assess their capacities and functionality 2. To conduct awareness on surveillance, reporting, investigation and response 3. To provide report to National Department of Health and to NDRC of the findings 2. AREAS VISITED & STATISTICS OF THE DISTRICTS IN EACH HIGLANDS PROVINCE N Name of Districts Population & Total Food Security Types of Category o per Province Districts Household Disaster affected Total Pop Stable food Impact Water Source Frost or /by 7 per Drought family 1 WHP 362,850 85,101 3 Tambul 75,000 11,000 Kaukau & All Creeks still Both 5 Upper Nebilyer 4, 000 600 English destroyed running Potatoes by Frost ENGA 432,045 3 Wabag District 3, 700 500 Kaukau & Food Creeks still Both 3 2 English gardens running but Potatoes affected with less volume Lagaip & Pogera 70,000 10,000 5 District Kaukau & All Certain creeks Both 1. Lagaip LLG 44,650 6, 400 English gardens running dry 2. Pilikambi LLG 29, 981 4, 300 Potatoes destroyed Kandep District 80,000 11,400 Same as Food Creeks Frost 5 1. Kandep LLG above gardens running 2. Wage LLG destroyed 3 SHP 510,245 3 Mendi Munhiu 144, 629 21, 000 Same as Food Source still Frost and 3 above gardens available drought partially destroyed Imbongu 106, 000 15, 000 Same as Food 5 above gardens destroyed Ialibu Pangia 63, 478 9, 000 Staple foods All All creeks Frost and 5 in short destroyed dried up Drought supply. by Frost & except big Drought river Kagua Erave 74, 139 10, 000 Staple food Food No proper Drought 3 running low gardens water source only affected 4 JIWAKA 343, 987 Drought South Whagi Rural 93, 000 13, 000 Staple foods Food Creeks and Drought 3 in short gardens river beds supply affected dried up 5 SIMBU 376, 473 54, 000 Gumine District 56, 860 8, 000 Staple food Food Creeks dried Drought 5 in short gardens up supply destroyed Kund/Gembogl 78, 521 11, 000 Staple foods Food Nil water Drought 5 District in short gardens supply in & Frost supply destroyed Town and around surrounding Gembogl villages. area. Chuave 39, 000 6, 000 Staple crops Gardens No reliable Drought 3 affected affected water supply only SinaSina 56, 805 9, 000 As above As above Some rivers Drought 3 Yongomugl dried up only Salt Nomane 52, 159 7, 500 As above As above As above Drought 3 only Kerowhagi 93, 107 13, 000 As above As above As above Drought 3 only 6 EHP 580, 000 Ungai Bena District 67, 125 10, 000 Staple crops Food Creeks dried Drought 3 affected gardens up and water only affected level in rivers reduced Henganofi District 63, 000 9, 000 As above As above As above Drought 3 only 7 HELA Magarima 36,000 5, 000 All crops Food All creeks Frost and 5 affected gardens dried up Drought destroyed except rivers Total Key: HF visited in Yellow. 3. IMPACT ASSESSMENT WERE DONE ON THE FOLLOWING AREAS 3.1. Coordination & Control Provincial Disaster Committees are seen not be functional and lack of coordination from the provincial level and district level as observed and reported by the local health workers. Magarima and Pangia reported that there were some form of committee working in these centres but health official were not part of the team. It was observed that Kandep district had 2 disaster committees working in parallel. 3.2. Health Facility Operations: All health facilities are operating; General Operations: Most health facilities have scaled down their operations mainly due to water shortage. There were some admissions (e.g. in Ialibu District Hospital) with shorter length of stay with medicines supplied for home treatment while rest attend to outpatient only & minor emergencies. Birth deliveries are referred while in cases, they asked to bring their own water for delivery. Diseases pattern: Some cases of diarrhoea and dysentery, skin infections are been seen but no increases over time suggestive of an outbreak. One health facility confirmed of referring a severe malnutrition case to a hospital. In some centres, there has been notable increase of new HIV cases. Deaths reported in the media were not verified by the authorities on the ground in the respective health facilities. Outreach programs: Notably, all health facilities experienced reduction in the number of people attending outreach programs such for maternal and child health programs including immunization sessions. Health staff: Generally despite the situation, health workers have been on site and no absenteeism has been observed as yet. Communication: Communicating with provincial level is difficult with the National HF radio out of order in all provinces, unavailability of telecommunication services while CUG is available in Western highlands province. Most resort to using their private cell phones. Electricity: Electricity supply is problem in some HF’s. Nongugl HC in Jiwaka province had their power cut due to non-payment of bills for the past 9 months. This centre has gas fridge functioning for Vaccines. 3.3. Water & Sanitation Availability of water at the health facility is most single important issue for which has resulted in scaling down of operations and water need for the health workers. Most health facilities depend on rain catchment and the tanks we saw were either empty or less water were in the tanks. Tambul HC and Mogol HSC water is supplied through the town reticulation system. Health care workers & families using water from big rivers however water collection containers availability is an issue for collection and storage. Water purification tablets were supplied with the 100% medical kits but not been utilized as staff were unaware of how to use them. Water carts are used in Ialibu/Pangia in SHP, Ziwaka and Simbu provinces with costs ranging from K250 – K350 per 7,500 litres. 3.4. Food Security We observed garden produce food shortage as there were zero to fewer fresh produce products in the markets. Food prices increasing for both fresh produce and store goods. Health workers are not yet going out searching for food but the general public are and already people have suffered from food poisoning as result of eating alternatives. For example mushrooms, bush beans. Stealing of food from gardens have been reported in some areas and this is expected to increase which may result in increasing law and order. In one particular district, the district authorities with assistance from rural police enforced ban on selling fresh food been sold at the market especially bought in other areas and resold for fear of missing out on handouts. 3.5 Drugs & Supplies Health facilities currently have adequate supplies of essential drugs, ORS, IVF and IV lines.
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