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HEALTH CLUSTER BULLETIN People are exposed to flood waters, contaminated by garbage and sewage. Health Cluster partners 1-30 November 2019 are responding to reduce harm resulting from flood waters. Cases of AWD, skin and eye infections and malaria have been reported in flood-affected areas. Photo: SOYDA/Hawo Hussein
Country Name: Somalia Emergency Type: Complex Emergency—Conflict, Drought, Floods, Disease Outbreaks Reporting Period: 1-30 November 2019
A late-November tropi- cal cyclone forecast by GDACs came to reality during the first week of December 2019 with the passage of PAWAN-19 over Nugaal and Bari regions of Puntland in north eastern Somalia. The cyclone resulted in heavy rain and floods, affecting an estimated 15,000 people, and pos- ing a high risk of water- borne diseases in the most affected districts of Eyl, Bandarbayla, Ga- luula and Laasqoray.
Sources: GDACS, ERCC—DG ECHO, JTWC.
Floods Situation Update 3.0M 2.4M In need of life‐saving health Targeted for health assis‐ assistance, HRP 2019. tance, HRP 2019. In Beledweyne town, River levels have been gradual‐ ly dropping during the last week of November 2019, Health has received an additional US$800,000 on top of with receding waters in the flood‐affected areas. $20,436,329 received during the last reporting period. This saw the return of close to 50,000 of the dis‐ placed people in Beledweyne returning to their $21.2M $93.2M homes in the last two weeks of the month. HRP The weather forecast published by the FAO‐ managed SWALIM system highlighted moderate to Out of $2.66M total Health requirements for Flood Response, heavy rains over the following seven days, the first $2.14M has been received from the Somalia Humanitarian Fund week of December 2019. Alarming new floods were $2.66M reported in the early days of December as moderate $2.14M SHF to heavy rains increased riverine water levels. Health Cluster Bulle n, November 2019 2
Floods Situational Update (cont..)
Many health facilities, including Hiran General Hospital in Beledweyne are still not operational. Two health centers run by Relief International (RI) were also affected and ceased functioning.
RI relocated the services provided by the two af- fected health centers by deploying mobile health teams to Eljalle where the flood-affected people relocated.
Ongoing Response
A number of Health Cluster partners, including SRCS, RI, SCI, Mercy USA, HIDIG and SMA es- tablished temporary health care facilities (7 in to- tal) to counter the challenge of access to health care. WARDI continues to provide services from a HCF in Eljalle that existed before the flooding.
SCI, RI, WARDI, HIDIG, CESVI, Direct Aid, IIRO, MIDNIMO, and the MoH/WHO Integrated Emer- gency Response Teams continue to provide life- Some of the health care facilities still affected saving health services through a total of 19 mobile by the floods in Beled Weyne town, Hiran teams in Beledweyn and nearby villages, some Region as of 27 November 2019 located as far as 40km from the city.
ZZF established a health center in Eljalle. The first phase of services ran from 4-24 November, with the second commencing on 4 December 2019. TRAINING OPPORTUNITY: Disability and Direct Aid and HIDIG (with support from the SHF) Inclusion in Humanitarian Action planned to establish new mobile teams to provide services to displaced people in and around Beledweyne. Other activities during in the last Humanity & Inclusion (formerly Handicap Interna- week of November included: tional) invites Health Cluster partners to participate
in two for training sessions under the project A measles integrated polio campaign (POPV, VitA, Albendazole) from 24-28 November; “Capacity development for inclusion of persons A fogging/space spraying exercise conducted with disabilities in Humanitarian Action” financed by the National Malaria Control Program that by the German Federal Foreign Office. started from 27 November to end on 10 De- cember 2019; Deployment of twenty SRCS/ICRC health and The first training of the kind will take plain Moga- hygiene promotion volunteers, also leading a dishu, on 16 December 2019, and will include Data household chlorine tablet distribution campaign to prevent AWD in Ejale and surrounding flood- Collection and Monitoring and Evaluation. Additional affected areas. training will be conducted between 22 January and 6 February 2020 (to be confirmed), and will include Gaps and Challenges Programming.
The major gaps and challenges identified include lack of referral health center/hospital in The training is suitable for project managers, officers Beledweyne, as the General Hospital was affected and others engaged in programming. It will be deliv- by the floods. ered in English (with later sessions offered in Soma- There is also a reported n increase post-flooding li) with Somali group works. For additional infor- mosquito breading sites poses a risk of outbreaks of vector-borne diseases and shortage RTDs to mation, please contact: [email protected] with a copy diagnose/detect malaria cases. to [email protected] Health Cluster Bulle n, November 2019 3
National: Mogadishu, 5 November 2019 National/Sub-national Updates
Main Highlights: The Na onal Health Partner experiences to be shared with OCHA with Cluster mee ng of 5 respect to prepara on and technical difficul es in November was an uploading projects on to the Projects Module in HPC opportunity to enable tools partners share experi‐ Need for the Cluster to share regular situa on re‐ ences, challenges and ports (weekly or bi‐weekly) on the flood situa on, lessons learnt from share the update presenta ons made by the part‐ the HRP 2020, update partners on emergency preparedness ners, the HeRAMS introductory presenta on and the planning on the recent floods and discuss the planned WHO report on rapid needs assessment in flood‐ affected areas. health informa on management ac vi es, including Need for the Cluster to come up with a mechanism HeRAMS and PHSA, a new Cluster Informa on Manage‐ to monitor and track partner a endance of mee ngs ment Officer, Richard Sennoga and introduc on of Ahmed at the na onal and sub‐na onal level. Osman from the WHO Eastern Mediterranean Regional Office on mission to support roll out of the HeRAMS.
Puntland: Meeting in Garowe, 30 October 2019 Mercy USA Somaliland planned on suppor ng 4 Health facili es, The Director of Public Health, Ministry of Health highlighted (Withwidth HC, Balicad HP, Xa‐ the importance preparedness (by all Cluster partner organi‐ ranran HC and Dhilaalo HP za ons) to respond to possible disease outbreaks during the through the Shine Program). rainy season. MOH CSR Data presented updates during epi‐ KAALO local NGO stated that they demiological week 41 and 42. At least 23 suspected diphthe‐ are facing shortage of supplies ria cases reported, with 2 deaths in Yube town of Sanaag and will meet supplies gaps in region. Of the these, 9% were among under 5‐year‐olds December since they don’t have while 91% were among above 5‐year‐olds since EPI 41. funds to procure supplies. there
are also immuniza on service WHO Somaliland conducted a verifica on and inves ga on gaps the health facili es support‐ of the suspected diphtheria outbreak in Yube Health facility ed by KAALO in Cirroley and Awrbogays. managed by Care Interna onal‐Somaliland. The mee ng EPI Partners and MOH EPI established an Inter‐agency agreed on having the response to the outbreak be overseen Coordina on Commi ee to coordinate the Expanded by the Somaliland Health Cluster, considering that Yube was Program on Immuniza on (EPI) in Puntland. under Somaliland administra on.
Follow‐up/Ac on Points Key partner updates included the following: MoH Immuniza on Unit to send immuniza on and other WVI, implemen ng EPHS in Burtline district and sup‐ medical supplies to some health facili es in Sool region por ng five health facili es reported service gaps in vil‐ by 8 November 2019 lages in Burtline district. Details were to be shared by 3 Convening of a side mee ng on 6 November between November, including BEmOc Assessment results upon MOH, KAALO and UNICEF to discuss how UNICEF could comple on of the then on‐going assessment. support medical supplies to KAALO for ac vi es in Sool CARE highlighted challenges with delivery kits and sup‐ region. plies for immuniza on ac vi es for the integrated
Health and Nutri on Project in Sanaag and Sool regions. Integrated Health & Nutri on project by NODO ended All agencies working EPI to nominate their respec ve repre‐ September 2019, extended for 3 months, suppor ng 15 senta ves to the Inter‐agency Coordina on Commi ee by 10 HCFs and one Stabiliza on Center in Ayn region. November 2019.
Health Cluster Bulle n, November 2019 4
Hirshabelle: Beledweyne, 28 November 2019 National/Sub-national Updates
Convened at Beledweyne Genenral Hospital and a ended by representa ves from 13 partner organiza ons, the Health cluster to reflect all ac‐ Health Cluster mee ng of 28 November 2019 at Hiran ve partners in all cluster infor‐ focused on the health impact of the floods in ma on products; Beledweyne, acknowledging the ongoing response in Establish a database for the providing life‐saving health assistance to flood affected func oning health facili es; people, the gaps and challenges as annotated in the Partners to respond to the Beletweyne Flood Response Update online flood response monitor‐ ing tool as soon as possible; The mee ng highlighted the following: To field test the form in some Partners to regularly provide updates on the flood health facili es in Beledweyne; response ac vi es and gaps through the online re‐ To revise the form and share the sponse tracking matrix at h ps:// final dra with partners for their input. ee.humanitarianresponse.info/single/::ns4042in; Cluster to share iden fied gaps with the concerned The mee ng also highlighted the obliga on of the partners agencies (the referral hospital, the issue of chikungu‐ in availing mely, accurate, and complete data on their re‐ nya, shortage of RTDs and other malaria supplies); sponse ac vi es to effec vely monitor progress in re‐ Partners to update the list of func oning health facili‐ sponse, avoid duplica on and/or concentra on of ac vi es es regularly; in specific loca ons and iden fy the gaps.
South West State: Baidoa, Bay and Lower Shabelle, 14 and 5 November 2019
Baidoa Ad Hoc CoordinaƟon Forum Bay and Lowe Shabelle – Highlights
During the Ad Hoc State Humani‐ Deteriora ng situa on in Qasahdhere district due to tarian Coordina on Forum with flash floods. 60 flood‐affected families fled their homes. Cluster Focal Points chaired by Malaria cases were reported on the increase. The floods His Excellency Minister Nasir in Berdale town resulted in contamina on of shallow Arusha, Ministry of Humanitarian wells by sewerage from latrines. The popula on in the Affairs & Disaster Management at town had no access to clean water. the Disaster Opera on Coordina‐ MoH reported that Baidoa IDPs were affected by the on Center, an update was made floods and were in urgent need of health and WASH as‐ of an es mated 70,000 people sistance. Addi onally, AYUUB NGO reported that affected and another 40,000 dis‐ Qoryoley suffered poor hygiene and water contamina‐ placed by flash flooding across on, with waterborne diseases such as malaria, bilharzia the region, with Berdale town (60 km northwest of Baidoa) and watery diarrhea. ERDO reported that floods also worst affected. affected Goofgaduud Buurey area.
The mee ng underscored the impact of the flood in In Bai‐ Response: doa, Xudur and Berdale districts, the ongoing response, gaps Six organiza ons, including INTERSOS, GREDO, SAMA, and the urgent health and nutri on needs, with an appeal to Red Crescent, CCC and MOH/WHO mobile teams were humanitarian partners opera ng in the State to support the on ground. Ac vi es included community awareness drought/flash flood and conflict affected popula on in the and hygiene promo on for disease prevent and control. en re south west state. WHO, in partnership line ministries, other UN agencies and NGOs (including MoH, MoEWR and MoHADM), de‐ The details are annotated in the following Mee ng High‐ livered 3 tons of medical supplies to Berdale in October. lights. (See also: h ps://www.humanitarianresponse.info/ SAMA maintains MCH services in Bardale town, provided en/opera ons/somalia/document/ad‐hoc‐state‐ medical supplies, aqua tabs and LLINs. EDRO also estab‐ humanitarian‐coordina on‐forum‐cluster‐focal‐points) lished MCH services and delivered medical supplies in Goofgaduud Burey. Health Cluster Bulle n, November 2019 5
Jubaland: Kismayo, 24 November 2019 National/Sub-national Updates
Rains in the Juba and Shebelle river basin and the Ethiopian highlands con nued to subside giving relief to the flooding Notable response experienced in the riverine areas. Along the Juba river, flood Reac va on of the Emergency waters affected about 76 se lements. Analysis of satellite Taskforce: Early in February imagery indicated that a total of 79,229 Hectares were inun‐ 2019, the Cluster established dated as of 10 November 2019, including 29,748 hectares of an Emergency Taskforce to agricultural land and 48,481 hectares of natural vegeta on. serve as regional steward for standards health emergency Besides WHO that trained eight (8) emergency response preparedness planning. The teams in Bardhere, no partner there were no reports of re‐ mee ngs agreed to reac vate sponse of partners responding to the floods in the area. The the taskforce to improve coor‐ government stressed the need for immediate support to vulnerable people in the most affected villages, including dina on. The taskforce com‐ Yontoy singerler and Bulagadud. prised WRRS, ARDI, WHO, OCHA, SRCS, MOH, ARC, Governor’s Office, representa‐ Reported reduc on in the number of new AWD/Cholera ve from Kismayu General Hospital, and WASH Cluster cases in Lower Juba since September 2019. No cholera‐ chair. related deaths had been reported across the region during Emergency casualty training: The mee ng resolved to the period. Somali Aid informed the mee ng that 28 cases improve the capacity of the health workers and prac ‐ of AWD were admi ed at Muslim Aid Health facility from oners by providing capacity building and training of incep on of rainfall and number of AWD cases since re‐ emergency casual es. The training beneficiaries will duced to 9. More stool samples were collected for transpor‐ cons tute CHWs and the emergency taskforce team ta on to Dhobley for cholera diagnosis. facilitated by WHO. All partners were encouraged to CRISIS WATCH
Access to Health in Quandala District Radio Ergo: Health Concerns
On 25 November, local authori es in parts of Quandala During the first week of November, the main talking
District, Bari Region of Puntland State reported that an points on Ragio Ergo, (a channel broadcas ng humanitar‐
es mated 2,000 residents from at least eight villages in ian news from Somalia) focused on the impact of flooding
Qandala district (including Moqor, Golcadaadeed, Gurur, on people's wellbeing. The key health concerns included
Hoobato, Harawo, Canjeel, Camayro and Jecayl) could not mosquitoes,” extreme coldness, lack of medical supplies in
access basic services due to the blockage of the main health facili es, diarrhea. Other callers also spoke about
road by the Islamic State of Somalia (IS). contaminated flood waters posing huge health hazards.
There” are mosquitoes here and we cannot afford nets. Access to health, and food were par cularly cri cal,
We need help...” with no health faciliƟes opera ng in seven out of the Female from Dhusamareb, Galgadud region. eight affected villages in the district.
The area has been security‐challenged and hard‐to‐ There are cases of diarrhoea in the area and the people
reach without effec ve humanitarian coverage. have been transferred to Adado. We need to get facili es
The most recent aggrava on of the humanitarian sit‐ ” in the hospitals here so that the people get health care
ua on occurred when a short‐term and large‐scale without spending money and me to get treatment...”
security opera on against IS in the Moqor and Gol‐ Caller from Do'oley Galgadud.
cadaadeed mountainous area (50‐78 km south‐east ” We have got rainfall, the people are recovering. There are of Bossaso) launched on 24 November. mosquitoes and cold at night, we need shelters and help” The local authori es in the area have since appealed Caller from Galgadud. for assistance through the OCHA Field Coordina on Unit in Puntland State. I would like to talk about cold and diseases that have affected children…” Female from Afmadow, Lower Juba. 6 Health Cluster Bulle n, November 2019
People reached with life-saving health services, November 2019
Monthly repor ng analysis indicates that at least 293,146 people were reached with health care services in November 2019. The number includes services delivered with both HRP and non‐HRP or other funding sources and modali es.
Funding progress (US$ ’000’000) with relation to key Clusters (FTS, h ps:// s.unocha.org/appeals/667/summary )
Health received additional funding of $800,000 on top of $20,436,329 over the last reporting period. Out of $93,203,762 appealed in the HRP 2019, the this leaves the total unmet requirements at $71,167,433 approximately (77.2%) in unmet funding.
Required (US$ ’000’000)
Funded (US$ ’000’000)
Cluster Coordination Contacts
Craig Stuart Hampton, Cluster Coordinator, Matilda Kirui, Cluster Coordination Support Officer, [email protected], +252612488306 [email protected], +254721665362
Farhan Bashir Hassan, Cluster Co-Coordinator, Richard Baker Sennoga, Information Management [email protected], +252618648 666 Officer, [email protected], +252614381315