Health and Nutrition cluster meeting minutes
Venue: PHD Hall Date: 21.11.2017 Time: 10:30 Chaired by: Dr. Ibrahim Tofiq Baban/ DOH Focal Point for Humanitarian Programs Co-chair: Dr. Najmaddin Ahmed/ Public Health Officer/ WHO Iraq- Sulaimaniyah Hub Minutes: Dr. Saya Mustafa, Polio eradication Officer, WHO Iraq- Sulaimaniyah Hub
Attendees: # Name Agency Email address 1 Dr. Rizgar Ali PHD-DOH [email protected] 2 Dr. Ibrahim Tofiq PHD-DOH [email protected] 3 Othman Rasul PHD-DOH [email protected] 4 Dr. Awaz Kamal Maulud PHD-DOH [email protected] 5 Ibrahim Ahmed PHD-DOH [email protected] 6 Kamil Ahmad Hama DOH Raparin [email protected] 7 Soran Abdulla DOH Garmiyan [email protected] 8 Dr. Najmaddin H. Ahmad WHO [email protected] 9 Dr. Saya Mustafa WHO [email protected] 10 Karzan Rafiq UNICEF [email protected] 11 Lavin Dhyaalddin PWJ [email protected] 12 Dr. Hersh Raof KSC [email protected] 13 Safia Wasfi Archenova [email protected] 14 Kamaran Ali UNHCR [email protected] 15 Antonio Nicolini EMERGENCY [email protected] 16 Benvegn Alessandro EMERGENCY [email protected] 17 Dr. Ayman Ibrahim IOM [email protected] 18 Ahmad Mirani DAMA [email protected] 19 Hozan Khalil DAMA [email protected] 20 Chiman Salih Saeid JCCC [email protected] 21 Norbert Luenenborg MSF [email protected] 22 Dr. Moaaz Sidawy QRC [email protected] 23 Dia MdM [email protected]
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Health and Nutrition cluster meeting minutes
Meeting agenda of November 21st, 2017: 1- Introduction of partners, Endorsement of previous meeting minutes and action points. 2- Update of Primary health care services and Communicable diseases. 3- Impact of 12th November earthquake and health responses. 4- Update on health response to IDPs from Kirkuk and Duzkhurmatu. 5- Gaps and Challenges. 6- AOB.
1. Introduction of partners, Endorsement of previous meeting minutes and action points. After introduction of attendants, the minutes of the last Cluster meeting and endorsed.
Action points from last meeting were reviewed as follows: Previous meeting’s action points status EPI manager to communicate with DOH Garmian and UNICEF Pending (DOH Garmian is ready to provide for providing vaccination to newly displaced people from teams if incentives are to be given) Duzkhormato in Garmin area.
DOH to follow up availability of ambulance and donated Done and the generator received. generator by UNFPA in Barzinjah.
DOH to coordinate with war zone team leader, UNFPA and Pending women union to assign volunteers and candidates for RH services. WHO to follow up proposal proceeding submitted by Done; proposals approved for Arbat, Ashty EMERGENCY organization to run Arbat IDPs camp. and Tazade IDPs camps.
Checking availability of supplementary food with food cluster Done; waiting for food cluster response. for children among newly received IDPs instead of powder milk.
DOH to request anti-TB drug from MOH Baghdad. Pending
Check possibility of putting war zone team in Barzinjah PHCC Pending instead of Barzinjah camp to serve larger population in the area.
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Health and Nutrition cluster meeting minutes
2. Update of Primary health care services and Communicable diseases: PHD manager updated the cluster members about: a. Formula milk distribution in camps: i. Reports from Barzinjah and Surdash camps indicated that some NGOs distributed formula milk for under 5 years’ children which is against DOH and UNICEF policy for breastfeeding encouragement. ii. Accordingly PHD health promotion team with support of UNICEF will conduct three days health education and promotion campaign for encouraging breast feeding in Barzinjah and Surdash IDPs camps. b. DOH’s emergency medical team (war zone team) in Barzinjah and Surdash camps: i. A 24 hour Emergency team with an ambulance has been fixed in Barzinja and Surdash camp to work 24 hours per day and to transport referred patients at critical times. ii. Although due to the effect of the earthquake in Darbandikhan, the team of Barzinja was withdrawn for one week and from the upcoming Friday the team will resume it is duty. c. School health activities in refugee’s and IDPs’ camps: i. As of 5th November 2017, Directorate of Preventive Health- DOH Sulaimaniyah has started pre-school entry student health screening with support of PWJ. Approximately 1200 first grade students will be screened for visual acuity, hearing problems, skin diseases especially infectious disease and dental care/screening to be managed accordingly. ii. KSC representative highlighted that they can pay for children’s operations that is beyond their family’s capability. d. Cholera updates: WHO highlighted increased number of reported confirmed Cholera cases in 9 provinces in Iraq totaling 294 cases by week 45, majority from Baghdad-Alresafa. Week 45 showed the highest incidence with 76 confirmed Cholera cases.
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Health and Nutrition cluster meeting minutes
3. Impact of 12th November earthquake and health responses:
The World Health Organization (WHO) updated the attendees that the 12th November earthquake with a magnitude of 7.2 Richter scale lead to casualties and damages in health facilities in Darbandikhan, Halabja and Sharazur.
WHO responded by providing trauma kits A & B and surgical kit to emergency hospital in Sulaymaniyah and delivering 4 tents (4x5 m), two of them allocated for Darbandikhan to be used for providing health services.
UNFPA provided medication for RH services to Darbandikhan, Halabja, and Sulaymaniyah maternity hospital, including deployment of a RH mobile clinic to Darbandikhan PHC for gynecological and natural births, as well as medication and kits for the maternity hospitals/ units. Mobile RH unit was given first to DOH Garmian for serving Duzkhormato IDPs but relocated later to Darbandikhan aftermath the damage caused by the earthquake to the district hospital there.
In Darbandikhan:
- Shahid Tawfiq hospital is damaged and evacuated (non-functioning) and Shahid Hameed PHCC is damaged and nonfunctioning too. Medical staffs from both damaged health facilities were relocated to Shahid Azadi-mama-alla PHCC in Darbandikhan which is utilized as first forum to receive inpatients in tents to be resuscitated transferred to secondary health facilities in Sulaimaniyah if necessary. A mobile hospital of the war zone medical team is there utilizing its portable x-ray machine. Utilizing WHO donated MMC, World Vision International provides primary health care services in same area.
- IMC in coordination with DoH Darbandikhan is providing health service six days in a week from 08:00am to 03:00pm. For that purpose, a tent installed in Shahid Hameed PHC with capacity of 1 medical doctor, 2 nurses and 1 pharmacist, providing general medical consultations to all age groups including communicable and non-communicable diseases, triage services including wound and injuries management, treatment and follow up with chronic diseases, facilitation of emergency and cold cases referrals, provision of essential drugs, and medical supplies. There is plan is to include mental health and psychosocial support and community health services (after competing relative assessments) and willing to assess the needs in Bani Khelan area as per Darbandikhan health authority’s request.
- Five ambulances are available in Darbandikhan health facilities, KRG promised to provide 2 extra ambulances in addition to WHO contribution of two more ambulances which are in the pipeline expected to arrvive by end December 2017 as there are too many referrals to Sulaymaniyah due to non-functioning hospital and lack of surgical operation services.
- The UNFPA’s RH mobile clinic is relocated from Garmiyan to Darbandikhan. DOH can also provide RH service if a space is allocated for such purpose.
In Halabja:
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Health and Nutrition cluster meeting minutes
- The maternity and pediatrics hospital is partially damaged and emergency hospital is also affected, DG of health of Halabja shared the BoQs for renovation of affected health facilities. PWJ is planning to renovate the maternity and pediatrics hospital.
In Sharzur (New Halabjah):
- The hospital is damaged and limited services are provided at the facility. IOM is providing basic health services through mobile medical team in Warmawa sub-district 3 days/week.
Maternity hospital of Sulaimaniyah:
The chairman requested DOH support to fix the damages made by the earthquake when the operation theater and neonatal department in the Maternity hospital were partially damaged which might affect sterilization and disinfection in the mentioned places.
4. Update on health response to IDPs from Kirkuk and Duzkhurmatu:
a. Surdash IDPs camp: WHO paid a monitoring visit to Surdash camp PHCC where lack of ECG machine is noticed and medication was insufficient with understaffing. Few days following the visit; ECG machine and medication provided in the PHC by QRC. The vaccination unit in mentioned camp is provided with an ice-liner by PHD-DOH for vaccine storage. Reproductive health (RH) service is available 3 days/week with UNFPA’s support. DOH emergency team is available to refer patients to Dukan, Piramagrun or Sulaimaniyah. Since opening of the PHC; one case of Ischemic Heart Disease (IHD) and 2 gynecological cases were referred. KSC visited the camp twice providing basic health service concerning children with total consultation of 30-40 patients per both visits, most of them suffered from upper respiratory tract infection (URTI). KSC can provide a mobile medical team based on need.
b. Zenana PHCC: since 15th November; DAMA in coordination with DOH is running the Zenana PHCC in Garmian providing primary health care services for Duzkhurmatu IDPs, but immunization service is still lacking.
c. Relocation of IDPs: MSF was asking about possibility to relocate IDPs from Duzkhormato in Garmian villages to camps for better service provision. For that reason, Garmian authorities conducted a meeting with IDPs to discuss about relocating them to camp, but IDPs there are not willing so and the camp which was planned to be established by MoDM in Garmian for these IDPs is not expected to be installed. Recently about 148 families were relocated to Tazade camp.
d. RH medication: UNFPA provided medication for RH services in Surdash camp.
e. Warany PHCC in Garmian: IMC has agreed with DOH Garmian to support Warany PHC serving Duzkhurmatu IDPs after official opening of the PHC by DOH and assigning medical staff with capacity of 2 doctors, 1 pharmacist and 4 nurses to provide services 6 days a week from 08:00am-
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Health and Nutrition cluster meeting minutes
03:00pm, caravan was installed by DoH, opening and service provision to be finalized before December. There is plan is to provide immunization in coordination with DOH within Warany PHC,
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5. Gaps and challenges: - IMC in Darbandikhan is facing the following challenges: o Lack of working ambulance in Shahid hameed PHC to transfer emergency cases. o Limited available space since IMC is providing service in a tent that was installed by IMC team. o Need to develop referrals pathway in coordination with nearest health facilities to ensure proper use of emergency and secondary health services. o Lack of labour unit in Darbandikhan area, that’s why all deliveries need to be referred to Sulaimaniyah (1 hour drive).
- In response to the recent earthquake; some NGOs and organizations started distributing tents for families without coordination with Shelter/NFI cluster and distribution of tents is not parallel with shelter strategy.
- The wheel chair which is requested by UNHCR for a refugee patient was not possible to be provided by DOH. IOM will provide one to help in this regard.
- Ultrasound service in Arbat camps for RH issues is still pending.
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6. AOB: - JCCC representative highlighted that KRG and USA promised to provide medicine in response to the recent earthquake. - JCCC mentioned that Kwait government sent medication twice; one week ago and one month ago brought from Erbil to Sulaymaniyah Health Directorate.
- On behalf of UNFPA; WHO invited participants for the opening ceremony of 16 days of activism against GBV which is planned to be held in 25th November at Hawari Shar Park at 10:00 – 11:30 am.
- EMERGENCY organization is conducting a health promotion campaign on vaccination targeting under 5 year children in Arbat and Ashti IDPs camps which has led to increased response for routine vaccination, for which reason EMERGENCY organization asked support from EPI manager to add a vaccinator to Ashti vaccination unit to help the vaccination team to catch the overcrowding.
- IOM is doing an assessment in PHCC of Barzinjah sub-district aiming to look at the possibility to support mentioned camp, but IDPs receiving health service by WVI are to be considered and duplication to be avoided.
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Health and Nutrition cluster meeting minutes
Action points:
# Action point Who When
DOH to provide Surdash camp manager with Mr. Ibrahim Ahmed/ 1. ASAP an official letter to prevent distribution of Head of Health bottle milk for children in the camp. Promotion - PHD DOH
DOH to liaise with war zone medical team to 2. Dr. Ibrahim Tofiq/ PHD- ASAP provide an ambulance to Shahid Hameed DOH PHCC in Darbandikhan. DoH to follow up possibility of identifying a 3. small room for RH service in new location in ? Next week Darbandikhan.
4. DOH to coordinate with DAMA to provide EPI manager/PHD-DOH ASAP vaccination service in Zenana PHCC.
Arrange a meeting with IOM, WVI, DOH and 5. WHO to clarify health service providing in DOH - WHO Next week Barzinjah in favor of avoiding duplication of services.
DOH to check damages resulted by the 6. Dr. Ibrahim Tofiq/PHD- earthquake in Shahid Amjad Haji Ghali PHCC in November DOH Sirwan sub-district.
Note: Next Health Cluster Meeting is scheduled for December 5th 2017.
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