Health Action in Crises (WHO/HAC) Highlights - No 34: Monday, 8 November 2004 The WHO/HQ Department for Health Action in Crises aims to produce a running note on select current issues at weekly intervals. This note—which is by no means exhaustive— is designed for internal use and does not reflect the official position of WHO. SUDAN - Darfur Crisis - Assessments and events: • Throughout the Darfur, clinically diagnosed malaria still accounts for most mortality and morbidity reported through the WHO-instigated Early Warning and Response Network (EWARN). • In North Darfur, preparations have begun for the 21 November polio campaign. Service provision agreements have been established between WHO, UNICEF, and NGOs for certain Sudan Liberation Army (SLA) areas. • A gap analysis in West Darfur has highlighted a chronic shortage of health staff and facilities. ¾ Only four out of six hospitals are providing services. ¾ There is one surgeon and no paediatricians, obstetricians, gynaecologists, ophthalmologists, orthopaedic surgeons, or dentists. ¾ There is no transport (e.g., ambulances) in the health sector. • It is with great sadness that we report the death of Ministry of Health Surgeon Dr Ihab on 5 November during a hold-up on the Nyala-Kass Road, South Darfur. Actions: • In West Darfur, WHO rehabilitated the laboratory, blood bank, gynaecology, female surgical and medical wards of El Geneina State Hospital, as well as contributed a generator, electrical goods and furniture. WHO also provided inputs to six rural hospitals that—in total—serve an estimated population of 336,240. • In West Darfur, WHO donated 10,000 Rapid Diagnostic Tests (to assist in the diagnosis of malaria) and 11 Basic Emergency Kits (each meeting the needs of a population of 1,000 for a period of three months) to NGOs. • In South Darfur, WHO supported the Federal MoH and State MoH in conducting Standard Case Management training for 21 doctors at primary health care facilities. • Training of Trainers (ToT) courses were conducted for nine doctors on "child health activities in emergencies" in South Darfur. ToT courses were also carried out for 11 NGO participants on key family practices to address health problems in children aged under five. • Funding for WHO humanitarian operations in Darfur has been provided by African Development Bank (AfDB), UK's Department for International Development (DfID), the Humanitarian Aid Office of the European Commission (ECHO), and the governments of Netherlands, Italy, Ireland, Norway and United States. COTE D'IVOIRE Assessments and events: • As a result of recent escalated violence in Cote d'Ivoire, all UN agencies have closed their offices as of today, 8 November. Staff movement is restricted. • ICRC reported that approximately 250 persons with gun wounds were admitted to hospitals in Abidjan in the past days. Actions: • WHO is: ¾ closely monitoring the current situation, examining implications for health and preparing itself to respond to requests for assistance; ¾ participating with UN system in the review of the contingency plan for the country and in the definition of a common UN action plan; ¾ supporting the enhancement of the early warning system for the surveillance of epidemic diseases, notably poliomyelitis; ¾ seeking funds for activities in Cote d'Ivoire, and encourages a renewed focus by donors on addressing the humanitarian situation there. Health Action in Crises 1 WHO is working with partners to address the health aspects of crises in more than 40 countries. Check the Health Action in Crises Web site for more details: http://www.who.int/disasters/ WEST BANK AND Assessments and events: • On 2 November, the UN Relief and Works Agency for Palestine Refugees in the GAZA STRIP Near East (UNRWA) Commissioner-General presented a statement to the UN Special Political and Decolonization Committee (Fourth Committee) that highlighted the challenges that UNRWA faces in the West Bank and Gaza Strip as a result of violence, curfews disclosures, and financial constraints. Actions: • WHO and the MoH carried out a Food Safety workshop from 29 October to 3 November in Ramallah. Twenty-three inspectors from the MoH and Ministry of Agriculture were trained on Hazard Analysis and Critical Control Point (HACCP) as part of a series of activities planned within the Food Safety project. Participants became familiar with modern risk management tools such as the Good Hygienic Practices (GHP) and Hazard Analysis Critical Control Point (HACCP) concepts, in line with internationally recognized standards (Codex Alimentarius). A similar training will be conducted for Gaza food inspectors in conjunction with the University of Crete (WHO Collaborating Centre). • WHO visited primary health care services in Khan Younis and Rafah districts (Gaza Strip) as part of the health baseline data collection at district level. Healthinforum and MoH are involved in this joint initiative in an effort to improve the health information system. • WHO met with representatives of the Government of Norway in order to develop a synergy between WHO’s nutrition project (aiming to strengthen the nutrition management of the MoH Nutrition Department) and the Norwegian nutrition project implemented through the MoH. • Current WHO humanitarian actions in the West Bank and Gaza Strip have been made possible by 2004 funding from USAID, AGFUND, and the Government of Norway, as well as pre-2004 funding from ECHO. IRAQ Assessments and events: • WHO is monitoring the humanitarian situation in Iraq. The spraying campaigns against Malaria and Leishmaniasis have been completed throughout Iraq, while fogging and rodent control activities are ongoing. Preventive and control activities in relation to cholera in Basra are ongoing and include the distribution of chlorine tablets and health education materials. Actions: • WHO is providing logistic and technical support to the MoH for a countrywide assessment of all Primary Health Care (PHC) centres – using assessment tools developed in partnership between WHO and MoH. • WHO supported the 1-4 November training workshop on “Results Based Management – Logical Approach to Managing Programmes”. The workshop focussed on the logical approach of implementing health programmes in Iraq and Web site on WHO activities in Iraq: was attended by 23 representatives from MoH and 14 from WHO. http://www.emro.who.int/iraq/ • WHO procured a shipment of I.V. canulas for emergency needs. The shipment arrived in Baghdad on 7 November. • WHO supported the MoH debriefing on the findings of the Independent Acute Flaccid Paralysis (AFP) Review Mission for Iraq. The meeting was attended by the senior officials from the Iraqi and Jordanian Ministries of Health and WHO, as well as focal points from Iraqi directorates of health including Erbil, Dohuk and Suleimaniyah. WHO facilitated this meeting through funding from the European Commission. • Three WHO Regional Advisors facilitated a MoH/WHO/UNICEF Expanded Programme of Immunisation Workshop from 31 October to 4 November. Thirty- two participants attended the meeting, representing MoH staff, experts from medical universities and independent national consultants. The support to this workshop was made possible through funding from the European Commission. • WHO is facilitating the participation of one MoH delegate at the meeting "International Regulations for Health", which is taking place in Geneva from 1 to 12 November. Health Action in Crises 2 WHO is working with partners to address the health aspects of crises in more than 40 countries. Check the Health Action in Crises Web site for more details: http://www.who.int/disasters/ UGANDA Assessments and events: • According to an October 2004 study by Médecins Sans Frontières, death rates in camps for the 1.6 million people displaced by conflict in northern Uganda are far above the threshold used to classify an emergency (one death per 10,000 persons per day). The MSF study—conducted in six IDP camps in the Lira and Pader districts—found a crude mortality rate of 2.8 deaths per 10,000 people per day for the general population, with rates for children far higher. (More information: www.msf.org) • As of 3 November, there were 56 cases of cholera with three deaths in Pabbo IDP camp since the index case appeared in early October. Actions: • WHO is currently finalizing all of administrative and security procedures for the establishment of a sub-office in Gulu, which will be used as a base for emergency interventions. The WHO Gulu team will: ¾ Build capacity and improve coordination for humanitarian health assistance; ¾ Monitor disease burdens and provide early warning of epidemics through improvements to the surveillance system; ¾ Coordinate the control of communicable diseases in the camps; ¾ Support IDP communities' engagement in environmental health, health education, and HIV/AIDS awareness activities. • In response to the cholera outbreak in Gulu camp, WHO is providing technical guidelines to health stakeholders. It is also supporting the Divisional Director of Health Services (DDHS) and other health partners in establishing treatment facilities, conducting laboratory diagnosis, and coordinating social mobilization. • WHO is in urgent need of funds to upscale operations in Northern Uganda. For more information on assessed health needs and planned WHO activities, see http://www.who.int/disasters/repo/14747.pdf. For additional information, including proposals, contact: [email protected]. INTER-AGENCY INITIATIVES ¾ Côte d'Ivoire. o WHO will participate in an inter-agency meeting