Health and MHPSS Report The Finale: Typhoon Pablo Six Months Later June 1, 2013 He alt h an d M H PS S Finale Report Highlights: May 31, 2013 PHO ComVal holds Exit Conference and recognizes partners assistance Partners present accomplishments, challenges and lessons learned ACF and Handicap International to come in with recovery and rehabilitation assistance I. Background: Typhoon Pablo (International name Bopha) entered the Philippine Area of Responsibility (PAR) on December 2, 2012. It made its landfall in the vicinity of Baganga, Davao Oriental around 4:00 am on December 4 with maximum sustained winds of 175 kph near the center and gustiness of up to 210 kph. Striking also the majority of Compostela Valley Province, Typhoon Pablo is now known to be one of the biggest disasters to hit the Philippines. Moreover, Typhoon Pablo will not be easily forgotten by being one of the first typhoons to hit Compostela Province affecting almost of its 11 municipalities and 249 out of its 267 barangays. These areas severely suffered as these aren’t used to these types of disaster. II. Humanitarian Needs: The coping with, for the survivors, seemed to be impossible. Destroying vast lands of Table 1: Summary of Statistic Typhoon Pablo Immediate Impact to residences and livelihoods, the typhoon left the Health as of April 30, 2013 survivors with nothing to move forward with. No of Deaths 632 Houses, trees, and even the rocks that were thought No of Injured 856 to be immoveable, were blown away and flushed by Missing 243 the strong winds and rushing waters brought by the heavy rain. Lifelines were interrupted; roads and No of Totally Damage Health 08 BHS Facilities bridges were severely damaged. Health facilities were among the structures that were damaged No of Partially Damage Health 93 BHS Facilities which resulted to disruption of health services. 4 RHUs Starting off in December 5, 2012 immediately after Typhoon Pablo made landfall, the Provincial Government of Compostela, stood with their commitment to respond and address the needs of the affected residents seeking for help and temporary refuge. Search and rescue for the survivors, providing immediate and life saving care, distribution of food and water and retrieval of dead bodies were the initial response of the government. Due to the vast destruction brought by Typhoon Pablo, a State of National Calamity was declared in the provinces of Compostella Valley, Davao Oriental and Davao del Norte in Region XI, Surigao del Sur in CARAGA, Lanao del Norte, Misamis Oriental and Cagayan de Oro in Region X, Siquijor in Region VII and Palawan in Region IV-B. The declaration of State of Calamity opens the way for international organizations and UN agencies to come in and provide assistance. Many humanitarian sectors entered the chaotic scene of Compostela, bringing help and assistance. Medical team and rescue team from the government, non-government organizations, private sectors, civic organizations, and volunteers flocked working with one goal that is to save lives. For the first two months after Typhoon Pablo made landfall, health services were complementary delivered by the itinerant teams as the local health staff were dealing with a lot of concerns including restoring what they have lost personally and with their health facilities. III. The Response: a. Coordination As the situation evolved the Local Government with the help of the UN and non-government organizations facilitated the delivery of humanitarian assistance. Each organization committed to support the Cluster Approach as a response strategy to coordinate and maximize the use of resources. The Provincial Health Office of Compostela Valley Province, as the lead agency for the four clusters (HEALTH, MHPSS, Nutrition and WASH), started to call for cluster meetings supported by its co-lead from the UN agencies. Non-government and the private sector also extended their support to the Cluster Approach. The meeting became the venue for all humanitarian assistance to discuss issues and concerns, identify needs and gaps, and complement each and everyone’s capacity to ensure resources addressed the greatest needs of the community. Cluster meetings were initially held once a week and later became once in every two weeks. As there was a need to Name of # of Brgys No of No of Brgys No Of Brgy extend assistance to the areas not Municipality Mobile with at least 2 with No being reached during the early part Teams Visits Visit of the response, the mapping of Deployed mobile teams for the month of Compostela 16 21 11 1 February noted that only about 60% Montevista 20 18 06 4 of the areas were visited twice a Monkayo 21 46 16 0 month by either the mobile medical New Bataan 16 39 09 2 team or by the local health staff. Laak 55 12 14 1 Transportation services then through Table 2: Medical Team Coverage the assistance from the provincial December 4, 2012 - February 28, 2013 government and cluster members were used to support the delivery of health services to remote barangays of the Province. Also, certain humanitarian needs were given attention to five priority municipalities as recommended by the provincial government. Compostela, Montevista, Monkayo, New Bataan and Laak, severely affected and hardest hit by Typhoon Pablo, were considered as the priority municipalities for the response. b. Information Management Information management as the vital step for the basis in decision making was revitalized through the collaborative effort of all agencies involved in the response. Conforming to the partner’s weekly submission of 3Ws, the commitment and support extended by all local health staff in the Weekly Data Board Monitoring as well as regular attendance of partners to the Cluster Meeting were successfully completed. The mapping of mobile team deployments and reporting of the status of damaged health facilities and services led by WHO with support from the local health staff and UNOCHA became the baseline information of the cluster to identify next priority areas. It was then when health services and deployment of teams were considered to the GIDA and in areas not visited by the mobile teams. From 60% of areas visited by the mobile team during the first two months it later increased to 80% areas covered. c. Delivery of Basic Health Services Delivery of health services in the 31 evacuation centers in Compostela was through the mobilization of the medical teams from the Department of Health, LGUs and non-government organizations; establishment of emergency health stations; and establishment of temporary health stations in the barangay halls for areas with severely damage health facilities. Health services were affected in terms of regularity, frequency, and quality brought by inaccessibility to the area, damage roads and bridges, and damage to health facilities. Medical Outreach by the Compostela Provincial Health Office, PEEMO, and MHOs were given schedules and later on, were supported by the other DOH Regional Health Offices, PHOs, PRC, IOM, and WHO. These medical outreach programs reached barangays previously not visited due to non passable road conditions and sometimes due to security and safety reasons. Mental Health and Psychosocial Support was given equal importance. The Department of Health with the support from IOM provided Mental Health and Psychosocial Support services to the health workers. CFSI, PRC, Plan International provided Psychosocial Support activities both in evacuation centers and in the community. ACF focused their support to pregnant and lactating women and children under-5 years old. Reproductive health services in emergencies were set in motion by the UNFPA together with the PHO and local health staff. A total of 2,674 Pregnant and lactating mothers availed of RH Medical Missions covering 97% of their target population. UNFPA however admitted that they have to work hard to increase coverage of the info session related to Gender-Based Violence. Currently only 16% of their target population were being covered. By the end of February 2013, as reporting system have slowly re-established, the gaps that need to be covered already significantly Fig 1. Tot al Number of Consult at ions By Municipalit y and Facilit y February 18-April 30, 2013 decreased. Medical services and consultations were 90000 being regularly provided by the local health staff. 80000 70000 From Feb 18-April 30, 2013, 4% of the total 60000 50000 population of the four municipalities with almost 40000 30000 complete data submitted per week was given 20000 10000 medical care at the RHU and BHS (Figure 1). PRC 0 Compostel a M ontevi sta New Bataan Laak also reported to have provided consultation to a total BHS RHU P opul ati on 9,754 patients and provided transport and referral to 21 patients mostly from the evacuation centers of Compostela, New Bataan and mobile consultation from the municipalities of Montevista, and Monkayo. IOM also reported a total of2, 885 consultations, and assisted referral of 26 patients of their consultation in the established transitional health facilities. Government hospitals in Compostela Valley became the immediate referral facilities of cases from the RHUs and evacuation centers before it is referred to the next higher level of care. Humanitarian needs however remain. Figure 2. Basic Services Regularly Rendered Per M unicipality Perhaps, it should remain important as much as it Feb 16-April 30, 2013 was in the first days even after all the operations. Laak By giving solution to the non-passable roads of New Bat aan Compostela, additional coverage of assistance Mont evist a were noted, consultations became more regular at Compost ela the main health facility and barangay health 0 1000 2000 3000 stations. Medical Team from PHO and NGO Vit A AMV OPV Pre Nat al Post Nat al Deliveries complemented delivery of services to the areas making at least 90-95% of the areas covered from 60% initial coverage during the early response phase.