1 Health Response to Floods & Landslides Nepal 2007 World Health Organization Emergency &...
Transcript of 1 Health Response to Floods & Landslides Nepal 2007 World Health Organization Emergency &...
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Health Response to Health Response to Floods & Landslides Nepal Floods & Landslides Nepal
20072007
World Health Organization World Health Organization Emergency & Humanitarian ActionEmergency & Humanitarian Action
27 July – 23 August 200727 July – 23 August 2007
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Flood Preparedness Flood Preparedness Floods and landslides are annually recurring Floods and landslides are annually recurring
challenges in Nepal challenges in Nepal Flood preparedness takes place at various levels Flood preparedness takes place at various levels
every pre-monsoon seasonevery pre-monsoon season Frequent Emergency Health and Nutrition Working Frequent Emergency Health and Nutrition Working
Group coordination meetings – resource mapping Group coordination meetings – resource mapping and ‘who does what where’ exercise completed and ‘who does what where’ exercise completed
Rapid health assessment forms printed and agreed Rapid health assessment forms printed and agreed upon with EDCD and partners in healthupon with EDCD and partners in health
One outcome of the SIDA-funded CAP ‘Health Action One outcome of the SIDA-funded CAP ‘Health Action in Crisis’ was a logistic supply chain (2 containers) in Crisis’ was a logistic supply chain (2 containers) and pre-positioned medicine (New Emergency and pre-positioned medicine (New Emergency Health Kits and Dirreahoal Kits)Health Kits and Dirreahoal Kits)
EDCD on high alert due to cholera response from 20 EDCD on high alert due to cholera response from 20 May to 10 JulyMay to 10 July
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Flood & Landslide Profile Flood & Landslide Profile Localised flooding and severe landslides from 10 JulyLocalised flooding and severe landslides from 10 July Widespread flooding from 27 July onwardsWidespread flooding from 27 July onwards Flood data:Flood data:
Scale of emergency not catastrophic by national standardsScale of emergency not catastrophic by national standards High level of public awareness due to international media High level of public awareness due to international media
coverage and regional flooding in India and Bangladeshcoverage and regional flooding in India and Bangladesh Pressure from humanitarian agencies to engage / intervenePressure from humanitarian agencies to engage / intervene Response capacity assessed to be available in countryResponse capacity assessed to be available in country
NRCS 23 AugNRCS 23 Aug MOHA 10 SepMOHA 10 Sep
DeathsDeaths 148148 185185
InjuredInjured 9494 ??
Displaced familiesDisplaced families 24,11624,116 16,27316,273
Affected familiesAffected families 79,20079,200 69,39869,398
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Mortality and InjuriesMortality and Injuries
0
50
100
150
200
250
300
350
400
450
2058 2059 2060 2061 2062 2063 2064
Injured
Deaths
Mortality and injuries caused by floods and landslides year 2001-2007
Source: MOHA data with 2007-data from NRCS superimposed
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Displaced Families Displaced Families
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
2002 2003 2004 2005 2006 2007
Displacement as key public health indicator – usually not recorded by MOHA
Number of displaced families caused by floods and landslides year 2002-2007
Source: Last NRCS sitrep each year
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DOLPA
MUGU
JUMLA
KAILALI
BARDIYA
HUMLA
DOTI
SURKHET
NAWALPARASIKAPILBASTU
RUPAN-DEHI
DANG
BANKE
ACHHAMKALIKOT
JHAPAMORANG
SIRAHA
SAPTARI
DARCHULA
BAJHANG
BAITADI
DADEL-DHURA
KANCHAN-PUR
BAJURA
PARSA
BARA
RAUT-AHAT
DHANUSA
MAHO-TTARI
SUNSARI
SARLAHI
DHADING
MAKAWAN-PUR
CHITWAN
KASKIBAGLUNG
TANAHU
PALPA
SYANGJAPARBAT
ARGHAK-HACHI
GULMI
UDAYAPUR
SINDHULI
ILAM
BHOJ-PUR
PACH
ETHA
R
DHAN-KUTA
TAPLEJUNG
RAMEC
HHAP
OKHAL-DHUNGA
TERHA-THUM
KHOTANG
LALIT
BHAK
KATHM
SULUKHUMBU
DOLAKHASANKHUWASABHA
NUWAKOTSINDHU-PALCHOK
KAVRE
RASUWA
LAMJUNG
GORKHA
PYUTHAN
ROLPASALYAN
MYAGDI
DAILEKHJAJARKOT
RUKUM
MUSTANG
MANANG
KATHMANDU
LALIT
BHAK
India
China
No. of displaced families (NRCS)
1 - 100
100 - 999
1000 -
Flood & landslide affected district: 28 districts
Public health monitoring based on NRCS, Epidemiology and Disease Control Division, WHO and media reports, 31.07.07
Evolution of Floods Week 1 Evolution of Floods Week 1
77
DOLPA
MUGU
JUMLA
KAILALI
BARDIYA
HUMLA
DOTI
SURKHET
NAWALPARASIKAPILBASTU
RUPAN-DEHI
DANG
BANKE
ACHHAMKALIKOT
JHAPAMORANG
SIRAHA
SAPTARI
DARCHULA
BAJHANG
BAITADI
DADEL-DHURA
KANCHAN-PUR
BAJURA
PARSA
BARA
RAUT-AHAT
DHANUSA
MAHO-TTARI
SUNSARI
SARLAHI
DHADING
MAKAWAN-PUR
CHITWAN
KASKIBAGLUNG
TANAHU
PALPA
SYANGJAPARBAT
ARGHAK-HACHI
GULMI
UDAYAPUR
SINDHULI
ILAM
BHOJ-PUR
PACH
ETHA
R
DHAN-KUTA
TAPLEJUNG
RAMEC
HHAP
OKHAL-DHUNGA
TERHA-THUM
KHOTANG
LALIT
BHAK
KATHM
SULUKHUMBU
DOLAKHASANKHUWASABHA
NUWAKOTSINDHU-PALCHOK
KAVRE
RASUWA
LAMJUNG
GORKHA
PYUTHAN
ROLPASALYAN
MYAGDI
DAILEKHJAJARKOT
RUKUM
MUSTANG
MANANG
KATHMANDU
LALIT
BHAK
India
China
No. of displaced families (NRCS)
1 - 100
100 - 999
1000 -
Flood & landslide affected district: 33 districts
Public health monitoring based on NRCS, Epidemiology and Disease Control Division, WHO and media reports, 05.08.07
Evolution of Floods Week 2 Evolution of Floods Week 2
88
DOLPA
MUGU
JUMLA
KAILALI
BARDIYA
HUMLA
DOTI
SURKHET
NAWALPARASIKAPILBASTU
RUPAN-DEHI
DANG
BANKE
ACHHAMKALIKOT
JHAPAMORANG
SIRAHA
SAPTARI
DARCHULA
BAJHANG
BAITADI
DADEL-DHURA
KANCHAN-PUR
BAJURA
PARSA
BARA
RAUT-AHAT
DHANUSA
MAHO-TTARI
SUNSARI
SARLAHI
DHADING
MAKAWAN-PUR
CHITWAN
KASKIBAGLUNG
TANAHU
PALPA
SYANGJAPARBAT
ARGHAK-HACHI
GULMI
UDAYAPUR
SINDHULI
ILAM
BHOJ-PUR
PACH
ETHA
R
DHAN-KUTA
TAPLEJUNG
RAMEC
HHAP
OKHAL-DHUNGA
TERHA-THUM
KHOTANG
LALIT
BHAK
KATHM
SULUKHUMBU
DOLAKHASANKHUWASABHA
NUWAKOTSINDHU-PALCHOK
KAVRE
RASUWA
LAMJUNG
GORKHA
PYUTHAN
ROLPASALYAN
MYAGDI
DAILEKHJAJARKOT
RUKUM
MUSTANG
MANANG
KATHMANDU
LALIT
BHAK
India
China
No. of displaced families (NRCS)
1 - 100
100 - 999
1000 -
Flood & landslide affected district: 36 districts
Public health monitoring based on NRCS, Epidemiology and Disease Control Division, WHO and media reports, 12.08.07
Evolution of Floods Week 3 Evolution of Floods Week 3
99
DOLPA
MUGU
JUMLA
KAILALI
BARDIYA
HUMLA
DOTI
SURKHET
NAWALPARASIKAPILBASTU
RUPAN-DEHI
DANG
BANKE
ACHHAMKALIKOT
JHAPAMORANG
SIRAHA
SAPTARI
DARCHULA
BAJHANG
BAITADI
DADEL-DHURA
KANCHAN-PUR
BAJURA
PARSA
BARA
RAUT-AHAT
DHANUSA
MAHO-TTARI
SUNSARI
SARLAHI
DHADING
MAKAWAN-PUR
CHITWAN
KASKIBAGLUNG
TANAHU
PALPA
SYANGJAPARBAT
ARGHAK-HACHI
GULMI
UDAYAPUR
SINDHULI
ILAM
BHOJ-PUR
PACH
ETHA
R
DHAN-KUTA
TAPLEJUNG
RAMEC
HHAP
OKHAL-DHUNGA
TERHA-THUM
KHOTANG
LALIT
BHAK
KATHM
SULUKHUMBU
DOLAKHASANKHUWASABHA
NUWAKOTSINDHU-PALCHOK
KAVRE
RASUWA
LAMJUNG
GORKHA
PYUTHAN
ROLPASALYAN
MYAGDI
DAILEKHJAJARKOT
RUKUM
MUSTANG
MANANG
KATHMANDU
LALIT
BHAK
India
China
No. of displaced families (NRCS)
1 - 100
100 - 999
1000 -
Flood & landslide affected district: 47 districts
Public health monitoring based on NRCS, Epidemiology and Disease Control Division, WHO and media reports, 19.08.07
Evolution of Floods Week 4 Evolution of Floods Week 4
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Immediate PrioritiesImmediate Priorities Immediate needs were shelter, food, water, Immediate needs were shelter, food, water,
sanitation and primary health caresanitation and primary health care Relative few post-flood medical needs; health Relative few post-flood medical needs; health
camps with no surprising findingscamps with no surprising findings Public health key to successful responsePublic health key to successful response Provision of clean waterProvision of clean water Availability of basic sanitationAvailability of basic sanitation Health promotion focussing on prevention of Health promotion focussing on prevention of
diarrhoeal and vector-borne diseasesdiarrhoeal and vector-borne diseases Strengthen public health monitoring based Strengthen public health monitoring based
on multiple sources on multiple sources Strengthen disease surveillance and Strengthen disease surveillance and
outbreak controloutbreak control
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Health Impact Health Impact Fear of epidemics was a main theme among Fear of epidemics was a main theme among
affected population and responders from the affected population and responders from the beginning of the emergencybeginning of the emergency
No major or unexpected outbreaks have been No major or unexpected outbreaks have been reported from any of the flood-affected areas reported from any of the flood-affected areas since 27 Julysince 27 July
Common illnesses reported:Common illnesses reported:- Fever- Fever- Respiratory infections- Respiratory infections- Diarrhoeal diseases- Diarrhoeal diseases- Skin diseases- Skin diseases- Eye and ear infections- Eye and ear infections
Risk of vector-borne diseases due to wide-Risk of vector-borne diseases due to wide-spread water-logging in inundated Terai spread water-logging in inundated Terai districtsdistricts
1212
DOLPA
MUGU
JUMLA
KAILALI
BARDIYA
HUMLA
DOTI
SURKHET
NAWALPARASIKAPILBASTU
RUPAN-DEHI
DANG
BANKE
ACHHAMKALIKOT
JHAPAMORANG
SIRAHA
SAPTARI
DARCHULA
BAJHANG
BAITADI
DADEL-DHURA
KANCHAN-PUR
BAJURA
PARSA
BARA
RAUT-AHAT
DHANUSA
MAHO-TTARI
SUNSARI
SARLAHI
DHADING
MAKAWAN-PUR
CHITWAN
KASKIBAGLUNG
TANAHU
PALPA
SYANGJAPARBAT
ARGHAK-HACHI
GULMI
UDAYAPUR
SINDHULI
ILAM
BHOJ-PUR
PACH
ETHA
R
DHAN-KUTA
TAPLEJUNG
RAMEC
HHAP
OKHAL-DHUNGA
TERHA-THUM
KHOTANG
LALIT
BHAK
KATHM
SULUKHUMBU
DOLAKHASANKHUWASABHA
NUWAKOTSINDHU-PALCHOK
KAVRE
RASUWA
LAMJUNG
GORKHA
PYUTHAN
ROLPASALYAN
MYAGDI
DAILEKHJAJARKOT
RUKUM
MUSTANG
MANANG
KATHMANDU
LALIT
BHAK
India
China
No. of displaced families (NRCS)
1 - 100
100 - 999
1000 -
Flood & landslide affected district: 47 districts
Public health monitoring based on NRCS, Epidemiology and Disease Control Division, WHO and media reports, 19.08.07
Confirmed outbreak
Unconfirmed outbreak
Floods and Outbreaks Floods and Outbreaks
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Health Response Health Response EDCD / DHS immediately deployed three response EDCD / DHS immediately deployed three response
teams to different parts of the country. These teams teams to different parts of the country. These teams worked together with DHOs / DPHOs and RRTs in the worked together with DHOs / DPHOs and RRTs in the affected districts to provide public health guidance and affected districts to provide public health guidance and epidemiological supportepidemiological support
Supply of essential medicines to 33 districts and 5 Supply of essential medicines to 33 districts and 5 regional stores; including emergency supplies from regional stores; including emergency supplies from WHOWHO
Daily rumour verification and situation updates from Daily rumour verification and situation updates from DHOs / DPHOs; including weekly WHO sitrepsDHOs / DPHOs; including weekly WHO sitreps
EDCD opened a hotline for Rapid Response Teams to EDCD opened a hotline for Rapid Response Teams to call and inform urgent health updatescall and inform urgent health updates
An MOHPAn MOHP high-level committee established six health high-level committee established six health teams to coordinate field response and provide teams to coordinate field response and provide emergency medical care and public health guidanceemergency medical care and public health guidance. . These teams, headed by senior DHS officials, covered These teams, headed by senior DHS officials, covered 17 districts17 districts
1414
WHO Response WHO Response After 27 July, WHO mobilized the IPD SMOs in the field After 27 July, WHO mobilized the IPD SMOs in the field
to conduct assessments, assist DHOs / DPHOs and to conduct assessments, assist DHOs / DPHOs and provide public health guidanceprovide public health guidance
On 2 August, WHO called an Emergency Health and On 2 August, WHO called an Emergency Health and Nutrition Working Group meeting to discuss the flood Nutrition Working Group meeting to discuss the flood situation in the country and facilitate coordination and situation in the country and facilitate coordination and operational planning operational planning
On 3 August, WHO delivered emergency medicine to On 3 August, WHO delivered emergency medicine to five MOHP teams five MOHP teams
On 14 August, two additional diarrhoeal kits were pre-On 14 August, two additional diarrhoeal kits were pre-positioned in Banke districtpositioned in Banke district
On 15 August, one diarrhoeal kit was airlifted to On 15 August, one diarrhoeal kit was airlifted to Kalikot district to contain the surge in diarrhoeal casesKalikot district to contain the surge in diarrhoeal cases
Weekly WHO sitreps including district-specific health Weekly WHO sitreps including district-specific health datadata
Disease surveillance is being strengthened in Disease surveillance is being strengthened in collaboration with EDCD and DHOs / DPHOscollaboration with EDCD and DHOs / DPHOs
1515
Provision of Medical Provision of Medical SuppliesSupplies
1616
Learning ExperiencesLearning Experiences Past disaster statistics helped to identify the Past disaster statistics helped to identify the
appropriate response level and not being ruled by appropriate response level and not being ruled by subjective factorssubjective factors
Pressure from international agencies and the ‘South Pressure from international agencies and the ‘South Asia flood affect’ to substitute rather than support Asia flood affect’ to substitute rather than support national response efforts was resistednational response efforts was resisted
The magnitude of the emergency was appropriate for The magnitude of the emergency was appropriate for the country to test and enhance response mechanismsthe country to test and enhance response mechanisms
Emergency preparedness, pre-positioned medicine and Emergency preparedness, pre-positioned medicine and close collaboration with EDCD played an important role close collaboration with EDCD played an important role for our flood and landslide responsefor our flood and landslide response
Recent WFP / UNICEF assessment of the flood response Recent WFP / UNICEF assessment of the flood response in 19 districts concluded that the health response was in 19 districts concluded that the health response was impressive and no major shortcomings were identifiedimpressive and no major shortcomings were identified
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RecommendationsRecommendations Continue regular efforts to strengthen the disaster Continue regular efforts to strengthen the disaster
management section in EDCDmanagement section in EDCD Stronger efforts to coordinate with MOHP and align Stronger efforts to coordinate with MOHP and align
with health policies to systematically introduce with health policies to systematically introduce response preparedness and risk management in response preparedness and risk management in health sector policies and practiceshealth sector policies and practices
Maintain the logistic pipeline introduced last year Maintain the logistic pipeline introduced last year and re-stock international medical kitsand re-stock international medical kits
Develop cost-effective local medical kits specifically Develop cost-effective local medical kits specifically designed to meet field needs in Nepal; invest in designed to meet field needs in Nepal; invest in packaging and labellingpackaging and labelling
Decentralize the health sector’s emergency Decentralize the health sector’s emergency preparedness further; pre-positioning at district level preparedness further; pre-positioning at district level and focus on training and capacity building at and focus on training and capacity building at peripheral levelsperipheral levels
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Thank YouThank You