ELECTIONEERING CONTINGENCY PLAN

REPUBLIC OF KENYA

THE HEALTH SECTOR ELECTIONEERING CONTINGENCY PLAN FOR 2013 GENERAL

ELECTIONS

February 2013

Health and Mass Casualties Pillar

Main Objective

Address immediate life threatening needs, prevent excess morbidity, disability and mortality and provide prioritized health care.

Specific objectives

• Ensure mass casualty management systems are available throughout the electioneering period

• Ensure continuity of essential primary and secondary health care services

• Ensure early recovery strategies are incorporated into the response actions

HOT SPOTS

South Rift North Rift

Nakuru central district Eldoret East, West, Wareng

Nakuru North Baringo/Marigat

Molo Tranzoia East/west

Naivasha Nandi North, Central, East, Tinderet

Koibatek ,Mogotio

Upper Eastern North Eastern

Moyale, Marsabit,Isiolo Mandera, Wajir, Garissa

Coast Province Nyanza

Tana river, Kilifi,Mombasa, Kwale, Lamu, Taita Taveta

Kisumu

Nairobi

Kibera, Mukuru, Kiambio, Mathare Valley, Majengo, Kawangware, Kangemi

Estimated number of people to be displaced per Hub

HUB Districts

Population (2009 census)

Estimated no. of people

displaced Remarks Isiolo Moyale,

Marsabit, Isiolo434,460 50,000-

60,000Based on Isiolo hub workshop Nov 2012

Nakuru Nakuru, Naivasha, Kipkelion, Molo, Njoro, Narok, Subukia

  185,000 According to the protection workshops

Eldoret Kitale, Nandi, Uasin Gishu, Burnt Forest

  25,000 According to the protection workshops

Mombasa Mombasa, Lamu, Tana River, Kwale, Malindi, …

3,325,307

50,000-70,000

Based on Mombasa hub workshop Oct 2012

Estimated number of people to be displaced per HuB

HUB Districts

Population (2009 census)

Estimated no. of people

displaced Remarks

Garissa Garissa, wajir, Manerda, Ijara, Fafi, Hagadera

2,310,757 18,000 Based on CP consultations

Kisumu Nyanza, Western

9,776,993 10,000 Percentage estimation

Turkana   855,399 3,000 Percentage estimation

Nairobi Urban area

Kibera, Makandara, Kasarani, ….

1,099,453 30,000 Based on hub consultation

Other areas …   20,000 Percentage estimation

Total    

350,000-400,000  

The 8 Hubs for Humanitarian Coordination as identified by Humanitarian Pillar

Location

Coverage Priority Focal point organization

Nairobi (informal settlements)

Kasarani, Westlands, Langata and Makadra dsitrcits, Embakasi, (covering, Kibera, Mathare, Kariabangi, Kariakor, Korogocho, Kangemi) , Eastleigh

High Concern Worldwide / UVF

Eldoret Eldoret: Eldoret East, Eldoret West, Wareng, Trans Nzoia East, Trans Nzoia West, Kwanza, Nandi North, Nandi Central, Nandi East, Tinderet, Keiyo South and Keiyo North.

High IOM / OCHA

Nakuru Nakuru: Nakuru Central, Nakuru North, Rongai, Subukia, Naivasha, Gilgil, Molo, Njoro, Kuresoi, Trans Mara East, Trans Mara West, Baringo, Marigat North, Kericho and Kipkelion

High OCHA, NRC, Protection Working Group

The 8 Hubs for Humanitarian Coordination as identified by Humanitarian Pillar

Location Coverage Priority Focal point organization

Garissa Mandera, Wajir, Garissa, Ijara

High UNICEF / Islamic Relief, Save the Children

Mombasa Mombasa informal settlements / Kilifi, Kwale, Lamu, Taita Taveta

High WFP / WVI

Isiolo / Marsabit

Isiolo, Marsabit, Moyale, Samburu

High WFP / WVI

Lodwar All districts in Turkana county

Medium OCHA

Kisumu Western Kenya, Nyanza High UNICEF

Strategies for Preparedness

• Establish coordination, joint planning , emergency response , communication and information management structures at all levels.

• Ensure prompt availability of emergency information through joint rapid assessments and/or national and global networks e.g. GIS technology

• Facilitating early warning systems, diagnosis and prompt management of cases including referral system corresponding to international humanitarian standards during crises

• Facilitating availability of essential drugs, consumables, detergents etc

• Mobilizing resources; financial, human, logistical, technical etc to fill critical gaps

Establishing Coordination Structures

• National Level: National Health Sector Crisis Management Team

– Membership• Ministers for Health – Chair• Assistant Ministers – Deputy chair• Permanent secretaries – Secretary• DMS/DPHS – Vice secretary• Departmental heads – Members• Partner organizations – WHO, UNICEF, CDC, KRC, ICRC etc

• Province, County, District– Disaster Management Committees

Functions of the Committees1. Joint planning, implementation and monitoring of the

response at all levels2. Pre-positioning of medical supplies and blood3. Planning for pre-hospital and hospital management of

trauma cases4. Identifying staff for deployment /re-deployment5. Mapping of “ Who does what, where and when”,6. Facilitating emergency health information

management and dissemination etc.7. Conducting joint initial rapid assessments8. Reporting to other levels 9. Preparing daily SITREPs and press releases 10. Resource pooling11. Update and share contact list eg KEMSA, HUBs, Police

Pre-Positioning of Medical Supplies 1• The national committee has made plans to pre-

position trauma kits as follows:– Kisumu KEMSA - Available– KNH trauma store - Available– Eldoret KEMSA – Nakuru KEMSA available If needed– Mombasa KEMSA– Garissa KEMSA

• All provincial directors will be informed once these are delivered

Pre-Positioning of Medical Supplies 2• The national committee has made plans to pre-

position inter-agency (medical kits) as follows:– Kisumu KEMSA– Eldoret KEMSA– Nairobi KEMSA– Nakuru KEMSA– Garissa KEMSA

• All provincial directors will be informed once these are delivered

• KEMSA is also distributing normal supplies to all facilities in hot spot areas

Pre-Positioning of Blood and Lab Supplies

• All 6 regional and 9 satellite blood transfusion sites have adequate blood

• More to be mobilized if need be• Screening kits and blood bags also adequate• Kenya Red Cross and Kenya Airways will be

contacted to assist in re-distribution in case of crisis• Also planning to pre-position some lab supplies at

provincial hospitals esp for enteric pathogens e.g. cholera, salmonella, shigella

Pre-hospital Management of Trauma Cases

• This involves search and rescue, triage, initial treatment and transport to hospitals

• Lead agency is Kenya Red Cross assisted by– GOK– ICRC– St John Ambulance– Kenya police– AMREF , Volunteers, etc

• All levels must identify available stakeholders for pre-hospital care

Hospital Management of Cases

• Every level must identify hospitals that cases will be referred to for definitive management

• These can be national, provincial, district, private hospitals or FBOs

• Ensure they have adequate trauma kits, medical supplies, disinfectants, detergents, technical staff etc

• Need to liaise with KEMSA stores for replenishment if they run out of stock

Deployment and Prepositioning of Short term Critical Staff

• The provinces need to compile a list of health workers that can be deployed at short notice to facilities

• Priority should be nurses, medical officers, surgeons and anesthetists who can work in those regions

• Can be those retired, in private practice or jobless• Talk with local partners for support if needed eg

APHIA+, Global One 2015, Merlin• National level to intervene only if local partners are

unable to support• MOMs to provide list of unemployed health workers

Moving Emergency Supplies and Critical Staff to areas of Need

• Each province will be given some funds for– Moving emergency supplies from KEMSA to areas

of need– Transporting critical staff (doctors, nurses etc) to

areas of need– Conducting initial rapid assessments

• These funds must be used well and accounted to UNICEF

• Provinces and districts can also mobilize more funds locally

Care of HIV and TB patients

• Before the elections– All TB patients on treatment to receive 1 month

supply of intensive phase and 1 month of continuation phase

– All HIV+ patients on ARVs to receive 3 months supply

Nairobi Plan

Nairobi Preparedness Plan

• Nairobi province coordination team has zoned the hot spots into 4 districts: Langata, Embakasi, Kasarani and Starehe

• A total of 31 facilities + KNH have been identified in these districts

• Each will be supplied with trauma kits, medical kits , post-rape kits and fire extinguishers

• Health workers are also being trained on disaster management

Zoning of the 31 Health Facilities

District Public PrivateLangata Langata H/C Kibera Amref

Karen H/C ACK KiberaKibera D.O.

Senye Medical ClinicTabitha Clinic Wema Medical ClinicUshirika Johanna Justin JinchiUhuru CampJina Clinic

Zoning of the 31 Health Facilities

District Public PrivateEmbakasi Mama Lucy Hosp Mukuru MM

Kayole II Soweto Kayole HCDandora I & II H/C

Reuben CentreLunga lunga H/C St. Burkhita Disp

St Raphael Disp

St Patrick H/C

Imara H/C

Zoning of the 31 Health Facilities

District Public PrivateKasarani Kariobangi H/C

Mathare North

Starehe KNH

Mbagathi DHHuruma Lions Disp

If Mass Displacement Occurs• Contact the hub focal person who is in-charge of

humanitarian assistance in your province• Organize to take care of the vulnerable

– offer primary health services– Immunize children <5 against Measles and Polio– Offer special health services for people with chronic diseases

e.g. HIV, tuberculosis and others– Reproductive health services– Nutrition services– Gender based violence and rape management for victims– Special care for the elderly– Public health education and campaigns– WASH services– Set early warning systems against communicable diseases

National Contact List

Will have contacts for– DMS and DPHS – All PDPHS and PDMS– All KEMSA depots– All HUB focal points– All KRCS regional focal points– All regional fire emergency numbers

ELECTIONEERING CONTINGENCY PLAN ROLES AND RESPONSIBILITIES

CAPACITY PRIMARY RESPONIBILITY

SUPPORTING ENTITIES

Coordinating/security PAIS MOSD/UNOCHA

Shelter & NFIs MOSSP KRCS, UNHCR, IOM

Relief food distribution MOSSP KRCS, WFP

Early Recovery Network MOSSP UNDP

Information/media PAIS MOI

Logistics PAIS,MOSSP KRCS,WFP,ICRC

Finance Finance UN OCHA

Health MOMS,MOPHS WHO,UNICEF

Trauma Management MOMS ICRC,WHO,

Functions of the Committees1. Joint planning, implementation and monitoring of the

response at all levels2. Pre-positioning of medical supplies and blood3. Planning for pre-hospital and hospital management of

trauma cases4. Identifying staff for deployment /re-deployment5. Mapping of “ Who does what, where and when”,6. Facilitating emergency health information

management and dissemination etc.7. Conducting joint initial rapid assessments8. Reporting to other levels 9. Preparing daily SITREPs and press releases 10. Resource pooling11. Update and share contact list eg KEMSA, HUBs, Police

Thank You