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P Z o ] P Z ï ð ì ï ì î î í î ð U ò í ï h^ ¨ î í X ôD · 2019-11-30 · ] µ v o...
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DRC EBOLA SITUATION REPORT 12 November 2018 1 340 total reported cases (MoH, 12 November 2018) 302 confirmed cases (MoH, 12 November 2018) 212 deaths recorded (MoH, 12 November 2018) 4,613 contacts under surveillance (MoH, 12 November 2018) UNICEF Ebola Response Appeal US$ 21.8M Highlights 12 November, WHO’s Director General Dr. Tedros, head of emergencies Dr. Salama, and head of emergencies in WHO Regional Office for Africa Dr. Soce Fall, visited DRC to meet with the teams in Beni and with government officials and partners. They were accompanied by the head of the UN Peacekeeping mission USG Jean-Pierre Lacroix. Their mission was to assess what further support is needed and to recognize the hard work of teams on the ground. They also met with the Prime Minister, the Minister of Health and other government officials. A budget for a broader humanitarian action in the Ebola affected areas is currently being developed that includes education, child protection, essential household items, nutrition and the use of unconditional cash grants. Democratic Republic of the Congo Ebola Situation Report North Kivu and Ituri 12 November 2018 SITUATION IN NUMBERS [] 40% [] 60% Ebola Response Funding Status 2018 Ebola NK and Ituri Total Funding requirements* : $ 21,830,204 * Funding requirement includes budget for phase I ($ 8,798,899) and budget for phase II ($ 13,031,305) Photo Credit: Mark Naftalin
Transcript of P Z o ] P Z ï ð ì ï ì î î í î ð U ò í ï h^ ¨ î í X ôD · 2019-11-30 · ] µ v o...
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DRC EBOLA SITUATION REPORT 12 November 2018
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340 total reported cases (MoH, 12 November 2018)
302 confirmed cases (MoH, 12 November 2018)
212 deaths recorded (MoH, 12 November 2018)
4,613 contacts under surveillance (MoH,
12 November 2018)
UNICEF Ebola Response Appeal
US$ 21.8M
Highlights
12 November, WHO’s Director General Dr. Tedros, head of emergencies Dr. Salama, and head of emergencies in WHO Regional Office for Africa Dr. Soce Fall, visited DRC to meet with the teams in Beni and with government officials and partners. They were accompanied by the head of the UN Peacekeeping missionUSG Jean-Pierre Lacroix. Their mission was to assess what further support is needed and to recognize the hard work of teams on the ground. They also met with the Prime Minister, the Minister of Health and other government officials.
A budget for a broader humanitarian action in the Ebola affected areas is currently being developed that includes education, child protection, essential household items, nutrition and the use of unconditional cash grants.
Democratic Republic of the Congo
Ebola Situation Report North Kivu and Ituri
12 November 2018 SITUATION IN NUMBERS
[]40%
[]60%
Ebola Response Funding Status 2018
Ebola NK and Ituri Total Funding
requirements* : $ 21,830,204
* Funding requirement includes budget for phase I ($ 8,798,899) and budget for phase II ($ 13,031,305)
Photo Credit: Mark Naftalin
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Epidemiological Overview1
Summary Table (12.11.18):
Province Health Zone Confirmed and Probable Cases Total Deaths Recorded
Suspect Cases under investigation Confirmed Probable Total
Nord-Kivu
Beni 153 9 162 3 Butembo 10 3 13 30 Kalanguta 23 5 28 0 Kyondo 2 2 4 2 Mabalako 67 14 81 0 Masereka 6 1 7 3 Musienene 2 1 3 0 Mutwanga 1 0 1 0 Oicha 2 0 2 0 Katwa 14 0 14 0 Vuhovi 2 0 2 0
Ituri Komanda 1 0 1 3 Mandima 16 3 19 0 Tchomia 2 0 2 0
TOTAL 302 38 340 212 43 Previous Total 5 November 2018 270 35 305 189 60
1 Data source: Epidemiological table based on daily CNC numbers
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Humanitarian leadership and coordination
The Crisis Management Team continued to meet daily under the leadership of the Ministry of Health with all concerned partners and with the chairs of the different working groups providing thematic updates. UNICEF continues to participate actively in coordination meetings at the national level and in Beni (operational headquarters) and co-leads the commissions on communication, WASH and psychosocial care. UNICEF is also active in the working groups for logistics and vaccination. A UNICEF security specialist is deployed in the field to support the security assessment and safety of the operations.
Beni and Butembo health zones are the most concerning areas for the response due to the high number of reported confirmed and probable cases. At the moment, UNICEF activities cover communication and prevention, WASH, and psychosocial care around five coordination hubs based in Beni, Butembo, Tchomia, and Mabalako Health Zone and one sub-coordination hub in Bunia city.
The coordination of UNICEF’s response is dynamic due to the identification of confirmed cases and the geographical extension of the epidemic to newly affected health zones. UNICEF coordinates Musienene, Katwa, Masereka, Vuhovi, Kalanguta, and Kyondo’s response from the sub-coordination group based in Butembo health zone.
Response Strategy
In support of the joint response plan, the UNICEF response strategy will continue to focus on communication, WASH, and psychosocial care, nutrition and a cross-cutting education response.
Risk communication, social mobilization and community engagement with the aim to (1) proactively engage with affected and at-risk communities, (2) provide timely and accurate health advice to encourage positive health seeking behaviors and (3) address community concerns and rumors. The strategy is implemented through 5 pillars that include (i) community engagement; (ii) promotion of preventive behaviors; (iii) responding to resistance; (iv) advocacy and capacity building of actors and (v) communication in support of ring vaccination, surveillance, safe and dignified burials, and Ebola treatment centers
The WASH strategy, as part of the Infection Prevention and Control (IPC), aims to stop the spread of the disease through the availability of 1) WASH in public and private health care facilities, as well as reinforcement of basic WASH services and awareness with traditional practitioners, which includes providing water and WASH kits, 2) hygiene promotion and the provision of WASH kits in schools, including handwashing station and soap/temperature check points, and 3) WASH in communities through mass outreach on hygiene promotion to vulnerable communities and the setup of handwashing stations/temperature control in strategic transit locations 4) joint supervision of health infrastructures to ensure quality and efficient sustainability of programs developed
The child protection and psycho-social support to EVD confirmed and suspect cases and their family members as well as contact families seeks to (1) provide psycho-social support; (2) establish or re-establish social and community networks and support systems; (3) provide social kits to EVD affected families (4) identify and provide appropriate care to orphans and unaccompanied children due to the Ebola epidemic. The key element of the strategy includes (i) psychosocial support for EVD confirm and suspect cases, including children, in the ETCs, psychosocial activities for children and their families; (ii) material assistance to affected families to better support children; (iii) facilitation of professions help to children and families with more severe psychological or social problems / needs; (iv) coordinate mental health and psychosocial support (MHPSS); (vi) psycho-social assistance, appropriate care and research of long-term solution to orphans and unaccompanied children.
The nutrition component will focus on provision and pre-positioning of Ready for Use Therapeutic Food (RUTF), therapeutic milk and other drugs for systematic treatment of severe acute malnutrition (SAM) cases to the six health zones affected by Ebola or in situation of nutritional alert in North Kivu province. In addition, address young child and infant feeding practice that is impacted by the increasing number of women affected by the Ebola epidemic
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The education sector strategy involve key EVD prevention measures on the school premises, include: (i) mapping of schools to identify its proximity with a confirmed case and the identification of schools in the affected health areas (ii) training of educational actors (students, teachers, inspectors, school administration agents, head of educational provinces, parents’ association) on Ebola prevention in schools including WASH in school, psychosocial support in classrooms and against discrimination, (iii) provision of infrared thermometers and handwashing kits in school clean water, soap, and capacity reinforcement on hygiene behaviors in schools, (iv) provision of school cabins for school entry checking (v) provision of specific documentation and protocol for prevention, guidance and management of suspected cases in school (vi) provision of key messages on Ebola prevention to families.(vii) close monitoring of effective use and implementation of the protocol of prevention of EVD in schools
Summary Analysis of Programme Response
Overview of the key elements in the response, with a special emphasis on UNICEF’s response in the affected health zones, is detailed below.
Communication and social mobilization (C4D)
Extending and reorganizing the communication team in Butembo was the week’s focus, in response to the geographical spread of the Ebola epidemic to the five neighboring Health Zones. The communication commission teams needed to quickly scale up their capacities and efficiency in implementing as activities through the hiring and training of local experts. During the reporting period, 103 additional local coordinators and social mobilizers were hired and enrolled to integrate the new field response teams (surveillance, vaccination, safe and dignified burials, infection prevention and control). In addition, a stronger emphasis and re-focus was placed on data management, documentation, and the use of a more empathetic approach to reinforce community dialogue.
Community mobilization
In Beni health zone, 553 alerts coming from 150 community chiefs through the community telephone alert system, were documented. In addition, open visiting hours and tours of ETCs are scheduled every Wednesday and Saturday for local community members, of which 276 leaders and influencers visited the centers this week. It is acknowledged that these visits continue to play a major role in communities accepting ETCs services when people show Ebola symptoms.
During the reporting period, 394,647 (73% coverage) at risk population were reached through community engagement and interpersonal communications, of which over 39,000 church goers in 181 churches received messages concerning SDBs and the credibility of Ebola Treatment Units (ETUs). In addition, 21 additional radio stations were engaged in spreading Ebola prevention messages in the affected health zones of Kayina, Ubero, Vuhovi and Alimongo.
During the reporting period, 1,073 influential leaders were reached through advocacy. 12 local influencers joined the Butembo communications commission, 91 local social mobilizers were recruited to supervise activities in Beni and Butembo health zones, and 311 youth leaders were trained and engaged in the fight against Ebola. Furthermore, 319 frontline workers (RECOs) were mobilized for the Ebola response, reaching 6,074 (78% coverage) RECOs since the beginning of the response. During the reporting period, 59 households received personalized house to address reluctance to vaccination, immediate referrals to treatment centers, or refusal to respect secure and dignified burial protocol, reaching a total of 617 transformed households since the beginning of the response.
In the area of Ebola preparedness to the neighboring provinces of North Kivu, a compilation of 22 radio programs, 7 songs, and 166 testimonials was packaged and shared with partner NGOs working in Sud Kivu, Tchopo, Maniema and Tanganika. UNICEF’s C4D survey team began the preparations to conduct the first KAP survey in Ituri province, with other neighboring provinces soon to follow.
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Water, Hygiene and Sanitation (WASH)
During the reporting period, the intervention strategy for the WASH/IPC Commission was revised to better respond, monitor, and follow-up WASH/IPC activities in health centers. The revised strategy was validated by the commission and the implementation is ongoing.
UNICEF as co-lead of the WASH/IPC commission has committed to support the monitoring of Health Centers by providing qualified staff and its partners to be part of the monitoring teams. The teams will conduct bi-weekly follow-ups in the health centers evaluating the quality of service based on a pre-defined list of indicators agreed by the Prevention Commission and partners. In order to improve the quality of services provided and eliminate infections in Health Centers, a performance-based financing/payment system will be put in place as part of the revised strategy. Payment will be based on the scoring result of each IPC/WASH indicator. Follow-up will be done every two weeks, and payments increase as scores improve.
As of 11 November, four additional health facilities in the affected health zones in North Kivu province benefitted from essential WASH activities; these include the provision of handwashing points, briefing of staff on hygiene promotion, and disinfection, and the installation of chlorination points, reaching a total of 366 (100% coverage health facilities since the beginning of the response. Periodic follow-ups by respective partners in the health centers assures that all aspects of WASH package (handwashing, availability of chlorine) remain functional.
This week, UNICEF continued with the Community Engagement interventions in Beni, Butembo, Mangina and Tchomia health zones. The activities included training of staff in Health Centers on WASH/IPC and community briefings on Ebola Virus Disease (EVD).
As of 11 November, 866 (96% coverage) community sites (ports, market places, local restaurants, churches) out of the targeted 900 were provided with handwashing facilities for Ebola infection control in Beni, Mandima, Mabalako, Butembo and Tchomia health zones in partnership with Oxfam, Programme de Promotion des Soins de Sante Primaire (PPSSP), and Centre de Promotion Socio-Sanitaire (CEPROSSAN).
Private and public health posts are directly targeted by the current strategy, whereas traditional practitioners’ engagement will be reinforced under the new prevention approach.
Since the beginning of the response, a total of 856,432 (90% coverage) persons have gained access to safe water in the affected health zones, out of the targeted 952,946.
Key activities in the last seven days:
As of 11 November, 11,795 people benefited from drinking water treated through functional chlorination points, in Beni, Tchomia and Butembo health zones.
In Tchomia health zone this week, UNICEF completed the follow up and distribution of 22,320 liters of chlorinated water for 46 handwashing facilities in public areas.
In Butembo health zone, 11 schools in the health areas of Luotu and Lubero considered as high-risk areas, were provided with handwashing facilities, including thermometers.
Education
During the reporting period, UNICEF advocated for the reopening of schools in Beni town as well as continue the support to functioning schools against the spread of the Ebola virus. Thanks to UNICEF's advocacy in Butembo health zone, 73 schools whose classes were disrupted by unidentified youth groups, recovered their normal functioning. UNICEF supported six schools in Butembo, in Lubero and Musienene Health zones2 with handwashing kits, including thermometers, and Ebola prevention messages, benefitting 6,331 children, of which 3,407 are girls, reaching a total of 83,889 children (28% coverage) since the beginning of the response. In these six schools, UNICEF supported the briefing of 172 teachers of which 85 women
2 EP Mihake, EP Jou furu, EP Katolo, EP Ivatama, EP Kimbulu and EP Musimba
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on the use of handwashing facilities and thermometers and Ebola prevention messages, reaching a total of 3,929 teachers (55% coverage) since the beginning of the response. UNICEF conducted follow-up visits targeting 68 schools which already received prevention kits to ensure that prevention protocol is well understood and implemented accordingly. During these visits, refresher briefing is organized in all the targeted schools. The follow-up shows that the handwashing devices and thermometers are properly used without any resistance or misunderstanding due to the implication of the schools’ directors and education authorities during briefing activities on EVD prevention and the distribution of handwashing kits in schools.
UNICEF supported the Nord Kivu II Provincial Ministry of Education in Ebola risk mapping of schools. A monitoring mechanism covering the seven3 targeted educational sub-provinces with confirmed cases is established to facilitate communication related to all EVD possible cases in schools between teachers, head of schools, inspectors, school administration agents, head of educational provinces and UNICEF. Two representatives of PROVED sit on the daily coordination of the response in Beni and Butembo to share the schools' information related to EVD with other stakeholders, including health actors. In addition, UNICEF supports the EPSP Nord Kivu II Provincial Education on the reopening of schools, training sessions targeting heads of schools, teachers and parents on Ebola including students’ enrollment and access to school, WASH in school, and psycho-social support.
During the reporting period, 11 schools (72% coverage) were provided with handwashing facilities, reaching a total of 430 schools since the beginning of the response.
Psychosocial and Child Protection
During the reporting period, 54 children (10 confirmed, 44 suspect cases) went through ETCs and received individual psychological assistance. Among them, 33 children (5 confirmed, 28 suspect cases) were in the ETC of Beni and 15 children (4 confirmed, 11 suspect cases) were in the ETC of Butembo.
Two babies, 6 and 12 months old, survived Ebola Virus Disease (EVD). One of them is an orphan whose mother died of EVD. They received specific assistance adapted to their needs (food, Non-Food Items, hygiene and recreational kits). A psychosocial agent is also following up with them daily.
Nine recreational kits were distributed to the ETC of Beni. In addition, the nursery in the ETC was equipped by UNICEF with Non-Food Items (NFIs), food, recreational kits, tents, and mosquito nets. 15 cured persons received training on psychosocial support for children, with 10 cured persons placed in the ETC and five in the nursery to take care of the children who are confirmed or suspected cases.
In Butembo health zone newborn from an orphanage died in a hospital. He is suspected of having developed the EVD (his mother died after delivery and his brother is a confirmed case). The orphanage is at high risk of contamination. In addition to preventive measures such as vaccination and decontamination, the Psychosocial Commission distributed 30 NFI kits and 18 recreational kits. Continuous psychosocial support is given to the other children and contact persons of the orphanage.
146 families newly affected by EVD received psychosocial support and/or material assistance in seven health zones in North Kivu Province and three health zones in Ituri Province. The increase of affected families receiving assistance is linked to the increase of suspected cases, particularly in the ETC of Beni. 107 hygiene kits and 193 food assistance were distributed to discharged and cured patients. Eight families received funeral kits, eight8 families received newborn kits, and 14 families received NFI kits.
327 families previously identified as affected by EVD received continuous psychosocial support through regular visits of psychosocial agents in their communities.
42 new orphans and 52 new separated children due to the Ebola epidemic were identified and have received appropriate care, reaching a total of 309 children. The high number of orphans and separated children is linked to the increase of
3 Beni, Butembo1 and 2, Kyondo, Lubero 1 et 2 and Masereka
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suspected and confirmed cases in the ETCs of Beni and Butembo. This figure also includes the number of children assisted in the infected orphanage.
83 previously identified orphans and separated children received follow-up visits by psychosocial agents. Some orphans benefited from reinforced psychological support after losing another member of their families due to EVD.
A total of 297 contact families received a psychosocial support in Beni and Butembo health zones, reaching a total of 5,430 families, 100% of targeted contact families. 25 contact persons received a follow-up visit in Tchomia health zone (contacts above 21 days).
22 psychologists and psychosocial agents (8 in Mangina, 8 in Beni and 6 in Butembo) were trained by the World Health Organization on treatments and specific psychological support for cured persons.
Nutrition
During the reporting period, 272 pregnant and lactating women were sensitized by nutritionists on infant and young child feeding (IYCF) good practices, reaching a total of 1,732 (18% coverage) persons since the beginning of the response. In addition, quality nutrition care was provided to 105 patients in Ebola Treatment Centers. 13 children, including 12 children under 6 months old and 1 children between 6 and 10 months old, received adequate feeding support in line with IYCF-U guidelines.
Key activities in the last seven days:
briefing of health workers and nutritionists on the revised protocol for providing nutritional care in Butembo Ebola Treatment Center;
UNICEF provided support during a feeding practices assessment conducted at Bunyika orphanage, Vuhovi Health Zone and provided recommendations to improve the quality of feeding practices;
Continuous training of nutritionists at Ebola Treatment Center.
Supply & Logistics
Since the beginning of the response, $2,812,100.34 worth of items composed of WASH, C4D, Child Protection, Health, Education and ICT supplies have been procured for the Ebola response in Ituri and North Kivu province. Out of the total value of items, $ 163,983.00 are ICT equipment for staffs.
Offshore procurement represents a total value of $1,035,007.08 (37%) and local procurement represents a total value of $1,777,093.26 (63%).
Human Resources
As of 12 November, 72 UNICEF staff members have been deployed to the affected health zones in North Kivu and Ituri provinces.
Through the network of implementing partners mobilized by UNICEF for the response, a total of 389 personnel are currently
deployed in the affected areas supporting the response.
External Communication
The CO supported the recruitment for the DRC Government of an external communication officer, who is operating out of Beni, the epicenter of the epidemic. During the reporting period the Ebola crisis and UNICEF’s response got media coverage in Press Agency EFE, All Africa and La Vanguardia. New digital publications include Préférence, a childhood broken by Ebola. The CO published in 43 articles on its blog since the beginning of the crisis, as well as 41 Facebook posts, 27 pictures on Instagram and almost 300 tweets.
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Funding Based on the Joint Response plan of the Ministry of Health and partners, the total funding required for the response is estimated at USD 105 million. As part of the joint response plan, UNICEF response strategy focused on Communication, WASH and Psychosocial care, nutrition and cross-cutting education sector response is estimated at US$21.8 Million.
At present, the UNICEF response has a funding shortfall of USD 12.03 Million.
Funding Requirements (as defined in the UNICEF component of the Joint Ebola Response plan and aligned to the UNICEF Humanitarian
Appeal 2018)
Appeal Sector Requirements
$
Funds available Funding gap
Funds Received Current Year
$ %
Water, Hygiene and Sanitat ion - WASH / IPC 10,536,519 2,962,719 7,573,800 72%
Communicat ion for Development (C4D) - Community engagement and Communicat ion
for Campaigns 6,097,005 3,333,405 2,763,600 45%
Child protect ion and Psychosocial Support 1,851,200 648,800 1,202,400 65%
Medical Care : Management of Severe Acute Malnutrit ion in Ebola Treatment Center 749,800 549,800 200,000 27%
Operat ions support, Security and Coordinat ion costs and Information and Communications
Technology 2,273,680 1,304,175 969,505 43%
Preparedness Plan 322,000 0 322,000 100%
Total 21,830,204 8,798,899 13,031,305 60%
Next Sitrep: November 19, 2018
Who to contact for further information:
Pierre Bry Chief Field Operations UNICEF DRC Tel: + (243) 817 045 473 E-mail: [email protected]
Gianfranco Rotigliano Representat ive a.i. UNICEF DRC Tel: + (243) 996 050 399 E-mail:
Tajudeen Oyewale Deputy Representative UNICEF DRC Tel : +(243) 996 050 200 E-mail : [email protected]
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Ebola Response Tracking Indicators (12 November 2018)
RESPONSE COORDINATION Target Total Results Change since last report
# of affected localit ies with funct ioning partner coordinat ion mechanism 5 5 0
COMMUNICATION FOR DEVELOPMENT # of members of influent ial leaders and groups reached through advocacy, community engagement and interpersonal communicat ion act ivit ies. (CAC, religious /tradit ional leaders, opinion leaders, educators, motorists, military, journalists, indigenous group leaders, special populat ions, and adolescents.
11,200 10,043 1073
#of frontline workers (RECO) in affected zones mobilized on Ebola response and part icipatory community engagement approaches. 7,800 6,074 319
# of at-risk populat ion reached through community engagement, advocacy, interpersonal communicat ions, public animat ions, radio, door-to-door, church meet ings, schools, adolescent groups, administrat ive employees, armed forces.
8,200,000 6,014,554 394,647
# of households for which personalized house visits was undertaken to address serious mispercept ion about Ebola, refusals to secure burials or resistance to vaccinat ion.
620 617 59
# of listed eligible people for ring vaccinat ion informed of the benefits of the vaccine and convinced to receive the vaccine within required protocols. 29,491† 28,991 2,528
% of respondents who know at least 3 ways to prevent Ebola infect ion in the affected communities (from Rapid KAP studies) 80% 83% 0
WATER, SANITATION & HYGIENE
# of health facilities in affected health zones provided with essential WASH services. 366+ 366 38
# of target schools in high risk areas provided with handwashing facilities 600 430 11
# of community sites (port, market places, local restaurant, churches) with hand washing facilit ies in the affected areas 900 866 31
# of people with access to safe water source in the affected areas 952,946 856,432 11,795 EDUCATION
# of students reached with Ebola prevent ion informat ion in schools 297,000 83,889 6,331
# of teachers briefed on Ebola prevent ion information in schools 7,200 3,929 0
CHILD PROTECTION AND PSYCHOSOCIAL SUPPORT # of affected families with confirmed, suspects, probable cases who received one or several kits of assistance to support their children 383* 383 28
# of affected families, including children, with confirmed, suspects and probable cases who received cont inuous psycho-social support in their community 383* 383 28
# of contact family members, including children, who receive psycho-social support and/or material assistance 4,771** 4,393*** 0
# of unaccompanied children and orphans* ident ified who received appropriate care and psycho-social support 309+ 309 42
NUTRITION # of < 23 months children caregivers who received appropriate counseling on IYCF in emergency 9,756 1,732 272 † The target is dynamic as listing of eligible persons is defined +The target changes with changes in the epidemiology *The target is est imated based on both the number of confirmed, probable and suspect case, and would be adjustment as the response matures ** The target is dynamic and 100% of listed contacts is the identified target *** Number of contact is on the decline as response proceeds
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