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Refugee and Displaced Population Operations

During a Pandemic Dr. Sibyl Jade Pena, MPH

Regional Emergency Preparedness and Response Coordinator for Asia

United Nations High Commission for Refugees

Senior Leaders Event for Asia PacificPhnom Penh, Cambodia

12-15 October 2009

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Pandemic Preparedness

• HCR is mandated to lead & coordinate international action for protection and resolution of refugee issues

• Guided by 1951 UN Convention relating status of refugees and its 1967 protocol

• Consolidated Action Plan* for AHI states that HCR will work with other UN agencies, funds & programmes and their partners in support of refugee pandemic preparedness planning

• A Special Project was established (2007)in this regard with one senior coordinator in GVA and 6 regional coordinators…(funded by USAID since 2008)

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Focus on POCs

• Refugees, other population of concern (POCs)

Dependent on agencies for assistance (food rations from WFP)

Overcrowded living conditions Background of infectious diseases and malnutritionWatsan situation In case of urban refugees, scattered all over the city

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Nepal 7 camps – 80,000

Bangladesh 2 camps- 27,000

India approx. 12,000 (New Delhi)

Thailand 9 camps- 130,000

Pakistan > 82 camps - > 1 million

Malaysia 100,000 (Kuala Lumpur)

Myanmar* 800,000 (Northern Rakhine State)

PoC numbers

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Regional Updates

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Pandemic Preparedness Project

• Camp specific Contingency Plans / Operational Plans for AHI:

1. Establishment of Outbreak Control Team (OCT)2. Surveillance and Early Warning – HIS3. Public information – awareness trainings, mass

campaigns, IEC materials4. Health Facility Planning – stockpiling, isolation & surge

capacity, waste disposal, training5. Protection of staff – health & other critical staff6. Continuity of essential services – health, food and water

& sanitation 7. Coordination with host country government agencies,

UN agencies, NGOs 8. Coordination with Red Cross movement in H2P activities

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Pandemic Preparedness Project

1.Camp preparedness plans- Nepal, Bangladesh• Epidemic Preparedness Committees – Nepal,

Bangladesh

2.Surveillance – HIS Nepal, Bangladesh, Thailand

3. IEC materials• Awareness programs (NB: Malaysia

4. Stockpile- Nepal, Bangladesh, Myanmar

6. Isolation room/ward for township hospital Myanmar, health facility improvement in a couple of camps in Pakistan

• Watsan project – Bangladesh, Myanmar, Pakistan

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Pandemic 2009

• Reviewed stockpiles , preparedness plans, increased surveillance, food stocks checked with WFP

• Increased awareness activities, orientation of staff

• Coordination with district authorities

• Seasonal Influenza Outbreak in Nepal in 06.09 to 07.09 - gaps in preparedness revealed

• H1N1 cases in Mae La camp in Thailand

• Monitoring of situation for urban refugees in Malaysia and India

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• Clear case definition for Influenza-Like Illness (ILI) for HIS to alert health staff on increased cases.

• District level preparedness including simulation exercises.

• Linkage of camp preparedness plans with host country’s plans

• Plan for frequent staff turnover (due to resettlement)

• Address inadequate isolation facilities (HCF & homes)

• Address inadequate water and sanitation facilities

Lessons Learned

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Lessons Learned

• Social distancing – food distribution, water points

• Coordination and relationship building with government agencies, other agencies to cover other areas such as improving capacity of district governance structures

• Focus not only on upgrading government structures but also on human resources.

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Challenges• Support from technical agencies (WHO, UNICEF, FAO) in

advocating for inclusion of refugee population in host country’s preparedness plans.

• Inclusion of refugee population in pandemic related activities by technical agencies (UN) and the national governments.

• Access of refugees to health services and treatment in the event of pandemic.

• Non-discriminatory implementation of bio-safety measures

• Provision and development of remote managing tools

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Thank you very much

penas@unhcr.org