- Background
Eighteen years of conflict in northern Uganda has resulted in the displacement of over 90% of the population in Gulu, Kitgum and Pader districts into internal displaced peoples (IDP) camps. Congestion, overcrowding, inadequate healthcare services, poor water and sanitation facilities, violence and insecurity in the camps predispose the IDP population to high morbidity and mortality rates. WHO has been supporting the MOH, DDHS and other local and international partners to mitigate the health impact of the conflict in northern Uganda for an extended period. In order to provide better support to the population in need and strengthen emergency preparedness and response capacity in the country in general and northern Uganda in particular, WHO established the health action in crisis (HAC) office in Kampala and opened a sub-office based in Gulu in late 2004. Due to lack of human resources, the activities of the sub-office were constrained for most of 2005. However, activities scaled up in late 2005 following the arrival of two international focal points for HAC (based in Kampala and Gulu).
This short progress report documents the progress made to date by WHO/HAC team in responding to the high mortality and morbidity among IDPs in northern Uganda. It covers the period from December to March 2005.
2. Milestones: What has been achieved so far?
2.1 Joint Interagency Response to the Northern Uganda
A mortality survey (1) carried out in the Acholi sub-region in July 2005 showed crude mortality rate (CMR) of 1.54 and under five mortality rate of 3.18/10,000/day. The figures in Kitgum and Pader are double the emergency threshold for both CMR and U5 MR. The outcome of this survey raised a lot of concern about the humanitarian situation in northern Uganda within and outside the country. With this concern also came significant expectations that WHO take the lead in terms of health care coordination and delivery to the IDPs in the north. In December 2005, WHO in collaboration with UNICEF and UNFPA developed a joint proposal to address the key causes of high mortality and morbidity in the north and submitted this to DFID, which approved it in January 2006. The proposal is unique in the sense that it is the first occasion that these agencies are collaborating under one umbrella to present a common proposal to the donors and partners in Uganda.
The objectives of this proposal are in line with the objectives of the Health Sector Strategic Plan, the HIV/AIDS National Strategic Framework (including the Action Plan for the National Committee on AIDS in Emergency Settings), the CAP and UNDAF.
The proposal has a duration of 6 months seeks to support the internally displaced persons (IDPs) in the 5 conflict-affected districts of Gulu, Kitgum, Pader, Lira and Apac in northern Uganda through implementation of evidence-based targeted interventions including: malaria, child health (including immunisation), reproductive health (including family planning, post abortion care, safe motherhood, adolescent reproductive health, EmOC, and SGBV), HIV/AIDS/STIs/TB, epidemic preparedness and response. The proposal also aims at strengthening the response capacity of the district health system and health co-ordination in the 5 districts.
Footnote:
(1) Health and mortality survey among IDPs in Gulu, Kitgum and Pader district in Northern Uganda. MoH/WHO/UNICEF/WFP/UNFPA/IRC, July 2005.
(pdf* format - 248 KB)