Each week, the World Health Organization Health Action in Crises in Geneva produces information highlights on critical health-related activities in countries where there are humanitarian crises. Drawing on the various WHO programmes, contributions cover activities from field and country offices and the support provided by WHO regional offices and headquarters. The mandate of the WHO departments specifically concerned with Emergency and Humanitarian Action in Crises is to increase the effectiveness of the WHO contribution to crisis preparedness and response, transition and recovery. This note, which is not exhaustive, is designed for operational use and does not reflect any official position of the WHO Secretariat.
OCCUPIED PALESTINIAN TERRITORY
More information is available at: http://www.emro.who.int/palestine/ and on the HAC web site. See the WHO statement on Health services close to collapse in Gaza.
- So far 170 patients have been evacuated through Rafah, most for injuries and some for chronic conditions.
- UNRWA has suspended operations in Gaza following the death of a staff member in an UNRWA convoy.
- According to UNWRA, over 13 000 people have been displaced. If hostilities do not cease, the numbers can be expected to rise.
- An inter-Agency Principal Consultation on Gaza was held on 5 January.
Assessments and Events
- Since 27 December, up to 792 deaths have been recorded in Gaza, of which at least 340 are women and children, and 3500 people are reported injured, including at least 1530 women and children. WHO has not been able to independently verify these details.
- WHO is greatly concerned by the public health situation and the potential impact of the interruption of vaccination programmes. This could result in epidemics, such as acute respiratory infections and measles, a risk increased by Gaza's high population density and dire living conditions.
- Health services in Gaza are under enormous strain: of 58 primary health care centres managed by the MoH, 34 are functioning, albeit with major interruptions. Only a fraction of the health staff is reporting to work as most are either unable to get to work due to movement restrictions or have been redeployed to support hospital staff. Several primary health care facilities are reporting a sharp decline in patient attendance.
- Laboratory services antenatal care are no longer available due to lack of electricity, staff and supplies. Nutritional and epidemiological surveillance, preventive and occupational medicine, dental care, health education and school health services have all come to a halt.
Actions
- Jointly with the MoH, WHO established an emergency operations centre in Ramallah to assist health response coordination, advocate for access to Rafah and plan for re-entry to Gaza should a ceasefire be reached.
- WHO is coordinating the entry of medical supplies into Gaza and working with UN agencies and Red Crescent societies to track medical relief items and donations and to boost operational capacities on the Rafah border to ensure medical evacuations.
- WHO is supplying surgical kits donated by Norway to treat 5000 people for trauma for 10 days and interagency emergency health kits providing drugs and supplies for 90 000 people for three months. Supplies arrived on 7 and 8 January.
- WHO, in collaboration with Health Cluster partners, is mobilizing resources to mount the health response. WHO is requesting US$ 10.5 million to support this response.
ZIMBABWE
For more information see the Health Cluster Bulletin.
- The WHO Inter-country Support Team Coordinator presented the Cholera Command and Control Centre's terms of reference to the MoHCW, who will cochair the Centre with WHO. The MoHCW is reviewing the document for approval.
- The communication system is poor with no reliable network in most parts of the country. The Health Cluster has set up a toll free number (0808 9000) for provincial and district officers providing daily cholera data to the Centre.
Assessments and Events
- Between August 2008 and 8 January, 36 671 people have contracted cholera and 1822 have died from it (CFR 5%) in the country's ten provinces.
- A proposal is being devised for a compensation scheme for health and related staff working on cholera response.
- Medical and non medical equipment such as containers for hand washing, groundsheet polythene rolls, antibiotics and fuel for case investigation is lacking, especially in treatment centres manned solely by the MoHCW workers. The national pharmaceutical agency is lacking non medical items like beds, tents, buckets and utensils.
- The provision of food to cholera patients in treatment centres is a challenge with some facilities lacking the supplies and the capacity to provide meals.
Actions
- Within the framework of the Cholera Command and Control Centre's, WHO's major functions are surveillance, case management, water and sanitation and infection control, social mobilization and logistics. The Centre will work with the Health, Nutrition and Logistic Clusters and provide technical support to partners helping the MoHCW implement response activities.
- In Mashonaland West, a WHO/MoHCW team responded to an outbreak in Msengezi, Chegutu, where the number of cases had soared from 7 on 4 December to 60 on 16 December. They visited the cholera treatment centre in Msengezi to assess the situation and provide equipment and training to staff.
- WHO coordinates the cholera daily updates with the MoHCW.
- In the CAP 2009, WHO is requesting US$ 3 million to strengthen response and case management of cholera and other diarrhoeal diseases as well as emerging infectious diseases, and reinforce integrated facility and community-based management of acute malnutrition. Funding is also requested for Health Cluster coordination, disease surveillance and health information management .
- WHO has received funds from Botswana, Greece, the Republic of Korea and the United Kingdom for cholera-related emergency activities.
DEMOCRATIC REPUBLIC OF THE CONGO
More information is available from WHO North Kivu Crisis Situation Reports.
Assessments and Events
- In Kasaï-Occidental, 43 suspected of Ebola hemorrhagic fever have been reported in Mweka health zone, of which 7 have been laboratory confirmed. Fourteen related deaths were reported (CFR 32.5%). A further 224 contacts have been identified and are being followed up.
- Security remains precarious in North Kivu. Between 29 December and 4 January, 119 cases of cholera were recorded in the province, including 23 in Goma health zone, 6 in Karimbishi, 17 in Kirotche, 27 in Mweso, 28 in Rutshuru and 18 in Binza.
- In Orientale's Haut Uele district, new LRA incursions during the Christmas celebrations have killed seven people and burned several houses. More than 13 .000 persons face critical humanitarian situation in Doruma
Actions
- In Kasaï-Occidental, the WHO Country Office, the Regional Office and headquarters are supporting the MoH in Kinshasa, in Kananga and in the field at the location of the outbreak. WHO has deployed five vehicles to the field and has sent outbreak response equipment and medical supplies.
- In North Kivu, the WHO office in Goma is collecting data on reportable diseases and ensuring the distribution of the supplies donated for the response. WHO also visited the three Mugunga sites and Buhimba to assess the health, water and sanitation situation.
- WHO emergency activities in the DRC are funded by Australia, Finland, Italy, Norway, the CERF and the Pooled Fund for the DRC.
SUDAN
See also the Regional Office for the Eastern Mediterranean web site.
Assessments and Events
- No major security incidents are reported, but the situation remains tense and unpredictable, particularly in West Darfur, where two-thirds of Jabal Marra and part of Zalingi remain inaccessible. Jabal Moon, in Kulbus is also inaccessible and inter-agency assessments are under preparation. Reports indicate that children aged one to five have not been vaccinated for the last three years.
- In Abyei, the situation is calm but tense. IDPs residing in Agok are serviced by the NGO GOAL and the State MoH but support is insufficient. The expansion of services through community health workers is being considered.
Actions
- Throughout Darfur, WHO continues to provide technical and logistic support for communicable disease surveillance. For the last week of 2008, the surveillance system reported that acute respiratory infections accounted for a quarter of all conditions among children under five.
- In West Darfur, WHO provided clinical management guidelines for common diseases and monitored service provision in Abu Zer IDP camp. Training on health information system was also conducted in Geneina. Four NGOs, supported by UNICEF, are conducting nutritional surveys in Elsalam, Ottash, Kubum and Gredha IDP camps.
- In South Darfur, WHO visited Nyala Teaching Hospital to supervise free service provision and donate midwifery kits, obstetric surgical kits and basic supplies to Kass rural hospital. WHO conducted a training on water quality control system in emergencies in Nyala. Some of the samples taken in camps throughout South and North Darfur show lack of chlorine residue indicating the need to take precautionary measures to avoid water-related outbreaks.
- WHO's activities in Sudan are funded by the CERF, the Common Humanitarian Fund, ECHO, ERF, Finland, Ireland and Italy.
CHAD
See also the weekly mortality and morbidity report for eastern Chad.
Assessments and Events
- In 2008, 2214 cases of acute jaundice were reported in eastern Chad, including 31 related deaths (CRF 1.4%). Two new cases have been reported during the first week of January, one in Bredjing camp (Adre) and another in Djabal camp (Goz Beida).
- A total of 345 suspected cases of measles were also reported last year, of which 89% were notified in Abeche district. The outbreak continues and 31 cases were recorded during the first week of 2009. Fourteen samples were transmitted to the referral laboratory for confirmation.
Actions
- WHO is helping health authorities monitor the measles outbreak in Abeche. A visit to the two health centres reporting the highest number of cases has shown that some essential medicines are lacking. WHO will provide the supplies. Free health care for measles cases has been decided by local authorities.
- In Iriba health district, WHO provided essential medicines to the health centre in Amnabak refugee camp. WHO also trained 20 health staff on nutritional surveillance. They also serve Iridimi and Touloum refugee camps.
- WHO's emergency response is funded by ECHO, Italy, Finland, Spain and the CERF.