Horn of Africa Crisis: 2011-2012
The Horn of Africa crisis of 2011-2012 affected 13 million people. The main focus of the crisis was across southern Ethiopia, south-central Somalia and northern Kenya. Regional drought came on top of successive bad rains and rising inflation. It ramped up a chronic livelihoods crisis into a tipping point of potential disaster by putting extreme pressure on food prices, livestock survival, and water and food availability. Armed conflict across the region compounded chronic ecological and economic vulnerability, which escalated the crisis and limited people’s survival and recovery choices. (IASC Real-Time Evaluation of the Humanitarian Response to the Horn of Africa Drought Crisis in Somalia, Ethiopia and Kenya - Synthesis Report)
Appeals & Response Plans
Reporting December 2012 - Epidemiological weeks 49 – 52
• CHOLERA Ten alerts in Lower Jubba and Bay regions
• MALARIA Outbreak in Bossaso
• POLIO VACCINATION Campaign targets newly accessible areas
- Following recent confirmation of three vaccine-derived poliovirus type-2 (cVDPV2) cases in the refugee camps in Dadaab, Kenya and one cVDPV2 case in Kismayo, South Central Somalia, an immunization response is currently being planned. More than 800,000 children will be targeted in Kenya, including in the Dadaab refugee camps (target age groups in the camps will be <15 years), meanwhile in South Central Somalia 30,000 children will be targeted in two recently-accessible districts adjacent (Afmadow and Badhaade) to the Kenya border.
Suspected cholera outbreaks have been reported in Hoosingow and Waraq villages in Badhaadhe district, Afmadow and Dobley towns in Afmadow district and Hagar district. A total of 14 samples of suspected cholera cases were collected from Hoosingow and Dobley town, and 12 of these 14 collected samples tested positive for cholera.
Suspected cholera cases continue to be reported from Hoosingo village in Badade district (Lower Jubba). Between 5 and 13 September 2012, 107 suspected cholera cases and 12 deaths have been reported. The majority of the cases are children above the age of five. The village is not served by any health facility, however, WHO, UNICEF, health partners, the community and local authorities have concerted resources to ensure availability of adequate supplies on ground.
IN FOCUS STORY:
• Following the measles outbreak in June 2012 in Burao district, no suspected measles cases were reported in the same area during the reporting week. • During the reporting week, no suspected cholera cases were reported in Southern Somalia.
IN FOCUS STORY: Health partners trained on how to diagnose and treat correctly malaria cases
- Banadir and Lower Shabelle regions reported a total of 25 suspected shigellosis cases, with 84% (21 out of the 25 reported cases) located in Banadir region alone. Since week 23, all suspected shigellosis cases reported in Banadir region are located in one health facility; however this is being investigated as concerns were expressed about the adherence to the recommended case definition.
IN FOCUS STORY
On World Humanitarian Day, 19 August, WHO honours the thousands of people working in emergencies and humanitarian response throughout the world, such as Dr Alaa Abu-Zaid, Coordinator of the Health Cluster, Mogadishu, Somalia
For more than 20 years, Mogadishu has endured a chronic emergency situation, including the influx of thousands of internally displaced people fleeing insecurity and food shortages in southern parts of Somalia. In 2011, the country faced one of the worst famines in years
- In week 31, Bakool region in Central Somalia, reported a significant increase in reported suspected measles cases as compared to previous week. Eighteen of the 23 cases were reported from a single facility. Investigations are ongoing to establish if it is an outbreak.
EPIDEMIOLOGICAL SURVEILLANCE (EPI WEEK 31, 30 July – 5 August 2012)
- In the month of July, the regions of South and Central Somalia reported a significant decrease in number of reported cases for suspected cholera, suspected measles and confirmed malaria. A 84% and 38% decrease in suspected cholera cases was observed in South and Central Zones respectively.
- An unknown illness was reported from Qol village (Nugaal region) in northeastern Somalia with patients presenting with diarrhea and vomiting. A Ministry of Health (MoH) team verified 47 people affected of which 8 were hospitalized at Dhahar Hospital where they were treated with intravenous fluids and antibiotics. All patients recovered. The source and cause of illness was suggested to be contaminated milk.
(reflecting Epidemiological week 28)
• From 16-18 July 2012, a total of 331 215 children under the age of five were targeted with the second round of National Immunization Days (polio vaccine) in Banadir region.
65 patients received treatment, and 6 cases confirmed positive for cholera
13 July 2012 ¦
Nairobi – The World Health Organization (WHO) is very much concerned about the increased number of cholera cases, particularly in Kismayo town. One health facility did a rapid test among a sample of ten patients, and a total of 6 cases tested positive for cholera. Out of the 65 patients treated so far in the same health facility, 40 suffered severe dehydration and needed immediate hospitalization. The majority of the cases are children under the age of 8.
A fourth cholera treatment center (CTC) was opened in Xamarjajab district acting as a referral center for suspected cholera cases to decongest the caseload in Banadir hospital.
A total of 7 out of 37 stool samples collected from patients in Mogadishu tested positive for cholera. Renewed displacements due to current armed conflict affecting the Afgooye corridor and parts of Mogadishu may accelerate an increase of suspected cholera cases.
- During the National Immunization Days (polio vaccine) in Puntland, held from 21-23 May 2012, a total of 178 598 children under the age of five have been reached. During June, Banadir region (16 districts) Galgadud region (8 out of 13 districts) and Hiran region (1 out of 5 districts) successfully implemented National Immunization days too, however data on the actual reached beneficiaries is not available yet.
(reflecting Epidemiological week 23)
- During week 22, 6 out of 20 stool samples collected from new admissions in Hodan and Hamarjajab cholera treatment centers in Mogadishu tested positive for cholera.
(reflecting Epidemiological week 22)
As a response to the increased number of suspected cholera cases in Puntland, a cholera task force meeting led by the Ministry of Health was held in Bari region. An extensive prevention and response plan has been developed, and various response activities are in the pipeline (see page 4).
- As a response to the current cholera outbreak in Mogadishu, a fourth cholera treatment center (CTC) has been opened. The CTC, fully functional, is located in Xamarjajab district and acts as a referral center for suspected cholera cases to decongest the caseload in Banadir hospital.
(reflecting Epidemiological week 20)
- Of 37 stool samples collected from patients in Mogadishu during the reporting week, 19% tested positive for cholera on lab culture. Current armed conflict affecting the Afgooye corridor and parts of Mogadishu resulting in renewed population displacement could accelerate the spread of cholera in Mogadishu.
(reflecting Epidemiological week 19)
As a response to the current measles outbreak in Somaliland, particularly Burao district, the Ministry of Health has decided to organize a region-wide outbreak response campaign. Exact dates and target population figures are not known yet.