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Health Action in Crises - Highlights No. 232, 27 Oct to 02 Nov 2008

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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.

DEMOCRATIC REPUBLIC OF THE CONGO

- According to MONUC, there have been more than 40 attacks on health facilities and more than 80 attacks on convoys and humanitarian facilities since the end of August.

- Since last August, fighting between government and rebel forces have displaced 200 000 people. Overall, there are an estimated 1.4 to 2 million displaced people in North Kivu.

- WHO is also concerned about the deterioration of health services across the whole of DRC due to the nationwide strike of health professionals which has been going on since mid-September.

Assessments and Events

- After a sudden offensive that reached the immediate vicinity of Goma on 29 October, the rebels have declared a unilateral ceasefire that is holding so far.

- Over 45 000 IDPs are reported on the roads fleeing Rutshuru, Kiwanja, Rubaya and Goma. They are all in desperate need of protection, food, water, shelter and medical care. Hundreds are reported to enter daily into Uganda.

- The violence has seriously impacted on health services in North Kivu with widespread looting of health centres. Goma hospital is stretched to its capacity with the amount of wounded.

- Hygiene conditions are very precarious and there is concern over the propagation of the ongoing cholera outbreak. Cases of measles are also reported in the areas affected by the conflict.

- The provision of supplies for treatment of injuries and infections and of safe water and sanitation is critical to save lives and to prevent communicable disease outbreaks.

- Lack of security is hampering access to IDPs, but assessments are starting in the more stable areas, such as Minova and Beni. Although many NGO partners suspended their operations, some are resuming activities where they can.

Actions

- WHO provided four basic health kits to the NGO International Medical Corps for their health posts in the two UNHCR camps in Kibati. To prepare for potential outbreaks of cholera, WHO had earlier provided IMC with Ringer Lactate and a basic supply of drugs.

- WHO also provided surgical supplies to Goma hospital and supported the quick rehabilitation of the hospital's blood bank. WHO is also reinforcing epidemiological surveillance in the area.

- As the Health Cluster lead, WHO called an emergency meeting on 31 October with all partners in Goma. The Health Cluster in Goma estimates that five additional health kits will be necessary if the situation continues to deteriorate.

- WHO has offices with emergency focal points in Goma and in Bukavu, and staff in Kinshasa are on standby to assist. The WHO offices in Rwanda and Uganda are monitoring the situation at the borders.

- WHO supplies are pre-positioned in neighbouring provinces as well as in Burundi, Rwanda and Uganda, ready to be shipped as requested. On 30 October the Government of Italy announced a new donation of drugs for this crisis.

- WHO's emergency activities in the DRC are funded by Finland, Italy, the CERF and the Pooled Fund for the DRC.

PAKISTAN

- In Quetta, two coordination meetings were held with provincial disaster and health authorities, WHO, UNICEF, FAO, UNFPA, UNHCR and WFP.

- On 30 October, WHO conducted in Islamabad its first emergency Health Cluster meeting on coordination of activities. The second meeting, cochaired, with the MoH will be held on 3 November .

Actions

- The Government has declared emergency status for all the hospitals of the province particularly in Ziarat. The National Disaster Management Authority sent tents, blankets and other supplies, and provincial health authorities have dispatched ambulances, medicines and medical teams to the affected area.

- A health coordination office is being established in Balochistan consisting of the Provincial Department of Health, the Provincial Disaster Management Authority, WHO and cluster partners.

- WHO and its UN partners are now carrying out field assessments in the affected area of Ziarate and Pishin to obtain a clearer picture of the health needs.

- WHO sent a new emergency health kit and five mini emergency health kits from Islamabad, providing enough supplies for 20 000 people for 3 months, and is flying trauma supplies for 400 people from the UN Humanitarian Response Depot in Dubai.

- WHO is activating the disease early warning system in the affected districts.

- WHO's emergency activities are funded by the CERF, Sweden and USAID.