WEEK 37 UPDATE
The Eighteenth Health and Nutrition
Sector Working Group Meeting Agenda Thursday 22 September 2000
Background: - The Eighteenth Health and Nutrition Sectoral Working Group meeting was held on Thursday September 7, 2000 at the ministry of health CDC/PHC conference room and a total of 21 participants including the Director General of health services WHO representative in Eritrea and representatives of Agencies and non-governmental organizations have attended the meeting.
Mr. Berhane welcomed the participants and went through the agenda, which was adopted without amendments. The last meeting's minutes was reviewed, Page 3 paragraph 7 was corrected to read as UNFPA submitted proposal to the PRM State Department. Page three of the minutes was replaced with new page to accommodate UNFPA's adjustments.
MSF-Holland: - Measles vaccination and Vitamin A supplementation will take place be in Deda and UnaWatot camps. With the above-mentioned changes the seventeenth meeting minutes was amended.
MOH Briefing: -
Routine reporting from the IDP camps is improving from day to day and the number of reporting IDPs has reached 23 out of which 9 are reporting births and deaths. The commonly reported diseases from the IDP camps are Diarrhea other types and Bloody diarrhea, Malaria, ARI and some times Eye diseases. The outbreak of bloody diarrhea in Gindae and Mekete camps are under lab investigation, they have shown a resistance pattern to many antibiotics and to identify the strain and to which drug it is sensitive is under investigation. This will enable health workers to use an appropriate antibiotic. The outbreak is under control; so far no death has been reported.
Dr. Nsue Milang WHO Representative in Eritrea asked what preparations are under way to tackle malaria? As malaria outbreak might flare up any time towards the end of the rainy season. It was mentioned that mosquito bed nets have been distributed to the users, the exact number is not known. MOH encourages cost sharing, but in this particular situation they are provided free of charge as the people are displaced and have lost all their properties due to the war. The mosquito nets are provided not only to the people in the IDP camps, but also to people who are returning back to their villages and towns.
The number and percentage of mosquito nets distributed will be presented at the next meeting as the malaria unit personnel are in Southern Red Sea zone for malaria conference. The issue of prophylaxis of anti malarial drugs for pregnant women was raised and it was mentioned that there is a MOH policy and WHO guideline and MOH works according to that policy and guidelines.
It was asked if the units (sub groups of the health sector Nutrition, Immunization etc) could brief us on the activities done so far. The sub groups were not ready to brief the meeting.
Update by organizations: -
UNFPA: - Nothing new except that they are following up with different partners the proposal, which they submit to them.
USAID: - The team on disaster alleviation (prevention) has been reduced to one person; all the activities are well underway and no need for a team.
MSF-H: - working with staff in Mendefera
CIST/CRS: - It focuses on community based health activities; it is in the program development phase.
CARE International: - It is making contacts with different partners. The program will be a 5-year program and the assessment has been finalized. Proposal submitted to work in Alba and Zula camps.
It was mentioned by the chairperson that working places for NGOs should be selected together with the MOH, as some times the priority of the MOH and the proposal submitted by NGOs to work in the camps does not match. CARE International has been contacting with Dr. Ghirmay Tesfaselasie. It was mentioned that with previous care Int. staff it was agreed to concentrate on rehabilitation. It is an initial phase and discussion can be made where CARE Int. could fit in.
Question was raised about training of Community Health Workers (CHWs) in the IDPs and remuneration issues. The policy of the Government of Eritrea concerning the payment for CHWs is clear, government does not pay, but instead the community can pay for the services and this has worked in some places and failed in others. Payment for workers who participate in feeding children, who participate in studies and any other work, which requires full day commitment, they can be paid. It was mentioned that paying CHWs should not be encouraged from sustainability point of view as mentioned by WHO Representative in Eritrea.
ICRC: - Through assistance from Capuccini, ICRC will supply mosquito bed nets to the displaced people. It was mentioned that distribution should be done through the malaria unit at the MOH, and not directly to the IDP camps.
CORADIO-Holland: - It is a newly arrived organization; it will be working with the Catholic Relief Secretariat in Eritrea to help the displaced. Jointly with caritas it will support the secretariat to provide plastic sheets.
MSF-France: - Assessment in Jeja camp in Gash Barka was done; health and water supply is good. EPI activities are lacking. In Deda camp MSF-F is planning to carry out vaccination campaign; but due to lack of health personnel this is not happening. There is only one health assistant in the camp. Therapeutic milk is supplied to Adikeih Hospital, the referral hospital in the area. Six children who need therapeutic feeding are under treatment in the camp as their families refused to go to the referral hospital.
MSF-France is giving supplementary feeding in Harena camp. Active case finding in the camp found out 86 children identified, the plan is to open day care therapeutic feeding center. In Gindae we have targeted supplementary feeding program and we have 55 children under treatment. In Adikeih area mobile clinic is operating and will tour for 10 days to give health services. People are also supplied with soap.
In Afabet there are two MOH owned and one Catholic/CARITAS run clinics. MOH is working with the Italian Cooperation to improve the clinics. The problem needs attention and MOH will look in to it.
INTERSOS: - This is a new organization, it is not yet active in the camps it will do its best to assist the displaced.
WHO: - Dr. D.V Nsue Milang introduced himself to the new comers and explained that his office is open to every organization or individual who needs information or WHO publications for reference.
He also explained that about 80% of the program budget for the biennium 2000/2001 was reprogrammed to deal with the emergency situation. Activities like integrated management of Childhood Illnesses (IMCI) and Stop Transmission of Polio (STOP) team and EPI review and coverage survey will continue. The two rounds of the National Immunization Days (NIDs) will also continue as programmed (October 14 and 15 and November 18 and 19). The only programs, which will be affected, are the training part of the biennium program (capacity building).
WHO Representative in Eritrea Dr. D.V Nsue Milang and the Director General of health services at the MOH, Mr. Berhane Gebretensae have discussed with the Regional Director of WHO for Africa Dr. Ebrahim Samba about the reprogramming of the budget and what can be done to replenish the budget for developmental activities and he promised to look in to it. This was reaffirmed by Mr. Berhane.
ICC General meeting: -
Saturday September 9, 2000 at 11:00 AM at Selam Hotel.
Next Health and Nutrition Sector Group meeting: -
Thursday September 21, 2000 at 3:00 PM
Time started: - 3:15 p.m.
Agenda: -
1. Adoption/Amendment of the Draft Agenda.
2. Review of Minutes of last meeting.
3. Briefing by the Ministry of Health on the current situation and appeal
4. Update by individual organization and
5. A.O.B.
The agenda was adopted without amendments.
Last Minute review was adopted with the following amendments.
Page 5USAID - please correct with ESMG instead of PSI&SMG
Update
MOH
The MOH has informed the meeting that most camps especially the major IDPs camps are reporting regularly and according to the graph presented it appears that most of the major diseases occurring at this camps are diarrhea, ARI and malaria. The diarrhea at the Harena camp was getting worse last week and the MOH clinical department and the IDS unit in the CDC division have made several visit to the area and they took stool samples and found the causative organism e to be due to shigella shigae and the sensitivity pattern showed that the causative bacteria was resistances to most major antibiotics. However they have now contained the out break of the disease.
The MoH has also conducted a series of meetings with the health workers of the camps. The agenda was on how to report the notifiable disease regularly, the health interventions they are supposed to carry out and how to help the coordination of NGOs work in the camps.
NORWEGIAN PEOPLES AID:
The Norwegian Peoples Aid has donated to MOH USD 315,000 for medical supplies, and they hope they will get Nakfa 4,000,000 for health project. UNCLAD is working with other UN agencies and MoH in the supplementary feeding and they are also working with other bilateral like USAID and EU to get more funds for reproductive health.
CARE:
Care International registered as an NGO in Eritrea three weeks ago. They are assessing where they can best fit. They may eventually work in southern zone IDPs camps in reproductive health, malaria, IEC and HIV/AIDS. They have not yet decided but they will work where other NGO are not involved.
ICRC
Not yet involved in IDPs camps but they may possibly be involved in rehabilitation of the health facilities and services.
MSF.H.
MSF-H has opened an office in Barentu looking forward to work in Korokon, Kotobia and nearby camps.
They have now BB5 Biscuits and will start dry ration supplementary food.
They will do measles vaccination and Vit. A distribution at Deda camp in southern zone.
They will also do health promotion education in Alba camp.
UNFPA
A joint UNFPA, other UN Agencies and NGOs will help the MoH in the provision of supplementary food.
UNHCR will provide USD 150,000 through UNFPA for medical supplies and equipments.
UNFPA has approached USAID to help in reproductive health but there is no commitment and yet negotiations will continue.
EU could provide support through UNFPA if the MoH and ERREC make a request to the EU Office in Asmara.
WHO
WHO/AFRO Regional Director, Dr. E. Samba has acknowledged the request of the Minister of health and he is working very hard to get funds from donors, so that WHO could assist Eritrea in the health emergency and rehabilitation of health services.
WHO/UNICEF
A joint WHO/UNICEF assessment visit has been carried out in the drought affected areas and they have found out that this years rainfall is also short and the plight of the people is getting worse. It was also observed that transport and other means of communication are the main problems in the area.
ICC
Proposed to change the weekly meeting of H&N SWG to biweekly. Even though most of the participants supported the idea, due to low attendance the decision was deferred to the next meeting.
Time started: - 3:15 p.m.
Agenda: -
6. Adoption/Amendment of the Draft Agenda.
7. Review of Minutes of last meeting.
8. Briefing by the Ministry of Health on the current situation and appeal
9. Update by individual organization and
10. A.O.B.
The agenda was adopted without amendments.
Last Minute review was adopted with the following amendments.
Page 5USAID - please correct with ESMG instead of PSI&SMG