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WHO Health Situation Report West Timor 15 Dec 1999

Format
Situation Report
Source
Posted
Originally published
World Health Organization/UNICEF
Surveillance

Disease surveillance data have been forwarded to UN agencies by Kupang Provincial Health Office and Christian Children's Fund. The Kupang Provincial Health Office provided death and case mix data from four camps of TTU district during Dec 1-12. Provincial Health Office also provided daily death reports from Tuapukan Camp in Kupang District. Christian Children's Fund submitted case mix data from 6,492 presentations to their mobile clinics in Belu district from October 18-November 20. No district-wide mortality data have been forwarded by district or provincial health authorities since the last sitrep of 08/12/99.

Kupang District health authorities have completed rapid enumeration and health assessment of Tuapukan camp residents. The camp of 12,800 residents has been the largest in NTT. Home visiting was undertaken by district level health workers with financial assistance from UNHCR and technical assistance from WHO. District health authorities will next target Noelbaki and Naibonat Camps. The area of greatest number of refugee needing systematic disease surveillance remains Belu District.

Mortality

Crude mortality in Tuapukan Camp of NTT has decreased in the past week from 2.1 to 1.1 deaths /10,000/day. Under five mortality has decreased in the same time period from 9.2 to 4.8 deaths/10,000/day. Recent camp deaths were ascribed predominately to non-bloody diarrheas. Investigation of unprotected wells in the camp revealed that two of four were contaminated with fecal bacteria. Well covers have been installed and chlorination has begun in water trucked to the camp. Camp oral rehydration treatment posts, initiated by ICRC, are now operational.

Verbal autopsy of a sample of 30 deaths at Tuapukan camp undertaken by MSF-Belgium revealed that most patients received medical care for disease symptoms 1-2 weeks before death. Standardized case management is being intensified with providers at health facilities.

No deaths were reported from four TTU camps for the 12 days of observations.

Morbidity and Epidemic Potential

Proportional morbidity from TTU camps reveals the following disease burden among 450 presentations:

Under age 5
Over age 5
upper respiratory illness
39%
upper respiratory tract
27%
diarrhea without dehydration
14%
clinical malaria
14%
pneumonia
6%
bloody diarrhea
3%
bloody diarrhea
5%
diarrhea without dehydration
2%
clinical malaria
2%
pneumonia
1%
unspecified
31%
unspecified
53%

No reports from TTU or Christian Children's Fund of diseases of epidemic potential of dengue or meningitis. CCF reported 13 cases of suspected hepatitis.

Health Services Coverage

Several NGOs have expressed interest in starting or increasing health services in Belu District. This interest has been encouraged by UN agencies.

Disease Specific Issues

Measles

TTS district health service plans to imminently vaccinate 1,146 children with funding by UNICEF.

Nutrition

UNICEF nutritional assessment teams are expected to commence work this week. One team will assess Belu and TTU Districts, the other will assess TTS and Kupang Districts. Supplementary feeding has already begun as an interagency and NGO cooperative effort.

Compiled by D Bradt, S Collins, S Pareira, and S Baswedan

=A9 Copyright World Health Organization (WHO)