Madagascar: Plague (Epidemic) Revised Emergency Plan of Action Operation Update MDRMG013 Update no. 1

This revised Emergency Appeal seeks a total of 2.19 million Swiss francs to enable the International Federation of Red Cross and Red Crescent Societies (IFRC) to support the Malagasy Red Cross Society (MRCS) to deliver assistance to some 1.2 million people over 9 months (until June 2018), to contribute to the reduction in mortality and morbidity due to the plague outbreak in 10 priority regions (reduced from 22) through effective prevention, response and capacity building activities. The focus of the appeal is on Health promotion and Community Engagement and Accountability (CEA) for behavior change, Community-Based Surveillance (CBS), Clinical Case Management through running the Plague Treatment Unit (PTU) and vector control, sanitation and hygiene support. Capacity building activities and trainings are also to be carried in the areas of Psychosocial Support (PSS) and Safe and Dignified Burials (SDB).

Funding Status: The funding gap is currently CHF 1,297,334. We are in discussion with some partners who have indicated potential funding interest for an additional CHF 500,000 Additional resources are urgently required as there is still a significant funding gap which might affect operational continuity”

Summary of major revisions made to emergency plan of action (EPoA):

With the plague caseload decreasing over the last few weeks and the epidemic currently under control, the operational strategy was modified to meet the actual needs on the ground. Therefore, the Emergency Appeal has been revised with budget reduction and scaling down of some immediate response activities, while the capacity building component is being scaled up and trainings increased to reach over 900 volunteers who will carry out community based and preparedness activities to be able to respond in case of new epidemic peaks.

The highlights of this revision are as follows:

The operation will focus on ten regions (see list below) instead of the 22 regions originally intended.
The timeframe has been decreased from 18 to 9 months (until 17 June 2018)
The budget has been reduced from CHF 5,5 m to CHF 2,19 m The 6 pillar-response strategy will now focus on 4 pillars which are:

1. Health promotion and Community Engagement and Accountability for behavior change.

2. Community-Based Surveillance.

3. Clinical Case Management and running the Plague Treatment Unit (PTU) at the Andohatapenaka Hospital which will be kept on alert, with core staff ready to welcome plague patients and organize training in plague treatment, prevention and control.

4. Vector control, sanitation and hygiene activities.

Psychosocial Support (PSS) capacity building, PSS activities and anti-stigma campaigns will also be carried out alongside the four main pillars above. In terms of Safe and Dignified Burials (SDB), 30 staff and volunteers will be trained in SDB preparedness training. However, at this time, burials will only be initiated in case of a high number of plague deaths that the authorities would be unable to handle and subject to the SDB protocol being approved by the authorities.

Key activities to date; 900 volunteers have/ are being trained in CEA, out of which 600 are trained in CBS, 300 in vector control activities, 100 in PSS and 30 staff and volunteers in SDB. Since the plague season usually goes to April, plague cases are still possible to occur, and vigilance must be maintained with a MRCS core national team3 in place at the PTU ready to treat plague patients and able to continue to train medical and para-medical staff. Overall, the funds of all operational partners are running low whilst support is still needed to maintain the capacity at the PTU at least to the end of the plague season, to strengthen outbreak and vector control and to focus on capacity building of MRCS in community preparedness and reinforce prevention measures.