The Mozambique emergency Health Cluster Bulletin aims to give an overview of the health activities conducted by Health Cluster partners in the areas affected by the floods and cyclone Favio. It compiles health information received from the different organizations and partners active in the area. The Health Cluster Bulletin is issued every Friday.
- On 12 March, a Mozambique Flash Appeal for Floods and Cyclone was launched for a total of US$ 17.7 million. The funds have been asked to provide life saving emergency assistance to 285,000 affected people for a period of up to six months.
Health sector share is US$ 3,487,330 to reach the below main objectives:
1. Contribute to the provision of essential Primary Health Care services.
2. Put in place an epidemiological surveillance system to reduce mortality from communicable disease outbreak and coordinate a comprehensive and effective response.
3. Support health promotion activities for the affected people
- No epidemic outbreaks have been reported to the Ministry of Health (MoH) or WHO.
- The global emergency phase has shifted from Red alert to Orange. However, for health, the Health Cluster recommends to keep the Red phase.
- Water levels are receding in affected areas. New health facilities have been reached by assessment teams.
- The global emergency phase has shifted from Red alert to orange. However, for health, the
Health Cluster recommends to keep the Red phase because water is still stagnating.
Thousand of people are living together in poor hygiene, water and sanitation conditions. As a consequence, the risk of water born diseases (Cholera) and vector born diseases (Malaria) is very high. Even thought no diseases outbreaks have been reported so far, epidemiological surveillance in the camps is one of the most urgent priorities.
- Mozambique authorities reported that only 40% of the latrines requirement in the accommodation centres is filled (Mozambique emergency standard). Most of the water supply requirements have not been addressed (A precise estimation is not available).
- Information collected from The Mozambique Red Cross (MRC) volunteers indicates that malaria, diarrhoea, respiratory infections and conjunctivitis are major causes of morbidity.
Information on regular basis is needed to monitor the trend of these diseases and take appropriate actions.
Note that data collected with the kind support of MRC volunteers based on simple case definition (only on symptoms). Subsequent data with a harmonized tools and training would help to monitor the trend.
Health Response to the Humanitarian Crisis
1. Assessment and monitoring
- Health surveillance is the major gap to be filled as soon as possible. WHO is working with the MOH and Health partners mainly MRC to set up a surveillance system which will have the capacity to provide regular information from the accommodation centres.
- Several weeks after the event, more affected communities have been reached such as in Vilanculos. Roads are starting to be accessible.
- The Health Cluster is coordinating the assessment of the health situation in the camps. This includes: identifying appropriate referral facilities, preparation for epidemiological surveillance, Cholera and malaria prevention and availability of essential medicines.
- The government established a slogan “Food for Latrine” in Caia. Food will only be given to the population if they build their own latrine in order to reduce the risk of diarrhoeal diseases including cholera. The Health Cluster might parallel this with sanitary education campaigns to teach people the proper hygienic use of latrines.
- Caia has 3 Health Centres - Caia Health Centre; Murraca Health Centre and Sena Health Centre. It has also 9 health posts with a health agent. The posts are located at Amilcar Cabral; Sombreiro; Gangala; Nhambalo 1; Nhambalo 2; DAF, Tchetcha, Magagade e Nhacazize.
- The Mozambique authorities are considering the use of common kitchens. Food will be prepared in a single kitchen to assist 10-20 families. If this is adopted, the Health Cluster will have to reinforce the hygiene practice.
2. Health coordination
- The latest Cluster meeting took place on 12 March 2007 in the MOH. Main outcomes:
- Health Promotion sub group to finalize a plan and submit it to the MOH’s focal point.
- MOH to provide a list of requested drugs in response to outbreaks.
- Surveillance sub group to work on a plan to improve the surveillance system and data collection tool.
- Next Health Cluster meeting will take place Monday 19 March 2007 in WHO building.
- Three WHO staff have been deployed to Caia, Zambezia and Tete to support health partners in strengthening health coordination.
- The Caia Regional office will be decentralized shortly and each province will have its own office and team to assist on the emergence response.
3. Filling health gaps
- In response to the Post-Emergency National Recovery Plan, WHO is planning the procurement of VHF radios aiming at strengthening the surveillance for Communicable Diseases. WHO, DDS and INGC are mapping the available radios in the region to allow daily reporting of epidemiological data to DDS in Caia and identify gaps to be filled.
- The Health Promotion working group, created by the Health Cluster, conducted a meeting to define the urgent needs to be accomplished within the coming 10 days which are:
- Training of community health activists, teachers, traditional leaders, religious leaders, traditional healers, community radio producers and journalists. Its main objective is to contribute to the improvement of the well being of the population by preventing the incidence of Malaria, Diarrhoea, Cholera, Conjunctivitis, Meningitis, HIV/STDs and nutrition in the affected areas.
- Printing of 6,000 Emergency Health Education Manuals.
- Purchase of megaphones and batteries.
- Replication of existing radio spots (priority diseases).
- Replication of the existing radio songs (priority diseases).
- Acquisition of 31,000 dignity kits for women (Hygienic pads for woman).
- Acquisition of 2,000 delivery Kits.
- Acquisition of 160 post-delivery tents
- The Working group members are:Red Cross, UNICEF, UNFPA and WHO. It’s is led by MOH.
- UNFPA is procuring 31.000 Dignity kits and 2000 Delivery Kits to be distributed in the camps.
- MRC distributed 2348 Insecticide-treated mosquito nets (ITN) in Tete and 600 in Caia.
Preparation to open 16 First aid posts is under way; 6 posts in Zambezia, 2 in Vilanculos and 8 in Sofala. The MRC distributed 20 First Aid kits in Vilanculos.
- UNICEF contributed in the below activities:
- Worked with other partners to increase the number of ITNs distributed in affected areas to 53,000 ITNs (two per family);
- Supported multimedia mobile units to project videos and conduct sessions on HIV prevention and the promotion of good health and hygiene practices in all affected provinces. Activities are planned to continue until the end of March;
- Supported community theatre groups to conduct sessions on HIV prevention and promotion of good health and hygiene practices in all affected provinces. Activities are planned to continue until the end of March;
- Supported Radio Mozambique and partners to broadcast radio spots on Cholera prevention in Portuguese and eight local languages. Child to child radio programs have been broadcasted as well.
- Supported activists from the local health authorities and NGO to conduct ongoing activities using IEC materials on the prevention of cholera, diarrhoea and conjunctivitis.
4. Capacity building
- WHO and MoH are planning with NGOs to train health workers in basic surveillance system, including case definition to improve data collection.
- IFRC is assisting MRC to train volunteers on first aid and community based health programs.
A total of 584 volunteers are conducting health education sessions. A total of 37 health posts in accommodation centres were opened.
5. Interview of the week
Each week, the Health Cluster bulletin will interview a health partner. This week, Dr.El Hadi Benzerroug, WHO Representative in Mozambique and Head of Health Cluster answers the below questions.
1. As a Health Cluster leader for the Zambezi River floods and cyclone Favio crisis, what is your main priority now?
- The Heath Cluster main priority is to strengthen the epidemiological surveillance and to follow-up the trend of some diseases. After the floods, water is still stagnating. Thousand of people are living together in poor hygiene, water and sanitation conditions. As a consequence, the risk of water born diseases such as Cholera is really very high. We strongly believe that, for health, we have to keep the red phase ON even though globally, the situation is shifting from the red alert phase to the orange phase.
- We need to be ready for the epidemiological response in case we have an epidemic outbreak. This mean, having enough funds to provide medicines, laboratory reagent and duplicate guidelines for a rapid response.
2. Which stage of the epidemiological surveillance are you now?
- Before the floods, WHO finalized in December a need assessment on epidemiological vigilance. It had shown weaknesses in terms of collecting data, analysing it, laboratory support, and reporting.
To address these weaknesses, WHO:
- Sent 3 teams to Tete, Zambezia, and Sofala provinces to look after the epidemiological vigilance, data collection and support future health training for health workers and partners.
- Called upon all actors in the field to support the collection of data, coordinate the information circulation, to link with Mozambique National Centre for Emergencies and to follow up the trends of epidemic risks.
- Together with the MOH, we are examining the possibility of putting more VHF radios in some provinces to communicate on daily basis the health information collected in the camps. With the MRC we are working on analysing the information they are collecting in the camps.
- We are planning to have at least two epidemiologists to strengthen the capacity of the MOH in keeping the flow of collected information and analysing it.
3. After WHO recent assessment what’s the main issue that have not been addressed yet?
- The increasing risk of HIV aids has not yet been fully addressed. With our partners we are making sure that condoms are available in the camps. However, we have to do much more in health promotion. For this reason, we are in the process of developing health promotion guidelines that will be distributed to all health partners in the field.
4. What’s your next step?
- First and foremost, our aim is to keep the affected regions and it’s population without any epidemic.
- Support early recovery in the resettlement phase in the floods and cyclone affected regions.
We have a team in Vilanculos looking into technical assistance during the reconstruction phase.
- Develop an updated contingency plan to cover all the risk that a health sector may face in case of new floods, cyclone or any other emergency.
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