Northeast Nigeria Response (Borno State): Health Sector Bulletin #25, 1 - 15 May 2017
An upsurge of violence has been reported in some areas in central Borno State and at the border between Niger and Nigeria. This increase in casualties hampers the provision of humanitarian assistance.
As a result of the ongoing conflict, market disruption, restricted food flow in remote locations, elevated food prices and limited agricultural activities, food insecurity persists and the risks of acute malnutrition and related mortality are high. In the least accessible areas, communities are at elevated risk of famine (Integrated Food Security Phase 4/5), despite the increase in humanitarian aid.
The risk of spread of hepatitis E outbreak from Niger to Nigeria is high due to increased cross-border movement of population and animals. Systematic screening of patients with Jaundice and fever, and laboratory testing should be performed for both hepatitis E and yellow fever.
In order to improve malaria case diagnosis before treatment, WHO is facilitating the distribution of 1,000,000 malaria Rapid Diagnostic Test (RDT) in 300 health facilities across Borno state and additional 600,000 in Yobe and Adamawa.
From the Health Sector platform, preparedness activities for malaria response are ongoing as malaria is endemic in the northeast region with season increase from July to November. The preparedness and response strategy includes improvement of environmental and health surveillance, prevention strategies, social mobilization as well as diagnosis and treatment of malaria.
Despite the counter-insurgency operations of the Multinational Joint Task Force (MJTF), Boko Haram continues to carry out attacks on security forces and perpetrate violence against civilians; an upsurge of violence has been reported in some areas in central Borno State and at the border between Niger and Nigeria.
Access to some of the worst-affected people remains a concern for humanitarian actors.
The impending onset of the rainy and lean season (June through September) is expected to further exacerbate the shelter and food needs and the associated health and sanitation risks. Moreover, it will also limit humanitarian access. The flood vulnerability mapping indicates that about 59 IDP camps could be exposed to flooding hazards, as they are located in proximity to water flow/accumulation areas. Strong winds and the first season’s rainstorms have already destroyed hundreds of shelter units in IDP camps, more than 50 temporary learning spaces, and dozens of latrines in Borno and Yobe. Partners (FHI 360, IRC, PUI, IMC, ACF, MRRR) are working to rebuild, reinforce facilities, communicate on health hazard prevention and preposition of drugs and supplies across the three most affected states.
Currently, 4.7 million people are estimated to be food insecure in the most affected areas of Borno, Adamawa and Yobe State. This number is expected to rise to 5.2 million in the next three months. The findings of the Household Economic Approach (HEA) exercise were released in late April, revealing that almost 3 out of 4 IDPs (73 per cent) are unable to fully meet their daily kilo calorie needs (2100 kcal per day) with the available food commodities.
Following the IHR notification from Niger on Hepatitis E, field investigation was carried on in Damasak on 3 May 2017. Several samples were sent for laboratory confirmation. An LGA-rapid response team was briefed with the DSNO as well as community leaders to conduct screening and social mobilization for acute Jaundice. The states Rapid Response Team will deploy next week to further establish screening activities of Jaundice. To better understand the magnitude of the outbreak, active case finding is being conducted in different health centers in the region and at community level. The reinforcement of water, sanitation and hygiene (WASH) interventions will support breaking the transmission of the virus and prevent new cases. It will be important to keep the cross border communication ongoing so that experiences on management of hepatitis E outbreaks can be shared.