Philippines: Tropical Storm Ketsana ("Ondoy") and Typhoon Parma ("Pepeng") , Typhoon Mirinae ("Santi") Health Cluster Situation Report 21

Situation Report
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As of 5 November 2009, 210 816 families / 1 103 569 individuals reside in still-flooded areas in 152 barangays in 29 municipalities of NCR (Pasig , Taguig, Muntinlupa) and Region IV-A (Laguna and Rizal provinces)

As of 30 October 2009, NEC reports the top morbidities in sentinel evacuation centers as: acute respiratory illness, skin infections/wounds, diarrhea, febrile illness, influenza-like illness, severe acute respiratory illness, and pneumonia

Leptospirosis cases from NCR, Regions I, II, III, IVA and CAR since the disaster now totals 3 125 cases, with 240 cumulative mortalities. 73% of these cases are from NCR alone

Tropical Storm Ketsana

As of 30 October 2009, 995 587 families / 4 918 503 individuals have been affected in 1 975 barangays in Regions I, II, III, IVA, IVB, V, VI, IX, XII, ARMM, Cordillera Administrative Region (CAR), and NCR

16 173 families / 72 305 individuals remain in 252 evacuation centers

Casualties (directly attributable to disaster): 358 confirmed dead, 1 111 injured

Typhoon Parma

As of 28 October 2009, 945 402 families / 4 419 034 individuals have been affected in 5 406 barangays in Regions I, II, III, and Cordillera Administrative Region (CAR)

3 258 families / 14 892 individuals remain in 54 evacuation centers

Casualties (directly attributable to disaster): 492 confirmed deaths , 163 injured

Typhoon Mirinae

As of 5 November 2009, 78 915 families / 382 541 individuals were affected in 871 barangays in NCR and Regions III and IVA.

5 213 families / 24 954 individuals remain in 123 evacuation centers

Casualties (directly attributable to disaster): 20 confirmed deaths , 7 injured (partial reports)

Health Situation Update

Communicable Diseases

- Based on reports from DOH hospitals in NCR and reports from regional offices from Regions I, II, III, IVA and CAR, cumulative leptospirosis cases since the disaster now totals 3 125 , with 240 cumulative mortalities. 2279 cases (73%) are from NCR alone. Reports from other regional offices are still incoming.

- As of 4 November 2009, the top morbidities from Region IV-A are acute respiratory infections (47%), febrile illness (15%), tinea pedis (athlete's foot) (6%), infected wounds (4.3%), diarrhea (2.2%), headache (2.2%), asthma (3%), abdominal pain (2%), viral conjunctivitis (1.2%).

Access to Essential Health Services

- In a joint rapid needs assessment done after Typhoon Mirinae in Sta Cruz, Laguna, several barangay health stations were noted to be submerged in water. Assessment by WHO in the municipalities of Sta. Rosa and Biñan in Laguna province after Typhoon Mirinae (Santi) showed that out of 31 centers assessed, 22 have been visited by mobile health teams, 8 have medicines for chronic disease (diabetes, hypertension) treatment, 21 have measles vaccination services, 9 have childbirth services, 27 have had hygiene kit distribution, and 19 have functioning latrines.

- Mapping of affected primary care centers is currently ongoing.

Health Cluster Response

As of 5 November 2009, a total of 276 543 individuals have been given leptospirosis prophylaxis (NCR: 203 264 individuals; Region IVA: Rizal -73 279 individuals).

The Global Outbreak Alert and Response Network (GOARN) team has been visiting high-risk areas and hospitals in Region I, NCR, and Laguna province. A consolidated report and recommendations is expected to be released by next week.

As of 30 October 2009, the following health services have also been provided to NCR, Region I, II, III CAR, IVA, : A total of 16 865 individuals have received medical care through ambulatory response and through hospital referral. 255 water sources have undergone water testing, and 973 toilets facilities have been inspected.

Based on partial reports as of 30 October 2009, 17 504 individuals in NCR, 303 in Region III, and 2 062 in Region IVA have been given measles vaccination. Vitamin A supplementation for children under 5 has been given to 52 110 children in NCR, 340 in Region III, and 2 457 in Region IVA.

Continued mobile health care services and psychosocial program coverage is being provided in affected areas through the efforts of MSF, Australian Aid International, IOM, MERLIN, Save the Children, CFSI, Plan International, PNRC, UNFPA, Handicap International, CRWRC, MERCY Malaysia, and HUMA (Japan).

An assessment mission has been conducted by WHO in affected evacuation centers, municipalities and cities in Laguna Province.

Critical Constraints

Typhoon Mirinae has caused flooding in areas already affected by Tropical Storm Ketsana. Access to mobile healthcare services is further limited by persistent flooding.

Damage to primary care centers such as barangay health stations hampers access to primary care for evacuees and affected communities.

Urgent Needs

- Scaling up access of essential health services to all affected

- Improve case-based disease surveillance for communicable diseases and health and humanitarian service coverage in evacuation centers

- Increase resources aimed at containing the spread of water-borne and vector-borne diseases

- Ensuring a return to functionality of primary care facilities and re-establishment of essential health care activities, including vaccination

With contributions from:



International Organization for Migration (IOM)


Philippine National Red Cross


Save the Children

Handicap International

Australian Aid International (AAI)

Plan International

Corporate Network for Disaster Response (CNDR)

Community and Family Services International (CFSI)

Family Planning Organization of the Philippines (FPOP)

Integrated Midwives Association of the Philippines (IMAP)


1. Department of Health - Health Emergency Management Staff (DOH-HEMS) - Health Emergency Alert Reporting System (HEARS)

2. National Disaster Coordinating Council Update - Situation Report No.23 (6 October 2009, 2300 hrs)

3. Daily updates from health cluster agencies and health cluster meetings

For more information, please contact:

WHO Country Office

Dr Paul Andrew Zambrano

Dr Rene Andrew Bucu