A. Situation analysis
Description of the disaster
On 5 July 2019, the Dominican Republic's Ministry of Public Health declared an epidemiological alert due to the sustained increase in dengue cases in the country.
During the last 4 weeks there have been a progressive and concerning number of cases of dengue from 5,548 cases reported as of EW29 to 8,855 as of EW33, meaning that 37% of the total cases have been reported just during the last 4 weeks. These figures show that there has been a peak of the outbreak during the last weeks that has triggered the need for a response.
The Ministry of Public Health has reported a total of 8,855 cases of dengue as of Epidemiological Week (EW) 33 (11 to 17 August), there is an increase that looks quite significant compared to the number of cases reported for the dengue epidemic in 2018 (711 cases as of EW 33).
The incidence rate for EW 32-2019 is 126.66 cases per 100,000 inhabitants whereas the incidence rate in 2016 was 54.20. According to authorities, 12 people have died of dengue as of EW 32.
Four dengue serotypes are present in the Dominican Republic. According to laboratories, the predominant serotypes identified during the current outbreak are D1 and D3, and the presence of all four serotypes increases the risk of severe cases.
This current epidemic event is affecting 29 of 32 provinces in the country. The province of San Jose de Ocoa is under a Red Alert (more than 10 cases/1000 inhabitants while remaining provinces are under Yellow Alert. The highest incidence rate is seen in the provinces of Barahona (485.4) and Independencia (457.6), and Santo Domingo reports the highest number of cases (2614 cases) due to its large population.
Summary of the current response
Overview of Host National Society.
Dominican Red Cross (DRC) published a GO report on 13 August 2019 regarding the dengue outbreak. DRC has strong capacity for organizing humanitarian response interventions from both its Headquarters and its 32 province branches and 96 municipal branches. DRC has some 20,000 volunteers nationwide.
The National Society has a Community-Based Health programme with solid response capacity in terms of health in emergencies, and has trained personnel in Epidemic Control for Volunteers, Participatory Hygiene and Sanitation Transformation, Psychosocial Support and Health in Emergencies.
The volunteers who are part of these teams have reinforced their arbovirus prevention and control skills thanks to their work with the Community Action against Zika (CAZ) project during the last three years in 18 communities in nine provinces. This project has included activities such as vector control, community-based surveillance, psychosocial support and community mobilization.
For four weeks now, DRC branches have been carrying out activities to respond to the dengue outbreak. These activities are based on community approaches that consist of conducting home visits to identify and eliminate breeding grounds, educational sessions to deliver dengue prevention messages and delivery of chlorine for application to water tanks. These activities are being conducted in seven provinces: San Cristóbal, San Pedro de Macorís, Puerto Plata, Monseñor Nouel, Barahona, as well as in the National District and Santo Domingo Metropolitan Area. Some 123 DRC volunteers have been engaging in these activities.
The foreseeable increase in dengue cases over the next few weeks requires establishing social mobilization strategies aimed at involving and empowering the most affected communities. This will facilitate the implementation of activities to promote key messages and identify and eliminate breeding sites.
Overview of Red Cross Red Crescent Movement in country
The IFRC is represented in Dominican Republic through its Country Cluster Support Team office; which provides direct support to the National Society.
The Americas Regional Office has also been supporting the Dominican Red Cross with the implementation of health project linked with Zika disease and vector control activities. Spanish Red Cross and Italian Red Cross are present in country.
The ICRC from its regional delegation in Panama supports the National Society in RFL/migration and capacity building and works with the penitentiary authorities and the IHL commission.
Overview of non-RCRC actors in country
The Ministry of Public Health, with support from the Dominican Armed Forces and municipal town halls in affected areas, has undertaken activities to eliminate breeding sites and socialize dengue prevention messages. It has also allocated greater resources (financial, human, equipment and medical supplies) at the hospital level to respond to the increase in demand caused by the dengue outbreak.
Government institutions, such as the Ministry of Defence and Ministry of Education, have mobilized resources and personnel to work door-to-door to promote dengue prevention and elimination of vector breeding sites, as well as to hold health fairs. These activities have been carried out in the municipality of Santo Domingo Este. All proposed activities included in this operation are complementing efforts from national and local authorities with regards to the dengue outbreak response.
The national Emergency Operation Centre health sector working group has been activated, in which Dominican Red Cross has continuous participation. There have been a fluent and collaborative coordination with PAHO