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Health action in crises - Highlights No 133 - 06 to 12 Nov 2006

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Each week, the World Health Organization Department for Health Action in Crises in Geneva produces information highlights on the health aspects of selected humanitarian crises. Drawing on the various WHO programmes, contributions cover activities from field and country offices and the support provided by WHO regional offices and Headquarters. The mandate of the WHO Departments specifically concerned with Emergency and Humanitarian Action in Crises is to increase the effectiveness of the WHO contribution to crisis preparedness and response, transition and recovery. This note, which is not exhaustive, is designed for internal use and does not reflect any official position of the WHO Secretariat.


Assessments and events:

All across the Horn of Africa, insecurity due to violence as well as precarious access to food and health care continues. Inter-state tensions are rising.

In Ethiopia, 67 people were killed and 119 000 to 217 000 affected by the Wabe Shabelle River floods. Access to the affected areas is impossible and relief a challenge. Urgent action is needed to prevent outbreaks of infectious diseases, especially malaria and acute watery diarrhoea (AWD).

This week, 2768 cases of AWD and 23 deaths were reported, bringing the total to 35 314 cases and 411 deaths. Main reasons for the continuing spread of AWD are lack of safe water and environmental sanitation and poor community awareness. Human and financial resources also remain insufficient.

Armed violence is forcing refugees out of South and Central Somalia (where the floods of the Wabe Shebelle also drowned 47 and left thousands homeless) into Kenya and Ethiopia.

In Eritrea, a survey for evaluation of the June/July measles campaign shows 98.3% of the children were vaccinated.

In Kenya, two new cases of acute flaccid paralysis were reported in Garissa.

A national immunization campaign against polio began 4 November in the districts of Moyale, Mandera, Ijara, Wajir and Garissa. Over 250 000 children under five are targeted.


In Ethiopia, WHO consultants are supporting the Regional Health Bureaus (RHB) of all flood-affected areas on needs assessments, surveillance, case detection and management and community education for AWD control.

Twelve emergency kits were sent through the Federal MoH, of which two will be allocated to flood-affected districts.

Through the Federal MoH, WHO provides financial support to the RHB to fill gaps in essential drugs, operational costs and staffing.

WHO will allocate funds to strengthen surveillance and response activities in malaria endemic areas. Free insecticide-treated nets were distributed by the RHB and UNICEF and some affected villages were sprayed. Malaria drugs have been positioned in all flood affected regions.

In Eritrea, the survey recommends strengthening awareness raising, outreach vaccination and routine services for immunization and highlights that improved estimates of target population for EPI programmes are needed.

In Kenya, four WHO staff and three Inter Country Support team members supported the MoH in conducting the polio campaign.

WHO activities in Ethiopia are supported by a grant from CERF, Italy for Djibouti and Sweden and Finland for Somalia and cluster coordination.


Assessments and events:

The shelling of a residential area in the Gaza Strip town of Beit Hanoun killed 18 people.

Over the past week, the primary health care system in Beit Hanoun ceased to function as staff were unable to reach their places of work. Compounded with shortages of specific medications, particularly for the treatment of chronic diseases, it caused increasing health risks for chronic patients, children and pregnant women.


In Beit Hanoun, WHO and the MoH are monitoring drug availability, access to and provision of health services.

Steps have been taken to set up a UN interagency response including WHO, OCHA, UNICEF, WFP and UNRWA.

WHO delivered two burn kits and necessary medical supplies.

WHO gave a briefing at an EC-organized meeting about the health situation in the oPt with a focus on Beit Hanoun and the health impact of the violence.

WHO's 2006 emergency activities are funded by the Organization's Regular Budget and contributions from ECHO, Japan, Finland and Norway.


Assessments and events:

In the South-East, local conflict and the spill-over from the armed violence in Darfur have pushed the number of IDPs from 50 000 to an estimated 63 000. This includes more than 2000 persons displaced near Koukou in October. Up to 220 people have been killed in clashes in the region during the past week.

Eastern Chad already hosts 200 000 refugees from Sudan's Darfur region.

As of 22 October, 1201 cases of cholera and 56 deaths were reported, including 301 cases in N'djamena.


From 1 to 3 November, WHO conducted an mission to Goz Beida and Koukou to assess the situation of the population displaced by the recent fighting. WHO provided the local health facility with essential drugs and plans to dispatch two more emergency kits next week.

A loan from the United Kingdom revolving emergency funds has helped WHO initiate emergency activities in Chad.


Assessments and events:

The capture of Birao by rebels in the remote Vakaga region last week is also seen as marking the spill-over of the Darfur conflict.

No information is available so far on Birao but the rebels seem willing to allow international humanitarian organizations to send a mission and assess the needs of the city's 30 000 inhabitants.

The first UN flight landed in Kaga Bandoro, where three weeks of fighting have driven thousands of people from their homes.


WHO participated in a rapid assessment in Kaga Bandoro: there are 1400 IDPs in the town and no basic goods in the local market. According to the regional medical officer, health centres outside the town have closed and the staff has been displaced. The local hospital has no funds nor logistic systems to ensure the supply of medicines.

Nutritional problems as well as outbreaks can be expected (the rainy season is not over) and local partners such as Caritas and the CAR Red Cross will need support to assist the vulnerable populations.

WHO is opening a sub office in Bossangoa which will help monitor the situation and to conduct early assessments in Kaga Bandoro.

Support for WHO's emergency activities was received from Finland.

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