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Benin: Cholera outbreak (MDRBJ013), DREF final report

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Summary: CHF 201,952 was allocated from the IFRC’s Disaster Relief Emergency Fund (DREF) on 10 October 2013 to support the National Society in delivering assistance to some 20,000 beneficiaries. A second allocation of CHF 39,902 was made on 21 November to assist 25,000 additional beneficiaries.

The Benin Red Cross Society (BRCS) responded to the cholera outbreak initially detected in August 2013.
Up to 129 cholera cases were confirmed in Sô-Ava in the department of Atlantique in the south of Benin by October second. The total number of cases reported for the duration of the operation is 592 and 6 deaths.

According to the BRCS health coordinator, information received from the Ministry of Health indicates that the case fatality rates were 1.4 as of 17 November 2013, 1.1 as of 31 December 2014 and 0.0 as of January 2014.

The government of Benin responded by supplying the health centres with medical supplies albeit leaving gaps in community sensitizations activities. With the support of the DREF, the BRCS thus complemented the government’s efforts with activities hygiene promotion, improving access to clean water as well as training of Red Cross volunteers. The IFRC ensured the provision of technical support by deploying two regional disaster response team (RDRT) members to focus on health and water and sanitation (WatSan).

Whilst the operation started in Sô-Ava and Abomey-Calavi, the geographical distribution of the cholera evolved with an increase in cases in Cotonou. On the basis of analysis of these new epidemiologic data, the IFRC agreed to an extension of the activities to Cotonou expanding volunteer training, community sensitization and water treatment. Whilst the activities continued in Cotonou and Sô-Ava, another outbreak emerged in Sô-Ava in four new communities (Ahomey-Gblon, Ahomey-Lokpo, Ahomey-Gbépka and Gbéssou) reported in second week of January 2014. According to the Ministry of Health the January outbreak was due to the festival of Vodoun, which is a kind of popular religious rejoicing where meals are shared under not very good conditions of hygiene; and the high number of locals returning from Nigeria, where cholera was also reported.

Due to emerging cases and the spread to other localities initially not budgeted for; BRCS had to increase some budget lines such as volunteer mobilisation, training and stipend, information and public relations activities, transport and vehicle running cost. These actions were critical to ensure BRCS effectively and efficiently responded to the epidemic within the support of the DREF. As reported in the operations update n° 2 the change of logistical arrangements, reduced unit prices and increased transport costs were registered for items shipped through the IFRC global logistics services. To accommodate this change and the additional volunteer activities in Sô-Ava, a revised budget was announced decreasing the water, sanitation and hygiene costs with CHF 25,000 and increasing transport costs with 12,000 and volunteer costs with 13,000.Unfortunately, these changes were not loaded into the finance management system, resulting in the indicated overspends in the final financial report. All activities planned under this DREF operation were implemented and this narrative is final in terms of activities carried out, with a final financial report attached. A balance of CHF 11,518 will be returned to DREF.

In order to examine whether the DREF operation has achieved the objectives and expected results, and evaluate the results in relation to the action plan, a multidisciplinary team carried an end of operation review. Conducted in a period of three days in January 2014, the DREF review had also a mandate to assess the achievements and challenges, whilst alongside it collect the lessons learned from staff, volunteers and stakeholders.