|
| Haiti• Hurricane Tomas • Cholera
Situation Report #11
1 November 2010
I. HIGHLIGHTS/KEY PRIORITIES
• Haiti remains at high alert in preparation for Tropical Storm Tomas, according to the Civil Protection (DPC). The UN and humanitarian community continue to support the DPC contingency plan by prepositioning shelter, health, food and water supplies across Haiti.
• Humanitarian partners estimate 150,000 tarpaulins are required to meet shelter needs following Tropical Storm Tomas.
• World Food Programme distributed 2.1 million water purification tablets to Gonaives in Artibonite to be distributed in schools in the affected areas as part of their cholera prevention initiative.
II. Situation Overview
According to the National Meteorological Centre (CNM), Hurricane Tomas has weakened since yesterday to become a tropical storm and is projected to reach the southern coast of Haiti in the next 72 hours. A special bulletin has been issued and the orange alert has been maintained since 30 October. The departments of Southeast, South, Nippes, Grande Anse and West are at risk of flooding, landslides and might experience moderate to strong winds, in particular in the south. Although the storm itself has weakened, the trajectory could be more detrimental to Haiti bringing wind and rain for several days. In support of the Civil Protection (DPC), the UN and humanitarian partners continue to dispatch supplies to key areas across the country while working to ensure that appropriate measures are taken to enable response in Port-au-Prince.
Supplies are being pre-positioned notably in Jérémie, Les Cayes, Jacmel and Léogane which are expected to experience the storm more severely. Today the Humanitarian Coordinator led an inter-agency mission comprising of representatives from OCHA, the shelter cluster, International Organisation for Migration (IOM) and the World Food Programme (WFP). The team carried out an evaluation of emergency preparedness measures implemented in preparation for the approaching storm, visiting Jacmel, Jérémie, Les Cayes and Miragoane.
As of 30 October, the Ministry of Health (MSPP) has reported 4,764 cases of cholera reported in hospitals and 337 deaths from the disease. As today and tomorrow are national holidays, new data is not expected before 3 November. In lieu of the holidays, water and sanitation (WASH) partners report conducting special activities to inhibit the spread of cholera at festivals and markets.
In IDP camps across Port-au-Prince today cleaning, disinfection and chlorination activities, distributions of hygiene kits, and awareness programs on cholera prevention continued. IOM started a mapping exercise of plans implemented by camp management agencies acting to prevent and contain cholera in the camps. Hurricane preparedness continued in camps today as well.
III. Humanitarian Needs and Response for Tropical Storm Tomas
Health
Tropical Storm Tomas is not anticipated to significantly increase the impact and breadth of the cholera outbreak. The challenge for the health cluster and partners will be more logistical; distribution of supplies dueto damaged roads, bridges, landslides, and flooding. The cluster anticipates health facilities may be weakened by winds and rain, hindering provision of services to those affected by the storm. Typical health related injuries from a hurricane would be caused by mudslides and debris. The health cluster is working daily to update a list of supplies which is strengthening the response to both Tomas and the cholera outbreak.
The MSPP, health cluster and humanitarian partners throughout Haiti are preparing for the storm and the potential impact that it will have on the health sector. Health supplies that are part of the contingency plan are being replenished.
In Northwest department, the IOM Health Unit deployed a total of 1,050 medical supplies to prepare and respond to Tropical Storm Tomas as well as the cholera outbreak. At the request of the MSPP, IOM also deployed 250 cholera cots to Les Cayes, in the South department and 200 cholera cots to Nippes in preparation for possible cholera outbreaks in the wake of Tropical Storm Tomas.
The International Committee of the Red Cross (ICRC) reports that following Tropical Storm Tomas it will primarily focus its response to needs encountered in detention places in Haiti and support to the Haitian Red Cross.
Water, Sanitation and Hygiene (WASH)
According to UNICEF, the WASH cluster has been coordinating with cluster partners to identify and assess the water and sanitation facilities of hurricane shelters. The assessments will not only verify the facilities in place but ensure that they respond to new levels of hygiene and chlorination to be effective in preventing the spread of cholera and other water borne disease.
Shelter/ Non-food-items (NFIs)
In adherence to the national contingency plan, the shelter/NFI cluster and humanitarian partners work in support of the DPC in all pertinent areas regarding disaster preparedness and response. The shelter/NFI cluster and partners advise all residents living in emergency and transitional shelter to follow the DPC evacuation plan. Those living in transitional shelters are asked not to use them as hurricane shelters and to evacuate to a safer place. Shelter/NFI Cluster agencies are distributing technical assistance as well as more durable materials such as wood, nails, ropes, tarps and tools to assist in reinforcing and waterproofing shelters.
Gaps and challenges
The Shelter/NFI Cluster alongside OCHA are presently consolidating all available information on contingency stocks of shelter agencies, though it is clear there is a shortage of emergency shelter materials.
Food
WFP in Les Cayes received two Atlas M6 trucks for prepositioning and two more are on the way to Jérémie in Grand Anse. WFP staff are currently securing sensitive items in the warehouses across the country against flooding. WFP reports having sufficient stocks prepositioned to respond to an emergency including food for 1.1 million people for at least one month.
Logistics
The UNICEF cargo that was sent to Jérémie yesterday, containing plastic buckets, soap, tarpaulins and bladders of 5,000 litres has been delivered to the Caritas warehouse. Two Inter-Agency trucks have been prepositioned in Jérémie (at the MINUSTAH compound), two in Les Cayes (at the WFP sub office) and one in Port de Paix (in the ACF compound). A second truck will be prepositioned in Port de Paix on Tuesday 2 November. The Logistics Cluster has sent WFP communication staff and equipment, such as satellite phones, fly away kits and radios to Léogane and Les Cayes. Emergency Telecommunications Cluster has programmed 80 VHF radios for WHO and 17 for Aide Médicale International (AMI).
MINUSTAH mission support and the Force Commander report that they are on stand-by to respond to Tropical Storm Tomas with assets, logistics and engineering capacity. The logistics cluster is liaising with MINUSTAH for the coordination of surface transportation in key areas across the country.
Communication
The DPC continues to communicate their disaster preparedness public information campaign “Take care of you neighbour”, encouraging people to have an alternative place to go when a storm hits as opposed to staying in an emergency or transitional shelter.
The International Federation of the Red Cross (IFRC) and Haitian Red Cross as well as IOM have been disseminating disaster preparedness messages to help prepare camp residents for weather events for months and have ramped-up their SMS text and community-based communications in lieu of Tomas. IOM, the DPC, the Haitian Red Cross, IFRC, the camp management cluster, and shelter agencies have contributed to the dissemination of 45,000 posters which focus on disaster preparedness throughout various IDP camps.
IOM’s communication team sent another round of over 130,000 text messages to IDP camp residents on how to protect important documents from water damage. IOM deployed 36 community-based communicators who have been trained on both disaster risk reduction in camps and cholera prevention through the joint UNOPS, IFRC and IOM project in 16 camps. The camps where the sensitization took place were specifically selected for their proximity to the sea and the Grise River in Martissant, La Saline, Cité Soleil, Croix des Bouquets, and Tabarre. This sensitization campaign will continue until the conditions no longer permit the teams to work.
IOM also distributed almost 10,000 copies of the graphic newspaper Chimen Lakay, which focuses on communicating to people in camps. The latest issue was on hurricane risk reduction in the camps and the securing of tents.
Internews produced a special program about hurricane Tomas with news and information from the National Meteorological Center, the DPC, and humanitarian partners as part of their (Enfomasyon Nou DwèKonnen/News You Can Use) humanitarian radio program broadcast daily in over 30 radio stations acrossHaiti.
In Jacmel in the Southeast department, OCHA reports that the DPC has requested 20 VHF radios to help facilitate communication in the aftermath of a serious storm.
IV. Humanitarian Needs and Response for Cholera
Health
WHO/PAH reports having distributed more than 64,000 sachets of oral rehydration salts, more than 3,500 liters of intravenous (IV) fluids, and more than 180,000 antibiotic tablets to treat patients suffering from thedisease.
The Government of Mexico is supporting the cholera response in Haiti by deploying a Mexican Navy team of three internists, two public health specialists, six medical doctors, and four nurses, as well as other military personal, to help coordinate logistical and medical activity. 2.2 tonnes of medical supplies are also included with the personnel, due to arrive in the coming days.
In South department, the IOM Health Unit deployed 200 cholera cots and 400 buckets to Port de Paix to respond to the urgent needs of hospitals in the area. IOM assessments and compiling of information on health facilities in Port-au-Prince metropolitan area are ongoing to assist the MSPP in the establishment of first and second line treatment facilities against cholera. In Northwest department, IOM distributed 200 cholera beds today in Port de Paix: 25 beds to Bassin Bleu Hospital and 175 to Immaculée Conception Hospital. 400 basins were distributed: 50 to Bassin Bleu Hospital and 350 to Immaculée Conception Hospital.
A list of cholera treatment centres (CTCs) currently opened and planned is available at:http://haiti.humanitarianresponse.info/ in the health cluster section. Partners wishing to communicate additional information on CTCs can email the health cluster at: haiclsan@paho.org.
Starting 20 October, International Committee of the Red Cross (ICRC) teams comprising two doctors and two nurses and six water and sanitation engineers assessed the situation in four places of detention near the epicentre of the outbreak, as well as hospitals and health centres, in Hinche, Mirebalais, Saint Marc and Gonaïves. Only the Mirebalais prison (342 inmates) was found to be affected. The ICRC provided prison health staff with oral rehydration salts, Ringer’s lactate and antibiotics and oversaw the administration of these products to detainees. It also arranged for the hospitalization of 39 detainees. By 27 October, all hospitalized detainees had returned to the prison after treatment. Follow-up treatment at the prison is carried out in two tents provided by the ICRC. No new cases have been reported since 23 October. The ICRC reports having set up tents, mattresses, water reservoirs with chlorinated water and other materials.
Water, Sanitation and Hygiene (WASH)
In Artibonite, Action Contre la Faim (ACF) distributed 9,543 hygiene kits to more than 35,000 people in the communal sections of Marchand Dessalines (Villars, Boudette) and Saint Michel de l'Attalaye and to mothers and girls participating in a program in Gonaives. Distributions of hygiene kits in health facilities in Gonaives, Gros Morne, Marchand Dessalines and Ennery also took place. Nearly 10,000 people have been sensitized in Artibonite during distributions of cholera kits. As of yesterday, IOM had trained 6,476 people at the Fête de Gonaives. IOM WASH continued its hygiene promotion training activities, focusing on sensitization at festivals taking place today and tomorrow. Trainings of 20 community mobilization staff for cholera sensitization are underway at the Patronal Feast in upper Artibonite.
In the West department, ACF also increased systematic cleaning activities of camps, disinfection of water points and latrines as well as chlorination of water to prevent the spread of cholera. Spraying of chlorine on water taps and latrines is conducted twice and three times per day in the 68 water points and the 900 latrine serected by the organization.
Gaps and Challenges
Following assessments by the WASH cluster, partners have expressed particular concern for the more impoverished communities in Port-au-Prince at risk of cholera. Although there is a great focus on IDP camps, initial assessments show that non-camp areas may be most at risk of cholera outbreaks. The WASH cluster is currently developing strategies to address concerns in these areas.
Logistics
The logistics cluster has reinforced its staff capacity with the deployment of a medical logistics officer tasked to liaise with the health cluster. MINUSTAH peacekeepers continue to provide thousands of gallons of potable water to communities in the cholera-affected area on a daily basis.
Food
WFP is using the School Feeding Programme as a platform for the distribution of water purification tablets to ensure safe drinking water for children at school. Today, WFP sent 2.1 million water purification tablets to Gonaives to be distributed in schools in the affected areas. A total of 41,809 students in the schools will receive tablets. Water purification tablets will also be sent tomorrow to Hinche and Cap Haitien. In the communes of Mirebalais, in the Centre department 89 schools will receive tablets for a total of 23,000 school children in Las Cahobas and Saut d’Eau. New posters approved by the MSPP have been sent to WFP suboffices to start the cholera prevention public awareness campaign in schools.
Since the beginning of the outbreak, 28,916 meals-ready-to-eat (MREs), 0.85 metric tonnes of high energy biscuits and 0.29 metric tonnes of dry rations have been distributed. Today, 2,688 MREs were distributed to 1,282 beneficiaries in Artibonite.
After consultations with authorities in the Centre department, WFP will be extending food assistance to reach the hospital in Hinche and will distribute MREs tomorrow. In total, WFP is now assisting affected people in 3 centres in the Centre department for a planned 350 beneficiaries per day. WFP partners are urged to submit distribution plans and sensitization plans to WFP by Wednesday 3 November.
Shelter
In preparation for Tropical Storm Thomas, the shelter cluster and partners are securing tents and the contents of tents currently being used as CTCs and in support of medical facilities for the cholera outbreak. The cluster is working to provide materials to secure such structures, as keeping health facilities open and safe for cholera patients is important before, during and after the storm.
Communication
A number of humanitarian actors have been involved in communication and sensitization activities. The NGO Internews continues to broadcast a daily radio show (Enfomasyon Nou Dwè Konnen/News You Can Use) which produces a 15-20 minute humanitarian radio program broadcast daily in over 30 radio stations across Haiti. Since last week, ENDK has a special focus on cholera and cholera prevention, disseminating public health messages approved by the MSPP and general actionable information on symptoms, prevention, the status of the epidemic and the government response. ENDK is currently liaising with over 15 community radio stations in the cholera affected departments to broadcast them the program for free.
In upper Artibonite, the WASH cluster partners and local authorities are conducting hygiene promotion activities in Gonaïves. DINEPA plans to support these activities with increased soap distributions. Sensitization in markets in Artibonite is ongoing. ACF is active in Gonaives, Ennary, Poto and St. Michel markets, IOM is active in Beyonee market as disinfection of markets and cholera awareness activitiescontinue.
Coordination
On 31 October, OCHA convened a meeting in St Marc in Artibonite to discuss cholera prevention activities planned for the holidays of 1 to 2 November. Locally engaged partners ACF, CECI, CARE and IOM as well as local authorities coordinated on disinfecting market areas and public places as well as conducting distributions during the holidays.
WHO/PAHO has dispatched a coordination officer to the North Department to reinforce health coordination.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
There are a few sentences in this that actually made me laugh out loud. Are you kidding me? They are preparing people for the hurricane by handing out rope and nails?! Understatement of the year: "it is clear there is a shortage of emergency shelter materials." Really? | | |
| We have 12 health workers traveling the in the country side all around us trying to spread the word on cholera and prevention. They are doing a fantastic job and have already spoken to 13467 people this week.
The have given megaphone messages in markets and to those along the roads, paths, and gardens.
They have spoke in schools.
They have gathered people at churches for group meetings.
| | |
| Haiti • Cholera
Situation Report #7
28 October 2010
This report was issued by OCHA Haiti. The next report will be issued on or around 29 October.
I. HIGHLIGHTS/KEY PRIORITIES
• The Ministry of Health has confirmed 4,649 hospitalisations and 305 deaths from cholera accordingto data from 20 to 27 October recorded by the government.
• The Artibonite, Centre and North departments have reported confirmed cholera cases according tothe Ministry of Health.
• Viva Rio reports supporting teams who disseminate prevention information while distributing oralrehydration salts in communities with a population of 50,000 people. The organisation will focus inparticular on engaging with pregnant women, children, the elderly and handicapped.
• The WASH cluster reports almost two thirds of communities in the 15 communal sections at theepicenter of the outbreak have received water purification tablets and supplies in the past five days.
• The logistics cluster reports available air, road and sea transportation capacity.
II. Situation Overview
The Ministry of Health (MSPP) reports that 305 deaths and 4,649 hospitalized cases of cholera have been confirmed in Haiti from 20 to 27 October. In support of the national strategy against cholera, WHO/PAHO continues to provide the MSPP with technical support in epidemiology and monitoring the outbreak. In surveillance, WHO/PAHO follows the case and death rates, representative of cases as of 17h00 the previous day. The figures are then reported by the MSPP at a daily press conference at 10h00. The numbers provided represent confirmed cases while suspected cases are often aggregated by other sources, thus resulting in afluctuation in reported figures.
The strain of Vibrio cholerae O: 1, which according to WHO/PAHO as causing the epidemic, has been isolated in Haiti and tested by the Centres for Disease Control and has shown resistance to trimethoprim/sulfamethoxazole,furazolidone, nalidixic acid, and streptomycin.
With an estimated 1.3 million people living in spontaneous settlements in the areas affected by the 12 January earthquake, the Government, humanitarian partners, and UN continue to increase sensitization,contingency planning and cholera prevention activities in camps for internally displaced people (IDPs) in the West and Southwest departments and in particular Port-au-Prince. Camp-level communication initiatives led by numerous humanitarian partners utilise community radio, SMS and voice messages, community mobilisation teams and flyers to pass on MSPP-approved prevention and sensitization messages.
Demonstrations and trainings explaining how and when to prepare and administer oral rehydration solutions as well as hand washing techniques are ongoing in the affected area and with a special emphasis in IDP camps and communities in Port-au-Prince. In collaboration with local government, partners are reported to be carrying out sensitization activities in the Northeast, Northwest, West, South and Southeast departments in support of these initiatives.
In support of distributions of medical supplies, personnel, and WASH equipment, logistics cluster has madeavailable trucking fleets in Port-au-Prince, Jacmel, Cap Haitien and Gonaives with a total of 40 trucks. A1,500 metric tonne barge is available and calls at regional ports and/or wharfs to re-supply regional reliefoperations. United Nations Humanitarian Air Service has on standby a helicopter with the capacity totransport three metric tonnes of humanitarian assistance to inaccessible areas.
III. Humanitarian Needs and Response
Health
The MSPP, WHO/PAHO, UN and humanitarian community continue to respond to the cholera epidemic, transporting urgent medical supplies and personnel to treat cases while continuing to support the public information campaign which is essential for prevention, early detection and treatment of cholera.
WHO/PAHO has trained 60 community health workers whose role will be to provide public information related to hygiene, sanitation, treatment and locations of public health centres. Eight hospitals are being prepared for increased case load, and three are currently ready. Among the ten CTCs planned for metropolitan Port-au-Prince, five are ready, with a bed capacity of 450 beds. The Red Cross Movement plans to open one of five CTCs which will provide additional medical assistance and isolate cholera patients.
IOM psychosocial teams have incorporated MSPP messages, hand washing demonstrations and stress management as part of their regular activities including guided self-help, discussion groups and counselling. These activities cover 17 IDP camps and two psychiatric hospitals in Port-au-Prince having reached an estimated 6,000 people in the past week. Counselling and psychological first aid sessions are being organized for IDPs who have lost family members or relatives to cholera in affected areas.
J/P HRO (J/P Haiti Relief Organization), an NGO, has reportedly deployed personnel and supplies to the affected area with three medical staff and ten cleaners dispatched to the Partners in Health-run St Nicolas Hospital in St Marc. A five person cleaning team was also reported to have been deployed to Donald King Hospital in Arcahaie, in the West department. The organization is building capacity in Port-au-Prince for treatment of patients. Nearby the JP/HRO-run hospital facilities at the Petionville Golf IDP camp, a cholera isolation centre with 40 beds and a 100 person capacity is being erected.
Four new communes out of seven in upper Artibonite have reported confirmed cases: Gonaives, Gros Morne, Saint-Michel (Platana, Bayonne), Marmalade and Ennery with a total of 455 cases including 10 deaths from 20 to 26 October. In upper Artibonite MSF-Spain is reportedly planning to establish a CTC. The Sisters of Charity of St. Vincent have distributed 15 beds and provided five nurses at the hospital of Gros Morne.
In Jacmel, local health authorities and the directorate of the Ministry of Environment of the Southeast department has circulated a list to partners identifying needs as they develop a cholera-preparedness contingency plan. In Léogane, all suspected cholera cases are being referred to the MSF hospital Swiss Chatuley. The MSPP is now chairing a committee to address the cholera outbreak through development of an operational action plan. In Petit Goâve the MSPP reports that a CTC is being established.
Health authorities in the Northwest department reported 120 cases of severe diahorrea with two deaths on 27 October. 80 per cent of cases are reported to be in Blue Basin bordering Artibonite and 20 per cent in Chansolme and Port-de-Paix. According to the departmental director of health, the number of cases are increasing.
Gaps & Challenges
Health authorities in the Northwest department report two CTCs, medicine, and WASH facilities are needed. Access is difficult to rural communities in the department in case of rain. The departmental director of Health may request the support of international partners to support ongoing prevention efforts.
Action Against Hunger (ACF) reports a need for 13 nurses and three physicians as well as medical supplies such as Ringer´s lactate, units of dextrose saline, tablets of doxicyclin and tetracycline, gloves and mattresses to support their activities in the Northwest department.
Water, Sanitation and Hygiene (WASH)
Almost two thirds of communities in the 15 communal sections targeted for blanket distribution of waterpurification tablets have received supplies in the past five days, according to WASH cluster. The area inquestion is at the epicenter outbreak along the Artibonite River where the risk of contracting the disease ishigher than in other parts of the country. Many communities are isolated due to poor roads or the high waterlevel of the river. Distributions are ongoing as a key operational NGO ACTED reports improved logisticalsupport and as additional actors commit assistance in the region.
The six priority hospitals in Artibonite and Centre departments report having committed partners to facilitate the installation and maintenance of water, sanitation and hygiene activities.
ACF is the only WASH partner reported in the Northwest department and local authorities report only havingfive health officers for the entire department. ACF has provided a total of 15,000 water purification tablets tocommunities in the area.
In Artibonite, ACF has begun distributing hygiene kits to 3,700 families in the commune of Saint Michel and will continue these operations in Gros Morne and in Platana on Saturday. MINUSTAH military has also reported delivering 5,000 litres of potable water to the community in Dauphin, which is isolated due to high river levels and reportedly unreachable by road.
The Red Cross Movement continues activities in the communes of Dedune, Verrettes and Peitit Riviere where it has mobilised volunteers who are conducting household sensitization, distribution of soap, water purification tablets, oral rehydration salts as well as disinfecting schools, health centers and markets. IOM reports conducting training activities for 23 people on hygiene promotion in Gonaives, in addition to monitoring training activities in the L’Estère area, Desdunes and Douin.
Gaps & Constraints
ACF reports a need for 100,000 water purifications tablets, 250 gallons of bleach, 100 kilograms of chlorinepowder, and kits for hand washing in Northwest department. In Artibonite, ACF reports a need for waterpurifications tablets and oral rehydration salts. Some communes and communal section are not yet reportedto be covered by WASH activities according to the WASH cluster based in St Marc. To continue to supportthe prevention of cholera in Artibonite and Centre departments as well as the spread of the diseaseelsewhere, replenishment of stocks and continued distributions of WASH supplies are recommended.
Logistics
The logistics cluster, MINUSTAH and partner organisations continue to increase support for the response across the country. In Artibonite, Handicap International has made available two trucks to facilitate the delivery of supplies in the northern part of the department. The NGO IDEA in collaboration with Organisation Sante Populair report having two vehicles that may be used for evacuation and transfer of patients upon request of the health cluster partners. The Spanish Red Cross reports that it has offered four water tankers to be used by the WASH cluster to supply water to health institutions. International Medical Corps and GrassRoots United also report assisting with logistical and other efforts to assist in responding to the crisis.
Logistics cluster has provided helicopter support for Save the Children delivering medical items to Maissades and to Grand Saline. In support of WASH activities in Grand Saline, 1.5 metric tonnes of supplies such as water filters, water purification tablets, hygiene kits, and bleach were airlifted for the Partners in Health today.
Partners engaged in responding to the cholera outbreak can request logistical support from MINUSTAH through the Joint Operations and Tasking Centre (JOTC). Request forms can be picked up at the crisis information centre in OCHA's office at the United Nations Logistics base in Port-au-Prince, or at MINUSTAH Regional Offices. Forms can be submitted by email to Minustah-jotc@un.org.
Humanitarian partners interested in utilising services provided by the logistics cluster should first approach the cluster to verify whether the request can be satisfied with the resources available. If the request cannot be met by the humanitarian community, it can be referred to the JOTC following the logistic cluster endorsement of the request. For any Cargo Movement Requests and/or Temporary Storage Requests, humanitarian partners are asked to complete a form available http://www.logcluster.org/ops/hti10a and submit tohaiti.cargo@logcluster.org.
In addition, OCHA should also be informed of requests and be used as an intermediary to submit humanitarian requests to MINUSTAH though its representative to the JOTC. Should partners be unable to contact directly cluster leads for requests and/or signatures, OCHA will facilitate communication with and agreement from the clusters as well. Please contact uncmcoordhaiti@gmail.com for more information.
Food
The World Food Programme (WFP) works continuously with the departmental health authorities, and humanitarian partners to support the response to the cholera outbreak. Distributions of meals-ready-to-eat (MREs) and dry food rations to hospitals are ongoing in affected areas in upper and lower Artibonite. At the Hopital St Nicolas in St Marc, 1,404 MREs were delivered today to provide food to 500 patients and 200 hospital staff. In Gonaives, WFP continued distribution, delivering 396 MREs to Hopital de la Providence and 132 MREs to the hospital in Raboteau. Distribution of 300 kilograms of dry rations reached the hospital in Dechapelles today, providing sufficient food stocks for the hospital for the next two weeks.
Education
The education cluster in collaboration with the Ministry of Education is finalizing an strategy on the cholera response in schools. The strategy is centred on the treatment of water sources in schools, sensitization of school directors on hygiene promotion and the enforcement of hand-washing practices in all schools across the country.
As part of the school feeding program, WFP has procured 20 metric tons of soap to be distributed in schools in the affected areas and will begin to conduct hygiene trainings in schools. The shipment is expected next week and will be distributed shortly thereafter. Seven food aid monitors have attended a training on cholera awareness, water and sanitation led by WFP and partners.
The NGO People in Need is training school directors in 88 schools in Petit Goâve on hygiene promotion. Once these directors begin communicating hygiene promotion messages in their schools, UNICEF estimates that approximately 23,000 students in the region will benefit. Outreach International is raising awareness on cholera in 21 schools and distributing oral rehydration salts.
In 120 schools with an estimated 48,000 students, Plan International is conducting assessments of water and sanitation facilities in addition to facilitating the training of teachers and school directors on hygiene promotion. These activities are carried out in tandem with distribution of flyers containing MSPP-approved cholera awareness messages, soap, oral rehydration salts, and water bottles. MINUSTAH peacekeepers are distributing 1,000 water filters to schools and other entities in Artibonite.
Communication
Joint sensitization campaigns continue, with UNOPS, Red Cross, and IOM. Teams were divided into smaller units to allow a greater coverage of sites: UNOPS teams covered 9 camps in Delmas, IOM teams covered 4 camps in Carrefour, and Red Cross teams covered 4 camps, reaching a total of 17 camps today.
Viva Rio bas been engaged in sensitization activities since 21 October, focusing on disseminating cholera awareness messages and demonstrating hand-washing techniques and waste management in IDP camps,schools and in churches across Port-au-Prince. An estimated 1,500 people have already been involved in the sensitization campaign which takes place at their community center, Kay Nou (Our House). Viva Rio has also trained and mobilised teams that conduct community-based sensitization in the areas of Bel Air, Solino, Fortouron, La Saline, Warf Jeremie and Fort-Dimanche which have an estimated population of 90,000 people. In IDP camps, Viva Rio reports supporting teams who disseminate prevention information while distributing oral rehydration salts in communities with a population of 50,000 people. The organisation will focus in particular on engaging with pregnant women, children, the elderly and handicapped.
Help Age International also reports outreach and communication activities, including training 36 home-based care providers supporting care of the elderly. The training was a joint initiative with IOM, Goal and the American Red Cross. In all, Help Age reports sending out 219 personnel into the eight communes of and around Port-au-Prince in teams which include nurses and “vulnerable people focal persons”.
In upper Artibonite, ACF has deployed 40 hygiene promoters, including 30 in St Michel and 10 in Gonaives. Community awareness will be reinforced by posters approved by the MSPP. CARE International is stepping up sensitization activities through 14 radio stations as well as disseminating messages in schools and communities across the affected area.
| | |
| Haiti
• Cholera
Situation Report #2
23 October 2010
This report was issued by OCHA Haiti.
The next report will be issued on or around 24 October.
I. HIGHLIGHTS/KEY PRIORITIES
• The number of deaths in Haiti’s cholera outbreak has risen to 208 dead and the number of confirmed cases to 2,646 in the Artibonite and Central departments. Of the five people with confirmed cases of cholera in Port-au-Prince, four were shown to have originated in Artibonite and one from the Central department.
• The relatively small increase in the caseload today is a possible indication that some containment efforts may be taking effect.
• The government of Haiti, MINUSTAH, the Humanitarian Community continued to reinforce cholera prevention and response measures
• The construction of 12 Cholera Treatment Centres and public information campaigns gathered speed today. Distributions of soap, water purification tablets and rehydration salts continue;
II. Situation Overview
The number of cases identified in the current outbreak of cholera in the Artibonite and Central departments of Haiti has now reached 2,646 and the number of deaths 208. A further five cases were confirmed in Port-au-Prince, though all five individuals had traveled from Artibonite. The communes most affected are St. Marc (Bocozelle), Grande Saline, L’Estere, Marchand Dessalines, Desdunes, Petite Riviere, Lachapelle, and St Michel de l’Attalaye. The severity of the outbreak seems to be decreasing in the southern area of Artibonite but concerns remain regarding the spread of the disease in northern Artibonite. At the Hospital de Bon Repos in Gonaives 38 patients from nearby towns of l’Estere and Marchand Dessalines were admitted today. Although there is an increase in the number of confirmed cases, it is increasing at a slower pace than in previous days, which is a possible indication that some of the prevention and treatment measures are taking effect.
Of the five people with confirmed cases of cholera in Port-au-Prince, four were shown to have originated in Artibonite and one from the Central department. All those cases are people who contracted the illness in Artibonite and subsequently travelled to Port au Prince where they developed symptoms. These cases thus do not represent a spread of the epidemic because this is not a new location of infection. While a worrying development, it is not unexpected. All patients have been isolated and are receiving appropriate treatment. The identification of the five cases in the capitol, while worrying, also demonstrates that the reporting systems for epidemic management are functioning.
The state of emergency declared by the Ministry of Health remains in place for Artibonite while the rest of Haiti is on high alert. St Nicholas Hospital in St Marc is now filled to capacity though and other health facilities are under strain to cope with the numbers of patients. In collaboration with the government, the humanitarian community is ramping up its efforts to respond to this crisis, focusing in particular on health, water, sanitation and hygiene (WASH) and communication through a coordinated response in collaboration with the government. Health officials continue to monitor the situation in the capital and West department.
In Port au Prince, work has begun to prepare for a possible spread of the epidemic to the metropolitan region both in camps and vulnerable zones. The construction of five Cholera Treatment Centers (CTCs), supplementary facilities usually attached to clinics or hospitals are currently underway.
There remain key gaps in prevention and response.
III. Humanitarian Needs and Response
Health
Haitian health officials and the health cluster continue to bolster their response to the cholera outbreak and are planning on the assumption that there will be a need to respond to this situation for another four weeks. The departmental health authorities along with the health cluster are intensifying their response by mobilizing additional medical personnel, dispatching medical supplies and equipment as well as conducting assessments of health facilities and affected areas. There is enough tetracycline to treat 100,000 cases of cholera, and sufficient rehydration salts for 200,000 people. Supplies of ringers lactate is sufficient for only 30,000. A number of NGOs have begun to mobilize doctors and nurses to respond.In the lower Plateau region 35 medical students from the Universite de d’état d’Haiti and 13 nurses have also been deployed to assist.
The mobilization of medical experts continues, while the WHO/PAHO coordinates closely with the Haitian Ministry of Health as well as health officials in the US, Canada and the Dominican Republic.
In St Marc, which has been at the center of the outbreak, efforts at St Nicolas a Médecines sans Frontiers (MSF)-run hospital continue to focus on treating patients whilst improving their security. The perimeter of the hospital has been cordoned-off and entry and exit into the hospital are closely regulated. There are sufficient medical supplies at present, but a lack of ringers lactate profusion has been reported. To preserve stocks of ringers lactate profusions, oral rehydration salts are being administered to patients with less severe cases while all others receive profusions. A delivery of additional ringers lactate profusions is expected in three or four days which will replenish the stock. Patients with severe cases will be grouped together and separated from those with less severe cases. To further cope with the outbreak St Nicolas Hospital, MSF has established a Cholera Treatment Center (CTC) inside the hospital. A CTC with the capacity to treat a further 150 patients is also planned for a site nearby the hospital.
The establishment of 12 CTCs and smaller Cholera Treatment Units (CTUs) commenced today. This includes six in Artibonite, one in the Central department and five in the West department in Port-au-Prince. It is important that cholera patients are treated in an environment away from other hospital patients to help inhibit the transmission of the illness. Meanwhile many medical facilities, especially in rural areas do not have the capacity to deal with the number of patients. CTCs can host up to 150 patients where as CTUs typically host 50 patients or less. Assessments are underway to determine if and where additional CTC and CTUs will be established. Although partners have largely responded to material needs of the CTC/CTUs, it remains clear that personnel to staff theses centres as well as WASH facilities are significant gaps. It is important to note that health and WASH assistance is needed in rural areas with smaller populations as well for CTCs and CTUs in more populated zones.
To support the establishment of a CTC in St Marc and another in l’Estere, MINUSTAH Bolivian and Brazilian battalions started round-the-clock site preparation today. Additional medical supplies for clinics in St Michel de l’Attalaye, l’Estere, Drouin in the commune of Grande Saline are needed urgently.
Assessments of medical facilities by health officials from Artibonite, WHO/PAHO and MSF are ongoing in rural areas. Many rural health clinics do not have the capacity to respond to cholera. Teams of experts from MSF, WHO/PAHO and other organisations continue to make assessments of existing medical facilities on a daily basis. Tomorrow and Monday a team of doctors and other experts from MINUSTAH and the government of Haiti will conduct assessments in Grand Saline, traveling by boat to isolated areas inaccessible by road.
Water, Sanitation and Hygiene (WASH)
The Haitian water and sanitation directorate (DINEPA) with support of the WASH cluster is enabling access to clean water, assessments of hygienic conditions and water points, distribution of soap and unrolling a sensitization campaign in affected and at-risk areas. Cluster partners have agreed on a joint strategy for the distribution of WASH supplies for 100 per cent of households. The package for a family of 5 for one week will contain 5 bars of soap, water purification tablets to ensure 40 liters of water per day per family, and 10 rehydration salt sachets.
OCHA staff in Artibonite was informed that both rice and fish farming may be affected by the cholera outbreak. The region in question is a flood plane, which also requires additional precaution when burying corpses. Assessments show that bodies cannot be buried in areas with a prevalence of salt water.
In Artibonite and in central Plateau, ACTED, ACF and Action International have significant stock for distribution, though only ACTED have distributed water purification tablets and hygiene supplies. The WASH cluster and local authorities (CESAM) will begin household water testing on effectiveness of water purification tablet usage on 25 October. Assessments of water points are also a central component to the WASH response. The Artibonite River and communal sections are being targeted to assess the general sanitary conditions, while DINEPA has agreed to chlorinate water networks in large cities and smaller networks in the Artibonite and Plateau Central. According to the WASH cluster, the number of households reached with WASH supplies doubled from 6,000 to 12,000 from the first to the second day of the response. Water distribution by MINUSTAH peacekeepers continues.
Rapid progression of efforts of assessments and treatments are ongoing. Additional chlorine treatment is needed. The National guidelines on Cholera are currently being developed and will be available on Monday.
The Minister of Health has called for assistance with potable water, chlorine, and plastic mattresses.
Communication
Effective communication to the affected population is crucial to effective prevention and treatment of cholera and is being implemented by a number of actors. A communications campaign has been developed by the government of Haiti, which includes community-based mobilization, implicating humanitarian and governmental partners in the process, and the use of megaphones and sound trucks to communicate messages about cholera. The Ministry of Health has set up a service whereby sending the text “Maladi” to number 4636 one can receive health information via SMS message on cholera free of charge.
A focal person from the WASH cluster will be designated to train journalists in messaging around cholera and to respond to media queries from local press. The focus of this campaign will be to encourage hand-washing and drinking only clean water. Through the communications cluster and Communicating with Disaster Affected Communities (CDAC) working group, information-sharing amongst communicators in the government as well as humanitarian organisations is essential to ensure that messages transmitted are common, easy to understand, widely disseminated and approved by the relevant authorities. Today CDAC disseminated government approved messages on cholera to journalists and to cluster partners in St Marc. Meanwhile the International Federation of the Red Cross and Haitian Red Cross facilitated the diffusion of public health text messages. The WHO/PAHO sent today some general messages on how to safely handle corpses.
In Artibonite, a training of trainers and communicators is to be held next week in order to ensure that communications campaigns and social mobilisation shares the common approved messages.
Coordination
Coordination has ramped up in response to this crisis. The key clusters involved in this response, WASH, Health, Logistics, and Camp Management met in Port-au-Prince today to discuss national strategy as well as contingency planning for Port-au-Prince.
A strategy was developed and agreed upon by the government of Haiti and health clusters. This outlines measures taken for the identification of land where the CTC will be erected and who is doing what and where for the various clusters.
Outside the capital clusters met to determine their strategies to respond to this crisis.
Because of the situation in Plateau Central, OCHA is deploying a staff member to support the coordination structures in Plateau Central in Hinche. OCHA is also mobilising staff to improve coordination in the field in Artibonite, both in St Marc and in Gonaives.
A crisis information centre was established to facilitate the transmission of information for this response. A website has been developed at http://haiti.humanitarianresponse.info/ . Please send your information requests and other queries to haiti.choleraresponse@gmail.com.
MINUSTAH’s Force Commander and the DSRSG/RC/HC held a teleconference with General Keen of US Southern Command. They briefed General Keen on the ongoing response, current in-country capacity, highlighting areas of potential needs and discussing possibilities for future cooperation. | | |
|
Premium