1 health response to floods & landslides nepal 2007 world health organization emergency &...

11

Health Response to Health Response to Floods & Landslides Nepal Floods & Landslides Nepal

20072007

World Health Organization World Health Organization Emergency & Humanitarian ActionEmergency & Humanitarian Action

27 July – 23 August 200727 July – 23 August 2007

22

Flood Preparedness Flood Preparedness Floods and landslides are annually recurring Floods and landslides are annually recurring

challenges in Nepal challenges in Nepal Flood preparedness takes place at various levels Flood preparedness takes place at various levels

every pre-monsoon seasonevery pre-monsoon season Frequent Emergency Health and Nutrition Working Frequent Emergency Health and Nutrition Working

Group coordination meetings – resource mapping Group coordination meetings – resource mapping and ‘who does what where’ exercise completed and ‘who does what where’ exercise completed

Rapid health assessment forms printed and agreed Rapid health assessment forms printed and agreed upon with EDCD and partners in healthupon with EDCD and partners in health

One outcome of the SIDA-funded CAP ‘Health Action One outcome of the SIDA-funded CAP ‘Health Action in Crisis’ was a logistic supply chain (2 containers) in Crisis’ was a logistic supply chain (2 containers) and pre-positioned medicine (New Emergency and pre-positioned medicine (New Emergency Health Kits and Dirreahoal Kits)Health Kits and Dirreahoal Kits)

EDCD on high alert due to cholera response from 20 EDCD on high alert due to cholera response from 20 May to 10 JulyMay to 10 July

33

Flood & Landslide Profile Flood & Landslide Profile Localised flooding and severe landslides from 10 JulyLocalised flooding and severe landslides from 10 July Widespread flooding from 27 July onwardsWidespread flooding from 27 July onwards Flood data:Flood data:

Scale of emergency not catastrophic by national standardsScale of emergency not catastrophic by national standards High level of public awareness due to international media High level of public awareness due to international media

coverage and regional flooding in India and Bangladeshcoverage and regional flooding in India and Bangladesh Pressure from humanitarian agencies to engage / intervenePressure from humanitarian agencies to engage / intervene Response capacity assessed to be available in countryResponse capacity assessed to be available in country

NRCS 23 AugNRCS 23 Aug MOHA 10 SepMOHA 10 Sep

DeathsDeaths 148148 185185

InjuredInjured 9494 ??

Displaced familiesDisplaced families 24,11624,116 16,27316,273

Affected familiesAffected families 79,20079,200 69,39869,398

44

Mortality and InjuriesMortality and Injuries

0

50

100

150

200

250

300

350

400

450

2058 2059 2060 2061 2062 2063 2064

Injured

Deaths

Mortality and injuries caused by floods and landslides year 2001-2007

Source: MOHA data with 2007-data from NRCS superimposed

55

Displaced Families Displaced Families

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

2002 2003 2004 2005 2006 2007

Displacement as key public health indicator – usually not recorded by MOHA

Number of displaced families caused by floods and landslides year 2002-2007

Source: Last NRCS sitrep each year

66

DOLPA

MUGU

JUMLA

KAILALI

BARDIYA

HUMLA

DOTI

SURKHET

NAWALPARASIKAPILBASTU

RUPAN-DEHI

DANG

BANKE

ACHHAMKALIKOT

JHAPAMORANG

SIRAHA

SAPTARI

DARCHULA

BAJHANG

BAITADI

DADEL-DHURA

KANCHAN-PUR

BAJURA

PARSA

BARA

RAUT-AHAT

DHANUSA

MAHO-TTARI

SUNSARI

SARLAHI

DHADING

MAKAWAN-PUR

CHITWAN

KASKIBAGLUNG

TANAHU

PALPA

SYANGJAPARBAT

ARGHAK-HACHI

GULMI

UDAYAPUR

SINDHULI

ILAM

BHOJ-PUR

PACH

ETHA

R

DHAN-KUTA

TAPLEJUNG

RAMEC

HHAP

OKHAL-DHUNGA

TERHA-THUM

KHOTANG

LALIT

BHAK

KATHM

SULUKHUMBU

DOLAKHASANKHUWASABHA

NUWAKOTSINDHU-PALCHOK

KAVRE

RASUWA

LAMJUNG

GORKHA

PYUTHAN

ROLPASALYAN

MYAGDI

DAILEKHJAJARKOT

RUKUM

MUSTANG

MANANG

KATHMANDU

LALIT

BHAK

India

China

No. of displaced families (NRCS)

1 - 100

100 - 999

1000 -

Flood & landslide affected district: 28 districts

Public health monitoring based on NRCS, Epidemiology and Disease Control Division, WHO and media reports, 31.07.07

Evolution of Floods Week 1 Evolution of Floods Week 1

77

DOLPA

MUGU

JUMLA

KAILALI

BARDIYA

HUMLA

DOTI

SURKHET


RUPAN-DEHI

DANG

BANKE

ACHHAMKALIKOT

JHAPAMORANG

SIRAHA

SAPTARI

DARCHULA

BAJHANG

BAITADI

DADEL-DHURA

KANCHAN-PUR

BAJURA

PARSA

BARA

RAUT-AHAT

DHANUSA

MAHO-TTARI

SUNSARI

SARLAHI

DHADING

MAKAWAN-PUR

CHITWAN

KASKIBAGLUNG

TANAHU

PALPA

SYANGJAPARBAT

ARGHAK-HACHI

GULMI

UDAYAPUR

SINDHULI

ILAM

BHOJ-PUR

PACH

ETHA

R

DHAN-KUTA

TAPLEJUNG

RAMEC

HHAP

OKHAL-DHUNGA

TERHA-THUM

KHOTANG

LALIT

BHAK

KATHM

SULUKHUMBU



KAVRE

RASUWA

LAMJUNG

GORKHA

PYUTHAN

ROLPASALYAN

MYAGDI

DAILEKHJAJARKOT

RUKUM

MUSTANG

MANANG

KATHMANDU

LALIT

BHAK

India

China


1 - 100

100 - 999

1000 -




88

DOLPA

MUGU

JUMLA

KAILALI

BARDIYA

HUMLA

DOTI

SURKHET


RUPAN-DEHI

DANG

BANKE

ACHHAMKALIKOT

JHAPAMORANG

SIRAHA

SAPTARI

DARCHULA

BAJHANG

BAITADI

DADEL-DHURA

KANCHAN-PUR

BAJURA

PARSA

BARA

RAUT-AHAT

DHANUSA

MAHO-TTARI

SUNSARI

SARLAHI

DHADING

MAKAWAN-PUR

CHITWAN

KASKIBAGLUNG

TANAHU

PALPA

SYANGJAPARBAT

ARGHAK-HACHI

GULMI

UDAYAPUR

SINDHULI

ILAM

BHOJ-PUR

PACH

ETHA

R

DHAN-KUTA

TAPLEJUNG

RAMEC

HHAP

OKHAL-DHUNGA

TERHA-THUM

KHOTANG

LALIT

BHAK

KATHM

SULUKHUMBU



KAVRE

RASUWA

LAMJUNG

GORKHA

PYUTHAN

ROLPASALYAN

MYAGDI

DAILEKHJAJARKOT

RUKUM

MUSTANG

MANANG

KATHMANDU

LALIT

BHAK

India

China


1 - 100

100 - 999

1000 -




99

DOLPA

MUGU

JUMLA

KAILALI

BARDIYA

HUMLA

DOTI

SURKHET


RUPAN-DEHI

DANG

BANKE

ACHHAMKALIKOT

JHAPAMORANG

SIRAHA

SAPTARI

DARCHULA

BAJHANG

BAITADI

DADEL-DHURA

KANCHAN-PUR

BAJURA

PARSA

BARA

RAUT-AHAT

DHANUSA

MAHO-TTARI

SUNSARI

SARLAHI

DHADING

MAKAWAN-PUR

CHITWAN

KASKIBAGLUNG

TANAHU

PALPA

SYANGJAPARBAT

ARGHAK-HACHI

GULMI

UDAYAPUR

SINDHULI

ILAM

BHOJ-PUR

PACH

ETHA

R

DHAN-KUTA

TAPLEJUNG

RAMEC

HHAP

OKHAL-DHUNGA

TERHA-THUM

KHOTANG

LALIT

BHAK

KATHM

SULUKHUMBU



KAVRE

RASUWA

LAMJUNG

GORKHA

PYUTHAN

ROLPASALYAN

MYAGDI

DAILEKHJAJARKOT

RUKUM

MUSTANG

MANANG

KATHMANDU

LALIT

BHAK

India

China


1 - 100

100 - 999

1000 -




1010

Immediate PrioritiesImmediate Priorities Immediate needs were shelter, food, water, Immediate needs were shelter, food, water,

sanitation and primary health caresanitation and primary health care Relative few post-flood medical needs; health Relative few post-flood medical needs; health

camps with no surprising findingscamps with no surprising findings Public health key to successful responsePublic health key to successful response Provision of clean waterProvision of clean water Availability of basic sanitationAvailability of basic sanitation Health promotion focussing on prevention of Health promotion focussing on prevention of

diarrhoeal and vector-borne diseasesdiarrhoeal and vector-borne diseases Strengthen public health monitoring based Strengthen public health monitoring based

on multiple sources on multiple sources Strengthen disease surveillance and Strengthen disease surveillance and

outbreak controloutbreak control

1111

Health Impact Health Impact Fear of epidemics was a main theme among Fear of epidemics was a main theme among

affected population and responders from the affected population and responders from the beginning of the emergencybeginning of the emergency

No major or unexpected outbreaks have been No major or unexpected outbreaks have been reported from any of the flood-affected areas reported from any of the flood-affected areas since 27 Julysince 27 July

Common illnesses reported:Common illnesses reported:- Fever- Fever- Respiratory infections- Respiratory infections- Diarrhoeal diseases- Diarrhoeal diseases- Skin diseases- Skin diseases- Eye and ear infections- Eye and ear infections

Risk of vector-borne diseases due to wide-Risk of vector-borne diseases due to wide-spread water-logging in inundated Terai spread water-logging in inundated Terai districtsdistricts

1212

DOLPA

MUGU

JUMLA

KAILALI

BARDIYA

HUMLA

DOTI

SURKHET


RUPAN-DEHI

DANG

BANKE

ACHHAMKALIKOT

JHAPAMORANG

SIRAHA

SAPTARI

DARCHULA

BAJHANG

BAITADI

DADEL-DHURA

KANCHAN-PUR

BAJURA

PARSA

BARA

RAUT-AHAT

DHANUSA

MAHO-TTARI

SUNSARI

SARLAHI

DHADING

MAKAWAN-PUR

CHITWAN

KASKIBAGLUNG

TANAHU

PALPA

SYANGJAPARBAT

ARGHAK-HACHI

GULMI

UDAYAPUR

SINDHULI

ILAM

BHOJ-PUR

PACH

ETHA

R

DHAN-KUTA

TAPLEJUNG

RAMEC

HHAP

OKHAL-DHUNGA

TERHA-THUM

KHOTANG

LALIT

BHAK

KATHM

SULUKHUMBU



KAVRE

RASUWA

LAMJUNG

GORKHA

PYUTHAN

ROLPASALYAN

MYAGDI

DAILEKHJAJARKOT

RUKUM

MUSTANG

MANANG

KATHMANDU

LALIT

BHAK

India

China


1 - 100

100 - 999

1000 -



Confirmed outbreak

Unconfirmed outbreak

Floods and Outbreaks Floods and Outbreaks

1313

Health Response Health Response EDCD / DHS immediately deployed three response EDCD / DHS immediately deployed three response

teams to different parts of the country. These teams teams to different parts of the country. These teams worked together with DHOs / DPHOs and RRTs in the worked together with DHOs / DPHOs and RRTs in the affected districts to provide public health guidance and affected districts to provide public health guidance and epidemiological supportepidemiological support

Supply of essential medicines to 33 districts and 5 Supply of essential medicines to 33 districts and 5 regional stores; including emergency supplies from regional stores; including emergency supplies from WHOWHO

Daily rumour verification and situation updates from Daily rumour verification and situation updates from DHOs / DPHOs; including weekly WHO sitrepsDHOs / DPHOs; including weekly WHO sitreps

EDCD opened a hotline for Rapid Response Teams to EDCD opened a hotline for Rapid Response Teams to call and inform urgent health updatescall and inform urgent health updates

An MOHPAn MOHP high-level committee established six health high-level committee established six health teams to coordinate field response and provide teams to coordinate field response and provide emergency medical care and public health guidanceemergency medical care and public health guidance. . These teams, headed by senior DHS officials, covered These teams, headed by senior DHS officials, covered 17 districts17 districts

1414

WHO Response WHO Response After 27 July, WHO mobilized the IPD SMOs in the field After 27 July, WHO mobilized the IPD SMOs in the field

to conduct assessments, assist DHOs / DPHOs and to conduct assessments, assist DHOs / DPHOs and provide public health guidanceprovide public health guidance

On 2 August, WHO called an Emergency Health and On 2 August, WHO called an Emergency Health and Nutrition Working Group meeting to discuss the flood Nutrition Working Group meeting to discuss the flood situation in the country and facilitate coordination and situation in the country and facilitate coordination and operational planning operational planning

On 3 August, WHO delivered emergency medicine to On 3 August, WHO delivered emergency medicine to five MOHP teams five MOHP teams

On 14 August, two additional diarrhoeal kits were pre-On 14 August, two additional diarrhoeal kits were pre-positioned in Banke districtpositioned in Banke district

On 15 August, one diarrhoeal kit was airlifted to On 15 August, one diarrhoeal kit was airlifted to Kalikot district to contain the surge in diarrhoeal casesKalikot district to contain the surge in diarrhoeal cases

Weekly WHO sitreps including district-specific health Weekly WHO sitreps including district-specific health datadata

Disease surveillance is being strengthened in Disease surveillance is being strengthened in collaboration with EDCD and DHOs / DPHOscollaboration with EDCD and DHOs / DPHOs

1515

Provision of Medical Provision of Medical SuppliesSupplies

1616

Learning ExperiencesLearning Experiences Past disaster statistics helped to identify the Past disaster statistics helped to identify the

appropriate response level and not being ruled by appropriate response level and not being ruled by subjective factorssubjective factors

Pressure from international agencies and the ‘South Pressure from international agencies and the ‘South Asia flood affect’ to substitute rather than support Asia flood affect’ to substitute rather than support national response efforts was resistednational response efforts was resisted

The magnitude of the emergency was appropriate for The magnitude of the emergency was appropriate for the country to test and enhance response mechanismsthe country to test and enhance response mechanisms

Emergency preparedness, pre-positioned medicine and Emergency preparedness, pre-positioned medicine and close collaboration with EDCD played an important role close collaboration with EDCD played an important role for our flood and landslide responsefor our flood and landslide response

Recent WFP / UNICEF assessment of the flood response Recent WFP / UNICEF assessment of the flood response in 19 districts concluded that the health response was in 19 districts concluded that the health response was impressive and no major shortcomings were identifiedimpressive and no major shortcomings were identified

1717

RecommendationsRecommendations Continue regular efforts to strengthen the disaster Continue regular efforts to strengthen the disaster

management section in EDCDmanagement section in EDCD Stronger efforts to coordinate with MOHP and align Stronger efforts to coordinate with MOHP and align

with health policies to systematically introduce with health policies to systematically introduce response preparedness and risk management in response preparedness and risk management in health sector policies and practiceshealth sector policies and practices

Maintain the logistic pipeline introduced last year Maintain the logistic pipeline introduced last year and re-stock international medical kitsand re-stock international medical kits

Develop cost-effective local medical kits specifically Develop cost-effective local medical kits specifically designed to meet field needs in Nepal; invest in designed to meet field needs in Nepal; invest in packaging and labellingpackaging and labelling

Decentralize the health sector’s emergency Decentralize the health sector’s emergency preparedness further; pre-positioning at district level preparedness further; pre-positioning at district level and focus on training and capacity building at and focus on training and capacity building at peripheral levelsperipheral levels

1818

Thank YouThank You

1 health response to floods & landslides nepal 2007 world health organization emergency &...

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