Health action in crisis

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1 Health actin in crisis WHO Emergency Health Prgramme fr the Fd Crisis in Niger Situatin Reprt # t 17 Octber 2005 Highlights Training f healthcare trainers and healthcare wrkers n the treatment f malnutritin is cntinuing at a fast rate. As f 15 Octber, 369 health care wrkers had received training. It is planned t prvide training fr a ttal f 570 healthcare trainers and healthcare wrkers by 31 December On Mnday 10 Octber, the Hnrable Margherita Bniver, Italian Under-secretary f State, respnsible fr humanitarian affairs, met with heads-f-agency frm WHO, FAO, WFP, OCHA UNICEF t discuss the current situatin in Niger. The Italian Gvernment has pledged t WHO emergency peratins in Niger The recently appinted UNDP Administratr, Mr Kermal Dervis visited Niger Octber The WHO Niger Representative, Niger Embassy representatives and ther heads f UN agencies accmpanied Mr Dervis n a field trip t the Zinder and Agadez regins. In the Zinder regin, the delegatin visited an Intensive Nutritinal Rehabilitatin Centre (CRENI) perated by MSF-Switzerland. The UNDP Cmmunity Nursery Prject was fficially pened by the inauguratin f the first cmmunity nursery in Zinder. It is planned t pen a ttal f 1000 nurseries in the suthern areas f the regins f Maradi and Zinder. The target ppulatin f the nurseries is 1.5 millin peple, cmprising wmen and their children aged between 6 mnths and 5 years. This UNDP initiative, cmbined with the WHO training t cmmunity healthcare wrkers, is an imprtant step in the creatin f durable cmmunity-based prjects fr the preventin f malnutritin. A seminar n Supprt f the Niger Islamic Assciatins fr plimyelitis vaccinatin and malnutritin in Niger, financed by WHO, was held in Niamey, Octber 2005 fr ver 350 ulemas frm arund the cuntry. The bjective f the seminar was t invlve these ulemas in the mass vaccinatin campaigns and the respnse t malnutritin in Niger. Outcmes: heightened awareness and engagement t supprt and prmte vaccinatin campaigns as well as ther health prjects that aim t prmte the health f wmen and children; engagement f the ulemas t teach, thrugh religius services, the imprtance f vaccinatin and ther health prjects that aim t prmte the health f wmen and children. At the clse f the seminar, a cnsensus was reached n the imprtance f the supprt f ulemas fr a successful vaccinatin campaigns.

2 Health actin in crisis Axis 1: Enhance capacities t treat severe malnutritin at health centre levels by ensuring that staff receive fcused training and that therapeutic fd supplies are available. The WHO medical-nutritinist presented the advancement f the training prgramme fr healthcare trainers and healthcare wrkers n the treatment f malnutritin at the weekly health crdinatin meeting, 12 Octber It is planned t prvide training fr a ttal f 570 healthcare trainers and healthcare wrkers by 31 December Since July 2005, 369 healthcare wrkers had received training. Of the 396, 48 participated in the training fr healthcare trainers n the treatment f malnutritin and 321 participated in training n the treatment f malnutritin. Supervisin manuals have been finalized and will be distributed t help ensure lng-term effectiveness f the training. The interagency grup n nutritin reprted an verall decline in the nutritinal status f children under 5 years at their weekly crdinatin meeting held at UNICEF n the 14 Octber There are 570 Intensive Nutritinal Rehabilitatin Centres (CRENI) and Outpatient Nutritinal Rehabilitatin Centres (CRENA) currently in peratin in Niger. As f n 13 Octber 2005, a ttal f children have been admitted in CRENI and CRENA facilities perated by 20 health partners arund the cuntry. Of the cases, were admitted fr mderate malnutritin and were admitted fr severe malnutritin. It is imprtant t nte that these numbers are nt cmplete. Ten partners have nt cmmunicated their weekly data, and nly six f the twenty partners have cmmunicated their mnthly reprts. Axis 2: Strengthen health sectr crdinatin and infrmatin management t ensure better targeting and address needs in under-serviced areas The eighth interagency health crdinatin meeting at the WHO Niamey peratins rm, 12 Octber The meeting was c-chaired by the Ministry f Public Health and Endemic Disease and WHO and cmprised f health sectr partners frm the Ministry f Public Health and Endemic Disease, United Natins Office fr the Crdinatin f Humanitarian Affairs (OCHA), NGOs and USAID. The representative frm the Ministry f Health reiterated the imprtance f thrugh surveillance. All relevant health infrmatin must be cmmunicated in a timely manner t the nearest CSI, t Prvincial Health Infrmatin System (SPIS) f the Reginal Department f Public Health (DRSP) and then t the Natinal Health Infrmatin System (SNIS). The imprtance f cntinuing targeted free fd distributin t the mst vulnerable grups until 2006 was discussed. In rder t develp effective pst crisis plans, the fd distributin shuld be accmpanied by systematic surveillance f the nutritinal status in all regins. The USAID Reginal Advisr fr West and Nrth Africa expressed agreement n the imprtance f surveillance and infrmed that USAID wuld like t becme invlved in the nutritinal surveillance. MSF/Switzerland, MSF-France and Islamic Relief prvided updates n their activities. The crdinatr f the Health Natinal Malaria Cntrl Prgramme and the WHO Natinal prgramme fficer n Malaria c-presented and analysed the malaria epidemilgical data fr 2003, 2004 and WHO Emergency Health Prgramme fr the Fd Crisis in Niger page 2 f 8 Situatin Reprt # 10 Perid: 11 t 17 Octber 2005

3 Health actin in crisis WEEKLY EVOLUTION OF MALARIA IN NIGER 2003, 2004, 2005 (CASES AND DEATHS) S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 S11 S12 S13 S14 S15 S16 S17 S18 S19 S20 S21 S22 S23 S24 S25 S26 S27 S28 S29 S30 S31 S32 S33 S34 S35 S36 S37 S38 S39 S40 S41 S42 S43 S44 S45 S46 S47 S48 S49 S50 S51 S52 Number f cases f malaria epidemilgic weeks The epidemilgic curves abve shw peak transmissin during the rainy seasn. WHO has begun training f trainers and training f healthcare wrkers n first line treatment f uncmplicated malaria in children under five years t the CRENI and CRENA, and distributin f medicatin has begun in the regins f Agadez, Diffa, Dss and Tillaberi. T further supprt the n ging training f healthcare wrkers n first line treatment f uncmplicated malaria, WHO is rganizing additinal shipments f anti-malaria medicatin fr distributin t children under 5 years t the regins f Agadez, Diffa, Dss and Tillaberi. The Zinder Regin Crdinatin meeting was held at the Reginal Department f Public Health n 11 Octber All f the NGOs wrking in the Zinder regin were present at the meeting and all specified the natinal public health structures where they functin; WHO distributed t all partners all dcuments prduced by the crisis peratins respnse team; Lcal medical authrities and WHO reminded NGOs f the necessity f cmmunicating all data cllected t the Integrated Health Centres (CSI) that service the villages and areas where they are present; In respnse t the magnitude f malaria in the regin, the Chief f the paediatric department at the Zinder reginal hspital appealed fr mre supplies f medicatin and paediatric nasal glasses fr treatment f malaria f thse wh can nt affrd prescriptins. WHO engaged t supply nasal glasses t cmplement the shipment f anti-malaria medicatin delivered n the 9 Octber t the Reginal Department f Public Health (DRSP). The NGO Islamic Agency fr Africa (Agence Musulmane d Afrique) ffered t prvide 20 paediatric beds; The Reginal Directr requested NGOs that are buying and treating malaria with chlrquine t cnfrm t natinal directives. WHO Emergency Health Prgramme fr the Fd Crisis in Niger page 3 f 8 Situatin Reprt # 10 Perid: 11 t 17 Octber 2005

4 Health actin in crisis The Maradi Regin Crdinatin meeting was held at the Reginal Department f Public Health n 14 Octber 2005: WHO will take ver the task f rganizing the weekly reginal meetings; WHO distributed t all partners all dcuments prduced by the crisis peratins respnse team; The Gvernr f the Maradi annunced that in spite f the current harvest, 350 villages d nt have adequate fd supplies; The Reginal Directr requested partners, wh intend t establish nutritinal rehabilitatin centres, t d s within the natinal Integrated Health Centres (CSI) and t assciate the existing persnnel f these centres in the verall management. The fifth issue f the Epidemilgical Weekly Mrbidity, Mrtality and Nutritinal Surveillance in Niger Bulletin, which will feature data analysis fr week 39, will be published n the 17 Octber by the Ministry f Health, with the supprt f WHO and UNICEF. Axis 3: Early identificatin and cntrl f suspected utbreaks supprting health partners in surveillance systems and strengthening preparedness fr epidemic prne diseases thrugh prvisin f technical expertise and prepsitin f medical kits Chlera. Five (5) new cases f chlera were reprted in the Tahua regin between 7 and 14 Octber Since 13 July 2005, 474 cases including 46 deaths have been reprted in Tahua. Since 15 September 2005, 3 cases but n deaths have been reprted frm the regin f Tillaberi. The ttal number f reprted cases in Niger is 477, including 46 deaths. The verall case fatality rate (CFR) is 9.6%. Case f chlera in the Taha regin f Niger 13 July t 13 Octber 2005 Number f cases TAHOUA (474 cases, 46 deaths) Cases 13/7 15/7 17/7 19/7 21/7 23/7 25/7 27/7 29/7 31/7 2/8 4/8 6/8 8/8 10/8 12/8 14/8 16/8 18/8 20/8 22/8 24/8 26/8 28/8 30/8 1/9 3/9 5/9 7/9 9/9 11/9 13/9 15/9 17/9 19/9 21/9 23/9 25/9 27/9 29/9 1/10 3/10 5/10 7/10 9/10 11/10 13/10 Deaths Number f deaths weeks WHO Emergency Health Prgramme fr the Fd Crisis in Niger page 4 f 8 Situatin Reprt # 10 Perid: 11 t 17 Octber 2005

5 Health actin in crisis The Cre Grup in charge f distributin lgistics fr the natinal vaccinatin campaign days, t be held Nvember and December, tk place in Niamey, Octber The twday planning meeting was held t define the lgistical requirements f all the partners t facilitate the distributin f resurces (medical, technical and persnnel). The natinal vaccinatin campaign days target children under 5 years. Alng with mass vaccinatin, ver 2 millin Lng Lasting Insecticidal Nets will be distributed as well as vitamin A and anti-helminth medicatin. Frm Octber 2005, WHO hsted a three day wrkshp in Niamey fr the Niger Rapid Interventin Team (ENIR), n the preparatin and the respnse t the epidemics. The bjectives f the wrkshp were t reinfrce the capacity f the members f the reginal and central teams in disease surveillance and rapid respnse t epidemics; Seventeen participants including persnnel f the Natinal Health Infrmatin System (SNIS), the Directr fr Child Immunizatin (DIE), the natinal representative f the Haemphilus influenza type B (Hib)-Paediatric Bacterial Meningitis Surveillance Netwrk and technical partners (WHO, UNICEF, Belgian Technical C-peratin and the Canadian prject f Supprt t the Integrated Epidemilgic Mnitring phase 2) attended the wrkshp financed by WHO. At the end f the wrkshp, the fllwing recmmendatins were expressed: Ministry f Public Health and Endemic Disease T imprve administrative methds, such as pre-signed missin rders; T facilitate rapid respnse, increase the allcatin f funds; T have financial and lgistic resurces easily available fr the respnse t epidemics. Partners T cntinue the technical and financial supprt fr disease surveillance and rapid respnse t epidemics; WHO t cntinue t hld internatinal meetings n disease surveillance and rapid respnse t epidemics. A jint Natinal Health Infrmatin System (SNIS) / WHO team is visiting the regins f Zinder and Maradi t imprve the cllectin and analysis f malnutritin data frm all stakehlders at the respnse level (natinal centres, NGOs, UN agencies,), t be frwarded t the Reginal Department f Public Health (DSRP), fr a mre cmplete analysis f the situatin. All regins affected by the fd crisis will be visited by this SNIS/WHO team end f Octber Axis 4: Supprt the develpment f an emergency plicy and strategy t imprve reliability f access t and affrdability f essential health care The UK s Department fr internatinal Develpment (DFID) has cntributed USD 250,000. N fficial feedback has been annunced cncerning the Recvery f Csts cncept paper fr the slidarity fund Santé de prximité which was presented t the Gvernment at the Natinal Wrkshp n the 2006 Actin Plan, Niamey, 6 Octber Travel III. Operatins The crdinatr f the WHO Niger crisis peratins team visited the regin f Zinder and the WHO reginal ffice in Maradi. The reginal Directr f the Department f Public Health requested technical supprt frm WHO fr the analysis f the epidemilgic data f malnutritin and asked that the paediatrician-nutritinist remains permanently in Zinder. WHO Emergency Health Prgramme fr the Fd Crisis in Niger page 5 f 8 Situatin Reprt # 10 Perid: 11 t 17 Octber 2005

6 Health actin in crisis Persnnel A WHO malaria expert jined the crisis respnse team n the 15 Octber 2005 fr a perid f 6 weeks. Lgistics 200 paediatric nasal glasses have been rdered fr hspitals in regins f Maradi and Zinder. WHO Emergency Health Prgramme fr the Fd Crisis in Niger page 6 f 8 Situatin Reprt # 10 Perid: 11 t 17 Octber 2005

7 Health actin in crisis MAP REPRESENTING THE 8 REGIONS OF NIGER: WHO Emergency Health Prgramme fr the Fd Crisis in Niger page 7 f 8 Situatin Reprt # 10 Perid: 11 t 17 Octber 2005

8 Health actin in crisis Agadez, Diffa, Dss, Maradi, Niamey, Tahua, Tillabéri, and Zinder WHO Emergency Health Prgramme fr the Fd Crisis in Niger page 8 f 8 Situatin Reprt # 10 Perid: 11 t 17 Octber 2005

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