VIETNAM RED CROSS SOCIETY Hochiminh Chapter Hochiminh City, 20 June 2011 CONTINGENCY PLAN DENGUE FEVER PREVENTION AND RESPONSE IN HOCHIMINH CITY IN 2012 I. Background Following the guideline of Vietnam Red Cross in prevention and response to dengue fever and to respond to the increase in dengue fever cases in the city. In 2011, there was more than 9,000 people who were infected with dengue fever in Hochiminh City, which made Hochiminh a city with highest cases of dengue fever in the country. Noticeably, the caseload in 2011 increases two-fold in comparison to 2010. Existing evaluations by Pasteur Institute has pointed out that dengue fever prevention activities have covered a large geographic area but have not motivated people to take actions to eliminate larvae and mosquito. In recent years, there has been a high and sudden increase of migrant workers moving to HCMC. Community members are not actively involved in preventive activities such as elimination of larvae and mosquito as well as lacking of knowledge on prevention. In the city, there are many construction sites in progress, including reconstruction of drainage system which provides the condition for mosquito breeding and difficult for vector control. Overloaded hospitals, particularly in pediatrics hospitals, shortage of health professionals for treatment, high medical care costs are among factors contributing to increased burden on households in term of health, economics and life. There are about 250 locations in the city where often suffered from flooding by rain water during raining season, which provide conditions for mosquito breeding. In addition, raining season has the tendency to start earlier and end later, which also challenges preventive activities. Information from the office of Meteorological service in Hochiminh says that raining season is usually from May to November. The annual rainfall on average is about 2,949mm while the temperature is around 27.5 degree Celsius. In history, the year with highest rainfall in HCMC is in 1908 with 2,718mm and lowest in 1958 with 1,392mm. On average, there are 159 days in a year with shower rain. 90% of annual rainfall in the city is from May to November. June and September are usually the two months with highest rainfall by month. From January to March, there is almost no raining. On average, humidity in HCMC is 79.5%. During raining season, humidity is about 80% on average. In the most humid days, it could reach to 100%. In dry season, humidity on average is 74.5%. And it lowest level can be 20%.
Year No. of times of heavy rain Translated version Statistics of rainfall in HCMC in 2011 No. of times that heavy rain resulted in flood No. of raining with rainfall above 100 mm No. of raining with rainfall above 90 mm No. of raining with rainfall above 80 mm No. of raining with rainfall above 70 mm 2009 150 48 03 02 04 03 2010 150 78 01 03 02 09 2011 163 55 02 05 02 07 Source: Meteorological service Hochiminh, 2011 There are about 10,000 cases of dengue fever annually in HCMC. HCMC is often the province with highest dengue fever cases in the country. Infection cases are often peaking up during raining season. Data from the Institute of Public Health and Hygiene shows that from during the period of 2008 to 2011, June July is start of the high season. Weekly caseload of dengue fever in Hochiminh City from 2008-2011 Infected cases 800 700 600 500 400 300 200 100 0 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 Maéc 2008 Mắc 2009 Mắc 2010 TPHCM Deaths Hochiminh Red Cross Chapter has been active in dengue fever prevention and control in a number of years mainly to respond to outbreaks in community. Within the framework of the dengue fever prevention and control program, a contingency for 2011-2012 has been made. II. Objectives 1. Objective: To increased behaviour change communication among at population in dengue fever. 2. Specific objectives: - Strengthened awareness and knowledge of dengue fever prevention for 10,000 staffs, members and volunteers in the city
- To implement prevention activities in dengue fever in high risk areas including of rented residents, migrant workers residents, industrial zone in District 1 and District Binh Chanh. Indicators: - The number of weekly cases - Monthly distribution of cases per district. - 20% of total households in District 1 and District Binh Chanh have knowledge of dengue fever prevention and implemented larvae elimination at household. - Community-based surveillance is resulted in having no larvae in 10% of total households in two districts III. Activities - Maintain household s visits to at risk families by volunteers in communes where there are new cases. - Organize refresh training for 10 staffs and 200 volunteers in District 1 and District Binh Chanh in dengue fever. - Update preparedness plan for communication and response to outbreak of dengue fever A. Pre-season activities: from December to April Threshold: No announcement by the department of preventive medicine for outbreak. On average, weekly cases are under 200. - Review and pre-preparedness base on the Climate Centre s monthly forecast - Monitor dengue fever cases and rainfall - Recruit and strengthen of volunteers for behaviour change communication in dengue fever - Equip staffs and volunteers with knowledge of dengue fever prevention and outbreak control - Retain volunteers - Conduct campaigns to raise awareness - Sustain vector control activities through regularly adding the fish in household water storage tanks and cleaning water storage tools - Sustain clean up and removal of bush, trash. - Visit families with severe dengue fever case. B. Activities in high season of dengue fever: from May to November
Threshold: from 200-700 cases per week, occurrence of dengue hotspot. According to the Ministry of Health, a hotspot is alerted when there are two lab confirmed cases of dengue fever within 14 days in the same cluster of household (in urban area) or village (in rural area). Secondly, larvae and/or aedes aegypti or aedes albopictus is found in the area where cases are found. In hotspot area, suspected cases of dengue fever need to be reported and following the same guideline as for confirmed cases. Announcement to dismiss a hotspot is made when there is no new case found within 14 days from the date of the last reported case. When a hotspot is detected and information is shared by the center of preventive medicine to Hochiminh Chapter, following actions will be implemented: - Conduct house-to-house education in dengue fever at household level in alerted commune. Volunteers to carry out visit at household among at risk families one a week. - Provide households with guidance in case of dengue fever case detection - Strengthening elimination of breeding size and larvae through clean-up, putting fish in and cleaning of household water storage tanks, removal of bushes around households. - Early detection of dengue fever cases and share information with the community health workers - Conduct group meeting to sensitize households on detection of symptoms, severe symptoms, and local available resources for dengue fever. - Assist health professionals in case management and control of outbreaks - Regularly update and disseminate updates on dengue fever in Binh Chanh District and District 1 - Monitor dengue fever cases 2. Resources - Mobilize Red Cross staffs, members and volunteers as well as youth and community members in preventive activities of dengue fever - Pre-position of communication materials and resources for training of trainers and volunteers 3. Finance: 500 million (breakdown to be provided upon request) III. Stakeholders and Coordination mechanism 1. Stakeholders who are involved in the plan
2. Vietnam Red Cross The Healthcare Department of Vietnam Red Cross will be responsible to give guidance to chapter with updates on technical materials, updates and actions in case of outbreak. - Sensitize Red Cross s contingency plan at city, district and commune and household level - Sign inter-agency plan between Red Cross and the Department of Health and Health Centre at district and communal level - Participate in the steering committee for dengue fever prevention at district and communal level - Join in monitoring in dengue fever prevention and control at household level together with the health agencies - Organize training for Red Cross staffs, volunteers and behaviour change communication activities with family members in communities 3. Department of health and Health Centres The units who are responsible for dengue fever surveillance and public health who will share with Hochiminh Chapter information on updated situation and local response by health sector. - Jointly implement the inter-agency plan in dengue fever
- Share update the monthly reports and technical guidance in dengue fever prevention and control - Share in advance projection of dengue fever - Share information of cases location 4. People s Committee The Department of Social, Cultural Affairs and Health Vietnam Red Cross will take the role of the advisor to the People s Committee in dengue fever prevention and control at community level. The People s Committee will help facilitate the implementation and monitoring the Red Cross s contingency plan at provincial, district, communal and household level. Leaders of the People s Committee at city, district and communal level will periodically monitor the implementation of the plan. 5. Mass organizations and other agencies The communication departments - Vietnam Red Cross and other mass organizations such as the Women s Union, Youth Union, Farmer s Association as well as Department of Education in coordination in communication activities, key messages, integrated actions and avoid duplication in target groups. The cooperation with mass organizations will be operationalized in following activities: - The Women s union will provide knowledge of dengue fever prevention to their members, and reinforce preventive measures at household level among their members, while the VNRC will provide house-to-house visit for household education. - The Youth Union will work jointly in clean up activities and forming community educators for communication activities in dengue fever. - The Farmer s Association and its members will work with Red Cross s volunteers in reinforcing vector control activities at household level such as putting fish in household water storage tanks, clean up activities and removal of water stagnant. - The department of education will maximize the role of the Red Cross in schools through integrating Red Cross s communication sessions in dengue fever in social activities in schools such as community theatre, plays, games as well as clean-up activities in schools. - Community leaders and health committee at communal level will work with the Red Cross in follow up on implementation of preventive measures with families in the commune. IV. Monitoring and reporting: In normal situation, the chapter will perform quarterly report. In outbreak situation, the chapter will apply monthly report following the agreed format. If call for assistance in emergency to Red Cross is made by a community authority in affected areas, the Red Cross will activate its weekly emergency reporting. - Red Cross volunteers will report upward implementation of preventive activities in communities. Reporting routines from volunteers to Red Cross staff at communal level are:
- Before and after outbreak: monthly report - Red Cross staffs in charge of dengue fever prevention at communal level will report back to the steering committee on dengue fever at different levels. Reports from communes and districts will be consolidated by provincial chapters and sent to Vietnam Red Cross Headquarter. V. Annex: 1. Vulnerability map: - Showing where the Red Cross s interventions will be. 2. Capacity map: - Showing 38 Red Cross s first aid posts in District 1 and Binh Chanh District) - Showing health station, health centres, community s information billboard, offices of people s committee - Showing cultural and information access points in community 3. Health facilities - In district 1, there are two hospitals, three clinics and two traditional medicine clinics as well as 10 health stations at communal level. - In Binh Chanh District, there are two hospitals, four clinics, two traditional medicine clinics and 20 communal health stations. 4. List of Red Cross staffs, volunteers and community health workers - Red Cross in-charge officers at district level: four persons - Red Cross in charge officers at communal level: 20 persons - Red Cross s volunteers: 500 - Community health workers: 20 Copied: On behalf of Executive Board - VNRC HQ, Healthcare Dept. Vice Chairman - Healthcare Dept, HCM Chapter (signed) - Filed in HCM Chapter office Dr. Le Quang Ninh