1 TYPHOON YOLANDA HEALTH CLUSTER BULLETIN December 11, 2013 TYPHOON YOLANDA HEALTH DECEMBER 11, 2013 HIGHGLIGHTS As of 10 December 2013, the National Disaster Risk Reduction Management Council (NDRRMC) of the Philippines reported 5 786 deaths, 27 022 injured, and 1 779 missing. A total of 11 241 237 people have been affected, 4 006 747 are displaced, and 103 604 are in 386 evacuation centers. Top 5 health events reported via SPEED from Region 6 (Capiz, Aklan, Antique and Iloilo) on 9 Dec 2013 were acute respiratory infection, wounds, high blood pressure, fever, and animal bites. Alerts were noted for tetanus and acute haemorrhagic fever in Cabatuan and Iloilo City. The number of evacuation centres is declining as people begin rebuilding their homes and schools are cleared to permit classes to begin. To date, 1068 of 9297 health facilities in the affected regions have been assessed. Among assessed facilities there has been substantial damage. Many of the remaining facilities will not be assessed as they are outside the Yolanda Corridor and assumed to not be damaged. The routine immunization programs in region VIII will begin soon; stocks and cold chain are now being re-established. Photo: WHO/Frainisco Guerrero Inside this bulletin: Affected population and areas Main public health concerns Public health risks, needs, and gaps Health cluster action ISSUE #7
Transcript
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TYPHOON YOLANDA HEALTH CLUSTER BULLETIN
December 11, 2013
TYPHOON
YOLANDA
HEALTH
DECEMBER 11, 2013
HIGHGLIGHTS
As of 10 December 2013, the National Disaster Risk Reduction Management Council
(NDRRMC) of the Philippines reported 5 786 deaths, 27 022 injured, and 1 779 missing. A
total of 11 241 237 people have been affected, 4 006 747 are displaced, and 103 604 are in
386 evacuation centers.
Top 5 health events reported via SPEED from Region 6 (Capiz, Aklan, Antique and Iloilo) on 9
Dec 2013 were acute respiratory infection, wounds, high blood pressure, fever, and animal
bites. Alerts were noted for tetanus and acute haemorrhagic fever in Cabatuan and Iloilo City.
The number of evacuation centres is declining as people begin rebuilding their homes and
schools are cleared to permit classes to begin.
To date, 1068 of 9297 health facilities in the affected regions have been assessed. Among
assessed facilities there has been substantial damage. Many of the remaining facilities will not
be assessed as they are outside the Yolanda Corridor and assumed to not be damaged.
The routine immunization programs in region VIII will begin soon; stocks and cold chain are
now being re-established.
Photo
: W
HO
/Fra
inis
co G
uerr
ero
Inside this bulletin:
Affected population and areas
Main public health concerns
Public health risks, needs, and gaps
Health cluster action
ISSUE #7
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TYPHOON YOLANDA HEALTH CLUSTER BULLETIN
December 11, 2013
AFFECTED POPULATION AND AREAS
As of 10 December 2013, the National Disaster Risk Reduction Management Council (NDRRMC) of the
Philippines reported 5 786 deaths, 27022 injured, and 1 779 missing. A total of 11 241 237 people have
been affected, 4 006 747 are displaced, and 103604 are in 386 evacuation centers (Table 1).
Source: Situation report #58 NDRRMC as of 10 December, 2013
The number of evacuation centres
is declining. According to OCHA
people are leaving centers as
shelter materials from aid organi-
zations or salvaging become avail-
able. The reopening of schools
that previously hosted evacuation
centers has been a factor for this
decline. Many affected people
have begun returning to the sites
of their former homes. Some stay
with others in affected areas or
urban centres such as Cebu and
Manila. Others have moved to
temporary relocation centers
where tent cities and wooden pa-
vilions are being erected. The De-
partment of Social Welfare and
Development (DSWD) has provid-
ed each departing IDP with a
Family Assistance Card, making
them eligible to receive assistance
in the neighborhood where they
had lived prior to the typhoon.
Local Government is constructing
temporary relocation centers, each
housing 28 families, in Tacloban,
Palo inLeyte; Basey, Marabat in
Samar; Guiuan, Hernani and Gi-
porlos in Eastern Samar. The goal
is to build 375 by Christmas. This
will provide housing for 52,500
persons. DTM seeks to track con-
ditions at these sites for the provi-
sion of services.
Migration outflow desks are still
operating at the ports and airport.
About 500 people per day leave
the affected areas, approaching
normal levels of pre– typhoon mi-
gratory movement.
The oil spill clean up in Estancia,
Iloilo is reported to be improving.
Japan has dispatched an oil clean-
ing expert team, at the Govern-
ment’s request.
UNICEF has put out a reminder
asking people to look for and as-
sist unattended children.
AFFECTED POPULATION
(NDRRMC, 10 December 2013)
Number of af-
fected popula-
tion
% of total pop-
ulation of the
area*
Number of
Displaced
Population
% of inter-
nally dis-
placed
Region IV A 27 076 0.2 - -
Region IV B 467 050 17 1 960 0.07
Region V 656 239 23.7 - -
Region VI 2 829 806 39.8 2 414 276 33.83
Region VII 2 898 027 42.6 258 484 4.30
Region VIII 4 271 816 104.2 1 340 381 31.93
Region X 19 592 0.5 - -
Region XI 5 000 0.1 - -
Caraga 66 631 2.7 22 -
Total 11 241 237 23.8 4 006 747 9.27
Humanitarian
Case Load ac-
cording to
Flash Appeal
12 900 000 29.84%
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TYPHOON YOLANDA HEALTH CLUSTER BULLETIN
December 11, 2013
PUBLIC HEALTH RISKS, NEEDS, AND GAPS
Public Health Concerns
Department of Health is con-cerned by the potential increase in illnesses with cold weather occur-ring in some affected regions. Health programmes do not yet have sufficient programming for Elderly men and women. The Cebu cluster raised concerns
about unattended injuries, in-
creased risk for sexual violence,
petty crimes, trauma and stress.
Morbidity
Top 5 health events reported via
SPEED from Region 6 (Capiz,
Aklan, Antique and Iloilo) on 9 Dec
2013 were acute respiratory infec-
tion, open wounds and bruises,
high blood pressure, fever and
animal bites. Alerts were noted for
tetanus and acute haemorrhagic
fever in Cabatuan and Iloilo City.
The DOH sighted the top causes
of referred cases from 11 Novem-
ber to 5 December 2013 at the
Villamor Air Base in Tacloban
were wounds, fracture, acute gas-
troenteritis, pneumonia and post-
exposure prophylaxis for Leptospi-
rosis.
Health facilities
To date, 1068 of 9297 health
facilities in the affected regions
have been registered as as-
sessed. Among those facilities
there has been substantial dam-
age. Many of the remaining facili-
ties will not be assessed as they
are outside the Yolanda Corridor
or are otherwise assumed to not
be damaged. Full information on
damages will not likely be availa-
ble for a few weeks as the De-
partment of Health is still accu-
mulating and correcting infor-
mation day by day. Among those
health facilities that have been
assessed 402 have been found
to be partially damaged and a
further 188 have been complete-
ly destroyed.
Essential health services
All six facilities for diagnosing mul-tidrug resistant TB in the affected areas are functioning. One TB-Directly Observed Therapy (DOTS) treatment facility was de-mand as non-functional and the DOH is awaiting assessments on a further 15. Fourteen TB micro-scopic sites are not functioning yet, and 15 TB-labs, mostly in Bo-hol, are yet to confirm their status. Please refer to maps.
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TYPHOON YOLANDA HEALTH CLUSTER BULLETIN
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TYPHOON YOLANDA HEALTH CLUSTER BULLETIN
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HEALTH CLUSTER ACTION
Health Cluster coordination
The Department of Health is the lead of the Health Cluster, with WHO as co-lead. As of December 4, the DOH downgraded the situation from Code Red to Code Blue. This downgrade indicates that activities are returning to normal.
Assessment
UK Naval Ship HMS ILLUSTRI-
OUS team conducted an assess-
ment of Cadiz City, Cardiz Viejo
and Sicaba on Negros Island, re-
gion VI. They found that most are-
as had been well prepared for the
disaster and sustained little disrup-
tion. The medical facilities func-
tioning were not disrupted and the
general health of the communities
seems fair. However, there was
psychological trauma in some of
the children, especially around the
coastal areas. There was limited
damaged to homes in all places
except for Sicaba where an esti-
mated 50% of homes were dam-
aged and 30% were destroyed.
Aid has been received by the
Sicaba community from some
NGOs.
Response
Health Care Services
Eighty-five registered Foreign
Medical Teams (FMT) and 148
local medical teams were in the
affected areas as of 9 December
(refer to maps). Seventy-five of the
teams are functioning with basic
type 1 services, 7 teams function-
ing with more sophisticated type 2
services and 2 teams with special-
ty type 3 services. Seventy-two of
the 85 FMTs are in Region VIII.
FMTs that wish to donate equip-ment and supplies to local ser-vices are requested to coordinate with the DOH in doing so. A guidance note from the DOH on the entry and exit strategy of FMTs can be found at: http://www.philippineconsulate.com.au/surgical-and-medical-missions-to-the-phl.html
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TYPHOON YOLANDA HEALTH CLUSTER BULLETIN
December 11, 2013
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TYPHOON YOLANDA HEALTH CLUSTER BULLETIN
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Eastern Samar cluster reports that health teams have provided
services at evacuation centres. As of 9 December Medical Team International (MTI) relocated their team to Tacloban and transi-
tioned their activities to MSF. Cebu cluster reported that in Leyte
and Samar, FMTs were accompa-
nied by construction crews in-
stalling temporary roofs to dam-
aged health facilities.
Vector control A dengue expert from MSF is working with the DOH on vector control. In the Philippines media the DOH Assistant Secretary Eric Tayag warned about a possible spike in dengue cases in typhoon-affected areas. Mosquito control operations and distribution of mosquito nets has been indicated to take place.
Vaccination and cold chain The mass vaccination campaign has been completed in Tacloban, Guiuan, Borongan, and Palo. It will continue in Tanuan, Tolosa, as well as coastal communities south of Tacloban. Routine immunization programs will be re-established soon through prepositioning stocks and the reestablishment of the cold chain. The total number of children vaccinated as of 10 De-cember is 14 478 for polio,14 521 for measles and 10 808 were pro-vided vitamin A. Eastern Samar cluster reported that in Guiuan the Expanded Pro-gram on Immunization (EPI) team will map availability of vaccines and Oxytocin at health facilities. Cold Ccain assessment has been completed in Roxas, Iloilo, Cebu and Aklan, with assessments on-going in Tacloban and in Eastern Samar.
Surveillance and communicable disease control The quality of SPEED data is im-proving. The Provincial Health Of-fices on the ground are strength-ening their surveillance systems with more facilities reporting with SPEED and additional facilities transitioning over to PISDR. Cur-rently 50% of teams operating within Tacloban are reporting reg-ularly. However, there are still sig-nificant challenges in getting con-firmatory laboratory samples test-ed. The WHO is obtaining rapid diagnostic tests for dengue. With an increase in confirmed dengue cases, teams are preparing for possible outbreaks. FMT’s are requested to input into SPEED to provide better surveil-lance coverage of the affected areas.
Table 2: Summary of SPEED Reporting in Typhoon Yolanda affected Areas6 – 10 Dec 2013
Region Provinces (#)
Municipalities (#)
Health Facilities and Reporting Sites (#)
VI 4 58 69
VII 1 1 2
VII 3 14 26
Reproductive Health UNFPA has provided reproductive health kits to referral facilities in Roxas City (Capiz), Estancia (Iloilo) and Guiuan (Eastern Sa-mar). The kits provide clean deliv-ery, family planning services, treatment for STIs and medical management of sexual violence for the estimated needs of 10,000 people for 3 months and for the management of miscarriage and suture of vaginal tears for 30,000 people for 3 months. OCHA also reported that repro-ductive health kits have been dis-tributed to three key Rural Health Units in Leyte, each able to serve 30,000 people. Rural health mis-sions were conducted in Tacloban City to provide pre/post-natal, health promotion and family plan-ning services.
Water, Sanitation and Hygiene (WASH) and Environmental Health A water purifying unit was de-lievered to Palompon District Hospital in Ormoc. The DOH reported that the water supply in Leyte has been sufficient since 15 November 2013.In Busuanga town water is function-al. However, in Coron they have implemented a rationing system. In Roxas, Capiz, Metro Roxas Wa-ter District and Municipal Water District has resumed services, but water supply remains limited. For-ty percent of municipal water dis-tricts in Antique and 70% in Iloilo are operational. The Department of Health (DOH) is reporting that water samples taken from November 27 to 30 from Sta. Fe, Tanauan, and
Tacloban City in Leyte and 10 mu-nicipalities in Eastern Samar in-cluding Hernani and Guiuan tested positive for fecal coliforms or E.coli bacteria. Residents are being urged to chlorinate or boil their drinking water.
Disability Inclusion
The current focus of the disability and rehabilitation stakeholder meetings has been how to ad-dress the specific health, rehabili-tation and assistive device needs of people with serious injuries and disabilities. There were many people with disabilities living in the most affected areas and the vul-nerability of people with disability is particularly apparent in disaster situations. There were also many people who sustained serious inju-ries during the typhoon, many of these people are now in health
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TYPHOON YOLANDA HEALTH CLUSTER BULLETIN
December 11, 2013
facilities in Manila, Cebu and Tacloban, those with spinal cord injuries, amputations, serious frac-tures and traumatic brain injuries are initial priority. The current WHO Disability and Rehabilitation response will complement Protec-tion Cluster activities. These in-clude:
Develop database of people with serious injury (SCI, Am-putations, TBI and serious fractures) future follow-up/ tracking. Most of these people are currently still in hospital facilities in Manila, Cebu and the Field Hospitals set up by FMTs.
Map stakeholders able to meet the specific health, reha-bilitation and assistive device needs of disabled people. This is occurring through networks including the Disabled Peo-
ples Organizations (DPOs) and Community Based Reha-bilitation (CBR) organizations.
Communicate with health facil-ities to ensure discharge plan-ning for people with serious injuries and ensure linkages are made on discharge with local community service pro-viders.
Mental Health and Psychosocial Support (MHPSS) WHO trained 30 people in Psycho-logical First Aid (PFA) on 5 De-cember. Trainees included NGOs, DSWD, DOH, Department of Edu-cation (DepEd) and Philippine Red Cross Society. Partner’s implantation of PFA pro-grams will be further established once all information on MHPSS 4W is received.
Cebu cluster reported that a psy-
chosocial tent will be established
in the temporary relocation site in
Cebu. They are also in the pro-
cess of developing a TOT for
MHPSS of teachers. DepEd has
been invited to the Cebu MHPSS
cluster for further planning and
counselling of schoolchildren.
Planning A semi-final version of the Strate-gic Response Plan has been pub-lished and is being reviewed. WHO has received 19 plans from 16 partners, with half of the pro-grams running for a full year and the remaining will last 6-7 months.
FUNDING STATUS OF ACTION PLAN
As of 11 December 2013, OCHA has updated the action plan, which is now at is 28% funded for the health sector (table 4).
Table 4 FUNDING STATUS OF ACTION PLAN FOR HEALTH (US$)
Project Appealing Agency
Amount Required
Funding % Covered
Merlin & Save the Children Essential Health Services for Preventing Excess Mortality and Morbidity in Typhoon Haiyan affected Popu-lation
Save the chil-dren
4707706 800000 17% Ensuring Access to Reproductive Health Services in the Aftermath of Typhoon Haiyan
UNFPA
10000000 1499518
15%
Provision of emergency health services to typhoon affected populations
WHO
15000000 10749603 72% Immediate assistance to injured and vulner-able persons affected by Haiyan typhoon in Philippines
HI
240000 179063 0% Emergency Health care, public health and referral initiatives for displaced and affected persons ‘on the move and their vulnerable host communities’
IOM
1810511 0 0% Provision of life-saving interventions for health to children 0-59 months affected by Typhoon Haiyan emergency
UNICEF
19000569 182041 1% Provision of quality medicines and develop-ing resilience in the supply chain to avoid gaps by strengthening the department of health medicines stock management sys-tems
IHP
806000 0 0% Prevent increase in maternal, neonatal and child mortality post disaster through ensuring continuity of services for these more vulner-able groups
Major WHO donors: Australia, Canada, Norway, Japan, the United Kingdom and the UN Central Emergen- cy Response Fund (CERF), Russian Federation, Sweden and the United States of America, and from the European Commission Humanitarian Aid and Civil Protection (ECHO).
Promoting mental health and psychosocial wellbeing of populations affected by Typhoon Haiyan
IMC
727961 0 0% Ensuring the health needs of older people in Typhoon Haiyan
HelpAge Inter-national 465000 0 0%
Health care support for Typhoon Haiyan af-fected populations
IMC
3865225 0 0% Enhancing coordination within and outside the health sector
WHO
1816100 0 0% Surveillance, outbreak prevention and vac-cination
WHO
3929850 0 0% Local health system recovery for social and economic protection
WHO
4061800 0 0% Delivery of essential health services to meet the immediate health needs of the affected population
WHO
3524500 0 0% Typhoon Haiyan emergency health response WV Philippines
400000 400000 100% Health assistance for disaster affected com-munities of inland Leyte and coastal Baran-gays of Tacloban municipalities of Tacloban City, Jaro, San Miguel and Carigara
RI
955500 0 0% Provision of emergency medical assistance to affected population of the Typhoon Haiyan
MDM France
2700000 0 0% Saving Women’s lives in Typhoon affected provinces through reproduction health
Saude em Protugues 1150800 0 0%
Restoration of basic health package within Concepcion Municipal Health Office area
