LIBERIA

ADDRESSING HEALTH ISSUES IN THE CURRENT CRISIS

The World Health Organisation’s contribution

Strategy – Ver1 - 12th August 2003

1.Overall situation assessment

The information available to WHO indicates that most of Liberia’s health infrastructure – particularly hospitals, public health facilities and distribution systems – is not working. In Monrovia, Catholic, ELWA and JFK hospitals are operating with minimum staff thanks to support from ICRC and MSF. Merlin and MERCI also support temporary clinics in some parts of the city as well as an ambulance service. The majority of Liberia’s people are unable to access health care.

The people of Liberia now face greatly increased risks of illness and death as a result of communicable diseases due to lack of water and sanitation, population movements and this health system breakdown. Threats include diarrhoeal diseases, especially cholera and dysentery, Malaria, Acute Respiratory Infection, measles, malnutrition and – for pregnant women - complications of delivery.

2. Priority Goals

To increase the health security of Liberia’s people, immediate attention must be given to the following priority goals during the next four weeks:

 

A rapid and thorough assessment of

  • People’s health situation throughout the country,
  • The state of health facilities and
  • The potential for establishing essential personal and public health services

Regular chlorination of all accessible water supplies and efforts to ensure that all person, particularly the most vulnerable, can access an adequate supply of water that is safe to drink

Plans developed and initiated for measles immunisation, diarrhoeal disease, essential mother and child health care, including the management of malnutrition and micronutrient deficiency, and malaria control, directed, particularly to the most vulnerable

Health assessments give also attention to gender issues, sexual health, and actions to prevent HIV/AIDS, especially among women and young people

Priority personnel and supply needs are identified and, if not available in country, are mobilised from outside

Basic systems for the rapid surveillance of health issues throughout the country, monitoring the consequences of humanitarian effort and tracking health outcomes

3. Actions needed to achieve these priority goals

  1. The in-country health action task force should be strengthened so that it draws on relevant national bodies, NGOs, UN system agencies, to work on the above priorities, and others as identified
  2. The relevant roles for different members be identified and agreed, with immediate attention to a joint health security assessment (UNICEF and NGOs are key)
  3. Once the assessment is yielding results, the essential actions for health security of those most vulnerable will be identified, and action plans will be developed and implemented by task force members
  4. Urgent human resources, training and supply needs – especially for medicines, vaccines and equipment are identified and steps taken to obtain them
  5. The necessary logistics, communications and security infrastructure is established by Task Force members so that this work can progress efficiently

4. Purpose and objectives

Purpose  

Objectives

Contribution to a co-ordinated and effective response to ill-health in the current crisis

  1. Recruit and assign four international staff to the country office for four months, September to December 2003 (Logistic, Information officer, Epidemiologist and nutritionist). salary, Insurance and travel.

 

Leading the health situation assessment

  • To contribute to the joint assessment of the current trend of main cause of health (Diarrhoea diseases; Malaria, ARI, Cholera, measles and malnutrition and childbirth )
  • To contribute to the assessment of the gap of health resources to meet the health needs especially for the vulnerable group – women , children and elderly
  • Supporting establishment of nutrition & diseases surveillance,

    Capacity for outbreak investigation

    and response

  • Refresh training in nutritional & diseases surveillance, outbreak disease investigation in the IDPs camps and case management.
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  • Urgent actions for the control of specific diseases (especially malaria)
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    Supporting to Essential Actions for Health Security

  • Human resources: To ensure that trained personnel are available in health facilities with particular emphasis on maternal and child health (focusing, where relevant, on hospitals, PHC units and mobile clinics)
  • Water: To organize a mass campaign of wells chlorination on community based
  • Medicines and supply: To make available essential drugs and equipment to hospitals and PHC units including mobile clinic services as well as safe delivery
  • Referral system : To strengthen existing services or establish emergency services on obstetric care, trauma injuries and blood safety
  • Health education: To facilitate health and hygiene education for health promotion by providing pilot training and material including STD and HIV/AIDS awareness.
  • Immunisation: To contribute to the multi-Antigen Catch-up Campaigns in the south eastern counties of Monrovia and Lofa by training health workers and monitoring the vaccination activities
  • 5. Budget

    The cost to achieve the above priority goals are in the attached tables also available in the revised CAP of JULY 2003, which can be found on: http:/www.reliefweb.int/ pages 14, 15 and 16