UPDATE OF THE HUMANITARIAN & HEALTH SITUATION IN BURUNDI

During the first week of March

 

1. General Context and Security

1.1. Concerning the second term of the transition period that should start on the 1rst May 2003, discussions are still ongoing between the political parties. Therefore, the President of Burundi during his speech to the Nation on the 27 February 2003 declared that all political parties should submit before the 31 March their proposal on the way forward for the transition process knowing that the ceasefire following the Arusha Agreement was not respected.

1.2. The Mini-Summit of the Heads of State of the Regional Peace Initiative for Burundi convened on the 1rst and 2nd March in Dar es Salaam urged political parties in Burundi to follow the transition process according to the signed agreement of the 2nd December 2002 .

1.3. The soldiers demobilisation exercise remains for a great concern due to the improper social response to their reintegration into the different areas of the life and this will maintain the insecurity in the country.

1.4 UN security Phase IV declared since 25 April 2000 is still prevailing for some provinces (Bubanza, Bururi, Bujumbura Rural, Makamba, Rutana, et Cibitoke) and Phase III for some others areas (Bujumbura Mairie, Kirundo, Muyinga, Karuzi, Ngozi, Kayanza, Muramvya, Mwaro, Gitega, Ruyigi, Cankuzo et Cibitoke Mairie) .

1.5. All field trip for UN staff are necessarily organized with a military escort. A curfew is in place from 11 pm to 6 am.

1.6. During the period of this report, insecurity is now prevailing in almost all the provinces of Burundi. Heavy fighting are still ongoing between the National Army and the Rebels in many provinces increasing the displacement of the population.

2. Humanitarian Situation 

2.1. According to the registration exercise organized in September 2002 by the Ministry of Interior with the support of some partners, there are 281,052 Internally Displaced Persons located in 230 sites in Burundi. Moreover 80, 000 to 100,000 persons are temporarily displaced every month.

2.2. Amongst the vulnerable population in Burundi 1,137,000 children are subject to food insecurity: This number is composed of street children (5,300), orphans (620,000), disabled children (10,558), soldier children (9,000) and displaced children (143,336)

2.3. In this way, for 2003 perspectives the most probable scenario expected by OCHA is be "a statut quo with the deterioration of the situation" followed by : No respect of the ceasefire agreement, no reintegration of the Rebels in the National Army, Political instability around the 1rst May 2003, Division in the political families, Intensification of the fighting all over the country and the Deterioration of the socio-economical situation. Although the positive scenario with respect of the ceasefire and political agreement is also possible, people are not expecting any dramatic improvement in the social and health situation and the security will remain a concern. In the mid term vision

2.4. The immediate consequences of this scenario will be: the increase of the Internally Displaced Persons and also of the population movement towards Tanzania, a lot of arbitrary arrests, the increase of the impoverishment of the population and an increase of population vulnerability with a critical Health and sanitary situation.

2.5. Some 40,533 refugees mainly from DRC and Rwanda are still residing in Burundi. Meanwhile Burundese refugees living in Tanzania are under pressure from Tanzanian authorities. To facilitate this repatriation exercise, a tripartite summit was convened on the 26 February in Dar es Salaam between both countries (Burundi, Tanzania) and UNHCR. Meanwhile the prevailing insecurity in some provinces causes a reserve amongst some Burundese refugees willing to go back home.

3. Health and Epidemiological situation

3.1. Health system in Burundi

The functionality of the health system remains depending on the inaccessibility and the insecurity prevailing in the country. The result of this situation is the decrease of the qualified health personnel all over the country. For primary health care activities, the Ministry of Health is working on two types of policy: in some areas it is related to the emergency and humanitarian situation and in some others it is related to the development activities with a cost sharing involving the community into the health activities.

3.2. Update of Meningitis epidemic situation:

- The meningitis epidemic declared in some provinces of Burundi during the months of November and December 2002 is now under control. With the support of WHO and UNICEF 1,763,344 persons were vaccinated in the most affected areas (Kirundo, Ngozi, Muyinga, Ruyigi, Cankuzo, Gitega and Karuzi).

- But during January 2003 some non significant cases were reported (27 cases) in some provinces. Therefore a high risk of meningitis epidemic for June and July 2003 (beginning of the dry season), should be foreseen.

3.3. Update of Malaria epidemic situation

- The malaria epidemic situation in Burundi is still alarming. But the data collected for January 2003 from some provinces showed that the situation is under control with still a high number of cases in Kayanza (20,784 cases), in Makamba (17.379 cases) and in Ngozi (66.717 cases);

- The use of COARTEM for the patients treatment in the epidemic areas helped to come quickly over the epidemic. Meanwhile a high number of cases is still recorded in some provinces. Currently we are handling the issue of COARTEM availability and facilitating the dialogue between the MOH and External partners about.

- WHO supported the Ministry of Health in the adoption of a new treatment protocol (Amodiaquine / Artesunate) for Malaria in Burundi due to some resistance observed in the past. This new treatment protocol will be effective hopefully in July 2003.

3.4. Update on the Cholera epidemic

- The cholera epidemic declared on the 10 February in Rumonge (Bururi province) is now under control according to the data collected by WHO from Rumonge Hospital : 157 cases, 5 deaths and 7 inpatients at Rumonge hospital on the 4 March 2003. (see table 1).

- Cholera is now an endemo-epidemic disease in the Imbo plain ( along the Lake Tanganyika). Therefore it is now important to work for a reinforcement of preventive measures mainly related to the supply of clean drinking water.

 

4. WHO among Partners

- Increasing opportunities for a close relationship with the Ministry of Health and the Minister in Particular

- The new WHO Representative for Burundi Office resumed duty in early February 2003. At the same time the Emergency and Humanitarian Action Public Health Officer also joined the Office. The CSR officer is expected to join this week end.

- This newly arrived staff is on the process of having first contact meetings with all the partners ( NGOs, UN Agencies, Donors and Department and Programmes of the Ministry of Health) to establish a good working environment. During these meetings, information exchanges were about the role of WHO amongst the Partners, WHO main activities, the constraints and the difficulties usually encountered.

- WHO is fully involved in the UN coordination mechanisms and participate also in the Contact Group meetings ( OCHA) handling and to the Briefing / information meeting with the African Union Peacekeeping Observers.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Table 1 :

CHOLERA SITUATION IN ROMONGE HOSPITAL FROM 10 FEB TO MARCH 2003

DATE

NEW CASES

TOTAL CASES

INPATIENTS

DEATH

TOTAL DEATH

10/02/2003

2

2

2

0

0

11/02/2003

0

2

2

0

0

12/02/2003

4

6

6

0

0

13/02/2003

6

12

11

1

1

14/02/2003

10

22

17

0

1

15/02/2003

8

30

23

2

3

16/02/2003

29

59

43

0

3

17/02/2003

23

82

43

0

3

18/02/2003

19

101

42

1

4

19/02/2003

10

111

39

1

5

20/02/2003

6

117

36

0

5

21/02/2003

3

120

29

0

5

22/02/2003

0

120

25

0

5

23/02/2003

3

123

24

0

5

24/02/2003

5

128

20

0

5

25/02/2003

4

132

13

0

5

26/02/2003

5

137

11

0

5

27/02/2003

5

142

5

0

5

28/02/2003

5

147

8

0

5

01/03/2003

3

150

7

0

5

02/03/2003

3

153

8

0

5

03/03/2003

2

155

6

0

5

04/03/2003

2

157

7

0

5

Source MOH