Situation Report 2
WHO is concerned with ensuring that the basic needs of the survivors of the earthquake (shelter, water, food and sanitation ) are met. Of particular concern is the cold weather and with the survivors living in tents near their destroyed homes , it is feared that cases of Acute respiratory infections and pneumonia would rise among children. The focus also should be on improving hygiene and sanitation conditions and monitor cases of diarrheal diseases . With road being difficult, rainy weather and fog the problems of accessing health services are increasing. Thus it was decided to establish temporary emergency health facilities to provide essential services to the survivors near to their tents.
- Relief interventions have reached most of the affected populations by today despite difficult weather and road conditions.95 % of injured were taken to hospitals in Zarand, Kerman or Rafsanjan.
- During the meeting with WHO Representative, the Government has asked WHO to coordinate the water, sanitation and health sectors and to urgently facilitate and support the establishment of the emergency health facilities and has provided a list of urgent requirements
- Government also requested WHO to coordinate the activities of INGOs in the field.
- A number of International agencies that were positioned in Bam have offered their support for relief activities like, Merlin, MSF (France) Mercy Corps and Medair in addition to UNICEF.
- The survivors of the earthquake are suffering from psychological trauma.
|No of deaths||No of injured||No of villages||No displaced||Damage||Comments|
|520||909||40||30,000 - 40,000||12 villages with 70% destruction, 20 villages 100% destroyed, 5 health centers destroyed||Major towns and cities escaped heavy damage|
Case Fatality Rate is 1.6%
Injury Rate is 300 per 10000 affected populations
The disease profile of the area affected is shown in the attached graph. High prevalence of Malaria and Hepatitis B is noted with frequent reporting of meningitis cases. With the impaired water and sanitation systems, outbreaks of water borne diseases can happen thus should be monitored.
For the moment, the situation is monitored but the disease surveillance system needs to be strengthened and activated with an early warning and response network established.
Environmental Health (access to safe water and hygiene, sanitation situation)
For now the water is being provided in bottles and tanks. Safe drinking water and sanitation are now priorities to avert disease outbreak. Immediate set up of temporary toilets and shower areas are essential to address the need of the survivors. Population influx from rural areas might happen (as in Bam). Adequate awareness of the survivors and the authorities on environmental health issues and hygiene will help improve the situation.
Other health issues (mother and child health, mental health)
Maternal and child health are two major concerns after primary emergency and trauma care for the survivors. Elderly and disabled population need special care in such situation. Nutrition of the survivors especially child bearing mothers and children should be given adequate attention In addition, mental health interventions should start as soon as possible.
Health system and infrastructure
12 rural hospitals and 10 health houses at Zarand will be assessed for their functionality and their resistance to further aftershocks. The authorities estimate that the number of facilities is insufficient and with the survivors refusing to seek health care in the present infrastructures for fear of further shocks. Referral hospitals at Kerman are providing specialized health care to the patients referred from Zarand. So the establishment of emergency health centers becomes a priority.
To address this very critical issue the government has decided to set up 12 temporary emergency health care centers in the tents. This has been discussed with WHO and the MOHME officials expressed the need of 12 tents (50 sqma) and 12 generators (3KVA) to establish the facilities and thus to offer appropriate need based health care to the survivors. Along with the existing facilities, theses 12 emergency health centers target around 75,000 population of Zarand.
WHO and coordinated aid actions
During his mission to Zarand WR and the WHO team attended meetings with local health authority - Chancellor, Vice Chancellor of University of Kerman, Task Force of Kerman Health Network and MSF (France). He also discussed key issues regarding health with the Governor of Kerman over phone directly from the field. Based on the decisions that have been taken in these meetings WHO has taken following actions:
- WHO is supporting the recruitment of an epidemiologist at Kerman to train 300 health workers for establishing a comprehensive disease surveillance network in the health centers. The training for these 300 health workers is underway.
- WHO is in process of finalizing the list of necessary equipment
- WHO is coordinating the INGO activities in the field.
- WHO is leading UN joint need assessment mission at Zarand which will start on Sunday 27 February.
- WHO has extended all its technical and logistic support to the local government to address the health issues in emergency.
- An assessment has been planned on all the health facilities to look at the staff, equipment and physical facilities of the health centers. 12 rural health centers and 10 health houses of Zarand have been identified to be assessed to make adequate improvement. This missions will start tomorrow.
- WHO will provide support technically and financially to all priority health interventions at Zarand.
- One Staff from Regional Office has already joined WHO-Iran for better coordination in processing of the equipments.
- The Senior Epidemiologist from WHO Sudan will be closely working with this disease surveillance team to provide all technical support and to use the experience of Darfur.
- WHO is coordinating with probable donors, partners and the government at country level in order to have best utilization of resources to address the need.
- WHO attended the meeting with MOH- Kerman with UNICEF, MSF, Dr. Aflatunian and Focal Point of OCPRM in the MOH&ME (Tehran). Following are the decision of the meeting that addressed the overview of the situations and formulated the list of required items:
- WHO has been requested to coordinate the water sanitation and health sector.
- Daily meeting has been scheduled among WHO, Dr. Aflatunian and Dr. Russel.
- Regular Morning Meeting on situation at Zarand has been held at WR’s office with EHA Team. In the meeting WR emphasized on the following issues to be taken up with acute attention at field level:
- Coordination with Government of Kerman and other partners.
- List of equipments requirement with estimate to reach WHO-Tehran office as soon it is prepared.
- Adequate coordination with joint need assessment mission.
- Regular update on the casualties.
- Continuous supervision, monitoring of the situation and regional coordination have been provided by regional office.
- More technical and logistical supports are kept on stand by to dispatch immediately on the basis of country office requirement.
WHO strategy in response to the earthquake in Zarand is:
- Early warning - Tracking patterns of life-threatening diseases among those at risk through prompt set-up of a surveillance and early warning system with daily epidemiological reports (immediate mobilization and deployment of epidemiologist
- Public health - Providing guidance on critical public health issues (including response to disease outbreaks, water quality, excreta management, chemical threats, chronic disease management and mental health) and filling critical gaps until others are able to take on the task
- Access to essential health care - Work with all partners to ensure equitable access to adequate quality of essential health care through key hospitals and health centres
- Medical supplies - Contributing to ensuring that medical supply chains function as efficiently as possible and respond to the needs of end-users
- Coordination - Joint action of health actors at local, national and international level with agreed strategies and joint action