Health Sector Response to Floods in North

1. Health Sector Response to Floods in North Dr Amofah GK Deputy Director General Ghana Health Service

2. Background • Heavy rains and spillage of water way from Burkina Faso in August and September 2007 leading to flooding in parts of 3 northern regions

3. Potential health effects of flooding • Displacement of people leading to overcrowding • Destruction of health facilities or rendering them inaccessible • Worsening insanitary conditions with pollution of water supply and food leading to potential increase in water-related diseases such as malaria, diarrhoea diseases including cholera, dysentary, typhoid and hepatitis A • Destruction of food crops leading to acute and chronic malnutrition • Potential worsening of Guinea Worm situation due to contamination of artificially created ponds as flood water recedes

4. Actual health effects • Damaged health facilities • NR: 3 facilities damaged • UER: 21 CHPS compounds/feeding rehabs damaged; erosion of landscape • UWR: No health facility damaged • Facilities rendered inaccessible • In the Northern region, 6 facilities in West Mamprusi, 5 in Tolon Kumbungu, 1 in Kushegu Kraga, 1 in West Gonja, in Saboba Cheriponi and 1 in Central Gonja were cut off. • UWR: Bawiesebele H/C in Sissala East and Goh CHPS Zone in Wa East districts cut off • UER : similar situation

5. Disease Profile • All epidemic prone-diseases such as CSM, cholera, Yellow fever and measles are being monitored countrywide weekly, with special focus on the 3 northern regions. • So far, as at October ending, no outbreak of any of these diseases has occurred.

6. Health sector response • Intensification of Surveillance • Preparedness plans activated • Alert circulated • Essential supplies moved up north • Monitoring of epidemic prone diseases • 3 northern regions did rapid appraisal and submitted needs to HQ for assistance • On 25-28 September 2007, visit of the Honourable Minister of Health and his team to parts of the Northern and Upper East regions. • Establishment of Health Sector Flood Committee on 24 September 2007 to coordinate response

7. Response • Assessment of the water and sanitation situation and needs in Tamale and its environs with UNICEF, CDC etc • ICC on Guinea Worm meeting to assess GW situation and prepare for eventualities • Initial funds released to support GW preparedness • Based on plans submitted by regions, amount of GHC100,000 processed for initial operational activities like IEC, orientation of staff etc • Details of actual infrastructural requirements being developed • Nutritional support with food from WFP and nutritional assessment on-going

8. Threat of CSM outbreak • Potential outbreak of CSM • Emergence of a hyper virulent Neisseria meningitidis sero group A subgroup III/ST2859 clone in the country for the first time • 8-12 year cyclical CSM epidemic in ‘meningitis belt’, last epidemic in 1996/1997 making 2007/8 special • Displacement of people and overcrowding due to floods • Situation expected to worsen with CAN 2008 in January-February 2008

9. Actions • Preventive mass vaccination before end of year depending on availability of vaccines • Main challenge is access to limited vaccines at global level • Intensification of surveillance activities, including monitoring of alert/epidemic thresholds plus reactive vaccination as indicated • Orientation of staff plus other preparedness activities

10. Provisional Estimate of need • A total budget of GHC4,958,465.00 is required for health response to flood including CSM threat • Regional response and re-building plans; • Northern region = GH¢ 895,500.00 • Upper- East region = GH¢949,500.00 • Upper-West region = GH¢169,579.00 (excluding re-building) • CSM vaccines = GH¢ 1,400,000.00 • CSM campaign = GH¢ 1,360,386.00 • Surveillance and epidemic = GH¢83,500.00 preparedness and response • Supervision and Monitoring = GH¢100,000.00