D ISTRIBUTION OF HAZARDS BY ZONE

1. Managing Explosions-The Nigerian ExperienceFIFTH FOCAL POINTS MEETING ON EMERGENCY AND HUMANITARIAN ACTION, PRETORIA29 OCT-2 NOV 2001

3. DISTRIBUTION OF HAZARDS BY ZONE Meningitis Belt Lassa fever Yellow fever Cholera Pipeline explosion

4. Objective of WHO Intervention • Support country to attain the highest level of health • General Objective: To prevent deaths and reduce morbidity. • Specific Objectives: • Assessment of health risks • Response to risks: support human and material resources • Coordination of activities • Epidemic Surveillance. • Reducing the impact of future crises

5. Explosion management in Nigeria • Source of information: Surveillance Officers/state Officials/mass media/FMOH report • Rapid assessment Team visit the area • Meetings: Coordination of activites; Identification of needs, who will be responsible for what; supply of immediate needs; Mass mobilization (IEC-English and relevant local languages) to create community awareness; • Mobilisation of Resources---- Materials---Emergency kits Experts on Burns treatment Training Investigation to identify causes Future Prevention/recurrence and Approach

6. Common Causes • Pipeline Vandalization • Weak and rusted pipelines (leakages) • Adulteration of petroleum products • Sabotage (restive youths in the Niger Delta region) • Low level of literacy and general poverty • Human error

7. Effects Immediate • Deaths (In Jesse over 2,000 deaths, burnt to the bones or ashes) • Varying degrees of burns (from 6%-100%), asphyxia due to fume inhalation, multiple trauma • Environmental degradation (Aquatic life, agricultural and farmlands adversely affected • Economic and property damage estimated in billions of Naira after each incident) • Displacement, confusion, anger and panic Long term • Disabilities, Strictures, Keloids, • Skin and Lung lesions • Still births, deformities and other congenital malformations* • Neurological and chromosomal abnormalities* • ?Cancers* • ?Mental retardation and reduced IQ due to Lead poisoning* *This needs further studies

8. Effects (contd.) • Psychological • Orphaned children (father and mother burnt) –found in all epidsodes • Post Traumatic Stress Disorders (PTSD) • Multiple family involvement (5 out of 6 family members affected) –Lagos and Benin incidents • 300 Family units affected in the Warri episode • 65% of women affected in the Ovirrhi Court explosion • 3 day old baby affected with gangrene of the toes and risks amputation in the Lagos kerosene explosion. • 3 babies delivered prematurely (induced labour) –Lagos experience

9. Preparedness • Rapid assessment teams exist in Lagos (South) and Abuja (North) • Pre-positioned supplies (WHO, UNICEF, FMOH, NNPC, NEMA) • Logistics support (NNPC helicopters and aircraft, 4-wheel drive, etc) • Coordination planning meetings (UN thematic group). • Mass Mobilization (Red Cross and States) • Local NGOs and volunteers. • Information sharing

10. Response -Steps • Gather relevant information (surveillance, media, rumors, etc) • Verify the information (phone calls, e-mail, radio, etc) • Mobilize for immediate response(manpower, materials and funds) • Intervention • Write report and feedback • Plan for future

11. Response (contd.) • Different levels of intervention • Strategic (HMH/Director – Special Projects, UNICEF and WHO Reps, GMD-NNPC, HCH-SMOH) • Tactical (EPR focal person, UNICEF and WHO field officers, NNPC Medical Officers, Red Cross EPR person and Burn surgeon) • Operational (burn specialists, general duty doctors, epidemiologists, anaesthetic and theatre nurses, accidents and emergency nurses, environmental health officers, psychologists, Red Cross volunteers, Local NGOs, Community and other local volunteers) • Response teams available (case management group, case search/mass mobilization group, surveillance/missing persons survey group, pathology/disposal of dead bodies group, logistics/coordination group) • Designated teaching and specialist hospitals for case management • Coordinated response

12. Response (contd.) • Consultative and enlightenment meetings with local opinion leaders • Visit of VIPs (HMH, Governor, etc.) • Establishment of treatment facilities near to affected villages to sort out serious cases and refer them for specialist treatment • Ambulance service established to go round the villages and bring victims from their homes for proper treatment • Contact tracing and case finding • Missing/dead persons epidemiological survey established • Overall cost of intervention by Federal government, partners and NGOs for the Ovirrhi Court disaster is estimated at N400 million

13. Constraints • Oath of secrecy (cult members) • Lack of contingency plan for effective response to oil pipeline and kerosene explosions nationwide • Lack of policy for disaster management • Limited funds for field operations • Limited logistics and communication support • Poor data analysis for planning • Poorly trained manpower for emergency preparedness and response. • Dearth of specialized manpower (Plastic Surgeons, nurses). • Enormous cost of managing burn patients (each patient is conservatively said to need N0.7 million for his/her treatment). • Poorly developed specialized burns centers in at risk zones of the country. • Limited drugs and essential supplies for effective case management.

14. Recommendations • Training of District EHA Teams • Vulnerability assessment and risk mapping • Advocacy and social mobilization • Establishment of well equipped and specialized burns units in areas of the country at highest risk. • Increased budgetary allocation and funding of disaster management • Pre-positioning of relevant supplies • Improve logistics and communications support • Improved coordination • Improved information sharing amongst stakeholders

15. THANK YOU ALL FOR LISTENING. MERCI BIEN