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Current State of Knowledge of Flood/Post-Flood Health Situation in Bangladesh - 2004

Current State of Knowledge of Flood/Post-Flood Health Situation in Bangladesh - 2004. ‘UN Flash Appeal’ for Health Sector WHO, UNFPA, UNICEF. Flood Situation as on 3 rd August’04. Flood 2004 (12 July-12 Sep.). Affected Districts: 38. Death Toll : 726. Affected Population: 30m

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Current State of Knowledge of Flood/Post-Flood Health Situation in Bangladesh - 2004

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  1. Current State of Knowledge of Flood/Post-Flood Health Situation in Bangladesh - 2004 ‘UN Flash Appeal’ for Health Sector WHO, UNFPA, UNICEF

  2. Flood Situation as on 3rd August’04 Flood 2004 (12 July-12 Sep.) • Affected Districts: 38 • Death Toll : 726 • Affected Population: 30m • (24% of total Popln) • Temporary Shelters: 2,710 • Temporary TC: 35

  3. Flooded area of Bangladesh in different year Source: Bangladesh Water Development Board 2004 Historical Perspectives Flood before liberation • Frequent (1954-1970) • Affected small areas • Relief and medical care: Govt’s role less prominent • Role of media: Less • Health staff: Less in number and less competent Flood after liberation • Less frequent (1974-2004); becoming frequent • Affecting wider areas • Relief and medical care: Govt. is main player and using electronic media extensively • Role of media: Super-active • Role of public representatives: Veryactive • Large number of competent health staff • People’s coping capacity; Rx of diarrhoea-known

  4. Flood Impact on Health & Hygiene Movement becomes difficult Home goes under water People suffer from food shortage Flood Trap Bathing, washing and playing in flood water cause disease Rural Area Toilets become unprotected Human & animal excreta, rubbish & contaminated soil mix with water Cooking becomes difficult Tube wells and safe water sources are submerged Open defecation increases

  5. Flood-borne Morbidities • Water & Food-borne diseases • Respiratory infections • Skin diseases • Eye infections • Drowning • Snake bites • Accidents • Malnutrition Flood Impact on Health & Hygiene… Bathing, washing, playing, and walking in flood water • Gastrointestinal diseases • Respiratory infections • Skin diseases • Eye infections • Drowning Food contamination Due to food preparation in: • Dirty environment • Use of unsafe water • Purchase from open food shop • Sharing with sick people • By flies and vectors • Via careless utensil handling Food contamination causes food borne diseases Scarcity in food supply & monotony of uncooked food • Malnutrition of vulnerable groups (children, pregnant and lactating mothers, elderly and sick persons) • Lower immunity > More infections Water & food-borne diseases Diarrhea, dysentery, cholera, jaundice, typhoid, helminthiasis

  6. Disease reported during and post-flood state (July 12 – Sep 12, 2004)Name of DiseaseCases Deaths CFR (%)Acute watery Diarrhea 2,71,630120 0.04Water Borne Diseases 77,9110 0.00Pneumonia/ ARI 28,283167 0.59Skin, Eye & Ear Infections 72,2940 0.00Drowning death 247 - -Snake-bite deaths 75 - - *Source: DGHS Control Room and NDSC, IEDCR

  7. Flood Impact on Health Status, effect on Infrastructure and Logistical Supplies MOHFW Flood 2004 Physical damage (2004) DGHS: ~Tk. 32 crore Loss of logistics (2004) Medicines & Supplies No. of deaths (Flood 2004; On 12 Sep 04) Disease No. Diarrhoea 116 Pneumonia 156 Snake bite 85 Drowning 244 Dysentery 0 Jaundice 0 Skin disease 0 Eye disease 0 Total 601 Source: DGHS, MOHFW (as of Aug 30, 2004)

  8. Indirect Flood Impact on Services Flood 2004 EPI service loss BCG: 41,544 doses Measles: 41,544 doses DPT: 1,24,632 doses OPV: 1,24,632 doses Hepatitis B (25 dist & 5 City Corps):4,800 doses TT: 2,18,064 doses EPI out-reach sessions (not held): 10,384 Nos. Family planning service loss • Mother & child care • Ante-natal, natal & post-natal care • Sterilization camps • Clinic based services (IUD, Injection, Norplant) • Home visits NNP service loss • Programme Upazila affected: 70 • Community Nutrition Centre (CNC) did not function: 3802 • Nutrition gardens damaged: 88369 • Nursery damaged: 985 • 1-day old chick died: 62355 • Chicken died: 51807 Postponement of health & FP training/workshop/seminars: Many Postponement of examinations in medical institutions: all in this period

  9. Comparison of morbidity pattern of 1988 and 1998 Flood in Bangladesh

  10. Donor & Private Initiatives Flood 2004 WHO UNICEF UNFPA BMA medical teams UN Flash Appeal

  11. 1. Direct intervention: Government and NGOs agencies Technical support: UN agencies (WHO, UNICEF, UNFPA).2. Procurement of logistics/other supply materials: UN agencies.3. Maintain and strengthen regular liaise: DGHS, NGO partners (in receiving reports of outbreaks of impending CD and carry out interventional activities as per needs) Strategies:

  12. Health and Nutrition Group: • Assistance Provided by WHO, UNFPA and UNICEF • Health (WHO): • ·In-house Crises Management Team formed at NDSC, IEDCR: Assistance to the DGHS • Preparing SITREP…on flood/post flood health situation • ·WHO provided Computer/Printer/Fax machine to DGHS Control Room. • ·Div. Coordinators and Dist. surveillance medical officers (SMO) from WHO are monitoring the situation, surveillance and providing technical supports to the Civil Surgeons and sending daily reports to FCMT. • · • ·Procurement of Medicine and supplies to the following Offices:  • DGHS • BMA • Red Crescent Society • DPHE • Sylhet City Corporation • WPT, Bleaching Powder, Intravenous Cholera Saline, Antibiotics syrup and tablets, Paracetamols, Antihistamines, Anti-snake venom. • Until 12 Sep. the total contribution from WHO: US $ 218,000 from Regular Budget

  13. UNFPA support to Flood - 2004 • Medicine* -  Basic medicine required for pregnant, lactating and 0 - 5 children: The following are included in each kit:   * Medicine  to cover 8,000 clients/patients in each district   * ORS - 10,000 /each district   * Cholera Saline - 200 each district*WFP Biscuits*:In addition to above, WFP biscuits are also being distributed by these teams. The qty per districts are as follows:Brahmanbaria: 540 ctns (4.0 mt)Hobiganj:: 540 ctns (4.0 mt)Narhsingdi/Kishroreganj: 400 ctns.  (3 .0 mt)Bogra  540 ctns. (4.0 mt)Dhaka: 500 ctns (3.75 mt)*UNFPA Subkit 6*: Delivery Subkit -30 kits arrived at the airport and are under custom clearance.  We are expecting another 70 kits from HQs.*UNFPA Subkit 12:* Transfusion - 10 kits arrived at the airport and are under custom clearance.

  14. UNICEF’s support to Flood – 2004 Procured WPT ( 5 million distributed, 5 million in pipeline) Procured ORS for medical centers and temporary shelters (0.5 milliondelivered, 4.5 million in pipeline) Procured IV fluid to combat diarrhea dehydration (25,000 500 ml distributedto health facilities, 150,000 500 ml and 75,000 1000 ml in pipeline) Procuring measles vaccines (8,800 vials), AD syringes (100,000) andrecantation syringes (120,000) and safety boxes (1250) for measlesvaccination campaign in flood shelters Procuring 100 MT blended food for infants and young children in floodshelters

  15. Future plansThe H&N groups (WHO, UNICEF, UNFPA) is meeting for • Detailed work plan • Monitoring mechanism, • ImplementationComposition of groups:WHO, UNICEF, UNFPA, Red Crescent has joined Other players: ICDDR, B and/or Other NGOs

  16. …THANK YOU…

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