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8/7/2019 Health Cluster Bulletin No 19-Final
1/13
Unit
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ersexpectt
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ealthfaciliti
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uge agricult
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rtageofHea
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survivalstra
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s.
by Syed Haide
lth
e
egyto
egy is
luster
Fl
r Ali
ods in28 S
Pakiseptember
8/7/2019 Health Cluster Bulletin No 19-Final
2/13
ituationoverviewandcurrentscaleofdisaster
he situation has been stable over the past with no new flooded areas except for Lake Manchar in Southern Sindh
evertheless, large areas, especially in southern Sindh, are still underwater andmany people remain displaced. Relief
perations continue in severaldistricts. InKhyberPakhtunkhwa (KP)andPunjab, the situation continues to stabilize.The
ealth coordinator inMultan reports that almost all internally displaced people (IDPs) in the area have returned home
agnantwater,lackofsanitationandpooraccesstohealtharethemaincausesofconcern.
ccordingtoPakistan'sdisastermanagementauthorities,thenumberofpeopleaffectedbythefloodsstandsat20.25million
78districtsacrossthecountry,withover1.9millionhousesdamagedordestroyed.Accordingtoprovincialgovernments
14healthfacilitiessofarhavebeenaffected(280partiallydamaged(PD)and234fullydamaged(FD).
Partiallydamaged Fullydamaged
Baluchistan 117 35
Punjab 14 40
KP 123 46
Sindh 26 113
here are currently threedistinct targetpopulation groups,eachofwhich requiresadifferentapproach:1) IDPs2) IPDs
turninghomewhereservicesareavailable;3)IDPsreturninghomewhereservicesarenotavailable.Humanitarianagencies
econcernedthatthewidespreaddispersalofthesereturneesmaycreatedifficultiesinprovidingthenecessaryservices.ItouldbenotedthatsomeIDPshadbetteraccesstohealthcareinthesettlementsthanbeforethefloods,whenonlyaround
3%oftheruralpopulationhadaccesstohealthcarewithin5km.Healthcareaccessis,therefore,likelytodecreaseupon
turntotheoriginalareas.
Healthimpact
cute diarrhoea, acute respiratory infections (ARI), skin infections and suspected malaria remain the leading causes for
ekinghealthcareinthefloodaffectedareas.
Basicstatisticsupdate(reportingperiod1824September)
Since29 July,6243723patient consultationshavebeen reported to theDiseaseEarlyWarningSystem (DEWS)DEWSisinplacein64ofthe78floodaffecteddistricts(82%)andreportsarereceivedfrom50ofthese64districts
(78%)
In KP, ARI has increased from 13% to 18% while acute diarrhoea continues to decline. Diarrhoea remainsproportionallyhigherthantthesameperiodofthelastyear.
8/7/2019 Health Cluster Bulletin No 19-Final
3/13
InPunjab,ahigherproportionofsuspectedmalariawasreportedthisweek(1%to8%),butdecreaseinunexplainedfeverhasbeennoted(17%to7%).EpidemiologistsinWHOrecommendcautionininterpretingtheincreaseinrates
ofmalaria.
OneoutoffivestoolsamplescollectedfortestingbyWHOinSukkurturnedouttobepositiveforcholera.
ForamoredetailedEpidemiologicreportkindlygotohttp://www.whopak.org
Upcomingissues
ealthconcernsareevolvingaswinterapproaches.Diarrhoeaislessreportedinthenorth,asexpectedwiththechangeof
eather,butremainshigh inthesouthernareasofPakistan.ARIontheotherhand isexpectedtorise inKPandnorthern
unjabwiththecoldandtheinadequateshelter.
alaria still remains a potential threat. Areaswhere vivaxwas endemic are now reporting falciporum,which is more
angerous.Theseasonforfalciporumisapproaching;epidemiologistsanticipateoutbreaksinthecomingweeks.
alnutritionisincreasinglyaconcern.Foodinsecuritywillcontinuetobeveryhighinthecomingmonths,mainlyasaresult
disruptionofcanalizationand lossofseeds. Increasingnumbersofchildrenareexpected todevelopacutemalnutrition
ombined
with
infectious
diseases
(which
can
be
life
threatening
in
malnourished
children).
GovernmentResponse
ThefourthmeetingoftheNationalSteeringCommitteeonHealthEmergencieswasheldon23September2010at the National Health Emergency Preparedness and Response Center (NHEPR), Islamabad, under the
chairmanshipofSecretary,FederalMinistryofHealth,MrKhushnoodLashari.RepresentativesofallProvinces
participated.
Theprovinceswereaskedtoprovideconsolidatedrequirementsfortheearlyrecoveryphase. Four teams from theMoH'sNational Health Volunteer Programme (NHEPRN), comprisingmale and female
doctors,nursesanddispensers,providedmedicalcaretofloodvictimsinCharsaddaandNowshera.Additiona
medicalteamswillbedeployedtoRazzakabadCamp,KarachiandSwatinearlyOctober.
NHEPRN iscoordinating thedeploymentof foreignmedical teamsand fieldhospitals inallprovinces.A teamfromSpain(whicharrivedonTuesday)willbeassignedtoJhalMagsi,Baluchistan.AttherequestofKP'shealth
department, the field hospital donated by Italy will be deployed at Swat and Dasu, Kohistan instead of
CharsaddaandNowshera.
NHEPRNwillshortly installthreewaterpurificationunitsatCivilHospitalAkoraKhattak,EDOOfficeandMianESSAcampatNowsheradistrict.
Ahandover ceremony for 250 000 longlasting insecticidetreatedbednetsdonatedbyWHO andUNICEF isplannedfor1October.
Donor
Response
heHealth Clusterwould be unable to carry out its lifesavingwork in the floodaffected areas ofPakistanwithout the
eneroussupportof itsdonors.Thesectionbelowhighlights theworkand contributionsofsomeof thesedonors. (Note
ereisnotenoughspaceinthebulletintoacknowledgeallcontributionsfromalldonors.Therefore,pleasenotethatthelist
elowisnotexhaustive:itincludestextreceiveddirectlyfromsomedonorsaswellasabriefsummaryofsomeoftheHealth
uster'smaindonors).
ashcontributions
AUSAIDisplanningtodonateAus$2millionforthefloodresponse.(Seealsounderinkindcontributions.)
8/7/2019 Health Cluster Bulletin No 19-Final
4/13
CANADA:Pakistan isoneofCanada's20countriesof focus.CanadahasdonatedoverUS$4million forhealthsecto
floodresponseactivities.
CENTRALEMERGENCYRESPONSEFUND(CERF)hasallocatedoverUS$4millionforthehealthresponse.
EISAICO.LTD.(Japan)hascontributedUS$100,000.
EUROPEANCOMMISSIONHUMANITARIANAIDDEPARTMENT(ECHO)hasallocated70milliontoaddresstheimpact
of the floods, ofwhich overUS$12million is for health. ECHO's rationale is to support partnerswhowere already
working in the conflictaffected areas andare thereforeable to integrate the flood response into themoregenerasupporttotheconflict affectedpopulation.ECHOalsosupportspartners'effortstocoverevolvinghealthneedsinthe
floodstruck areas. As the situation evolves, health and WASH activities must be expanded to encompass newly
accessibleareasaswellas thosewhere the floodwatershavenot fullyreceded.Moreover,earlyrecoveryneedsare
hugeintheareasofreturn,wherethepopulationisconfrontedwithalackofbasichealth,waterandsanitationservices
andsystems.
ECHO is supporting PHC services, including themanagement of acutemalnutrition, andWASH activities. It aims to
maintainitscurrentlevelsofsupporttohealthoperationswhileatthesametimebeingpreparedforemerginghealth
threatsincludingmalaria,malnutritionandacuterespiratoryinfections.
ECHO'shealthandWASHpartnersincludeActed,Alliance2015,DCA,GermanRedCross,Hope87,IRC,Merlin,Oxfam
SavetheChildren,Solidarite,andWHO.
FINLANDhasdonatedalmostUS$800000forthehealthresponse.
GERMANYhasdonatedalmostUS$2millionforthehealthresponse.
ITALYhasdonatedoverUS$600000,inadditiontoitsinkinddonations(seenextsection).
JAPANhasdonatedalmostUS$1.5millionforthehealthresponseinadditiontoitsinkinddonations(seenextsection).
MONACOhasdonatedjustunderUS$130000forthehealthresponse.
NEWZEALANDhasdonatedoverUS$400000forthehealthresponse.
NORWAYhasdonatedoverUS$3millionforthehealthresponse.
PACKARD FOUNDATION has allocatedUS$887 778 for flood relief, ofwhichUS$700 000 has been awarded to the
NationalRuralSupportProgramme(NRSP),theHealthandNutritionDevelopmentSociety(HANDS),andtheSocietyo
ObstetriciansandGynecologistsofPakistan (SOGP).NRSP 'sactivities include theprovisionof food,shelter,clothing
livestock care, and medical services. SOGP is providing medical outreach services, including maternal health care
through teams of doctors,midwives anddispensers/vaccinators.HANDS has over 1200 staff and 10 000 volunteers
workingtomeetimmediatereliefneedsindifferentdistricts.ThePunjabRuralSupportProgramme,ShirkatGahandthe
IndusResourceCentrereceivedthebalanceofthefundsallocatedbythePackardFoundation.
UNITEDKINGDOMDEPARTMENTFOR INTERNATIONALDEVELOPMENT (DFID)has committed134million for flood
relief inPakistan,ofwhich64million (including 22.5million forhealth and/orwater and sanitationprojects)has
alreadybeenallocated.Themoneywillbeusedtoprovidesafedrinkingwater,hygienekitsand latrines;monitorthe
qualityofdrinkingwater;andsupporthygieneawarenesscampaigns,sewageclearanceandwasteremoval.Itwillalso
beused to scaleup the geographic coverageof the country's disease earlywarning system (DEWS) and strengthen
immediate and essential primary health care services, including obstetric care and the treatment of communicable
diseasesinchildrenunderfive.DFIDhasalsodeployedexpertstosupportitsofficeinPakistanonafulltimebasis.(Fo
moreinformationonDFID'ssupporttothefloodresponse,seeunderinkinddonations.)
8/7/2019 Health Cluster Bulletin No 19-Final
5/13
UNITEDSTATESAGENCYFORINTERNATIONALDEVELOPMENT(USAID)hasprovidedsupportforseveraltypesofflood
responseand recoveryprograms inhealth:approximately$21.5million toUNagencies forexpansionof theDisease
EarlyWarningSystem,establishmentofdiarrhea treatmentcenters,measlesandpoliovaccinationactivities,malaria
control,andemergency reproductivehealthactivities.USAIDhasalsostrategicallyprovidedbilateralsupport toboth
international and localhealth agencies: not including support forWASH andnutrition, todate,USAID hasprovided
nearly$13.6tosupportdirectprimaryandsecondaryclinicalcareviaemergencyandmobilemedicalteams,emergency
medical transportservices, logisticssupportandmedicalsupplies,communityhealtheducation, includingsupport fo
theLadyHealthWorkerprogram,andhealthfacilityrehabilitation.
nkindcontributions
AUSTRALIAhascommittedAUD75millionforfloodreliefandearlyrecovery inPakistan.Thisassistancesupports life
savingandearlyrecoveryinterventionsdeliveredthroughUNagencies,theRedCrossandRedCrescentMovementand
Australian NGOs. On 2 September, AusAID and the Australian Defence Force established an Australian Medica
Treatment Facility (AMTF) in KotAddu, Punjab, staffed byAustralianDefence Force and civilianmedical teams and
includeslaboratoryandradiologyfacilities.
The
first
three
weeks
of
operation
treated
over
5,000
patients,
with
major
presentations
being
malaria
(includingfalciparum),diarrhoea,skinandrespiratorycomplaints.TheAMTFaresystematically treatingpatients forwormsand
arecollectingstatisticsonweightforageandarmcircumferencefortheNutritioncluster.Threesamplestakenbythe
AMTF that tested positive for Schistosomiasis have been highlighted with the relevant authorities. This is being
investigatedbytheinstituteofpublichealth.
AUSTRIAhasdonatedwaterpurificationsuppliesandoneinteragencyEmergencyHealthKit(IEHK).
CHINAhasdonatedafieldhospital,whichhasbeenestablishedinThatta,Sindh.Thehospitalhastreatedover18000
patientstodate.
DENMARK:theDanishEmergencyManagementAgencyhasdonatedalightfieldhospital,whichisoperatingintheareaofRadhan,Sindhprovince.Denmarkhasdonatedwaterpurificationsuppliesanddeployedtechnicalexperts.
FRANCEhasdonatedwaterpurificationequipmentandemergencymedicalsuppliesincludingacholerakit.
GERMANY has donatedwater purification equipment and deployed technical experts. It has also donatedmedica
supplies.
ITALYhascontributedtothehealthclusterthroughWHOanddonatedmedicalkitsandmaterials(91 IEHKsandeight
diarrhoeal disease kits) to flood affected areas. 7 Italian light fieldhospitals arebeingdispatched todifferent flood
affectedlocalitiesofPakistan.Waterpurificationsuppliesandequipmenthavealsobeendonated.
JAPAN has donated 1650 tents, 67 dewatering pumps, 20 water tanks, 25 water purifiers and 1 million wate
purificationtablets.FollowingconsultationswithPakistan'sMinistryofHealth,provincialauthoritiesandtheUN,Japan's
InternationalCooperationAgency(JICA)dispatcheda46strongmedicalteamtoMuzaffargarhDistrict(Punjab)from5
to23September. TheteamestablishedamedicalfacilityatRuralHealthCentreSinawanandexaminedatotalof3501
patientsduring theirstay. Amidwife in the teamplayedan importantrole in instructingnursingmothersoncorrect
lactationskills.
8/7/2019 Health Cluster Bulletin No 19-Final
6/13
MOBILINK PAKISTAN has donated 237 prefabricated structures (each measuring 12m2) to the Health Cluster. The
structuresare intendedtoreplacedamagedordestroyedhealthfacilities incampsandotherareas.Theycanalsobe
usedasmedicalwarehousesifneeded.
SWEDENhasdonatedwaterpurificationsuppliesandsentreliefteams.
UNITEDKINGDOMDEPARTMENTFOR INTERNATIONALDEVELOPMENT (DFID)hasdonatedwaterpurificationtablets
andotherreliefsupplies.DFIDhasalsobroughtforwarda10millionprogrammetoprovidebridgesaspartoftheearly
recoveryeffort.TenprefabricatedroadbridgesfromtheUKarescheduled toarrive inKarachi inmidSeptemberfo
installationinKP,withmoretofollowinduecourse.
HealthClusterResponse
CARE
Reportingperiod:11to17September)
KP
CAREtreated772patients(including277womenand356children)viafourbasichealthunits(BHUs)inupperSwat.In
Charsadda,15mobileclinicsmanagedbythreemobileteamstreated2416patients(including725womenand977
children).CAREalsoconducted41healthandhygienesessionsthatwereattendedby738people. InNowshera,anothe
12mobileclinicsmanagedbyfourteamstreated1833patientsincluding588womenand788children.Atotalof1158
peopleattended44healthandhygienesessionsconductedbyCAREinNowshera.
PUNJAB
CAREtreated1203patients(including436womenand706children)via12mobileclinicsinRajanpur.
SINDH
CAREprovidedprimaryhealthcare(PHC)servicesto897patients(including298womenand423children)via17mobile
medicalcampsindistrictsSukkur,KashmorandShikarpur.
CENTREOFEXCELLENCEFORRURALDEVELOPMENT(CERD)KP
InNowshera,CERD isprovingPHCservices includingmotherandchildhealth (MCH)andnutritionalservices (initially
throughmobile clinics and now through theMCH centre) inUC PashtunGharee. InDir Lower,CERD ishelping the
ExecutiveDistrictOfficerforHealth(EDOH)toprovidemedicalandnutritionservicesinUCBaduwaan.
HURCHWORLDSERVICE(CWSP/A)
KP
CWSP/AmobileandfixedhealthunitsareoperatinginMansehra,Kohistan,SwabiandSwatdistricts.CWScarriedout
10402consultationsandexamined1527childrenunderfive.Ladyhealthvisitors(LHVs)registeredandgavemedicines
to240ante and67postnatalwomen.CWSP/Aalsoheld293educationsessionsattendedby2936people(1661
womenand1275men).ItisplanningtoexpandoperationstoincludeShangladistrict.
MainneedsandchallengesreportedbyCWSP/Aincludedamagedhealthinfrastructures,alackofhumanresources,
andshortagesofmedicinesandmedicalequipment.
ELPINGHANDFORRELIEFANDDEVELOPMENT(HHRD)
8/7/2019 Health Cluster Bulletin No 19-Final
7/13
eportingperiod:29Julyto23September)
Todate,morethan75000patientshavebeentreatedinHHRD'sfreemedicalcampsinKP(Charsadda,Nowshera,Dir
Swat,Buner),Punjab(Mianwali,Muzaffargarh,Layyah,D.G.Khan)andSindh(Nawabshah,Sukkur,KarachiandLarkana)
Majordiseasesobservedincludediarrhoea,scabies,eyeandskininfections,andmalaria.
TERNATIONALMEDICALCORPS(IMC)
eportingperiod:18to24September)
KP
IMCtreatedatotalof822patientsindistrictsPeshawar,CharsaddaandNowshera,andprovidedpsychosocialsupport
to254people.
PUNJAB
IMChassignedamemorandumofunderstandingwithPunjab'sHealthDepartmentcoveringtheprovisionofemergency
health care services.Most field staffhavenowbeen recruited, and four teamshavebeendeployed to ruralhealth
centre (RHC)RohillanWala,andbasichealthunits (BHUs)AludayWali,Umerpur JanobiandMahra.More teamsare
beingdeployed invariousgovernmenthealth facilities inRajanpur,Multan,Rahimyarkhan,Muzaffargarhand Layyah
districts. Diarrhoea Treatment Centres (DTCs) are being established in RHCs Jampur (Rajanpur), Rohila wala
(Muzaffargarh),andLalisanCrore(Layyah).
SINDH
IMC is recruiting staff and deployingmedical teams to THQRatoDhero,RHCsNodhero,Banguldhero,Gerello,BHU
Areeja inLarkanaDistrictandBHUs JehangirTahim,NimandNabiShahWagan inShikarpurdistrict.DTCs arebeing
establishedinRHCsDhokri(Larkana),Khanpur(Shikarpur)andQambarShahdatkot.
TERNATIONALORGANIZATIONFORMIGRATION(IOM)
eportingperiod:20to24September)
PUNJAB
IOMtreated1262patientsinMuzaffargarhandRajanpurdistricts.Italsoorganizedsevenoutreachmedicalcampsin
Ameer Abad, Basti Bandu Sandela and BHUUmer Kot that reachedmore than 1000 internally displaced people
(IDPs).
SINDH
IOMtreated772patientsindistrictThatta.
MALTESERINTERNATIONAL
10,698patientshavebeentreatedby5MSTs/MMTs,overthelasteightweeksofourintervention.During2monthlong
provisionofPHCServicesin3healthfacilitiesthetotalof6,498patientshasbeentreated;withaveragenumberof60
patients/perday,perfacility.
Malteser has also organized tenMedical Camps,where over 4,200 patients treated by our 2MMTs,while severa
hundredsofchildrenhasbeenvaccinated(EPIprotocol+Influenza)bytheEDOHealthOfficeVaccinationTeam;these
medical campswere organized inUCs remote areas, Transitional Camps of IslampurUC, and Tahirabad quarter o
MingoraTown.
OurMMTsarealsoprovidingintensivehygieneawarenesscampaignsintheareawithsuspectedAWD(Cholera)cases
namelyinareasofBarikot,MargazalandAhunbabaofIslampurUCandMingoraTown.Everyweek,severalhundredso
8/7/2019 Health Cluster Bulletin No 19-Final
8/13
familieshavebeen enrolled,hygieneprintedmaterialsdisseminated, aswell asAquaTabs, soap andORS sacs.Ou
MSTs/ MMTs also distributed 3,000 jerrycans, 800 kg of soap, and several hundreds of thousands of AquaTabs
donatedtousbyWHO,UNICEFandOxfam.
Since10August2010,wearealsoprovidingcleanwatertothepopulationofIslampur,KokarayandDangramUCs;10
m3,perday foreachof these twoareas.150NFI/Hygiene FamilyKitswillbedistributed inKokaraiUCof the Swat
District.850willbedistributedthroughourimplementingpartnerLasoona,NationalNGOfromSaiduSharif.
MERLIN
Reportingperiod:2223September)
Merlinisscalingupoperationsandmobilizingitsentirestafftomeettheneedsofagrowinghumanitarianemergency
Since5August2010,Merlinhasconductedatotalof227545consultations.
KP
Merlin isworking throughhealth facilities,mobilehealthunitsandDTCs toprovidehealthandnutritionservicesand
healthpromotionsessionsinNowshera,Swat,BunerandCharsadda(approximatecatchmentpopulations:153000,590
000,338000and172000respectively).
InNowshera,whereMerlinisprovidinghealthandnutritionservicesthroughsixmobilehealthunits(MHUs)insixUnionCouncils(UCs)andsix24/7staticclinics inJalozai, ithelda totalof3827consultationson22and23September,and
distributedmultimicronutrients tablets,micronutrientsachets,andAmunuts. Italsoconducted55healthpromotion
sessionsfor423beneficiaries,andheldanother266consultationsinaDTC.
In Swat,whereMerlin is providing health services through nineMHUs and 11 health facilities, it conducted 5249
consultations on 22 and 23 September, and carried out 337 health promotion sessions. It conducted another 144
consultationsattheDTCinTHQMatta.Merlinteamsalsodeliveredseventeenbabiesandreferredfourpatients.
InBuner,whereMerlin isprovidingPHCservices(includingreproductivehealth)through10healthfacilitiesandthree
MHUs, itconducted2592consultationsandcarriedout52healthpromotionsessions. Itheldtwentyconsultationsat
the
DTC
in
THQ
Pachakalay.
It
also
delivered
21
babies
and
referred
four
patients.
InCharsadda,Merlin conducted135 consultationsat thenewlyestablishedDTC inDHQCharsaddaandanother307
consultationsattheDTCinCHShabqadar.
PUNJAB
Merlincarriedout153consultationsatthenewDCTinDHQMuzaffargarh.MerlinwillbeginprovidingPHCandnutrition
servicesthroughfivestaticandmobilehealthfacilities,andwillexpandservicestoanothertwohealthfacilitiesinthe
comingweeks.
MOTHERHELPAGE
Mother
Helpage
is
taking
care
of
critically
injured
patients
and
vulnerable
groups.
It
has
set
up
maternal
and
child
healthmedicalcampsandcommunicationcentres,andisofferingtraumacounseling.IthassetupmedicalcampsinMakriand
Pateekavillages(AzadJammu&Kashmir)andplanstosetupothercampsinNeelumandShonthervalley,Punjab,Sindh
andKPK.Itisalsoconstructingchairliftairbridgesatseverallocations.
MUSLIMAIDUK
KP
InCharsadda (BHUGulabAbad,UCAgra),MuslimAid treated207women,299childrenand81men,distributed320
hygienekitsand17800sachetsofaquatabs,andconducted18hygieneandpublicawarenesssessions.TheBHUhas
beenrehabilitated,cleanedandpainted,andanewwellhasbeendug.
8/7/2019 Health Cluster Bulletin No 19-Final
9/13
MuslimAidalsoassessedwater,sanitationandhygieneneeds in25villages (10 inUCMirzaDher,12 inTarnab and
threeinHisarDheri).InNowshera(MohibBanda,BandaMalaKhanandAmanKot),MuslimAiddistributed6600aqua
tabsand conducted16hygiene sessions.The rehabilitationofBHUsAmanKot,BandaMulaKhanandMohibBanda
continues.
PUNJAB
In Jampur (DistrictRajanPur)aMuslimAidmedical teamhas treated161women,183childrenand172men. Itwil
begin offeringmedical services inUC KotalMughaln nextweek.Muslim Aid has conducted 20 hygiene awareness
sessionsin10villages,andhasdistributed50000aquatabsand2400sachets.
SINDH
InShikarpur,MuslimAidtreated75women,155childrenand31men,andreferredthreepeopletohospitallevel.Italso
conducted21hygieneandgeneralhealthawarenesssessionsanddistributed200mosquitonets. InQambarShehdad
Kot, itdistributed320mosquitonets,conductedeightawarenesssessions,andtreated616women,517childrenand
289men. In Thatta, it treated282women,75 children and69men.Diseases includedbloodydiarrhoea, suspected
malaria,acuterespiratoryinfections(ARI)andskininfections.Italsodistributed1000aquatabsandtreated1252000
litersofwater through itswaterpurificationplant. InSukkur,wherehealthactivitieswere slower thanusualdue to
illness
among
the
medical
team,
Muslim
Aid
treated
20
women,
58
children
and
nine
men
for
malaria,
ARI
and
skininfections.Italsoconducted15hygiene/healthylivingsessions.
NATIONALRURALSUPPORTPROGRAMME(NRSP)
NRSPisrunningmedicalcampsinKP(districtsCharsaddaandNowshera),Punjab(districtsDGKhan,Rajanpur,Mianwal
andBhakkar)andSindh (districtsThattaandBenazirabad). It isalsorehabilitatinghealthfacilities inPunjab(Rajanpu
andDGKhan).
NCHD
KP
NCHDisrunningmedicalcampsinseveraldistrictsinKP.Ithastreatedatotalof163694patientstodate.
SUPPORTWITHWORKINGSOLUTION(SWWS)
KP
SWWSisprovidingmedicalcareatBHUSherigle,DirUpper,whereithassofartreated9867people,ofwhom57%have
been children. It has also organized threemedical camps at District Charsadda,with philanthropists and voluntee
doctorswhoprovidedmedicalcareto450patientsatKatukhailNowshera.
UNFPA
(Reportingperiod:1Augustto23September)
KP
UNFPAhasestablished12servicedeliverypoints,includingamobileunit,inNowshera,D.I.Khan,Tank,SwatandLowe
Dir. Ithasprovidedwomenshygienekits to1791 families,distributed1103newbornkits tonewmothers,andpre
positionedenoughreproductivehealth(RH)kitsinPeshawarwarehousetocaterfor600000peopleforthreemonths.It
hasprovidedRHandPHCservicesfor36513patients,delivered2137babies,conducted4678ante and1266postnata
consultations,providedpostabortion care for195women, referred149patients forCaesarean section, treated415
sexually transmitted infections, and held 1185 family planning consultations. UNFPA's PHC services included 5692
consultationsforgastroenteritis,1543forscabies,3369foracuterespiratorytractinfections,3652forfeverand11838
forminorailments.
8/7/2019 Health Cluster Bulletin No 19-Final
10/13
PUNJAB
UNFPAhasestablished11servicedeliverypoints,includingthreemobileunits,inMuzaffargarh,Rajanpur,Layyah,D.G.
KhanandRahimYarKhan. IthasprovidedRHandPHCservices for14622patients,delivered310babies,held2707
ante and499postnatalconsultations,providedpostabortioncarefor63women,referred29patientsforCaesarean
section, treated 186 sexually transmitted infections, and held 179 family planning consultations.Moreover, it has
donatedwomen'shygienekitsto1500familiesanddistributed600newbornkitstonewmothers.UNFPAhasalsopre
positionedenoughRHkitsinMultanwarehousetocaterfor1.2millionpeopleforthreemonths.UNFPA'sPHCservices
included 2235 consultations forgastroenteritis,942 for scabies,1537 foracute respiratory tract infections,1970 fo
feverand2858forminorailments.
SINDH
UNFPAhas established 31 servicedeliverypoints, including23mobileunits, in Jaccabad, Thatha, Shikarpur, Sukkur
Larrkana,Khairpur,Qamber Shahdadpur,KashmorandGhotki. Ithasdonatedwomenshygiene kits to724 families
distributed1400newbornkitstonewmothers,andprepositionedenoughRHkitsinSukkurandHyderabadwarehouses
tocaterfor1.1millionpeopleforthreemonths.IthasprovidedRHandPHCservicesfor67147patients,delivered370
babies,conducted8288ante and1392postnatalconsultations,providedpostabortioncarefor301women,referred
41 patients for Caesarean section, treated 377 sexually transmitted infections, and held 609 family planning
consultations.UNFPA'sPHCservicesincluded13775consultationsforgastroenteritis,12189forscabies,9379foracute
respiratorytractinfections,12637forfeverand6331forminorailments.
NEEDSANDCHALLENGES
Themain challenges faced byUNFPA include a lackof funds and skilled human resources to reestablish basic and
comprehensive RH services in areas affected by the floods. Limited information management resources are also
hampering theHealthCluster'sefforts togainacomprehensiveoverviewofneedson thegroundsand theactivities
beingimplemented.
UNICEF
BALUCHISTAN
Acutediarrhoea(12%),acuterespiratorytractinfections(12%)andsuspectedmalaria(23%)remaintheleadingcauses
ofseekinghealthcareinfloodaffecteddistricts,withhighernumbersofsuspectedcasesofmalariainNasreeabadand
Jaffarabadascomparedtootherdistricts.
UNICEF'smainactivities inBaluchistan includevaccinationcampaignsagainstpolio,measles,BCGandTT,Motherand
ChildDays,thedistributionofemergencyfoodrationsandsupplements,aswellashygieneandotherkits,andhealth
andhygieneawarenesssessions.
KP
UNICEF, in collaborationwith theMoH,WHOandotherpartners, is conductingmass vaccination campaignsagainst
polioandmeaslesin15districts,andcontinuingroutineimmunizationactivitiesinschoolsandcampsinfloodaffected
areas. Inphase1 so far, the followingnumbersof childrenhavebeenvaccinated:measles:335460;polio:384,397
Pentalentvaccine:13669;BCG:3,410;TT:9,474women.UNICEF isalsoprovidingspecializedobstetrics,gynaecology
and paediatric care through mobile units, and supporting medical teams at six static health facilities, as well as
specializedpaediatricservicesatDHQD.I.Khan.
UNICEF'sMother andChildDays (being conducted in 11Union Councils of Swat) include vaccinations, deworming
blanketdistributionofMMsachetsandaquatabs,anddistributionofnonfooditemsincludingcleandeliverykits,jerry
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11/13
cans, buckets, newborn and hygiene kits. UNICEF has also distributed highenergy biscuits, fortified blended food
micronutrientsachetsandtablets,andPlumpy'Doz.
PUNJAB
Routineimmunizationofchildreniscontinuinginschoolsandcampsinfloodaffectedareas.
SINDH
UNICEFisconductingroutinevaccinationactivitiesinschools,campsandfloodaffectedareas,andprovidingantenatal
natal,neonatalandpostnatalhealthservicesthroughmobileandstaticmother,neonatalandchildhealthservices.
UNICEFisalsoconductingroutinevaccinationactivitiesinfloodaffectedareasofAzadKashmirandGilgitBaltistan.
USAID/PAIMAN
USAID/PAIMANfieldstaffattendedlocallevelhealthclustercoordinationmeetingsandparticipatedinmassvaccination
campaignsinallprovinces.
BALUCHISTAN
USAID/PAIMAN has donated 1140 jerry cans and 566 water tanks to Sibi and Jaffarabad. Its local NGO partnersconductedeightmobilehealth campsand threehealthandhygienepromotion sessions,usingmaterialsdonatedby
UNICEF.
KP
USAID/PAIMANdonated21744jerrycansand1578watertankstoSwat,CharsaddaandDIKhan.Italsoorganized10
mobilehealthcamps,conducted10healthandhygienepromotionssessions,anddonated2000insecticidetreatedbed
netstoSwatandCharsadda.
PUNJAB
USAID/PAIMANdonated16293jerrycansand1524watertankstoMSDMultan(handoverceremonyattendedbythe
MinisterofHealth)andDCODGKhan.Italsoorganizedeightmobilehealthcampsandconductedsixhealthandhygiene
promotionsessions.
SINDH
USAID/PAIMAN donated 36 504 jerry cans and 3361water tanks to Sukkur (handover ceremony attended by the
MinisterofHealth)andKhairpur.USAID/PAIMANorganizedaspecializedmedicalcampintheGovernmentAttaHussain
DegreeCollegeRohri;512patientsweretreated.Italsosupported27mobilehealthcampsand15healthandhygiene
promotionsessions.
WHO
WHOisfinalizingthe"WhoDoesWhat,Where"(3W)tablemappingallpartners'activities.Theupdatedmatrix,revised
tomake itmoreuserfriendly,hasbeensenttoallhealthpartnersforreviewandcompletion.WHOwillusethedata
submittedbypartnerstocreatedetailedmapsshowingHealthClusterpartners'presenceontheground.WHO isalso
workingtoanticipatethehealthneedsofdisplacedpeopleinareasofreturn.
SomeDTCsreport thattheyworkingat lessthanfullcapacity.As IDPsreturnhome,theremaybeaneedtorelocate
someDTCs.IndependentlyofthenumberofpatientsinDTCs,aslongastheriskfactorsremain(stagnant,contaminated
water,poorhygiene, insufficient latrines),WHOwillmaintaintheDTCs inastateofreadiness.Therearecurrently18
DTCsinKP,12inPunjab,seveninBaluchistan,seveninSindh(includingthreeopeninginthreedays)andtwoinGilgit.
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WHO staff in Sukkur travelled to Islamabad to attend a "training of trainers" course on the casemanagement o
diarrhoealdiseasesandonpreventionand control strategies.Theywillbeginonsite trainingofDTCstaffnextweek
(beginningofOctober).
InSukkurWHO isdistributingmalariarapiddiagnostickits toallhealthpartners,andhasaskedpartnerstoshare the
percentageofpositivemalariacases.WHOwillalsoprovidemalariatreatmentguidelinestopartners.
A jointWHO/UNICEF/MoH immunizationcampaignpolioandmeaslesbeganon20September.The firstphaseof the
campaign
will
be
completed
by
2
October.
WORLDVISION(WV)
KP
WVcontinuestosupportfourstatichealthfacilitiesinKoto,Kandaro,MunjaiandChakdara.Duringthereportingperiod
10261peoplewereseenathealth facilitiessupportedbyWV. TheDTCatTHQChakdaraadmittedand treated138
cases of acute diarrhoea. WV has assessed health coverage gaps, and is deploying static and mobile teams in
consultationwiththeEDOHinNowsheraandCharsadda.TheteamshavebegunservicesinAmangarh,Nowsheraand
Umarabad MujikaiCharsadda, Majuki (UC MC2, UC MC4 and UC Meraprang). A total of 3378 individuals have
consultedthehealthteamstodate.InNowshera,onemobileandtwostaticunitshaveconducted2304consultations
Theteamswillshortlyexpandservicestoincludethreemorefacilities.WVhasinitiatedadetailedassessmentofhealthfacilitiesinCharsadda,NowsheraandLowerDir.
PUNJAB
WVhasprovided10trucksanddriversforonemonthtoEDOHtoensuremedicalandreliefsuppliesinMultanareable
to be distributed to the floodaffected districts. It is treating patients and conducting health education sessions via
mobileclinicsinOnttahwala(UCNusan)andShaheenNager(UCBasira).ItiscontinuingtoassessunmetneedsinAlipur
JatoiandS.Muzaffargarh.
SINDH
WVhasestablishedfourmobileteamsatKotdegiandGothAbdullahShahPanuAqil.
NEEDSANDCHALLENGES
WVreportsthattheshortageoftrainedhealthcareprovidersinPunjabisamajorconstraint.
HealthClusterCoordination
InterClusterCoordination:
MembersoftheHealth,Nutrition,WASHandFoodclustershavedevelopedajointstrategytoensureamoreintegrated
effectiveandtimelyemergencyresponseinpriorityfloodaffecteddistricts.Thestrategyaimstoaddressthefactorsthat
contributetothemainmortalityrisks(acutediarrhoea,acuterespiratoryinfections,malaria,measles,malnutrition,andmaternal and neonatalmortality/morbidity).An integrated approach is essential,with a very strong component o
communitybased interventions.Once"hotspots"havebeen identified,organizationswillneed toconsulteachothe
and comeupwithwaysofworking throughexistingprojectsandactivities (e.g.usingpolio campaigns to screen fo
malnutrition).Thestrategyneeds tobeoperationalizedatdistrictorevenUnionCouncil (orTehsil) levels.OCHAhas
assignedfulltimestaff ineachdistricttofacilitatecoordinationand implementationofthesurvival.Operationalplans
willbeestablishedina"bottomup"approach,notfromIslamabad.
Coordinationatprovincial&hublevels:
RegularHealthclustermeetingsarebeingheldinPeshawar,Multan,SukkurandHyderabad.Acoordinationsystemisin
placewithPDMA,DoH,OCHA,NGOsandotherUNagencies.
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RevisionofHealthClusterProjectsunderPFERP:
TheHealthClusterhascompletedtherevisionof itsprojects inthePakistanFloodEmergencyResponsePlan(PFERP)
TherevisionwasundertakenincompliancewithNDMAguidelinestomaketheprojectsmoreelaborativeandrealistic
TheHealthCluster is seekingoverUS$200million for95projects,which coverboth reliefandearly recovery, tobe
implementedbysixUNagencies,19internationaland28nationalNGOs.
AlfredDube
HealthClusterCoordinator
email:[email protected]
Telephone:+92 03004005934
SadiaIqbal
DonorRelationsFocalPoint
email:[email protected]
Telephone:+923004005937
MariaAngueradeSojo
CommunicationsOfficer
email:[email protected]
Telephone:+92 03018551459
SyedHaiderAli
Communicationsofficer
email:[email protected]
Telephone:+92 3004005944