Philippines: WHO report says outbreaks of disease rising among flood victims

03/18/2010 05:12 am ET | Updated May 25, 2011

By Mike Cohen Note: Bullet points from WHO health report - new storm feared in three days : The World health organization has issued a health alert and sought to get more medical assistance to help prevent serious outbreaks of disease after the floods of back to back typhoon affected millions in the Philippines. Hundreds of thousands remain in shelters and in need of care. Outbreaks of disease are increasing as well as death toll.

Tropical Storm Ketsana

• 880 175 families / 4 320 699 individuals have been affected in 1 902 barangays. 45 129 families / 216 941 individuals remain in 447 evacuation centres

• Casualties: Casualties: 437 Dead, 3 769 injured

• Confirmed acute watery diarrhea outbreak in 2 municipalities (San Pedro, Laguna; Marilao, Bulacan)

• Confirmed Leptospirosis outbreak in 3 barangays in Marikina (Tumana, Concepcion, Malanday)• More than Php 1B (USD 21 M) in damage to health facilities reported

• The top 5 morbidity cases in the evacuation centers according to 3-day running average by National Epidemiology Center are: acute respiratory infection (53%), skin infection (19%), diarrhea (15%), fever (9%), influenza-like illness (4%), pneumonia (0.3%)

• As of 13 October 2009, mobile missions have been conducted by 187 Medical, 25 Psychosocial, 33 WASH, 5 Nutrition, 2 Disease Surveillance, 13 Assessment, 54 Public Health teams, and 6 international teams deployed by DOH to 452 sites

Typhoon Parma

• 675 681 families / 3 136 965 individuals have been affected in 4 472 barangays in 356 municipalities. 17 506 families / 83 432 individuals remain in 179 evacuation centres

• Casualties: 375 Dead, 185 injured

• The top morbidities based preliminary data from consultations in 2 Municipalities affected are: wounds, upper respiratory tract infection, skin infections, hypertension, and others (muscle pains, headache, acute gastroenteritis)

• More than Php 498M (USD 10.3 M) in damage to 13 health facilities has been reported

The WHO report goes on to warn of a notable increase in infections and waterborne disease problems that could escalate if not given attention. Meanwhile; a Report on causes of deaths in Evacuation centers show a top cause being 'Upper respiratory' in nature and followed closely by "infections" albeit only 4% have been caused by a "Influenza-like illness" indicating that a health crisis is present and needs attention. particularly in many places where the situation is not expected to be resolved anytime soon.

Tropical Storm Ketsana Health Situation Assessment

• NDCC reported that the number of evacuees decreased to 45 129 families / 216 941 individuals in 447 evacuation centres. Total number of affected increased to 880 175 families / 4 320 699 individuals in 1 902 barangays.

• Access to essential health services: DOH estimates at least Php 1 B (USD 21 M) in damage was sustained by 17 Government Hospitals, 110 Municipal Health Centers, and 7 LGU Hospitals.

• The top 5 morbidity cases in the evacuation centers according to 3-day running average by National Epidemiology Center are: acute respiratory infection (53%), skin infection (19%), diarrhea (15%), fever (9%), influenza-like illness (4%), pneumonia (0.3%)

• The National Epidemiology Center (NEC) has confirmed an outbreak of acute watery diarrhea in one barangay in Marilao, Bulacan and one evacuation center in San Pedro, Laguna. 97 cases have been reported by DOH hospitals (1 adult, 96 pediatric). Two deaths have been confirmed in Marilao, both of female children (1 year-old and three year-old). Cases have been confirmed by The Research Institute for Tropical Medicine. Reports from San Pedro are still incoming. New cases down from 50 cases per day to 1-2 per day.

• NEC has also confirmed an outbreak of Leptospirosis in 3 barangays in Marikina (Tumana, Concepcion, Malanday). 230 cases of Leptospirosis (197 adult, 33 pediatric) are reported from DOH hospitals and reports from private hospitals are still incoming.

METRO MANILA: Overall the Philippine Government agencies The WHO, as well as relief organizations and NGO's along with the private sector have responded in many areas but the extent of the disaster is pushing all groups to seek aid for rising problems and health concerns.

The clearing of streets and repair of roads and drainage systems have not totally alleviated the crisis is far from over.

Compounding this are new floods caused by seasonal rain some affected areas in the last two days overnight rain has added more to woes of officials. As people stay in shelters the health risks are increasing.

Response

• In response to the acute watery diarrhea outbreak, rationing of water and water disinfection is being done by the LGU in Marilao. In San Pedro, an infirmary within the evacuation center has been established to treat cases of acute watery diarrhea.

• DOH will meet with local chief executives of affected areas and has increased logistic support to hospitals to enhance surge capacity. Details of government intervention measures will be seen in the coming days.

• NEC has given contact information for event-based reporting where cluster agencies and other partners can share information obtained from their mobile clinics or assessment efforts (see below).

• WHO has procured and will donate 20 diarrheal kits that can treat up to 10,000 cases to DOH HEMS and NGOs that are responding to the disaster. MSF has sent a medical team to Marilao. The surveillance system, case management, and preventive measures need to be reinforced in all evacuation centers and flood affected areas. More resources are needed to contain the potential spread of water-borne diseases.

• As of 13 October 2009, 227 portalets have been distributed for 8 evacuation centers in Marikina (80 units), 6 evacuation centers in Quezon City (36 units ), 4 evacuations in Pasig (29), one evacuation center in Pateros (3), 5 centers in Muntinlupa (26), 9 centers in Cainta (29), and 4 sites in Laguna (24). For a detailed distribution list, please visit: http://www.un.org.ph/response14.html.

• WHO is providing continued technical guidance to DOH and the health cluster by providing case management guidelines for Leptospirosis and acute watery diarrhea in the WHO Philippines Website (www.wpro.who.int/philippines), UN Health Cluster Response Page (link below), as well as through cluster communications. Health Cluster Toolkits are also being distributed to cluster agencies.

• Communicable disease risk analysis has been done by WHO and the results have been shared with cluster agencies through the publication of the document “Public health risk assessment and interventions: Tropical Storm Ketsana and Typhoon Parma: the Philippines” available in http://www.who.int/diseasecontrol_emergencies/publications/ philippines_20091009_en.pdf. • WHO will provide 2 generator sets to Amang Rodriguez Memorial Medical Center.

• CFSI continues to provide psychosocial care for 6 barangays in Marikina, 2 barangays and one relocation site in Cainta, and in the major evacuation center in Pasig. For Metro Manila's hundreds of thousands still affected over 200,000 of whom are still in shelters, these are the prime concerns according to the World Health Organization.

For Metro Manila's hundreds of thousands still affected over 200,000 of whom are still in shelters, these are the prime concerns according to the World Health Organization.

Critical Constraints

• Several areas have limited access to health services and aid

• Fluidity of evacuation camp situation hinders accurate mapping, assessment, and disease surveillance

• Prolonged high-risk exposure due to retained flood water in many areas is expected

Urgent Needs

• Scaling up access of essential health services to all affected

• Improve case-based disease surveillance for communicable diseases and health and humanitarian service coverage in evacuation centers

• Increase resources aimed at containing the spread of water-borne and vector-borne diseases

• Ensuring a return to functionality of primary care facilities and re-establishment of essential health care activities, including vaccination.

Northern and Central Luzon: The second storm Pepeing, (Parma) is treated separately by the WHO as the number of victims and extent of health concerns while equally as important are of a somewhat different nature. But the health risks remain a serious issue that needs attention.

Health Situation Assessment

• Rapid needs assessment by UN-GOP team still ongoing.

• The top morbidities based preliminary data from 74 consultations (58 adult, 16 pediatric) in 2 Municipalities affected are: wounds, upper respiratory tract infection, skin infections, hypertension, and others (muscle pains, headache, acute gastroenteritis).

• Php 498M (USD 10.3 M) in damage to 6 hospitals, 1 Regional office, 4 rural health units, and 2 barangay health stations have been reported. Region 1 Medical Center, the main trauma center for the region, reported damages amounting to more than Php 456M (USD 9.5M). Damage to records, pharmacy, laboratory, radiology, OR, ER, DR, blood bank, OPD facilities and equipment amounted to more than PhP 453M (USD 9.4M). Emergency room operations and ward admissions have resumed but serious cases and those requiring surgery are referred to private facilities or to the provincial hospital. Health Cluster Response

• The United Nations Disaster Assessment and Coordination (UNDAC) team, together with representatives from IOM, WFP, WHO, UNFPA, and DOH will conduct a rapid needs assessment of the affected areas in Regions I, III, and Cordillera Administrative Region (CAR).

• DOH has deployed 1 medical and 1 assessment team to 6 Evacuation Centers in CAR. • More than Php 2.72 M (USD 566 679) has been given by DOH in augmented drugs, medicines and supplies.

• UNFPA has distributed 430 hygiene kits to Region III and is doing rapid assessments in Baguio City and the Province of Benguet. Critical Constraints • Massive flooding in the affected areas from the collapse of dikes and release of water from major dams in the affected regions is expected to continue early into the coming week.

• Thirty eight (38) municipalities and three (3) in Region I are still flooded as of 10:00 PM, October 11, 2009: 23 and 3 cities in Pangasinan; 9 in La Union, 1 in Ilocos Sur and 5 in Ilocos Norte.

• A total of fifty six (56) road sections and nine (9) bridges were affected which were rendered impassable or hardly passable. Urgent Needs

• Continued assessment of the health situation in the affected communities and in evacuation centers to determine the most urgent health needs

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