Minutes of Health Cluster Meeting # 9
November 6, 2012, Islamabad
WHO Pakistan
Participants:
ARC International, CAMP, CARE, CDO Pakistan, Friends Foundation, HHRD, IMC, IHS, I-LAP, IOM, MDM-F,
MSF-H, Nage Pakistan, NHEPRN, OCHA, PAO Baluchistan, Relief International, UNFPA, Shifa Foundation,
USAID, Muslin Aid, Helping Hands, Save the Children, HelpAge International, UNICEF, WHO
Agenda:

Floods situation updates - Partners
–
WHO
–
CARE International
–
MSF-Holland
–
HHRD Pakistan
–
CDO Pakistan
–
Muslim Aid Pakistan
–
Helpage International
–
Save the Children
–
UNFPA

Funding updates

Epidemiological situation / Polio Update

IDPs updates – KP/FATA

A.O.B.
Action Points

For health activities to be documented; it is strongly suggested to resume the monthly health
bulletin with deadlines.

Issues

The NGOs working in the health sectors in the flood affected districts of Pakistan are being faced
by couple of issues including Capacity, Medical Supplies, NOC and Visas related issues for ground
presence.
Floods Situation Updates - Partners

WHO is continuing its humanitarian support by providing Essential medicines and supplies to 7
targeted districts of Baluchistan, Punjab and Sindh. So far with this provision 594,799 population
were catered for one month. WHO assistance were through customized packages; 63
emergency health kits (EHKs), 28 Diarrheal disease kits, 70,000 Anti-malarial treatments
(primaquine), 6,336 skin treatments, 455 Anti Snake Venom (ASV), 175, 00 ORS and 46 TIGs.
WHO environmental health team tested more than 525 water sources , where >86% of these
being found contaminated and in support of WASH partners, WHO distributed 1000,000 pursachets and 2,000,000 Aquatabs, 50,000 soaps and 20,000 jerry canes in all flood affected
districts. 500 health and hygiene education sessions conducted with distribution of IEC material
in affected districts. 130 Healthcare/WASH workers were trained on infection control measures,
including safe collection, transport and disposal of hazardous healthcare waste. Standard
package of infection control equipment/hand-tools and supplies were provided to these
facilities with on job training.

CARE International is providing emergency health services through two Mobile Health Team
which include mother and child healthcare, health education and referral services in Rajanpur.
CARE International has conducted 32 Mobile clinics, benefiting 4,380 patients including 1313
women & 2,266 children while distribution of 1,000 mosquito nets has also been undertaken
among 1,000 families in Ghotki.

MSF: Since early September, the Doctors without Borders/Médecins Sans Frontières (MSF) team
is working in the eastern reaches of Pakistan’s Balochistan province and Jaccobabad in Sindh.
MSF has expanded its existing services to include basic health care for people affected by heavy
monsoon rains lashing the area. The needs become apparent as heavy monsoon rains flooded
the town of Dera Murad Jumali and surrounding areas, forcing thousands of families to abandon
their homes and seek shelter on the sides of roads in makeshift tents. In response, MSF’s team is
now supplying water to 20 water tanks and two 15 cubic meter water bladders to ensure that
there is safe drinking water for thousands of people who otherwise cannot access it. MSF is
providing more than 650,000 liters of clean drinking water to the displaced people every day.
In addition, teams set up a temporary 10-bed Diarrhea Treatment Center (DTC) in Dera Murad
Jamali’s Civil Hospital to treat patients diagnosed with acute watery diarrhea. Two mobile
medical clinics are providing basic health care to people in Nasirabad and Jaffarabad, treating an
average of 150 patients daily, and more than 1,000 children under the age of five have been
enrolled in MSF’s ambulatory nutrition program.

HHRD Pakistan: working on Union Council level; HHRD Pakistan is extending its support to flood
victims by providing relief in terms of food and non-food items including basic and primary
health services. HHRD is reaching out in a total of 28 villages in 9 Union Councils in the provinces
of Baluchistan, Sindh, and Punjab. The information has already been shared to WHO by 4W.
Situation Report has also been shared by PHF.

CDO Pakistan: Provision of Emergency Comprehensive PHC, Nutrition & Psycho Social Support
to the Flood Affected Women, Children & Vulnerable groups of District Shikarpur; Sindh
November, 2012. CDO Pakistan has launched its integrated Health, Wash & Nutrition based
activities at District Shikarpur. On the suggestion of district Health Authorities &
Health/Nutrition Cluster CDO Pakistan has targeted UC Jaggan, UC Jahanwar & UC Humayun
through RHC Sultankot. Generally focusing on the provision of PHC, Nutrition & Wash activities
CDO mobile & static teams are specifically catering for the needs of pregnant & lactating
mothers, children under five, elderly & disable. The teams are also distributing safe delivery kits
& conducting Awareness Sessions on exclusive breast feeding, immunization/Polio vaccination,
hygiene & health related issues & Nutrition screening.

Muslim Aid Pakistan: Muslim Aid Pakistan has rapidly responded to the recent devastating
floods by establishing a free medical camp for the flood victims of district Sajawal Junejo and
Jampur from October 06 to November 20th, 2012. Migrated affected people in Sibi, Quetta,
Khuzdar

Help Age International: Through a recent program; initially designed for two months; the NGO
is providing PHC services in Jacobabad to the flood affected population including the vulnerable
groups.

Save the Children: Save the Children is providing PHC services through a 6 months health
project including mobile health services, basic health care services and primary health care
services.

UNFPA: Mobile Service Units are providing Integrated RH/GBV services to the flood affected
population ensuring 24/7 BEmOC covering 03 districts in Punjab and 05 in Sindh. The
Geographical coverage is 50,000 per MSU where each MSU targets 3 Talukas. For MSUs PunjabMoPW and Sindh-Pakistan National Forum on Women’s Health are the Implementing Partners
for UNFPA.
–
–
–
RH Services --- Issues

Geographical access to underwater areas / road access.

Non availability of proper transport and logistics.

None working on RH- except UNFPA/PNFWH.
Challenges in Sindh

Availability of WMOs

Coordination with partners and other agencies working in HR in districts

Activated District (JCB) HCC but provincial HCC not activated as yet
Joint assessment – UNFPA/UNICEF/MNCH (Oct 2012)

District Jacobabad

C-EmONC is only available in DHQ for limited time due to inadequate
resources.

Partial BEmOC is available at all centers for morning shift due to
shortage of technical female staff.


Medicines and equipment are available to some extent.
District Kashmore

C-EmONC is not available in public sector in whole district.

Delivery Care is available at two centers only and for morning shift due
to shortage of technical female staff.
–

Complicated cases are referred to private hospitals and Shikarpur DHQ.

Medicines are available to some extent
Health Facilities in FADs

District Jacobabad (DHQ Jacobabad, THQ Ghari Khero, THQ Thul, RHC Mirpur
Buriro, RHC Ghari Hasan, RHC Qadir pur)

District Kashmore (THQ Kashmore, THQ Kandhkot, RHC Ghouspur, RHC
Bakshapur, RHC karampur)
–
Case load Data
Sindh
Punjab
Post Abortion Care
5
97
Refferal for C-Section
1
16
Antenatal Consultations
528
454
Postnatal Consultations
27
170
Deliveries
12
55
# Maternal Deaths
0
0
# Neonetal Death
0
0
APH Managed
0
2
PPH Managed
4
2
Eclampsia/ Pre-eclampsia
1
182
Family Planning
50
163
STI
8
1478
Funding Updates

CERF $ 9.9m for all clusters

ERF $4.7M – Six Health Project Proposals Submitted to ERF Secretariat (HIS, HHRD, Friends
Foundation, BSDP, IHP, CDO)

Final Approval still awaited from ERF Secretariat

MHOP $32 soft pledges
Epidemiological Situation Update (Week 43)

Measles: 71 alerts investigated this week, responding to 12 outbreaks involving 172 measles
cases. Vitamin A was provided to cases and EDOs‐H took action to improve vaccination in
affected areas.

AWD: 7 alerts investigated this week and 1 outbreak identified, involving 15 AWD cases.
Outbreak was controlled by timely measures and by case management and infection control
at health facilities.

CCHF: No new CCHF case reported in week 43, 2012

Polio: No new polio cases were reported in week 43, 2012.

65 districts have reported to DEWS in week 43, 2012. 1,789 health facilities have shared
weekly data to the Disease Early Warning System (DEWS) in this week.

563,695 patients’ consultations were reported in week 43 compared to 930,263
consultations reported in week 42, 2012.

Altogether 127 alerts were investigated and responses were provided to 15 outbreaks.

No. of Alerts Received & Responded, Week 40 - 43
Polio Highlights (Week 44)

Global Update for polio cases

Comparison of polio cases by province/region 2011§ & 2012*

Comparison Environmental Sampling Results 2011-2012

Plan for November 2012 SNIDs
Province
Target Population
Vaccine requirement (with 15% wastage)
Sindh
427,754
491,917
KP
5,473,148
6,294,120
FATA
822,880
946,312
Balochistan
736,744
847,256
Pakistan
7,460,526
8,579,605
IDP Updates KP and FATA
Current Population Update
•
•
•
167,140 IDP Families
–
18,164 Families in Camps (11%)
–
148,976 IDP Families in Host Communities (89%)
In Camp IDPs
–
Jallozai Camp (13,772 Families) – Khyber, Bajaur
–
New Durrani (3,233 Families) – Kurram
–
Togh Serai (1,159 Families) – Orakzai
Host Communities
–
Peshawar (70,133 Families) – Khyber, Kurram
–
D.I.Khan (30,047 Families) – SWA
–
Kohat (26,122 Families) – Orakzai
–
Tank (13,517 Families) – SWA
–
Kurram (8,097 Families) – Kurram
Hangu (1,060 Families) - Orakzai
IDPs updates – KP/FATA
•
Out of the revised Funding Need of US$ 11,461,994, only US$ 3,668,789 have been secured,
leaving a gap of over US$ 7.7 Million till December, 2012
•
Out of the total 1.5 Million targeted beneficiaries, only 548,421 beneficiaries have been
reached.
•
More than 80,560 IDPs benefited from emergency primary health care in 3 IDP camps. 467,861
off camp located IDPs received necessary health care assistance in IDP hosting districts in KP and
FATA.
•
2,237 communicable disease alerts, including confirmed outbreaks were detected and
responded.
•
Reproductive health and mother and child health (MCH) services provided to 12,000 women in
the camps. Over 120,000 women received 24/7 basic EmOC services, including 10,356 newbors.
•
EPI services are provided to 280,000 IDPs..
•
4,150 pregnant and lactating women and 1,950 new-borns vaccinated in 3 IDP camps. A total of
50,756 pregnant and lactating women and 10,356 new-borns vaccinated in KP and FATA.
•
Medicines provided to cover emergency and specialized health needs of some 1,050,000
patients.
•
A total of 225 primary health care facilities receive regular support and assistance by present
partners.
•
More than 100 remote areas are covered by mobile medical teams.
•
A total of 5,600 health and non-health workers received the necessary capacity building support
through a series of training courses.
A.O.B

UNFPA: Proposals along with distribution plans for Reproductive Health Kits; for around 30,000
to 100,000 people are invited from NGOs.