-1-
AFGHANISTAN CONTINGENCY PLAN
Avian Influenza Pandemic
A/H5N1 AVIAN INFLUENZA VIRUS
02 May 2006
CONFIDENTIAL
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Table of Contents
Page
A.
Situation
3
B.
Background Information
3-4
C.
Purpose
5
D.
Outline Plan
5
Part One: Media Plan
5
Part Two: Inter-Pandemic Phases
5-6
Part Three: Pandemic Alert
6-8
Part Four: Pandemic
8-11
List of Annexes
Annex 1:
Annex 2:
Annex 3:
Annex 4:
Annex 5:
Annex 6:
Annex 7:
Annex 8:
Annex 9:
Annex 10:
Annex 11:
Non Medical Interventions & Medical Interventions
Template for Pandemic Procurement
Personal Protection Equipment (PPE)
Health Advisory for Travel
Protection against Respiratory Illness
Priority Group for Pandemic Vaccine
Use of PPE
List of 6 weeks of stores
Medical Facilities in Afghanistan
Avian Flu Countrywide Budget
Afghanistan Countrywide Cost Sharing Formula
-3-
Situation.
Definition - Pandemic
On occasion, animal influenza viruses, or influenza viruses containing genes from animal
influenza viruses can begin to infect people. When a completely new strain of influenza virus
emerges among human populations, and has the ability to spread easily from person to person,
the virus can spread world wide within months (and perhaps weeks) leading to higher levels than
usual of mortality and severe illness. In this situation, all age groups are vulnerable to infection,
and there can be disruption to all sectors of society. Such a situation is called an influenza
“pandemic." Pandemics are different from usual influenza seasons and happen relatively
infrequently.
Afghanistan UN Mission
1.
The United Nations Country Team in Afghanistan consists of twenty-one (21) agencies.
As of 2 May 2006 the total number of national and international staff, not including their
dependents, of UN agencies is 6600 all staff, broken down as follows: 977 international staff,
5624 national staff. The national staff total figure was multiplied by three to provide a baseline
total of national staff dependents.
Background
2.
Influenza is a viral respiratory disease affecting humans and certain animals. Normally,
only human influenza viruses and not animal influenza viruses infect people. Clinical disease
ranges from infection with no symptoms to mild nonspecific illness to many different lifethreatening complications, including pneumonia.
-43.
There is currently rising concern that an avian or bird influenza virus, known as influenza
A (H5N1) or simply as "H5N1," which is circulating widely among birds primarily in Asia but
now parts of Europe, may gain the ability to spread easily from person to person and lead to the
first influenza pandemic of the 21st Century. Many of the prerequisites for the start of influenza
pandemic appear to be in place but the virus still has not gained the ability to conduct efficient
and sustained human-to-human transmission. The possibility that the H5N1 virus will gain this
ability must be considered quite "real" but also is not certain.
4.







If an influenza pandemic appears, the following additional considerations
Given the high level of global travel, the pandemic virus may spread to much of the
world and within Afghanistan within weeks to months, leaving little or no time to
prepare.
In all three 20th Century pandemic, substantially more young people died from pandemic
influenza than normal when compared with regular influenza seasons. In the 1918
pandemic, the highest death rates and the largest total numbers of deaths occurred in
previously healthy young adults. These patterns suggest that the next pandemic could
have a substantial impact on the workforce and young people in Afghanistan.
Vaccines and antiviral agents for pandemic influenza, as well as antibiotics to treat
secondary infections will be in short supply initially, while distribution of available
supplies is likely to be unequal. It will take several months or longer before any effective
pandemic vaccine becomes widely available.
Many if not most medical facilities will be overwhelmed by patients. Moreover, the
health care workforce is likely to be reduced because health care workers will also
become ill and will also stay home to care for ill family members.
For weeks at a time, significant shortages of personnel may occur, disrupting essential
community services.
UN staff, depending on the UNAMA mandate and the mandate of UN Agencies, may be
required to continue their critical functions.
Once the virus has gained the ability to spread easily among people, then Afghanistan
cannot be considered a low-risk area for infection. In essence, there will be no "safe
havens" from potential exposure to the virus.
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C.
Purpose.
5.
:
The purpose is two fold
a)
b)
D
Protect the health of staff and dependents and to ensure advanced preparation for
a timely, consistent and coordinated response across the UN Country Team in
Afghanistan in the event of an Avian Influenza pandemic.
To minimize the impact of a pandemic on UN staff and their dependents.
General Outline Plan
6.
Part One: Aggressive media educational program, handouts, bulletins to all
UN
agency and National Staff’s dependents in Afghanistan – WHO & FAO & UNICEF are the
responsible agencies. Avian Flu Working Group presentations to all UN staff members in
Kabul and the regions.
7.
Part Two: Inter – Pandemic Phase
8.
Part Three: Pandemic Alert, and
9.
Part Four: Pandemic
Part One – Media Plan
10
Tasks: Educational programs / bulletins / talk shows on bird flu and its affects on
Afghanistan poultry
Responsibility: FAO
Timeline: Immediately AF Phase 1 & 2 & 3
11.
Tasks: Information Presentation on AVIAN Flu / Pandemic its effects and Do’s and
Don’ts
Responsibility: Avian Flu Working Group / WHO and UNICEF
Timeline: Immediately AF Phase 1, 2, 3
Part 2 – Inter-Pandemic Phases
12.
The following pandemic phases facilitates preparedness planning
-6
Phase 1: No novel influenza A virus subtypes have been detected in humans. An
influenza virus subtype that has caused human infection may be present in animals. If
present in animals, the risk of human infection or disease is considered to be low.
Task: Ensure to have storage of 6 weeks water
6 weeks stock of non perishable food
Select food that requires no refrigeration
Enough gas for cooking
Soap and alcohol based wash
Ensure to select the driest and coolest spot in the house to store food.
Medical kits
Emergency supply of fuel and petrol
Inventory list of personal items to HR
Responsibility: All staff members & Heads of Agencies
Task: Essential staff list
Numbers of dependents and their names
Responsibility: Heads of Agencies

Phase 2: No novel influenza A virus subtypes have been detected in humans;
however, a circulating animal influenza A virus subtype poses a substantial risk of human
disease
Task: As per the above
Responsibility: same as the above
13
Afghanistan is now in Pandemic Phase 2
Part 3 – Pandemic Alert
14.
Human infection(s) with a novel subtype, but no human to human spread, or at most rare
instances of spread to a close contact.
Task: Brief the SMT on present situation and possible outcomes and related resources
requirements
Responsibility: Avian Flu Working Group
Task: Convene regular meetings of the Avian Flu Technical
Working Group.
Responsibility: Deputy Designated Official
Task: Identify members and functions for a Crisis Management Team (CMT) or what is
called in UNAMA as a mission – SMT Working Group at the regional and country level.
-7Responsibility: Designated Official / Deputy DO
Task: Assess preparedness status and identify gaps
Responsibility: SMT Working Group (CMT)
Task: Identify critical functions and staff that are required to maintain these
functions.

Physical security of Staff

Medical care of staff

Maintenance of computers and telephone services

Ability to communicate with other Organizations and Governments

Maintenance of utilities (water and sanitation)

Ability to make important operational and policy decisions related to the
pandemic

Ability to make important operational and policy decisions related to critical
operations and programs continuity.
Responsibility: SMT Working Group (CMT) & AF Working Group
Task: Medical interventions. Pandemic vaccines planning by prioritizing and
identifying the groups who will receive the pandemic vaccine once it becomes available.
Responsibility: Avian Flu Working Group / SMT Working Group / WHO
Task: Antivirals. Stockpiling Oseltamivir (Tamiflu) to treat 30% or more of staff and
dependents. Stockpiling enough Oseltamivir to rpovide prophylaxis for 6 weeks primarily
for staff needed and identified to maintain critical functions with high risk of exposure.
Responsibility: Avian Flu Working Group / SMT Working Group / WHO
Task : Antipyretics such as paracetamol to be available and staff to be encouraged to
stock their own
Responsibility : Staff members.
Task: Antibiotics to treat secondary bacterial infections on an out-patient basis in 10%
or more of UN staff.. If such a supply is not available antibiotics should be stockpiled.
Responsibility: WHO / Avian Flu Working Group / Country Team
Task : Medical Supplies requirements;
 Surgical masks sufficient to provide all staff and dependents with 2 masks per day for
6 weeks
 Enough Personal Protective Equipment (PPE) including N95 masks, gloves and
gowns for two changes per day for 6 weeks for medical and paramedical staff when
in direct contact with ill patients or those staff whose critical functions involve high
risk of exposure.
 Consider procuring one set of needles and syringes per staff members and
dependents.
Responsibility: WHO / Avian Flu Working Group / Country Team
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Task : Non Medical Interventions. Familiarize with UN Country Team preparedness
plan and with the UN Medical Services Contingency Plan and inform the UNCT.
Responsibility : WHO / Avian Flu Working Group
Task : Identify hospitals in Afghanistan where critical ill staff may be send.. May need
to develop an MOU with the respective hospitals.
Responsibility : SMT / WHO / Avian Flu Working Group
Task : Prepare contractual agreements with outpatient and hospital-based health care
providers who will help prepare for the implementation of local plans and to take care for
ill UN staff members.
Responsibility : SMT Working Group / Avian Flu Working Group / ASC
Task : Developing plans for local auxiliary outpatients care clinics for the UN staff and
their dependents that are designated to reduce the risk of nosocomial influenza infections
(fever clinics) / Plan for the distribution of simple surgical masks and PPE.
Responsibility : Avian Flu Working Group advising the SMT Working Group & ASC
Task : Communicating the UN preparedness plan to all UN Agencies and regional
locations.
Responsibility : Avian Flu Working Group
Task : Disseminate periodic advise on personal hygiene and travel advisory
Responsibility: Avian Flu Working Group / WHO
Part 4. Pandemic
15.
Small clusters with limited human to human transmission but spread is highly localized,
suggesting that the virus is not well adopted to humans.
Task : Declarations of Pandemic Alert Phase 4
Responsibility : WHO
Task : Mobilize the CMT / SMT Working Group
Responsibility: Designated Official
Task : Convene regular meetings of the Avian Flu Working Group
Responsibility: WHO
Task : UN staff members should be advised to prepare for staying at home for 6 weeks by
stocking supplies
Responsibility : DO & Country Team & staff members
Task : Pandemic Vaccine – same as in Phase 3
Responsibility : same as in Phase 3
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Task : Antivirals – same as in Phase 3
Responsibility : same as in Phase 3
Task : Antipyretics – same as in Phase 3
Responsibility : Same as Phase 3
Task : Antibiotics – same as in Phase 3
Responsibility : same as in Phase 3
Task : Medical Supply – same as in Phase 3
Responsibility : same as in Phase 3
Task : Non Medical Interventions. Distribute surgical masks to staff and dependents
with clusters and distribute PPE to medical and paramedical staff with clusters
Responsibility : Individual Agencies / WHO / UN Clinics and UN Dispensaries.
Task : Distribute PPE to staff required to carry out critical functions with risk of high
exposure.
Responsibility : WHO / Individual Agencies
Task : Conduct “dry runs” of “fever clinics” to make sure they can be implemented and
operated smoothly when needed.
Responsibility : Avian Flu Working Group / UN Medical Services
Task : Confirm contractual medical care agreements with health care providers in
Afghanistan and facilities
Responsibility : SMT Working Group / Avian Flu Working Group
Task : Communications. Issue health and travel advisory for affected countries. Inform
Staff of local healthcare arrangements. Issue advise on personal hygiene and protection
Responsibility : WHO / Avian Flu Working Group / Individual Agencies
Phase 5. Larger clusters but human to human spread still localised, suggesting that the virus is
becoming increasingly better adopted to humans, but may not yet be fully transmissible
Task : Declare Pandemic Alert Phase 5
Responsibility : WHO
Task : Staff should be instructed to stay in their duty station / residences, having ensured
that they have sufficient food, water, prescribed medication and supplies, medical kits
and other essentials to last 6 weeks until the pandemic wave has passed.
Responsibility : Designated Official on advise from the SMT
Task : When UN staff is working in setting with very weak medical infrastructure, when
there is potentially severe shortage of essential services, or when responses to the
-10pandemic might lead to a marked reduction in security cover for UN staff, relocation
within the duty station might be necessary.
Responsibility : Designated Official advised by the SMT
Task : Medical Interventions treatment to be provided by the pre-identified
healthcare providers as necessary.
Responsibility : WHO / UN Medical Facilities / Contracted Healthcare Providers
Pandemic Vaccine - as in Phase 3 & 4
Task : Provide antivirals within 48 to symptomatic persons who meet the clinical case
definitions and provide antivirals primarily to tyhose staff whose critical functions
involve high risk of exposure for prophylaxis
 Antipyretics to be taken in accordance with case management guidelines
 Antibiotics to be used as required
Responsibility : WHO / UN Medical Facilities / Contracted Healthcare Providers
Task : Advise the use of surgical masks and PPE already distributed in Phase 4
Responsibility : Individual Agencies
Non Medical Interventions
Task : “Fever Clinics” to become operational as needed
Responsibility: UN Medical Clinics and Dispensaries / WHO
Task : Home confinement of symptomatic persons in affected areas. For containment at
early stage it is encouraged that family members of symptomatic person do not come to
work.
Responsibility : UN Physicians & Contracted Representatives / SMT
Task : Defer all non critical meetings in affected areas and prohibit or postpone any UN
activities requiring mass gathering
 Defer all non critical travel
 Defer all travel of UN staff presenting with influenza like symptoms
Responsibility : DO / SMT and ASMT & WHO / Country Team
Communications
Task : Inform staff of travel restrictions
 Reinforce personal protection and hygiene guidelines
 Disseminate infections control guidelines for cases and exposure of cases
 Keep staff regularly informed
Responsibility: WHO / UN Medical Officers / Avian Flu Working Group / SMT
Working Group
-11Phase 6 : Increase and sustained transmission in the general population
Task : Declare Pandemic Phase 6
Responsibility : WHO
Task : Acquisition of pandemic vaccine and planning of staff vaccination once the
vaccine becomes available
Responsibility : UN Medical Officers , Clinics and Dispensaries / Contracted
Healthcare Providers
Task : Regular meeting of the SMT Working Group
Responsibility : Designated Official / Deputy DO
Medical Interventions
Task : Treatment to be provided by the pre-identified healthcare providers as necessary
following case management guidelines
 Provide antivirals as prophylaxis primarily to staff who perform critical functions
with high risk of exposure
 Vaccinate with pandemic vaccine according to priority groups already identified
Responsibility : UN Medical Officers / UN Medical Clinics and Dispensaries and
Contracted Healthcare Providers
Non Medical Interventions – same as in Phase 5
Communications – same as in Phase 5
The Activation of the Contingency Plan
WHO has defined a series of phases in the progression of an influenza pandemic. These
phases cover the progression of a flu pandemic from the first emergence of a novel virus to
its worldwide spread.
The UN security phases will be activated, when the WHO confirms evidence of sustained
human to human transmission in Afghanistan or in neighboring countries. The Designated
Official may advise the Secretary General to declare security phase IV at short notice.
Afghanistan UN Avian Flu Contingency Plan was endorsed by the SMT on
Monday 08 May 2006.
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Annex 1
Non Medical Interventions & Medical Interventions
Medical Interventions -Vaccines
Vaccine against Seasonal Influenza
10.
There is a vaccine available to protect against seasonal human influenza. This vaccine
will not protect against a pandemic strain but it will protect against seasonal influenza which, at a
time of pandemic, could be mistaken as being caused by the pandemic virus. Such a situation
would create unnecessary concern and misuse of limited antiviral medications.
11.
The UN Country Team plans to procure seasonal influenza vaccines and will offer
vaccination to all UN staff and their dependents. The vaccinations will be administered through
the UN Medical Team. All staff will be advised accordingly.
12.
UN Agencies who requires the assistance of UNAMA for the procurement and
administering of this vaccine must arrange an MOU with UNAMA. UNAMA has procured some
influenza vaccines with those agencies that have signed an MOU with UNAMA and have started
administering this to UN staff since November 2005
Vaccine against Pandemic Influenza
13.
Although a vaccine against the influenza virus A/H5N1 is being developed with the hope
that it will be effective against a new emerging pandemic strain, such a vaccine is not yet
available, nor is there any guarantee that it would necessarily be effective against a new human
strain.
14.
WHO and FAO will closely monitor the development of any new pandemic vaccine and
will make recommendations and advise as soon as the product is available and the UN Country
Team will follow their recommendations.
15.
It is expected that any new pandemic vaccine will initially be in short supply as the
demand will far outstrip availability. Recognizing the reality of not being able to vaccinate
everyone and following the WHO Health and Medical Services Contingency Plan
recommendations, each agency will be requested to develop a priority list of pandemic vaccine
recipients. Priority recipients will include those involved with direct clinical contact with
patients, those staff required to maintain essential functions and those at particularly high risk of
serious complications, such as the elderly and those with chronic diseases.
Pneumococcal Vaccines
16.
Pneumococcal vaccine will be considered for people at particular risk of bacterial
pneumonia complication of influenza, including those 65 years of age or older, those over the
-13age of two with chronic diseases such as congestive heart failure, emphysema, diabetes mellitus,
alcoholism, or chronic liver disease, and those who are otherwise immune compromised.
17.
The UN Country Team will procure pneumococcal vaccines with a single dose syringe
for 10% of staff and dependents. Each agency will draw up and maintain a list of pneumococcal
vaccine recipients.
Antivirals
18.
In recent years, new anti-viral agents to prevent or treat influenza infections have been
developed. An antiviral drug called oseltamivir, or Tamiflu, is widely used to treat the flu.
Tamiflu is used for treating patients one year of age and older whose flu symptoms started within
the last day or two. Tamiflu can also be used to reduce the chance of getting the flu if there is a
flu outbreak in the community.
19.
The efficiency of antiviral drugs in an Avian Influenza pandemic cannot be known with
any certainty until the pandemic is under way.
20
During a widespread pandemic, it will not be feasible to give post-exposure treatment to
non-ill contacts. Non-medical interventions and isolation will be the principal means of control.
In persons with febrile or respiratory illnesses, Tamiflu is used for treatment rather than
prophylaxis. It should be given to as post exposure prophylaxis treatment for persons who are in
direct contact with suspected or positive cases of Avian Flu.
Treatment
21.
In symptomatic patients suspected of having pandemic influenza, Tamiflu should be
medically administered in a dose of two 75 mg. capsules a day (total of 150 mg. per day) for 5
days.
22.
For maximum effect, the drug should be started within 48 hours of onset of symptoms.
During a pandemic situation, anyone with a fever or respiratory illness should be presumed to
have influenza and treated immediately, if possible.
Stockpiling Tamiflu
23.
If a pandemic is declared it is very likely that stocks of medicine useful against influenza,
particularly Tamiflu, will be rapidly exhausted.
24.
Taking into account a number of elements such as the epidemiology of previous
pandemics, the likely attack rate, and WHO recommendations, the UN Country Team will
procure a basic stockpile allowing for a 5-day course of Tamiflu treatment for 30 to 40 % of all
their staff and their dependants.
25.
Stockpiling of Tamiflu for preventive use is a personal choice of each staff member.
-1426.
Since antivirals will become valuable commodities during a pandemic, they should be
stored in a secure place. Stocks of medications will be under the responsibility of the WHO
office.
Antipyretics, antibiotics and medical supplies
27.
Antipyretic (such as paracetamol/panadol, but not aspirin) will be indicated as in most
febrile diseases to relieve pain and control fever. Antipyretics are widely available and the staff
is advised to stockpile their own.
28.
Monitoring one’s own body temperature is essential during an influenza pandemic. UN
staff is advised to purchase individual thermometers.
29.
As influenza is often complicated by secondary bacterial infection of the lungs,
antibiotics could be life saving in the case of late-onset pneumonia. Therefore the UN Country
Team will stockpile three types of antibiotics: Augmenting, Levofloxacin and Azithromycin.
30.
Since syringes and needles may be in short supply and are necessary for administration of
any vaccine, UNCT will procure and stockpile two sets of syringes and needles for 30% to 40%
of all staff and dependents
Personal protective equipment (PPE) and masks
31.
Personal protective equipment (PPE) is primarily for health care workers who are trained
how to use it, and will be stockpiled for this category of staff.
32.
Suspected cases should wear a simple surgical mask in order to limit the spread of the
virus through cough, speech, and fomites. Persons who have confirmed exposure to patients
with fever or clinical respiratory disease should also wear a mask as they may be infectious a few
days before symptoms develop.
33.
For this purpose, the UN Country Team will stockpile N-95 masks.
34.
In the event of a pandemic, it is anticipated that many staff will request masks as they
may provide some sense of security although no guaranteed protection. As a result, masks may
be in short supply. The UN Country Team will stockpile disposable surgical masks for all UN
staff and dependents (2 per day per staff/dependent for 42 days).
Medical care and medical evacuation
35.
Health care facilities in Afghanistan in case of an influenza pandemic will be evaluated.
However, recognizing that such facilities will be limited, a practical guideline for homecare will
be developed by WHO in conjunction with the UN Medical team in country.
-1536
Medical evacuation of severe cases that cannot be dealt with locally will be assessed on a
case-by-case basis according to the realities at the time and ability to use air and or ground
assets.
37.
It is further recognized that in case of an Avian Influenza pandemic people posted in the
regions may need to stay where they are and receive their medical care in site, in accordance
with the existing UN security plan guidelines applicable to their particular province (see
Annex 2).
38.
Adequate amounts of relevant medication and medical supplies will be stockpiled in each
region. These stocks will be under the responsibility of the ASC.
Non-Medical Interventions
39.
All UN staff and their dependants will be required to comply with the public health
measures taken by the national authorities, particularly those relevant to social gatherings (e.g.
schools, cinemas, transportation, etc).
40.
The general recommendations regarding "respiratory etiquette" (put your hand before
your mouth when you cough) and hand washing should be emphasized. Educational material and
information materials will be given to all staff members both in English, Dari and Pashto.
a.
Workplace
The individual agencies have identified their essential and non-essential staff
members for the purposes of possible relocation. This identification will guide
plans for use of drugs, vaccines (when available in a limited amounts) and need
for staff to ensure that certain work is completed (administrative responsibility).
Should Phase Four of the UN Security Plan be declared, all technical staff from
FAO and WHO involved in outbreak control should be considered as essential
staff.
b.
Quarantine
Voluntary quarantine must apply to staff or dependents having suspect symptoms
or having been in contact with cases. If a staff member has a relative or someone
else at home suspected to be affected by pandemic influenza, he/she should
refrain from going to work and inform his/her respective agency of the situation.
In addition, he/she should as soon as possible start a course of Tamiflu and wear a
mask when meeting with other people.
c.
Meetings
In a pandemic is declared, all face-to-face meetings will be reconsidered in line
with WHO public health measures recommended at the time. Teleconferences and
the Internet will be used as an alternative to face-to-face meetings.
d.
International Travel
WHO recommendations on international travel will be followed.
-16-
e.
Precautionary Measures and Restricted Movement
At an early stage, in case of localized outbreaks of influenza with pandemic
potential, the Designated Official will convene a meeting of the Security
Management Team (SMT) with the objective of reviewing the situation and
declaring security phase I or II as appropriate. Advance planning for the
relocation of non-essential recruited staff members should be considered as a
preparation for the declaration of security phase IV.
Symptomatic (e.g. feverish) persons should not travel unless under special
circumstances.
National staff should remain at home and keep themselves updated on the current
situation using different public sources (such as the media) and the UN
information system. They should follow the guidelines laid down by WHO and be
aware that isolation is likely to be the best course of action during this stage.
f.
Relocation of Staff
In case of increasing pandemic risk in a region, it is likely that neighboring
countries will be affected quickly and disruption of travel and health services is to
be expected.
As soon as WHO Pandemic Phase 5 is declared with cases confirmed in the
country or in a neighbouring country, the Designated Official will recommend to
the Secretary-General that Phase Four of the UN Security Plan be declared. As
indicated under Phase Four of the UN Security Plan, those non-essential
international staff, who are not ill and have no exposure to a known case will be
advised to relocate directly to their country of origin where health services are
less congested, providing this is the case.
Ultimately, relocation will probably not protect against exposure to a pandemic
strain (it might either delay it or increase chances of infectious contact through
travel) but it could ensure access to better quality of care in case of infection.
Staff about to be relocated will be screened by a UN-designated physician before
their departure to decrease the risk of spread of the disease through their
movement.
All national staff should receive an advance payment of their salary to a
maximum of three months. In addition the costs of relocation transport should be
paid to those members of the national staff who would wish to relocate
themselves and their recognized dependents to a more isolated part of the country.
It should be noted, that the medical facilities available in the rural areas may not
be as well developed as those in the capital. It is important to avoid large transport
vehicles such as buses and pick-up trucks. Hiring of private transport may be the
-17best course of action. National staff who would plan to relocate at this stage
should inform their agency administrative office well in advance so that adequate
relocation funds can be made available.
The remains of deceased international staff and as a result of the pandemic
influenza may not be allowed to be repatriated and will be subject to WHO
guidelines for disposal. As the repatriation of bodies may be an unlikely option
under the pandemic realities, the bodies may have to be cremated in Afghanistan.
In preparation for the prospect of staff casualties, the UN Country Team will
stockpile mortuary bags.
As from WHO Pandemic Phase 5 and until the pandemic alert has been officially
declared over, all UN staff remaining in the country should check their body
temperature at least once daily and notify the WHO or UN physician on duty of
any respiratory symptoms, such as cough or any fever (temperature above or
equal to 38°C) by phone. In this instance, a crisis control centre would be
established to assist the team.
g.
Communication
1. General communication
The threat of a pandemic will create a high demand for information both within
the UN and from external partners. It will be vital to coordinate the information
that is circulated by headquarters, regional and country offices. A country
communication plan will be prepared to rapidly provide proper information to all
UN staff. This should identify who is responsible for coordinating UN
information and communications. Clear internal and external communication will
be essential to rapidly deal with rumors and anxieties.
2.
Emergency communication
In the likely event of staff home isolation, it is important to remember that mobile networks will
be congested and that staff will most likely be required to use VHF (Very High Frequency)
radios as the main and most reliable means of communications.
Each agency is responsible to ensure they have enough VHF radios.
UN emergency contacts play an important role and the existing security warden system will be
used for communicating with staff within their area (see Annex 4). The Security Wardens both
all regions will be well briefed during all pandemic phases.
-18-
Annex 2
TEMPLATE FOR THE CONTINGENCY PLAN FOR PANDEMIC – PROCUREMENT
Action
Quantity
Seasonal human flu
vaccines
For staff and dependants who
are at high risk for
complications from influenza or
who will be travelling
internationally. If supplies allow
it can also be made available to
all other UN personnel and their
dependents.
Pandemic strain
vaccines
For Proposed Priority Groups
for Pandemic Vaccine refer to
Annex 6
Antivirals:
Treatement
Tamiflu
(Oseltamivir)
A 5-day treatment course for
30% of staff and their
dependents.1 Increase by 10%
for a cushion. (10 capsules per
course)
Antivirals:
Prophylaxis
Tamiflu
(Oseltamivir)
One tablet per day for 6 weeks
primarily for healthcare workers
and those performing critical
functions with high risk of
exposure (42 capsules/person)
Unit cost
(in US dollars)
$
7.3/dose
7.3
N/A
0
16.4/pack of 10
capsules
16.4
Notes
Single dose syringe
Not expected to be
available for at least 6
months after the
pandemic virus has
been isolated
Treatment
Prophylaxis
IF SUCH A SUPPLY IS NOT AVAILABLE OR IS CONSIDERED UNRELIABLE, CONSIDER STOCKPILING
THE FOLLOWING SYRINGES
Syringes and
needles**
One set of syringes and
needles per staff member and
dependent
12.0/pack of 100
(half 5 ml and
half 10ml
syringes with
23G and 21G
needles)
0.12
Need to order in blocks
of 100 at minimum
1
For purposes of prophylaxis and treatment, “staff and their dependants” denotes all staff members and their
recognized dependents and all other individuals who have a direct contractual relationship with the organization
and their recognized dependents.
**
To ensure injection safety, if injectibles have to be used at the local facilities, this stockpile is not specific for
pandemic.
-19-
Action
Quantity
Unit cost
(in US dollars)
$
Notes
IF SUCH A SUPPLY IS NOT AVAILABLE OR IS CONSIDERED UNRELIABLE, THE FOLLOWING ANTIBIOTICS SHOULD BE STOCKPILED
Antibiotics
Amoxicillin (500 mg)
+ Clavulanic Acid
(125 mg)
1 course of 30 tablets for 7.5%
of staff population
Available as
blister 10x5
tablets (30
tablets per
course: US$
4.50)
$4.50
Oral drug to be used for
secondary (bacterial)
pneumonia – good for
S. pneumonia
Antibiotics
(fuoroquinolone)
Ciprofloxacin
1 course of 20 tablets for 2.5%
of the staff population
Available as 100
tablets/bottle or
blister 10x10
500 mg tablet:
(20 tablets per
course US$ 0.56)
$0.56
Oral drug to be used for
secondary (bacterial)
pneumonia if not
responding to
Augmentin – good for
H. Influenza but may
not be good for S.
pneumonia
Antibiotics
Azithromycin
1 course of 5 tablets for 2.5% of
staff population
Available as 6
caps/bottle
(Cipla, India:
US$ 1.08)
4caps/bottle
(Durbin, U.K.:
US$ 23.08)
500 mg tablet
once per day for
five days
$1.08
Taken once per day for
five days – Staph and
S. pneumonia and also
for those allergic to or
not responding to
amoxicillin.
$23.08
Note should be taken of the expiry date and unused antibiotics should be donated to local
healthcare facilities in good time for use and restocked accordingly.
Repatriation of
bodies of deceased
international staff and
family members
(mortuary bags)
3% of international staff
population
PPE Kit
For health workers and those
performing critical functions
with high risk of exposure
Simple Surgical
masks
2 per day per staff and
dependents x 42 days
Sub-total
Shipping
Contingency fund
TOTAL
Packing, freight, insurance
18.0
18.0
$50.00
(This unit cost is
less from the
previous quote of
$130.07)
$50.00
0.06
0.06
When local
availability is not
sufficient
The cost of one kit
with supplies to cover
2 changes for 42 days
is $650.00 as per
Annex 3.
3 ply
-20-
Annex 3
PERSONAL PROTECTIVE EQUIPMENT KIT (PPE)
FOR MEDICAL AND PARAMEDICAL STAFF, AND OTHER STAFF WHOSE CRITICAL
FUNCTIONS ENTAIL HIGH-RISK EXPOSURE *
This is an average supply that has been worked out for this category of staff, calculating 2 changes
per day for each person for 6 weeks.
Item
Description
Unit
Quantity
Per day
Quantity
for 6
weeks
Unit price
in USD
Total cost
for 6
weeks in
USD
1
Protective goggles, polycarbonate, reusable
Each
3
N/A
$8.00
$24.00
2
Face mask grade P2 (or N95), disposable
BX/20
2
84
$0.49
$41.16
3
single use gloves, small, anatomically shaped,
latex, non-sterile
PAIR
10
420
$0.06
$25.20
4
Single use gloves, medium, anatomically
shaped, latex, non-sterile
PAIR
10
420
$0.06
$25.20
5
Single use gloves, large, anatomically shaped,
latex, non-sterile,
PAIR
10
420
$0.06
$25.20
6
Single use plastic apron,
EACH
2
84
$0.07
$5.88
7
Rubber Gloves (reusable for environmental
cleaning
PAIR
10
N/A
$3.00
N/A
8
Coverall, disposable, non sterile
EACH
2
84
$5.38
$451.92
9
Alcohol rub disinfectant** – Dangerous goods –
UN code 1987, Class 3
bottle/
1000ml
1
N/A
$8.25
$8.25
10
Disposable bag for bio-hazardous waste –
1 bag per day for 6 weeks.
EACH
1
42 bags
N/A
$0.35
$14.70
42 bags
11
Disposal bag for bio hazardous waste, small,
with “Bio-Hazard” print, polypropylene –
1 bag per day for 6 weeks
EACH
1
42 bags
N/A
$0.35
$14.70
42 bags
Total US$ 636.21
*
**
This PPE kit is not adequate for veterinarian purposes including for culling.
This should be procured locally to avoid problems with shipping of dangerous goods. If it cannot be supplied
locally, order separately. Alternatively, chlorhexidine gluconate 4% solution in bottles of 250 ml each (that
means 4 bottles per kit to equal the liter requirement per kit), could be procured.
-21-
Annex 4
HEALTH ADVISORY ON SELF PROTECTION FOR TRAVEL TO/THROUGH OR LIVING
IN OUTBREAK REGIONS
The following recommendations are directed to UN staff and their recognized dependents
travelling to/through or living in areas where avian influenza A (H5N1) outbreaks among poultry
or human H5N1 cases have been reported. These recommendations may be revised as more
information becomes available.

To minimize the possibility of infection, observe precautions to safeguard your health.
Specifically, travelers should avoid touching live or dead poultry (e.g., chickens, ducks,
geese, pigeons, quail) or any wild birds or their feces, and avoid settings where H5N1infected poultry may be present, such as commercial or backyard poultry farms and live
poultry markets.

Do not eat uncooked or undercooked poultry or poultry products, including dishes made
with uncooked poultry blood.

As with other infectious illnesses, one of the most important preventive practices is
careful and frequent hand washing. Cleaning your hands often, using either soap and
water (or waterless, alcohol-based hand rubs when soap is not available and hands are not
visibly soiled), removes potentially infectious materials from your skin and helps prevent
disease transmission.
When preparing food:

Separate raw meat from cooked or ready-to-eat foods. Do not use the same chopping
board or the same knife for preparing raw meat and cooked or ready-to-eat foods.

Do not handle either raw or cooked foods without washing your hands in between.

Do not place cooked meat back on the same plate or surface it was on before it was
cooked.

All foods from poultry, including eggs and poultry blood, should be cooked thoroughly.
Egg yolks should not be runny or liquid. Because influenza viruses are destroyed by heat,
the cooking temperature for poultry meat should reach 70°C (158° F).

Wash egg shells in soapy water before handling and cooking, and wash your hands
afterwards.

Do not use raw or soft-boiled eggs in foods that will not be cooked.

After handling raw poultry or eggs, wash your hands and all surfaces and utensils
thoroughly with soap and water.
-22If you believe you might have been exposed to avian influenza, take the following precautions:

Monitor your health for 10 days.

If you become ill with fever and develop a cough or difficulty breathing, or if you
develop any illness during this 10-day period, consult a health-care provider. Before you
visit a health-care setting, tell the provider the following: 1) your symptoms 2) if you
have had direct poultry contact, and 3) where you traveled.

Do not travel while sick, and limit contact with others as much as possible to help prevent
the spread of any infectious illness.
-23-
Annex 5
PROTECTING YOURSELF AND OTHERS AGAINST RESPIRATORY ILLNESS
Respiratory illnesses like influenza are spread by coughing, sneezing or contaminated hands. To
help stop the spread of microorganisms,
 Cover the nose and mouth when coughing or sneezing
 Use a tissue and dispose of it after use in the waste.
 Clean your hands after coughing or sneezing
o Wash with soap and water or
o Clean with alcohol-based hand cleaner.
 If using a surgical mask, dispose of it carefully after use and wash hands.
 Be careful with respiratory secretion (e.g. coughing and sneezing) when around other
people.
o It may be best to avoid contact with individuals at risk (small children or those
with underlying or chronic illnesses such as immune- suppression of lung disease)
until respiratory symptoms have resolved.
For staff in high-risk situations see Annex 7
-24-
Annex 6
PROPOSED PRIORITY GROUPS FOR PANDEMIC VACCINE
Proposed Priority groups for pandemic vaccine:
Group
1. Health professionals (healthcare providers and relevant public health specialists e.g. WHO/FAO)
2. Staff performing critical functions with high risk of exposure
3. Remaining staff performing critical functions
4. Persons at high risk of severe or fatal outcomes following influenza infection
 staff and dependents with high risk medical conditions
 immunocompromised
 >65 years of age
 children between 6 – 23 months of age
 pregnant women
5. Children 24 months to 18 years
6. Healthy adults
Even though the recommended priority groups are determined, they will be continually revised in light
of new information that is learnt about the pandemic virus.
When sufficient pandemic influenza vaccine is available, the entire staff population will be offered
vaccination.
-25-
Annex 7
USE OF PERSONAL PROTECTIVE EQUIPMENT KIT
If full personal protective equipment needs to be worn, please note the
following.
The order for putting on personal protective equipment is not important, however, for
practicality, the following sequence is given as an example:
 When required, wear boots / or shoe covers with trousers tucked inside
 Wear a mask (N95 or equivalent). This should be correctly fitted ensuring a good face
seal
Mould the nose piece to the shape of your nose. Ensure there is a correct seal.





Wear a gown
Wear an impermeable apron if splashes of blood or body fluids are expected
Wear a cap
Wear protective eye wear / goggles (reusable, wash with water and detergent after every
use)
Wear gloves with gown sleeve cuff tucked into glove
Removing personal protective equipment.
The key principle when removing personal protective equipment is that the wearer should avoid
contact with respiratory secretions and other contaminants. Mask should be kept on until all
other PPE is removed. Hands should be washed or decontaminated with 70% alcohol solution
once all PPE has been removed.
-26The following is an example of how to remove personal protective equipment:
 Remove gloves.
 Remove gown/apron.
 Remove goggles and cap.
 Remove boots (if worn).
 Remove mask. Do not touch face
 Wash hands or decontaminate hands using 70% alcoholic hand-rub.
Full personal protective equipment using coverall instead of a surgical gown
Hood of coverall
Coverall
(Reference: WHO. Practical Guidelines for Infection Control in Health Care Facilities, WHO,
2004.)
-27-
Annex 8
LIST OF 6-WEEK SUPPLIES TO BE STOCKED
Water
Stock bottled water or store water in plastic containers such as soft drink bottles
A normally active person needs to drink around two litres of water each day. Plan to store 4 litres
of water per person per day (2 litres for drinking and two litres for household use such as food
preparation and sanitation). Water requirements will also depend on other factors such as
temperature, in hot climates an individual’s water requirement may double and children, nursing
mothers and those who are ill often require additional supplies.
You should store enough water for at least a six-week period. Water purification kits or filters
are readily available and should be purchased as a back up.
Food

Store a six-week supply of non-perishable foods, you may wish to consider if you can
start a vegetable garden and what you could grow yourself during the winter season, in
order to supplement your provisions.

Select foods that require no refrigeration as electricity supplies may not be available.
Consider how you will cook the food, if you need to stock up on gas bottles, for example.
As clean water may be limited, choose foods that require little or no water to prepare.
Foods that you may consider are:
 Ready-to-eat canned meats and soups, fruits and vegetables
 Dry goods such as noodles (remember that you will need to allow for enough
water to cook these items). Dry cereal, granola, dried fruits and crackers
 Canned juices
 Peanut butter or nuts
 Staples (salt, sugar, pepper, spices, etc.)
 High energy foods such as protein or fruit bars
 Food for infants – canned or jarred baby food and formula
 Comfort/stress foods
 Pet food

Other supplies such as soap and water or alcohol based hand wash
 Buy extra garbage bags and cleaning supplies; viruses such as Avian Influenza are
easily cleaned away with formalin and iodine-based disinfectants. For bathing
soap and water is sufficient
 Spare contact lenses
-28 Denture and personal hygiene needs (tissues, toilet paper, disposable diapers)

Other supplies (continued)
 Hearing aid batteries
 Fire extinguisher (make sure you all know how to use it)
 A clock that runs off batteries (include spare batteries)
 Flashlight
 Extra batteries
 Portable radio
 Manuel can opener
Food Storage Advice

Keep food in the driest and coolest spot in the house – a dark area if possible. Make sure
that it is sealed off from possible vermin

Keep food covered at all times

Open food boxes or cans carefully so that you can close them tightly after each use.

Wrap cookies and crackers in plastic bags, keep them in tight containers, this will stop
them from going stale and prolong shelf life

Empty opened packages of sugar, dried fruits and nuts into screw-top jars or airtight cans
to protect them from pests

Inspect all food containers for signs of spoilage before use

If you lose power, minimize waste by using the food in your fridge first, then the freezer
and then finally your non-perishable items
Shelf Life of Foods for Storage
Here are some general guidelines for rotating common emergency foods.
Use within six months:
Powdered milk (boxed), dried fruit (in metal container), dry, crisp crackers (in metal container),
and potatoes
Use within one year:
Canned condensed meat and vegetable soups: canned fruits, fruit juices and vegetables; ready-toeat cereals and uncooked instant cereals (in metal containers); peanut butter, jams; hard candy,
chocolate bars and canned nuts
May be stored indefinitely (in proper containers and conditions):
-29Wheat: vegetable oils; corn; backing powder, soybeans, instant coffee, tea, vitamin C and cocoa,
salt, non-carbonated soft drinks, white rice, bouillon products, dry pasta, powdered milk (in
nitrogen-packed cans)
Fuels



Purchase an emergency supply of petrol/diesel for your car
Buy extra provisions of candles, paraffin lamps, batteries, etc. as electricity supplies may
not be available
Consider how you will prepare foods and consider non-electrical alternatives
Disposal of Wastes
Remember that if there is movement restrictions imposed in an area, the collection of waste may
not be possible. It is important that you consider alternative arrangements such as composting
food wastes, worm farms, etc. If you live in a multiple storey building, ask the building manager
if there are emergency plans in place to deal with not only waste disposal but also possible
disruption to water and electrical supplies
Medical Kits
Emergency services may be limited during a time of crisis, therefore make sure your home
emergency medical kit is not out-of-date, check all supplies for expiry dates and replace any
items that are out-of-date or nearing the expiration date.
You may wish to consider the following items:

Glucose and blood pressure monitoring kit

Adhesive bandages, various sizes

Sterile dressings, small and large

Conforming roller gauze bandage

Triangular bandages

Packs of sterile gauze pads, large and small

Adhesive tape, 2” width

Pairs of medical grade non-latex gloves, medium and large

Waterless alcohol-based hand sanitizer

Antiseptic wipes

Anti-bacterial ointment

Cold pack

Scissors (small, personal)

Tweezers
-30
Thermometers – remember to have a spare

CPR breathing barrier, such as a face shield

Face masks, 3-ply simple surgical masks

Pain and fever reliever – remember to include both children and adult supplies
Medical Kits (continued)

Anti-diarrhea medication

Antacid (for stomach upset)

Vitamins

Fluids with electrolytes (an oral rehydration solution (ORS))

Stock up on prescription medications that you might need, for example, if one of your
family members is diabetic, ensure that you have enough supplies for at least 6 weeks, or
if someone has a heart condition, ask your doctor for an extra prescription so that you can
have an emergency supply of all the medications your family members need.

You may need extra bedding if a family member becomes sick, such as sheets, towels,
plastic mattress covers, etc. Consider where you could make up a sick bay which could
be isolated from the rest of the house, how would you ventilate this room? It is important
that air from the room is expelled to the outside of the house and not back into the house,
consider how this might be done
____________
-31-
Annex 9
Medical Facilities in Afghanistan
(Updated: March 2006)
I. REGION: Kabul
A. Hospitals/Clinics
1. International Security Assistance in Afghanistan (ISAF) Hospital
Location:
Along Jalalabad Road, about 2 kms. East of UNOCA compound
Facilities:
Capable of responding to all medical emergencies; Minor and
major trauma and surgical cases; Minor and major surgical
emergencies; Can assist UN staff in medical and surgical
emergencies but cannot provide ambulance in transporting
patients; Cannot meet all consultations because medical services
are dedicated mainly to their own military personnel.
Contact person:
RCC but through UNAMA Medical staff.
2. UNOCA Medical Clinic
Location:
Inside United Nations Operation Center for Afghanistan (UNOCA)
Compound, Jalalabad Road, Kabul
Facilities:
Provide primary care medical services, minor surgical procedures,
advance life support, laboratory, ultrasound, x-ray and dental
facilities. Has 11- bed capacity for patients’ observation from two
to five days. Extra 9 beds can be provided when necessary.
Contact Persons
Dr. Elvira G Ramos
Radio Channel 11, 17
Cell phone # 070286289
Radio Call sign: Golf 255
E-mail: ramos11@un.org
Dr. M. Munir
Cell phone# 070286292
Radio Call sign: Golf 250
E-mail: mmunir@un.org
-32Dr. Joel Binalingbing
Cell phone# 070606770
Radio Call sign: Golf 253
E-mail: jbinalingbing@un.org
Mr. Gul Nabi, Nurse
Cell phone# 070293509
Radio Call sign: Golf 25
E-mail: gulnabigulnabi@un.org
Staff Counsellor
Mr. Jorge Sierralta
Cell phone # 00 93 (0) 70 222766
Radio Call sign: Golf 228
E-mail: sierralta@un.org
3. UNDP Dispensary
Location:
Inside UNDP compound, Zambaq Square
Facilities:
Provide Primary Medical Services; Medical Consultation and
treatment 2 beds capacity for observation
Contact Details:
E-mail: dispensary.afg@undp.org
Digital Line: 2101691
Mobile phone: 079345373
Radio Channel 11
Contact person:
Dr. P. Nagarajan
UNDP Dispensary Physician
Mobile Phone: 0799761996
Dr. Mohammad Abidi
UN Dispensary Physician
Call sign: Kilo Delta 61
4. *Area Mine Action Centre (AMAC)
Office Address:
House No. 275, St. 14 Wazir Akbar Khan Kabul
Contact Details:
Sat. Phone:
Fax:
E-mail:
00870 762 918 170
00870 762 918 171
javed@unmaca.org
-33Contact Person:
Habibul Haq Javed
Area Manager
Mobile: 070 295 444
Akbar Oriakhil
Operations Assistant
Mobile: 070 223 352
Ajmal Ahmadzai
Admin/Finance Asst.
Mobile: 079 232 982
*
Can provide first aid treatment and can stabilize patients and
evacuate to the nearest hospital; AMAC/SAMAC knows where the
Field Medical Units are located; and can send the nearest Field
Medical Unit to the site of accident.
5. Blossoms Medical and Health Services- 40 beds capacity
Location:
Hanzala Mosque Road. Shehr-e now Kabul
Contact Person:
Dr. Mansoor Jamal
Mobile Phone: 070298397, 079330202
E-mail: mjm786_99@yahoo.com
Dr. Abdul Malik
Mobile Phone: 070235065
E-mail: blossominfo@yahoo.com
6. Cure International Hospital: 130 beds capacity
Location:
Darulaman Road, near Darulaman Palace, Kabul
Contact Person:
Erin Card
Mobile phone: 079156047
E-mail: card_em@hotmail.com
B. Security Officers: Kabul Region
UNDSS:
Terry Davis, CSA
Mobile Phone: 070 281 673
Radio Channel: 16
Call sign: Alpha Zulu 1
E-mail: davist@un.org
-34Michael Godfrey UNDSS COO
Mobile Phone: 070 281 882
Radio Channel: 16/17
Call sign: Alpha Zulu 2
Phone: 0039083134
E-mail: godfrey@un.org
UNAMA:
Wame Waqanivavalagi DSCA
Mobile Phone: 070 286 285
Radio Call sign: Golf 5
E-mail: waqanivavalagi@un.org
Allen Gay Jr. Security Officer
Mobile Phone: 070 250 350
Radio Call sign: Golf 53
Jai Prakash Keshri Security Officer
Mobile Phone: 070 250 345
Radio Call sign: Golf 54
II. REGION: Gardez
A. Medical Facilities
1. UNAMA Medical Clinic
Location:
Inside UNAMA compound.
Facilities:
Provide daily patients’ consultation and treatment of the UN Staff.
Respond to medical and surgical emergencies, stabilize the patients
and if needed evacuate patients to reliable medical centers.
Perform minor surgical procedures. Provide pre-hospital trauma
management. Do the required vaccination for the staff.
Only one bed is available for observation. Available for
emergencies for 24 hours.
Contact:
Dr Bareen Najeebullah
National Medical Officer
Mobile Phone# 079-822334
Intermission Extension: 6221
VHF Radio Call Sign: November Golf 3
E-mail: bareen@un.org
2. Gardez Civil Hospital (supported by IbneSina):
-35-
Location:
1 Km from UNAMA office
Facilities:
Can only provide basic first aid treatment and basic OPD. Can’t be
relied upon due to lack of instruments, diagnostic tools, and
medications. 50 Beds capacity in different wards
Contact person:
Dr Nazar Mohammad Habib Ahamad zai
Phone#079282130
3. Sub-Area Mine Action Centre (SAMAC)
Office Address:
Next door to UNAMA office
Contact Details:
Mirwais Hussaini
Operations Assistant
Mobile # 079-012567
Sat Phone: 00873763062565
Thuraya: 008821621129187
Email: wais_1380@yahoo.com
Mohammad Hakim Sulemanzai
Mobile # 079-116831
Facilities:
SAMAC can provide first aid only. SAMAC knows where the
field Medical Units are located; can send the nearest Field Medical
Unit having an ambulance to the site of accident that can perform
first aid treatment and carry patient to nearest hospital.
4. PRT/Coalition forces base dispensary:
Location:
About 3-4 Km from UNAMA compound
Facilities:
Can provide basic life support, minor trauma and surgical
emergencies but cannot attend to all medical or surgical cases as
their services are dedicated to their military personnel and/or
serious life threatening non-military emergencies. 4 Beds for
Emergencies.
Contact person:
Major McGill
Phone#: 079-471834
-36B. WHO Doctor:
Dr Shamsher
STC ( short term consultant) for Polio eradication program
No First aid or consultation facility
Phone#: 079-226152
Thuraya# 008821633330437
E-mail: shamsher@afg.emro.who.int
Security Officers

UNDSS:
Jean-Luc Massart
FSCO SER/Gardez
Basic first aid in case of emergencies
Phone# 0799 037470
E-mail: massart@un.org

UNAMA:
Reaz Ahmed, DFSCO
Mobile# 079-179304
Email: ahmed75@un.org

UNHCR:
Imal Shahab, DFSA
Mobile# 079-813049
Email: shahabi@unhcr.org

IOM:
Hortensia Vidaurim,HoO
Mobile# 079-569753
Email: hvidauri@eikmail.com
III. REGION: Kandahar
A. Hospitals/Clinics
1. UNAMA Medical Clinic:
Location:
Inside UNAMA Compound, Hindoo Chawk, Shahre naw,
Kandahar City.
Facilities:
Can provide Medical and surgical first aid, Investigation, diagnosis
and treatment of OPD patients. Evaluating patients for evacuation
to the nearby/other well equipped hospitals. Provide 24-hour
medical services for emergencies only. Only one bed is available
for observation.
Contact:
Dr. Najibullah Najib
National Medical Officer
Phone: 079-152514/ 070281184 Ext: 6706
E-mail: najibn@un.org
-37-
2. Chinese Hospital or MIRWAIS Hospital (Government but Funded by ICRC)
Location:
Near Dand Chawk, District One, Kandahar City (4. km. away from
UNAMA compound)
Facilities:
Have Medical, Surgical, Orthopedic, Gynea/obstetric, Pediatrics,
Dental, Ophthalmologic, ENT, and ICU wards daily POD of each
department. OT for surgical, Orthopedic and Gynea/Obstetrics
Wards. X-Ray, USG, ECG, Routine Laboratory Investigations are
available ambulance Service is available 200 Bed Capacity
Contact:
Dr. Abdul Jabar MD
Deputy Chief of Health Department
Tel: 070 304 352
Dr. Mohammad Khalid MD
M.O. Surgical Ward
Phone: 079 333 704
Dr. Humayoon Noorzad MD
M.O. Medical Ward
Phone: 070 311180
3. Military Hospital (Government)
Location:
Kabul Doorahi, District 10th, Kandahar City. (10 km. away from
UNAMA compound)
Facilities:
Have Medical, Surgical, Orthopedic, and ICU wards.
X-Ray, USG, ECG, Routine Laboratory Investigations and
Ambulan services are available - 100 Beds capacity
Contact Person:
Dr. Amir Mohammad
Tel: 070 30 60 67
4: Area Mine Action Centre (AMAC)
Office Address:
Kandahar City, Shar-e-Now, and Behind Kandahar Hotel. Next To
AHDS (About 5 km from UNAMA Compound)
Contact Details:
Sat. Phone: 00873 763 063 745
Fax: 00873 763 063 746
Email: amackandahar@yahoo.co.uk
-38Thuraya: 882 162 113 3247
Contact Persons:
Abdul Samay
Area Manager
Mobile: 070 302 037
M. Moqim Noori
Operations Assistant
Mobile: 070 304 703
Sayed Murtaza Mahboub
Admin/Finance Asst.
Mobile: 070 302 126
Facilities:
5:
6:
Can provide first aid treatment and can stabilize patients and
evacuate to the nearest hospital; AMAC/SAMAC knows where
the Field Medical Units are located; and can send the nearest Field
Medical Unit to the site of the accident .
KAF /Coalition Hospital:
Location:
25 km. away from UNAMA compound
(In Kandahar airport)
Facilities:
Medical, Surgical, Orthopedic, Pediatric, Psychological,
Gynea/obstetric ICU wards, X-Ray, USG,ECG, Routine and
Advanced Laboratory Investigations are available
15 Beds For Emergencies
Contact Person:
MAJ. Woll, Medical Superintendent
MAJ. Grocia DMS
Al-Shefa-u-Khedmat Hospital:
Location:
In Pacha Jada, Near To Shekarpoor Darwaza, Distric 3 -Kandahar
City (8 km. away from UNAMA compound)
Facilities:
Have Medical, Surgical, Orthopedic, Gynea/obstetric and ICU
wards X-Ray, USG,ECG, Routine Laboratory Investigations and
Ambulance services are available
20 Beds Capacity
Contact Person:
Dr Mohammad Naseem MD
Medical Superintendent
Phone: 070 307088
-397:
Al-Hadi-Farhad Hospital (Pvt):20
Location:
Heart Darwaza Kandahar City,
(4km away from UNAMA compound)
Facilities:
Have Medical, Surgical, Orthopedic, Pediatric, Gynea/obstetric
and ICU wards X-Ray, USG,ECG, Routine Laboratory
Investigations and ambulance services are available 20 beds
capacity
Contact Person:
Dr.Abdul Ghani Mesbah MD
Phone: 070303526
8: Kandahar Central Polyclinic (Gvt):
Location:
Heart Darwaza Kandahar City,
3-4 km away from UNAMA compound
Facilities:
Have Medical Surgical, Ophthalmologic, Gynea/Obstet, Dental,
ENT, Dermatology and Psychological department.
Diagnostic investigations and blood Bank are available.
No admission services (only part time service)
No Beds for patients
Contact Person:
Dr. Payenda Mohammad Arghandabi MD Medical Superintendent
Cell Phone: 070 301888
B. Security Officer:
Rodney Cocks FSCO
Cell phone: 070 224 954
E-mail: cocks@un.org
Shafiq Ahmad AFSCA
Cell Phone: 070 302 583
E-Mail: unama2@un.org
C. WHO Medical Officer:
Dr. Shahwali (MD. DTM&H)
National Health Coordinator
E-mail: Popals@afg.emro.who.int
Mobile #: 070 303356
-40-
IV.REGION: Kunduz
A. Hospitals/Clinics:
1. UNAMA Medical Clinic:
Location:
Facilities:
UNAMA Office
Can provide Medical and surgical first aid, Investigation, diagnosis and
treatment of OPD patients. Evaluating patients for evacuation to the
nearby/other well equipped hospitals. Provide 24-hour free medical
services. Only one bed is available for observation.
Contact:
Dr Shahin Entezari
National Medical Officer
Phone: 070-182741
Ext:
6418
E-mail: entezari@un.org
2. 200-bed Hospital :
Facilities:
200 beds capacity with different medical, surgical, pediatric, Gynaecology
wards.Lab facilities available
Location:
Bandar Kabul, near Sedrak 3km From UNAMA.
Contact person Dr. Homayoon Khamosh
Mobile# 079-359-470
3. Military Hospital:
Location:
Near the Qomandany..About 1.5km From UNAMA
10-bed
Contact person Dr. Zulmai Alfat
Mobile# 079-204-974
4. PRT (ISAF) Hospital:
Location:
Near midan Pakhta .2km from UNAMA with more facilities.
6 Beds capacity for emergencies
Contact person. Dr Simon
Phone Mobile# 079-549-567.
-41-
5. AMAC – Area Mine Action Center
Location:
House # 143, Kasani Street, Muhkaberat road. Kunduz City
Contact person: Eng. Said Agha
Mobile phone: 079 226 274
E-mail: amackunduz@yahoo.com
Said Moqim
Mobile phone: 070 042 159
E-mail: sayedmuqim@yahoo.com
Facilities
B.
Can provide first aid treatment and can stabilize patients and evacuate to the
nearest hospital; AMAC/SAMAC knows where the Field Medical Units
are located; and can send the nearest Field Medical Unit to the site of
accident.
Security officer: Viliame Seruvakula
Ext:
AFSCO Kunduz NER
Phone # 079 681 096
Email:seruvakula@un.org
V. REGION: Jalalabad:
A.
Medical facilities in Jalalabad.
1.
UNAMA Medical Clinic:
Location: UNAMA Office
Facilities: Can provide Medical and surgical first aid, investigation, diagnosis and
treatment of OPD patients. Evaluate patients for evacuation to the
nearby/other well equipped hospitals. Provide 24 hour medical services.
Only one bed available for observation.
Contact:
2.
Dr. Mohd. Omar Bahaand
National Medical Officer
Phone: 070 179513
Ext: 6530
E-mail: bahaand@un.org
Nangarhar Public Health Hospital
Location: On main Kabul-Jalalabad highway, 2 Km west of UNAMA office
-42Facilities: Surgical, Medical, Gynecology and Pediatrics related emergencies and
treatment could be tackled. Laboratory services available.
500 beds capacity
Contact Person: Duty Medical Officer
Phone: 070 636364
3. University Hospital
Location:
On main Kabul-Jalalabad highway, about 1 Km East of UNAMA
office
Facilities:
Surgical, Medical, Gynecology and Pediatrics, Eye and ENT related
emergencies and treatment could be tackled. Laboratory services
present. 350 Beds capacity
Contact Person: Duty Medical Officer
Phone: 070603591
4. *Area Mine Action Centre (AMAC)
Office Address:House # 668, Bank Street, Cheshma-e-Khanjee, Ward#3, Jalalabad
Contact details: Sat Phone: 008707 6346 7825
Email: mullah jan@yahoo.com
Thuraya: 8821 651120 301
Contact persons: Mullah Jan: Area Manager
Mobile phone: 070 230 802
Shir Agha Ahmadzai
Mobile phone: 079 364 089
E-mail: shir_agha@yahoo.com
Facilities:
Demining Field Medical Units can only provide first aid treatment
and can stabilize patients and evacuate to the nearest hospital;
B.
Security Office
Christian Fredriech, AFSCO
Ext: 6520
Mobile# 079-402576
Email: friedrichs@un.org
C.
WHO Medical Doctor: Dr. Hassan Paraq
Tel. 070 252 652
-43-
VI. REGION: Bamyan
A.
Hospitals/Clinic
1. UNAMA Medical Clinic:
Location: Inside UNAMA compound
Facilities: Can provide Medical and surgical first aid, Investigation, diagnosis and
treatment of OPD patients. Evaluating patients for evacuation to the
nearby/other well equipped hospitals. Provide 24-hour free medical services.
Only one bed available for observation .
Contact:
Dr. Zabihullah Zaheer
National Medical Officer
Phone: 079-825953
Ext: 6458
E-mail: zzaheer@un.org
2. Ministry of Health Bamyan Hospital (Government owned but partly Funded by
ICRC and MSF)
Location: 500 meters away from UNAMA office
Facilities: Can provide medical and surgical emergencies
Can perform abdominal and thoracic surgery
Cannot provide ambulance for transport of patients
70 Beds capacity
3. Area Mine Action Centre (AMAC)
Location: San Aseyab, West Side of Governor’s Office, Bamyan Center, Bamyan
Contact : Abdul Qader Qayumi:
Email: qayomi73@hotmail.com
Mobile#: 070 404 434
B.
Security Officer:
Andrzej Chlebowski, UNAMA Security officer
Ext: 6499
Mobile# 079-393273
Email: chledowski@un.org
-44-
VII. REGION: Mazar Sharif
A.
Hospitals/clinics
1. UNAMA Medical Clinic:
Location: Inside UNAMA Office
Facilities: Can provide medical and surgical first aid, investigation, diagnosis and
treatment of OPD patients. Evaluating patients for evacuation to the
nearby/other well equipped hospitals. Only one bed available for observation.
Available for 24 hour medical services.
Contact:
Dr. Mohd. Salim Maqsood
National Medical Officer
Ext: 6992
E-mail: salim3@un.org
Mobile# 070606773
2. Jordanian Military Hospital
Location: Beside Mazar Airport, about 17 kms. Away from UNAMA compound.
Facilities: Open 24 hours, ICU and operating rooms.
Can perform minor and major surgical operation
Can provide medical consultation and treatment.
Ambulances are available. Number of beds not known.
Contact : Col.Dr.KASAB
Cell phone: (0) 79 122 348
Staff is changing every three months.
3. Civilian Hospital
Location: South of blue mosque, hospital Road, about 2 kms. Away from NAMA
compound.
Facilities: 100 Bed capacity, different medical branch, Open 24h
Provide Ultrasound, x-ray and Laboratory services.Indian doctors’ team is
working in OT and OPD.
Ambulances are available.
Contact :
Dr. Mirwis Rabi head of health in Mazar
Cell phone: (0) 70 503 600
-454. Military Hospital
Location:
Medical faculty Road, about 3 kms. away from UNAMA compound.
Facilities:
200 Bed capacities, ICU, CCU, OT,
Ambulances are available.
Limited services for military personnel but tapped in case of emergency.
Supported by National Army,
Contact :
Dr. M.Asif Bromand in charge of hospital
Cell Phone: (0) 70 501 881
5.
Eye Hospital
Location:
Shortagozar Street
Facilities:
40-bed capacity, well equipped, Supported by IAM
Contact
Dr Zia Ammon
Cell Phone: (0) 70 507 099
6. PRT base
Location:
Baba Yadgar about 4km away from UNAMA compound.
Facilities:
2-bed for observation and emergency
Ambulance is available and equipped.
Contact :
Dr. Duncan Roberson
Cell phone: (0) 79 489 634
7. Area Mine Action Center (AMAC)
location:
House # NA, Street #1, Karta-e-Bakhter Mazar City
Contact :
Habib khan Zazi, Area manager
Mobile phone:(0) 70 502 710
E-mail: habibzazi@yahoo.com
Azizullah –Operation Assistant
Mobile phone: 079 436 125
E-mail: azizullah_99@yahoo.com
Facilities:
Can provide first aid for victims and evacuate to the nearest hospital.
-468. HALO Trust demining organization
B.
Facilities:
Can provide first aid for victims and evacuate to the nearest hospital.
Contact :
Dr Hamed, Local manager
Cell phone: (0) 70 507 824
E-mail: habibzazi@yahoo.com
Private clinics
Psychotic Hospital
Location:
Haji Hayat Street
Facilities:
20-bed capacity, well equipped
Contact:
Dr Nadeer Alemi
Sayed Qadeer Sayed Diagnostic clinic
C.
Location:
Opposite of 100-bed hospital
Facilities:
x-ray, ultrasound and Lab. exam
Phone No (0) 79 403 211
Security officer:
James Bell (Area security officer) UNDSS
Phone # (0) 70 500 926
E-mail: bell/UNAMA
VIII. REGION: Herat
A.
Hospitals/Clinics
1. UNAMA Medical Clinic:
Location:
Clinic inside UNAMA compound
Facilities:
Daily consultation and treatment of the UN staff members. Respond to
medical and surgical emergencies, stabilize the patients and if needed
evacuate patients to reliable medical centers. Perform minor surgical
procedures. Provide pre-hospital trauma management.
Do the required vaccination for the staff. Only one bed available for
observation.
Available for emergencies 24 hours.
.
-47-
Contact :
2.
Dr Khalil Ahmad Aazar
National Medical Officer
Ext: 6634
Mobile# 070-403370
Email: aazar@un.org
Herat Regional Hospital
Location:
Herat city 10km from UNAMA office
Facilities:
400 beds hospital 24h functioning:

Emergency service

Surgical ward (major& minor surgery)

Medical ward

Infectious diseases ward

Gynecology ward

Pediatric ward

TB ward

Stomatologic ward

S T D office

X-Ray

Ultra sound

ECG

DC shock

Blood Bank

LAB(Routin, Biochemistry, Serologic Blood tests Urine analysis)
Contact :
3.
Dr.Raofa Niazi
Phone # 009340223412
DAC Hospital:
Location:
15km for from the city
Facilities:






Contact person
50 beds hospital:
Medical ward
Surgical ward
Pediatric ward
Gynecologic ward
X-Ray
LAB
Dr. Saidah Said
Phone # 009340443590
-48-
4.
PRT/Coalition forces base Dispensary:
Location:
About 12 Km from UNAMA compound
Facilities:
Can provide basic life support, minor trauma and surgical
emergencies but cannot attend to all medical or surgical cases as
their services are dedicated to their military personnel.
Contact person:
Enrico Mara
Phone:
223445 - 224457
5.
AMAC (Area Mine Action Center)
Location:
House # 1104, Ameriat Street Hirat
Contact Persons:
M. Shafiq Yousofi - Area Manager
Mobile phone: 070 500 860
E-mail: shafiqyosufi@yahoo.com
Ashoqullah – Operation Assistant
Mobile phone: 079 211 411
E-mail: ashoqullahhedayet@yahoo.com
B. WHO Doctor
Dr Rasoli
Phone#: 222391
-49Annex 10
Afghanistan Countrywide Budget for Avian Flu
Item
Quantity
Cost per
person
(USD)
Population
Covered
13,000
Stockpile
Quantity
Total
budget
(USD)
Drugs
Tamiflu anti-viral
treatment
10
capsules/person USD 16.40
Tamiflu anti-viral
prophylaxis
42
caps/pers/6wks
Augmentin antibiotic
40% = 5200 52,000
85, 280
USD 68.88
5% =
44,772
30 tabs/persons
USD 4.50
10% = 1300 39,000
5,850
Ciprofloxacin 500
20 tabs/persons
USD 0.56
10% = 1300 26,000
728
Azithromycin
Avian Flu vaccine
05 tabs/person
not available
yet
USD 23.08 10% = 1300
USD 5.04
Thermometer
84/persons/6
wks
1/person
Syringes and needles
1 set/person
USD 0.12
Medical/ Front line
persons
PPE Kit (Annex 3)
2/person/6wks
USD
636.21
1 pc
USD 18.0
1 pc
USD
768.00
Medical Individual
Protection
Face masks (Simple)
Body Bags (Mortuary
bags)
Transfer case
USD 1.00
650
95% =
12,350
100% =
13,000
100% =
13,000
5% = 650
6,500
39
30,004
1,037,400
62,244
13,000
13,000
13,000
1,560
650
3% = 390
0.30% =
27,300
413,536
390
7,020
39
29,952
693,946
Shipping Cost and
Insurance
Total Cost
15% total
amount
104,091
798,037
-50Annex 11
Afghanistan Countrywide Cost Sharing Formula
UNITED NATIONS DEPARTMENT FOR SAFETY AND SECURITY
AFGHANISTAN
Avian Flu Country medical stockpiling of medicine and medical equipment
SER# AGENCY NAME
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
WFP
UNHCR
UNAMA
UNICEF
UNDP
UNV
UNODC
HABITAT ????
IMF
ADB
ANBP
UNESCO
IOM
W.BANK
UNFPA
FAO
ILO
UNOPS
IRIN
UNEP
WHO
UNMACA
UNIFEM
TOTAL STAFF
Int. SMs
Estimate
Dependants # Total Int.
Nat. SMs
PERCENTAGE
for Each
& Nat
National (3)
36
114
4
10
8
220
582
4
75
1000
660
1746
12
225
3000
916
2442
20
310
4008
8.72
23.24
0.19
2.95
38.15
47
7
420
17
1260
51
1727
75
16.44
0.71
9
22
66
97
0.92
7
5
15
27
0.26
1
6
5
14
15
42
21
62
0.20
0.59
28
6
283
170
22
2556
510
66
7668
708
94
10507
6.74
0.89
Not Included
Not Included
Not Included
$69,572.85
$185,476.95
$1,519.06
$23,545.40
$304,419.18
Not Included
Not Included
$131,170.64
$5,696.47
Not Included
Not Included
$7,367.43
Not Included
$2,050.73
Not Included
$1,595.01
$4,709.08
Not Included
$53,774.65
$7,139.57
$798,037.00
Total Cost
COST PER PERSON
TOTAL COST
798,037
$75.95