nepal - who · damaged or totally destroyed. as of 5 august 2015, twenty nine of the 50 medical...

HEALTH CLUSTER BULLETIN # 8 6 August 2015

Nepal Earthquake 2015 Reporting period (3 July – 3 August 2015)

5.6 MLLION AFFECTED

7,324 SURGERY

2 22,309 INJURED

8,898 DEATHS

HIGHLIGHTS HEALTH SECTOR

Slightly more than one hundred days into the response, 99% of the destroyed and damaged health facilities have resumed services across all affected districts; however, some services remain interrupted due to landslides and road blockage with the beginning of monsoon.

Rehabilitation of people with orthopedic and spinal injuries resulting from the earthquakes continues, with step-down facilities and referral pathways in place across the country.

One of the eight stool sample collected from ward number 13 and 14 (Balkhu, Kalimati, Kuleshwor, Soltimode) of Kathmandu tested positive for vibrio cholera.

Ensuring uninterrupted access to essential and life-saving health care for all pregnant women, mothers, new-born and children remains a priority.

National Tuberculosis Centre concluded a post disaster needs assessment (PDNA) in 11 of the 14 affected districts for TB programme, which will provide a coordinated and credible basis for recovery and reconstruction activities.

During the reporting period, 12 Foreign Medical Teams (FMTs) continue to support existing health services, while medical camp kits have been replacing damaged and unserviceable primary health centres throughout the most affected districts.

227 HEALTH CLUSTER PARTNERS

3,035

HEALTH CLUSTER ACTIVITIES

MEDICINES & SUPPLIES

>42 TONNES OF MEDICINE DISTRIBUTED

>32 TONNES OF MEDICINE IN IN-COUNTRY STORAGE

PUBLIC HEALTH FACILITIES

446 FULLY DAMAGED

765 PARTIALLY DAMAGED

HEALTH ACTION

103,686 CASES TREATED

31,707 ADMISSIONS

EWARN

32 - 40 SENTINEL SITES

FUNDING $US

45.8

% FUNDED

41.8 M REQUESTED

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A mobile health clinic in Bhumlichok VDC, Gorkha.

1 Policies and Programmes of the Government of Nepal for Fiscal Year 2072-73 (2015-16) Presented by Rt. Hon. President,

Dr. Ram Baran Yadav at the Meeting of the Constituent Assembly/Legislature-Parliament.

Situation Update

August 2, 2015 marked 100 days since the 7.8 magnitude earthquake struck Nepal, killing

more than eight thousand people and injuring almost three times as many. It was one of the

deadliest disasters in the history of Nepal after 82 years of 1934 earthquake. The

devastating April earthquake and repeated and stronger aftershocks resulted in substantial

damages to infrastructure and led to immediate health consequences to population,

particularly residing in the worst affected 14 districts. A total of 446 public health facilities

were completely destroyed while a total of 765 health facility or administrative structures are

partially damaged. Eighteen health workers and volunteers lost their lives and 75 got injured

adding further challenges in the delivery of health services.

Since the day one of the earthquake, Ministry of Health and Population (MoHP) together

with the health cluster partners continued tirelessly to respond to the health needs of the

affected people, initially with the dedicated focus for the management of trauma cases

followed, after one month, by early recovery and rehabilitation priorities, ensuring the

continuity of follow up and rehabilitation care to the injured ones in the worst affected

districts.

Health Cluster, led by the World Health Organization (WHO), is working alongside the

MoHP to support in re-establishing health services, particularly in the remote areas of the

districts where most of the primary health care centres and the health posts were either

damaged or totally destroyed. As of 5 August 2015, twenty nine of the 50 Medical Camp

Kits (MCKs) have been established as an immediate step to resume primary health care

services before the permanent structures are rebuilt.

Nepal Government Policy and Programme for the fiscal year 2015-16 (2072-73 BS)

presented by the President at the meeting of the Constituent Assembly/Legislature-

Parliament on 8 July has emphasized on the smoother service delivery “by completing

repair and reconstruction of government buildings and residences, schools, health

institutions, drinking water and sanitation, roads, electricity, industrial installations and

structures of local bodies by using earthquake resistant technology”1. The government

policy and programme has also pronounced an immediate launch of short-term, medium-

term and long-term plans for rehabilitation and reconstruction of the infrastructure damaged

by the recent earthquake.

Slightly more than one hundred days into the response, 99% of the destroyed and damaged

health facilities have resumed services; however, some services remain interrupted with the

beginning of monsoon: (a) Immunization services were interrupted in the northern VDCs of

Gorkha, Dolakha and Rasuwa districts owing to difficulties in transporting vaccines supplies

and movement of vaccinators and due to landslides, (b) most of the northern VDCs in

Dhading, Dolakha and Nuwakot districts are inaccessible by road due to landslides, (c)

three out of 16 health service delivery points (additional service sites arranged by districts in

addition to the health facilities) remained disrupted due to the absence of health workers in

Public Health Priorities, Needs and Gaps More than three months into the response, the emergency medical needs have been over. As the

resumption of regular health care services are moving ahead, health priorities now transition to

supporting the medium and long-term health system recovery. In this light, the on-going health

priorities include:

o Demolition of damaged buildings and repairing /construction of the health facilities with the

provision of basic equipment and essential drugs.

o Continue providing rehabilitation and follow up treatment support to patients who are

discharged from hospital in Kathmandu as well as other affected districts.

o Ensuring uninterrupted access to essential and life-saving health care for all pregnant

women, mothers, new-born and children remains a priority. Health cluster partners

Dhading district. Table below summarizes the status of health facilities in all 14 affected

districts.

District

Total HF damaged Services Resumed (# HFs)

Fully Partial No

damage Total

Fully

Partial No

damage Total

Bhaktapur 6 14 5 25 6 14 5 25

Dhading 33 13 7 53 33 13 7 53

Dolakha 52 5 2 59 52 5 2 59

Gorkha 55 21 9 85 55 21 9 85

Kathmandu 8 45 13 66 8 45 13 66

Kavrepalanchok 42 49 7 98 42 49 7 98

Lalitpur 9 20 12 41 9 20 12 41

Makwanpur 15 17 14 46 15 17 14 46

Nuwakot 42 19 6 67 42 19 6 67

Okhaldhunga 17 21 18 56 17 21 18 56

Ramechhap 25 27 3 55 25 27 3 55

Rasuwa 15 5 0 20 13 5 0 18

Sindhuli 26 21 10 57 26 21 10 57

Sindhupalchok 63 12 5 80 63 12 5 80

Total 408 289 111 808 406 289 111 806

99.8%

Source: District Health Cluster Situation Report, updated 5 August 2015

The surveillance system for water and vector borne diseases including outbreak control

measures have been in place in all the affected districts. Recently, cases of acute gastroenteritis

(AGE) were being reported to Sukraraj Tropical & Infectious Disease Hospital (STIDH) in the

week of 26 July to 4 August 2015. These cases were from various parts of the Valley and

neighboring districts. Majority of the cases were from ward number 13 and 14 (Kuleshwor,

Kalimati, Balkhu, and Soltimode) of Kathmandu. One of the eight stool sample collected by the

hospital tested positive for vibrio cholera. The preliminary investigation done by Epidemiology

and Disease Control Division (EDCD) and District Public Health Office (DPHO) suggests that the

contaminated water source may be the reason behind the case. The pipe water samples

collected from the area have been sent to National Public Health Laboratory (NPHL) for testing.

together with the MoHP are attempting to address this through the provision of essential

drugs, medical equipment, tents, vaccines and midwifery kits.

o Strengthening surveillance systems of water and vector borne diseases including outbreak

control measures and the management of non-communicable diseases, disabilities, mental

health and injury rehabilitation through the provision of essential medicines and supplies,

and rehabilitation of damaged health facilities.

o Replenishing damaged equipment and supplies.

Due to the ongoing monsoon season, transportation of medicines and medical supplies to health

facilities of remote area of districts becomes difficult, particularly due to road blockage following

landslides and bad weather condition for the helicopter transfer. Reduction of the number of

helicopter flights to transport health commodities due to the changed priorities is also hampering

the timely transfer of medicines and other logistics to the remote area.

Third round of displacement tracking matrix issued by International Organization of Migration

(IOM) on 16 July 2015 indicated that a total of 59,433 people from 11,100 households are living in

104 displacement sites across 13 districts. Two third (66%) of sites assessed reported having

access to functioning health facilities nearby (either on-site or within 30 minutes of distance). Of

these facilities, 44% were managed by government, 26% by local clinics and 10% by different

non-government organizations (NGOs). The IOM reported that diarrhea was the most common

health problem reported in nearly half of the sites (49%), followed by skin infections (8%). In

addition, none of the sites in Kabhrepalanchok, Ramechhap and Rasuwa districts reported having

latrines in ‘good condition’ and all reported evidence of open defecation. The majority of all

displacement sites (74%) had no evidence of hand-washing which heightens the risk of potential

disease outbreak. Below is the status of most prevalent disease at displacement sites:

Source: IOM/DTM-III

There is high possibility of damage of drugs stored in medical tents due to rain water and

unregulated temperature in the remote area.

Tendering process for construction of semi-permanent structures taking longer than expected.

Increasing difficulty in conducting reproductive health (RH) camps due to landslides in

Okhladhunga and Rasuwa districts where there is limited access to RH services. According of

United Nations Fund for Population Activities (UNFPA), the cases of gender based violence

survivors seeking health care services have been increasingly reported from the affected districts.

There is an on-going need to provide shelters and psychosocial support for health workers.

Disrupted delivery of essential health care services for pregnant women, mothers, new-borns and

children due to physical damage of the facilities, on-going monsoon and service under the tents.

22%

15%

1%

1%

1%

3%

8%

49%

0% 10% 20% 30% 40% 50% 60%

None

Other

Malnutrition

Conjunctivitis

Measles

RTI

Skin infections

Diarrhea

Health Cluster Action

Health Cluster Coordination

The MoHP continues to lead fortnightly health cluster meetings with co-leadership from WHO. The

health cluster activities are concentrated in all affected districts and the district level cluster

meetings continue as per the district schedule. WHO continues to coordinate medical relief and

early recovery activities through Health Cluster coordination at the central level and operational

clusters in the highly affected districts.

Post Disaster Recovery and Reconstruction

As the health sector response transitions towards recovery phase, MoHP has established an early

recovery working group led by the Chief of Policy Planning and International Coordination Division

(PPICD) to coordinate with partners who are planning to support MoHP in the reconstruction of

damaged health facilities.

The MoHP has adopted a post disaster recovery and reconstruction strategy with immediate,

intermediate and medium priorities: Immediate priorities are to furnish the districts with necessary

logistics and human resources to ensure follow-up treatment of those injured, resume health

services, and enable the district offices and facilities to deal with foreseen risks and vulnerabilities

of an immediate nature by providing necessary logistics such as drugs and supplies and a budget

for preparedness and rapid response. Intermediate priorities intend to replace the temporary

arrangements (for example, sheds or tent) with short-term arrangements to ensure the continuity

of service delivery and provide routine services in an uninterrupted manner. This would also

include demolition of damaged buildings, accomplishment of repair works and reinstitution of

peripheral health facilities by setting up pre-fabricated structures. Medium term priorities include

the reconstruction of the sector from a longer term perspective to build back better which would

entail setting up of new physical health infrastructure. The graphs below show the intermediate

need for construction/repair work and commitment from the partners (MoU).

Source: MoHP Presentation – Post Disaster Recovery Reconstruction

In line with the Government Strategy, health cluster partners and external development partners

namely: America Nepal Medical Foundation-Nepal, Canadian Red Cross, Doctors for You, GIZ,

Impact Nepal, International Medical Corps, Japanese Red Cross, Karuna Foundation, KOICA,

MdM France, MdM Spain, MSF Belgium, NLR, Nyaya Health, Neuro Foundation Nepal, One

Heart Worldwide, Save the Children, TDH, UNICEF, have either signed or are in the process of

finalizing the MoU with MoHP to support the construction of prefab structures for health facilities in

affected district.

Communicable Diseases

Hospital Based Syndromic Surveillance: The hospital based syndromic surveillance of epidemic

prone communicable diseases initiated in 14 highly affected districts is continued by EDCD under

Department of Health Services in 38 hospitals and primary health care centres (PHCC). The

system covers 21 public and private hospitals in Kathmandu valley and 17 district hospitals,

PHCCs and private hospitals in 11 districts.

The objective of hospital based syndromic surveillance is to rapidly identify any increase in a

number of outbreak prone syndromes and thus triggering alert, verification/investigation and

detection of outbreaks. The surveillance includes eight syndromes: Influenza like illness (ILI),

severe acute respiratory infection (SARI), acute watery diarrhoea, acute bloody diarrhoea,

suspected cholera, fever with rash, fever with jaundice and fever without rash & jaundice. Besides

this daily surveillance system, routine early warning and reporting system (EWARS) also exists in

some of these hospitals. EWARS collects case based information on three syndromes and vector

borne diseases with epidemic potential and some events of public health importance on weekly

basis.

Syndromes trend in 14 districts: There was no significant increase observed in the number of

acute watery and bloody diarrhea and other syndromes in all 14 districts during the month of July,

and none of the districts have reported any outbreak of acute watery diarrhea during this period

except in Sindhupalchowk district. Two suspected cholera cases reported during this period, but

the laboratory results were negative for vibrio cholera.

Outbreak surveillance and rumour verification: EDCD is carrying out daily event monitoring.

Information on outbreaks, events and rumours in earthquake hit districts are collected/received

through media scanning, information from respective district health offices, daily reports from

district health offices, reports received from foreign medical teams, daily telephonic follow and

information received from surveillance medical officers.

All highly affected districts have enhanced their surveillance and have put all peripheral health facilities and health workers on high alert. Reports of possible outbreaks or rumors from periphery are being collected through active telephone calls and zero reporting by respective district health/public health offices.

A suspected outbreak of fever of unknown origin and diarrhea including three deaths was reported from Batase VDC, ward number 1, Sindhupalchok on 7 July. A rapid response team from district health office, Sindhupalchok was mobilized on the same day and another team from EDCD was mobilized next day to the affected village. The teams verified three deaths: a 5 days old neonate and a 2 year old child, who had fever, died at home on 5 July 2015 and a 46 years female having fever and jaundice died on the way to hospital on 6 July 2015. The teams treated 125 cases presenting with fever, jaundice, diarrhoea, cold and cough and headache. Water and blood samples were collected. One of the stool samples tested positive for Salmonella and four others serologically positive to typhoid. A district rapid response team (RRT) including water, sanitation and hygiene (WASH) team visited the affected village on 15 July with additional medicines and WASH materials. Forty more cases were seen and treated. The outbreak was under control by 22 July.

Measles and Rubella vaccines campaign will start from 15 August 2015 in all 14 earthquake

affected districts. The campaign will target a total of 596,757 children aged 6 months to 5 years.

It will be administered together with a dose of Oral Polio Vaccine (OPV) through 8, 375

immunization booths across the affected districts.

Tuberculosis

The National Tuberculosis Centre (NTC) and partners IOM, HERD, JANTRA and BNMT with

WHO logistical and technical support has been assisting district teams (DPHO, DTLO, Health

Supervisor and other key stakeholders) to undertake a Post Disaster Needs Assessment of the

National Tuberculosis Program (NTP) in the 11 most affected districts namely: Bhaktapur,

Dhading, Dolakha, Gorkha, Kathmandu, Kabhrepalanchowk, Lalitpur, Nuwakot, Ramechhap,

Rasuwa, Sindhupalchowk. The National TB Programme PDNA is comprised of three distinct

parts:

o Damage and Loss Assessment (DALA): This will provide an analysis of damages and

losses to the National TB Programme (NTP).

o Qualitative Questionnaire: This will provide a clear understanding of the needs and

planning to reinstate NTP services and Build Back Better (BBB)

o Recovery Framework: The recovery framework summaries the recovery recommendations

from the district. It outlines the short, medium and longer term priorities for the NTP’s

recovery.

The NTP PDNA will provide a platform for the international community to assist the Government in

recovery and reconstruction of the NTP; it will provide a coordinated and credible basis for

recovery and reconstruction planning, incorporating risk reduction measures and financing

plans.

IOM has been supporting in tracing TB patient and NTP’s PDNA in earthquake affected districts.

Support to Health Service Delivery and Provision of Essential Services

MoHP supported by cluster partners has been working to fulfill the vacant positions of health

human resources in the affected districts. A detailed mapping of health human resources is in

progress, which is a follow up of the DPNA and will detail the technical and non-technical;

preventive and curative specialties required for the continuity of basic function in the district as

well as the PHCCs and health posts.

Action medeor e.V. German medical aid organization donated 11 tons of medicines to the Logistic

Management Division (LMD)/MoHP and some medicines and medical equipment to Kirtipur

Hospital and Annapurna Hospital in Kathmandu and Amppipal Hospital in Gorkha. They also

provided a forklift to Americares, who then donated to LMD/MoHP.

British Nepal Medical Trust (BNMT) conducted health camps in Dhading, Kathmandu,

Makawanpur, Nuwakot and Sindhupalchok districts whereby more than 1000 individuals received

free treatment and medicines. They also provided financial and technical support to DPHO

Kathmandu for psychosocial support programme and organized trainings on Post-Disaster

Psychosocial Counselling and Support to various NGOs and delivered counselling to more than

600 individuals in Bhaktapur, Kathmandu and Makawanpur districts.

HelpAge International Nepal has been providing rehabilitation, nursing care, physiotherapy and

counselling support to 20 homeless older people affected by earthquake. In addition, they have

been implementing an integrated free health camp targeting older people. The key activities

include: general health check-up and distribution of assistive devices such as reading glasses

together with psychosocial support and counselling for stress relief in different VDCs of

Kathmandu, Bhaktapur, Nuwakot and Kavrepalanchok district. So far, they completed 11 mobile

health camps in three districts and reached 2,208 beneficiaries (Male: 849; Female: 1,359). Out of

total beneficiaries reached 1,128 (51%) were above 60 years of age. In addition, psychosocial

counseling was provided to 476 people in different VDCs.

Japanese Red Cross Society (JRCS) completed their medical services in Melamchi on 31 July.

They provided service to 13,786 patients in Melamchi PHCC and treated 1,183 patients through

mobile clinics. They completed two batches of two-day workshop for health post staff on 3-4, and

5-6 July focusing on diarrheal diseases and the simple treatment of fracture and dislocation.

Nepal Red Cross Society (NRCS) has been conducting assisted referral services, psychosocial

support and health and hygiene promotion activities together with the human resource and

coordination support to the earthquake affected districts. The major activities include: blood bank

services, first aid services, ambulance services, basic health care services; health and hygiene

promotion (IEC materials distribution, community based health and hygiene activities) through

volunteer mobilization; Oral Rehydration Point trainings for health post staffs and NRCS

volunteers; mosquito net distribution in Kavre district; provision of Psychosocial First Aid (PFA),

Child Friendly Space (CFS) and referrals.

Save the Children continues to support MoHP in reducing direct and indirect morbidity and

mortality due to earthquake through targeted public health interventions, distribution of medical

supplies and equipment, capacity building of health workers and community members, providing

psychosocial support and facilitating the referral services in Dolakha, Gorkha, Kavrepalanchowk,

Kathmandu, Lalitpur, Nuwakot, Rasuwa and Sindhupalchok districts.

Terre Des Hommes (TDH), through the mobile health camps, has been providing post-earthquake

follow up service including general health check-up, dressing, physiotherapy, psychosocial

counseling, maternal and child health (MCH) services, and Tetanus Toxoid (TT) vaccine and

medicine distribution in Kavre and Sindhupalchowk districts. During the reporting period, a total of

9,985 persons (3,716 Male and 6,269 Female) received the services - among them 3,314 were

children. Altogether 981 cases were related to injury – follow up as well as fresh injury caused in

course of removing debris, 490 were MCH services and 83 psychosocial counseling.

UNICEF provided supplies, including nine emergency health kits (basic units), nine medical tents,

1,800 blankets, 700 baby suits, and 462 family hygiene and dignity kits to affected health facilities

to restore primary health care for children and women. It also supported to re-establish cold chain

system (e.g. walk in cooler) by repairing a total of 40 refrigerators in 14 affected districts.

World Vision International delivered 155 tents to female community health volunteers (FCVHs) in

Sindhupalchowk and distributed 241 baby hygiene kits (190 in Gorkha and 51 in

Sindhupalchowk). It also established Women, Adolescent and Young Children Spaces for

counseling and trainings in Fulpigkot, Kubinde, Sanusiruwari of Sindhupalchowk, Dubdhanjyang,

Basheswor of Sindhuli and Palumtar of Gorkha districts.

WHO received drugs donation from various donor partners namely Oman (approx. 3 tonnes),

Operation USA (four 40 feet containers with medical supplies and WASH equipment) and

International Health Partners (1.5 tonnes).

With the monsoons setting in, WHO is deploying 50 MCKs to the 14 worst hit districts where 85%

health facilities have been damaged. The MCKs are being strategically located in the most

affected districts to serve as temporary patient consultation and treatment facilities. These

temporary facilities will ensure the continuity of services during the rainy season. As of 5 August,

29 of the 50 MCKs have been set up and started providing primary health care services. MCKs

have the basic services and facilities including provision for male and female wards, as well as

staff and consultation rooms. They are solar-powered, and with water and sanitation kits as well

as facilities and supplies necessary to ensure reproductive health. This effort has been

collaborated with AmeriCares, FairMed, IOM, UNFPA, UNICEF and WFP.

Trauma and Injury Care

Sub-cluster has been collaborating with the cluster partners and the MoHP to develop a longer

term national strategy on disability prevention and injury rehabilitation. The strategy will be built on

the current short and medium term strategy developed by the sub-cluster.

Handicap International continues to strive for the prevention of post fracture and surgery

complication and enhance mobility and functionality of injured beneficiaries with a proper linkages

and referral of beneficiaries to appropriate service provider as per their needs including to

minimize psycho-social distress. They have been providing physiotherapy (indoor and outdoor

patients in the hospitals), providing assistive devices (wheelchairs, crutches, toilet chairs, and

walker, walking stick and elbow crutches) and providing training on rehabilitation and use of

mobility devices to caregivers in addition to coordination and referral support.

International Organization for Migration has continued an assisted discharge, referral and targeted

transport of the most vulnerable earthquake affected patients with severe injuries or new

disabilities in addition to the psychosocial support to severely injured and disabled patients who

remain in health facilities three months after the earthquake. A total of 417 severely injured and

disabled patients were assisted for transfer, discharge or taken for follow-up from home or

hospital or temporary settlements. IOM is planning to set up a step down care for patients

requiring rehabilitation in Sindhupalchowk district. It is expected to begin service in the first week

of September 2015.

Foreign Medical Teams (FMTs)

A total of 12 FMTs have been providing services in different affected districts:

SN FMT Organization Name Country Team District VDC Name

1 Buddhist Tzu Chi Foundation Taiwan Bhaktapur Bhaktapur Municipality

2 Del Mundo Medicos Spain Ramechhap Ramechhap

3 Canadian Red Cross Canada Rasuwa Dhunche

4 Medcins Du Monde France Sindhupalchowk Pangtang

5 Japanese Red Cross Society Japan Sindhupalchowk Melamchi

6 Norway Red Cross Norway Sindhupalchowk Chautara

7 Medecins sans Frontieres Belgium Dolakha Bhimeswar Municipality

8 Resurge International UK Kathmandu Kritipur Municipality

9 Medical Emergency Response Team (MERT)

Thailand Kavrepalanchowk BHIMTAR

10 Medical Emergency Response Team (MERT)

Thailand Dolakha CHANDENI MANDAN

11 German Red Cross Germany Dolakha Jiri

12 German Red Cross Germany Dolakha Lamidanda

Source: FMT Coordination Cell/MoHP

Injury Rehab Sub cluster is working to clean the data so as to draw a clear picture in terms of the

current case load (number of patients requiring follow up services per districts for example),

services available in and outside Kathmandu valley etc.

Reproductive Health

The FCHV motivational package has been finalized and endorsed by the RH sub-cluster in close

coordination with the Family Health Division and Child Health Division of MoHP. The procurement

for the package is on-going and the distribution to affected districts will start soon. Partners have

committed to delivering this package in each of the affected districts.

RH sub cluster is collaborating with the partners and the relevant divisions of the Ministry to

develop uniform and standard protocol/guidelines for the transit home across the affected districts.

Adolescent Sexual Health Working Group has been developing a menstrual health package which

will be integrated into the school health programme.

Medical Teams International has been supporting to restore maternal and child health services in

Kari, Nalang, Dhola, Chainpur, Salang VDCs of Dhading district targeting primarily the children

under five and women of reproductive age. The project also aims to train approximately 45

FCHVs on integrated management of childhood illness (IMCI). Other activities include: community

IMCI training, distribution of 5,500 hygiene kits and provision of essential medicine to remote

health-posts as well as the antenatal and postnatal care workshops at the community level.

UNFPA distributed a total of 208 RH kits to health facilities in 5 districts (Dolakha, Gorkha,

Makwanpur, Nuwakot and Okhaldhunga) through 6 partner agencies (IMC, World Vision

International, FPAN, ADRA, WHO and MIDSON) and conducted 28 mobile RH camps in 9

districts (Bhaktapur, Dhading, Gorkha, Kabhrepalanchowk, Lalitpur, Makwanpur, Okhaldhunga,

Ramechhap and Rasuwa) reaching 12,571 beneficiaries, including 1,637 family planning (FP)

clients. Eight transition homes have been established in Dhading, Gorkha and Makwanpur

districts providing temporary shelter for 54 pregnant and postpartum women. In addition, three

maternity units have been established in Dhading and Gorkha to provide RH services during the

reporting time.

UNICEF established 22 shelter homes in 11 affected districts directly benefiting 2,388 women and

children while waiting for labour or after delivery for recovery. With these shelter homes, estimated

26,000 women have access to a safe place to stay. This initiative to improve access to essential

care among affected mothers and children is found to be instrumental in addressing inequality as

more than half of the beneficiaries are from lower caste groups.

A total of 83,000 people were reached by 330 UNICEF social mobilizers with life-saving

health/WASH/nutrition information and counselling in 11 most affected districts. 26 nurse

midwives have been supporting 24 birthing centers (three in Sindhupalchowk, four each in

Dhading, Gorkha, Nuwakot and Rasuwa, and five in Dolakha) and eight senior mentors have

been covering 50 birthing centres for onsite coaching and capacity development of health workers

involved in maternal, neonatal and child health (MNCH) programme. 400 private providers are

trained on the revised Integrated Management of New-born and Childhood Illness (IMNCI).

Mental health and psychological support,

WHO has been supporting Patan Mental Hospital to hire one Psychiatrist and one Psychologist to

be deployed to the affected areas.

A new instruction tool for the Mental Health screening has been devised to be used by lower level

paramedics and FCHVs at the community level.

FAIR MED Foundation Nepal organized home visit to provide Psychological First Aid support to

people with particular focus to sick people, children, elderly, disable people, pregnant mother, post

natal mother and new born.

Water, sanitation and hygiene and environmental health

FAIR MED Foundation Nepal conducted training of trainers (ToT) on post disaster health

education for health workers of affected areas of Kathmandu district and volunteers’ orientation in

Shankharapur Municipality with the focus of promoting Hygiene and Sanitation including safe

drinking, hand washing, and personal hygiene.

Training of health human resources EDCD, MDM and district health office, Sindhupalchok organized a-three day training on outbreak

investigation to rapid response team and other health workers of DHO Sindhupalchok.

Funding status of action plan

Funding requirements:

Humanitarian partners revised the Nepal Flash Appeal extending the implementation period from three to five months to ensure linkage with the Government’s recovery programme. The revised flash appeal was re-launched on 2 June 2015. The Health Cluster component of the Flash Appeal plans to respond to the most urgent health needs of 5.6 million people. The revised funding requirements for the Health Cluster amount to US$ 41.8 million.

Funding partners:

As at 5 August 2015, the health component of the flash appeal is 45.8 % funded. Health Cluster’s humanitarian response to the Nepal earthquake has received support from the following contributors: Australia, Brazil, Estonia, Finland, Friends of UNFPA, Italy, Japan, Netherlands, Norway, the Russian Federation, Switzerland, Thailand, and UN Central Emergency Response Fund, USAID, World Health Organization, private sector donors and foundations.

Health Cluster Activities (4Ws)

Health Cluster Partners per district (from 4Ws mapping) Bhaktapur

Adara Development International Medical Corps

Alliance of International Doctors International Organization for Migration

AmeriCares Japan-Nepal Health TB Research Association

Bowberos Chidos Sin Frouleros (Foundation Madrazo) John Snow Research and Training Institute

Buddhist Tzu Chi Foundation Korea Disaster Relief Team

Centre for Victims of Torture Nepal Labour Women & Child Welfare Council

Child Workers in Nepal Nepal Disaster and Emergency Medicine Center

Corps Mondial de Secours Nepal Disaster and Emergency Medicine Center

Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) - HSSP Nepali Cine Artists

Nepal Public Health Association Nurse Teach Reach Inc.

Midwifery Society Of Nepal Pakistan Medical Team

Nepal Public Health Foundation Reach Out Worldwide

Family Planning Association Of Nepal SOS Himalaya

Handicap International The Leprosy Mission Nepal

Health Research and Social Development Forum Transcultural Psychosocial Organization

Helen Keller International United Nations Children's Fund

Help Age International World Health Organization

Indian Medical Association

Dhading

Adara Development John Snow Research and Training Institute

AmeriCares King George Medical College

Banglore Medical College Landseed International Medical Group

British Nepal Medical Trust Medecins sans Frontieres -Belgium

CBM International Medical Teams International

Centre for Victims of Torture Nepal Neplalese Nursing Association UK

Chandrajyoti Integrated Rural Development Society (CIRDS) New York City Medics

Committed Society for Change (COSOC) One Heart World Wide, Nepal

Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) - HSSP Patan Mental Hospital

Nepal Public Health Association Pompiers Humanitaines Francais

Midwifery Society Of Nepal Red Cross Society of China

Nepal Public Health Foundation Seikh Mujib Medical University (Nepali doctors)

Global Outreach Doctors Singapore Medical Team

GOAL Global Taiwan Landseed hospital

Government of Bihar Terre des hommes

Health Research and Social Development Forum Hospital and Rehabilitation Centre for Disabled Children

Himalayan Health Care United Hands Club

International Medical Corps United Nations Children's Fund

International Nepal Fellowship United Nations Population Fund

International Organization for Migration World Health Organization

Jhpiego Johns Hopkins University Center for Communication Programs

Dolakha

Acts World Relief - Beth Israel Deaconess Medical Center Disaster Medical Fellowship Maharastra Team

Centre for Victims of Torture Nepal Medecins sans Frontieres Belgium

Child Workers in Nepal Medecins sans Frontieres Holland

Compassionate hands for Nepal + Natan Medical Service CenterAll Nepal Progressive Public Health Association

CWIN Nepal and TUKI Plan International

Dutch Aid Team The Leprosy Mission Nepal

German Red Cross Trekmedic

Health Research and Social Development Forum United Nations Children's Fund

Indian Air Force World Health Organization

International Organization for Migration World Neighbors

John Snow Research and Training Institute Lifeline Nepal

Gorkha

Adara Development International Organization for Migration

Aides Actions Internationales Pompiers + Action Pompier Pour lUrgence Internationale INTERSOS

AmeriCares INTERSOS-OPPORTUNITY VILLAGE

BG Hospital and Research Center John Snow Research and Training Institute

Canadian Medical Assistance Teams Madhyapur Hospital, Bhaktpur

CARE Nepal Medecins Sans Frontieres - France

COMMUNITY ACTION NEPAL Medecins sans Frontieres Belgium

Nepal Public Health Association Medecins sans Frontieres France

Midwifery Society Of Nepal Medecins sans Frontieres Spain

Nepal Public Health Foundation MountainChild

FAIRMED Psychiatrists Association of Nepal

Good Neighbors International Save the Children

Humanity First Swiss Agency for Development and Cooperation

Indian Air Force SWISS AGENCY FOR DEVELOPMENT AND COOPERATION- Humanitarian Aid


International Nepal Fellowship United Nations Population Fund

World Health Organization Working with Local NGO

World Health Organization World Vision International Nepal

Kathmandu

Adara Development Marie Stopes International

AmeriCares Medecins Sans Frontieres - France

Centre for Victims of Torture Nepal Mercy Malaysia

Child Workers in Nepal Materity hospita

Chinese Army Medical Team (Chengdu) MSF France

Cuban Medical Brigade Naya Goreto

Institute of Medicine Nepali Cine Artists

Tribhuvan University Teaching Hospital Netherlands Rescue Team

Department of Psychiatry and MentalHealth NITTE University

Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) - HSSP Project Hope

FAIRMED Prosthetics Orthotics Society Nepal

Family Planning Association Of Nepal Psychiatrists Association of Nepal- America Nepal Medical Foundation

Gift of the Givers Resurge International

Global Medics Save the Children

Government of Karnataka Singapore Army

Handicap International Taiwan Root Medical Peace Corps

Health Research and Social Development Forum Team for Chirayu

Helen Keller International The Leprosy Mission Nepal

Help Age International Transcultural Psychosocial Organization

Indonesia Medical Team UK Emergency Medical Team

Indonesia-Civilian (Indonesia-BNBP) UK Emergency Medical Team

International Charitable Public Foundation for Children in Disasters and Wars UMKE - Members of Turkey's national medical rescue team


International Organization for Migration Vicente Sotto Memorial Medical Center

Interplast World Health Organization

Israel Medical team John Snow Research and Training Institute

Japan Ground Self Defense Force Karisz usar and Medical Rescue team

Japanese Military Karuna Foundation Nepal

Japan-Nepal Health TB Research Association Leo club of Kathmandu Nanasaku

Nepal Apanga Sangh Orthopedic hospital, Jorpati Tribhuwan University Teaching hospital

Kanti hospital Model hospital

Om hospital

Kavrepalanchok

Action Works Nepal Johns Hopkins University Center for Communication Programs

Adara Development John Snow Research and Training Institute

ADRA Kelab Putera I Malaysia

America Nepal Medical Foundation Marie Stopes International

AmeriCares Medical Emergency Response Team (MERT)

Bangladesh Association of Physical Medicine and Rehabilition Medical Help World

Bharatiya Jain Sanghathan Mercy Malaysia

CBM International Nepal Disaster and Emergency Medicine

Centre for International Studies and Cooperation OATH

Chandrajyoti Integrated Rural Development Society (CIRDS) Plan International

Chiang Mai University Maharat Hospital Royal Melbourne Hospital

ChildFund International Save the Children

China Medical Team Special Medical Team of University of Debrelev

Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) - HSSP Sri Lanka Army

Dhaka Community Hospital SWISS AGENCY FOR DEVELOPMENT AND COOPERATION- Humanitarian Aid

Center for Public Health and Environment Development Terre des hommes

Midwifery Society Of Nepal Thai Spinal Rehabilitation Team

Nepal Public Health Foundation The Leprosy Mission Nepal

Hospital and Rehabilitation Centre for Disabled Children UK Emergency Medical Team

Family Planning Association Of Nepal United Nations Children's Fund

Health Research and Social Development Forum United Nations Population Fund

Help Age International World Health Organization

Himalayan Health Care World Neighbors

International Organization for Migration Japan International Cooperation Agency

Iri Shinkwang Presbyterian Church

Lalitpur

Adara Development Indian Air Force

Al-Khair Foundation International Organization for Migration

AmeriCares John Snow Research and Training Institute

Bangladesh Medical Team Nagarik Awaz

Centre for Victims of Torture Nepal Naya Goreto

Child Workers in Nepal Nepal Youth Foundation

China Medical Team Nepali Cine Artists

Hospital and Rehabilitation Centre for Disabled Children Samaritans Purse International Relief

Family Planning Association Of Nepal Save the Children

Good Neighbors International Thai Army

Gwangji-Metrocity Medical Relief Team The Leprosy Mission Nepal

Health Research and Social Development Forum UK Emergency Medical Team


Human Care Foundation World Health Organization

Makawanpur

Acts of Mercy Plan International

CBM International The Leprosy Mission Nepal

Centre for Victims of Torture Nepal United Nations Children's Fund

Family Planning Association Of Nepal World Health Organization

International Organization for Migration

Nuwakot

Adara Development Marie Stopes International

AmeriCares Medecins Sans Frontieres - France

Bhutan Army Team Medecins sans Frontieres spain

British Nepal Medical Trust Nature Care Hospital

Centre for Victims of Torture Nepal Nursing Association of Nepal

Chosum University Hospital, Hope Tree and Kwangju Metropolitan City Patan Mental Hospital

Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) - HSSP Psychiatrists Association of Nepal

Nepal Public Health Association Qatar Red Crescent

Midwifery Society Of Nepal Save the Children

Nepal Public Health Foundation Terre des hommes

Doctors for You The Leprosy Mission Nepal

GOAL Global Transcultural Psychosocial Organization

Handicap International UK Emergency Medical Team


Help Age International Vicente Sotto Memorial Medical Center

InREACH-Nepal World Health Organization

International Organization for Migration Italy Civil Protection

Italian Red Cross Lions Club of Kathmandu, and Norvic hospital

Okhaldhunga

International Organization for Migration SWISS AGENCY FOR DEVELOPMENT AND COOPERATION- Humanitarian Aid

Jhpiego Transcultural Psychosocial Organization

John Snow Research and Training Institute World Health Organization

Ramechhap

Centre for Victims of Torture Nepal Save the Children

Del Mundo Medicos Tamakoshi Sewa Samiti, Manthali Ramechhap

Good People International The Leprosy Mission Nepal

International Organization for Migration United Nations Children's Fund

Medicos del Mundo Spain World Health Organization

Metropolitan Manila Development Authority

Rasuwa

Canadian Red Cross International Organization for Migration

Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) - HSSP

Johns Hopkins University Center for Communication Programs

Kamana Karuna Foundation Nepal

Nepal Public Health Association Save the Children

Midwifery Society Of Nepal The Leprosy Mission Nepal

Nepal Public Health Foundation UK Emergency Medical Team

Family Planning Association Of Nepal UK Fire and Rescue Service USAR

GOAL Global United Nations Children's Fund

Helen Keller International World Health Organization

Helen Keller InternationalMayo Hospital Lahore Human Outreach Project

Sindhuli

Centre for Victims of Torture Nepal Jhpiego

Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) - HSSP United Nations Children's Fund

Nepal Public Health Association Working with Local NGO

Midwifery Society Of Nepal World Health Organization

Nepal Public Health Foundation World Vision International Nepal

International Organization for Migration

Sindhupalchok

Adara Development Japanese Red Cross Society

Association of Medical Doctors of Asia- Nepal Japan-Nepal Health TB Research Association

AmeriCares John Snow Research and Training Institute

BRAC Korean Red Cross

Canadian Military Disaster Response Team Lifeline Nepal

CBM International MAGNA children at risk

Center for Womens Right & Development Malteser International

Centre for International Studies and Cooperation Marie Stopes International

Centre for Victims of Torture Nepal Medcins Du Monde

Child Workers in Nepal Medecins du Monde France

ChildFund International Medecins sans Frontieres Holland

Crises Relief Singapore Medical Emergency Response Team (MERT)

Czech Medical team Medical Teams International

Center for Public Health and Environment Medicare National Hospital and Research Centre

Development

Midwifery Society Of Nepal Miral welfare foundation

Nepal Public Health Foundation National Health Professional Association

Disaster Medics National Medical Organization

Emergency Team Poland New Era

FAIRMED Norway Red Cross

Hospital and Rehabilitation Centre for Disabled Children NPO Tokushukai Medical Aid Team

Handicap International NSI

Haridwar Shanti Kunj One Heart World Wide

Heart to Heart International Plan International

Humanitarian Medical Assistance Psychiatrists Association of Nepal- America Nepal Medical Foundation

Humedica Remote Area Medical

Indian Medical Association Rotary Club of East Calcutta

International Medical Relief Save The Children

International Organization for Migration Sewa Foundation

Israel Forum for International Humanitarian Aid Sustainable Development Center

Japan Disaster Relief Medical Team Team Rubicon

Department of Psychiatry and MentalHealth Terre des hommes

UK Emergency Medical Team The Johanniter International Assistance

United Nations Children's Fund The Leprosy Mission Nepal

Working with Local NGO Transcultural Psychosocial Organization

World Health Organization Institute of Medicine

World Neighbors Tribhuvan University Teaching Hospital

World Vision International Nepal

nepal - who · damaged or totally destroyed. as of 5 august 2015, twenty nine of the 50 medical...

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