REVIEW OF HEALTH SITUATION

floods -2010

Overall SituationDisease ThreatsResponseRecommendations

Pakistan: Flood Affected Districts

Province Total affected districts

Districts affected

AJK 7 Bagh, Kotli, Mirpur, Muzaffarabad, Neelum, Poonch, Sudhonti

Balochistan 6 Barkhan, Bolan, Jhal Magsi, Kohlu, Naseerabad, Jaffarabad, Sibi

Gilgit- Baltistan 4 Diamer, Ghanche, Ghizer and Skardu

KP/ FATA 19

Bannu, Battagram, Buner, Charsadda, Chitral, Dera Ismail Khan, Haripur, Kohat, Kohistan, Lower Dir, Mansehra, Mardan, Nowshera, Peshawar, Shangla, Swat, Tank & Upper Dir, Mohmand Agency

Punjab 18

Attock, Bhakkar, Chakwal, Gujrat, Hafzabad, Jhang, Khushab, Lahore, Leiah, Mianwali, Multan, Muzaffargarh , Nankanasahib, Rahim Yar Khan, Rajanpur , Sargodha and Sialkot

Sindh 19

Badin, Benazirabad, Dadu, Ghotki, Hydrebad, Jacobabad, Jamshoro, Kambar, Kashmore, Khairpur, Larkana, Matiari, Naushero feroz, Shikarpur, Sukkur, Tando Allah Yar, Tando Muhammad Khan, Thatta and Umerkot

Total 73Source: NDMA, PDMA

Province Deaths Injured Houses Damaged Population Affected

Balochistan 45 98 75,261 672,171

Khyber Pakhtunkhwa 1,068 1,056 179,874 4,365,909

Punjab 103 350 500,000 8,200,000

Sindh 71 408 462,251 3,684,267

AJK 69 83 6,472 245,000

Gilgit Baltistan 183 60 2,820 8,561

Total 1,539 2,055 1,226,678 17,175,908

Source: NDMA, PDMA

Total population *17.1 million

Male 8,379,000

Female 8,721,000

Women of CBA 3,762,000

Pregnant Women 513,000

Children Under five 2,907,000

Above 65 684,000

*Source: NDMA

Province Population Affected

Affected under 5

years of age

Maternal Health Services

Expected Diarrhoeal

Cases

Expected Malarial

Cases

Balochistan 672,171 114,269 20,166 67,217 46,916

KP 4,365,909 742,205 130,977 436,591 654,886

Punjab 8,200,000 1,394,000 246,000 820,000 1.230,000

Sindh 3,684,267 626,325 110,528 368,427 552,640

AJK 245,000 41,650 7,350 24,500 36,750

Gilgit Baltistan 8,561 1,455 257 856 1284

Total 17,175,908 2,919,905 515,278 1,717,591 2,522,477

Source : WHO

Province No. of Assessed HF Partially damaged Fully damaged

KP 288 51 13

Sindh 103 23 0

Balochistan 189 28 14

Punjab 388 284 104

Total 968 386 131

Source: WHO

Number of cases

Punjab Khyber Pakhtunkhwa

Sindh Balochistan Total

Total Consultations 958,951 318,032 292,973 26,006 1,595,962Diseases/ConditionsAcute Diarrhea 99,056 51,822 47,103 6,063 204,044

Bloody Diarrhea NR 1,578 8,553 1,138 11,269

Acute Respiratory Tract Infections

105,350 47,200 48,262 3,835204,647

Suspected Malaria NR 2,059 31,654 5,493 39,206

Skin Infections 151,703 55,780 51,641 4,232 263,356

Unexplained fever 83,240 8,418 380 92,038

Snake bite 332 NR 200 137 669

Dog bite 691 NR NR 23 714Source: WHO

Daily pattern of diarrhoel diseases reported from the flood affected districts, Pakistan (29 July - 18 August, 2010)

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Perc

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Balochistan Khyber Pakhtunkhwa Punjab Sindh

15%

17%16%

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18%17%17%

15%

13%

14%15% 15% 16%

15%18%

19%

18% 18%

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1-Aug 2-Aug 3-Aug 4-Aug 5-Aug 6-Aug 7-Aug 8-Aug 9-Aug 10-Aug

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Weekly pattern of acute diarrhea, IDP crisis and hosting districts, Khayber Pakhtunkhwa (2009-2010)

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Epi-week

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2009 2010

17%16%

15%

18%17%17%

14%

17%

12%11%

17%17%

15%

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6-Aug 7-Aug 8-Aug 9-Aug 10-Aug 11-Aug 12-Aug 13-Aug 14-Aug 15-Aug 16-Aug 17-Aug 18-Aug

Pe

rce

nta

ge

23%

17%

19%19%18%

25%26%

23%18%

14%

20%

15%

20% 21%19%

21%

26%24% 23%

33%

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40

29-Jul

30-Jul

31-Jul

1-Aug

2-Aug

3-Aug

4-Aug

5-Aug

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9-Aug

10-Aug

11-Aug

12-Aug

13-Aug

14-Aug

15-Aug

16-Aug

17-Aug

18-Aug

Pe

rce

nta

ge

14%

10%9%

8%8%

14%

10%

0.35%

11%

9%7%

10%

9% 18%6%

8%

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3-Aug 4-Aug 5-Aug 6-Aug 7-Aug 8-Aug 9-Aug 10-Aug 11-Aug 12-Aug 13-Aug 14-Aug 15-Aug 16-Aug 17-Aug 18-Aug

Perc

enta

ge

Province Alerts Out breaks Deaths

KP 41 14 11

Punjab 3 3 0

Sindh 8 2 6

Balochistan 1 0 2

AJK 1 0 0

Total 54 19 19

Province Cholera Kit

IEHK EH kit Medicines(Tons)

Basic surgical kit

Anti Snake Venom

Coverage population

wise

Balochistan 11 2 11 13 3 1150 151,550

Gilgit-Baltistan 3 16 - 18,000

KhyberPakhtunkhwa 87 3 115 35 600 1,032,120

Punjab 21 6 36 61 150 426,173

Sindh 57 8 35 36 5 700 549,700

Grand Total 176 19 200 161 8 2,800 2,677,543

Province BCG OPV Pentavalent Measles TT Vit. A

Balochistan 387 4,629 123 5,570 890 1,105

KP 3,183 199,746 4,442 187,562 23,404 167,969

Punjab 6,928 43,117 17,356 39,265 8,063 10,270

Sindh 4,699 20,709 8,510 13,584 5,788 12,831

Total 15,197 268,201 30,431 245,981 38,145 192,175

Current passive surveillance into active surveillance

Federal task force on diarrheal disease activated

Establishment of Diarrheal Treatment Center (DTCs)

Cholera kits being prepositioned at Multan, Sukkur and Peshawar

hubs

Distribution of 2 million water purification tablets

47 water purification units functional (0 Balochistan, 14 KP, 17

Punjab,15 Sindh,1 AJK)

Province No. of District

Total DTC Established In progress

Under discussion

KP 15 27 11 10 6

Sindh 16 23 1 3 19

Balochistan 8 8 0 4 4

Punjab 8 11 9 0 2

Total 47 69 21 17 31

Establishment of 180 MNCH service delivery points Antenatal services Skilled Birth services Postnatal services Family Planning

Challenges Malnourishment: high rate of abortions and miscarriages Lack/retention of trained Human resource Lack of referral mechanism/services

Federal task force activated- National and International experts

Distribution of 200,000 primaquin anti malarial tablets

Anti malarial medicines delivered in all kits

Distribution of 40,000 LLINs

Long lasting impregnated nets, larvicidal, rapid diagnostic kits

being procured

Mosquitoes repellents are made part of Medical kits being

distributed

Arial spray to be commenced shortly

All the coordination of Foreign teams being carried out at NHEPRN

UAE, Sri Lankan, Jordanian and Palestinian teams on ground and

deployed at Multan, Nowshera, Multan and D I Khan

Turkish Field Hospitals deployed at Sibbi and Khairpur

Saudi Team arriving on 25th of August

Spanish, Italian, Bangladeshi, Saudian and Australian teams have

committed

MoH through PIMS (KP) and JPMC (Sindh)

Launched on 19th Aug 2010

Mobile teams with medicines

40 most affected districts

Male and female doctors, LHVs & nurses, dispensers and

attendant

840 applications received in three days

Logistics and deployment to be finalized in coordination with

Provincial Governments

National Steering Committee on Health Emergency Management

Strong Coordination Mechanism Federal, Provincial & District - NHEPRN Immediate nomination of coordinators- Provincial & District

Establishment of active disease surveillance (DEWS)

Prime Minister’s National Health Volunteer Programme – Coordinated

implementation with the Provinces

Establishment of Diarrheal Treatment Centers at district level