Ministry of Health Government of Pakistan

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Ministry of HealthGovernment of Pakistan

• REVIEW OF HEALTH SITUATION
• floods -2010

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Sequence of Presentation

• Overall Situation
• Disease Threats
• Response
• Recommendations

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Pakistan Flood Affected Districts
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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 73
Source NDMA, PDMA
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Situation as of 23rd August 2010
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
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Population Affected
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
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Population Affected and Expected Case Load
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
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Health Facilities Damaged as of 23rd August 2010
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
Initial damaged status of assessed health
facilities
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Disease Situation
  Number of cases Number of cases Number of cases Number of cases Number of cases
  Punjab Khyber Pakhtunkhwa Sindh Balochistan Total
Total Consultations 958,951 318,032 292,973 26,006 1,595,962
Diseases/Conditions Diseases/Conditions Diseases/Conditions Diseases/Conditions Diseases/Conditions Diseases/Conditions
Acute 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 3,835 204,647
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 23 714
Source WHO
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Daily trend of proportion of Acute diarrhea out
of total consultations in flood affected
districts, Khyber Pakhtunkhwa
Khyber Pakhtunkhwa
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Daily trend of proportion of Acute diarrhea out
of total consultations in flood affected
districts, Sindh
Sindh
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Balochistan
Daily trend of proportion of Acute diarrhea out
of total consultations in flood affected
districts, Balochistan
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Punjab Daily trend of proportion of Acute
diarrhea out of total consultations in flood
affected districts, Punjab
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Disease alerts and out breaks
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
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RESPONSE
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Distribution of Essential Medicine
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
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Vaccination Coverage
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
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Response to Diarrhea

• 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)

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DTC Plan
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
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Maternal and Child Health

• 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

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Response to Malaria

• 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

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Medical Teams

• 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)

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Prime Ministers National Health Volunteers
Programme

• 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

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Recommendations

• 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 Ministers National Health Volunteer
  Programme Coordinated implementation with the
  Provinces
• Establishment of Diarrheal Treatment Centers at
  district level

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Thank You