Earthquake disaster in Bam, Iran. Preliminary indication of urgent requirements for those responding to the health needs of the affected population

Transcription

1 Earthquake disaster in Bam, Iran Preliminary indication of urgent requirements for those responding to the health needs of the affected population Prepared by the World Health Organisation 29 th December Geneva Time Situation analysis 1 On 26 December 2003, a severe earthquake, measuring between 6.5 on Richter scale hit the city of Bam in Kemran province Iran.. It destroyed around 90% of houses and at least 60% of the public buildings including 2 hospitals, claimed the lives of more than 20,000 persons, and injured more than 50,000. The entire population of the city of Bam and surrounding villages estimated to be between 100,000 to 120,000 is affected. 2 The devastated city is without power, communication, water and gas supply. Thousands of residents are sleeping outdoors, under blankets in temperatures close to the freezing, without adequate access to food, water and sanitation. They face greatly increased risks of illness and death as a result of communicable diseases. 3 Damage to health facilities is significant. Emergency assistance for health involves the setting up of temporary centres for urgent treatment of injured survivors and persons with medical conditions, the airlift of wounded away from the affected area and priority actions to maintain public health. The airlift operation - using helicopters and planes - has been underway since the quake: many wounded people have been transported to hospitals in other cities and provinces. 4 The Iranian authorities have responded swiftly and organized the response activities but due to the immensity of the disaster have appealed for help from the international community. Search and rescue teams from 20 countries have already arrived and started to look for survivors under the rubble. 5 Blood loss compensation, resuscitation, emergency surgical intervention and medical life saving support activities created a massive demand that consumed the capacities of neighbouring hospitals and health care units. 6 The public health functions include caring for vulnerable groups (elderly people, persons with disabilities and children), ensuring adequate shelter, food and water for all, and responding to the needs of homeless people (including psychosocial needs) whether they are in reception centres, outdoor camps or the homes of others.

2 The World Health Organisation s contribution to the response so far: 7 WHO responded immediately to a request for support from the Ministry of Health in Teheran. An operations room was set up in the Ministry of Helath with WHO's full participation. A medical officer and communications centre have been sent to the affected area and the MO is in a position to provide regular reports to the head of the WHO country team and to the Ministry of Health. 8 The Government s immediate requirement was for cash to enable the Ministry and local authorities to purchase essential items, A sum of US $150 thousand emergency funds, released within hours of the earthquake by WHO's Director General, Dr JW Lee, and Eastern Mediterranean Regional Director Dr Hussain Gezairy, and made available to the Ministry of Health, has already been used to purchase urgently needed items (indeed, as of this afternoon, some $200k has been spent). 9 Items procured include medicines and surgical supplies, water testing and chlorination kits, generators, pumps, fumigators and similar equipment. The items are already being moved to Bam for use by local teams working hard to maintain the health of all in the area, to treat those who are injured, and to minimise the possibility of communicable disease outbreaks. 10 The Ministry of Health has indicated that there is no shortage of qualified personnel to handle the aftermath of the earthquake: however, certain key items (medicines, equipment etc) are in short supply and are needed urgently. To this end, three WHO "Trauma Kits A+B" will be shipped via an Italian Co-operation medical team due to arrive in Iran 28 th December; 3 more such kits will be consigned to the Ministry of Health and shipped a day or two later as transport becomes available. 11 Today (December 28 th ) the MOH developed its list of urgent requirements: this includes surgical equipment, medicines, anti-tetanus immune globulin and emergency equipment (trauma kits). The list is attached. WHO will work with the different groups offering health assistance to identify which of these items is already reaching Iran, and which need to be purchased either from in-country, from nearby locations or if necessary from further afield (ie within Europe). 12 Once resources have been mobilised items still needed will be procured and shipped rapidly to where they are needed. 13 A senior officer from the WHO Geneva Department of Health Action in Crisis, was, on December 26th, deputed to join the UN assessment team that left for Teheran am December 27th. The WHO Eastern Mediterranean Office (EMRO) has also mobilized staff from the region to join the WHO response team. Field mobility has been prepared to facilitate transport and communication of the WHO team in BAm with MOH partners, UN sister agencies, Country office in Tehran and WHO Cairo and Geneva. An

3 additional senior specialist in communicable diseases is on standby in case there is seen to be a need for a focused assessment on means for reducing post-quake morbidity and mortality The WHO strategy for supporting the response during the next week or so: 14 Earthquakes cause high mortality resulting from trauma, asphyxia, dust inhalation or exposure to severe environmental conditions. Surgical needs are important the first weeks. Trauma kits with medicines and supplies are needed. Medicines to care for the acutely and chronically sick will be needed. Provision of clean water, prevention of water borne diseases, waste disposal will be crucial in preventing further deaths. Implementation and supervision of these important public health functions will require support and resources. Effective disease surveillance, monitoring of morbidity and mortality, and outbreak response is needed from the start. 15 WHO will work with national authorities to ensure that there is up to date information on the numbers and profile of people affected, their priority needs, the current capacity for implementing effective responses, and the kinds of future outcomes that need to be anticipated. It is already evident that health issues will be important in influencing the extent of human suffering as a result of this crisis. Hence, priority is being given to rapid assessments of health risks. The WHO team in Bam and Kerman along with partners from MOH and Iranian Red crescent and colleagues from the UNDAC team will undertake a rapid health needs assessment the results of which will be communicated and shared with concerned partners. 16 The WHO-National Authorities assessment of health needs will be subsumed within the consolidated UN appeal to be submitted shortly to the international community. This will cover the full range of needs - all of which are likely to have an impact on the health and well-being of those who have survived this tragedy, and the crisis now affecting the people in the ancient city of Bam and its surroundings. WHO will support the National Health authorities in Iran, local health authorities and the partners from the Iranian Red Crescent to address the Public health consequences of the earthquake. 17 A three tear plan of action is being prepared by the Country office to support the national health activities on: a. Immediate environmental health needs of Bam b. Communicable diseases surveillance, control and epidemic response c. Response and counselling on the post trauma stress disorder (PTSD) 18 Given that there is a substantial international response to Iran s appeal for help, WHO will also support mechanisms to coordinate the planning, reception and use of external assistance for health including logistics and communications capacity as well as to compile, analyse and disseminate health focused progress reports.

4 19 Requirements for funding health-related relief work - in the next 2-3 months - and longer term reconstruction needs, are likely to be substantial. WHO will help the MOH in Iran to liaise with donor countries to cover the requested needs or to seek financial resources in that respect. It seems likely that the urgent inputs and activities required include the following: 1- Funding and procurement of urgently needed supplies and drugs: MOST URGENT: Tetanus Immunoglobulin 2- Ensuring that rapid health assessments are undertaken and health monitoring systems are established 3- Strengthening surveillance of and responses to - diseases 4- Supporting the MOH and local authorities with coordination, planning and reception of external assistance from governments, NGOs and other agencies 5- Helping the MOH to establish an emergency mental health support program for survivors Financial requirements for health support to be administered through WHO (preliminary estimation) for the first 2 Months (Jan-Feb 2004) Activities Requested funds (US$) 1-Reestablishment of Epidemiological 150,000 surveillance, control of disease and outbreak response 2- Rapid assessment and support to 50,000 coordination 2- Support to the management of ,000 seriously wounded victims (supplies and drugs) 3-Ensuring health needs of 70,000 IDPs 150,000 in 3 camps 4- Management of dead bodies 100, Water and sanitation, water treatment 150, Replenishment of drugs and supplies 1,000,000 7-Mental health support program 75, Rehabilitation of the Imam city 800,000 hospital and 7 urban health clinics 7 HAC program coordination, 302,632 monitoring and reporting 8- Program support costs 190,658 TOTAL 3,368,289 Appendices include the latest lists of requirements released by the Ministry of Health that are now being appraised within the context of the UN s joint assessment mission

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