The rehabilitation of MoH building Revitalization of CDD Insure sufficient amount of essential drugs and revitalizing the drug distribution systems Provision of medical services to chronic conditions Drug distribution system and cold chain are of the top priority Provide assistance to the most vulnerable groups WHO Representative s Report from the Field: Still Heads of UN Agencies are confined to UNOHCI Headquarters compound; No communication with external world except through Thuraya phones or arranged meetings with staff inside the compound; On 4 May 2003, Dr. Ghulam R. Popal, WHO Representative participated in a Press Conference held at UNOHCI building, attended by 100 journalist and reporters. A brief presentation was given by Mr. Romero Lopez De Selva, UN Humanitarian Coordinator in Iraq. During the press release, Dr. Popal made the following statements: He was happy to be back in Baghdad and re-join a very dedicated team of national staff who remained in Baghdad during the war and provided all needed support required. However, he is sad to see the destruction of Baghdad and the damage of health facilities; He highlighted that the breakdown of disease surveillance system, breakdown of public health programmes, damage done to health facilities, disruption of water and sanitation network will lead to outbreaks of diseases, especially water born diseases and vaccine preventable diseases. The pressing health related action to be taken during such times, is:
Maintain and support the operation of health programmes by provision of support to running cost as well as technical support. WR expressed his deepest appreciation and gratitude to all the health personnel and staff who continued working in the health facilities. They played a major role at a time of crisis putting their own lives and their families at risk to provide the much needed health assistance. This level of dedication and commitment is a good example for others and is highly commended. Dr. Ghulam R. Popal, WHO Representative, still confined to UNOHCI building and not allowed to leave the compound, had a meeting with WHO national staff on 3 rd of May 2003. A number of decisions were taken which are enclosed to the report as annex I. Soon after his arrival in Baghdad, Dr. G. Popal, WHO Representative, was trying to see the MOH Officials. Due to security restrictions, to all heads of agencies, WR was confined to the UNOHCI headquarters in Baghdad and not allowed to go outside of the compound. He sent a message to Dr. Ali Shinan, the newly appointed Head of MOH, former Undersecretary of Health, to meet him at UNOHCI HQs in order to discuss WHO/MOH bilateral issues. Dr. Shinan kindly agreed and paid a visit to WHO Representative on 4 May 2003. The following issues were discussed: Personal greetings from DG and RD to the staff of MOH and appreciations of their hard work during the war. Top priorities of MOH including critical needs of MOH main building in Baghdad as most of their office equipment and supplies have been looted. Dr. Ali Shinan asked for WHO support for the urgent provision of some furniture, computers, communication means, fuel and stationary. o Decision: A team from WHO will meet the MOH staff on 5 May to prepare the list of requirements and hand over to WHO. Immediate
Dr. Popal had a third meeting with the Health Advisor ORHA, (Office for Reconstruction and Humanitarian Assistance) to MoH, Mr. Steve Browning and Mr. Nick Harvey, Humanitarian Assistance (ORHA). Discussions covered three areas: WHO with the help and coordination of other agencies will rehabilitate the damaged system and facilities once assessment is finalized. WHO will re-install the micro-drug programme to enhance the distribution of medicine and medical supplies. Revitalization of Priority Health Programmes including the following programmes: Revitalization of disease surveillance system. Control of priority diseases such as diarrhoea, ARI, Measles, Malaria, TB, Typhoid, MCH, etc. Vaccination Programme. WHO is requested to urgently procure and send to Baghdad Pentostan for the treatment of Kalazar. Issues for OP raised with Head of MoH: 1. Security of warehouses of MOH 2. Security of health facilities and distribution network. 3. Some armed groups (newly emerged parties), have taken control of some health facilities including PHCs and some hospitals. Some groups established new health centres. They made appointments of new heads of some existing centres. Occupying forces to prevent these groups in interfering in the work of centres and to evacuate their armed guards and newly appointees from the centres.
e. WHO will make proper recommendations and give technical advice to MOH on the issues of NGOs registration. Donations: a) Donations should be Needs driven b) Donations should be according to WHO guideline for drug donation c) Cash donation is recommended d) No field hospitals (Instead of bringing field hospitals, the donors to support the existing facilities) e) No consumables except as requested by MOH Priorities: The same as discussed with Dr. Ali Shinan, Head of Ministry of Health WR and Head of UNICEF had a joint meeting with Mr. Steve Browning, ORHA Advisor to MoH to discuss coordination and donations. Other Activities: Meeting with ICRC Head delegation Lunch with European Commission delegates Meeting with WHO/ Iraq national staff Daily security briefing by UN Security Assessment Team. There is a high possibility that Dr. Papal would be authorized to go out of the compound by Wednesday and visit WHO office and related ministries but he is supposed to go back to UN compound in the afternoon. Action to be taken by HQs/ EMRO:
Today the Humanitarian Coordinator for Iraq and Heads of UN agencies had a guided and guarded tour to UN offices when all Heads of Agencies visited and assessed the damage of UN offices. Within their tour, they visited WHO Office in Baghdad where the HC and WR/Iraq inaugurated the office in a simple ceremony. Dr. Ali Hazaa (presently in the Regional Office) Dr. Ibrahim Labouta (presently in the Regional Office) d. The recruitment of the following experts are urgently needed Eng. Mohammed Kassim, Biomedical engineer to be recruited as soon as possible. Dr. Zakir Hussein Dr. Khalil Dawood Dr. Ibrahim Bani on non reimbursable basis from UNOHCI e. The assistance of the following Regional Office staff is highly needed during this critical time in Baghdad and are therefore requested to visit Iraq as soon as possible and upon receipt of security clearance: Dr. Abdul Aziz Salih, to give advice on drug procurement and distribution system Dr. Ezzidine Mohsini to give advice on EPI targeted diseases Dr. Suzan Farhoud to give advice on CDD, ARI and childhood illnesses; f. WHO Treasury to contact UNDP Treasury at HQ level to send to WR Office in Baghdad an amount of USD 100,000. This is based on information received from the Humanitarian Coordinator for Iraq. An agreed upon system for such action is now in place. R- Opening of WHO Office in Iraq 5 th MAY, 2003
Three cases of whooping cough were reported from Ibn Al Asser Hospital in Mosul city. All are 2-5 years of age and were diagnosed on clinical basis and Pharmacy Issues Based on the principle of coordination for fulfilling some of KIMADIA's needs for certain important and vital items of medicine and medical supplies for some of the governorates of Iraq, WHO Baghdad arranged with WHO/ Suleimaniaya for the above purpose. Consequently, on Monday, 5 th May 2003, WHO Suleimaniaya sent 5 trucks full of the required items to KIMADIA warehouses. The value of items sent is within USD 260,000. Other Issues: Dr. Faris Bunni, WHO Medical Officer visited the CDC (Centre for Disease Control) on 5 May to follow up on collection of data of sentinel reporting sites. Data from reporting sites of Resafa was received and currently under compilation. Dr. Faris also visited NPL (National Polio Laboratory) and agreed on the actions that will be taken to incinerate the remaining seeds of wild Poliovirus and documenting that by photos. A proposal was prepared by Dr. Faris and Dr. Nabeel Ibrahim; AFP surveillance focal point to reactivate the past Polio/AFP surveillance in Baghdad and nearby governorates. Tomorrow, WHO/Baghdad will report the results of Rapid Health Assessment of the Dept. of environmental Labs and of Al-Shimokh complex of handicaps in Zafaraniyah-South east of Baghdad which was accomplished by Dr. Moez and Miss layla Hassan. The compound contains 150 houses inhabited by 132 families. Mosul Governorate :
Weekly Morbidity In Mosul City- 27-4-2003 to 2-5-2003 The daily morbidity in Mosul City during the week 27-4-2003 to 2-5-2003 shows that still ARI and diarrhoea are the most frequent diseases in this city, especially in the under 5 years age group (2172 cases of ARI and 1131 cases of diarrhoea). The frequencies of these diseases are also high in the 5 years or over group age. Mental Health and Stress-related problems are relatively high (139 cases). It could be related to the stressful situation during these times. (no security, no job, no food.etc). Trauma and injuries are of high frequencies while other diseases are within the normal levels. Cardiovascular disease is the leading cause of death.