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Earthquake in Peru Situation Report August 22

Health Situation Report
22 August 2007

1. Summary of the general health situation and priorities

Preliminary damage assessment(*)

 

Cañete

Chincha

Pisco

Ica

Other
locations

Total

Deaths

6

75

335

71

16

503

Injured

172

240

100

487

43

1.042

Missing

 

 

 

 

 

 

Homes
Destroyed

928

16.010

16.000

300

1.012

34.250

(*) According to Estimates from INDECI, 21 Aug 2007.

  • In Pisco, the primary affected location, only 3% of the city has water supply at the household level and the rest of the population receives water supply transported through water tankers.
  • The majority of the affected population (more than 30,000 families) have vacated their homes. Many people have been transferred to the shelters, while other lodge in improvised shelters that lack basic sanitation, and still others sleep outside their homes with their furniture and household effects for fear of theft.
  • The priority health priority concerns the shelters. On the subject, the Ministry of Health is working jointly with several national or international institutions (INDECI, Ministry of Housing, cooperation agencies, etc.. ).
  • In the remaining affected locations in Ica, the health network is recovering to normalcy. And, patients are no longer referred to Lima or other places.
  • Greater emphasis must be given to health promotion, with clear messages.
  • The general coordination for managing the emergency has significantly improved. In Pisco, INDECI is coordinating response actions between national and local actors. They have also formed as well as lead an intersectoral EOC in order to better rationalize decisions and use of the existing resources. The Ministry of Health has established a health EOC which is functioning both in Pisco and Ica, which are supported by situation rooms situation for information follow up.
  • PAHO/WHO is supporting the development of a health situation room on the emergency at the Ministry of Health headquarters in Lima.
  • LSS/SUMA has extended its processing points. The INDECI headquarters in Lima has installed a unit to continue to inventory and organize the humanitarian assistance received.

Most urgent priorities for the health sector

    • The different sectors and authorities agree that one of the of highest priority subjects are the shelters and efforts to guarantee the delivery of basic services: safe water; food; mental health, among others.
    • Is necessary to form multidisciplinary teams for public communication and health promotion, in order to educate people regarding healthy habits, hygiene, food management, etc.
    • Maintain the supply and provision of safe water, and management of excreta.
    • Organize and provide psychosocial asístanse.
    • Continue to evaluate the health services network and recovery of the services.
    • Need to strengthen epidmiological surveillence to avoid transmission of diseases.
    • Optimizing effective humanitarian assistance by using LSS/SUMA.

2. General Epidimiological Situation

  • To date there is only information from the province of Ica once a day. During the five days following the earthquake in the province, there has been a downward trend of injuries. The initially high number of psychosocial problems has also shown a downward trend. While respiratory infections, conjunctivitis, diarrheal diseases, and skin infections had increased on the 18 and 19 Aug, they began decreasing on 20 Aug. Initially there were some cases of reported food borne illnesses and dog and spider bites, however, as of the fourth day there have not been any more reported cases of these health problems.
  • The provinces of Pisco, Chincha and Cañete have exhibited a similar situation with respiratory infections as the principal health problem.
  • However, it still is not possible to conclude if the increase of illnesses is caused by the disaster and population displacement, or if it only reflects the greater availability of medical services.
  • The Ministry of Health continues to organize information flow from the affected areas up to the central command in order to maintain a daily monitoring of the affected provinces.

3. General health situation in Pisco

  • Basic services are being reestablished. Telephone communication is being restored, electrical power has been restored in some sectors of the city, although it continues to be rationed.
  • For two days the most affected buildings are being demolished (including part of the façade of Hospital Dos de Mayo). The demolition has created an increased amount of dust in the air, which affects the respiratory tracts and eyes.
  • There are sufficient health workers available to meet the demand for health care. Presently there are additional external workers in the area (both national and international) that need to be organized by the EOC.
  • Current figures on health care show an increase, thanks to better information and greater availability of service. According to the information processed in the EOC, respiratory infections have increased but not cases of diarrhea.
  • Given the pressure from the media and from the community regarding possible epidemics, the Ministry of Health began to fumigate the affected homes. However, the EOC epidemiology team could not confirm firve reported cases of chicken pox in shelters.
  • In the area, the solidarity of the business sector is perceived with the provision of food, telecommunication services, the distribution of clothes, cleaning supplies, etc.

Health services

  • Of the 140 beds and 7 pediatric beds existing in Pisco (50 beds in ESSALUD Hospital and the rest of the Ministry of Health) only 4 (of this last entity) are functioning.
  • In addition to the Ministry of Health, there are several public and private institutions that are collaborating in the delivery of services, among others:
    • ESSALUD (in the field hospital installed in the Main Square)
    • Municipality of Lima (in a mobile clinic installed in the plaza de armas)
    • Municipality of Callao (in a mobile clinic)
    • Institutions of international cooperation (in different health facilities of the Ministry of Health and AECI in two field hospitals located next to two destroyed health centers: San Clemente and Humay)
  • Of the 22 health facilities of the network of Pisco:
    • 18 are functioning (10 of them without electric power and are supplied with water through cisterns), eight of them with the support of external staff, both of the country and from abroad (Cubans, French, Taiwanese, Spanish, Colombians).
    • 2 have not reestablished their services for lack of staff.
    • 2 have been closed from before the disaster.
  • In light of the lack of electricity, 10 electric generators are necessary.
  • The National Institute of Health has evaluated the laboratories of the Chincha-Pisco network and found the 3 principal laboratories, located in the hospitals of Chincha, Pisco, and Ica in operation.
  • The San Juan de Dios Hospital has redistributed its personnel and has general and emergency health care services covered.

Mental Health

  • A diagnosis or damage assessment of Mental Health needs was carried out and a plan of intervention was agreed upon along with the agencies that work in the subject.

Water and Sanitation in Urban Areas

    • DIGESA- General Environmental Health Directorate- is coordinating the institutions and international players involved in areas of water and sanitation through daily meetings.
    • International cooperation has mobilized to the area 14 potable water treatment plants (of different productive capacity), and DIGESA will define its location. The large shelters that will be installed as well as the principal health facilities that lack this service will be a priority.
    • In order to reestablish water and sanitation services in the area of Chincha/Cañete, Ica, and Pisco, the Ministry of Housing has requested the effort of various service providing entities (EPS) of the country. They are supporting the EPS of Pisco (EMASPISCO), that of Lima (SEDAPAL, that has mobilized 56 professionals), Cuzco, and Arequipa. This equipment has the operational support of the Army and is accompanied by the National Authority of Water and Sanitation (SUNASS).
    • The water services in Chincha/Cañete and Ica are recovering upon the return of electricity and the replacement of destroyed health networks. The sewers have been damaged and continue to be an unknown with respect to the extension of damages and its repair, which will take a long time to rehabilitate. While the service is rehabilitated, there will continue to be a distribution of water through cisterns providing the population with bottles of chlorine for domestic disinfection.
    • The management of human waste continues to be a critical subject. The decision to install 500 DISAL latrines with chemical solution chambers are indispensable in the short term but they involve the challenge of its daily operation and the sanitary disposal of the chemical substance and the feces/urine.
    • The ministry of housing is planning to construct 100 latrines, whose location will be defined jointly with health.
    • The excreta management continues to be a critical subject. The decision to install 500 DISAL latrines with chemical solution chambers are indispensable in the short term, but the daily operation and sanitary disposal of the chemical substances and the excreta/urine presents a challenge.
    • The Ministry of Housing is planning to construct 100 latrines, whose location will be jointly defined with the health sector.

Shelters

  • There are 24 registered shelters (some are supplied with tents that have been delivered by national institutions and international cooperation, others are simply "refuges" made of materials recovered from homes and tarps).
  • The Ministry of Health is in charge of health care and as such surveillance of water quality and INDECI coordinates food delivery and the distribution of water using tankers.
  • Mental health actions are being executed with the participation of Ministry of Health professionals, professionals from international organizations, as well as national artists that are deployed to the zone to help the population face recovery.
  • Authorities consider the shelters a priority in care. In light of the situation, INDECI is proposing the installation of large shelters where large groups of the population can be stay. Foreign government ( such as Venezuela), international agencies and the Un will be supporting these actions.

4. General Health situation in Ica

  • The aftershocks in the region continue with less intensity. In the city of Ica, social, economic and productive activities are practically normal.
  • Medical brigades continue to be mobilized to the rural areas and to the outlying areas of Ica.
  • Psychological support to the population and to workers affected by the earthquake has been initiated.
  • In the Regional Hospital of Ica clean up efforts have started in affected areas that are safe enough to work, in order to adapt some services. Outpatient consolations are operating from tents and temporary structures.
  • Patients are being seen in health facilities, network hospitals, and health brigades that are deployed daily (Cañete, Ica and Chincha).
  • Patients are no longer being transferred to Lima; they are being served in the department’s network. Trauma care is at a minimum.
  • There are no established shelters in Ica and as such, people are staying in their yards and in many cases have made provisional housing using recovered materials, mats or other means. People are grouped into small conglomerates of neighbors to receive assistance (Ica, Chincha, Cañete).
  • There exist a small increase in the number of cases of acute respiratory infections and diarrhea, but the Ministry of Health attributes it to the increase of health services offered by the medical brigades.
  • The department of social work of Ica, along with the health sector, has begun the task of assistance to those affected with an evaluation of damages and needs.
  • As of 20 August, 35,000 food rations have been delivered to 35,000 families. Prepared food is not being rationed, and in some cases communal meals are encouraged.
  • There is a health EOC that has daily meetings for the general coordination of activities, resources, needs, etc. there is a situation room where information is managed and analyzed. Tracer diseases, case reports, etc and information is sent at the central level.

5. Humanitarian Assistance. LSS/SUMA Situation in Pisco

The LSS/SUMA team was installed in two points of the Lima-Pisco aerial bridge, which was established by the Peruvian government to facilitate movement between the capital and the affected zone.

As of August 21, the Pisco Aerial Base has received 931 tons, of which 74% is food, drinks and water. These items are being distributed daily by INDECI to district, provincial and region committees of Civil Defense such as shelters, populated centers and settlements in Ica, Chincha and Pisco.

The mobilized team is made up of personnel from FUNDESUMA and the Ecuadorian Red Cross, and has worked with INDECI. The team has relied on the invaluable assistance of Telecoms Sans Frontieres, the UNDAC team and the Argentine White Helmets.

6. General Coordination

  • The general coordination of the emergency management has improved significantly. In Pisco, INDECI is articulating actions between the national and local actors, and has formed and led an intersectoral EOC that is allowing for the better rationalization of decisions and better use of existing resources.
  • Health actions are being led by the Ministry of Health. In Pisco a health EOC has been set up under the coordination of the director of the San Juan Hospital, which is also allowing for more adequate intersectoral action and for more coordinated assistance. Information is updated daily in the health EOC’s situation room.
  • The UNDAC team continues to strengthen the coordination process, supporting the INDECI leadership, articulating the action of actors and providing technical assistance for a better response. They have emphasized the task of the health sector in addressing the treatment and the prevention of the public health problems, as well as in the quality of information that it processed in its situation room.
  • The Peruvian Minister of Health traveled the disaster impact zone along with the Chilean Minister of Health, who offered her solidarity in name of the Chilean and Latin American people. The Peruvian minister pointed out the immediate response of the health sector and thanked all the institutions that have collaborated in the response.

7. PAHO/WHO Actions and Responses

  • Supporting authorities in defining a mass communication work strategy, in promoting health in shelters, and in collaborating actions with the media and other institutional actors that help to protect the public health of affected people.
  • The teams of experts in the affected zones are continue to support damage assessment and health needs, intersectoral coordination, the formation of an EOC in Pisco and the development of a situation room.
  • Coordination with the UNDAC team and other international cooperation agencies in the capital of the country and in affected zones.
  • Supporting the implementation of SUMA-LSS under the coordination of the National System of Civil Defense.
  • Permanent coordination with the UN system and the established EOC.
  • Permanent support to the Ministry of Health in strengthening the leadership and general coordination in health.


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