Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1696591047536.pdf (Vanuatu)
Tropical Cyclone Harold Vanuatu National Health Situation Report #9 – 12 June 2020 HIGHLIGHTS ❖ Following initial reports of increases in communicable diseases in the three most severely-affected provinces of Sanma, Penama and Malampa, decreases in water-borne diseases, influenza-like illness and conjunctivitis have been noted in Samna (although additional malaria cases have been reported).

❖ Other indirect or delayed impacts are still observed especially on nutritional status in rural areas.
❖ Elevated risk of preventable morbidities (NCDs, RAMNCAH) and gender-based violence has been noted.

❖ Integrated outreach programs and other health sector response activities continue in all affected areas.

NOTE: Major updates to figures or text relative to the last Situation Report are indicated blue highlights.

BACKGROUND On 06 – 07 April 2020, Severe Tropical Cyclone Harold made landfall in Vanuatu and caused widespread damage.
The National Disaster Management Office identified health as a sector of immediate need in Sanma, Malampa and Penama provinces.

This Report produced by the National Health Incident Management Team presents a brief overview of the health situation and health sector response to TC Harold as reported by Health Emergency Operations Centers operating at national and provincial levels.
The Tropical Cyclone Harold Health Sector Response Plan has been revised to guide transition from emergency to intermediate and recovery phases.

Provincial plans have been devised accordingly, and implementation for the intermediate phase has commenced.

This document summarises the situation and actions taken, with a focus on the intermediate phase.
IMMEDIATE IMPACT AND RESPONSE The direct impacts of TC Harold on the health of the population in affected areas included deaths and injuries resulting from building collapse, fallen objects, wind-strewn debris, drownings or pre-existing illness.
Full information including for Emergency Medical Team deployments and Health Facility Assessments is provided in earlier Situation Reports, available at: https://moh.gov.vu/index.php/pages/tc-harold INTERMEDIATE IMPACT AND RESPONSE Other indirect or delayed health impacts have resulted following TC Harold due to interrupted health and other public services, destruction of gardens which has undermined food supply, and contamination of water sources.
A brief update on the current situation and actions taken is presented by thematic area in Table 1.

Further information is included in earlier Situation Reports.
MORE INFORMATION ABOUT THE HEALTH SITUATION AND RESPONSE TO TROPICAL CYLCONE HAROLD • MOH website: http://moh.gov.vu/index.php/pages/tc-harold • National Health Emergency Operations Center: nheoc@vanuatu.gov.vu • Vanuatu Health Hotline: 119 • Ministry of Health, Health Promotions Vanuatu Facebook page: https://www.facebook.com/Health- Promotions-Vanuatu-1674266679566197/ • Health Incident Management Team Coordinator: Dr Posikai Samuel Tapo - Mobile: 773 7178 Approved by: Issued: Next SitRep Expected*: Dr Posikai Samuel Tapo, Coordinator - Incident Management Team 12 June 2020, 05.00pm 22 June 2020 *The intention is to issue Situation Reports once every two weeks, though the frequency will depend on the evolving situation.
Page 1 of 3 Table 1.

Updates on situation and actions taken by thematic area, as reported to NHEOC by 12 June at 5.00pm Port Vila time AREA SITUATION ACTION TAKEN Environmental health/ community engagement/ health promotion Mental health / psychosocial support Surveillance Communicable diseases RMNCAH and nutrition • Water-borne diseases: Decreases in water diarrhoea noted • Public Health Integrated Community Leaders Training & Outreach in Sanma.

Slight increase noted in Penama.


program commenced in Sanma; to be rolled out.

• Respiratory infections: Decreases in influenza-like illness (ILI) noted in Sanma, which may be a result of ongoing awareness and hygiene promotion.

Slight increase in ILI noted in Penama.

• Weekly surveillance reporting continues.

• Vector-borne diseases: No new cases of dengue in Sanma.

51 malaria cases confirmed in areas of Sanma that had ongoing transmission prior to the cyclone.
• Other communicable infections: Leptospirosis confirmed for 4 of the deaths reported earlier at NPH.

• Conjunctivitis: Decreases noted in Sanma and Penama.

• Yaws: No additional cases confirmed.

• RMNCAH (Reproductive, maternal, newborn, child and adolescent health): Services affected in Sanma (especially Tasmalum Health Centre), Penama and Malampa due to major infrastructure damage and restricted access to health facilities.
Plan to strengthen sexual and reproductive health in Sanma under finalisation.

• Nutrition: Malnourishment reported in rural areas in Sanma, Malampa and Penama.

• Malaria and dengue mass clean-up and awareness campaign completed in Sanma.

• Water, sanitation and hygiene (WASH) activities continue to be conducted by MOH and partners (handwash stations, hygiene kits, filters and buckets).
• COVID-19 awareness completed in Penama in partnership with Red Cross Society and Vanuatu Disability Society • One person with a mental health condition treated in Penama.

• Public Health Rapid Response Teams continue to investigate and respond to infectious diseases cases and ensure treatment.

• Mass bed net distributions continue in Sanma, Malampa and Penama.
• Ongoing health awareness and commodities distributions (COVID- 19, dengue, malaria, TB, Yaws, scabies, de-worming, hygiene, oral health, nutrition etc.)

• NTD monitoring and de-worming ongoing in Sanma (treated >38,406).

De-worming continued in Penama (treated 3,187).

• Outreach program in Sanma continued so as to maintain standards for provision and access to RMNCAH services and to minimise the risk of mortality and morbidity.
• Sexual reproductive health services provided in remote areas of south Pentecost; 13 deliveries, 83 antenatal mothers and 12 family planning clients seen in Penama.

• Nutrition responses have included screening for malnutrition and distribution of Vitamin A supplements, multi-nutrient powders and albendazole to target under 5s in Sanma (4779), Pentecost (1859) and North Ambrym (459).
Other activities have included management of moderate and severe acute malnutrition, active case finding, nutrition surveillance and high-impact nutrition intervention training.

Page 2 of 3 Immunization • Vaccine-preventable diseases: No increases noted.

Non-communicable diseases (NCDs) • Non-communicable diseases: Cases continue to be reported particularly in rural health facilities in Sanma.
Women, children and adolescents who face crises are in need of in preventable humanitarian morbidities highly expected due to interrupted RAMNCAH services.

assistance; increases • Sufficient stocks of vaccines in Penama following re-stock.

Vaccine mobile outreach conducted in Bwatnapini, Melsisi, Bay Barrier health facility catchment areas.

• NCD screening and management of patients ongoing in communities in Penama; 89 persons treated for NCD conditions.

Other • 2 medical evacuations from Penama to VCH.


• Gender cluster and Vanuatu Society of Disabled People registered vulnerable individuals in Penama.

• Temporary and quick fixes to health facilities (including cold chains) and associated shelters ongoing.

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