What sectors appear to be the priorities for response? (Tick and rank top three choices) Water Sanitation Food Livelihood support Immediate Shelter Repairing damaged house Clothing, footwear Fuel and cooking materials Health treatment Cultural and religious Support for feelings of fear and insecurity of population Children returning to school Transport and access to affected area Transport and access within affected area (to markets, health care etc) Communication systems Other (name): Identify the sectors where there is the greatest shortfall in capacity for response at the local level (i.e. where assistance from beyond the Dzongkhag /Gewog/Thromde/YenlagThromde will be required)? Sanitation Food Livelihood support Immediate Shelter Repairing damaged Clothing, footwear Fuel and cooking materials Health needs/injury treatment Cultural and religious Support for feelings of fear and insecurity of population Children returning to school Transport and access to affected area Transport and access within affected area (to markets, health care etc) Communication systems Other (name): WASH (Water, Sanitation and Hygiene) Question Pre-emergency situation Existing background information to be compiled Post-emergency situation Information to be collected/estimated % People improved water source: What support has been provided to date for water? Support No. of household covered estimated need Nothing so far New water source Water disinfection tablets Distribution of bottled water Other, explain What support has been provided since the disaster for sanitation (include % of need covered) Nothing Shovels CGI sheets Tarpaulins Other, explain: What support has been provided since the disaster for hygiene (include % of need covered) Nothing Soap Sanitary pads Bathing enclosures Other, explain:
Question Pre-emergency situation Post-emergency situation Percentage of household with toilets: Percentage of household with shared toilet: Percentage of household practising open: SHELTER Question Pre-emergency situation Post-emergency situation How many households require temporary shelter? How many people normally residing in buildings than homes require temporary shelter? Building Number of people requiring shelter Monasteries Boarding schools Staff quarters Government quarters (including armed forces) Others, list Type of shelter assistance most appropriate to the situation (give approximate numbers) Type of material Approximate number required Tarpaulin Tents CGI-sheets Other, list: What are the locally available resources in the community and coping mechanisms that could assist with shelter needs? e.g. manpower available, local materials available, local buildings that could be used to house people... Please describe and comment: What types of temporary shelter arrangements are available in the community, and what is the capacity? Arrangement: Approximate percentage/or number of affected population that can be accommodated: Note if the figure represents number of people or percentage: Beside houses in tents With neighbours/relatives/host families Collective centre (e.g. school building not in use, warehouse, other, explain) There are no temporary shelter arrangements. Site needs to be identified for temporary camp Safe natural shelter (caves, trees) Other, explain: Shortfall for temporary shelter Number of people that authorities need to provide temporary shelter for: Has a site/s been identified that could become a displaced persons settlement or collective centre/s? Yes No NA If yes, give location/s and explain capacity Are any specific weather conditions that need to be taken into account for the setting up the temporary shelters? Comment: Total number of houses reporting damage Damage Grade Number of houses Yes, Grade 1: Negligible to slight damage
Local markets Facilities to prepare food Food related coping strategies Impact on crops Impact on land Impact on livestock EDUCATION Question Pre-emergency situation Post-emergency situation For each educational facility in affected area Background information sources: EMIS, Annual Education Statistics Post Crisis information sources: DEOs office, schools in affected area A separate record will be required for each educational institution in the affected Gewog. This part of the form will need to be reproduced for each educational institution. NAME (of school or educational institution): Location: What kind of educational facility? Primary school High school ECCD NFE Institute College specify Pre-emergency situation Post-emergency situation Time to walk to the nearest road head (from school) Tick one only < 30 min 31 min-1 hr 1-2 hours > 3 hrs Don’t know Not accessible, explain Tick one only < 30 min 31 min-1 hr 1-2 hours > 3 hrs Don’t know Not accessible, explain Time to walk to the nearest farm road Tick one only < 30 min 31 min-1 hr 1-2 hours > 3 hrs Don’t know Not accessible, explain Tick one only < 30 min 31 min-1 hr 1-2 hours > 3 hrs Don’t know Not accessible, explain Time to walk to the nearest feeder road Tick one only < 30 min 31 min-1 hr 1-2 hours > 3 hrs Don’t know Not accessible, explain Tick one only < 30 min 31 min-1 hr 1-2 hours > 3 hrs Don’t know Not accessible, explain Time to walk to the nearest mule Tick one only < 30 min 31 min-1 hr 1-2 hours > 3 hrs Don’t know Not accessible, explain Tick one only < 30 min 31 min-1 hr 1-2 > 3 hrs Don’t know Not accessible, explain What are the main sources of drinking (at the school)? Tick the most used 3 Piped water to school buildings Piped water to school compound to near-by area/compound Public tap Tick the most used 3 Piped water to school buildings Piped water to school compound Piped to near-by area/compound Public tap
Yes, substantial to heavy damage. Grade 3 = moderate structural damage and heavy non-structural damage. Yes, very heavy damage. Grade 4 = obvious, damage. Yes, completely destroyed. Grade 5 = near or total collapse Are alternative or temporary learning spaces, or space for the other activities required to operate the school, required? Type of space For how many? Learning/teaching for students Residential accommodation for students Residential accommodation for staff Office Other, explain: Time to walk to nearest functioning health facility (from school?) Tick one only < 30 min 31 min-1 hr 1-2 hours > 3 hrs Don’t know Health facility not accessible, explain: Tick one only < 30 min 31 min-1 hr 1-2 > 3 hrs Don’t know Health facility not accessible, explain: Number of students Number of girls and boys by age and grade according to school records. # Boys: # Number attending this school the emergency # Boys: # Number of students estimated to be affected in some way by the emergency (e.g. destroyed, family member injured/killed, livelihood impacted, afraid...) # Boys: # Girls: Number of teaching (teaching and non-teaching) Total number of staff prior to emergency # Male: # Female: Number attending school the emergency # Male: # Female: