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Page 1 of 34
SOLOMON ISLANDS GOVERNMENT
MINISTRY OF HEALTH AND MEDICAL SERVICES
P.O. BOX 349, HONIARA
MINISTRY OF HEALTH EMERGENCY OPERATIONS CENTRE (MOHEOC)
SITUATIONAL REPORT 6 (18th April to 21th April 2014)
Events Flash and River Flooding – 03 April 2014
Tsunami warning/watch – 13th April 2014
Date Issued: 22/04/2014 Time Issued: 3pm Next update: 3pm, 23/04/2014
From: Incident Controller To: Chairperson, PDOC HCC, PDOC GP, NDOC, NDC, Chairpersons – All
Clusters
cc: Government Ministries, UN Agencies, NGO’s
Situation Description
At 11:00 am on April 3, 2014 a tropical low with a central pressure of 1002 hectopascals as relocated near 11.1
degrees latitude south and 158.7 degrees longitude east, approximately 63 nautical miles northwest of Bellona
Island and 100 nautical miles south of Guadalcanal island. As a result of flash flooding, approximately 10,000 people
in Honiara city and 40,000 people in Guadalcanal Province were affected.
On 13th April 2014, at 7:20 am an earthquake with a magnitude of 8.3 later down-graded to 7. 6 occurred at a
latitude of 11.3 degrees south and longitude of 162.3 degrees East, 108km SSE of Kirakira, Makira Province. A
Tsunami Warning was issued by the SI Meteorological Service at 7:33am. Further after-shocks occurred through-out
the day.
HEALTH SECTOR CONTROL CENTRE AND COORDINATION
Since the health emergency operation centre was activated on the 5th April 2014, the Ministry of Health continues
to support the Honiara Health Division and the Guadalcanal Health Division with key public health and curative
assessments and interventions.
The primary objectives of the Ministry of Health during the response and immediately post disaster are:
a. WASH
Page 2 of 34
b. Public Health Assessment and Interventions in the affected areas, including Vector-borne disease
control interventions, Health Promotion, Environmental health interventions, social welfare
services.
c. Acute clinical care involving Maternal and Child Health, Nutrition, and vulnerable populations
including the psychologically affected individuals in the affected areas.
d. Enhance surveillance coordination, information management, communications and response
including preparation for surge in demand.
The Health Sector noted the directions from the P-DOC (HCC) as follows:
a. Reducing the number of evacuation centres. b. Providing relief assistance at home. c. Conduct survey of IDP in all evacuation centres. d. Infrastructure and economic assessment of impact. e. A package for voluntary repatriation.
And the health sector has been tasked to make an environmental assessment of the original homes of evacuees as well as assessments of FOPA village as an alternative evacuation centre for the immediate term.
The Ministry of Health has established a Health Command and Control Centre at the Henderson Police Post
to support Guadalcanal Province PEOC.
The Ministry of Health has been working closely with the Honiara Health city services and as of today has
assigned a senior health official to establish a health command and control center at the HCC health
services Head-quarters.
The Ministry of Health continues to operate a 24 hour 7 days a week, Command control Centre at the NRH.
The health sector has been coordinating with the IDP/welfare cluster, and has completed and sent the HAP
to NDMO on 15th April 2014.
The NDMO Multi-sectoral Assessment Team was assembled on 15/4/2014 of which Health has been
requested to be a part of. The assessment forms (including health –specific assessment forms) have been
reviewed and training is planned for the Team on the 16/4/2014, before they are dispatched to perform the
assessments.
The Health Cluster along with WASH will assess the Burns Creek area on 21st April 2014 for suitability of
return of IDPs.
HEALTH INFRASTRUCTURE STATUS
All HCC Clinics are fully functional except for the 3 clinics that were affected (White river, Mataniko and Pikinini
Clinics). Safety assessment has been done for White River clinic on 11th April as well as for the Mataniko/Pikinini
Clinics on 12th April 2014. Spraying by the Fire Service commenced on 15th April at the Mataniko and Pikinini Clinics
with clean-up is being assisted by local volunteers. Volunteers started cleaning up the White River clinic as of 16th
April 2014. Cleaning of the affected clinics continued into 17th April.
As of 18th April the interior of White River Clinic has been cleaned but the surrounding area is still full of mud.
Mataniko Clinic still requires interior additional cleaning while the Pikinini Clinic needs further assessment of the
building structure in addition to cleaning up of its interior and surroundings.
Page 3 of 34
At the NRH there is erosion of the coastline (2.5meters), which has caused risk to the children’s ward being
inundated by high tides and weatherly conditions. The immediate solution was discussed which include filling up
the coast-line with tripod sea breakers, or option recommended by infrastructure cluster. A request for assessment
of the National Referral Hospital, physical, environmental and functional capacity has been included in the HAP.
The physical status of the antenatal and postnatal wards has now been condemned and currently is not being used.
The drainage system at the NRH is currently blocked which is also causing sewage drainage blockage. It has been
observed that this is due to the rising sea level which frequently blocks the outlet.
HEALTH SERVICE DELIVERY
1. Honiara City Health Services
MoH/HCC combined mobile clinics which started on the 7th April 2014, are currently providing services to the
evacuation centres. They have also made some assessment in at least 14 evacuation centres as at 7th April 2014.
The health services delivered at the evacuation centres is being coordinated by the IDP/welfare cluster. There is
now resumption of normal services in the non-affected HCC clinics, as well as focused enhanced services and
assessment in MCH, surveillance and general outpatient services.
On the 14th and 15th of April, the three HCC mobile clinics visited all evacuation centres. Normal services in the
non-affected HCC clinics continue, as well as focused enhanced services and assessment in MCH, surveillance
and general outpatient services with 2 medical officers each assigned to cover the East and West HCC clinics.
There is currently MSF team support in public health consultation and psychological services which have been
so far provided to the FOPA, Panatina Pavilion and Mbokonavera evacuation centres.
A health team from Taiwan is assisting with health care in HCC located camps. These visits still need better
coordination with the existing HCC teams for optimum delivery of health services.
Mobile clinics continue visits to ECs from 18th to 21th April with the 3 teams being reduced to 2 teams on 20th
April. The MSF team continued to provide supporting clinical and psychological services.
A: White River Clinic; B: Mataniko Clinic; C: Pikinini
Clinic.
Page 4 of 34
The above chart illustrates the number of post-disaster notifiable diseases seen by the HCC mobile clinics each
day.
The above chart illustrates the number of cases receiving deworming and vitamin A treatments from the HHC
mobile clinics per day. As the days progress the number of children being treated reduces as they near towards
the treatment of all at risk children.
1.1 Health Promotion
On 14th April the HP headquarters had a meeting with the WHO Risk communication expert and conducted a
second meeting with other stakeholders/ agencies including WHO, UNICEF, WV, RC and CARITAS to enhance
proper coordination and support of HP activities to the ECs & affected communities.
IEC materials on WASH materials and a personal hygiene fact sheet have now been developed and the HP
component for HAP Health /Nutrition cluster has been completed.
Also on 14th April, training on WASH and Hygiene Promotion of the camp leaders/ ECs group leaders for FOPA
and Panatina ECS was done. Health awareness talks on the same topics were carried out in nine (9) classes at
the Panatina ECs. Provision of interpersonal communication by the incorporation of nursing staff to the five (5)
ECS (White river, Bishop Epale, Police club, Mbokona, Naha school) was done.
As of 10th April the HP division have developed IEC materials comprising information on a new born baby and a
fact sheet on WASH. Media support continues through the Daily Radio Health radio program. Two groups were
0
10
20
30
40
50
8-Apr 9-Apr 10-Apr 11-Apr 12-Apr 13-Apr 14-Apr 15-Apr 16-Apr 17-Apr 18-Apr 19-Apr 20-Apr 21-Apr
20 24 24
41
17
8
21 15
10 13 11
8 9 9
1 2 0 1 0 1 0 1 2 0 2 0 1 2 6
13 15
6 0 0
4 1 1
6 5 0 0 0
10 4
9
2 0 1 0 0 0 0 2 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 1 1 0 0 0 Nu
mb
er
of
Cas
es
HEOC notifiable diseases seen by HCC mobile clinics
Diarrhoea without blood Bloody diarrhoea Red Eye Influenza like infections Suspected dengue Malaria
0
100
200
300
Nu
mb
er
of
case
s
Albendazole and Vitamin A treatment covered by mobile clinics
Albendazole Vitamin A
Page 5 of 34
deployed with the first group focused on establishing and training IDP Camp advocators at the KG VI and
Mbuavalley camps on personal hygiene, washing of hands, boiling of water, cleaning up of surroundings, proper
rubbish disposal/ management and proper use of toilets. The second group focused on health awareness to
patients presenting to Rove, Mbokona, Mbokonavera, Kukum, Vura and Naha clinics on identified health issues
such as diarrhoea, red eye, dengue, common cold and acute respiratory infections.
The HP headquarters coordinated Risk Communication training on 15th April, facilitated by a WHO/RC Specialist
for HP staff and teams from HCC & GP. Mapping out of the challenges experienced in the field after 11 days of
commencing HP activities was done including the setting up of the direction for the 2nd phase of the risk
communication plan with identified gaps for possible assistance by partners in the HPCWG. The second health
promotion communication working group (HPCWG) meeting was coordinated and conducted and consisted of
various agencies including WHO, UNICF, WS, RC and CARITAS. HPCWG selected appropriate IEC materials from
RC, UNICEF & WV for adoption and have delegated and funded mass printing to partners (RC & UNICEF).
RC has indicated support for the personal protection of HP outreach teams through provision of gumboots
raincoat and hand gloves. UNICEF is also prepared to support the HP media coverage through health spots in
the SIBC and the health column in the newspaper whilst HPCWG has also agreed on 30 HP Volunteers to be
coordinated through RC for HCC and GP evacuation centres and affected communities with RC meeting the cost
of HP volunteers.
HCC HP team attended the Risk Communication training in the morning of 15th April then went on into their 2
teams with HPD team 1 conducted camp leaders training for the three camps, namely White River, Bishop
Epalle and Rove police club. The HPD team 2 conducted interpersonal communication counselling for the camps
situated at Holy cross, HCC education, Coronation school and Koloale school. On 16th April, one HPD team
conducted training of camp leaders on WASH and hygiene practices as well as conducting awareness talks at
Varamatha, Koloale and Kukum Parish. The other team covered Rove, Mbokona, Mbokonavera and Kukum
clinics.
On 17th April the HP team continue preparations for volunteer training for disaster outreach scheduled for 23rd
April. The HP team in collaboration with the WHO/ Risk Communication specialist has developed a time table
for the media forum for health promotion.
The HP team with the Mental Health team have conducted awareness programs at the KGI camp on 17th April.
Another session is scheduled for the Mbokonavera EC during the night. Furthermore, a team has conducted
Health awareness talks targeting diarrhoea at the NRH outpatient and the use of the portaloos installed at NRH.
The HP team has also conducted Health awareness talks for the Mbokonavera camp leaders, on WASH and
Hygiene Practises.
The HP team are now doing after hours awareness talks at evacuation centres.
1.2 Vector-borne Disease and Control Program
On Wednesday the 9th, fogging was performed in East Honiara. As of the 10th April 2014, 2158 mosquito nets
(LLIN) have been distributed to the evacuation centres.
Larval surveillance of potential malaria mosquito breeding sites in temporary flooded areas in Burns Creek, and
drainage line is Kukum has been done. No Anopheles breeding detected, but high levels of non-vector Culex in
the temporary pools. Some controls measures have been applied.
LLIN top campaigns were conducted at KGVI and FOPA, targeting new residents inside the camps that have
Page 6 of 34
moved in since the mass distribution of bed nets last week. This work will continue at all of the major
Evacuation Centres.
ULV treatments were applied at NRH compound with a backpack machine, and at high risk dengue transmission
areas in Honiara, including: Bahai, Kola Ridge, Mbua Valley and Kukum.
Exterior residual spray treatment was applied at the Varamata EC. Interior treatments will be applied at this site
on 15th April.
As of 15th April, LLIN top up operations have been completed at all major ECs including Panatina Pavilion and
Mbokonavera School. Precautionary preventative interior and exterior treatments have been applied at all
major ECs in Honiara with populations over 150 people. Locations treated on 15 April include Tuvaruhu School,
Varamata, Mbuavalley School and the Catholic Hall next door.
Some of the NVBDCP responses will be restricted to the larger, more permanent ECs, as it appears that
populations in many of the smaller ECs are dwindling rapidly, so will not require longer term preventative
measures.
Dengue case house responses were conducted in west Honiara on 14th April, and this mode of treatment will
continue targeting houses with recent transmission, with the aim of knocking down any infective mosquitoes in
that area.
All preventive measures have been completed and fogging at dengue hotspots and around camps continue.
No new update.
1.3 Environmental Health and WASH
The EHD are coordinating with Camp Managers who have just recently identified and reported which evacuees
wish to return to their homes so that the EHD can then carry out assessment on HCC evacuees’ houses to
determine whether their original sites are safe and meet WASH minimal requirements. During the first week
post disaster, the WASH Cluster has completed its initial assessment. Over the last 10 days the WASH Cluster
has improved the delivery of water to affected communities and evacuation centres. As of 9th April, a total of
157,800 litre of water have been distributed to affected communities. Sanitation facilities in the evacuation
centres remain a challenge. For instance, in the Mbokonavera centre the number of latrines is approximately
200 persons/latrine which is also the case in the FOPA village. Distribution of sanitation materials in
collaboration with NGOs is ongoing. The WASH Cluster is currently finalizing the HAP.
The EHD and WASH team are planning to do assessments of sites to determine the safety of returning IDPs. The
current focus of activities is on solid waste management.
Solid waste collection at ECs is still posing a challenge and additional latrine installations at current ECs have
been advised to be halted as IDPs are to be either repatriated or relocated to a single EC this week.
From 12th to 14th April, assessment teams went out to Honiara communities from which IDPs originated, based
on information from the camp managers. A rapid assessment was done at a community wide level to get a feel
for the overall situation from a WASH perspective. Communities visited were: Burns Creek, White River, and
Mataniki River side from Tuvaruhu and downriver.
General findings from this assessment are as follows:
Page 7 of 34
1) Most houses in Burns Creek and White River are ok;
2) The environment along the Mataniko River is generally not suited for return;
3) Some water is available, but drinking water is an issue in most areas;
4) Most toilets are gone but the majority practiced open defecation prior to the flooding so little change in
the practised use of toilets.
[Refer to Annex 3 for tabulated results]
1.4 Maternal and Child Health
A. Nutrition
A rapid nutritional survey done in two evacuation centre in east Honiara showed undernourished children.
Micro nutrient supplements, deworming and vitamin A are being given to children in the evacuation centres
and a food basket recommendation is being put forward. Mothers are being trained how to administer
micronutrient sprinkles. There is a need to liaise with partners on the poor nutritional quality of food being
supplied at the camps. A meeting has been held with WHO Food Safety expert on 14th April, with further
support from UNICEF.
An Urgent food partners cluster meeting was held with NDMO on 15th April to discuss the nutrition situation in
the evacuation centres. WHO/MHMS have been tasked to present weekly requirements list (including fruit and
vegetables) to NDMO and discuss urgent food needs for affected populations. A comprehensive nutrition
assessment proposal is to be submitted to WHO this week and an assessment will be conducted week 6 post
disaster. As an immediate measure, women’s groups from churches have been organised to provide one hot
meal per day to evacuation centres. The nutrition team will work with these groups to ensure nutritious meals
are provided. Women’s groups continue to provide hot meals to care centres as of 19th April and collaboration
with WHO is underway for the creation of a hot meal program for schools.
The food alert was presented to the Provincial government on 17th April and the MCH team is now having
regular meetings with the welfare cluster. A nutritional assessment will be conducted from 22nd to 24th April in
HCC with assistance from UNCEF who are leading the proposal to OCHA, alongside FPA, FAO and WHO, for
funds for supplementary food to evacuation camps for the next month. Team leader training for the nutritional
assessment was done on 21st April while training of 40 volunteers for the nutritional assessment starts on the
22nd of April. In-depth nutritional assessment focused on the communities of IDPs once they’ve resettled is
being planned this week while the nutritional assessment of ECs has now been cancelled as repatriation of IDPs
is now in progress.
From 19th to 21st April the MCH are working with WHO to best address clinical cases of malnutrition. Solutions
include advocating for assistance and training and commodities for the treatment of malnutrition with a
nutrition clinician to be provided by UNICEF in nutrition planning.
B. Safe Motherhood
Up until the 15th of April, 66 antenatal mothers have been identified in the evacuation centres. 12 of these
antenatal mothers are adolescents between the ages of 15 to 19 years of age while a total of 29 antenatal
mothers are unbooked. A total of 5 antenatal mothers identified at the Pavilion on 10th April had no birth plan
or accessible contact information in the event that they go into labour. Birth plans have been developed with
the development of an alert/referral system for antenatal mothers. A recommendation has been made for the
issue of identification stickers on antenatal cards of pregnant mothers identified in camps to ensure they are
not discharged early from the hospital.
Page 8 of 34
Above illustrate charts of the age distribution and stage of pregnancy distribution of antenatal mothers residing
in evacuation camps. As of 21st April the number of antenatal mothers is now 71 with 49 of them now in their
last trimester.
On 14th April a reproductive health alert is to be issued focusing on safe delivery, care of the neonate, Family
Planning and gender based violence. Increased supplies of Reproductive Health commodities to Honiara City
Health service clinics is planned of which 100 cartons of dignity kits have just arrived on 14th April 2014.
Lack of privacy for medical examination is another issue raised by the evacuation centres. The SINU clinic at the
Pavilion centre has now been reserved for antenatal examinations whilst mobile clinics are requesting tents to
provide more privacy for patients.
MHMS staff have planned to procure 10 mobile tents and beds for mobile health teams in both HHC and G
Province, to be used for antenatal assessments and private care. UNFPA will procure the cost of RH 1-12 Kits of
which some have started to arrive on 15th April.
On 17th April UNFPA dignity kits have been received and are ready to be distributed to pregnant women at
evacuation centres as part of focus groups. A total of 11 dignity kits have now been distributed to 5 evacuation
centres on 17th April. The number of postnatal mothers is increasing with now a total of 8 postnatal mothers at
Mbokonavera. They were visited yesterday by HCC and MCH staff.
SIPPA on the other hand will replenish its office. SIPPA/UNFPA emergency training was carried out on 17th April
from 10am to 12pm. IEC materials continue to be developed by SIPPA and they will feed these materials
through Health Promotion Unit.
As of 19th April the MCH team continue to assist in conducting focus discussions with antenatal and postnatal
mothers and is planning with UNFPA to provide multivitamins and high protein biscuits/bars to this group of
mothers.
As of 21st April, 49 UNFPA dignity kits for antenatal and postnatal mothers have been distributed while another
load of 104 dignity kits are expected to arrive this week. UNFPA have suggested that mothers who are 1 week
prior to labour and 1 week after delivery of their baby should be allocated to a rest house which is being looked
into by the MCH team. Stickers for EC residing antenatal mothers will be prepared this week as well.
C. Adolescent Health
The review of adolescents in evacuation centres by the MHMS is to be completed next week. A new evacuation
site at Tanagae, situated near Kakabona, of which a whole school of adolescent students of both gender are
0
50
15-19years
20-24years
25-49years
12 23
30
Nu
mb
er
of
an
ten
atal
m
oth
ers
Age
Age Distribution of Antenatal Mothers Residing in Evacuation
Centres
0
50
4 17
40
5
Nu
mb
er
of
ante
nat
al
mo
the
rs
Pregnancy stage
Distribution of antenatal mothers according to pregnancy stage
Page 9 of 34
residing was visited on 15th April. UNFPA staff led GBV focus group discussions at Tanagae on 16th April. On 19th
April, another focus group discussion conducted alongside UNFPA on sexual health has been done on 2 groups
of adolescent male and female students at Tanagae where dignity kits were distributed. Needs identified by
students included school books, stationaries and eating utensils. This will form the baseline and preliminary
assessment results for the MHMS. Further assessment is planned to occur post MISP. The MCH team is also
meeting with AFL who will be organising sporting activities and health activities in affected communities.
On 19th April an Adolescents Needs Pack (ANP) comprising IEC material and condoms has been created but is
still waiting funding for its procurement and prepacking before distribution.
D. Gender Based Violence/STI/HIV
The Head of the Child and Maternal Health Division will be inviting Safenet representatives to attend MCH
meeting 1-2 times a week and provide updates on gender based violence, STI/HIV activities. To date, SIPPA has
been distributing condoms and providing education in the evacuation centres and will be in charge of providing
information and awareness on Sexual violence and HIV/STI in evacuation centres. SIPPA will work closely with
HIV/STI team in MHMS. IEC material on gender based violence (GBV) and STI/HIV continue to be developed and
work is being done on the distribution of condoms along with the MHMS HIV/STI team.
Safenet conducted training of 30 participants including those from Red Cross and Christian Care centre while
SIPPA is due to distribute 30,000 condoms over the next 3 weeks.
E. Child Health
The MCH unit has an immunization plan drafted whereby UNICEF will fund the vaccines. There is however a gap
in the cost of implementing the immunization. Vaccination campaign will commence in 1 to 2 weeks’ time.
Work is still ongoing on logistics, micro planning, administration, social mobilisation, and implementation for
the immunisation campaign budget. As of 19th April the plan and budget has now been completed and the first
draft sent to the Financial Controller.
The MCH budget is being prepared for emergency response for MHMS and will include IEC materials and EPI.
On 17th April, “Wet feeding” has been added to the proposal being submitted to OCHA to encourage children to
return to school.
From 21st April a child treatment manual and WHO pocket book is waiting printing by WHO while UNCEF will
print the mother’s card and baby book. A Children’s kit has been developed and is also awaiting procurement.
1.5 Mental Health Services and Psychological Support
The team is currently putting together an action plan with support from overseas NGO (MSF). The MSF is
supporting the HCC clinical mobile services with psychological services at the evacuation camps.
The MSF continues to support the HCC clinical mobile services with psychological services at the evacuation
camps which have provide a positive impact. A psychosocial clinic was conducted at the Mbokonavera
evacuation centre with on 14th April with a total of 64 consultations carried. An assessment report identified a
significant number of IDPs have psychosocial needs and there is still the need for more mental health support.
MSF psychosocial services continue in evacuation centres. Findings from a psychosocial visit to Mbokonavera EC
on 16th April show that children have been traumatized and need to resume school quickly. There is also the
Page 10 of 34
need for stationaries and backpacks for these children in preparation for school.
As of 19th April the MSF team is conducting awareness during the night alongside the Health Promotion team.
1.6 Social Welfare
The social welfare team are conducting assessments in the camps and distribution of food items to affected
families who are not receiving assistance. The Social Welfare team have carried out assessments in the FOPA
and SINU Pavilion Centres to date. They were scheduled to do assessment on 11th April at the KG VI School
Camp but were notified of a security risk so this activity is postponed until a later date.
The social welfare team have conducted assessment in 5 ECs (Pavilion SINU, FOPA, Naha School, KGVI School,
Mbokonavera and White River) and have identified issues ranging from non-proportionate, irregular
distribution of food and basic needs to inadequate facilities and safety available at the evacuation centres.
(Refer to annex 1 for details).
No new update.
2. National Referral Hospital
The National Referral Hospital located in Honiara, continues to provide secondary health services to the Honiara
population, as well as providing outreach general clinical care services to GP as well as Honiara health services.
On the 13th April 2014, the NRH emergency operation centre coordinated the evacuation of 103 patients and
143 guardians (total 246) following the tsunami warning. All evacuees are now safe and have returned to the
hospital after the tsunami warning was cancelled.
The above graph illustrates the number of HEOC notifiable diseases presenting to the NRH ED.
0
5
10
15
20
25
30
35
40
7-Apr 8-Apr 9-Apr 10-Apr 11-Apr 12-Apr 13-Apr 14-Apr 15-Apr 16-Apr 17-Apr 18-Apr 19-Apr
Nu
mb
er
of
Cas
es
7-Apr 8-Apr 9-Apr 10-Apr 11-Apr 12-Apr 13-Apr 14-Apr 15-Apr 16-Apr 17-Apr 18-Apr 19-Apr
Suspected Dengue 2 11 5 5 6 0 0 1 5 1 3 2 10
Influenza like illness 1 3 11 0 0 0 0 0 0 0 0 0 0
Diarrhoea with no blood 11 20 34 27 27 15 9 13 16 35 24 36 17
Diarhoea with blood 0 7 0 5 8 0 2 2 1 0 8 1 3
Cholera 0 0 0 0 0 0 0 0 0 0 0 0 0
HEOC Notifiable Diseases presenting at ED
Page 11 of 34
The above chart illustrates the number of patients are seen and admitted to the emergency department per
day. This number excludes those admitted to the other NRH wards. The ED has a total of only 26 beds with an
added 4 beds to the dengue/diarrhoea holding area at the referral clinic.
A total of 19 nursing staff have now been rostered for shifts at ED. In response to the reported increase in
watery diarrhoea presenting to ED, a triage system for diarrhoeal cases presenting at NRH has been developed.
The OPD waiting area is being converted to outpatient management bays for diarrhoea cases with the referral
clinic being marked for diarrhoea cases requiring admission. The eye ward is being prepared for admission of
these cases. Guidelines for diarrhoea management is being devised and doctors and nurses are being identified
and rostered for shifts at ED. Chronic gaps in human resources and infrastructure that existed prior to the
flooding disaster persist and are major obstacles to the provision of adequate clinical services in this post-
flooding situation. A request submission has been forwarded to the NZMAT to be on standby for surge in
demand as well as filling in medical officer and nursing gaps at the NRH, HCC, and G Province.
Three pregnant mothers were referred to NRH from ECs on 11th April and delivered successful at the Labour
ward.
A dengue and diarrhoea desk was activated on 15th April and is now functional at the NRH OPD waiting area
where by severe cases are referred to the referral clinic for stabilization and assessment by a doctor. However,
some issues hindering its optimal functionality remain to be addressed.
Toilets at OPD/ED are non-functional so 3 portable toilets have been secured from Bolmar Plumbing contractor
on 16th April. The engineering of the set-up of these toilets needs to go through the EHD who can provide
technical advice. As of 22nd April the portaloos are on site and awaiting installation.
There is good support from the additional medical officers being rostered at ED and a clinical guideline for the
diarrhoea treatment protocol has been drafted. A request for the recruitment of additional security, cleaners
and porters to support the ED department is being considered.
Elective surgery at NRH is still suspended. However, the NRH NDC clinic is still open to those with chronic
diseases who required replenishment of medications and reviews.
It has been agreed that emergency referrals from health field teams and evacuation centres can be done
through the control centre on 25256 24/7.
155
115
160
108 108
168
141 155
189
139
63 50
13 33
50 66 66
37 26 28
0
50
100
150
200
10-Apr 11-Apr 12-Apr 13-Apr 14-Apr 15-Apr 16-Apr 17-Apr 18-Apr 19-Apr
Tota
l nu
mb
er
of
case
s
Chart illustrating the total number of cases seen and admitted to the Emergency Department
Patients seen Patients admitted
Page 12 of 34
NRH has a total bed capacity of 303 beds. The total number of NRH inpatients remains between 250 - 300
patients from 17th April 2014.
The AUSNZMAT team has been incorporated into the roster and have commenced work at NRH on 17th April.
The team will also be deployed to HCC and GP at a later date.
OPD/ED is still without the portable toilets whilst the dengue/diarrhoea triage system is in place and is working
well at ED. Supplies such as burettes are still not enough so work is in progress to acquire these.
The dengue/diarrhoea triage desk continues with the observation bay cleared by the evenings. There is a short
supply of burettes for IV hydration of children so hydration is heavily reliant on ORS with burette use only
permissible by request of an experienced medical officer. New supplies expected to be received 22nd April.
3. Guadalcanal Province
The Guadalcanal Provincial Health Services has established an internal structure, team leaders and terms of
reference in order to manage the emergency disaster response. This includes 4 domains namely, the Planning
Domain, the Curative Care Operations Domain, the Public Health Operations Domain and the Logistics Domain.
The Guadalcanal Provincial health services has prioritized field level health assessments as well as provision of
curative care. Key emergency health issues include environmental health and public health interventions.
GPHEOC is on standby for emergency referrals and is preparing for surge in demand, especially from the
Guadalcanal Plains.
The Guadalcanal Health Department systematically assessed 64 non-randomly selected accessible communities
in the most affected Health Zones in Northern Guadalcanal Province in order to provide a rapid overview of the
health situation of affected population. Key findings include:
Only 13% of assessed communities reported adequate clean water;
Only 29% of communities reported a functional toilet;
62% of communities reported that more than 50% of the population defecated in the open;
Only 3% of communities report adequate food and 13% have received food assistance;
Only 17% of births have been attended by a skilled personnel;
Only 11% of the communities have received health promotion messages.
0
50
100
150
200
250
300
350
400N
um
be
r o
f in
pat
ien
ts
Date
Daily census of NRH inpatients
Category 4 & 5 patients evacuated to FFA
Page 13 of 34
Although all areas assessed require enhanced attention, the available data indicated that Health Zone 6 which
covers the floodplains of central-northern Guadalcanal and has the largest population in Guadalcanal, is the
most seriously affected with the most concerning health and WASH metrics.
Recommendations as a result of this assessment are:
1. Systematically upgrade the Guadalcanal response with initial steps to include supporting and
strengthening the GEOC.
2. Expand ongoing Guadalcanal assessments and recruit additional partners as necessary to support this
activity, assuring consistent data collection tools and methods.
3. Urgent detailed review of the preliminary assessment findings by the Health, WASH and Food security
clusters with timely and appropriate follow-up actions.
4. Prioritize Guadalcanal infrastructure rehabilitation to assure access to inaccessible communities, with
particular attention to Health Zone 6.
[ Refer to annex 2 for full report]
The 5 integrated community health assessment teams were dissolved on 15th April and teams have been
renamed and reallocated according to the different health clusters to serve their purpose in the next phase of
addressing health needs of affected populations that have been assessed during the previous phase of
assessment.
The 5 new teams are:
I. Good Samaritan Team- this team will be responsible for the patients at the Good Samaritan
Hospital. This includes OPD, in-patients, and emergency and referred patients. This team includes
the GP medical officers as well as GSH staff. On 17th April a meeting was organized for the hospital
staff through which a general planning session was done aiming to find ways of increasing the
clinical capacity of the hospital in response to the public Health Disease Outbreak following the
recent Flush Flood to Guadalcanal Province. An inspection of the wards and patient area is also
done.
II. Maternal Child Health team (MCH)/Clinical Team- this is a mobile team that moves around the
identified communities to address MCH issues. Examples of their task include immunization,
deworming, and Vitamin A supplement programs.
III. EHD/RWASH- this team has been assigned to continue with WASH activities that have been
initiated in the previous phase. Their tasks include cleaning and pumping of wells and water
container distribution.
IV. Vector Borne- this team is assigned to continue with Malaria-related tasks such as bed net
distribution, spraying, fogging, and Mass blood testing.
V. Health Promotion- this is a team comprised mainly of health promotion officers who will be
assigned to present communication risk awareness, distribute IEC materials to affected
communities.
GP HEOC cluster team leaders met on 15th April and a one-month micro-plan for each cluster is being devised
for implementation of activities on 17th April.
3.1 Health Promotion
On 14th April the 5 integrated teams conducted health awareness talks and WASH and hygiene practices at the
Page 14 of 34
Selwyn, Lambi, Numbu, Barande, the Koli points communities, Ngalibu river side surrounding communities and
lengalau to Mbebe sea side communities.
The integrated GP team conducted health awareness talks in 22 villages in Tandai Ward, West Guadalcanal and
35 villages in the Guadalcanal Plains.
The GP/HP team members attended the Risk Communication training on the morning of 15th April 2014 and on
16th April conducted health awareness talks on diarrhoea, red eye, WASH and hygiene promotion at Don Bosco,
Christian Care Centre and Tetere Care Centre. Another team covered the same activities at NAC and Tenaru
beach.
The team started on 17th April with one risk communication awareness program in Zone 1 and two in Zone 6.
On 19th April the team did risk communication talks at Tanaghai, Don Bosco, and Tetere evacuation centres.
Topics covered were diarrhoea, red eye and dengue fever. Hand washing demonstration was done with a total
of 435 leaflets distributed.
On 21st April the team did risk communication talks at Vatupilei, and Tamboko area in Zone 1 (West
Guadalcanal). Topics covered were diarrhoea, Red eye, Dengue fever, and Malaria with a total of 180 related IEC
materials distributed.
3.2 Vector-borne Disease Control Program
In G province, distribution of bed nets in Poha area started on the 9th of April 2014 as most have lost their nets
during the flood. On the 11th LLIN were distributed at GPPOL 1. On 12th April, LLIN were further distributed to
Don Bosco evacuation centre, Foxwood evacuation centre, Ngalimbiu Primary School and Talaura which brings
a total of 1500 nets distributed.
ULV spraying was done at Don Bosco, and Tetere evacuation centres on 11th April. Assessment was done at
GPPOL before spraying. ULV & Fogging are planned for Don Bosco EC and GPPOL 1.
Ongoing work which includes LLIN distribution and precautionary IRS and ERS treatments, as well as ULV
fogging is being conducted in GP, and data and information on this work will be included in the weekly NVBDCP
sitrep.
An up to date community list with GIS location being used for bed net distribution is being integrated with the
assessed community list for the purpose of increasing coverage whilst budget for one month was submitted as
well. Preventive measures are ongoing with 4-5 night cycles for fogging being carried out. Lunga has been
monitored for larva breeding but no evidence shown to date.
On 21st April the VBDC divided into 2 groups where group 1 did bed net distribution at Kaotave in Zone 6 while
group 2 did bed net distribution in Vatupilei and Tamboko coastal area in zone 1.
3.3 Environmental Health and WASH
The G Province team is being supported by SOLBREW to distribute water in the Guadalcanal plains as there is
urgent need for water. There is a situation of well and bore hole contamination throughout the plains. A private
company: Capital drilling company is assisting G Province with logistics to service bore holes – water blasting.
Red cross have supplied water purifiers in the East and Poha area in the West.
The WASH team has been divided into 3 teams whereby the first team is tasked to distribute 46 water
Page 15 of 34
containers in 14 communities in Sali Area, the second team are servicing wells in the GPPOL area with only a
single pump in their disposal whilst the third team are continuing to identify contaminated/damaged wells in
affected area.
A water purifier is now operational at Nguvia school while 1420 containers have now been distributed to 27
communities as of 12th April.
There is an urgent need for more pumps to speed up water provision and also provide back-up and relieve the
load on the single pump currently being continuously used.
The EH/WASH team have sent s request to the GP Health accounts for procurement of 2000X10L water
containers and 5 generator pumps on 17th April. UNICEF has agreed to supply 1000 water containers and 8000
soap on 18th April. The team also placed a request to the national WASH cluster for 31 X 800 gallon water tanks
for the affected communities. To date, the National WASH cluster group has already supplied 1X 1000 gallon
water tank, 2 X 40HP OBMs, and 1 boat.
On 19th April the team continued pumping of wells where they left off on 18th April at Koli Point area whilst still
waiting for the procurement of 2 extra water pumps. The team worked with a WASH engineer from Save the
Children to make assessment of affected sites for possible rehabilitation as well as collaborated with World
Vision and Red Cross for the distribution of water in GPPOL 3.
On 20th April the team liaised with a WASH engineer and arranged by Australia DFAT to acquire 2 water pumps,
2 ladders, and some buckets.
On the 21st of April the WASH group 1 postponed pumping of wells today as the team was redeployed to Visale
clinic catchment area to check if the current diarrhea outbreak there was related to WASH. The 2nd group
accompanied Save the Children team to Talaura, Popoloi, Suaghi, and Rarata to identify affected wells for
pumping.
3.4 Maternal and Child Health
On 17th April, preparation for deployment which included Vaccines, Medical stock, patient record cards, and
stationeries was assembled. Planned services proposed are attending out patient, deworming, updating and
booster immunization, and providing MCH services. Current human resource allows for 1 group to be mobilized
in Zone 1 and 2 groups in Zone 6. Discussion was held with the national Maternal Child Health cluster for ways
to collaborate activities.
A nutritional assessment will be conducted from 22nd to 24th April alongside HCC.
On 19th April all three groups were deployed to the field where group 1 visited Tanaghai Evacuation Center
where Ruavatu students are still temporarily residing. Group 2 visited Don Bosco and Lunga Evacuation Centers
where the team escorted 1 diarrhoea case to Good Samaritan Hospital. Group 3 were deployed to Tetere
Evacuation Center where only a total of 11 patients presented to the team.
On 21st April, group 1 was deployed to Visale with extra supplies to assist the nurse who is attending an
increasing number of diarrheal cases. Group 2 Return to Don Bosco evacuation center upon request from PEOC
to revisit patients and attended to a total of 25 out patients out of which 2 were referred to GSH for further
diarrhoea management. Group 3 was deployed to Kalaubola and Baravule communities for that day.
Page 16 of 34
4. Surveillance and Laboratory
There has been an increase in Diarrhoeal disease since EPI week 8. This started before the disaster and the
trend immediately post disaster continues to show increase in diarrheal cases in some of the evacuation centres
namely: KGVI evacuation centre, Mbokonavera and Panatina Pavilion. On the 9th of April 2014, the MoHEOC
dispatched an investigation team to KGVI evacuation centre to verify report of diarrheal cases in the centre.
Their finding showed four cases of diarrhoea. A sample obtained was tested using RDT which is negative for
cholera and Rota virus. Result of the culture of the sample showed no growth of organisms after 48 hours of
culture. Sample obtained from a patient in the children’s ward with diarrhoea also showed negative RDT test for
cholera and Rota virus. On 11th April a further 3 patients were admitted to Medical ward, ED and Children’s
ward respectively and samples collected showed amoeba on microscopy for the ED and children’s ward
admissions. All 3 samples tested negative for Cholera and Rota virus on the RDTs and were also all culture
negative for Salmonella or Shigella after 48 hours.
As of 17th April a total of 11 stool samples have been tested at the NRH Medical Laboratory. The above chart
illustrates that 2 samples have tested positive for Rotavirus. Note that 2 of the 11 samples were unsuitable for
RDT testing while the 2 most recently collected samples are still pending culture results.
Surveillance Unit completed post disaster risk assessment and presented with priority recommendations one of
which is the roll out of the Post-Flood Early Warning Surveillance has been finalised and planned to be
implemented in Honiara health facilities this week. An Outbreak Response System is being developed.
Below is the trend of diarrhoea cases to date which shows diarrhoea cases prior to the flooding with a 4.5 times
increase within 4 days post flooding.
0
5
10
Cholera RDT Rotavirus RDT Culture
Tota
l nu
mb
er
of
sam
ple
s
Laboratory tests
Labotory results of stool samples tested at NRH (from 9th to 15th April)
Samples tested positive Samples tested negative
0
50
100
150
200
250
300
350
400
16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 2 4 6 8 10 12 14
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr
2013 2014
Re
po
rte
d C
ase
Number of diarrhoea cases collected from the National Syndromic
Surveillance System, Solomon Island, 2013-2014
All Diarrhoea Bloody diarrhoea
*4.5 days
Page 17 of 34
The current status of Laboratory reagent stock as of the 7th April 2014 is as follows:
1360 Dengue test kits, 200 Leptospirosis test kits, 200 cholera test kits, 1000 rota virus test kits, ILI swabs for
influenza test.
List of needed lab reagents and out of stock emergency medical supplies was given to WHO.
EWARS rolled out already to HCC and GP training on disease case definitions at HCC on 12th April & GP 15th and
16th April. The surveillance team has been divided into 2 teams to investigate the information received from GP
HEOC regarding a rise in diarrhoeal cases.
The Health Surveillance team is continuing their surveillance assessments, and have as of 15th April 2014 moved
out into northeast and northwest Guadalcanal. The team is also setting up the enhanced surveillance system, as
well as training healthcare workers in the healthcare facilities on Guadalcanal on the use of assessment forms
and surveillance sheets.
In Honiara, the three sentinel reporting sites (NRH, Rove and Kukum Clinics) have all reported an increase in all
contacts, when compared to epi week 14(which also include increase in the total number of diarrhoeal
diseases). The complete report for epi week 15 is scheduled to be released on 18th April.
WHO surveillance team has confirmed on the 17th of April that the following 7 clinics are to be included in the
EWARS: Visale, Kohimarama, Marara, Tinaghulu, Good Samaritan Hospital, Aola, and Totongo. Investigations
into the dysentery outbreak at Aola and Verani show that these occurred before the disaster from flooding. The
stool samples collected are awaiting results from the NRH laboratory.
As of the 17th of April, the national syndromic surveillance system is collecting data among 8 sentinel sites in
Solomon Island. Four of them are located in Honiara city (with one in the National Referral Hospital).
One week after the flood (epidemiological week 14), the number of diarrhoea cases has dramatically increased.
A total number of 370 cases was reported, with 87% in Honiara city, the most affected area by the flush flood.
The evolution of this spike has to be followed carefully over the next few weeks.
The number of cases of dysentery is increasing also and some samples have been collected in order to define
the bacteria or parasite and provide the more adequate treatment.
With regards to dengue surveillance, the samples sent to the ILM lab for serotyping have confirmed that the
type of dengue present in Solomon Island is DENV-3, same type than the one that was causing the dengue
outbreak last year. As of 18th April, 754 cases have been reported since January 2014 with an additional 138
cases reported this week.
Page 18 of 34
The increase of cases could be due to the increase number of vectors.
No new update.
5. National Pharmaceutical Supplies
The National Medical Store assessed HCC clinics of which only 6 were open for pharmaceutical assessment on
11th April. Standard assessment using the WHO priority list for Mothers/Children 2012 was used. Average
availability of drugs in these clinics showed an overall 88.24% of the 17 items present on standard assessment.
Paracetamol supplies have been received from Fiji on 14th April and NZAF have supplied stethoscopes, BP
machines and iv cannulas. Main tender for medical supplies for this year have been placed and will be coming
on its normal schedule in May/June. Medical Laboratory have placed orders for reagents and consumables with
haematology reagents already on site.
The NMS continues to track stocks and identify gaps in supplies. There is now a renewed stock of Amoxicillin
suspension and bathroom scales have been delivered to health facilities in Honiara and Guadalcanal Provinces.
On 16th April the NMS will assess the cold chain at the HCC clinics. Disaster Kits have been received from
UNICEF which will initially be supplied to HCC clinics. One disaster kit has already been supplied to Good
Samaritan Hospital on the 14/4/2014.
No new update.
6. Logistics
Availability of vehicles has been a key item for assisting mobility of clusters during the emergency response. The
absence of detailed up to date vehicle registry identifying the status of vehicles within the Ministry has impeded
effective vehicle management and fuel allocation to emergency response designated vehicles.
Purchases initiated during the response include, water tanks, insecticide for mosquito control, 2 Toyota Hilux
vehicles, food, water and hygiene for response teams and flood evacuees and printing items for production of
health promotion material and emergency staff IDs.
Communication mechanisms have been enhanced by availability of mobile phone credits for HCC team leaders,
internet dongles for Guadalcanal personnel and reestablishment of internet access within the MHMS Command
and Control Centre. Communications within the most remote areas of Guadalcanal without mobile phone
coverage remains problematic with options to be identified to facilitate improved communication.
A MHMS Health Emergency Response Fund Standing Imprest of SBD40, 000.00 requested by WHO and VBDCP
as a result of the Dengue outbreak has been initiated and will be administered by the MHMS. This should
provide more expedient access to urgent funds during the initial stages of the health emergency response.
No new update.
Sender Details Receiver Details
Name Ventis Vahi/A Oritaimae Name NDMO,MOHEOC , HCC-PEOC, GP-PEOC, Chairman of all clusters
Contact 7612250/25256 Contact
Time 3:00PM Time
Signature VV Signature
Page 19 of 34
EVACUATION CENTRE PROTECTION ASSESSMENT DEBRIEF FINDINGS: SUMMARY
Location: Pavilion SINU FOPA Naha School King George School Mbokonovera White River
Date: 9 & 10 April 11 April 12 April 14 April 14 April 14 April
Dis
trib
uti
on
- F
oo
d - Unequal distribution of
food - Some did not receive food
yesterday - No baby food - Food not appropriate for
pregnant women or breastfeeding mothers
- Private people giving food – distribution channelled through appropriate authorities
- Only food provided is rice, noodles and biscuits
- Portion sizes are the same for each family regardless of how many family members.
- Food has expired - to be returned
- Different days different amount of foods are delivered by HCC/Red Cross. NDMO using different formulas? Distributors take the food? Private offers?
- Distribution comes at different time every day. Sometimes at midnight when children are asleep, which means they skip meals
- Food and water not sufficient for numbers per house and family
- Rice, noodles, tuna, coffee mix, sugar, and biscuits distributed – IDPs told it is enough for 2 days but it really isn’t - it’s centrally cooked and given out. Families don’t have their own portions.
- Clothes and food provided from churches
- Food and water not sufficient for numbers per house and family - 1 small bottle of water distributed to most families per day, regardless of number in family
- Committee members keeping food, not letting others be involved in distribution
- Big groups and small groups being given same amount of food regardless of how many people in the group
- Enough food for everyone but unbalanced diet with no nutrients
- Specific needs not being met – pregnant women, people with disabilities hidden and not receiving items (not happy with distribution)
- 1 girl with disability is allergic to tuna and not eating at all
- Honourable members giving corned beef to some families and not others
- Some women buying own vegetables and fruit from market
ANNEX 1
Page 20 of 34
Location: Pavilion SINU FOPA Naha School King George School Mbokonovera White River
Date: 9 & 10 April 11 April 12 April 14 April 14 April 14 April D
istr
ibu
tio
n -
NFI
s - Not enough tarpaulins - Not enough sleeping mats - No utensils - Many children do not have
clothes - Distributed clothing not fit
for young women - Clothes only for boys and
food given to women - No clothes for pregnant
women - No utensils - contributes to
health issues as people eating with hands
- No beds for women and children
- Mosquito nets distributed but no ropes to hang them so they are not used
- No detergents or cleaning products
- No waste bins - No sanitary pads - No mats. Zone 3, 4, 6, 10,
11, 12 had no mattress, blankets, pillows (first come, first serve/ not enough?)
- No bedding provided - most are sleeping on gravel
- No cups, plate, cutlery, or utensils distributed
- Extra tents/tarpaulins needed to prevent rain from coming inside
- Women, girls, boys and babies need clothing
- No utensils or pots provided
- Just received World Vision family kits – not enough within the kits for bigger families. Only given to some families.
- Mats and mosquito nets given out per family, not per person
- Mosquito nets provided but no rope
- Bushknives needed for cutting firewood
-
- Towels toothpaste and soap provided per family regardless of how many in family
- No bedding provided – most are sleeping on concrete
- No cups, plate, cutlery, or utensils distributed
- Committee members keeping NFIs, not letting others be involved in distribution
- World Vision Family Kits allocated per family (regardless of how many people in that family)
-
- Not enough clothes for everyone – young girls don’t have many clothes
- Pregnant women have no mats – using lavalava
- Not enough towels - No cooking utensils
Page 21 of 34
Location: Pavilion SINU FOPA Naha School King George School Mbokonovera White River
Date: 9 & 10 April 11 April 12 April 14 April 14 April 14 April D
istr
ibu
tio
n –
pro
cess
/ O
ther
- Leaders distributing but people not involved in consultation - equity issue.
- Same things given to everyone regardless of need
- People just come and drop supplies and then they leave.
- No women in distribution committees
- Only men managing distribution
- Some people want to return home but need provisions such as food, utensils etc
- Distribution based on number of families within each zone – number of family members not considered
- They would like to be consulted on what they need – some would prefer tools and seeds for resettlement so they can go home
- Number of IDPS has substantially increased over last few days – supplies are reflecting original numbers, and not taking into account this increase
- Breakdown of communication between committee members and other IDPs
- FOPA Committee Chair receives zero support – no phone for communication, has spent all of his money on Evacuation Centre
- Potential for unfair distribution – centre is split into ethnic groups and Items are distributed to dominant group, who then distributes to other groups
- Suppliers are not supervising distribution – IDPs want NGOs to do distribution, not committees
- Women afraid to participate in decision making because men are telling them they shouldn’t
- Distribution based on original numbers but more families have arrived since original count
- Some people moving back and forth from centres at distribution time to get more food and NFIs
- Some people living at home (possibly not affected by disaster) visiting centre to collect food and NFIs
- No identification of people who actually need assistance
- No female representative in Council – positions allocated by men
- 2 committees – I for distribution 1 for repatriation (not really strong)
- Families being counted, not number of members of families
- Committees taking care of their wontok and not others
- Committee with 6 active members
- Distribution based on number of families, not number of people
- Some happy with distribution in general
- IDPs using different surnames to get more food and NFIs
- Non-voters not receiving anything
- Some people visiting for distribution and returning home
Page 22 of 34
Location: Pavilion SINU FOPA Naha School King George School Mbokonovera White River
Date: 9 & 10 April 11 April 12 April 14 April 14 April 14 April Sa
fety
- Men, women and children sharing bathroom facilities
- No security during nights - Some blocks have no
power - Toilets are some distance
from populated areas - Young girls have no
privacy- no space to change - Shower in boys dormitory -
they all use one bathroom
(mixed)
- Boys saw men touching/harassing girls - worried for their relatives
- One wife forced to have sexual intercourse by husband - Issue of privacy and GBV
- Boys being slapped by security
- Drunk people visiting at night
- Very large pool of stagnant water – mosquitoes, dirty water, children can access it (not fenced off)
- Lack of privacy creating risk of gender based violence (no space for intimacy)
- No trust in SI Government to organise the response – talks of planning anti-government demonstration (this risk has decreased as of 4pm as distribution commenced)
- Anger about Ministers using relief money to respond to their constituents only
- Only 1 room with lights (but torches and candles provided)
- IDPs staying within school boundaries – not leaving (fear of leaving)
- Police visit frequently - Potential for aggression –
ethnic groups definitively separated
- General physical environment unsafe – very muddy, cooking areas next to rubbish piles, burning rubbish close to living quarters
-
- Drunk men at night - Dam nearby – concern
about flooding - Incident where boy
assaulted sister and another boy due to anger over sexual relationship between the two
- Children are fighting and stealing
- Women won’t go to Committee meetings because they afraid of people stealing their belongings
- Child protection – parents assaulting children (eg. child with disability)
- Need for CFS and child friendly spaces
- Young girls getting drunk at night time disrupting families and mothers worried about exploitation – health related issues – children seeing this behaviour
- No private space for intimacy – risk of GBV when men forcing women into sex/women refusing sex
- Children stay close to road and big drain – safety risk
- 2 women had a physical alteration due conflict over food distribution and space
- Toilets separated by sex - Toilet at back – no lighting - No rationing of water –
just taken as needed - No security - Drunk people from
outside visiting
Page 23 of 34
Location: Pavilion SINU FOPA Naha School King George School Mbokonovera White River
Date: 9 & 10 April 11 April 12 April 14 April 14 April 14 April H
eal
th - No utensils - contributes to
health issues as people eating with hands
- Not enough medicines,
particularly for skin
conditions and eye
conditions
- Food provided offers no nutrition
- Diarrhoea outbreak - Dehydration - Medication needed - Children have health issues
– eye and skin infections obvious
- No disinfectant for cleaning - No toilet paper - Capacity of water tanks not
enough to supply everyone for 1 day
- Older women sleeping on floors
- Types of food provided – no nutrients
- Breastfeeding mothers, pregnant women and children not receiving any nutrients in diet – breastfeeding mothers not producing milk
- Sleeping on concrete is making people sick
- Some people using clothes or cardboard to sleep on
- Breast feeding mothers, no nutrients – one mother feeding baby coffee mix instead, baby not sleeping at night
- Extra support needed for sick children – medical examinations, medicine
- Medical examinations needed – especially for IDPs caught in floods
- Children with diarrhoea - Children with flu - Pregnant mother
confirmed malaria - No safe playing area for
children – playing in mud
- Types of food provided – no nutrients
- Breastfeeding mothers, pregnant women and children not receiving any nutrients in diet – breastfeeding mothers in pain when feeding
- Children - Diarrhoea, red eye and flue, vomiting
- 5 Pregnant mothers – 2 due soon. I delivered at No.9 and returned to centre next day – extremely high risk for new baby and mother getting sick
- No space for post-natal mothers
- Pregnant women being referred to nearby clinics
- Widespread diarrhoea
- Scheduled visit for medical assessment and treatment
- Not enough medication – many go without
- Nurses visit from local clinic (closed)
- Red eye, flu, women look stressed
- Most sleep on floor – not enough mats
- Unbalanced diet – no nutrition
- Given coffee mix, rice, noodles only
WA
SH - Waste management -
urgent need of Rubbish bins and collection
- Sanitation - toilets are
blocked
-
- - 4 female toilets (not flushing)
- 4 male toilets (not flushing)
- Bucket showers - Drinking water tank has
not yet emptied – but saving water for school staff – may become an urgent need as only water source
- - No rubbish collection
- No rubbish bin or collection
- Water around ground everywhere – no drainage
- Some rooms filled with water
- 2 toilets blocked, no water, no drainage
- 1 tank used for shower
Page 24 of 34
Location: Pavilion SINU FOPA Naha School King George School Mbokonovera White River
Date: 9 & 10 April 11 April 12 April 14 April 14 April 14 April So
cial
- Too crowded
- Lots of anger - People are
fighting, frustrated, scared
and lost trust for
authorities and each other
- People don’t know what
services are coming and
when, so they miss out (no
information given out)
- Churches not present - Big need recreation for
children and young (sports) - Some activities starting with young children
- Need for prayer time - Meeting spaces for young
people and mothers - Boys not doing anything - PE lessons provided for
children (with expectation of support to be provided)
- Rooms overcrowded - Many children looking
stressed/distressed - No activities for children –
need to identify what organisations can do
- People with disabilities are hidden
- Boredom – nothing to do all day
- Churches not present - Insecurity/lack of clarity
about what is happening to
them next
-
- No activities for children (though UNICEF has set up a tent for this purpose)
- Rehousing anxiety - No privacy within houses
mixed families
- Lots of children - Anxiety about repatriation
– safety of houses (no forms provided)
- IDPS have heard about Gold Ridge contaminating water supply – reason for not wanting to return home
- Mud covered gardens in floods – source of income gone
- Little privacy – no space for intimacy
- Families being separated between centres
- Children traumatised – fear of returning home
- Need financial assistance to rebuild homes
- Need help to get gardens back for income
- No activities for children or young people
- No activities or space for children
- Rehousing anxiety – some told they must leave by 2 pm TODAY by the Committee
- No repatriation forms provided
- What will the government do to help them with repatriation – fear of returning – will land be provided? Proper assessment of who wants to return and who wants to stay
- Parents of students telling IDPs they should leave
- No activities or place for children
- Rehousing anxiety – principle gave deadline for leaving 6 days ago
- Parents concerned about raising money for their children’s school – has this been considered in repatriation plan
- Confusion around what “repatriation” means
- People starting to tire of agencies asking questions and taking notes but no response seen
- Children need school material/stationery to go back to school
- No space for additional IDPs – some living close by in affected houses
- Can’t move home because houses full of mud, not safe
- Need tools for rehousing - No resources for cleaning
up - Most people spending
their time cleaning up houses
Page 25 of 34
Location: Pavilion SINU FOPA Naha School King George School Mbokonovera White River
Date: 9 & 10 April 11 April 12 April 14 April 14 April 14 April In
form
atio
n - Not many relief workers
talking to internally displaced people
- Repatriation – confusion around what this entails, if and how stocks of food will be provided, the rights of internally displaced people and assessment of houses. Communication issues present (HCC needs to clarify)
- People don’t know what services are coming and when they are coming, so they miss out - No information shared
- They received talks from health on wash
- Messaging on health, hygiene, protection, return and conditions at home, activities and when services provided in the centre, services available, sexual and reproductive health, info on who is giving what, weather and cancellation of emergency (what is going on outside) their rights in this situation (people just accept situation), list of numbers they can call
- High levels of anxiety about if/when they will be moved out of centres
- - No information received about anything – rights, updates on what’s happening , protection, distribution times, messaging etc
- Medical supplies, money and tools for livelihood needed – no one has told them what they will receive if they leave
- Evacuation centre generally good, but IDPs concerned about it being a school – when will children come return, using electricity and water. Who will pay for the bills?
-
- No information from committee provided
- No official reporting mechanism set up
- No information from assessments given to IDPs – would like feedback
- No information from government provided
- No woman representative for women to report to
- Honourable Moffat Fugui announced 400 plots of land at Lau Valley available and that committee should identify a list of people to move onto land, to take to parliament. Only men present during this announcement. Risk of raising expectations and of unequal allocation of land
- Honourable Moffat Fugui questioned about where money is, and he responded $300,000 of RCDF has gone to NDMO
- No information or awareness raising
- People asking for awareness on health
- No information on roles of organisations/agencies
- No updates on anything except food
Page 26 of 34
Location: Pavilion SINU FOPA Naha School King George School Mbokonovera White River
Date: 9 & 10 April 11 April 12 April 14 April 14 April 14 April Th
reat
s - Worry about not having
enough food
- Security - drunken people
at night, theft of items
- 2 Security SINU patrolling
block- two children slapped
by them – not trusting
- People smoking inside
where children sleeping
- Teenagers drink kwaso in
the centre
- Main building without
walls- weather and safety
- Fights to share utensils and
pots - cooking takes a long
time and children/parents
argue over food
- Not enough wood for
cooking
- Overcrowding- people not
used to urban environment
- Limited lighting at night
time
- All children have diarrhoea,
pooing in room, nothing to
clean it with, no nappies
- Harassment to the girls and
the boys that try to
intervene
- Shared showers - no privacy
to change clothes
- - - Drunk men at night - Dam nearby – concern
about flooding -
- - Toilet at back – no lighting - No security - Drunk people from
outside visiting
Eth
nic
gro
up
s
pre
sen
t - - - - -
Page 27 of 34
Location: Pavilion SINU FOPA Naha School King George School Mbokonovera White River
Date: 9 & 10 April 11 April 12 April 14 April 14 April 14 April Sp
eci
al N
ee
ds/
Vu
lne
rab
le
Gro
up
s - 2 pregnant women @ 9 months
- 2 pregnant women @ 8 months
- 1 pregnant woman @ 7
months
- Nothing ready for labor,
police/health aren’t
contactable, they can’t rest
and have swollen legs
- Older people need rest
- Imbalance of diet-
breastfeeding mothers stop
lactating (cabbage)
- Over 7 people with disabilities – needs are not being considered (though CBR has visited for assessment)
- 1 mother with 6 children - needs separate space
- 1 person with a disability – cannot speak or move. Moved by family to area at risk of landslide, as Naha was not suitable for her
- 2 children with disabilities – needs are not being considered (1 has left already)
- Pre and post-natal care urgently needed
- 2 people with disabilities (I left)
- Breastfeeding mothers need nutritious food
- Infants need space because of over crowding – particularly vulnerable group
- Single mothers not provided with support
- At least 1 pregnant woman
- 5 babies - At least 3 people with
disabilities - 1 teenage girl with special
need (Downs Syndrome)- lots of people watch her shower
Po
siti
ves - Lights in houses come on
every night - UNICEF setting up - MHMS providing cleaning
products and raising awareness about hygiene
- HCC provided skip for rubbish
- World Health Project (MHMS) – spraying for mosquitoes
-
- Presence of Outdoor Global Evangelical Church
- No threat from outside people – community and church is very supportive
- IDPs happy with how they have been treated by relief workers
- Older people are ok - No stories of child abuse
or gender based violence - School treating IDPs well - Committee established
amongst IDPs - Reporting mechanism is to
the committee - Showers separated by sex - Security fence - Youths visit daily to lead
prayers for everybody - Red Cross doing health
checks – malaria and dengue testing
- Red Cross providing water (but IDPs not sure if it is safe for drinking)
- Church providing food (though unsure how distribution is done)
- Church programs have commenced
- Medical team – 2 nurses visit regularly
- Children playing and being creative – some seem happy
- Resilience of IDPs - Women contributing by
cleaning
- SDA provided cooked food one night – chicken wing, half one banana, one piece of melon (but not enough for everyone)
- Basketball court for children to play on
Page 28 of 34
Flash-Flood Emergency Assessments Guadalcanal, Solomon Islands – 8 to 11 April, 2014
Executive summary
Following the flash flood emergency in the Solomon Islands on 3 April 2014, the Guadalcanal Health
Division performed rapid health and WASH assessment in many of the flood-affected communities in
Guadalcanal Province. A total of 64 communities across North of Guadalcanal Province were assessed
from 8 to 11 April 2014. This interim report documents the findings of the assessments and highlights a
number of areas that require urgent follow-up actions by the Health, WASH, and Food Security clusters.
Key findings included:
Only 13% of assessed communities report adequate clean water
Only 29% of communities report a functional toilet
62% of communities report that more than 50% of the population defecate in the open
Only 3% of communities report adequate food and 13% have received food assistance
Only 17% of births have been attended by a skilled personnel
Only 11% of the communities have received health promotion messages
Recommended urgent priorities include:
Expand ongoing assessments and recruit additional partners as necessary to support this
activity, assuring consistent data collection tools and methods
Urgent and detailed review of these preliminary assessment findings by the Health, WASH and
Food Security Clusters, with timely and appropriate follow-up actions
ANNEX 2
Page 29 of 34
Background
From April 1-3, 2014, heavy rain from a tropical depression caused severe flooding in Honiara and
Guadalcanal Province (pop. 64,609 and 93,613, respectively, 2009 Census). Multiple rivers burst
their bank washing away houses and affecting an estimated 10,000 and 40,000 people in Honiara
and Guadalcanal Province (GP) respectively. There are approximately 10,000 displaced persons in
evacuation centres (ECs) in Honiara and an unknown number in GP. Many bridges were damaged or
destroyed and transportation to much of Guadalcanal is only by boat, limiting assessment and relief
efforts. The Northern part of Guadalcanal, in particular north-central Guadalcanal, is characterized
by extensive floodplains and multiple rivers that flow from the mountains in the south to the flat and
open plains of the North. Much of the Guadalcanal population live in this section of the Province.
A substantial multi-sector emergency relief effort by the Government of the Solomon Islands
supported by multiple United Nations Agencies, Non-Governmental Organizations (NGOs), and
foreign governments, has provided substantial assistance to many of the affected population,
especially in Honiara. Damage to multiple bridges and widespread and deep mud in the badly
affected North-central Guadalcanal Province has severely limited access.
Despite serious access challenges, the Guadalcanal Health Division conducted rapid health, WASH,
and food security assessments across much of Northern Guadalcanal Province. The assessments are
ongoing, but this interim report documents the key findings thus far.
Methods
Five assessment teams started assessments on 8 April 2014 using a standardized rapid assessment
form (Annex 1) modified from the Inter-Agency Standing Committee (IASC) Initial Rapid Assessment
(IRA): Field Assessment Form. The modified form has four components:
1) General population characteristics
2) Water and sanitation
3) Population health
4) Health facilities
Each assessment team was composed of 3-4 nurses from the Guadalcanal Health Division. Target
communities were chosen by the Guadalcanal Emergency Operations Centre [Health] and the
assessment teams based on likelihood of flood impact and ability to access by vehicle or boat.
Assessment forms were completed by the assessment teams in the field using a combination of
qualitative and quantitative methods including direct observation and interviews with community
residents. Completed forms were collected at the end of each day at the Guadalcanal EOC and
entered into a Microsoft Access database for descriptive analysis. Data for this report is based on
assessments conducted from 8-11 April, 2014. The health facility assessment data is not included in
this brief interim report.
Page 30 of 34
Figure 1. Guadalcanal Province and Assessments by Health Zone
Page 31 of 34
RESULTS
Health Zone-strafified MHMS assessment data -
Guadalcanal Province
Zone 1 -
Marrara%
Zone 5 -
Aola%
Zone 6 -
Good
Samaritan
%Total
(Zone 1, 5, 6)%
Total estimated Health Zone population (MHMS data 2013) 20263 12042 31826 64131
Total number of communities UKN UKN UKN UKN
Total number of assessed communities 11 2 51 64
Total estimated population of assessed communites (quick
estimate by Ministry of Health staff)3542 17% 800 7% 11234 35% 15576 0%
Number of communities in which the population has been
officially counted (systematic count by police or NGO)2 18% 1 50% 12 24% 15 24%
Number of communities in which the population is:
· Increasing 8 73% 0 0% 9 18% 17 27%
· Decreasing 2 18% 0 0% 7 14% 9 14%
· Staying the same 1 9% 2 100% 35 69% 38 60%
Relations between the displaced and the host community
· Host community willing to assist 5 45% 1 50% 8 16% 14 22%
· Tensions 0 0% 0 0% 1 2% 1 2%
· Other 0 0% 0 0% 3 6% 3 5%
Number of dead, missing or injured due to the crisis
· Dead 0 0 0 0
· Missing 0 0 0 0
· Injured 2 0 8 10
Estimated number of unaccompanied children 11 0 0 11
Total number of water sources in the health zone pre-
disaster34 2 129 165
Total number of water sources providing clean water post-
disaster28 2 40 70
Total number of communities with enough clean water
supply post-disaster4 36% 0 0% 4 8% 8 13%
Total number of communities with >50% of people currently
defecating in the open (ie. seaside or bush), not in a defined
and managed defecation area
7 64% 2 100% 30 59% 39 62%
Total number of communities with a functional toilet 5 45% 0 0% 13 25% 18 29%
Total number of communities with feces substantially close
to shelters (<20m)1 9% 0 0% 4 8% 5 8%
Total number of communities with feces substantially close
to water sources (<20m)0 0% 0 0% 3 6% 3 5%
Total number of communities with mosquito nets within the
health zone available for use7 64% 1 50% 16 31% 24 38%
Total number of communities which everyone has access to
a mosquito net5 45% 1 50% 15 29% 21 33%
Total number of births within the communities post-disaster 2 1 9 12
Total number of births attended by skilled personnel within
the communities post-disaster1 50% 0 0% 1 11% 2 17%
Total number of visibly pregnant mothers within the
assessed communities post-disaster6 1 35 42
Total number of cases of fever and rash post-disaster 29 0 34 63
Total number of cases of malaria post-disaster 7 0 15 22
Total number of cases of diarrhea post-disaster 10 0 33 43
Total number of cases of ARI post-disaster 70 5 91 166
Total numberr of cases of dengue post-disaster 0 0 0 0
Total number of injury cases post-disaster 4 0 5 9
Total number of pregnancy-related complications post-
disaster0 0 0 0
Total number of communities where an outbreak rumour
has been reported0 0% 0 0% 2 4% 2 3%
Total number of communities which have received food
supplies2 18% 0 0% 6 12% 8 13%
Total number of communities that have an adequate food
supply1 9% 0 0% 1 2% 2 3%
Total number of communities that have received health
promotion messages0 0% 0 0% 7 14% 7 11%
Page 32 of 34
COMMUNTY SUB-AREA WATER SANITATION ENVIRONMENT NOTES:
Burns Creek Date assessment: 12 April
Riverside (Zone 2) . 1 bore, needs repair; . 5 wells flooded . 2 rainwater tanks;
. some slabs, all flooded . 8 houses reported washed away; . area accessible again, some mud, lots of mosquitoes
. People from Perch and KG6 camps
Ivara (along riverside) . SSEC church has small tank; . people going to main road or camps to get water; . 3-4 wells, all flooded;
. some toilets, all flooded;
. mostly OD as before . Houses ok, some mud
Rice Farm . 2 wells, flooded . now collecting drinking water from Blue Lagoon or Bethlehem Church;
. 2 toilets, destroyed . road access difficult; . lots of mud and stagnant water; . still very wet . smelly
. most from KG6
Mosquito . wells contaminated, people boiling the water; . using water from Soap Factory (RWSS tanks;
. some slabs available, still ok . Dry; . very few houses affected;
. residing behind Soap Factory; . Chief said people are staying in camps for free handouts – they can return;
LR . about 11 wells, contaminated (1 dead animal?); . some tanks there but most get water from Blue Lagoon;
. the few toilets are damaged, all using river now
. Dry , little mud . from KG6 and some from LR Warehouse
Tanakake (Penatina valley)
SIWA available but 1 tap only, people have to pay for use; . SIWA water dirty now so not used, collecting from Pavillion tanks
. 3 raised toilets but flooded anyway; . using creek
. 16 houses flooded, still bad . From Pavillion camp, have returned home now
White River Date: 13 April
Upper Namoruka (upper White River)
.SIWA not on yet;
.Some tanks used;
. 1 bore used;
. washing and laundry in river
. 1 toilet there before, gone now; . using river
. access almost fully restored;
. 2 houses reported washed away;
. some debris yet
. people ran up the hill, never went to evac centers;
Lower Namoruka As above As above . houses generally ok; .some mud still; . 1 house reported swept away
Central White River (Riverside)
. No SIWA;
. 1 bore used for washing and drinking; . Children received bottled water
. the few toilets there still ok, rest using river
. lot of mud and stagnant water,
. smelly . 790 people . sleeping at school, cleaning at day
Independence Valley . 3 piped springs used;
. most have private toilet, damage not assessed
. Muddy and drainage issue;
. still flooding . pop 1070 (50+ HHs); .
Mamanawata . 4 wells, 1 used for drinking, rest for other use (possibly saline)
. still using sea . no flooding issues here . asked for assistance getting rubbish cleared
White River (World Vision
Tanakake Valley (Penantina Valley)
. SIWA there
Laundry Valley . 1 SIWA tap @ SBD150/month; . 1 PF toilet, ok; . 30+ people. (5HH)
ANNEX 3: Environmental Health/WASH Rapid Assessment Results
Page 33 of 34
assessment) . using stream as well; . no tanks seen
. need raised VIP toilet
Tikopia . SIWA access; . no tank seen
. OD, as existing toilets flooded . 74 (12+HHs) . need raised VIP latrine
Gilbert settlement . SIWA access; . no tanks seen
. using White River school toilet;
. using nearby stream . 74 people (12+ HHs)
Wind Valley . SIWA access; . 2 wells flooded
. OD
Mataniko River from Tuvaruhu down Date 14 April
No 3 . SIWA on but broken pipes so few water points
. No toilets acvailable anymore . almost all houses uninhabitable; . debris and rubbish everywhere; . rubbish dumped in river
Vara Creek Riverside . 1 small spring used; . some rainwater collected
. no more toilets;
. using river;
. diarrhea reported
Debris and mud everywhere; . most houses destroyed
. people staying at Varamata SDA church
Vara Creek (before bridge)
. intermittent SIWA;
. some drinking water supplied;
. not boiling SIWA
. many of previous toilets still ok; . one septic tank used, goes straight into river
. lots of mud and debris;
. rubbish pick up is needed badly;
. some houses washed away
. people staying at wantoks
Marble Street/Town council housing
. SIWA water available;
. children drinking bottled water;
. some rainwater collected
. indoor toilets now blocked by mud; . sewage straight into river (outlet broken at Tuvaruhu
. majority of houses washed away;
. malaria with some people . mainly staying with relatives
Lelei . using nearby stream and river; . all 7 PF toilets flooded; . using river and bush
. access partly restored;
. some debris but generally did not enter houses; . 8 houses reported washed away
. never went to evac centers
Tuvaruhu River side (East)
. used to use stream;
. now using 2 tanks at school . used to have toilet, all washed away; . now at relatives
. 5 houses washed away, 1 partially destroyed; . debris around, some houses filled with mud; . access good
. ran uphill, then returned
Fijian Qtr . 1 SIWA stand instlled on 13th
April; . one rainwater tank used
. some toilets still working;
. rest using river . lots of mud and stagnant water; . smelly and wet
. ran uphill, then returned
Mataniko/Ngalitatae . 2 SIWA taps in operation; . Red Cross providing water as well
. all 5 toilets gone;
. using river . access through the river; . still debris around houses; . 3 houses reported washed away, 1 partially damaged
. ran uphill, then returned
Vatusu . SIWA not working anymore; . using 2 nearby streams; . No water tank available
. only 2 toilets still used . generally clean area; . Caritas assisting with temporary shelter for homeless; . 6 houses reported as washed away
. ran uphill, then returned;
. affected evacuated to church building
Tamatanga 1 . using one person’s SIWA supply, and nearby streams
. OD at nearby drain;
. one slab currently being . general environment ok; . 2 houses reported as washed away,
. ran uphill and stayed with relatives
Page 34 of 34
cleaned; other full of mud; . cleaning up now;
Tamatanga 2 . SIWA disconnected due to land issues; . their well was buried; . using one private SIWA connection
. 2 toilets buried . debris needs removing; . 4 houses washed away;
. ran uphill, then returned
Koa Hill . No SIWA; . using nearby spring, but pipeline from dam is damaged;
. some uphill using toilets, rest river;
. lots of mud and debris to be cleared; . community needs tools;
. some reside at Mbokonavera and Holy Cross centers; . rest returned home