Health Cluster Coordination Meeting

Ministry of Health: 26 June2015

Agenda

Provisional agenda

  1. Business arising from meeting notes
  2. Updates from
  3. Mental health
  4. Injury rehabilitation
  5. Reproductive health
  6. TB
  7. Disease surveillance
  8. Information Management – update on 4W
  9. Update of ongoing response – MoHP
  10. AOB
  11. Displacement Tracking Matrix (DTM) - IOM

Next meeting of the Health Cluster: Friday, 10 July 2015, 10:00 AM

For queries and clarifications

1. Dr Edwin Salvador

Mobile: 9801010010

Email:

2. Abashya Rayamajhi

Mobile: 9803867947

Email:

3. Toya SUBEDI

Mobile: 9801010039

Email:

Key discussion and other update

Agenda / Updates / remarks
General information and Response Update /
  • Health cluster still faces a lot of challenges, especially with the monsoon season arriving.
  • Chief, PPICD acknowledged the very good support from all health partners in addressing health needs of the affected population. Request all partners to provide all activities into the 4W matrix
  • Partners encouraged to working closely with WASH cluster partners on the ground on preparedness and response to diarrheal diseases. Health cluster coordination has been advocating for WASH to be more proactive in working with health cluster at district level.

Disease Surveillance
Presented by
Dr Edwin Salvador
(WHO) /
  • The number of acute watery diarrhea in the 14 affected districts has been fluctuating and remained above 70 cases throughout the last two weeks.
  • The number of bloody diarrhea peaked on 19th June with 31 cases and decreasing afterwards.
  • The number of Influenza like Illness in the 14 affected districts peaked on 17th June with 82 cases and has remained above 27 afterwards.
  • The number of SARI in the 14 affected districts peaked on 14th June with 111 cases and it has remained below 50 cases afterwards.
  • Five water diarrheal cases were reported from Dhulikhel but all were negative for cholera on lab test
  • The number of fever with jaundice peaked on 21st June with 27 cases. Most of the fevers with jaundice cases were over 5years of age. However, there is no any report of laboratory confirmed Hepatitis A or Hepatitis E.
  • The number of Fever with rash peaked on 14th June with 24 cases and most of them are children under five. However, there is no any outbreak of measles or rubella reported in these 14 districts.
  • The number of fever without jaundice & rash peaked on 14th June with 219 cases and has remained above 80 cases afterwards.
•The number of Influenza Like Illness (ILI) cases in Dhadingpeaked on 19th & 23rd June, each day has 10 cases. There is no any laboratory confirmed influenza reported yet.
•The number of watery diarrhoea cases in Kathmandu has been fluctuating and peaked on 23rdJune with 86 cases.
•The number of acute watery diarrhoeacases in Lalitpur has been increasing since 16th June and peaked on 23rd June with 30 cases.
•The number of acute watery diarrhoea cases in Nuwakot has remained above 8 cases since 16th June and peaked on 19th June with 13 cases.
•The number acute watery diarrhoea cases in Sindhupalchowk has been fluctuating and remained below 10 cases in Chautara hospital.
•MDM France provided a brief of the reported bloody diarrheal cases in Gumba VDC (elaborated below)
Outbreak monitoring
Presented by
Dr Edwin Salvador
(WHO) / •Sindhupalchowk on 21st June
–Diarrhoea outbreak among IDPs of Gumbasthan, Gumba VDC reported by MDM France 180 households are in the affected area – open defecation is rampant, with drinking source from a contaminated spring
–A team led by DHO with WHO and MDM France visited the area and found 33 cases of diarrhea. 8 were bloody diarrheal. Seven stool sample and six water samples have been brought to NPHL for testing, report awaited.
–Control measures in place – Solidarité will be conducting mass chlorination campaign in the affected area. Health education in communities and schools is being conducted
•Makwanpur on 24th June
–Fever and Watery Diarrhoea reported in Dhiyal VDC - 5 (Rajuwa,ThuloHadi and Sano Hadi),
–RRT from DHO verified that there is no outbreak
•Rautahat on 20th June
–Five Watery Diarrhoea cases reported from Gaidatar VDC – 4
–It has been verified that there is no outbreak as such
•Dhading on 24th June
–Four family members of Pida VDC - 8, Baluwa; developed food poisoning after consumption of home made food (gundruk and dhindo)
–Treatment is still underway in the ICU in Manamohan Memorial Hospital, Shyambhu
–The health condition of all the four people are stable and improving
MHPSS
Presented by
Dr.Rishav
(WHO) /
  • There’s a mhGAP-HIG Training of Trainers planned for June 5 to June 8.
  • WHO supporting Patan Mental Hospital to appoint one Psychiatrist and one Psychologist to dispatch to the affected areas.
  • A new instruction tool for the the Mental Health Screening Tool has been devised to be used by lower level paramedics and FCHVs.
  • List of all the referral centers of 14 affected districts providing specialized mental health care can be found in or you can email: .

Reproductive Health
Presented by
Dr Shilu
(UNFPA) /
  • 12000 beneficiaries have been reached through RH camp.
  • RH sub cluster working on rehabilitation for next government fiscal year.
  • Plans are going on to go to 14 affected districts to do on-site training of health workers.
  • There has been much discussionon providing a relief package for FCHV workers. RH cluster partners are discussing with FHD to agree on the contents of the package. The hope is to support about 10,000 FCHVs in the 14 districts with such package

Tuberculosis
Presented by
Dr Ashish
(NTC) /
  • There is an ongoing process recruiting volunteers to assess the TB situation in the 14 affected districts.
  • Request to partners to refer TB patients or suspected TB patients to the TB & Leprosy Focal point at the district health office.
  • Focus is to continue to mitigate the emergence of Multi-Drug Resistant TB (MDR TB)
  • Encourage to visit National TB program website –

Injury Rehabilitation Sub Cluster / New information
  • Nepal Youth Foundation will be looking to scale down their injury rehabilitation stepdown response to respond to the growing need for nutrition rehabilitation. Contact LalitGahatraj: 9841421508 or
  • IMC/Gorkha District Hospital - due to issues with tentage, the patients requiring in patient rehab are being cared for in district hospital itself. Rehabilitation is being offered to all patients at the DH, and mobile teams are proposed with PT and Social Workers. Handicap International has offered advice on the operation of these teams.
  • Green Pastures Hospital Rehabilitation centre - has 12 beds free for rehab patients, including those with head injuries.
  • Spinal Injury Rehabilitation Centre - in discussion with MSF-B for possibility of opening stand alonestepdown/ general rehabilitation facility on SIRC land in Kavre district. Currently SIRC operation 20 bed transitional bed unit for Spinal patients who cannot go home.
  • Womens’ Dream - step down facilities for injured patients will be scaled up to 25 beds soon. Contact: SudhaBasnet: 9851173615 or Samrat Singh Basnet 9851015746
Patients with injuries in the community
Several issues have been highlighted by members of the subcluster concerning patients living in the community with injuries (ie not in formal stepdown or rehab units)
  • Some patients are not presenting to hospital for follow up as they have been charged on previous occasions
  • Some patients have severe mobility restrictions and cannot present for follow up care
  • There has been an increased incidence of infected wounds in the community, and readmissions to hospital
  • Both patients and health facilities are not aware of the facilities which will offer free follow up to earthquake patients.
The Ministry of Health and Population is requested by the IRSC to publicise those hospitals where free care is available to earthquake victims, as well as how people with injuries can access the injury ID card.
Handicap International continues to seek nursing staff from other organisations to support its mobile rehabilitation teams, as community nursing is proving to be a real need. If any international or national organisation can provide qualified nursing staff for these teams and the necessary supervision - please contact HI at or .
Training Working Group
The rehabilitation training working group has now been formalised, and has met several times over the past two week. These meetings have focused on the need to address immediate training needs at tertiary (National), district (DPHO) and primary level (VDCs/Wards) under Phase 1.
The targets of these immediate trainings are:
  • Nurses, paramedics and physiotherapists on injury management, bedside prevention of complications, and principles of rehabilitation including assistive devices at national and district level
  • HPs and community workers on injury management and referral system with focus on early identification of impairments, complications or risk factors for complications, referral for medical care and rehabilitation services between district hospitals and CBR programmes
At present, all organizations have contributed their existing curriculums, and liaised with NHTC. A core group are now working on consolidating the new curriculum to be rolled out mid-July targeting the above groups in a Training of Trainers approach.
  • Community training package has been developed by technical agencies.
  • Leprosy control division is the focal group.
  • Currently post trauma rehabilitation is the main concern.
  • IOM will support transporting patients.

Information Management
Presented by
Susheel Lekhak (WHO) /
  • The response from the sub-cluster and implementing partner in term of sending 4W and logistics report was improved over the period and we are getting data on time.
  • The data shows partner presence and number activities are mostly concentrated in selected districts and VDCs.
  • FMT are requested to provide daily surveillance data to concerned D(P)HO or they can send data to both EDCD Surveillance unit with a copy to D(P)HO in a daily basis. So that prompt action can be taken to prevent any unintended outbreaks.
All the partners are requested to provide data on beneficiaries reached by the activities. So that at the cluster level output based monitoring could be possible and also required to report OCHA.
  • Contact email for any clarification:

FMT update
(Dr Khem Karki, NHRC) /
  • To evaluate the effectiveness of the FMT deployment, a survey forms have been created. Partners are requested to complete these survey forms that had been sent to respective partners through emails.
  • All completed forms would be kept anonymous and confidential.
  • For more information, email

Early Recovery Working Group (Dr Mausam Bohara, NRCS) /
  • Under the lead of the Chief, PPICD, an early recovery working group had established to coordinate partners who are planning to support MoHP in the reconstruction of damaged health facilities.
  • Dr Mausam shared the districts and VDCs that the different partners have planned to support the MoHP such as UNICEF, IMC and the members of the Red Cross and Movement such as Canadian Red Cross, Qatari Red Crescent etc…
  • GIZ also shared of the 4 districts that they plan to support. KFW plan to support MoHP in the reconstruction of hospitals as well.
  • It was suggested that partners who would like to support in this area of work join the early recovery working group to coordinate with MOHP and partners to avoid duplication

Partners Update / Save the Children:
  • Save the Children will support MoHP to construct maximum 30 semi-permanent health facilities in 5 districts Sindhupalchok, Gorkha, Dolakha, Rasuwa and Nuwakota.
  • This will be done with comprehensive approach of health facility rehabilitation and construction which includes health facility rooms, birthing centers, WASH facilities, staff quarter and whole set of equipment and supplies

Next Meetings /
  • Health Cluster: Friday, 10 July,10 am MoHP
  • Mental Health: Friday, 03 July, 11 am MoHP
  • Rehab and Injury: 10July, 9 am NHRC hall
  • Reproductive health: 02 July. Venue to be confirmed