Disaster Risk Management for Health

Tropical storm Washi hits the Philippines

18 January 2012. Tropical storm Washi (local name: Sendong) made landfall in the Philippines on 16 December 2011, affecting particularly the Eastern Visayas and Northeastern Mindanao regions. Affected more severely than others were the cities of Cagayan de Oro (CDO) in Misamis Oriental Province and Iligan in Lanao del Norte Province. Water surges as high as three meters brought about by overflowing rivers wiped out entire villages along river banks, catching many residents sleeping which resulted in a death toll more than double that which resulted from typhoon storm Ketsana which affected Metro Manila in 2009.

The total population affected was estimated at 1.1 million people in 815 barangays (villages) in 57 municipalities and eight cities across seven regions. More than
14 000 houses were completely destroyed. The total cost of damage to infrastructure, agriculture, including schools and health facilities, was initially estimated as US $33.8 million.

As of 17 January, 5688 families (26 743 persons) remain in 56 evacuation centres. Of the 56 evacuation centres, 28 (50%) are in Cagayan de Oro (CDO) where 3054 families (13 081 persons) are currently staying, and 19 are in Iligan City sheltering 1809 families (9637 persons). The total number of deaths is 1257 with 6071 reported injuries. (National Disaster Risk Reduction and Management Council Sitrep 41, 17 January)

The most common morbidities included acute respiratory infection, acute watery diarrhoea, wounds, hypertension and skin diseases. The Department of Health declared an outbreak of leptospirosis in CDO and Iligan after recording more than 400 cases with 16 deaths in a span of three weeks.

A number of local and international relief organizations came in to provide assistance. While many were familiar with the cluster mechanism, still many more continue to go directly to evacuation centres and affected community sites without the knowledge of government agency cluster leads. This has led to the unequal distribution of assistance and duplication of services in several evauation centres. As cluster co-lead, it falls on WHO to continue supporting the Department of Health to ensure a coordinated and effective cluster response.

As co-lead to the government agency, WHO supported the health department in establishing the cluster mechanism and coordinating the health sector response. Local health staff were oriented on the cluster approach mechanism. The health cluster was made functional in both CDO and Iligan City and held weekly meetings. A meeting of all clusters led by the Department of Health (Health, WASH, Nutrition, MHPSS) was held once a week by the regional health office to discuss intercluster concerns.

WHO supported the Department of Health to set up a disease early warning system in the evacuation centres. This enabled early detection and intervention on suspected cases of measles and other communicable diseases like acute watery diarrhoea. The system had started reporting cases of leptospirosis at least two weeks before the outbreak was declared. As the evacuation centres have started to decamp and internally displaced people have started to be relocated or have returned to their homes, there was need to ensure continued surveillance at the community level where sanitation and access to safe water remain as concerns as water sources damaged by the floods are not yet fully restored.

WHO continued to assist the national health department in information management; ensuring standards and dissemination of guidelines; strategic and operational planning, analysis and prioritization; advocacy and resource mobilization; and monitoring of cluster activities.

The Health cluster aims to continue assisting approximately 300 000 affected people, including 10 000 pregnant and lactating women, 20 000 young people and 5000 family planning users through provision of management for common illnesses, psychosocial support to the affected, monitoring, disease prevention and, should it become necessary, containing disease outbreaks and addressing reproductive health needs of the displaced populations.