Emergency Response Summary:
International Medical Corps’ Emergency Response Team responded within 24 hours to provide essential medical care to the hardest-hit areas in India following Cyclone Phailin, a catastrophic storm roughly the size of Hurricane Katrina, which struck the country’s eastern coast on October 12, 2013. While authorities put the death toll from the massive storm at 30 - far fewer than anticipated - more than 12 million people were affected by the cyclone. In its wake, Cyclone Phailin left wide-scale crop destruction, contaminated water supplies, the threat of disease and a devastated infrastructure; hundreds of thousands of people returned to their homes to find them damaged or completely destroyed due to high winds and flooding. In addition to providing emergency services, International Medical Corps is working with local partners to provide training and rehabilitate water supplies, helping to thwart the spread of disease, support recovery efforts and rebuild self-reliance.
International Medical Corps Responded Quickly with Immediate Relief After Cyclone Phailin:
International Medical Corps Response: Cyclone Phailin struck India’s eastern coast on October 12, 2013 with winds gusting at 125 miles per hour and storm surges of ten feet, inundating the districts of Balasore, Mayurbhanj, Bhadrak and Jajpur in Odisha State. The government evacuated nearly one million people across the two most affected states of Odisha (873,000) and Andhra Pradesh (100,000).
Within 24 hours of the storm making landfall, International Medical Corps was on the ground in Odisha where an estimated 200,000 people were stranded due to flooding in two of the hardest-hit districts: Balasore and Mayurbhanj. Many communities in Balasore were not prepared for the continuous rain that flooded 1,725 villages, affecting 348,778 people and over 260 square miles of crops. In Mayurbhanj, the destruction was similarly devastating, with floods affecting 737 villages, 342,260 people, and over 200 square miles of crops. In partnership with the Chief District Medical Officers and local health authorities, International Medical Corps’ Emergency Response Team deployed mobile medical units to more than 38 villages marooned by the cyclone in Balasore and Mayurbhanj and provided more than 10,500 critically-needed primary healthcare consultations. Working through local partners, International Medical Corps also distributed hygiene kits that included sanitary and non-food items, such as soap, laundry detergent, mosquito nets and water containers, in local communities to thwart the spread of communicable disease.
True to its mission, International Medical Corps’ teams also identified medium- and long-term needs to rebuild self-reliance, supporting communities’ efforts to recover and providing them with the tools they need to be their own, best First Responders. These needs include training in water, sanitation and hygiene activities; capacity-building support to improve water purification techniques; and infrastructure improvements to water sources, such as raising platforms for hand pumps to prevent future contamination from flooding.
Supporting Local Programs: In support of the Government of Odisha’s nutrition program that targets children and mothers, International Medical Corps provided information, education and communication materials to the Balasore District Welfare Office as much of their educational materials were damaged in the floods. International Medical Corps’ Emergency Response team provided more than 500 informational posters on the importance of breastfeeding; information about providing vaccinations for newborns; and monitoring the weight and nutrition of children. These materials are being disseminated to government-supported nutrition centers all over the Balasore district.
International Medical Corps is Building Capacity for the Future in India:
Working with its local partner, Unnayan, International Medical Corps is currently focusing efforts on reducing future disaster risks, specifically related to the water supply and the links between hygiene and health. Using a comprehensive approach that includes rehabilitation of water sources, construction of hygiene facilities, stockpiling and dissemination of hygiene supplies, and hygiene education and promotion, International Medical Corps and Unnayan are working to ensure that families and communities are prepared to protect water sources and thwart the spread of communicable diseases before and after a disaster strikes.
Improving Infrastructure: A wide-spread challenge during the disaster in Odisha was the submersion of hand pumps. Due to flooding, water accessed through hand pumps was contaminated; in other areas, flood waters compromised access to clean water. To mitigate this issue, International Medical Corps and Unnayan is constructing elevated platforms to raise the height of hand pumps in eight villages, which will prevent the submersion of hand pumps in times of flooding in the future. Additionally, teams are helping families chlorinate water from private household hand pumps to ensure the safety of water being used.
Investing in the Future Through Education: International Medical Corps and Unnayan are also implementing an awareness campaign focused on safe water, sanitation and hygiene practices at the individual household level, community level, and in ten schools. International Medical Corps and Unnayan have already delivered these key messages to 140 children at two upper primary schools in Balasore district, and the awareness campaign will be provided to eight more schools, reaching children from primary to high school age. International Medical Corps is also providing professional development and training to community healthcare workers and hygiene promoters in India; training is focused on best practices in providing community-based education on women’s personal hygiene; safety processes for drinking, storing, and handling water; use of latrines; and the hazards associated with unhygienic behavior such as not washing hands.
Improvements that Respect People and the Environment: Further, consultations with villagers that took place in November revealed the need for longer-term solutions to hygiene needs and challenges, especially for girls and women. In response to these concerns, International Medical Corps is supporting the construction of bathing cubicles in eight villages in Balasore District, which will be connected to the elevated platforms of hand pumps and will allow girls and women to have a private area to bathe, thereby preserving their dignity. The use of soaps and washing detergents will be localized within the cubicles, with little runoff, thus also reducing the environmental impact and protecting local rivers and other natural water sources from the effects of contaminants.
In the weeks following Cyclone Phailin, International Medical Corps transitioned from emergency response primary health care services activities to restoring capacity and building self-reliance in storm-ravaged areas by developing solutions to mitigate destruction from future storms, helping local communities to become their own, best First Responders. While no area is immune to the damage that can be unleashed by a storm of Cyclone Phailin’s magnitude, families and communities can be equipped with the tools and knowledge in areas such as water, sanitation and hygience to prepare for future emergencies and recover more quickly.
International Medical Corps has been working in Somalia since 1991. At the height of the drought and famine crisis in 2011, International Medical Corps resumed operations in Mogadishu after several years of being unable to access the city due to the control of various armed groups. Since then, International Medical Corps has provided critically needed primary health care services to affected populations, particularly internally displaced persons (IDPs).
With the support of generous donors, International Medical Corps began directly managing two permanent clinics in the Wadajir and Wardhigley Districts in Mogadishu. International Medical Corps has provided extensive training to clinic staff to improve their short- and long-term ability to provide high-quality health care to Mogadishu’s residents. International Medical Corps recently upgraded these two primary health care clinics in Mogadishu into health centers, which offer IDPs and other vulnerable populations an integrated, comprehensive package of primary health care services including comprehensive antenatal care and planned basic emergency obstetric and neonatal care.
On December 30, 2013, an 11 month old baby girl named Ikhlaas, who was suffering from oral thrush - a fungal infection in the mouth - and abdominal pain, was brought by her mother to see the consultant nurse at the International Medical Corps supported health center in the Wadajir District. Ikhlaas's family is currently living in the Siliga IDP camp that is located next the health center. Her entire family including her sisters, brother and mother have accessed health care services from International Medical Corps’ clinic including vaccination services (Expanded Program on Immunization), free treatment services and health education sessions.
Unfortunately, this is not the first time little Ikhlaas has had to visit International Medical Corps’ clinic. The first time she was seen, Ikhlaas was only six months old and was successfully treated for dysentery. During this particular visit, Ikhlaas was examined by our physician, treated and discharged on the same day. Ikhlaas’s mother continues to recognize International Medical Corps’ health center as the best place for her to seek health care services. She expressed her satisfaction of the services offered while adding that these crucial services are essential to the overall health of the IDP community.
Over the next 5-6 months, International Medical Corps will continue its operations in this clinic and others like it serving the IDP community. In addition to supporting services at the health center, International Medical Corps plans to support implementation of a vaccination campaign with supplies provided by U.N. Children’s Fund (UNICEF), engage the clinic staff in the national polio campaign, and contribute to the coordination of health activities in Mogadishu.
While the drought crisis has largely been resolved, the IDP population in Mogadishu has not significantly decreased due to continued unrest in the county, and the needs of IDPs remain high. Compounding this problem, the recent reduction of NGO operations in Mogadishu and across Somalia have resulted in higher demands on International Medical Corps’ clinics. Therefore, International Medical Corps intends to remain operational in Mogadishu for the foreseeable future, despite security challenges, in order to continue providing services to those beneficiaries in need.
During 2013, International Medical Corps’ efforts in Haiti focused on cholera prevention for vulnerable populations in the north of Haiti, indirectly benefitting more than 125,000 people. According to the Haitian Ministry of Health (MSPP), reports related to new cholera infections started to increase in those communities during the month of June. In response, International Medical Corps conducted weekly visits in Haiti’s Grand North District to confirm and evaluate the situation within targeted health facilities and to assess the condition of the cholera patients. During the visits, several problems were identified by International Medical Corps health professionals, including, among others, a (lack of medical supplies to treat patients infected by cholera and a low awareness of cholera among the at-risk population, to which may be attributed to shortages in available trained health staff and volunteers in the community to conduct Cholera awareness and prevention activities.
International Medical Corps assessed the situation and designed an intervention that would reinforce the capacity of the selected health facilities to response to cholera outbreaks and increase the awareness of the community to avoid the spread of cholera to the remote and underserved areas during the rainy/hurricane season. During the rainy season, flooding from strong tropical storms and hurricanes can contaminate water sources in remote areas and cause waterborne diseases to spread. These storms also damage the already poor road infrastructure, which can lead to medicine shortages and prevent patients with severe cases of cholera from being able to reach major health centers for treatment.
International Medical Corps assessed the needs of several remote communities in the North and North-East Districts and focused its support on re-supply of the area’s health centers with general use and cholera medicines while also delivering education campaigns to help local residents prevent the spread of cholera. Based on the distance and needs of each community and considering the generally poor road infrastructure of the region, four underserved communities and their respective health facilities were selected for this effort. These health centers were serviced in the following order: (1) Hôpital de l’Espérance de Pilate, (2) Centre de Santé de Dondon, (3) Centre de Santé de Ferrier and (4) Centre de santé de Sainte Suzanne. These four health centers serve a combined population of 125,326 people.
International Medical Corps provided a several month supply of medicines to the health centers and deployed community volunteers through local community based organizations for one month. Awareness training needed to be conducted to help the vulnerable communities recognize the ever present existence of cholera and that they needed to continue using good hygiene practice in order to avoid further cholera contamination. International Medical Corps, in partnership with the Council of Haitian Non-State Players (CONHANE) and the MSPP, worked with four community based organizations in the selected communities to conduct cholera prevention awareness activities through house-to-house visits and hygiene awareness sessions in churches and schools. During the awareness campaigns, the volunteers reminded the population that cholera is still present in their community and that they need to apply good hygiene practice to avoid the spread of cholera.
Thanks to the generosity of Global Giving and other generous donors, the intervention has completed all the planned activities and all result has been positive. International Medical Corps, along with CONHANE, was able to deploy 40 volunteers and two zones coordinators, reaching two communities in the North and two communities in North-East. Over 34,000 people in 4,839 households have been sensitized to the importance of proper hygiene practices to prevent the spread of cholera, and also received Aquatabs and oral rehydration salts (ORS) to treat the disease. Further, all 40 volunteers are available to continue the campaign which will ensure that an even larger number of people can be reached with critical hygiene education in the near future. Additionally, 100,000 water purification tablets (Aquatabs) and 5,000 ORS sachets have been distributed to prevent cholera in the community. While the project has been successful, it is important to remember that cholera is still present in Haiti. Prevention efforts must continue to stop the spread of cholera, particularly in vulnerable communities.