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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

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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.

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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.

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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

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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

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10 13 11

8 9 9

1 2 0 1 0 1 0 1 2 0 2 0 1 2 6

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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

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HEOC notifiable diseases seen by HCC mobile clinics

Diarrhoea without blood Bloody diarrhoea Red Eye Influenza like infections Suspected dengue Malaria

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Albendazole and Vitamin A treatment covered by mobile clinics

Albendazole Vitamin A

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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

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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:

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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.

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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

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Centres

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Distribution of antenatal mothers according to pregnancy stage

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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

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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.

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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

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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.

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141 155

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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