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South-East Asia Regional Health Emergency Fund Making a Difference
South-East Asia Regional Health Emergency Fund Making a Difference
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© World Health Organization 2009 All rights reserved. Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – can be addressed to Publishing and Sales, World Health Organization, Regional Office for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi 110 002, India (fax: +91 11 23370197; e-mail: publications@searo.who.int). The designations employed and the presentation of the material do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from 2 use. South-East Asia Regional Health Emergency Fund its Making a Difference
Introduction Cyclones, tsunamis, floods, earthquakes – the SouthEast Asia Region regularly faces some of the world’s worst natural disasters, which often leave hundreds of thousands of people devastated. Speedy assistance can make all the difference to their survival. Yet most emergency funding arrives a few days or even weeks after the disaster. The South-East Asia Regional Health Emergency Fund (SEARHEF) is intended to bridge this gap. The fund was officially established during the Sixtieth Session of the WHO Regional Committee for South-East Asia, held in Thimphu, Bhutan, in 2007. SEARHEF meets immediate financial needs and fills critical gaps in an emergency, and is not intended for bulk relief, long-term recovery, reconstruction or rehabilitation work. Therefore, it does not replace existing mechanisms such as Flash Appeals, the Consolidated Appeals Process (CAP) and the Central Emergency Response Fund (CERF). Member States of the Region can obtain SEARHEF funds within 24 hours, provided there is: a declaration of a state of emergency; official request for external assistance by the national government; or appointment of a humanitarian coordinator for that particularly emergency by the UN Secretary-General.
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The maximum total funds that can be disbursed from SEARHEF for one emergency is US$ 350 000. It has to be used within the first three months of the emergency. SEARHEF was first used to provide vital life-saving medicines and supplies following Cyclone Nargis in May 2008. It has subsequently been used in a number of emergencies, large and small, making a difference to hundreds of thousands of the most vulnerable disaster-affected people in the Region.
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South-East Asia Regional Health Emergency Fund Making a Difference
Cyclone Nargis in Myanmar, May 2008 The emergency: On 2-3 May 2008, Cyclone Nargis rampaged through 47 townships of the Ayeyarwady and Yangon districts of Myanmar, with winds upto 160 kph and 15 hours of continuous lashing rain. The storm left more than 130 000 dead or missing and 19 350 injured according to official figures—one of the worst natural disasters in the Region. Funds allocated: A total of US$ 350 000–the maximum allowed under SEARHEF regulations–was disbursed. The first $ 175 000 South-East Asia Regional Health Emergency Fund Making a Difference
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was released within 24 hours of an official request by the WHO Representative to Myanmar.
How it made a difference: The cyclone blew away houses, tore down trees and ripped off roofs–including those of some health centres, rendering many nonfunctional just when their services were most needed. Vital lifelines for the community, such as village ponds (the main source of fresh water), were contaminated by sea water that surged inland. Stagnant pools of water, ideal for breeding mosquitoes, added to the risk of malaria and dengue. The thousands left homeless had little protection. Procuring essential medicines: Within hours, SEARHEF allowed the health sector in Myanmar to procure tonnes of basic medicines and equipment to treat the sick and injured, including antibiotics, emergency medical kits, bandages and surgical equipment. These potentially saved thousands of lives.
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South-East Asia Regional Health Emergency Fund Making a Difference
Health staff mobility: The funds were also used to mobilize health workers from other parts of the country to serve health clinics in the affected areas. Safe water: Chlorine tablets and bleaching powder were procured to clean the water. Consequently, although some water-borne diseases were reported, there were no major outbreaks. Preventing vector-borne diseases: Fogging machines and insecticide-treated bednets helped in protecting the affected people from vector-borne diseases like malaria and dengue. Protecting against snakebites: Snake anti-venom was also purchased, as the risk of snakebites increased for those exposed to the elements by the cyclone. SEARHEF covered the Myanmar Ministry of Health’s needs for the affected population weeks ahead of the bulk funding mechanisms of the United Nations, such as the Flash Appeal and CERF.
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Flash floods in Sri Lanka, June 2008 The emergency: On 2 June 2008, heavy monsoon rains triggered flash floods in southwest Sri Lanka. The water swept over five districts (Kalutara, Ratnapura, Colombo, Galle and Gampaha), killing 16 and affecting 173 778, according
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South-East Asia Regional Health Emergency Fund Making a Difference
to official estimates. Landslides added further to the emergency. Funds allocated: Immediately after the disaster, the Sri Lankan Ministry of Health and Nutrition requested 2 500 000 LKR (around US$ 23 500) from WHO for distribution to the five mostaffected districts. The funds were for procurement of essential items as well as fuel for mobile health-care
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services. WHO released the amount for equal distribution to the five districts. How it made a difference: Clean water for communities becomes a problem when flood waters seep into village wells. Lack of clean drinking water leads to an increased risk of water- and food-borne diseases like diarrhoea. Pools of water left behind by the receding rivers provide an ideal breeding ground for mosquitoes that transmit dengue and malaria. And as the people forced out of their homes by the water and the mud crowd into refugee camps, there is the danger of an epidemic. The challenge in this emergency was to prevent these health issues from spiraling out of control. That is where SEARHEF funds made a difference. Essential medicines: Funds were used to purchase basic drugs and chemicals to treat the wounded and sick, and to procure food for volunteers and the displaced alike.
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South-East Asia Regional Health Emergency Fund Making a Difference
Clean Water: Disinfectants were bought and wells were cleaned so that people could have access to safe water. Disease surveillance: SEARHEF funds allowed disease surveillance systems to be set up, so that communicable diseases could be tackled early before they became epidemics. Vector-borne disease: SEARHEF supported work to clean up vector breeding places. Health education: To successfully manage public health in emergencies, however, the support and cooperation of the affected people is essential. SEARHEF played a vital role in funding health education activities to make the public aware of the potential dangers and how they can be prevented. Leaflets, posters and banners were used to communicate these messages. The outcome of such prompt action: no disease outbreaks were reported.
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Conflict in Northern Sri Lanka, September 2008/February 2009 The Emergency: More than two decades of conflict between the Government of Sri Lanka and the Liberation Tigers of Tamil Eelam (LTTE) separatist group have resulted in more than 65 000 deaths according to humanitarian agencies. As the conflict escalated in September 2009, thousands were displaced in the strife-ridden northern provinces of the country. By February 2009, as the Sri Lankan military forces made further inroads into LTTE–dominated territory, the number of displaced people in welfare camps exceeded 150 000. Physically and mentally shattered by the war, they needed urgent medical attention. Funds allocated: Twice the Government of Sri Lanka requested funds to provide healthcare to those affected, during the period of the conflict—in September 2008, and again in February 2009. Each time, the total amount of SEARHEF funds for one emergency—US$ 350 000—was released in two tranches, with the first tranche of US$ 175 000 being allocated within 24 hours. How it made a difference: Tens of thousands of civilians made their way to the internally displaced persons (IDP) camps in northern Sri Lanka. They had lost their homes, livelihoods and loved ones. Many were seriously injured or sick. Pregnant women, young children and the elderly were particularly
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South-East Asia Regional Health Emergency Fund Making a Difference
vulnerable. To meet the demands on such a large scale was a big challenge and needed resources that were partially met by SEARHEF. Human resources: Doctors, nurses and other health staff were urgently needed to cope with the health requirements of more than 150 000 displaced people. SEARHEF helped to provide the budget for salaries and accommodation for health staff at hospitals and mobile clinics, so that as many people as possible could have access to their services. Hospitals and health infrastructure: In three districts, the funds helped build semi-permanent wards and emergency medical care units. Four temporary wards with a bed capacity of 40 each were constructed in collaboration with NGOs, as well as two primary health clinics in Vavuniya. Facilities at other hospitals were also scaled up. Mental health: For those traumatized by the conflict, mental health support was a pressing need. WHO had supported training for building a mental health workforce at the community level. SEARHEF funds have allowed this to continue and provide much-needed assistance to the internally displaced people. Medical supplies and health interventions: Bandages, antibiotics, emergency medical kits and surgical kits were urgently needed to treat the wounded and sick. As camps got increasingly crowded, chlorine tablets were needed to ensure clean water. Overcrowded hospitals needed equipment, from catheters to mattresses. SEARHEF helped provide medical supplies quickly so that more lives could be saved. South-East Asia Regional Health Emergency Fund Making a Difference
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Koshi River floods in Nepal, September 2008 The Emerency: On 18 August, the furious waters of the Koshi River, fed by heavy monsoon rains, burst through the eastern retaining wall of an embankment about 10 kilometres north of the Koshi barrage. The wall of water that gushed out totally inundated Shreepurjavdi and Shreeharipur, and portions of Lohaki and Kusahapaschim in Sunsari District. Thirty-four people died and 49 000 were displaced. One sub-health post was completely destroyed, and two others suffered partial damage. Funds allocated: On the request of the WHO Representative to Nepal, US$ 325 000 was allocated for the emergency from SEARHEF.
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South-East Asia Regional Health Emergency Fund Making a Difference
How it made a difference: SEARHEF quickly provided substantial funds to mount an appropriate response to the emergency. Indeed, SEARHEF and CERF were the only two funding sources for the Koshi River emergency response in the health sector. Procuring essential medicines: With SEARHEF funds, essential drugs and supplies were speedily procured and distributed to ensure the health of the people and prevent outbreaks. Rapid assessment: Rapid assessment of the situation and follow-up assessments were done to understand the impact of the flood and the gaps that had to be filled for health care response. Provision of essential health care: The supplies and drugs were provided to rapid response teams that were mobilized by the Ministry of Public Health to provide essential health-care services to the displaced population. Ten mobile clinics were initiated. South-East Asia Regional Health Emergency Fund Making a Difference
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For further infomation please contact: World Health House Indraprastha Estate, Mahatma Gandhi Marg, New Delhi - 110002, India Telephone: +91-11-23370804, Fax: +91-11-23370197 Email: eha@searo.who.int, Website:www.searo.who.int/eha