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Health and Climate Health and Climate Change in Change in
MozambiqueMozambiquePresented by:
Dr. Maria HauengueDepartment of Environmental Health
Government of Mozambique
24 April 2007Early Lessons from Implementation of Climate Change Adaptation Projects
in South-eastern Africa Workshop
BACKGROUNDBACKGROUNDBACKGROUNDBACKGROUND
Miassa
Cabo Delgabo
Man
ica
Nampula
Zambezia
Sofala
TeTe
Inh
amb
ane
Gaza
Map
uto
Size: 799380km2, 2470 km Coast
Pop: 15774000, 47% : 53% M/F
77% Rural : 23% Urban
45% <= 15 yrs 10% >50 yrs
Health indicators:
Birth rate : 46.1 per 1000
Life expectancy : 45.5 years
Mortality rate : 18.0 per 1000
Infant mortality rate : 127.7 per 1000
Maternal mortality : ~ 1.000 per 100.000
FLOOD & FLOOD & CYCLONES CYCLONES
IMPACTIMPACT
HEALTH SYSTEM:Damaged/ Destroyed.. HEALTH SYSTEM:
Damaged/ Destroyed..
ENVIRONMENT:Poor sanitation
Conditions..
ENVIRONMENT:Poor sanitation
Conditions..
INCREASE OFDISEASE
INCREASE OFDISEASE
FLOOD´s IMPACTFLOOD´s IMPACT 2 millions people affected in 5 provinces; 500.000 displaced; 650.000 died More than 100 temporary accommodation centers; Very poor and unhygienic sanitary conditions; No adequate water supply, few latrines; Food distribution ‘inadequate’; Lack of shelters; People exposed to mosquito bites; Risk for outbreaks of endemic diseases:
. malaria,
. cholera,
. other preventable and communicable diseases.
FIVE FLOOD AFFECTED PROVINCESFIVE FLOOD AFFECTED PROVINCES
Manica:Affected population:
Health Cent.: %Number of affected Staff:
Manica:Affected population:
Health Cent.: %Number of affected Staff:
Inhambane:Affected population:
Health Cent.: %Number of affected Staff:
Inhambane:Affected population:
Health Cent.: %Number of affected Staff:
Gaza:Affected population:
Health Cent.: %Number of affected Staff:
Gaza:Affected population:
Health Cent.: %Number of affected Staff:
Maputo:Affected population:
Health Cent.: % Number of affected Staff:
Maputo:Affected population:
Health Cent.: % Number of affected Staff:
Man
ica
Inh
amb
ane
Gaza
Map
uto
Sofala
Nampula
Zambezia
TeTe
Sofala
Miassa
Cabo Delgabo
Nampula
Zambezia
Miassa
Cabo Delgabo
Sofala:Affected population:
Health Cent.: %Number of affected Staff:
Sofala:Affected population:
Health Cent.: %Number of affected Staff:
The health situation criteria
• Number of people affected at the assembling points
• Time that these people saty in accomodation centers
• Infrastructure, health conditions of the aco.centers
• Levels of organisation, prevention and control measures established
Weekly Cholera incidence Mozambique - 2000
45
125 119 133
218 208 194242 268
421
847
1391
1526
17781721
1555
1110
850
565
387340
145
0
200
400
600
800
1000
1200
1400
1600
1800
2000
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Semanas epidemiológicas
Ca
sos
CASOS: 14046OBITOS: 182T.L.: 1.3%
INÍCIO DAS CHUVAS
Cholera by affected Provinces Mozambique - 2000
0 1000 2000 3000 4000 5000 6000 7000 8000 9000
Tete
Manica
sofala
Inhambane
Gaza
P.Maputo
C.Maputo
PR
OV
ÍNC
IAS
CASOS
Series1 Series2
1318 288
202 203
10204
559
183 256
2142
13381
Weekly Cholera incidence Maputo City - 2000
4 7 2 5 6 10 10 2156
190
481
884
1113
12711238
1059
714
510
279
186 196
4600
200
400
600
800
1000
1200
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
SEMANAS EPIDEMIOLOGICAS
INICIO DAS CHUVAS
CASOS: 8288OBITOS: 131T.L.: 1,6%
Weekly Cholera incidence In Sofala Province - 2000
41
118 117128
212198
184
221212
231
366
427
246
300
153
72
90
152 4 0 00
50
100
150
200
250
300
350
400
450
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
SEMANAS EPIDEMIOLOGICAS
CA
SO
S
CASOS: 3,256OBITOS: 18T.L.: 0,55%
INICIO DAS CHUVAS
WEEKLY CHOLERA INCIDENCEWEEKLY CHOLERA INCIDENCE IN MAPUTO PROVINCE - 2000 IN MAPUTO PROVINCE - 2000
0 0 0 0 0 0 0 0 0 0 0
52
153
181
271
369
341
275
211
171
93 92
210
50
100
150
200
250
300
350
400
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
SEMANAS EPIDEMIOLÓGICAS
CA
SO
S INÍCIO DAS
Casos:2203 Óbitos:19TL: 0,9%
AIM OF ACTIVITIES ON THE HEALTH SECTOR
• Increase the capacity of the health sector to respond to the emergency situation.
• Prevent and treat outbreaks, namely cholera, meningitis and measles, among others.
• Treat on time cases of malaria among people affected by floods so as to avoid outbreaks.
AIM (cont.)
• Treat acute respiratory diseases;• Prevent vaccine- preventable diseases such as
meningitis, and measles;
• Prevent and treat malnutrition among children, pregnant and breast-feeding women;
• Respond to the needs of women in reproductive health
Framework for Public Health interventions
1. Rapid Assessment :
• To determine the extend of damage to the Health system and its capacity to respond to the crisis
• To identify urgent measures for prevention and treatment of IDPs
2. Reinforcement or development (in camps) of the Surveillance System :
• To increase the reporting system of keys diseases : Cholera, Malaria, Malnutrition
• (Communication using Pactors system)
1: Assessment 2: Immediate Reaction
Contingency Plan for major diseases, conditions and specific groups:
• Malaria
• Cholera
• ARI
• Sanitation
• Malnutrition
• Women (RPH)
• MST/AIDS
• Mental Health
• Immunization
• IEC ...
3: Initial rehabilitation
Reinforcement of Health System:
. Essential Infrastructure rehabilitation
. Drug and medical supplies,
. Staff issues:
- Training
- Redeployment
- Hiring new staff
- Consultants
- Other supplies including vehicles
(up to 6 months)
Strategies
- Reinforce malaria treatment in the affected areas;
- Vaccination campaigns against mrningities and measles in the affected areas;
- Chlorinating of water in accomodation centers, as well as construction of latrines;
- Health education campaigns
Strategies
• Health education campaigns
• Production and disseminantion of guidelines in order to dispose of the solid and liquid residuals
• Pressure on relevant institutions to solve problems of hygiene and environment
LESSONS LEARNT
• Adaptation as a key issue for the present;
• Strengthen institutions;
• Involve those at risk;
• Use sector-based approaches;
• Expand information, awareness and technical knowledge;
• Adaptation compared to development
Lessons Learnt (Cont.)
• International financial assistance is necessary;
• Adaptation is context-specific;• The importance of the level of decision
making• Better coordination and people’s
motivation;• Try to remove the obstacles ASAP
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