NewsNIH issues advisory on great health risks to IDPs
ISLAMABAD: The National Institute of Health (NIH) has issued an advisory to alert local health departments and public health personnel of various departments about the need to identify and respond to possible health risks associated with population displacements from the Federally Administered Tribal Areas (FATA).
Massive population displacement, with limited access to basic amenities, poses grave threats to the health of both displaced individuals as well as those residing in areas where the IDPs are temporarily settling down.
Preemptive measures and coordinated efforts on part of all stakeholders are, therefore, required to avert any untoward situation including disease outbreaks.
Considering the prevalent seasonal and environmental factors, there is an impending threat of the eruption of communicable disease outbreaks of water and vector-borne diseases such as gastroenteritis/acute watery diarrhoea, measles, polio, tetanus and other vaccine-preventable diseases, dengue, malaria, leishmaniasis, typhoid, and hepatitis A & E, etc.
Moreover, extreme weather conditions and vulnerabilities also significantly enhance the risk of non-communicable ailments such as injuries, sunstroke and health exhaustion, cardiovascular accidents, animal and snake bites, etc. The displaced population is also vulnerable to psychological stress because of prevalent uncertainty and sense of deprivation.
The NIH advisory calls for immediate activation of the Health Cluster platform at the national, provincial and district levels to guide various partners involved in response efforts. This has already been done. It also urges health departments to establish and maintain close liaison with relevant departments to monitor demographic characteristics of the displaced population at the registration points, and their subsequent settlement sites so as to immediately identify and effectively address their needs.
With reference to management of IDP camps, the advisory outlines a couple of mitigation measures. These include the designation, notification and facilitation of a senior Public Health Officer to supervise all health-related operations for IDPs in close coordination with camp management as well as the teams involved in relief work from line departments, NGOs, international agencies, etc.
The health officer, who needs to be designated by the concerned district health department, should be made responsible to keep updated record of IDPs, and particularly vulnerable groups i.e., children under five years of age, pregnant mothers, old individuals with chronic diseases, etc. “Besides having close linkage with health facilities in the vicinity, he/she may also keep a close check on medicine stocks as well as the daily surveillance data for timely detection and response to any communicable disease outbreak in the area,” the advisory recommends. The advisory lists a number of facilities that must be provided and regularly monitored in coordination with the local administration and relevant departments. These include access, safety and security of the camp; quantity and quality of water supply; sanitation facilities including dedicated latrines for males and females and safe waste disposal; sufficient quantities of soaps and detergents; distribution of chlorine tablets coupled with a vigorous health education campaign to instruct people how to use them; and vector control in breeding sites in the vicinity.
Since a majority of the displaced families are not entering designated camps and are taking shelter amongst host communities, families or friends, or in rented accommodation, the advisory calls for keeping track of the off-camp IDPs and supporting them as per their requirements.
Some of the specific interventions that the advisory recommends for mitigation of public health risks include the initiation of a mass awareness campaigns (in local language) particularly among ladies utilising LHWs and other female volunteers to promote use of safe drinking water, hygienic food preparation and storage, frequent hand washing especially before food preparation and after using latrine, use of bed nets, and early healthcare seeking for illness among family.
The advisory also alerts health authorities to the need for vaccinating 5-year-old children against all nine EPI target diseases, and 10-year-old children against measles. Maternal and child health facilities need to be ensured for pregnant ladies, it states. Regular sprays of high-risk areas through residual insecticide, along with provision of impregnated nets to prevent dengue, malaria and leishmaniasis, are also included in the advisory. Measures should also be taken to stop the sale of unhygienic food items in and around camps by the street vendors.
The importance of stock piling and regular supply of essential medicines including I/V fluids, ORS, bandages, antiseptics as well as anti-snake venom serum and anti-rabies vaccine has also been underlined. The advisory calls for appropriate facilities for the management of diseased persons on 24/7 basis, and referral/transportation arrangements for serious cases to major hospitals.
The NIH advisory also recommends implementation of the Disease Early Warning System (DEWS) for early detection, investigation and response to outbreaks. With reference to vaccination, it calls for carpet coverage of all vulnerable children through the establishment of vaccination points at every Permanent Transit Point and fixed clinic. Considering that children have been deprived of vaccination facilitation since quite some time, this measure is extremely important. Mass measles and polio immunisation with Vitamin-A supplementation should be implemented as soon as possible, it states. These measures too are already in place.
“For rapid detection of cases of epidemic-prone diseases, a surveillance/early warning system should be quickly established covering priority diseases like acute gastroenteritis, malaria, dengue, CCHF, scabies, viral hepatitis (A&E), measles, tetanus, meningitis, etc,” the advisory states in conclusion.
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