AMREF – Responding to crisis: Lessons from Kenya’s silent emergency

Source: African Medical and Research Foundation (AMREF)

Date: 06 Jun 2008

Responding to crisis: Lessons from Kenya’s silent emergency

AMREF’s Deputy-Director General, Dr Florence Muli-Musiime has warned that emergency institutions, both local and international, risk misdirecting their humanitarian crisis response if they are not sensitive to community dynamics that are not always visible in times of upheaval. In a powerful message to hundreds of delegates at the 35th Global Health Council Conference taking place in Washington DC, Dr Muli-Musiime described a ‘silent emergency’ that nobody spoke about following the post-election violence in Kenya, whose implications for healing and recovery has more serious implications for post-conflict health and social development than the more widely publicised plight of internally displaced people in the country.

‘When the crisis broke out,’ she said, ‘the focus of the health system was to mitigate the physical injuries, while that of the donor community and emergency institutions was on the Internally Displaced People. But we realised that there was a silent emergency which none of the two groups was looking at – that of thousands of people who were caught up in their own homes, unable to go to IDP camps because they would have had to go through hostile territory to get there, and unable to access health or any other basic services. To make matters worse, they were physically assaulted and sexually abused in their own homes.’

ICRC Kenya: Surgeons dissect lessons from post-election violence

Source: International Committee of the Red Cross (ICRC)

Date: 19 May 2008

Kenya: Surgeons dissect lessons from post-election violence

Following Kenya’s December 2007 general elections, hospital staff had to face a massive, and unexpected, influx of victims of violence. Now, during a series of ICRC-organized workshops geared at peace-time emergencies, they are discussing the lessons learned. The ICRC’s Iolanda Jaquemet reports.

“Even if the patient has his bowels hanging out, it does not necessarily mean this is the most urgent case on hand, as long as he is in stable condition.” The 20 members of the audience listened attentively to Dr Mauro Dalla Torre, the ICRC surgeon, as he illustrated the principles of triage.

Later, they looked with calm, clinical interest at a picture showing a little boy with horrendous leg wounds, used by Dr Dalla Torre to illustrate “the high energy transfer” caused by a bullet.

The participants’ poise was not surprising: they were surgeons, nurses and clinical officers from five hospitals in Nyanza province, Western Kenya. During two days in April, they swapped experiences at an ICRC-organized workshop on “emergency preparedness and treatment of wounds due to violence”.

Catholic Relief Services – Clean camps improve health in Kenya

Date: 29 Apr 2008

Clean camps improve health in Kenya

CRS continues to respond to the post-election crisis in Kenya. Recently, staff from CRS and the Catholic Diocese of Eldoret trained 18 volunteers to serve as hygiene promoters in camps in the Eldoret area of western Kenya. One volunteer, Milka Nyambura Kariuki, lives with 2,000 other displaced people in the Burnt Forest camp. Here she shares how she is working with other volunteers to teach residents about improving camp sanitation and personal hygiene:

Volunteer hygiene promoter Milka Nyambura Kariuki is helping her fellow residents improve sanitation in the camp they are living in after being displaced by the post-election violence in Kenya. Photo by Gilbert Namwonja/CRS

Cholera in Nyanza: Kenya Red Cross intervenes

Source: Kenya Red Cross Society

Date: 29 Apr 2008

Nairobi, 29th April 2008 – Nyanza region has had cholera outbreaks since last year where the first case was confirmed in Suba on 2nd December 2007. The outbreaks have been reported in 10 districts. The affected districts are Nyando, Homabay, Suba, Migori, Rongo, Bondo, Kisumu East and West, South Kisii and Bunyala Districts.

The Ministry of Health has been working with partners in the region to curb the spread of and control cholera in the region. Partners working closely with the MOH in cholera interventions are the Kenya Red Cross, Care Kenya, UNICEF, World Vision and MSF, among others.

KENYA: Camp conditions harsh for HIV-positive displaced people

KENYA: Camp conditions harsh for HIV-positive displaced people

Photo: Manoocher Deghati/IRIN

IDPs have insufficient food, soap and warm clothing in the camps

NAKURU, 29 April 2008 (PlusNews) – Harsh living conditions and the onset of the cold rainy season in Kenya are making it increasingly difficult for HIV-positive people displaced in the recent post-election violence to stay healthy, according to health workers in the camps.

“The main difficulty is getting a good balanced diet,” said Ancilla Kemunto, a government community healthcare worker at the largest camp for internally displaced people [IDPs] in the Rift Valley town of Nakuru. “Although, like other IDPs, they [HIV-positive people] get the WFP [United Nations World Food Programme] rations, they are not nutritious or large enough to keep them healthy.”

The situation is all the more worrying, given Kenya’s looming food crisis after a poor rainy season between October and December, and the impact of the post-election crisis on agriculture, in which tens of thousands of farmers, casual labourers and food traders were displaced.

The post-election violence started in early January 2008 after presidential elections were held on 27 December 2007, and continued until an agreement was signed on 28 February, usually the peak of the agricultural season.

KENYA: ARV programmes slowly recovering from post-election crisis

KENYA: ARV programmes slowly recovering from post-election crisis

Photo: Manoocher DEGHATI/IRIN

AMPATH has opened a satellite centre in the Nakuru Showground IDP camp where patients can receive ARVs

ELDORET, 28 April 2008 (PlusNews) – Thousands of Kenyans who dropped out of HIV treatment programmes in January as a result of the country’s post-election violence are gradually returning to clinics and the antiretroviral (ARV) drugs that help prolong their lives.

“Initially more than 90 percent of our patients failed to come for their monthly appointments during which they collect their drugs, but now they are returning slowly,” said Cleophas Chesoli, social work manager for the Academic Model for the Prevention and Treatment of HIV (AMPATH), a research institution linked to Moi University in western Kenya’s Rift Valley town of Eldoret.

At the height of the crisis, AMPATH placed national announcements in the newspapers and on the radio advising clients on the nearest available health facility where they could get ARVs. AMPATH has 67,000 clients, with an estimated 30,000 on treatment; although it is still unclear how many patients missed their doses, Chesoli is hopeful that the chances of patients developing resistance are low.

“We generally give patients as much as six weeks’ worth of medication because many of our patents may not make their monthly consultations due to lack of transport or bus fare, or distance for the nearest centre,” he said.

Kenya: Complex Emergency Fact Sheet #12 (FY 2008)

Date: 23 Apr 2008

BUREAU FOR DEMOCRACY, CONFLICT, AND HUMANITARIAN ASSISTANCE (DCHA)
OFFICE OF U.S. FOREIGN DISASTER ASSISTANCE (OFDA)

Note: The last fact sheet was dated April 9, 2008.

KEY DEVELOPMENTS

– The April 13 announcement of the formation of a coalition cabinet has led to a reduction in tensions in areas of Kenya affected by the post-election crisis. However, USAID Disaster Assistance Response Team (USAID/DART) staff caution that the overall security situation remains tenuous.

– On April 14, the U.N. and non-governmental organizations (NGOs) launched a revised appeal for $189 million targeting internally displaced persons (IDPs) and other populations impacted by Kenya’s post-election violence, as well as families potentially affected by drought. The revised appeal supplements the original $41.9 million Kenya Emergency Humanitarian Response Plan announced on January 16 to assist 500,000 people affected by the postelection violence.

– On April 10, USAID/OFDA airlifted 300 rolls of plastic sheeting from USAID/OFDA’s Dubai warehouse to Eldoret town, Rift Valley Province, to upgrade existing camp shelter resources in response to protracted displacement needs compounded by the onset of the March rains. The emergency relief commodities, valued at more than $165,000 including transport, will improve shelter conditions for approximately 50,000 beneficiaries.

– The USAID/DART continues to conduct field assessments throughout affected regions of central and western Kenya, engage with U.N. and partner relief agencies to identify evolving humanitarian needs, and facilitate coordination and information sharing regarding response and early recovery efforts.

NUMBERS AT A GLANCE		SOURCE
Conflict-Affected Population at Risk of Poverty(1)	2,000,000	The World Bank – January 18, 2008
Estimated IDPs in camps and centers	157,585	KRCS(2) – April 16, 2008
Estimated IDPs within host communities	196,000	NDOC(3) – March 26, 2008
Deaths(4)	1,020	NDOC – April 8, 2008
Kenyan Refugees in Uganda	2,000	UNHCR(5) – April 18, 2008

FY 2008 HUMANITARIAN FUNDING PROVIDED TO DATE

USAID/OFDA Assistance to Kenya: $6,222,429
USAID/FFP(6) Assistance to Kenya: $39,719,000
State/PRM(7) Assistance to Kenya: $10,843,105
Total USAID and State Humanitarian Assistance to Kenya: $56,784,534

CURRENT SITUATION

Health Action in Crises – Highlights No. 203 – 07 to 13 Apr 2008

Health Action in Crises – Highlights No. 203 – 07 to 13 Apr 2008

Date: 13 Apr 2008

KENYA

Assessments and Events

– On 8 April, the key political parties announced a suspension in their dialogue. The UN fears that this could slow or halt progress made in returning thousands of IDPs to their homes.

– Social networks are disrupted and health services are under pressure. Risks are particularly acute for people with chronic conditions, like TB or HIV/AIDS, who depend on regular medication.

Actions

– WHO and the Health Cluster partners (UNICEF, UNFPA, the Kenyan Red Cross, international and local NGOs, community- and faith-based organizations) continue to support the MoH in facing the increasing demand for care.

– In the context of the Emergency Humanitarian Response Plan, WHO is requesting external assistance to:

• strengthen coordination and health information management (assessments, monitoring, dissemination) in the most critical provinces as well as in Nairobi;
• ensure surveillance and respond to disease outbreaks;
• strengthen primary health care services and ensure the availability of medical supplies in IDP camps and host communities.

– Under the revised Response Plan, WHO is requesting US$ 1 177 000, of which 395 700 have already been received from the CERF, Australia and Turkey. WHO also advanced US$ 240 000 from its own regular budget.

Source: World Health Organization

Kenya issues alert after cholera kills 60

Date: 10 Apr 2008

NAIROBI, April 10, 2008 (AFP) – Kenya on Thursday issued a cholera outbreak alert after the disease killed 60 people in recent weeks, compounding a health nightmare in the country reeling from months of political violence.

Kenya’s Director of Medical Services James Nyikal said the outbreak had occurred in 16 districts in the western region, most of which were affected by violence spurred by disputed elections in December.

“So far, there have been 1,217 cases of the disease and 59 deaths reported. Most of the deaths occurred at home or on their way to hospital,” he told a press conference here. One more death was reported in the Rift Valley town of Naivasha early Thursday.

KENYA: Displacement raises risk of drug-resistant TB

KENYA: Displacement raises risk of drug-resistant TB

Photo: Siegfried/IRIN

The national referral hospital has already seen seven new cases of MDR-TB from one IDP camp in the capital, Nairobi

NAIROBI, 2 April 2008 (PlusNews) – The threat of multi-drug resistant tuberculosis (MDR-TB) has been heightened by the displacement of an estimated 300,000 people in Kenya’s recent political crisis, health workers have said.

“During the violence, many displaced people were disrupted from their lives, which meant disruption from drugs,” said Dr Henderson Irimu, head of the HIV/TB treatment care at the Kenyatta National Hospital, the country’s largest referral hospital. “Due to the violence it was impossible for people to come for medication.”

Irimu said there had been an increase in MDR-TB, a form of the disease that does not respond to standard treatment, usually because of a failure to complete first-line treatment. When patients are co-infected with HIV, it is often lethal.

“So far we have seven new cases of MDR-TB who were brought at the hospital from Mathare internally displaced settlement [in the capital, Nairobi],” he said. “Some would come and admit to not having taken TB medication since the violence began.”