After more than three years without cases, Haiti reported on 2 October 2022 a cluster of cholera cases in the metropolitan area of Port-au-Prince, just as the country was on the verge of being declared cholera- free.
This cholera resurgence in Haiti is happening in a complex operational context, am...id a volatile socio- political environment marked by blockades, fuel shortages, criminal gang activity and rampant insecurity. Civil unrest and lack of access to the affected communities are deepening the complex humanitarian crisis and hindering emergency response efforts.
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Archives of Disease in Childhood 2021;106:238-240.
South Sudan continues to struggle with a severe health crisis affecting 8.9 million people, primarily in flood- and conflict-affected regions with population movements (displacement and returns), and disease outbreaks. The nation's health system, heavily reliant on international aid, faces staffing ...and resource shortages. Vulnerable groups, including women, children, the elderly, and those with disabilities, have limited healthcare access and face heightened risks of mortality and illness.
The life expectancy at birth (55 years) is among the lowest globally, as mortality rates remain among the highest with neonatal, infant, under-five mortality rates estimated at 39.63, 63.76 and 98.69 deaths per 1000 live births respectively, and a maternal mortality ratio of 1,223 deaths per 100,000 live births. Although some disease specific mortality rates such as TB and AIDS-related mortality have declined, mortality due to malaria and non-communicable diseases have increased over the past five years.
The main causes of morbidity remain communicable diseases; malaria, is the top cause of morbidity (64%) and mortality (45%) among outpatients, followed by pneumonia and diarrhea.20 Several Counties report malaria cases above the threshold perennially especially during the rainy seasons, affecting mainly children under five years. The last malaria indicator survey (2017) estimated malaria prevalence of 32%, 34% and 18% among children under-five, protection of civilian’s sites, and internally displaced persons, respectively.
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Anaesthesia Tutorial of the Week
For the past years, Haiti has been engulfed in a socioeconomic, political, and humanitarian crisis that has reached critical levels since mid-September 2022 with the intensification of gang violence and social unrest. The widespread insecurity and
political instability have drastically affected the... country’s access to essential goods and services, including food, water, and health. The current fuel supply crisis has affected the water and electricity supply to the population, health centers, and hospitals. Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services.
In parallel, the public health system and international partners face limited response capacity due to reduced international personnel in Haiti, logistics issues, and difficulties in importing supplies. Indeed insecurity, roadblocks, and lockdowns are affecting the importation of internationally procured goods, which may slow the arrival of essential lifesaving supplies to support cholera response efforts. This scenario is particularly problematic, as cholera recently resurfaced in early October.
Armed gangs now control over 60% of the metropolitan area of Port-au-Prince, affecting at least 1.5 million people, and have expanded their influence outside of the capital city, interrupting vital humanitarian programs in most of the national territory,
including COVID-19 vaccination campaigns.
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Promoting People's Health to Enhance Social-economic Development
Early Identification and Early Intervention Services for Young Children with Developmental Delays and Disabilities in Namibia Republic of Namibia Namibia
Regional Consultations Report
The WHO Guide on Oral Cholera Vaccines in Mass Immunization Campaigns provides guidance on the planning and implementation of oral cholera vaccine (OCV) campaigns. It covers key aspects such as when and where to use OCVs, vaccine specifications, and recommendations for use in endemic areas, outbreak... settings, and complex emergencies. The document outlines steps for macro- and micro-planning, logistics, budgeting, human resource allocation, and risk communication. It also highlights challenges, including cold chain management, vaccine supply, and community engagement, ensuring that vaccination campaigns are efficient and effective in reducing cholera outbreaks.
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The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings.
In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive cholera outbreak followed, leading t...o 1 million suspected cases in 2 waves from September 2016-July 2018.
“We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states.
While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou
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