Ndrrmc update progress report diarrhea cases in palawan 14 april 201
REPUBLIC OF THE PHILIPPINES National Disaster Risk Reduction and Management Center, Camp Gen. Emilio Aguinaldo, Quezon City, Philippines NDRRMC UPDATE Progress Report on Diarrhea Outbreak in Bataraza, Palawan (Region IV-B) March 01 – April 13, 2011 Releasing Officer
USEC BENITO T RAMOS
Administrator, OCD DATE: 14 April 2011, 6:00 PM Source: DOH-HEMS, RDRRMC/OCDRC IV-B I. SITUATION OVERVIEW
• Based on the findings of Center for Health Development (CHD) IV-B, the
diarrhea cases in Bataraza, Palawan, which started on 01 March 2011 slowly increased peaking on the 3rd week of March. Age of cases ranged from 7 months to 85 years old
• A total of 430 diarrhea cases were reported from 01 March to 12 April 2011
with Brgy Culandanum having the highest attack rate 52.28% followed by Brgy Tarusan and Rio Tuba. and out of the 22 barangays in Bataraza, 17 were affected. Six (6) sitios in Brgy. Culandanum were affected namely: Sitios Linao, Apad-apad, Pajo-pajo, Kadulan, Cabinbin and Bato–bato where
• Ninety (90) persons were admitted at Rio Tuba Nickel (RTN) Hospital from
Casualties • There were 19 deaths (CFR: 4.41% reported in Brgy Culandanum with age ranging from 1 year old to 50 years old. The identities of dead victims are as follows:
Telefax: NDRRMC Opcen (+632) 911-1406; 912-2665; 912-5668; NDRRMC Secretariat (+632) 912-0441; 912-5947;
Office of the Administrator, OCD (+632) 912-2424
Email: dopcen@ndcc.gov.ph Website: www.ndcc.gov.ph
In addition to the 19 confirmed dead in Brgy Culandanum, Bataraza, two (2) possible cases of diarrheal deaths in the municipality of Rizal are still being verified by the Municipal Health Officer of CHD-IV B II. ACTIONS TAKEN
Health and WASH DOH-CHD IV B, PHO Palawan and MHO Bataraza
Dispatched an investigating team led by Dr. Faith Alberto on April 3 - 4, 2011
and validated the cases of diarrhea in Brgy. Culandanum, Bataraza. Findings of investigation are the following:
• Brgy.Culandanum has a total population of 3,786 and most of the affected
are indigenous people in Sitio Apad-apad who are members of Palawa-an tribe. Sitio Apad-apad is four (4) hour walk from said barangay
• Seven (7) cases of diarrhea with varying degree of dehydration were seen
during the investigation. Six (6) came from Sitios Apad-apad and Linao and one (1) from Sitio Bato-bato
• There is a fast progression of symptoms and rapid deterioration of patients’
condition from the onset of initial symptoms to severe dehydration and sudden death. Patients manifested symptoms of profuse watery diarrhea, abdominal pain and vomiting
• Affected individuals did not consult any health provider and was not given
any form of treatment prior to their death. Deaths started on 27 March 2011 and none of the deaths were seen by a health provider
The team provided the following drugs, medicines and medical supplies for
augmentation, management and control of diarrhea case: 1,000 Aqua tabs, 3,500 tabs metronidazole 500 mg, 1000 tabs cotrimaxazole 800mg; 224 bottles cotrimaxozole oral suspension, 500 caps ciprofloxacin 500 mg, 1000 caps amoxicillin 500mg, 1000 caps doxycycline 100 mg, 1000 caps tetracycline, 250 mg, 144 bottles chloramphenicol, 125 mg suspension, 1000 tabs paracetamol, 500 mg, 144 bottles paracetamol 250 mg suspension
Dispatched the Disease Surveillance Officers and Sanitary Inspector on April 2-
5, 2011 and conducted preliminary epidemiologic and environmental assessment. Poor environmental sanitation was observed in the area:
• Primarily absence of clean source of drinking water
• IPs seldom boils water prior to drinking
• No toilet facilities causing inhabitants to dispose human excreta anywhere
• Poor personal hygiene could also be one major factor because of their
• Remains of dead bodies were buried less than ten (10) meters from the
Set-up a temporary hospital in Sitio Linao, Brgy. Culandanum, Bataraza,
Palawan. Patients are being treated at the Linao Elementary School as temporary consultation and treatment camp and referred case to hospital facilities if it warrants admission. The “survivors” together with the local residents persuaded other members of the tribe who are still staying inside the cave to come down to the treatment camp for proper care. The assistant Regional Director of DOH IV B, Provincial Health Team leader and other CHD Staff conducted actual visit at the treatment/consultation site
Dispatched 2nd batch of CHD IV_B team on 07 April 2011 and conducted a
comprehensive health and environmental assessment. The team, composed of 2 doctors, 1 nurse, 1 medical technologist, 1 Sanitary Inspector and 1 Administrative Staff, brought additional medicines and supplies worth PhP84,151.00 comprising of 300 pcs. water containers (jerry cans), 144 bottles IV fluids, 72 bottles hyposol, 500 sachet oresol, 1,000 aqua tabs, 3500 tabs metronidazole 500 mg, 2,880 tabs metronidazole 125 mg, 1000 tabs cotrimaxozole 800 mg, 224 bottles cortimaxazole oral suspension, 500 caps ciprofloxacine 500 mg, 1000 caps amoxicillin 500 mg., 1,000 cap doxycycline 100 mg, 1000 caps tetracycline 250 mg, 144 bottles chloramphenicol 125 mg suspension, 1000 tabs paracetamol 500 mg, 144 bottles paracetamol mg suspension, 1,000 caps mefenamic acid 500 mg, 100 caps, Vitamin A and 500 tabs zinc. Also istributed 28 Jery Cans to the families in Sitio Bato-Bato, Brgy. Culandanum
Conducted public information and education campaign (PIEC) including proper
treatment, prior to drinking (i.e. using aqua tabs, puri tabs and waterine) among IPS
Collected water and stool samples from different water supply and sent to RITM
on April 11, 2011 for bacterial testing analysis. Also collected 35 rectal swab specimen from patients for cholera confirmation. Three (3) out of ten (10) specimens were (+) for vibrio cholera
MDRRMC Bataraza convened the local council (Barangay Assembly) presided
by the Vice Mayor attended by local officials, CHD IV-B, NEC, PHO, RHU Staff and RTN group and declared the municipalityunder a State of Calamity through a Municipal Council Resolution Mayor Abraham Ibba informed that the municipality can handle the requirements of the emergency (immediate term); that programs have been designed to control further spread of the disease and respond to the needs of those that had already been affected; and that request for national government assistance would be sought once the requirement exceeds local government capacity III. RECOMMENDATIONS
LGUs to provide each household (specifically indigenous people) with safe
water supply and clean water container which will be monitored for proper disinfection and utilization every month; to purchase aquatabs and dispatch fire trucks to selected barangays for temporary access to safe water. LGU Bataraza has been providing potable drinking water to the residents on regular basis
Institutionalization of an appropriate and culturally-sensitive health education
program focusing on the indigenous people. Intensified IEC, consider rural practices, level of knowledge/communication barriers (develop IEC materials suited for IPs)
Conduct massive Public Information and Education Campaign (PIEC) on
personal hygiene and disposal of human excreta. - CHD IV-B is currently conducting PIEC regarding proper human waste disposal, personal hygiene and proper treatment of water
Encourage members of the indigenous people to engage on health activities of
Rural Health Unit like inviting them to get involved as Barangay Health Workers
Pro-active response of RHU on possible outbreak particularly during rainy
“Adopt-a-community” program for implementation in the areas where indigenous
people reside. The “adopter” will serve as a direct linkage of the indigenous community of RHU and other agencies involved
Strict implementation of rules and regulations of sanitation code regarding
guidelines in the establishment of toilet facilities and safe water resources
Timely monitoring and reporting of diarrhea cases particularly in affected
Provision of emergency medicines at Rural Health Unit and allocation of funds
Activate/establish Brgy. Health Emergency Response Team
Long Term
Conduct of Stakeholder Planning and Construction of Water Systems L1 to L3
and toilet facilities in different IP barangays
Summary of Hall, et al. study “Mid-Century Warming in the Los Angeles Region.” Prepared by Paul Bunje PhD The first results from the “Climate Change in the Los Angeles Region” project, sponsored by the City of Los Angeles and US Department of Energy covers temperature changes. Future results will cover other elements of climate change (precipitation, snowpack, winds, clouds, etc.). T
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