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Health Emergencies Newsletter
Issue No.34: 07.12.2023
TOP STORY
3 December 2023: Dr Hans Henri P Kluge, Regional Director for WHO Regional Office for Europe gave a statement at Council of the Parties 28 (COP28) in Dubai, in which he stated, "the climate crisis is a health crisis, which carries the urgent call and responsibility to protect the health of current and future generations." He offered three main strategic priorities: robust policies and political commitments as the foundation for urgent action, the need to foster strong partnerships to drive change and action in countries and the importance of strong country action and leadership to address the climate threat.
Israelis have been shaken to their core. The Hamas attacks on 7 October 2023 left them deeply scarred and frightened. For many right now, moving forward with their lives and regaining a sense of security and normalcy seems impossible.
To collaborate on the provision of mental health and psychosocial support in Israel (a Member State of the WHO European Region), WHO/Europe spoke to health-care workers, families of hostages and members of community resilience centres about the support they need and how they are coping with their grief.
On October 7, Dr Noa Rosenfeld-Yehoshua was on duty as a paediatrician at the Assuta Medical Centre in Ashdod, Israel, where she is head of the Intensive Paediatric Unit. She and other colleagues were among the many health providers and workers who responded to the Hamas attacks that claimed some 1400 lives and injured over 4600 people. More than 200 people were taken hostage.
WHO recently met Dr Rosenfeld-Yehoshua in London on the day she was due to return to Israel after a visit to the United Kingdom of Great Britain and Northern Ireland. Sitting with her 8-year-old daughter Abigail, she described what happened on October 7 and the mental health impact on her community and country.
21 November, 2023. With heavy hearts, WHO announces the death of one of our staff in Gaza, in the occupied Palestinian territory. Dima Abdullatif Mohammed Alhaj, 29 years old, had been with WHO since December 2019. She worked as a patient administrator at the Limb Reconstruction Centre, a critical part of the WHO Trauma and Emergency Team.
Dima died when her parents’ house in southern Gaza—where she had evacuated to from Gaza City—was bombed. She was tragically killed alongside her husband, their six-month old baby boy, and her two brothers. Reportedly, over 50 family and community members sheltering in the same house also died.
The immediate need for mental health and psychosocial support (MHPSS) in Armenia is acute, as displaced people attempt to deal with a range of emergency-induced social problems that include family separation, lack of safety, loss of livelihoods and disrupted social networks. In the longer term, studies suggest that almost everyone affected by emergencies will experience some form of psychological distress. Among those who have gone through war or other conflict in the previous 10 years, 1 in 5 (22%) will go on to experience depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia.
Applying these estimates to the situation for refugees in Armenia, WHO expects that approximately 22 500 Armenian refugees may experience a mental health condition. Meeting the mental health needs of all refugees is a key component of WHO’s Armenia refugee response. To achieve this, WHO is scaling up its MHPSS services by training psychologists, primary health-care workers and volunteers.
While media attention may have diminished, the health needs of more than 100 000 refugees who entered Armenia from Karabakh have not.
WHO, through its Country Office in Armenia and Regional Office for Europe, has been meeting with refugees to assess their health needs. WHO has also met frontline workers operating 24/7 to care for them. Heroes from the community have been tireless in ensuring refugees have access to health care, while some refugees have joined WHO in helping address the health needs of the most vulnerable.
A new WHO/Europe report delves into the current state of primary health care (PHC) financing in Ukraine and presents 5 policy recommendations to enhance health outcomes, optimize public spending and increase value for money.
Ukraine is making significant strides in expanding PHC amid the war. Recent health financing reforms have prioritized strengthening PHC, introducing measures to increase services and improve quality, including on: implementing a PHC service package within the Program of Medical Guarantees (PMG) definition; ensuring patient choice and provider autonomy expansion; and implementing the Affordable Medicines Programme.
These reforms have led to a robust PHC-centred system in the country. Now, the new WHO policy paper, “Primary health care financing in Ukraine: a situation analysis and policy considerations”, puts forward a series of recommendations to take these reforms further.
The ongoing war in Ukraine continues to bring daily destruction across the country, severely impacting and disrupting the health-care sector. WHO has recorded over 1300 attacks on health care since 24 February 2022.To ensure continued access to primary health-care services in areas where facilities have been destroyed or irreparably damaged, WHO and the Ministry of Health of Ukraine have opened new, modular primary health-care clinics to serve affected communities.
Modular clinics can be assembled and installed in 10 to 14 days using a varying number of prefabricated modules depending on the required number of rooms. All clinics are equipped with essential amenities including electricity, sanitary facilities, sewage systems, waiting rooms and patient examination rooms. Generators and fans are provided to maintain an optimal environment for health-care delivery.The pilot project, sponsored by the Ukraine Humanitarian Fund and the Directorate-General for European Civil Protection and Humanitarian Aid Operations, will include 15 facilities in hard-to-reach communities near the frontline.
The National Centre for Disease Control (NCDC) of Armenia has developed an updated national routine immunization schedule endorsed by the Ministry of Health and in accordance with WHO’s latest guidelines.
The revised schedule now includes catch-up opportunities for children, adolescents and adults. A national catch-up campaign launched this month aims to reach out to individuals who missed vaccination in the past and to increase uptake among population groups most affected by the overall dip in routine vaccination coverage due to the COVID-19 pandemic. The impact of this decreased routine immunization coverage is evident from an increasing number of measles cases reported in Armenia in 2023. Catch-up vaccination will also be available to the over 100 000 refugees from the Karabakh region who recently fled to Armenia.
In December 2021, Eric Bossward, a vicar from Oxford in the United Kingdom (UK) was feeling distinctly lousy. He’d caught COVID-19 several weeks earlier and although initially he had only mild symptoms, he was now feeling a lot worse, both physically and mentally, but had no idea why.
“The fatigue had become just unbelievable. I couldn’t think properly. I was suffering from horrendous breathlessness, as well as dizzy spells. I also had the most horrific anxiety, waking up every morning with an overwhelming sense of dread. I’ve had anxiety and depression in the past – and had medication for it – but this was way, way beyond anything I’d ever experienced before.”
The massive 7.7-magnitude earthquake that struck Türkiye in February 2023 resulted in 51 000 deaths, with many more injured across 11 provinces. Many survivors are now living with disabilities, including approximately 1090 new amputees, while 2200 patients lost their protheses. These survivors need long-term, or even lifelong support, including rehabilitation and assistive technology.
WHO carried out an assessment of the support needed, following a request from the Turkish Government, and launched a project to strengthen physiotherapy services in 31 primary health care (PHC) centres across 15 provinces. The project aims to meet the rehabilitation needs of the affected population and build long-term and sustainable service capacity.
Margarida Tavares attributes her “being in the right place at the right time” simply to good luck. More likely, it’s a combination of her fascination with emerging infectious diseases, her tangible concern for protecting the health of the population and her love of planning.
Portugal’s Secretary of State for Health Promotion first encountered a serious infectious disease outbreak in São Paulo, Brazil, where she lived during her teenage years. A sudden outbreak of yellow fever in a local district prompted her, along with family and friends, to volunteer in a prevention campaign, advocating for control measures to tackle breeding mosquitos, and encouraging the affected community to get vaccinated.
The MRC Centre for Global Infectious Disease Analysis at Imperial College London has been redesignated as WHO’s Collaborating Centre (CC) for Infectious Disease Modelling.
The Centre’s mission is to serve as an international resource and centre of excellence for research and training in epidemiological analysis and modelling of infectious diseases. Building on decades of collaboration with WHO, it undertakes applied collaborative work at global, regional and state levels to support response operations and policy planning against infectious disease threats.
WHO PUBLICATIONS
COVID-19
European Respiratory Virus Surveillance Summary (ERVISS)
COVID-19 Epidemiological Update - 24 November 2023
COVID-19 Vaccination Insights Report - 27 November 2023
Increasing COVID-19 vaccination uptake
MPOX (MONKEYPOX)
Multi-country outbreak of mpox, External situation report#30 – 25 November, 2023
UKRAINE EMERGENCY
War in Ukraine: situation report from WHO Country Office in Ukraine. Issue No. 64, 17 November 2023
