1. Health and Climate Change in Mozambique Presented by: Dr. Maria Hauengue Department of Environmental Health Government of Mozambique 24 April 2007 Early Lessons from Implementation of Climate Change Adaptation Projects in South-eastern Africa Workshop

2. BACKGROUNDBACKGROUND Miassa Cabo Delgabo Manica Nampula Zambezia Sofala TeTe Inhambane Gaza Maputo Size : 799380km2, 2470 km Coast Pop: 15774000, 47% : 53% M/F 77% Rural : 23% Urban 45% 50 yrs Health indicators: Birth rate : 46.1 per 1000 Life expectancy : 45.5 years Mortality rate : 18.0 per 1000 Infant mortality rate : 127.7 per 1000 Maternal mortality : ~ 1.000 per 100.000

3. FLOOD & FLOOD &CYCLONES IMPACT IMPACT HEALTH SYSTEM: Damaged/ Destroyed.. HEALTH SYSTEM: Damaged/ Destroyed.. ENVIRONMENT: Poor sanitation Conditions.. ENVIRONMENT: Poor sanitation Conditions.. INCREASE OF DISEASE INCREASE OF DISEASE

9. FLOOD´s IMPACT FLOOD´s IMPACT

10. FIVE FLOOD AFFECTED PROVINCES Manica: Affected population: Health Cent.: % Number of affected Staff: Manica: Affected population: Health Cent.: % Number of affected Staff: Inhambane: Affected population: Health Cent.: % Number of affected Staff: Inhambane: Affected population: Health Cent.: % Number of affected Staff: Gaza: Affected population: Health Cent.: % Number of affected Staff: Gaza: Affected population: Health Cent.: % Number of affected Staff: Maputo: Affected population: Health Cent.: % Number of affected Staff: Maputo: Affected population: Health Cent.: % Number of affected Staff: Manica Inhambane Gaza Maputo Sofala Nampula Zambezia TeTe Sofala Miassa Cabo Delgabo Nampula Zambezia Miassa Cabo Delgabo Sofala: Affected population: Health Cent.: % Number of affected Staff: Sofala: Affected population: Health Cent.: % Number of affected Staff:

11. The health situation criteria Number of people affected at the assembling points Time that these people saty in accomodation centers Infrastructure, health conditions of the aco.centers Levels of organisation, prevention and control measures established

12. Diseases Malaria Cholera Other diseases (diarrhea, conjuctivitis and skin infections)

13. Weekly Cholera incidence Mozambique - 2000

14. Cholera by affected Provinces Mozambique - 2000 0100020003000400050006000700080009000 Tete Manica sofala Inhambane Gaza P.Maputo C.Maputo PROVÍNCIAS CASOS Series1Series2 1318 288 202 203 10204 559 183 256 2142 13381

15. Weekly Cholera incidence Maputo City - 2000

16. Weekly Cholera incidence In Sofala Province - 2000

17. WEEKLY CHOLERA INCIDENCE IN MAPUTO PROVINCE - 2000

19. AIM OF ACTIVITIES ON THE HEALTH SECTOR Increase the capacity of the health sector to respond to the emergency situation. Prevent and treat outbreaks, namely cholera, meningitis and measles, among others. Treat on time cases of malaria among people affected by floods so as to avoid outbreaks.

20. AIM (cont.) Treat acute respiratory diseases; Prevent vaccine- preventable diseases such as meningitis, and measles; Prevent and treat malnutrition among children, pregnant and breast-feeding women; Respond to the needs of women in reproductive health

21. Framework for Public Health interventions 1. Rapid Assessment : To determine the extend of damage to the Health system and its capacity to respond to the crisis To identify urgent measures for prevention and treatment of IDPs 2. Reinforcement or development (in camps) of the Surveillance System : To increase the reporting system of keys diseases : Cholera, Malaria, Malnutrition (Communication using Pactors system) 1: Assessment 2: Immediate Reaction Contingency Plan for major diseases, conditions and specific groups: Malaria Cholera ARI Sanitation Malnutrition Women (RPH) MST/AIDS Mental Health Immunization IEC... 3: Initial rehabilitation Reinforcement of Health System:. Essential Infrastructure rehabilitation. Drug and medical supplies,. Staff issues: - Training - Redeployment - Hiring new staff - Consultants - Other supplies including vehicles (up to 6 months)

22. STRATEGIES ADOPTED WITHIN THE FRAMEWORK OF EPIDEMIC CONTROL

23. Strategies -Reinforce malaria treatment in the affected areas; -Vaccination campaigns against mrningities and measles in the affected areas; -Chlorinating of water in accomodation centers, as well as construction of latrines; -Health education campaigns

24. Strategies Health education campaigns Production and disseminantion of guidelines in order to dispose of the solid and liquid residuals Pressure on relevant institutions to solve problems of hygiene and environment

25. LESSONS LEARNT Adaptation as a key issue for the present; Strengthen institutions; Involve those at risk; Use sector-based approaches; Expand information, awareness and technical knowledge; Adaptation compared to development

26. Lessons Learnt (Cont.) International financial assistance is necessary; Adaptation is context-specific; The importance of the level of decision making Better coordination and people’s motivation; Try to remove the obstacles ASAP

27. THANK YOU FOR YOUR KIND SUPPORT…