Situation Update

• The official Government figure reports a total of 6,250 death and 14,357 injured.
• The ongoing treatment efforts continue to focus on reaching a greater number of areas in the priority 14 districts including those in the remote and hard-to-reach areas.
• As of 1 May 2015, a total of 24,999 patients were treated in different hospitals in and outside the Kathmandu valley. 3249 patients were admitted for hospital services according the latest information from Health Emergency Operation Center (HEOC)/Ministry of Health and Population (MoHP).
• Reaching the injured in the remote areas remains a challenge due to access. Most of the remote villages are disconnected with road networks.
• A total of 86 registered foreign medical teams (FMTs) are in the country. More than 60 teams are deployed. Currently, there is no need for more teams of trauma or surgical response.
• There is a need for specialist groups capable of rehabilitation care, with physiotherapists and occupational therapists and rehabilitation physicians. A full paper for the critical gaps in rehabilitation care for an estimated >600 patients is being finalized with the MOHP, in conjunction with Handicap International, International Organization for Migration and WHO.
• Remote area teams are still reporting limb injured patients requiring care, but referral pathways are improving daily with access to more national hospitals and foreign medical teams, type 2 (surgical) set up in the districts. This forms the basis of the hub and spoke model of care designed to decrease the displacement of patients requiring care.
• Foreign medical teams have been given explicit instructions on the protocols and guidelines for work in Nepal and have almost universally registered and received license to practice in the country.

Immediate Needs

• There is an ongoing need for hospital tents and maternity tents for Kathmandu-based hospitals as well as in the affected districts.
• There is a long list of patients requiring surgeries in the hospitals of the Kathmandu The hospitals are in need of tents and surgical (orthopedic) accessories.
• Post operation rehabilitation care.
• Specialized medical services for groups with special needs including pregnant women and lactating mothers and neonates remains an issue.
• Psychosocial support
• Outbreak risk communication messages

Health Sector Response

Ministry of Health and Population (MOHP)

• MOHP is leading the health response operations through the Health Emergency Operation Center (HEOC).
• MOHP has mobilized a total of approx. USD $330 000 (130 000 from the Government regular budget and 200 000 from the Disaster Relief Fund) as of 1 May 2015.
• District Health Offices have deployed Rapid Response Teams for the prevention and control of potential outbreak in all affected districts.
• MOHP/HEOC has been coordinating with hub hospitals (Tribhuvan University Teaching Hospital, Bir, Patan, Civil Service, Sree Birendra, and Bhaktapur) for the referral of patients requiring specialized service intervention. The health cluster partners are supporting to map the discharge, referral and rehabilitation needs and services of the injured patients.
• MOHP assessment team supported by WHO will be deployed to Okhaldhunga and Sindhuli districts 3 May 2015 to assess the status and needs of district hospitals.
• Coordinating with Ministry of Home Affairs and Forensic Department for the identification and management of burial services.
• Transportation of the medical supplies is being done in close coordination with WHO and other cluster partners.
• Response coordination, including the coordination and deployment of foreign medical teams, is ongoing.
• MOHP has identified six hospitals to receive referral cases for emergency obstetric care.

World Health Organization (WHO)

• Provided a full set of Interagency Emergency Health Kit (IEHK) to Canadian Red IEHK is going to be used in Dhunche of Rasuwa district.
• Provided one basic IEHK, one minor surgery, one major surgery and one trauma backpack to MOHP for two medical team that are deployed in Dolakha district.
• One Mobile Storage Unit (MSU) will be set up at the MOHP logistic department to increase capacity storage by 3 May 2015.
• Three tents (72 Square meter) on the way to be delivered to Chautara, Rasuwa and Ramechhap for medical purposes.
• Two WHO sub-offices will be established early next week in Dhading and Gorkha districts.
• Providing logistic and technical support to the Information Analysis and Management Unit in the Health Emergency Operation Center to collate and analyze information and surveillance data from districts.
• Mental health sub-cluster was activated by WHO, International Organization for Migration (IOM) and MOHP. Daily meetings will be held at 9:30am, ahead of Health Cluster meeting.
• Providing support to strengthen disease surveillance system for epidemic-prone diseases.
• Measles and rubella vaccination campaign (WHO, UNICEF support to MOHP) started today in all 16 official and other non-official camps in Kathmandu valley. This will be extended to all affected districts.
• During this campaign, Nepal movie celebrities are being mobilized to disseminate outbreak prevention message.

Other agencies

• Health cluster partners are conducting public health assessments in internally displaced persons sites in the Kathmandu Valley as well as other affected districts. United Nations Population Fund together with CARE & ADRA, UNICEF, GIZ and PLAN Nepal have initiated rapid assessment of Reproductive Health services in the affected districts and results will be presented during the health cluster meeting on Monday.
• Direct Relief is sending an aircraft with over 50 tons or in excess of 120 pallets of medicines and medical supplies. This includes IV antibiotics, IV fluid, wound care supplies, prescription meds and hospital supplies. On specific request from MOHP, Direct Relief is also procuring six mechanical ventilator machines and five portable X-ray machines.
• Doctors Without Borders (Médecins Sans Frontières) has started helicopter mobile clinics in villages around the Langtang Valley and Rusuwa with a Nepali doctor, nurse and logistician to access the situation. The preliminary findings identify the need of food, shelter/non-food items, mental health and healthcare services.

See section 3.3 of WHO Situation Report No. 7 for update on Direct Relief response activities