Weekly SWS Situational update for AWD Cholera cases Week 18 and 19, Weekly SWS Situational update for AWD Cholera cases Week 18 and 19, Weekly SWS Situational update for AWD Cholera cases Week 18 and 19

1. Weekly AWD/Cholera task
force meeting.
Thursday 19th May 2022

2. Table of Contents;
Situational updated for AWD/Cholera confirmed outbreak
Weekly trend of AWD/Cholera cases, week 1 to week 19
Admitted AWD/Cholera cases at the 3 CTCs (Baidoa, Afgoye and Marka,
Coordination meeting with MoH, MoWER, WASH and Health Partners
Action taken w
Field visit to Bayhaw CTC and the available services in the CTC
Introduction of case tracing from the CTC level to be linked with monitoring for water
chlorination wk1-wk19
Oral rehydration points (ORPs/ORT) scale up from Health partners
Challenges
Recommendation
Planned activities for the next week

3. Situational updated for AWD/Cholera confirmed outbreak response in
SWS
• Active cholera transmission was reported in Baidoa since May 2020. On the 29th March 2022, Bayhaw
Cholera treatment center reported an increase in admission of suspected AWD/cholera cases from
different Baidoa village sections (Isha, Horseed, Howlwadag and Berdale village) and suspected
community deaths were reported in IDPs and host community including under five children.
• A cumulative total of 2,279 cases including 11 deaths (CFR 0.48%) have been reported since January
2022 up to date in Baidoa, Afgoye and Marka district CTCs.
• 95% of AWD/Cholera admitted cases at the Cholera treatment centers in Baidoa, Afgoye and Marka
districts did not receive cholera vaccine in 2017 (OCV campaign)
• AWD/Cholera cases had increased significantly in the next day of 30th March 2022 were a total of 45
cases were admitted, Outbreak alerts of acute watery diarrhoea (AWD) was investigated by the
surveillance Baidoa districts. Two (2) samples from the Baidoa district, out of 16 stool samples collected
and sent to the National Public Health Laboratory (NPHL) in Mogadishu for confirmation, tested positive
for Vibrio cholera Ogawa.
• An increased diarrheal disease in general since the beginning of the year. due to uncontrolled movement
of people in the 3 regions, serious water shortage that led to poor hygiene and sanitation, particularly
among the IDP population in Baidoa district. As a result of that WHO and Ministry of Health conducted
assessment in IDP settlement sites in Baidoa.

4. Cont….
• The assessed IDPs camps/villages (in Baidoa, are currently practicing poor hygiene habits; this is
due to lack inadequate water, inadequate water storage and lack of WASH items to assist in good
hygiene practices e.g. soap., most IDPs do not have sufficient water storage containers, while
those who have are not hygienic enough.
• Results from the last IDP verification exercise conducted by Camp coordination and camp
management in Oct 2021. A total of 572 IDP settlement sites were identified hosting 68,634
households or 475,035 individuals in Baidoa IDP surpassing the host communities. Out of 571
IDP sites only 148 IDP site are getting health services in Baidoa IDP sites. There are 18 health
centers close to the IDP sites, 4 are not operating.
• The drought, displacement and the dry condition, poor access to safe drinkable water and
deteriorate food security, has led to an increased burden of communicable diseases among the
population particularly among children under 5 years and IDPs. According to the respondent,
observations made from the Health facility registers and WHO surveillance data, diarrheal
diseases, malaria, measles and severe malnutrition are among the leading causes of morbidities
with an increase trend since the beginning of the year.

5. Wee number Male Female Cases <5yrs Cases ≥ 5 yrs
Week1 25 29 35 19
Week2 23 26 28 21
Week3 26 26 39 13
Week4 23 21 28 16
Week5 24 25 31 18
Week6 16 21 23 14
Week7 28 20 37 11
Week8 30 22 37 15
Week9 22 24 27 19
Week10 28 22 26 24
Week11 17 16 19 14
Week12 23 20 24 19
Week13 41 34 45 30
Week14 56 57 60 53
Week15 84 107 110 81
Week16 188 147 222 113
Week17 202 163 223 142
Week18 190 182 239 133
Week19 148 123 175 96
Grand Total 1194 1085 1428 851
AWD/Cholera admitted cases in 3 CTCs in Baidoa, Afgoye and Marka district Week 1 to Week 19

6. Weekly trend of AWD/Cholera cases, wk1-wk19
54 49 52
44 49
37
48 52 46 50
33
43
75
113
191
335
365
372
271
0
50
100
150
200
250
300
350
400
Week
1
Week
2
Week
3
Week
4
Week
5
Week
6
Week
7
Week
8
Week
9
Week
10
Week
11
Week
12
Week
13
Week
14
Week
15
Week
16
Week
17
Week
18
Week
19

7. Admitted AWD/Cholera cases at the 3 CTCs (Baidoa, Afgoye and Marka,
wk1-wk19-2022
District/CTC name Male Female Cases <5yrs Cases ≥ 5 yrs
Afgoye 184 157 243 98
Bayhaw Hospital 870 792 1032 630
Merka Hospital 140 136 153 123
Grand Total 1194 1085 1428 851

8. Admitted AWD/Cholera cases at the 3 CTCs (Baidoa, Afgoye and Marka,
wk1-wk19-2022
1662
341
276
0
200
400
600
800
1000
1200
1400
1600
1800
Bayhaw CTC Afgoye CTC Marka CTC

9. Other location and districts reporting suspected AWD/Cholera cases but
not confirmed
Location Cases reported
Wajid 74
Buurhakaba 394
Shalanbood 66
Daynuney 88
Qoryoley 1
Wanlaweyn 9
Hudur 14
Grand Total 646

10. Other cases reported (Bi-chart)
74
394
66
88
1
9
14
646
Other Cases reported
Wajid Buurhakaba Shalanbood Daynuney Qoryoley Wanlaweyn Hudur Grand Total

11. CTC/CTCU Status (Open) Support partnerBed capacity x-coordinate Y-coordinate
Baidoa/Bayhow
hospital
CTC MoH/ACF/UNICEF
104 3.13789 43.65432
Afgoi hospital
CTC
MoH/Juba
Foundation 15 N 2.8'41 E 45.7'3"
Merka hosptital
CTC
MoH/AYUUB/UNICE
F 12 1.714022 44.765091
Wajid
CTC MoH
10N/A N/A
Buurhakaba
CTC Qatar Charity/SOS
122°47'44.03796"
E
44°5'25.19448"
Baidoa
CTU MSF/MoH
50 3.101526 43.636963
Mapping of CTC/CTUs in drought affected districts of Somalia

12. Coordination meeting with MoH, MoWER, WASH and Health Partners
• On 5th May 2022, an Ad-hoc meeting was called for the MoH, MoEWR, WASH and Health cluster
partners and agreed for response while WHO, UNICEF and ACF has started deployment of human
resource and supplies to the CTC for immediate response. Four additional doctors, four hygiene
promoters, and eight nurses were deployed while there has been 2 doctors, 4 Hygiene promoters,
2 crowd controllers, and 9 nurses were available at the center, also cleaners and guards were
additionally deployed.
• On 8th May, 2022, Federal Ministry of Health, Env. And WASH unit head, and WHO Env focal point
have reached Baidoa for reinforcing the AWD/Cholera response. In the next day, another ad-hoc
meeting was intervened with the state MoH, and MoWR, WHO an the Federal ministry of health,
it was discussed and agreed:
• Establishment of AWD/Cholera response task force
• Field visit to Bayhaw CTC
• Establishment of Mass hygiene promotion/Chlorination campaign
• Development of service delivery forms/tools (reporting form, collecting forms).

13. NO ACTIVITY DESCRIPTION AGREED ACTION POINTS RESPONSIBLE Status
1 Establishment of Baidoa
AWD/Cholera Response Task force
Task force composing of 7 persons
from MoH, MoEWR, WASH & Health
Clusters, Bay region and Baidoa local
authority representatives and head
of CTC was established, Mr. Aden
from MoH will be leading the task
force
MoH Done
2 AWD/Cholera Hygiene Promotion
Campaign startup
All partners agreed to start hygiene
promotion awareness campaign
TASK FORCE Done
3 Resources needed (logistics &
staff)
60 staffs and 8 vehicles contributing
by all partners
ALL PARTNERS Done
4 Main responsibilities for HPs
during the awareness
1. Community mobilization
2. Water sources chlorination
3. Cases recording and reporting
4. Kits distribution in hotspot areas
TASK FORCE
Done
5 Target location/village & Number
of Teams
Horsed, Isha, Berdale & H.wadag will
be targeted, and each village will be
assigned for 1 team of (15 persons)
ALL PARTNERS
Done

14. 6 Meeting with the teams &
forming them
4 Teams & team leaders will be
formed by AWD/Cholera Task force
during introduction meeting
tomorrow at MoH Office
TASK FORCE Done
7
Partners mobilization for
resources contributions
Both WASH & Health Cluster focal
points will communicate to
partners and share with us their
contributions within this afternoon
WASH & HEALTH
CLUSTERS
Done
8 Campaign duration 7 Days (11th to 18th May 2022) TASK FORCE Done
9 Meeting location for the mass
campaign
MoH SWS main office baidoa,
WASH & Health clusters will make
sure all staffs from partners knows
the location
WASH & HEALTH
CLUSTERS
Done
10 AWD/Cholera task force meeting
with partners
Daily AWD/Cholera task force
meeting will be conduct among
task force members . Week
AWD/Cholera task force meeting
with partners will conducted every
Thursday
-TASK FORCE
Daily meeting
-Task force with
partners every
Thursday
Ongoing

15. Action taken
• Regional and district surveillance team has been alerted to strengthen the surveillance activities in
the district
• Outbreak alerts of acute watery diarrhea (AWD) was investigated Baidoa districts. Two (2) samples
from the Baidoa district, out of 16 stool samples collected and sent to the National Public Health
Laboratory (NPHL) in Mogadishu for confirmation, tested positive for Vibrio cholera Ogawa.
• The MoH District health team visited and provided medical supplies and hygiene kits to Baidoa
central prison where a suspected AWD/cholera outbreak was reported. Results from the National
Public Health Reference Laboratory confirmed that five (5) stool samples collected from Baidoa
central prison were negative.
• UNICEF/ACF and WHO has already prepositioned cholera kits to Baidoa, Afgoye and Merka districts,
and request of additional supplies were made should there be a need of DDK Kits for ADW/Cholera
treatment to responding partners.
• WASH cluster provided 6 drums of chlorine to CTC through WASH hub in Baidoa
• Most of the Patients are coming from Isha, Horseed, Berdale and Howlwadag village sections of
Baidoa town (Sixty CHWs were divided into four groups were been operating for seven days mas
campaign into these villages for AWD/cholera prevention and control measures
• WHO/MoH South West team contributed prevention, preparedness and response efforts by
preposition of medical supplies and PPEs in the established CTC and activated the rapid response
teams at all Baidoa villages.

16. Cont..
• Proposition of AWD/cholera supplies done so far by at Baidoa Bayhow hospital CTC (ACF, WHO
and UNICEF 400 ringer lactate, 150 pcs of canol24, 300pcs of canol22, 130 pcs of canol18, 100pcs
of canol20, 1 cartoon of ORS, 1 cartoon & 6 boxes of syringes 5ml, 1 carton of cleaner gloves, 1
cartoon of facemask, 5 liter of hand-sanitizer, 1 cartoon of chlorine-kit, 7 pcs of PP machine, 1 pc
of blood climate, 1 pc of HB machine, 3 pcs of weight adult (kg), 4 pcs of sprayer, 30 pcs of
surviving planning, 15 carton of gloves, 1 carton of pediatric, 14 pcs of bottled letter, 50 pcs of
metamazole syrup, 22 pcs of resamol, 5 boxes of Catton, 1 carton of soap, 2 pcs of metamazol
tap 400mg, 5 boxes of envelope, 40 pcs of paracetamol, syrup, 8 pcs of metermazol injection, 22
boxes of albendazole, 23 boxes of zinc, 1 carton of doxycline tap, 8 carton of chlorine kit, 40 pcs
of litter bottle, 10 boxes of ceprofrocine injection, 30 pcs of koras, 4 pcs of tents, 7 beds, 75 pcs
of cup 1000mm, 1 carton and 30 boxes of IVset, 5 carton of detergents, 7 pcs of metoclopramide,
1 pc of barela, 100 pcs of basin, 10 pcs of scoop and 10 pcs of buckets
• WASH Cluster and ACF provided 1850 HH hygiene kits to CTC through MoH

17. Cont..
• MoEWR-SWS provided chlorination training to 15 CTC staff supported by ACF
• 10 prepositions of staff by Save the children to conducting AWD/cholera awareness
water sources chlorination
• 35 MoEWR chlorinators conducted Mass water sources Chlorination campaigns in Baidoa
district and reached (838 shallow wells) so far.
• Sixty CHWs including HPs were deployed for four villages in Baidoa (each team consist of
15 individuals) and distributed water treatment (Aqua tabs) to 3450 HHs in Baidoa town.
• Water samples taken and tested for bacteriological test (3 samples identified positive out
10 samples collected from Baidoa and Buurhakaba)
• Water trucking by UNICEF through MoEWR on daily basis

18. Field visit to Bayhaw CTC and the available services in the
CTC
• On 9th May 2022, FMOH, SMOH, SMOWR, WHO, and ACF has extended visit to the CTC for
assessment in terms of the services available and the gaps exist
• Bayhaw hospital CTC has four wards (Plan A, B, C and Recovery wards)
• 104 bed capacity,
• Triage, screening and registration ward,
• Case management protocol are available
• Hygiene promotion and cleaning services,
• Laundry and pit for waste management (pit)

19. Cont…
• Three water tanks (one for washing and two for drinking)
• In and out chlorine spot checks
• Patient caretaker feeding center (kitchen)
• Latrines (6 pit latrines)
• Hand washing facilities (five portable hand washing facilities)
• Filtered drinking water stations Life straw water filters (7)
• In the visit, the team has interviewed the health workers and the patient care takers, and
also, they have been advised to take gowns, gloves and face mask as part of their IPC
compliance.

20. Introduction of case tracing from the CTC level to be linked with
monitoring for water chlorination
• Prepositioning one or two teams at the CTC level (one driver + one hygiene promoter/data
collector).
• When a sick person arrives at the CTC level, the team notes the name and place of residence of
the person
• The team then brings back at home the care taker (there is a need to be cautious and to disinfect
appropriately the shoes of the caretaker with a chlorine solution, to ask him to wash his hands
with chlorine solution and to disinfect the back of the car where the caretaker will sit) who has
brought the sick person and gives an hygiene kit (soap, aquatabs, bucket, Jcan, hopefully ORS/Zinc
tablet if possible) + hygiene advices to the affected family
• The team then can take the GPS coordinates of the house and ask a short set of questions to the
family regarding their hygiene practices, use of latrines and what is the water point that they are
using. Go to the water point and take the GPS coordinates/pictures

21. Cont…
• The team needs then to wash appropriately their hands with chlorine solutions
• When back to the office/CTC, there is a need to treat the data and do some mapping to
try to understand where are the hot spots in terms of contamination. This will then help
you to target what are the actions needed and where they are needed
• The Cholera / AWD situation in Baidoa is not improving. Thus, to strengthen our effort
needs another piece of information which will support CTC management as well.
• CTC will check the patient from where they are coming and follow up with the
responsible organization or Chlorinator to strengthen Chlorination at their respective
community back home.

22. Oral rehydration points (ORPs/ORT) scale up from Health partners
• In response to the increasing number of AWD/Cholera in the drought-affected areas in
SWS, health partners have scaled up for medical supplies to the newly established
ORP/ORT corners.
• Following health partners have established ORP/ORT corners.; MSF, IOM, SOS, ACF, WVI,
SCI, GREDO,NW, DMO, QRCS, AYUUB, READO,
• The main aim of the ORP/ORT corner is to provide treatment for mild (some) dehydration
cases and educate mothers on the most appropriate treatment of diarrhoea at home and
advise the mother to continue breastfeeding.

23. List of ORP established by Health partners
MSF- AWD/Cholera response - ORP sites in Baidoa May 2022
S/N Villae ORP site name Type of the site Latitude Longitude
1ISHA/Wadajir Baidoa South CTC CTC/CTU (HC and IDP) 3.101526 43.636963
2Isha Hagarka Mada GariIDP camp 3.0868433 43.6232326
3Isha Tawakal Gurban IDP camp 3.0897558 43.6320584
4Isha ADC1 IDP camp 3.072581588 43.61819127
5Isha Bur Iyo Shabelow IDP camp 3.1039791 43.662324
6Berdale Maka Dhagoole-1 HC/IDP camp 3.1273937 43.6777059
7Berdale Shabeelow Bay IDP camp 3.10628 43.67005333
8Berdale Qod Qode IDP camp 3.104908333 43.665035
9Berdale Busley MCH Host community 3.119004 43.657961
10Horseed Banadir IDP 3.1546938 43.6768703
11Horseed Garasiyool IDP 3.1633025 43.6697241
12Horseed Hareeriboor IDP/Host Community 3.14678 43.667156
13Howlwadag Kaamir IDP 3.0948877 43.6292355
14Howlwadag Lascanood IDP camp 3.1418618 43.62831761
15Howlwadag Kulmiye HC/IDP camp 3.124953 43.646896
16Howlwadag Al-Furqan-3 IDP camp 3.117158333 43.628245

24. SOS ORAL REHYDRATION POINTS AT BAIDOA DISTRICT
S/N District ORP Site # of working days Type of site
1 Baidoa Baidoa District Hospital 24/7 Fixed
2 Baidoa ADC 2 IDP Daily of day time Mobile
3 Baidoa Abow Asharow IDP Daily of day time Mobile
4 Baidoa Buula Ees IDP 2days ( Saturday and Wednesday) Mobile
5 Baidoa Hagarka Mada gerri IDP 2days ( Sunday and Tuesday) Mobile
6 Baidoa Ex-SOS medical Centre 4days a week (Saturday, Monday,
Tuesday and Thursday)
Mobile
SOS ORAL REHYDRATION POINTS AT Berdale and Buurhakabo Districts
S/N District ORP Site # of working days Type of site
1 Berdale October village Saturday, Sunday, Monday, Tuesday and
Wednesday
Mobile
2 Berdale Ahmed Gurey village Saturday, Sunday, Monday, Tuesday and
Wednesday
Mobile
3 Berdale Waberi village Saturday, Sunday, Monday, Tuesday and
Wednesday
Mobile
4 Berdale Horseed village Saturday, Sunday, Monday, Tuesday and
Wednesday
Mobile
5 Buurhak
abo
Waberi village Saturday, Sunday, Monday, Tuesday and
Wednesday
Mobile
6 Buurhak
abo
Wadajir village Saturday, Sunday, Monday, Tuesday and
Wednesday
Mobile
7 Buurhak
abo
Darulsalam village Saturday, Sunday, Monday, Tuesday and
Wednesday
Mobile
8 Buurhak
abo
Howlwdag village Saturday, Sunday, Monday, Tuesday and
Wednesday
Mobile

25. DMO- AWD/Cholera response - ORP sites in Baidoa May 2022
S/N Villae ORP site name
Type of the
site Latitude Longitude
Baidoa district
1 Isha Mogar I Mayow1 IDP fixed 3.7’0” 43.38’2”
2 Howlwadag Alfurqaan 2 IDP fixed 3.7’0” 43.38’2”
3 Howlwadag Boodan IDP mobilke 3.13648 43.63088
4 Horseed Kormari IDP mobile 3.8’42” 43.39’39”
5 Horseed Awal barwaaqo IDP mobile
Borwaaqo relocation Barwaaqo fixed 3.90’408” 43.39’57.5
6
Horseed Horseed HC
Health
center
3.5’34” 43.37’51”
Dinsoor district ORP site name
Type of the
site Latitude Longitude
1
Dinsoor HC Dinsoor HC
HC
2.24’318” 42.58’825’’
2 Raama dhowi IDP Raama dhowi IDP mobile 2.24’944” 42.58’981”
3
Siinay IDP Siinay IDP
mobile
2.24’318” 42.58’825’’
4 Dinsor horsed site Dinsor horsed site mobile 2.24’600” 42.58’230”

26. WVI- AWD/Cholera response - ORP sites in Baidoa May 2022
S/N Villae ORP site name
Type
of the
site Latitude Longitude
Baidoa district
1 Towfik MCH Towfik PHC 3.12179787 43.676144
2 Darsalam MCH Darsalam Village PHC 3.1126873 43.667151
3 Bula Busley Bulabusley IDP HP 3.09066 43.63
4 Alfurqan HP Alfurqan IDP HP 3.13546 43.65882
5 Awalbarwaaqo HP Awalbarwaqo IDP HP 3.13898 43.6692
6 Garas goof HP Garsgof IDP HP 3.14278 43.6598
7 Idaale 1 Idale IDP HP 3.09335 43.63686
8 11 Janayo 11 Janayo HP 3.09293 43.63504
9 Bulo-jimac MCH Bulo-jimac MCH PHC 3.7123 43.3828
10 Awdinle MCH Awdinle MCH PHC 3 1011 43.2494

27. ACF- AWD/Cholera response - ORP sites in Baidoa May 2022
S/N Villages ORP site name
Type of the
site Latitude Longitude
Baidoa district
1 Isha Isha MCH
Health
facilities
3.10777 43.6529
2 Adaada Adaada MCH Health
facilities
3.127308 43.6658
3 Horseed Bayhow Health
facilities
3.13698 43.65415
QRCS- Oral Rehydration Points (ORP) at the southwest state in May 2022
S/N Location ORP Site Name Type of the site
1 Baidoa Towfiiq-BHC Fixed
2 Lafole Afgoi-LHC Fixed
IOM-AWD/Cholera response - ORP sites in Baidoa May 2022
S/N Villae ORP site name Type of the site Latitude Longitude
Baidoa district
1 Horseed Barwaqo HC Fixed 3.16503 43.66632

28. GREDO- AWD/Cholera response - Oral Rehydration Point ORP sites in Baidoa May 2022
S/N
Village
Baidoa District
ORP site Name Type of the site Latitude Longitude
1
Horseed Hanano II MCH Fixed
3.142778 43.667888
2
Wadajir
Danwadag
MCH Fixed
3.095556 43.633361
3 Towfiiq
Towfiq Health Centre
3.120833 43.6711111
4
El-Adow El-Adow Health Centre
3.172222 43.6516667
5
Wadajir Salamey Idaale Mobile site
3.095556 43.633361
6
Awdinle Awdinle Mobile site
3.171647 43.4095528
7
Bonkay Bonkay Mobile site
3.153333 43.6325
8
Goof-Mareer Goof Mareer Mobile site
3.16863 43.5512
9
Horseed Hanano II Mobile site
3.142778 43.667888

29. AYUUB- Oral Rehydration Points (ORP) at the southwest state in May 2022
Location ORP Site Name Type of the site
1 Marka Ayuub Mch Fixed
2 Marka wadajir Fixed
3 Marka Eljaale Fixed
4 Marka tima Ade Fixed
New ways AWD/Cholera response - Oral Rehydration Point ORP sites in Baidoa May 2022
S/N
Village
Baidoa District
ORP site Name Type of the site Latitude Longitude
1
Baidoa Baidoa Berdaale HC Fixed
3.121354 43.661598
2 Awdinle Awdiinle Fixed 3.168264 43.408783
3 Degomar IDP Moble Site 3.104714 43.663618
4 Gaaloge-IDP IDP Moble Site 3.103235 43.663933
5 Jawaarey IDP Moble Site 3.125288 43.673947
READO- Oral Rehydration Points (ORP) at the southwest state in May 2022
S/N Location ORP Site Name Type of the site Latitude Longitude
1 Baidoa Bulo-jimac MCH Fixed 3.7123 43.3828
2 Lafole Awdinle MCH Fixed 3.1011 43.2494

30. SCI- AWD/Cholera response - ORP sites May 2022
S/N District ORP site name Type of the site Latitude Longitude
Baidoa Tawakal 2 Diinsoor ORP
Baidoa Alla-Tuuk ORP
Baidoa Galgalweyne ORP
Baidoa Barasoole ORP
Baidoa Tamaam ORP
Baidoa Ribo MCH ORP
Baidoa Bayhaw CTC CTC
Baidoa Bullo-Jadid HC ORP
Baidoa Bardalle HC ORP
Wajid Howlwadaag MCH ORP
Wajid Koonfur galbeed TCTC
Merka Merka CTC CTC
Merka Nurto Taliyow ORP
Afgoye Afgoye CTC CTC
Afgoye If iyo Aaqiro ORP

31. Challenges
• Coordination and communication gaps within the implementing agencies, and line ministries
• Poor referral system (high case load due to lack of ORPs in the city and poor community awareness)
• Limited of risk communication and community engagement at district level.
• Shortage of supplies (Medical supplies, Cholera kit supplies, hygiene kits)
• Shortage of information education communication (IEC materials)
• Humanitarian actors and civilians continue to experience challenging access constraints, including safety and
security concerns as well as road access challenges, particularly along major roads in SWS of Somalia.
• Poor waste management (damaged incinerator)
• Overcrowded of para patient, and visitors
• IPC and case management protocols were not in place
• Inadequate proper hygiene and sanitation facilities & lack of preventive knowledge for most of displaced
community.
• Inadequate quality monitoring and institutional structure; community/government for environment
sanitation.

32. Recommendation
• Improvement of coordination mechanism (line ministries and implementing partners) for emergency
response activities including the overall activities in Southwest state
• Establishment functioning ORPs/ORT coner in the health centers (hotspot areas) to minimize the CTC case
load
• Strengthen of the RCCE at health facilities and community-based surveillance
• Preposition of supplies to established CTC/CTU/ORPs
• Print and provision of IEC materials with Somali language
• Conduct capacity building training for the CTC staff
• Rehabilitation of the CTC incinerator
• Ensure joint effort in mass mobilization for hygiene promotion to minimize water borne diseases especially
among the displaced populations. Systematic Hygiene promotion approach in all locations to all individuals
and households at areas of catchment. (Host/IDPs).
• Implementation of SOPs, provision of case definition, IPC and case management guidelines
• Rules and responsibilities and staff ToR assignation and accountability measures should be adopted
• Follow up the suspected cases, alert verification and investigation on timely.
• Follow up timeliness and completeness of the weekly submitted reports by health partners and verify the
suspected outbreak of any disease in close collaboration with the concerned line ministry (MoH).
• To improve the capacity of health workers for priority disease detection collection and analysis and reporting
• Monitor eWARN completeness and timeliness for all health facilities who are expected to report on
immediate alert and on weekly basis in Southwest state of Somalia.

33. Planned activities for the next week
• Daily Coordination meeting with the task force member and CTC implementing partners
• Weekly SWS AWD/Cholera task force meeting with all stake holders including; MoH, MoEWR, health cluster partners and
WASH cluster to plan for the implementation of response
• Mass hygiene promotion campaign in host and IDP settlement sites plus continuous chlorination of water sources
(shallow wells).
• Preposition of AWD/Cholera supplies to hotspot CTC and balance of available MoH warehouse.
• Conduct training for community health workers on disease detection and response including the training of IPC for
health workers at the CTC and Health facilities, health post, outreach and ORPs.
• Joint supportive supervision to different affected districts and hotspot areas.
• Balance of AWD/Cholera supplies at Baidoa MoH warehouse
• Continuous RCCE for community informants - Imams, Clan chiefs, CSOs, women groups and community leaders.
• Early Warning Alert and Response Network EWARN surveillance expansion training for Health facilities Focal points in
SWS.
• Coordinating with partners as to strengthen AWD&COVID-19 response activities in South West State, mobilize resources
for you respective areas of intervention.
• Case management training and Oral cholera vaccination plan preparation for the 4 districts of SWS (Baidoa, Afgoye,
Wanlaweyn and Marka districts)

34. Field photos
End

35. Field photos