Namibia PDNA 2009 - GFDRR

and reproductive health. This was further strengthened by
dissemination of information, and creation of awareness on
nutrition, malaria, diarrheal diseases, and reproductive health,
gender and HIV/AIDS issues. Unfortunately these efforts have
not yet translated into behavioural changes, as they tend not
to take the social, economic and cultural factors that drive
behaviour into consideration.
Damage and Losses Assessment
The assessment of the health sector was mainly qualitative in
design and nature. The data collection tools were developed
by the assessment team, and included (i) the Initial Rapid
Assessment tool (IRA) developed by the Global Health Cluster,
which was modified to collect Post-Disaster health data; (ii) the
Health Resources Availability Mapping System, which collects
baseline data on the health facilities; (and (iii) the DaLA tool
which collects data on damages and losses incurred by the
health sector during the floods.
All the six affected Regions of north-central and north-eastern
Namibia were visited. A total of 26 health facilities were visited
including those that were flooded during the crisis. All the health
facilities in the affected Regions were entered into the Health
Service Availability Mapping system, mainly to register facility
name, type, status, ownership and human resources, both in
the facility and in the catchments population. The teams also
visited communities, including seven camps and six localities/
settlements, to assess the general conditions and nutrition and
health conditions of the populations. Key informant interviews
were the main avenues of data collection, although the team
also used group discussions, participant observation, and review
of records. Meetings were held with regional councils to brief
them on the purpose of the assessment and also to get briefed
on the crisis situation. Key informant interviews were held with
Regional Directors of the Ministry of Health and Social Services
(MoHSS), Chief Medical Officers (CMOs), Principal Medical
Officer (PMOs) and those in charge of health facilities. In the
communities, group discussions and key informant interviews
were used.
Damages from the flood were primarily sustained by the public
sector to buildings and equipment. Three health facilities were
flooded and relocated: Mabushe and Biro clinics in Kavango
Region and Liskili clinic in Caprivi Region. The private sector
was also affected. A private ward in Onandjokwe hospital
(Oshikoto region) was closed down for 2 months and the
paediatric ward was damaged when the sewerage pipes
were totally damaged. In Oshana, the basement and the front
entrance of the Oshakati Intermediate Hospital pharmacy was
severely damaged.
Losses were incurred as a result of relocation of the clinics
to other sites, opening of new outreaches and expanding
on the existing outreaches to serve the affected population.
Prevention of impending outbreaks through disease surveillance
and coordination of response and revenue losses incurred as
a result of closing some wards and facilities and changing the
TB treatment for some patients whose treatment had been
interrupted in Omusati, Ohangwena and Oshikoto Regions.
The Table below shows the damage and losses incurred during
the crisis. A total of N$6,344,503 was lost in the damages and
losses to the health facilities and extra health services that
were conducted. It was not possible to determine the damage
to health facilities accurately due to the absence of expertise
in the assessment teams.
Damage
Table 74: Damage and loss estimates
by type of health facility
Public Private Total
District/
Intermediate 500,000 150,000 650,000
Hospitals
Health Centres - - -
Clinics - - -
Total 500,000 150,000 650,000
Losses
Additional
medical care
1,891,345 - 1,891,345
Preventive
programmes
714,058 - 714,058
Temporary
facilities
1,589,100 1,500,000 3,089,100
Total 4,194,503 1,500,000 5,694,503
Disruptions to access to basic needs and
services
In the Oshikoto, Ohangwena and Omusati Regions, disease
control programmes were somehow disrupted. This was
especially true for TB control programmes where about 30
patients had to be changed from a category one to a category
two regimen, because of interruption in the treatment.
In the other Regions, the impact of the floods on disease control
programmes like TB, Malaria and HIV/AIDS was minimal. Most
of these programmes experienced some minor disruptions in
accessing patients for monitoring reasons. The Kavango and
Oshana Regions were completely unaffected, while in the
Caprivi Region there was some disruption to TB and HIV/AIDS
control programmes, although malaria programme remained
unaffected.
Physical access: On average, the furthest community in a
catchment population of the health facility is 15km. According
to the national health policy on accessibility of the population to
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Namibia POST-DISASTER NEEDS ASSESSMENT