E-DRUG: Flood drug kits in Northern Province, South Africa
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[Mozambique got all the attention recently, Madagascar (where the same cyclone
came) got virtually no international aid. Maybe something for E-Med, our french
speaking E-drug colleagues to address?
South Africa was also hit, especially the Northern and Mpumalanga Province (in the East).
I asked Danie Meyer, the head of Pharmaceutical Services of Northern Province, how
they had handled the floods. Below a description of "flood kits". Thanks Danie, Wilbert]
Dear E-druggers
A Disaster Management Committee has been put together and pharmaceutical
services is part of the team. Meetings are held each morning at 07H30 to
discuss progress and new problems.
Pharmaceutical Services have packed kits that concentrate on diarhoea,
malaria, dysentry and cholera. Kits contain the following:
* 100 pkts ORS
* 20 x 1L Ringers
* 5 x 200ml Ringers
* 5 x IV Cannula 24G
* 10 x IV Cannula 19G
* 5 admin sets 60 drops
* 10 admin sets 15 drops
* 2 rolls micropore
* water purification for 500L
* 20 x 40 Nalidixic Acid tabs
* 10 x 14 Doxycyclin
* 10 x 10 Ciprofloxacin 500mg
* 1 x 25 Rapid malaria test
* 20 x 3 Sulphadoxine/Pyremethamine (Fansidar, abbreviated as S/P)
* 20 x 10 Paracetamol
* Documentation on diarrhoea protocol, malaria protocol, dysentry
protocol, health education matters.
So far so good, no real outbreaks have been reported.
Supplies to hospitals are going ahead as normal, even though sometimes we
have to take detours of 100km and carry stocks across streams where bridges
have been washed away.
Further information on drug problems relates to vaccines and a broken cold chain.
All the clinics (16 in total) of Malamulele have lost all their vaccines
due to power failures for long periods. This seems
to be a pattern all over. No other big losses in medicines have been
brought to my attention.
Due to the large number of kits we have to pack it has affected the
stockholding of some items adversely, especially S/P and nalidixic acid. At
this stage we have to beg, steal and borrow from other provinces and
institutions for nalidixic acid and in this regard Pharmacare has been
assisting us greatly by flying in the stocks to us, at their expense.
Having a centralised budget has allowed us to re-order stocks much faster as
we do not have the trade account system where there has to be funds
available and that hospitals have to pay first. In a situation like this we
could open an account (without available funds) and issue all stocks for the
kits to that account and distribute to many clinics without specifying the
clinic. It must be remembered we are using volunteers to distribute the
kits and they have no idea to which clinics they are going to until they
reach the hospital.
It will also be much easier to cost the disaster medicines at the end and
claims can then be made to the so-called Disaster Fund.
Water purification sachets were apparently donated and are being distributed
through the system. This has never been a stock item and had no affect on
us yet.
Apparently Germany is donating some IV Fluids but not S/P, what type of IV
fluids is yet not known and we have no idea what the labeling is like.
Could cause a huge delay in using these.
I will keep you posted on any further developments.
Danie Meyer
Head Pharmaceutical Services
Northern Province
South Africa
Email: DMeyer@NPHW.NT.Healthlink.org.za
[From Mozambique comes the message that clean water is the most needed essential drug!
The helicopters started arriving in big numbers (too late to save people);
they are now transporting food and medicines but how to get clean water to millions
of people when all infrastructure and sewerage systems are destroyed?
Dead bodies are contaminating the water. Mozambique is reporting outbreaks of dysentery
and cholera is expected soon. Anybody wants to review the treatment of cholera?
For flood victims: can we use the 'standard' emergency health kits as developed by
WHO (last edition 1998)? Or do we need to add more IV drip sets and infusions because
of cholera?
Wilbert Bannenberg
SA Drug Action programme
WilbertBannenberg@compuserve.com]
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