Cyclone Nargis Update

 

May 20, 2008

 

Note: New content has been inserted in red, italicized, bold font.

 

Current Status

 

Tropical Cyclone Nargis struck southwestern Myanmar (Burma) around 16:00 local time on May 2 with sustained winds of 120 mph (190 kph) and causing widespread damage to buildings, infrastructure and swaths of farmland. The official death toll remained at 77,738 Tuesday (May 20), with 55,917 reported missing. The UN says the number of dead could reach 102,000 and the Red Cross estimates as high as 127,990. Yangon (Rangoon), Irrawaddy (Ayeyarwady) Division, Pegu (Bago) Division, Karen (Kayin) state and Mon state have all been declared disaster zones. The UN estimates 2.4 million people were affected by Nargis, most in the Irrawaddy Delta region. Only about 500,000 have been reached.

The UN Flash Appeal stands at US$201 million. US$43 million has been contributed so far, including US$20.4 million from the UN Central Emergency Response Fund. According to OCHAÕs Financial Tracking System, US$99.6 million has been committed to relief operations, with a further US$107.9 million pledged. The UN and ASEAN are planning a Yangon donor conference for May 25. Myanmar says losses from the cyclone are expected to exceed US$10 billion. The emergency phase of the response is expected to continue for some time. (OCHA, May 19).

 

Myanmar is allowing foreign aid to enter the country, although it continues to restrict international relief worker access. Myanmar has agreed to allow medical teams from its fellow Association of Southeast Asian Nations (ASEAN) nations and ASEANÕs Emergency Rapid Assessment Team (ERAT), being assisted by a five-member UN Disaster Assessment and Coordination (UNDAC) team that is in-country, will go to Myanmar Wednesday (May 21) to gauge the extent of aid needed. With Foreign Ministry approval, ASEAN will set up a task force to handle the distribution of foreign aid. Myanmar allowed nine UN WFP helicopters to deliver aid to remote affected areas Tuesday, according to the UN, indicating that the junta may now recognize the scale of the disaster. (BBC, May 20) Local authorities in hard-hit Labutta are reportedly granting access to villages outside of the main town for the first time. (OCHA, May 19)

 

The World Bank says it cannot legally give financial assistance or loans to Myanmar because the country has unpaid debts. The bank has promised to help ASEAN with disaster assessments and relief work. (CNN, May 20)

 

UN Emergency Relief Coordinator and OCHA head John Holmes was to meet with government officials in Myanmar Tuesday.

 

The IFRC says lack of clean water will be the biggest killer in Myanmar in coming days, primarily because of the spread of disease. The UN lists food, shelter and medical supplies as critical needs. The IFRC lists limited communication, few transportation options, unknown local procurement capacity and limited information as key challenges to relief operations. Heavy rains continue to impede road transportation in delta areas, complicating relief efforts. The UN also reports challenges in delivering health assistance in outlying communities, with at least 50 percent of health structure believed to be damaged or destroyed. (OCHA, May 19)

 

A significant portion of the Irrawaddy DeltaÕs population relies on rice production, fishing and trade for its livelihood, meaning that NargisÕ damage to farmlands and infrastructure has left many without jobs for the foreseeable future. Save the Children assessments have determined a need for providing immediate income or food through cash/food for work programs. (SC, May 19) Some people are moving back to their places of origin, where they require livelihood assistance. (OCHA, May 19)

 


Impact

 

The official death toll remains at 77,738 with 55,917 reported missing. State media reports 19,359 people are injured. The majority of deaths were reportedly caused by the 12-foot (3.5-meter) tidal wave (storm surge). About 21.5 million people out of Myanmar's 53-million population live in the five regions that have been declared disaster zones - Yangon, Irrawaddy Division, Pegu (Bago) Division, Karen (Kayin) state and Mon state.

 

New assessments indicate 2.4 million people were affected by Nargis, including 75 percent of people (1.4 million) in the Irrawaddy Delta region that includes the townships of Bogalay (Bogale), Labutta, Ngaputaw, Dedaye, Pyapon, Kyaiklat and Mawlamyinegyun. (OCHA, May 18) As many as 90 percent of deaths were women, children and the elderly. (CARE, May 17)

 

MyanmarÕs Foreign Ministry says losses from the cyclone are expected to exceed US$10 billion. Several sources report 95 percent of structures in the delta were destroyed. In Bogalay an estimated 10,000 people died. About 1.8 million of the deltaÕs estimated 6.6 million people live below 16.4 feet (5 meters) in elevation. Initial estimates indicate 150,000 survivors are staying in about 120 temporary settlements in the delta, many of them unofficial. (OCHA, May 18)

 

The storm took down electricity and communication lines while landlines remain down, some cell phones are functioning. Water and power have been restored in some areas.

 

Widespread destruction and lack of running water could yield epidemics of food- and water-borne diseases such as cholera and diarrhea. Health workers continue to report cases of severe watery diarrhea, but the number of cases is still within the normal seasonal range for affected areas. (OCHA, May 19)

 

About 2.3 percent (718,400 MT, including 585,000 MT in storage) of MyanmarÕs annual rice crop was lost in the storm, which caused major damage to agricultural land and infrastructure in the delta. With heavy monsoon rains arriving, MyanmarÕs main planting season, which began at the beginning of May and would normally wrap up five to seven weeks from now, could be disrupted. In that case, the main November rice harvest could be lost and food assistance would be required for months, the local economy would be affected and livelihood opportunities would be reduced. The five worst-hit states produce 65 percent of the countryÕs rice, and have about half of all irrigated areas. They produce roughly half of the countryÕs poultry and 40 percent of pigs. The price of rice has quadrupled in the country since Nargis struck. (ACF, May 18) MyanmarÕs main hunger season is May to October. (SC, May 19)

 

MyanmarÕs Ministry of Education says 3,000 primary schools were destroyed or damaged, affecting 500,000 children. UNICEF says children account for 40 percent of the hardest-hit population and are the most likely to die in disease outbreaks. Children who have lost homes and families are now vulnerable to exploitation, child soldier recruitment and trafficking. UNICEF says 1 million children need urgent assistance.

 


Response Coordination

 

MyanmarÕs government is coordinating disaster response with the UN Resident Coordinator and UN officials leading the cluster system established by the UN Disaster Management Team with assistance from an Inter-Agency Standing Committee (IASC). Most aid delivery is facilitated through national NGOs and community-based NGOS with the Myanmar Red Cross Society the key agency.

 

MyanmarÕs Ministry of Social Welfare, Relief and Resettlement is in charge of national relief efforts, with the Information Management Unit (MIMU) taking the lead in information management. Myanmar Deputy Foreign Minister U Maung Myint is the designated officer for all relief assistance and the Ministry of Revenue and Finance is the contact point for cargo arrival. A Ministry of Health team is working out of Yangon General Hospital to manage and coordinate the overall health response.

 

The junta reiterated the need for UN agencies and INGOs to follow official procedures for relief donations, informing the National Disaster Preparedness Central Committee so distribution arrangements can be made. (Xinhua, May 20)

 

The Ministry of Social Welfare, Relief and Resettlement has agreed to deploy UN national staff to support national emergency relief efforts initially in Pathein, Labutta, Bogalay and Yangon. National UN liaison officers stationed in government facilities work closely with the national Disaster Management Teams to assist coordination, planning and information sharing. The officers are briefed by UNDAC.

 

MyanmarÕs Emergency Supply Supervisory Committee is working with UN agencies and INGOs to ensure all relief funds and supplies go to storm victims. (OCHA, May 19)

 

Cluster leads may develop a single multi-sectoral assessment tool to inform an operational, scenario-based work plan for each cluster. (OCHA, May 18)

 

A coordination center has been established in Labutta where multi-sector meetings are taking place daily, currently lead by the UN Development Program. Operation centers are opening in Pathein and Bogalay as well.

 

OCHA has launched a Humanitarian Information Center (HIC) Web site for Myanmar at http://myanmar.humanitarianinfo.org to improve collaboration between agencies and has also set up an On-Site Operations Coordination Center (OSOCC).

 

An NGO Resource Center has been formed to focus on funding, training and information management needs for national NGOs and CBOs and will promote information sharing between the cluster system and local NGOs. An interagency mission of Myanmar NGOs, INGOs and UN staff will deploy to worst-affected townships this week to improve coordination among stakeholders, including town governments.

 

 


                                                                 Sector Status

Logistics

WFP is the designated lead for the logistics cluster.

 

Coordinated In-Country Response (For more detailed Situation Reports for each cluster please check the HIC website http://myanmar.humanitarianinfo.org/ ) (OCHA, May 20)

 

Myanmar logistics cluster website: http://www.logcluster.org/mm08a/ (UNJLC, May 20)

 

Yangon Airport remains the primary hub although capacity is stretched to the limit with the current number of flights. Myanmar officials have requested one dayÕs notice be given for clearance of airlifts through the airport. All chartered flights require landing permission at Yangon International Airport (RGN) from the MOFA. The template for all procedures is available at http://www.logcluster.org/mm08a. The Cluster Lead continues to call upon partners to provide cargo forecasts. Capacity at the airport to receive, process and clear flights still limited. (DFID, May 18).

 

Thailand has approved the use of the Don Muang former international airport as a staging area for cargo. The operations hub will be managed by WFP. WFP is taking Cargo Movement Requests (CMRs). (UNJLC, May 19)

 

Requests for the approval of international staff to travel to the affected region are still pending. Relief arriving on commercial flights is being transported to the affected areas, but not of the quantity or frequency required. Access is also compounded by heavy rains which prevent cargo from moving along some roads. (OCHA, May 18)

 

The humanitarian community says 500,000 people received some form of international assistance. This is substantially less that the 2.4 million estimated to be affected of whom more than half (1.4 million) in severely affected areas requiring prioritized assistance. It is clear that the emergency phase is set to continue for some time. Some people are moving back to their places of origin where they will need assistance as well as support to restart their livelihoods and farming. (OCHA, May 19)

 

Heavy rains are continuing and the conditions for road transportation remain poor in delta areas. (OCHA, May 20)

 

The second barge rented for inter-agency use has been loaded this afternoon at the MITT terminal at Yangon port to departure for Labutta. The barge has been loaded with WFP and Merlin cargo. (UNJLC, May 20)

 

Local authorities in Labutta granted access to villages outside of the town that had previously been restricted, as well as to eight government distribution stations, for the delivery of food. (OCHA, May 20)

 

The Logistics Cluster in Yangon has secured a dedicated fleet of 30 trucks for inland road transport in Myanmar. Furthermore, three barges with a capacity of 200 - 800 MT will be operating out of the ports of Yangon and Pathein, covering the eastern and the western parts of the Irrawaddy delta respectively. (OCHA, May 20)

 

Ten Thai army trucks left Bangkok on May 20 for Yangon to deliver some 120 MT of relief. (Xinhua, May 20)

 

UNDP says that over the past few days access to remote villages on the waterways has greatly improved. UNDP has hired three boats in Bogale to reach more communities. (UNDP, May 19)

 

The BKK staging area will have one area for items procured in Thailand and one for cargo in transit to Myanmar. Further details on how to use the staging area will be shared shortly. (UNJLC, May 20)

 

As per traffic control information, 13 flights were planned to come in today: 11 from bilateral cooperation (5 US AIR FORCE) and 2 for UN. (UNJLC, May 20)

 

There are currently 109 national UN staff present in affected areas, and 72 international UN staff in Yangon. No international UN staff have been authorized to work in the affected areas. (OCHA, May 18)

 

WFP is looking to expand its inland waterway operation. Three boats with a capacity of 570 tons have been contracted for food delivery from Yangon. Another barge and tug have been identified in Pathein. (WFP, May 18)

 

A number of key roads are reported to be in bad condition, including Kyayklat to Bogale and Myaungmya to Labutta. The two bridges previously reported as damaged between Yangon and Bogale have been repaired. (WFP, May 18)

 

In Labutta, the public works department is planning to construct bailey bridges for the replacement of the wooden bridge. They are also repairing the Nyaumg Chaung bridge. (UNJLC, May 19)

 

A 3,000 square meter warehouse close to the Yangon airport is being managed by the DHL Disaster Response Unit, which has hired 10 local staff, and obtained forklift and generators. (OCHA, May 17)

 

Restrictions on importation and use of communications equipment are impacting communication between agencies. (OCHA, May 18)

 

The establishment of three operational centers in Labutta, Pathein, and Bogalay in the delta region is underway. (OCHA, May 18)

 

Agility, TNT and UPS have provided a temporary 4,000 MT warehouse space at the Suvanabhumi airport. (OCHA, May 15)

 

There is an urgent need for cargo handling equipment to accelerate the off-loading of aircraft. A key limitation on flights in Yangon is that there is no refueling capacity at the airport. (OCHA, May 16)

 

World Vision reported the following traveling times to reach population centers in some affected areas:

Yangon – Kyaiklat: 3 hours by road

Yangon – Bogale: 4.5 hours by road

Yangon – Pyapon: 3.5 hours by road

Pyapon –Mawlamyinegyun: 1.5 hours from Pyapon by river by motorized boat (OCHA, May 16)

 

Road conditions on the border crossing at Mae Sot/Myawaddy are said to be good for 25 MT trucks, and the road will be passable throughout the rainy season. The road to Labutta may be closed due to seasonal flooding. Two bridges damaged on the way to Bogale have been repaired but road conditions still not good. (UNJLC, May 15)

 

WFP is using up to 30 local trucks for delivery. A key limiting factor is that most bridges in Irrawaddy can only handle a 5-ton truck and heavy vehicles will severely damage existing roads. (WFP, May 14)

 

UN opened a logistics hub in the southern town of Labutta, which has two mobile storage units. An additional four warehouses will be set up in Labutta. (OCHA, May 16) Both Yangon and Pathein ports have been opened, allowing boats carrying a maximum of 250 MT through. (OCHA, May 15) The logistics cluster finalizing contracting of 3 barges and pusher for inland waterways operations. Main road from Yangon to Pathein is in good condition. (UN, May 15) The Kyayklat – Bogale and the Myaungmya – Labutta roads are in poor condition. (UNJLC, May 15)

 

As many as 90 percent of boats in the affected area may have been destroyed. WFP has contracted several boats for the delivery of food and has also requested clearance from the Civil Aviation Authority for one helicopter.

 

Food

WFPÕs Emergency Operation for Myanmar with a budget of US$69.5 million aims to deliver a complete food basket to a total of 750,000 people in need of immediate food assistance. (WFP, May 16) So far, WFP's operation has received US$8.5 million in confirmed contributions, including over US$5 million from the UNÕs CERF. (OCHA, May 16)

 

WFP has dispatched enough food to feed over 250,000 people in affected areas since the cyclone hit. (WFP, May 18) WFP has purchased enough rice inside Myanmar to feed over 1.5 million people with a two-week ration of rice (8,500 tons). A further 1,050 tons of beans have also been purchased. (WFP, May 18)

 

Myanmar allowed nine UN WFP helicopters to deliver aid to remote affected areas Tuesday, according to the UN. (BBC, May 20)

 

In order to ensure that food assistance is provided to the affected populations effectively it is important that the cluster move down from the township level. Closer collaboration with community based organizations to reach those at the village level is a priority. (OCHA, May 20)

 

Cluster partners operating at the field level in Bogale, Kyaiklat, Maubin and Pyapon met on May 18 to discuss geographical coverage, distribution modalities, and to develop a response plan at the local level. A similar exercise for Labutta will be conducted on May 19. (OCHA, May 20)

 

The cluster is working with the local authorities in Labutta to transport food to the government stations where it is distributed to beneficiaries. Two monitors will be deployed to each station where the distributions will be organized and monitored by the local relief committee and WFP. Staff report that food distribution using this arrangement previously has been working smoothly. WFP has dispatched 245.7 tons of food during May 17 and 18 to Irrawaddy Division. (OCHA, May 20)

 

WFP emergency food assistance rations will be composed of:

Rice 400g per day per person

Pulses 100g per day per person

Vegetable oil 30g per day per person

Iodized salt 5g per day per person

The monthly relief food basket for a family of five includes 60 kg of rice, 15 kg of pulses, 4.5 kg of oil and 0.75 kg of iodized salt. High-energy biscuits are to be provided for children under five years of age. (OCHA, May 20)

 

WFP has dispatched more than 1,480 tons of food and distributed 859 tons of food to approximately 255,000 beneficiaries. Cluster is in process of consolidating data on assistance provided in order to get a clear picture of the gaps. (OCHA, May 20)

 

Once one of the largest rice exporters in Asia, Myanmar currently faces difficulties in providing adequate food to poor and vulnerable families. (WFP, May 20)

 

WFP has so far managed to organize a total of 13 air cargo shipments into Yangon airport. (WFP, May 18)

 

WFP has managed to establish two field offices in the Irrawaddy – in Laputta and Bogale – which either have been or are being equipped with both internet and HF radio connectivity. A logistics hub is being set up in Pyapon and another hub may be established in Pathein. (WFP, May 18)

 

Food is available in Laputta proper, but insufficient, although the situation is improving. (UNICEF, May 18)

 

The daily ration will meet a minimum daily requirement of 2,100 kilocalories, composed of rice, pulses, vegetable oil, and salt. Ready-to-eat food (e.g. high energy biscuits, rice-lentil mix and supplementary foods for young children). (OCHA, May 16)

 

The Food Cluster awaits the approval of the Government to import rice, pulses and oil. A follow-up request has been made. (OCHA, May 18)

 

The number of WFP staff deployed to the country since the cyclone is 10. WFP has 220 local staff and 15 foreigners on the ground.

 

WFP is establishing three sub-offices in the Irrawaddy region and has relocated national staff members from the north to the affected areas in the south. Two sub-offices have been established in Labutta and Bogale.

 

Shelter

UNHCR is the designated lead for the shelter cluster. UNHCR will support the IFRC, which has been designated as the in-country lead for the Shelter Cluster.

 

OCHA says early estimates suggest that temporary settlements may now be sheltering over 550,000 people in Irrawaddy and Yangon Divisions. (OCHA, May 16)

 

Initial estimates indicate 150,000 people in about 120 settlements in the delta. This is a mixture of both official and unofficial temporary settlements. (OCHA, May 18)

 

Increases in the numbers of displaced persons in population centers were reported including in temporary settlements Labutta and Pathein. Local officials have told aid workers that they have started sending villagers back to their villages. (OCHA, May 18)

 

As part of yesterdayÕs tour of the affected areas, UNDAC staff visited Maubin, Mawlamyinegyun, Labutta and Hlaingbon as part of the ASEAN team. In Mawlamyinegyun there are 15 Government-organized relief camps sheltering 6,749 persons. The population of Mawlamyinegyun before the cyclone was 346,000 and 4,463 persons were killed, 6,075 are still missing, and 76,277 have been made homeless. 125 tons of rice and 450 tons of other supplies have been distributed to survivors. (OCHA, May 18)

 

Initial assessments were hampered by limited access, including difficult weather conditions. In some areas, estimates are still difficult to obtain. It is clear from analyzing the assessments received that further evaluation of temporary settlements where access has been limited, is required. This includes Wakema township where there are also official settlements and Mawlamyinegyun township where flood waters are still high.

Areas were classified by priority in four categories by partners:

a. Areas most severely affected by the cyclone where the levels of damage exceed 75%.

b. Areas severely affected but where the cycloneÕs intensity was less and access to services is slightly better.

c. Areas less affected but where there are official and unofficial temporary settlements of displaced people

d. Areas less affected in Yangon Division.

There are varying needs within these categories, with those for example in most severely affected areas lacking access to adequate shelter, clean water and sanitation. This is the case in most of the Irrawaddy Division. South of Yangon the intensity of the cyclone was less and access to services slightly better, while the temporary settlements are found in the townships north of the Irrawaddy Division. (OCHA, May 18)

 

UNICEF reported that as of May 17, n Laputta, there are around 33,000 people living in 49 camps, which remain messy and disorganized. People are continuing to sleep on the streets, in schools and in the monastery without bedding and frequently without protection from the rain. However, the camps have begun to be reorganized, along village lines, with new camps starting to open using donated tents and equipment. (UNICEF, May 18)

 

The team also report that the government has moved a considerable number of people (the current estimate is 12,000), by truck and boat, to Myaing Mya, which was unaffected by the cyclone and is around two hours drive from Laputta proper. The team report that once in Myaing Mya people seem pleased that they have been moved, as conditions within, at least, some of the 24 resettlement camps that have been established are significantly better than those in Laputta. (UNICEF, May 18)

 

In Bogalay proper (the capital of Bogalay Township) the team report that people are living in six camps in six separate locations. However, the authorities only officially recognize the existence of 1 camp. UNICEF has been providing supplies to people in those camps, who do not have access to government food and water. (UNICEF, May 18)

 

The authorities in Bogalay have been moving displaced persons to two unaffected towns: Ma Au Bin and Phur Pon. Over 3,000 people have been moved from Bogalay to new camps in Ma Au Bin. (UNICEF, May 18)

 

Shelter cluster has standardized three types of kits among partners. The high number of affected households cannot all be covered with traditional kits that include tools. There is close coordination with the WASH cluster to avoid duplication. The first kit is primarily a tool kit. This will contain tools needed for fixing or rebuilding a shelter. This kit is to be distributed to a group of 10 or more households, to be shared among the households. The second kit is a basic building material kit and will consist of tarpaulin, rope etc. This is to be distributed one per household. The third kit will be a Non-Food Items kit. (OCHA, May 17)

 

Tarpaulin and blankets are priority items. (SC, May 17)

 

Shelter cluster has use of a warehouse at old International Airport in Bangkok, one warehouse outside the airport and one warehouse in Yangon. (SC, May 17)

 

Monsoon season is arriving and farmers will urgently need shelter. Shelter cluster says it will keep in contact with the Agriculture cluster so that priority could be set for the farmers when distributions occur. (SC, May 17)

 

UNHCR is receiving five flights over next few days from Dubai with shelter materials for some 50,000 families. (SC, May 17)

 

Out of the US$187 million Flash Appeal, UNHCR is asking for some US$6 million to help some 250,000 people with temporary shelter materials.

 

UNHCR plans to have 304 additional staff in Myanmar this week pending entry visas. (May-11, OCHA)

 

The cluster plans to reach 200,000 households in a 2-3 week timeframe out of an estimated 300,000 affected households. (OCHA, May 14) UNHCR says a total of 93,412 pieces of tarpaulin have been distributed to Irrawaddy and Yangon Divisions. (SC, May 16)

 

More is known about the situation in Labutta, Ngapudaw, Maungmya and Yangon, but less about south Bogale, Mawlamyinegyun, Dedaye, Kyaiklat, Pyapon and camps in Wakema. The main camps for homeless are in Maubin, Mawlaminegyun, Wakema and Labutta. (IFRC, May 14) UNICEF says the government has moved around 12,000 people by truck and boat from Labutta to 24 resettlement camps in the Myaing Mya area, where conditions are reported to be much better. (UNICEF, May 15)

 

In Ngaputaw, 46 percent of the population in the township was affected by the cyclone and 49 percent of houses suffered some damage. Sixteen temporary shelters were opened near affected areas in Ngaputaw township and four in Pathein. (WHO, May 17)

Health

The World Health Organization (WHO) leads the health cluster, which comprises 22 international NGOS and other UN agencies. Sixteen WHO surveillance officers have been deployed to Irrawaddy and Yangon, including 11 international staff. Cluster projects submitted to the CERF amount to US$4 million. (OCHA, May 15)

The Ministry of Health reports that 90,000 outpatients and 10 000 inpatients have been treated in the cyclone-affected areas till 18 May 2008. There have been 2887 mild and 124 severe diarrhea cases. In a population of 1.5 million, approximately 200 diarrhea cases per day is within the range seen in previous years. (WHO, May 20)

 

Reliable reports of severe watery diarrhea continue, but the number of cases is still within the normal seasonal range. A reliable early warning system has been put in place by the MoH, UN and NGOs in the affected areas. The water supply system has been compromised in many areas forcing people to collect water from ponds and rivers which seem to be widely contaminated. Every possible action to prepare for a potential outbreak is being taken as all risk factors are present. With the upcoming rainy season dengue fever is also expected, however the current situation poses a more serious outbreak. The MoH has begun preparing prevention activities with the support of the Cluster. (OCHA, May 20)

 

Myanmar health authorities are providing daily reports on disease cases from the affected townships. These are being provided by Divisional Health Directors to the MOH Central Epidemiological Unit (CEU). MOH has a team of high level officials working out of Yangon General Hospital responsible for planning, managing and coordinating the overall emergency response in health. MOH is expanding coverage beyond hospitals to outlying affected areas by sending health assistants and midwives to the delta region. Reports coming in highlight the need for this and stress the need for health workers who can tackle health promotion and disease prevention activities. NGOs continue to send health teams to the affected areas as reports are still coming in of the need for trauma care and wound care. Several reports coming back from affected areas also describe apathy and resignation among the people in temporary shelters. Social and moral support is needed and while a few NGOs are providing psychosocial support, their capacity to respond to the level of needs is limited. (OCHA, May 20)

 

The Ministry of Health (MoH) is focusing on cross-sectoral prevention measures, such as ensuring clean water, food and shelter, to reduce the risk of disease outbreaks, as water-borne diseases routinely peak in the months of May and June. (WHO, May 20)

 

The MoH has invited cluster partners to establish and support the surveillance system. The sources of information will extend to the community and not be limited to health workers, in order to strengthen surveillance work and rumor verification. (WHO, May 20)

 

The cluster has procured more than 350 MT of medical supplies and equipment to date. Supplies include 3 million water purification sachets, 90,000 water containers, more than 50,000 insecticide-treated mosquito nets, shelter equipment, emergency health kits and essential medicines. (OCHA, May 20)

 

ASEAN announced that Myanmar had agreed to accept international aid agencies and medical workers from all ASEAN countries. Each ASEAN country would send a team of 30 personnel, with unrestricted movement. (OCHA, May 19)

 

Health supplies continue to reach key hospitals in the major centers, yet delivery of this assistance beyond the hospitals remains a challenge. At least 50% of health structures are damaged or destroyed and restricted access continues to hamper efforts. (OCHA, May 20)

 

According to an ongoing assessment, there is an urgent need to provide safe and clean delivery space within settlements for pregnant women. UNICEF is working to provide temporary safe delivery space and has already sent delivery kits to the affected townships. (OCHA, May 20)

 

WHO has supplied one emergency health kit to the Maubin Hospital, which is functioning as a referral hospital for the affected areas. MOH has redeployed 10 medical doctors and 12 nurses from Mandalay and Yangon General Hospital to Maubin Hospital as well as three Public Health Officers. Public health activities such as chlorination, vaccination, mobile teams and disease surveillance are being carried out by health workers. (OCHA, May 20)

 

On May 18, IOM Yangon received 14 MT of drugs donated by Americares. IOM on May 21 will take delivery of 10,000 treated mosquito nets donated by SDC. (IOM, May 20)

 

Two central-level assessment teams have visited the affected areas. One team was for emergency assistance, the other for logistics and supplies. The teams provided medical care, transferred severely injured patients by helicopter, and provided water and sanitation emergency equipment, including emergency health kits and bleaching powder for water chlorination. (OCHA, May 20)

 

Three medical ships with 34 doctors are providing health services in the delta area. Another 390 mobile teams are in the field to improve access to health services. (WHO, May 20)

 

Government Health professionals are also providing services in 12 ÔforefrontÕ, ÔmiddleÕ and ÔrearÕ relief camps. (WHO, May 20)

 

The MoH has assigned mental health professionals to some areas. Mental health specialists from Thailand have also been deployed. (WHO, May 20)

 

Polio and measles immunization in temporary shelters continue. Sufficient measles vaccines are in stock. (WHO, May 20)

 

In Dedaye township, the hospital is functioning even though its roof was blown away. All eight rural health centers and 20 sub-centers were badly damaged according to an INGO report. (WHO, May 20)

 

International medical teams from Thailand, India, China and Laos are now working in the affected areas with national health professionals. (WHO, May 20)

 

WHO has provided more than 65 MT of medical drugs, supplies and equipment. This includes more than 3 million tablets of various antibiotics, 15 emergency health kits to cover 450 000 people for a month, 20 000 insecticide treated bed-nets, 15 000 tubes of mosquito repellent cream, 12 800 kg of bleaching powder and 36 000 tablets of chlorine tablets. (WHO, May 20)

 

IOM has received 10 000 impregnated mosquito bed-nets. CESVI has distributed five emergency kits A and one emergency kit B. CESVI is supportive preventive and curative care in Dedaye township, Maternal and Child Health services in four rural health centers and eight subcenters. (WHO, May 20)

 

MoH has invited health cluster partners to assist in transportation of midwives to outlying areas for immunization activities. (WHO, May 20)

 

Health partners are to train up to 2000 volunteers in the field of disease prevention and surveillance of communicable diseases.

 

Cluster reports have expressed concern on the referral of complicated mental health cases. WHO, which has an ongoing program for mental health in the country, is developing a plan of action. The agency has already distributed guidelines in this subject, translated into the local language. IOM also plans to have an active role in providing mental health and psychosocial support.

 

Inter-agency partners have agreed to convey health education messages during food distribution. (WHO ,May 20)

 

WHO and health partners will conduct in-depth assessment of the health situation in coordination with the Ministry of Health. (WHO, May 20)

 

The Cluster has now developed a ÒWho, What, WhereÓ matrix, to facilitate a more efficient and coordinated response by health sector partners.

 

Medical supplies such as emergency health kits and water and sanitation equipment continue to be the priority public health requirements.

 

UNAIDS reports that in spite of the cyclone, all anti-retroviral therapy (ART) services are functioning and providing the necessary services to the HIV-positive community. Most service points delivering ART are taking special measures to track and assess patients' needs and drug supplies. The Myanmar Positive Group in collaboration with local community organizations such as Phoenix group and with support from HIV/AIDS Alliance and UNDP and other organizations working with self-help groups such as AFXB are tracking all their members and organizing to ensure that relief supplies, including shelter rehabilitation, are being provided. (WHO, May 18)

 

The Health Cluster is supporting, with medical supplies, 200 extended first-aid posts run by doctors from the Myanmar Ministry of Health and Myanmar Red Cross volunteers in the cyclone-affected areas. (WHO, May 18)

 

The health partners are supplying 80 basic health units to the health centers in rural areas. This is in addition to the basic malaria treatment module which is also being supplied. UNICEF has received 30 emergency health kits and therapeutic food. (WHO, May 18)

 

IFRC has mobilized four basic health clinics (emergency response units). (WHO, May 18)

 

Five out of six station hospitals in Ngaputaw township are reported destroyed. However, the township hospital is functional. Referral cases are being sent to Pathein township hospital. (OCHA, May 17)

 

The hospital in Maubin is being used as a referral hospital for Pyapon, Bogale, Kyaiklat and Dedaye townships in Irrawaddy Division. WHO dispatched emergency supplies to Pathein hospital for the management of diarrhea. Some cases of snakebite have been reported.

 

In Ngaputaw township the most common conditions reported after the cyclone are injuries, followed by acute respiratory infections (ARIs), gastroenteritis, dysentery and malaria. Local authorities have alerted the population on larvae control to control dengue. (OCHA, May 16)

 

The health cluster has established three operations centers in the townships of Pathein, Labutta and Bogale. (WHO, May 17)

 

WHO reports 50 percent of rural and township health centers in affected areas have been damaged.

 

The Ministry of Health (MoH) has begun measles vaccination campaigns for children in relief camps between the ages of 9 months to 5 years. Those injured are being immunized by tetanus-toxoid (TT) vaccine. (OCHA, May 15)

 

Nutrition

Before Cyclone Nargis, the hard-hit Irrawaddy region had around 30 percent chronic and 9 percent acute malnutrition. (May-11, OCHA)

 

Nutrition Cluster partners (ACF, SC, Merlin, PSI, MSF-Switzerland and UNICEF) are working to identify the locations and types of nutrition interventions to be undertaken in next six months. A joint call for support for appropriate infant and young child feeding was finalized by WHO, UNICEF and SC. Essential messages on exclusive breastfeeding were shared with all partners. (OCHA, May 20)

 

Save the Children says that some 30,000 children under the age of five in cyclone-affected areas were acutely malnourished before the cyclone hit, of those the NGO believes several thousand are at risk of death in the next two to three weeks due to a lack of food. (DFID, May 18)

 

MSF-Switzerland has been carrying out nutritional screening of under-five children in Twantay township. Results indicate an approximate 3 percent rate of severe malnutrition. (OCHA, May 15)

 

The National Nutrition Center and Ministry of Health have planned a Vitamin A supplementation campaign for all children aged from 6 to 59 months in cyclone-affected areas, in collaboration with UNICEF. (OCHA, May 15)

 

Myanmar currently faces difficulties in providing adequate food to poor and vulnerable families. Despite being a food-surplus country, one-third of children remain malnourished; one-fifth are born underweight. High chronic malnutrition rates indicate a worsening of the food security situation due to insufficient nutritious food, poor access to health facilities, inadequate water and sanitation facilities, poor maternal and child care and limited livelihood opportunities. In the 2007/08 UNDP Human Development Index, Myanmar is placed 132nd out of 177 countries. (WFP, May 16)

 

Water, Sanitation and Hygiene (WASH)

UNICEF leads the water/sanitation cluster and has launched an appeal for an initial US$8.2 million. The agency is carrying out needs assessments in water/sanitation with 16 NGOs.

 

Cluster partners are distributing chlorine solution sufficient to disinfect 6 million liters of water per day. Challenges have been encountered in the construction of sanitation facilities due to high water table in the delta areas. (OCHA, May 19)

 

Relief agencies that are not registered to operate in Myanmar have made available several water treatment units for the use of agencies already operating in-country. The cluster lead is coordinating requests. Discussions are ongoing on standardization of supplies. The regional cluster has provided details of stocks available in Bangkok for immediate shipment to Myanmar on request of agencies. (OCHA, May 19)

 

There is shortage of sanitary facilities and water containers in Labutta and Myaungmya townships. Coverage of WaterGuard disinfectant solution appears to be good. (OCHA, May 19)

 

Merlin is currently addressing water and sanitation and basic health needs with its 73 staff in Labutta and is partnering with other agencies in order to be able to expand the reach of services. By May 17, Merlin had reached 64,000 beneficiaries in Labutta town, in 21 villages in the area, and in seven temporary settlements. (OCHA, May 19)

 

IFRC will start operating a water and sanitation unit for 40 000 people. (WHO, May 18)

 

2 trucks filled with pipes of various sizes for the distribution of water were sent to Laputta. (UNICEF, May 18) In Laputta, a portable water treatment plant was providing treated water to displaced people in 228 tents. The team report that the situation in outlying villages in Laputta Township, where reports indicate significant numbers of people remain, is even worse than in Laputta proper, where the team is stationed. (UNICEF, May 18)

 

The number of latrines is increasing, but is still insufficient and personal hygiene is poor, with a lack of soap and hand-washing facilities. Water continues to be available, as there is (at least, for the moment) sufficient water in 10 ponds, which can be effectively treated by water purification chemicals, which are being provided by UNICEF and the Disaster Management Committee (DMC). (UNICEF, May 19)

 

The Cluster has finalized a 4-month initial response action plan based on an assumption of 1.5 million affected people, including 0.5 million in temporary relief settlements.

 

The Cluster agreed, in this phase, to adopt the following indicators: Safe drinking water: 3 liters per capita per day, ÒClear and freshÓ water (bathing, general purpose, not necessarily bacteriologically pure): 10 liters per day in temporary settlement settings. Latrines (or safe excreta disposal facility): 1/100 people in 60 days time, 1/50 in 90 days, 1/36 persons per day after 120 days, and thereafter at a rate of 5,000 latrines provided per month until the target of 1 latrine for 20 persons is reached. Hygiene promotion: 1 community per Hygiene Promoter per 2,000 persons in 60 days, and 1 per 500 persons in 90 days. (OCHA, May 17)

 

25 water treatment plants with a combined capacity of 50 cubic meters per hour are on standby to be deployed, pending staff visas. (OCHA, May 17)

 

Agriculture

The rice planting season starts in a few weeks and the UN Food and Agriculture Organization (FAO) estimates need for 50,000 tons of rice and 15,000 tons of fertilizer, covering 250,000 hectares. (OCHA, May 14)

 

While Agriculture and Early Recovery remain separate clusters, both are collaborating closely and strategic planning is done jointly. The most affected areas are predominantly rural and normally produce a significant proportion of the countryÕs agricultural output. (OCHA, May 20)

 

UNDP and FAO are in discussion with Ministries of Agriculture, Livestock, Fisheries, and Cottage Industry Department and Department of Development Affairs for assistance activities. UNDP hopes that this process will also facilitate access of NGOs to the field. (OCHA, May 20)

 

The Irrawaddy delta, which bore the brunt of the storm, is known as the country's granary and has an extensive fishery industry along its coast. Much of the recent harvest was already complete, but rice stored for household consumption has most likely been lost in the most affected areas. The loss of crops, shrimp farms, fishing ponds, nursery hatcheries, fishing boats and other productive assets has led to increased unemployment of the extreme poor who depend on wage labor for their livelihood. (WFP, May 20)

 

OCHA reports time is of the essence with the fast approaching monsoon season. Extensive damage to the agriculture production risks the loss of the November harvest given the planting season ends within five to seven weeks. If this planting season is lost then assistance would be required for some months to come. In addition this could also potentially disrupt the local economy and livelihood opportunities for the communities in the delta. It is estimated that over US$10 million worth of seeds is needed. (OCHA, May 18)

 

The Ministry of Agriculture and Irrigation reports that the current loss of rice is only 2.3% (718,400 MT) of total production in 2007/2008. Wet season rice production will be seriously and significantly affected due to urgent need of seeds, fertilizers, farm machinery, draught animals, the loss of labor in rice farming communities, and salt water intrusion. Ministry says detailed assessment is in progress and a significant reduction of rice production could be expected unless wet season rice crop can be grown in a timely manner. (MAI, May 16)

 

130,000 farming households were affected in Irrawaddy Division and 117,000 in Yangon Division. (MAI, May 16)

 

FAO estimates agriculture rehabilitation will cost $243 million plus $20 million to replace livestock. The five worst-affected areas account for 65 percent of rice production, 20 percent of rubber plantations, 50 percent of poultry, 40 percent of pigs and 80 percent of fish. The FAO estimates that 20 percent of rice fields – 650,000 of 3.2 million hectares – in the five disaster zones were damaged.

 

FAO has confirmed that there are enough seeds for wet season planting in-country, though fertilizers will need to be imported.

Child Protection

UNICEF leads the protection cluster.

 

Pre-cyclone statistics indicated that about one-third of children under five suffer from some form of malnutrition. While the food supply to the affected areas has improved over the past few days, clearly huge infusions of food assistance are urgently required. Children are among the most vulnerable in any disaster and with so many children already in a weakened state, lack of nutrition, water, sanitation and shelter, can be a lethal combination. (OCHA, May 20)

 

Cluster partners have established 55 functioning Child-Friendly Spaces (CFS) to date, with 92 more being set up. In Yangon Division there are 51 functioning CFS and 75 being set up, while in Irrawaddy Division four are functioning and 17 are being set up. The CFS are supported by World Vision, UNICEF, Save the Children, EMDH, MRCS and local NGOs. (OCHA, May 20)

 

Assessment teams have returned from Labutta, Myaungmya and Bogale, and are compiling figures of separated and unaccompanied children, to inform cluster partnersÕ response. (OCHA, May 20)

 

The Cluster has now finalized the Myanmar language versions of the Code of Conduct to prevent any form of sexual abuse and exploitation for staff, humanitarian workers, partners and volunteers, and the Ethical guidelines on photography, interviewing and reporting on children in emergencies. (OCHA, May 20)

 

Of the affected populations across Yangon and Irrawaddy Divisions one third to 40% are estimated to be children. The teams stationed in both Laputta and Bogalay report that they have seen large numbers of children in the camps. (UNICEF, May 18)

 

Several UNICEF Child Protection staff members are still in the field, in Laputta, Myang Mya and Bogalay. The situation in Laputta is of serious concern. 648 children are reported as separated. In Pawain village, where 250 people (of which 100 are children) have been moved from Bogalay, a child-friendly space is being established, in partnership with MRCS. (UNICEF, May 18)

 

UNICEF estimates 40 percent of the hardest-hit are children. UNICEF estimates 2 million children need Òurgent assistance.Ó Other aid groups say children are vulnerable to abuse and recruitment as laborers, sex workers or child soldiers.

 

Education

UNICEF leads the education cluster. Immediate priorities have been assessing damages to schools and planning for education to resume on June 1.

 

Ministry of education says 3,000 primary schools have been destroyed or damaged affecting some 500,000 children. OCHA says that it is estimated that some 2,400 primary schools have been damaged, affecting the education of 360,000 students. UNICEF says 85 percent of educational buildings have been destroyed or damaged.

 

UNICEF says an unknown number of teachers were killed or missing and focus is on training volunteer teachers, providing as many as 300,000 school kits and setting up temporary schools.

 

Data on the status of schools in the affected Townships in Yangon and Irrawaddy Divisions continues to be collected by UNICEF field and Yangon based staff. The Education team in Bogalay has contacted the Township Education Office and is currently compiling information regarding the requirements for roofing sheets for schools that can be repaired within the next 2-6 weeks. (UNICEF, May 18)

 

UNICEF staff made the first round of supply delivery to 22 affected primary schools in Shwepyithar Township and 17 schools in Hlaingthayar Township in Yangon Division. However, the truck carrying supplies was unable to reach 4 schools due to the condition of the roads. After consultation with the school heads, the supplies were placed at the nearest accessible school, which the school heads will arrange delivery for to their school when possible. One school in Shwepyithar Township had totally collapsed, so no roofing sheets were delivered. 70 Ôschool-in-a boxÕ were delivered to the 39 affected schools. Almost 20,000 children will benefit from these supplies. The essential learning package will also soon be delivered to these schools. (UNICEF, May 18)

 

The Government has announced that schools will open on 2 June 2008. There is concern regarding those schools in both the delta and Yangon areas that are currently being used as temporary settlements.(OCHA, May 18)

 

Schools are being repaired. The team was told that those people living in schools will be relocated to camps to ensure that the new academic year could resume on 1 June as planned. (UNICEF, May 18)

 

Telecommunication

The Cluster coordinator arrived in Yangon. Communications equipment is being held by customs authorities in Yangon while clearance is sought.

 

The Ministry of Social Welfare, Relief and Resettlement has confirmed that no communications equipment could be imported, and as an alternative offered to provide CDMA SIM cards and phones for sale through the Ministry of Posts and Telecommunications. A maximum of ten units per agency could be provided at a cost of US$1,500 each. The CDMA system is reported to have good coverage in affected areas. (OCHA, AP, May 17)

 

IPSTAR connectivity to Bogale is being installed by UNICEF, and emergency power supply to support communications in Labutta for the humanitarian community is being provided by WFP. Both WFP and UNICEF continue to provide technical support to the humanitarian community in Yangon, Laputta, Bogale and Bangkok. (OCHA, May 20)

 

On May 16, telecommunications equipment intended to be used to support the humanitarian relief activities was seized by officials in Yangon. (OCHA, May 19)

 

Early Recovery

UNDP leads the early recovery cluster. It has established a relay system using road transportation of personnel and supplies into Irrawaddy Division. UNDP has assembled a technical team to arrange recovery assessments from 1,700 villages. Baseline information for most sectors has already been collated.

A SURGE Team has been requested by UNDP to support the coordination, assessment and strategic planning for early recovery processes.

 

Early Recovery strategy will focus on two components: Immediate Activities, and Early Recovery. Cluster partners have identified priorities for the Immediate Activities component of the Early Recovery program. Immediate Activities are to organize assistance to help farming communities in the delta to prepare for the monsoon planting (early June to July). Assistance includes agricultural inputs, provision of livestock and poultry, fishing boats and nets, as well as non-agricultural support, in particular shelter, sanitation and water collection tanks, cleaning of ponds, clearance of debris, essential village access infrastructure such as footpaths, culverts and jetties. The Early Recovery component will provide a framework for a more comprehensive recovery program that will form the foundation for a long-term recovery plan, and will begin in 4-6 weeks. Planning (including data collection and analysis), resource mobilization and programming will begin immediately. (May 20)

 

A UNDP field team conducted an assessment this week in Kyaiklat township including consultation with 24 self-reliance group members from UNDP HDI projects in 12 villages. The assessment also extended to Bogale township, however participation of villagers there was limited due to difficulties in access. Immediate activities were identified based on the villagersÕ own assessment, and options for implementation arrangements were discussed. Cluster partners felt that this was a sound approach for needs assessment in affected townships. Cluster partners agreed on developing an Action Plan in the immediate term (in next two weeks) based on the having village communities to prioritize their needs. (May 20)

 

Partners of various clusters have together examined Cash for Work strategy, feasibility and modalities of implementation. An inventory of agencies planning to engage in Cash for Work activities is now available. (OCHA, May 20)

 

As reports of damaged buildings continue to come in, the government has clarified that it is responsible for the rehabilitation of public buildings, but would welcome support form NGOs and other partners for damaged equipment, instruments and other supplies.

 

The Cluster has identified the following recommendations: In preparing for early recovery the most likely scenario guides intervention planning: namely that the situation is currently fragile but holding, and that no major natural disaster occurs other than the seasonal monsoon (which will exacerbate the current infrastructure and capacity issues). (OCHA, May 17)

 

 

 

Background

 

Cyclone season in the Bay of Bengal typically runs from May through November. Nargis was the first cyclone to hit the Bay since category-4 Cyclone Sidr struck Bangladesh on November 15, killing nearly 3,400 people and devastating the southeastern coastline. In May 2004, the junta made a rare request for assistance after a cyclone hit Rakhine state, killing at least 140 people and displacing around 18,000 others. Some casualty estimates put the death toll for the 2004 storm at more than 1,000. It was reportedly the worst storm to hit Rakhine since 1968 and carried sustained winds up to 100 mph.

 

Country Profile

 

Myanmar, formerly known as Burma, has a population of about 53 million and has been ruled by a succession of military juntas since 1962. It is one of Asia's poorest nations. The current junta, ruling since 1988, has isolated the country from the outside world, making it difficult at times to extract information about events taking place in the country. The capital city, Naypyidaw, is located about 240 miles (390 km) north of Yangon.

 

Many Western nations have imposed sanctions on Myanmar in protest of its alleged human rights abuses and a crackdown on peaceful pro-democracy protests in September 2007 in which at least 31 people were killed. Myanmar receives far less foreign aid - about $US2.50 per capita - than regional neighbors Cambodia ($47) and Laos ($63) and below the $14 average for low-income nations. (Reuters)

 

 

Government Response

 

The Ministry of Social Welfare, Relief and Resettlement is in charge of national relief efforts. The government has fewer than 40 helicopters, most small or old, and only around 15 transport planes, primarily small jets unable to carry hundreds of tons of supplies. At least five helicopters are airlifting supplies to the disaster-hit regions. Four infantry divisions have been deployed to affected areas. A National Disaster Preparedness Central Committee (NDPCC) headed by the prime minister has been established and has mobilized military and police units for rescue, rehabilitation and clean-up operations in the Yangon area. MyanmarÕs Information Management Unit (MIMU) has taken the lead in information management.

 

The junta reiterated the need for UN agencies and INGOs to follow official procedures for relief donations, informing the NDPCC so distribution arrangements can be made. (Xinhua, May 20)

 

The junta declared three days of mourning for cyclone victims from May 20-22.

 

Officials say schools will re-open on June 2, although many schools in affected areas are being used as temporary shelters.

 

State media reported May 20 that the government had spent more than US$45.5 million (50 billion MMK) on relief operations, had met immediate food, shelter and health care needs and was starting its reconstruction phase. (AP, May 20) The NDPCC said US$5.1 million has been given nationally while foreign donors gave US$1.62 million.

 

NDPCC says 122 civilian and military medical teams with 2,029 members are working with local health staff on disease prevention and treatment in Yangon and Irrawaddy divisions. No infectious diseases beyond normal levels have been found. The Ministry of Health is providing daily disease reports through its Central Epidemiological Unit and has invited health cluster partners to establish and support the surveillance system. (OCHA, WHO, May 19-20)

 

Emergency Supply Supervisory Committee is working with UN agencies and INGOs to ensure all relief funds and supplies go to storm victims. (OCHA, May 19)

 

The Public Works Department plans to construct bailey bridges to replace damaged wooden bridges in Labutta. (OCHA, May 19)

 

National Response

 

More than 100 Myanmar organizations, companies and benefactors have donated relief items. More than 40 Myanmar NGOs are participating in a local NGO Resource Center. Buddhist monks are playing a major role by housing victims in monasteries and distributing rice and shelter materials delivered by aid agencies.

 

The Myanmar Red Cross Society (MRCS) is one of the key agencies responding to the disaster with large numbers of people on the ground. MRCS has distributed emergency relief supplies to 57,000 people in Yangon and Irrawaddy Divisions through its established logistic system and network of local volunteers, and is expected to receive US$4.5 million (5 billion MMK) from the government. (Reuters, OCHA, May 18) MRCS will distribute 40 tons of relief items the IFRC plans to fly in this week. MRCS has five operational assessment teams in Irrawaddy, Yangon and Pegu divisions, Mon and Kayin states. MRCS is helping UNICEF distribute supplies.

 

Knowledge and Dedication for the Nation (KDN), Pact Myanmar and Myanmar Egress are delivering food in partnership with Action Aid. KDN has set up four relief camps providing food, medical aid and temporary shelter to survivors in the delta.

 

Anglican Church of the Province of Myanmar (CPM) has a relief committee that has sent three teams to assist and assess three affected areas.

 

International Response