Cut-off values for emergency warning

More than

Health status

· daily crude death rate

1/10 000 population

· daily under-5 death rate

2/10 000 children under 5

Nutrition status

· acute malnutrition (weight-for-height <- 2Z scores) in under-5s

10% of children under 5

· growth faltering rate in under-5s

30% of monitored children

· low weight at birth (less than 2.5 kg)

7% of live births

Standard structure of population

Average in the population

· 0-1 year

4%

· 0-5 years

18%

· fertile women

24%

· pregnant women

5%

· expected births

4.4 per 100 population per year

Water

Indicator

Average requirement

· quantity

no. of litres/person/day

20 litres/person/day

· quality

no. of users/water point

200 people/water point

(1 cubic metre = 1 tonne = 1 000 litres)

(not more than 100 metres from housing)

Food

kcal (MJ) content

Radon, kg/person/month

· cereals

350 (1.46)/100g

10.5

· pulses

335 (1.40)/100g

1.8

· oil

860 (3.59)/100g

1.2

· sugar

400 (1.67)/100g

1.2

kcal value of recommended ration, person/day:

2100 kcal (8.79 MJ)

Total kg/person/month for feeding

14.7 kg

Household fuel

Average need

Firewood

15 kg/household/day

Note: with one economic stove per family, the needs may be reduced:

5 kg/stove/day

Space for accommodation

· Individual requirements (shelter only)

4 m²/person

· Collective requirements, including shelter, sanitation, services, community activities, warehousing and access

30 m²/person

Prevalent health hazards

Expected attack rate in emergency situations

· Acute respiratory infections in children under 5

10%/month in cold weather

· Diarrhoeal diseases in children under 5 (other than dysentery and cholera)

50%/month

· Malaria, in total non-immune population

50%/month

Essential primary health care activities

Target

Optimal coverage of target

· under-5 clinic and growth monitoring

all children of 0-59 months

100% of under-5s per month

· antenatal clinic

all pregnancies

50% of pregnancies per month

· tetanus toxoid

all pregnancies

30% of pregnancies per month

· assisted deliveries

all deliveries

1/12 of total annual deliveries per month

· BCG

all new births

1/12 of total annual births per month

· DTP1-TT1

all children 0-1 year

1/12 of total group per month

· DTP2-TT2

all children 0-1 year

1/12 of total group per month

· DTP3

all children 0-1 year

1/12 of total group per month

· Measles

all children 9-12 months

1/12 of total group per month

· STD/HIV prevention (by condoms)

all sexually active males

12 condoms per man per month

Health personnel requirements

Output of one person/hour of work

Activity

· vaccination

30 vaccinations

· under-5 clinic and growth monitoring

10 children

· antenatal clinic

6 women

· assisted delivery

1 delivery

· outpatient department consultation

6 consultations

· outpatient department treatment (dressings, etc.)

6 treatments

Note: one person/day = 7 hours of field work

Health workers emergency requirements (e.g. refugee camp) for vaccinations, growth monitoring, antenatal clinic, assisted delivery, outpatient department consultations and treatments, registry and clerical duties

60 staff × 10 000 population

Health supplies requirements

Needed

Essential drugs and medical equipment

· The WHO emergency health kit

1 kit for 10 000 population/3 months

Nutritional rehabilitation

Needs of each under-5 patient

· oil

90g/day

· milk

120g/day

· sugar

70g/day

Safe drinking-water

amount

a) to prepare 1 litre of stock solution 1%:

use 1 litre of water, plus:

15g calcium hypochlorite 70%

or 33 g bleaching powder^a 30%

or 250 ml sodium hypochlorite 5%

or 110 ml sodium hypochlorite 10%

b) to disinfect drinking-water with the stock solution:

use 0.6 ml or three drops of solution per litre of water;

use 60 ml of solution per 100 litres of water.

(Note: allow the chlorinated water to stand at least 30 minutes before using)

· Cholera

Likely maximum attack rate

6% over 4 months

100% cases needing ORS

6.5 packets/patient

20% cases needing IV fluids

3 litres/patient

20% cases needing antibiotics: doxycycline 300 mg, 1 dose

1 tab per course

· Meningococcal meningitis

100% cases treated with oily suspension chloramphenicol

6 amps per course

100% population to be vaccinated

1 dose/person

· Measles

Likely maximum attack rate in non-immunized under-12s

10%

100% non-immunized under-12s to be vaccinated

1 dose/child

100% under-12s to be given vitamin A

· children 6 months to 1 year

100 000 IU/child

· children 1 year and over

200 000 IU/child

· Typhus

100% population to be deloused

Individual spraying with permethrin 1%

· adult

30g

· infant and child

15g

Weights and volumes

· Food per week

individual ration per month

14.7 kg

amount per 10 000 people

36.8 tonnes

(1 tonne of food grains/beans in standard 50kg bags occupies 2m³)

· Drugs and supplies:

1 WHO emergency health kit

860 kg, 4m³

· Vaccines:

1000 doses of measles

3 litres

1000 doses of DTP

2.5 litres

1000 doses of BCG

1 litre

1000 doses of polio

1.5 litres

1000 doses of tetanus

2.5 litres

· Food for therapeutic feeding:

standard under-5 patient ration

2 kg/week

· Family-size tents:

35-60 kg unit

1 tonne, 4.5m³

· Blankets

compressed

1 tonne, 4.5m³

loose

1 tonne, 9m³

Warehouse requirements

· approximately 25m² for 1000 population

· 1.2 m² for 1 tonne of bagged food grains stacked 6m high

Average truck capacity

· 50 tonnes

Small aircraft capacity

· 3 tonnes