Managing Explosions-The Nigerian Experience FIFTH FOCAL POINTS MEETING ON EMERGENCY AND HUMANITARIAN ACTION, PRETORIA 29 OCT-2 NOV 2001

D ISTRIBUTION OF HAZARDS BY ZONE Meningitis Belt Cholera Yellow fever Lassa fever Pipeline explosion

Objective of WHO Intervention Support country to attain the highest level of health General Objective: To prevent deaths and reduce morbidity. Specific Objectives: Assessment of health risks Response to risks: support human and material resources Coordination of activities Epidemic Surveillance. Reducing the impact of future crises

Explosion management in Nigeria Source of information: Surveillance Officers/state Officials/mass media/FMOH report Rapid assessment Team visit the area Meetings: Coordination of activites; Identification of needs, who will be responsible for what; supply of immediate needs; Mass mobilization (IEC-English and relevant local languages) to create community awareness; Mobilisation of Resources---- Materials---Emergency kits Experts on Burns treatment Training Investigation to identify causes Future Prevention/recurrence and Approach

Common Causes Pipeline Vandalization Weak and rusted pipelines (leakages) Adulteration of petroleum products Sabotage (restive youths in the Niger Delta region) Low level of literacy and general poverty Human error

Effects Immediate Deaths (In Jesse over 2,000 deaths, burnt to the bones or ashes) Varying degrees of burns (from 6%-100%), asphyxia due to fume inhalation, multiple trauma Environmental degradation (Aquatic life, agricultural and farmlands adversely affected Economic and property damage estimated in billions of Naira after each incident) Displacement, confusion, anger and panic Long term Disabilities, Strictures, Keloids, Skin and Lung lesions Still births, deformities and other congenital malformations* Neurological and chromosomal abnormalities* ?Cancers* ?Mental retardation and reduced IQ due to Lead poisoning* *This needs further studies

Effects (contd.) Psychological Orphaned children (father and mother burnt) –found in all epidsodes Post Traumatic Stress Disorders (PTSD) Multiple family involvement (5 out of 6 family members affected) –Lagos and Benin incidents 300 Family units affected in the Warri episode 65% of women affected in the Ovirrhi Court explosion 3 day old baby affected with gangrene of the toes and risks amputation in the Lagos kerosene explosion. 3 babies delivered prematurely (induced labour) –Lagos experience

Preparedness Rapid assessment teams exist in Lagos (South) and Abuja (North) Pre-positioned supplies (WHO, UNICEF, FMOH, NNPC, NEMA) Logistics support (NNPC helicopters and aircraft, 4-wheel drive, etc) Coordination planning meetings (UN thematic group). Mass Mobilization (Red Cross and States) Local NGOs and volunteers. Information sharing

Response -Steps Gather relevant information (surveillance, media, rumors, etc) Verify the information (phone calls, , radio, etc) Mobilize for immediate response(manpower, materials and funds) Intervention Write report and feedback Plan for future

Response (contd.) Different levels of intervention Strategic (HMH/Director – Special Projects, UNICEF and WHO Reps, GMD-NNPC, HCH-SMOH) Tactical (EPR focal person, UNICEF and WHO field officers, NNPC Medical Officers, Red Cross EPR person and Burn surgeon) Operational (burn specialists, general duty doctors, epidemiologists, anaesthetic and theatre nurses, accidents and emergency nurses, environmental health officers, psychologists, Red Cross volunteers, Local NGOs, Community and other local volunteers) Response teams available (case management group, case search/mass mobilization group, surveillance/missing persons survey group, pathology/disposal of dead bodies group, logistics/coordination group) Designated teaching and specialist hospitals for case management Coordinated response

Response (contd.) Consultative and enlightenment meetings with local opinion leaders Visit of VIPs (HMH, Governor, etc.) Establishment of treatment facilities near to affected villages to sort out serious cases and refer them for specialist treatment Ambulance service established to go round the villages and bring victims from their homes for proper treatment Contact tracing and case finding Missing/dead persons epidemiological survey established Overall cost of intervention by Federal government, partners and NGOs for the Ovirrhi Court disaster is estimated at N400 million

Constraints Oath of secrecy (cult members) Lack of contingency plan for effective response to oil pipeline and kerosene explosions nationwide Lack of policy for disaster management Limited funds for field operations Limited logistics and communication support Poor data analysis for planning Poorly trained manpower for emergency preparedness and response. Dearth of specialized manpower (Plastic Surgeons, nurses). Enormous cost of managing burn patients (each patient is conservatively said to need N0.7 million for his/her treatment). Poorly developed specialized burns centers in at risk zones of the country. Limited drugs and essential supplies for effective case management.

Recommendations Training of District EHA Teams Vulnerability assessment and risk mapping Advocacy and social mobilization Establishment of well equipped and specialized burns units in areas of the country at highest risk. Increased budgetary allocation and funding of disaster management Pre-positioning of relevant supplies Improve logistics and communications support Improved coordination Improved information sharing amongst stakeholders

THANK YOU ALL FOR LISTENING. MERCI BIEN