1. ELECTIONEERING CONTINGENCY PLAN REPUBLIC OF KENYA THE HEALTH SECTOR ELECTIONEERING CONTINGENCY PLAN FOR 2013 GENERAL ELECTIONS February 2013

2. Health and Mass Casualties Pillar Main Objective Address immediate life threatening needs, prevent excess morbidity, disability and mortality and provide prioritized health care. Specific objectives Ensure mass casualty management systems are available throughout the electioneering period Ensure continuity of essential primary and secondary health care services Ensure early recovery strategies are incorporated into the response actions

3. HOT SPOTS South RiftNorth Rift Nakuru central districtEldoret East, West, Wareng Nakuru NorthBaringo/Marigat MoloTranzoia East/west NaivashaNandi North, Central, East, Tinderet Koibatek,Mogotio Upper EasternNorth Eastern Moyale, Marsabit,IsioloMandera, Wajir, Garissa Coast ProvinceNyanza Tana river, Kilifi,Mombasa, Kwale, Lamu, Taita Taveta Kisumu Nairobi Kibera, Mukuru, Kiambio, Mathare Valley, Majengo, Kawangware, Kangemi

4. Estimated number of people to be displaced per Hub HUBDistricts Population (2009 census) Estimated no. of people displacedRemarks Isiolo Moyale, Marsabit, Isiolo 434,46050,000-60,000 Based on Isiolo hub workshop Nov 2012 Nakuru Nakuru, Naivasha, Kipkelion, Molo, Njoro, Narok, Subukia 185,000 According to the protection workshops Eldoret Kitale, Nandi, Uasin Gishu, Burnt Forest 25,000 According to the protection workshops MombasaMombasa, Lamu, Tana River, Kwale, Malindi, … 3,325,307 50,000-70,000Based on Mombasa hub workshop Oct 2012

5. Estimated number of people to be displaced per HuB HUBDistricts Population (2009 census) Estimated no. of people displacedRemarks Garissa Garissa, wajir, Manerda, Ijara, Fafi, Hagadera 2,310,75718,000 Based on CP consultations KisumuNyanza, Western9,776,99310,000 Percentage estimation Turkana 855,3993,000 Percentage estimation Nairobi Urban area Kibera, Makandara, Kasarani, …. 1,099,45330,000 Based on hub consultation Other areas… 20,000 Percentage estimation Total 350,000- 400,000

6. The 8 Hubs for Humanitarian Coordination as identified by Humanitarian Pillar LocationCoveragePriority Focal point organizatio n Nairobi (informal settleme nts) Kasarani, Westlands, Langata and Makadra dsitrcits, Embakasi, (covering, Kibera, Mathare, Kariabangi, Kariakor, Korogocho, Kangemi), Eastleigh High Concern Worldwide / UVF Eldoret Eldoret: Eldoret East, Eldoret West, Wareng, Trans Nzoia East, Trans Nzoia West, Kwanza, Nandi North, Nandi Central, Nandi East, Tinderet, Keiyo South and Keiyo North. High IOM / OCHA NakuruNakuru: Nakuru Central, Nakuru North, Rongai, Subukia, Naivasha, Gilgil, Molo, Njoro, Kuresoi, Trans Mara East, Trans Mara West, Baringo, Marigat North, Kericho and Kipkelion High OCHA, NRC, Protection Working Group

7. The 8 Hubs for Humanitarian Coordination as identified by Humanitarian Pillar LocationCoveragePriority Focal point organization GarissaMandera, Wajir, Garissa, IjaraHigh UNICEF / Islamic Relief, Save the Children Mombasa Mombasa informal settlements / Kilifi, Kwale, Lamu, Taita Taveta High WFP / WVI Isiolo / Marsabit Isiolo, Marsabit, Moyale, Samburu High WFP / WVI LodwarAll districts in Turkana countyMedium OCHA KisumuWestern Kenya, NyanzaHigh UNICEF

8. Strategies for Preparedness Establish coordination, joint planning, emergency response, communication and information management structures at all levels. Ensure prompt availability of emergency information through joint rapid assessments and/or national and global networks e.g. GIS technology Facilitating early warning systems, diagnosis and prompt management of cases including referral system corresponding to international humanitarian standards during crises Facilitating availability of essential drugs, consumables, detergents etc Mobilizing resources; financial, human, logistical, technical etc to fill critical gaps

9. Establishing Coordination Structures National Level: National Health Sector Crisis Management Team – Membership Ministers for Health – Chair Assistant Ministers – Deputy chair Permanent secretaries – Secretary DMS/DPHS – Vice secretary Departmental heads – Members Partner organizations – WHO, UNICEF, CDC, KRC, ICRC etc Province, County, District – Disaster Management Committees

10. Functions of the Committees 1.Joint planning, implementation and monitoring of the response at all levels 2.Pre-positioning of medical supplies and blood 3.Planning for pre-hospital and hospital management of trauma cases 4.Identifying staff for deployment /re-deployment 5.Mapping of “ Who does what, where and when”, 6.Facilitating emergency health information management and dissemination etc. 7.Conducting joint initial rapid assessments 8.Reporting to other levels 9.Preparing daily SITREPs and press releases 10.Resource pooling 11.Update and share contact list eg KEMSA, HUBs, Police

11. Pre-Positioning of Medical Supplies 1 The national committee has made plans to pre- position trauma kits as follows: – Kisumu KEMSA - Available – KNH trauma store - Available – Eldoret KEMSA – Nakuru KEMSA available If needed – Mombasa KEMSA – Garissa KEMSA All provincial directors will be informed once these are delivered

12. Pre-Positioning of Medical Supplies 2 The national committee has made plans to pre- position inter-agency (medical kits) as follows: – Kisumu KEMSA – Eldoret KEMSA – Nairobi KEMSA – Nakuru KEMSA – Garissa KEMSA All provincial directors will be informed once these are delivered KEMSA is also distributing normal supplies to all facilities in hot spot areas

13. Pre-Positioning of Blood and Lab Supplies All 6 regional and 9 satellite blood transfusion sites have adequate blood More to be mobilized if need be Screening kits and blood bags also adequate Kenya Red Cross and Kenya Airways will be contacted to assist in re-distribution in case of crisis Also planning to pre-position some lab supplies at provincial hospitals esp for enteric pathogens e.g. cholera, salmonella, shigella

14. Pre-hospital Management of Trauma Cases This involves search and rescue, triage, initial treatment and transport to hospitals Lead agency is Kenya Red Cross assisted by – GOK – ICRC – St John Ambulance – Kenya police – AMREF, Volunteers, etc All levels must identify available stakeholders for pre-hospital care

15. Hospital Management of Cases Every level must identify hospitals that cases will be referred to for definitive management These can be national, provincial, district, private hospitals or FBOs Ensure they have adequate trauma kits, medical supplies, disinfectants, detergents, technical staff etc Need to liaise with KEMSA stores for replenishment if they run out of stock

16. Deployment and Prepositioning of Short term Critical Staff The provinces need to compile a list of health workers that can be deployed at short notice to facilities Priority should be nurses, medical officers, surgeons and anesthetists who can work in those regions Can be those retired, in private practice or jobless Talk with local partners for support if needed eg APHIA+, Global One 2015, Merlin National level to intervene only if local partners are unable to support MOMs to provide list of unemployed health workers

17. Moving Emergency Supplies and Critical Staff to areas of Need Each province will be given some funds for – Moving emergency supplies from KEMSA to areas of need – Transporting critical staff (doctors, nurses etc) to areas of need – Conducting initial rapid assessments These funds must be used well and accounted to UNICEF Provinces and districts can also mobilize more funds locally

18. Care of HIV and TB patients Before the elections – All TB patients on treatment to receive 1 month supply of intensive phase and 1 month of continuation phase – All HIV+ patients on ARVs to receive 3 months supply

19. Nairobi Plan

20. Nairobi Preparedness Plan Nairobi province coordination team has zoned the hot spots into 4 districts: Langata, Embakasi, Kasarani and Starehe A total of 31 facilities + KNH have been identified in these districts Each will be supplied with trauma kits, medical kits, post-rape kits and fire extinguishers Health workers are also being trained on disaster management

21. Zoning of the 31 Health Facilities DistrictPublicPrivate Langata Langata H/C Kibera Amref Karen H/C ACK Kibera Kibera D.O. Senye Medical Clinic Tabitha Clinic Wema Medical Clinic Ushirika Johanna Justin Jinchi Uhuru Camp Jina Clinic

22. Zoning of the 31 Health Facilities DistrictPublicPrivate Embakasi Mama Lucy Hosp Mukuru MM Kayole II Soweto Kayole HC Dandora I & II H/C Reuben Centre Lunga lunga H/C St. Burkhita Disp St Raphael Disp St Patrick H/C Imara H/C

23. Zoning of the 31 Health Facilities DistrictPublicPrivate Kasarani Kariobangi H/C Mathare North Starehe KNH Mbagathi DH Huruma Lions Disp

24. If Mass Displacement Occurs Contact the hub focal person who is in-charge of humanitarian assistance in your province Organize to take care of the vulnerable – offer primary health services – Immunize children <5 against Measles and Polio – Offer special health services for people with chronic diseases e.g. HIV, tuberculosis and others – Reproductive health services – Nutrition services – Gender based violence and rape management for victims – Special care for the elderly – Public health education and campaigns – WASH services – Set early warning systems against communicable diseases

25. National Contact List Will have contacts for – DMS and DPHS – All PDPHS and PDMS – All KEMSA depots – All HUB focal points – All KRCS regional focal points – All regional fire emergency numbers

26. ELECTIONEERING CONTINGENCY PLAN ROLES AND RESPONSIBILITIES CAPACITY PRIMARY RESPONIBILITY SUPPORTING ENTITIES Coordinating/securityPAISMOSD/UNOCHA Shelter & NFIsMOSSP KRCS, UNHCR, IOM Relief food distributionMOSSPKRCS, WFP Early Recovery NetworkMOSSPUNDP Information/mediaPAISMOI LogisticsPAIS,MOSSP KRCS,WFP,ICR C Finance UN OCHA HealthMOMS,MOPHSWHO,UNICEF Trauma ManagementMOMSICRC,WHO,

27. Functions of the Committees 1.Joint planning, implementation and monitoring of the response at all levels 2.Pre-positioning of medical supplies and blood 3.Planning for pre-hospital and hospital management of trauma cases 4.Identifying staff for deployment /re-deployment 5.Mapping of “ Who does what, where and when”, 6.Facilitating emergency health information management and dissemination etc. 7.Conducting joint initial rapid assessments 8.Reporting to other levels 9.Preparing daily SITREPs and press releases 10.Resource pooling 11.Update and share contact list eg KEMSA, HUBs, Police

28. Thank You