Oxfam, with partner organization, SIM-CARDD, Inc., headed to the Municipality of Alamada in Cotabato last May to respond to the cholera outbreak that has struck the community. This quick response was called A-CHORES: Alamada Cholera Response.

ALAMADA CHOLERA OUTBREAK RESPONSE

Alamada is among the 17 municipalities of Cotabato Province. It is a first class municipality geographically bounded by Lanao del Sur Province (north) and Maguindanao Province (west).

It is a tri-people municipality inhabited in harmony by Christians, Muslims and the Indigenous Communities. It is physically characterized by rolling hills and mountains, valleys and rivers, waterfalls and plateaus.

It has 17 barangays with a population of 57,323.

Agriculture is the main source of income, cultivating corn, rice, banana, mango, coconut, oil palm, rubber, vegetables and fruits. Livestock and poultry production is also common.

The place has recently become a popular tourist spot because of its beautiful waterfalls, plenty of springs and caves.

www.northcotabato.net

It was on May 12, 2014 that reports on many cases of diarrhea came out publicly. Day by day, cases increased until it reached to a peak of more than a thousand individuals were hospitalized and 10 of them died. A week after, cases of cholera were reported.

There were more than 400 cases of cholera based on the report of the Department of Health. The local health authorities and the local government unit (LGU) were surprised with the upsurge of cases in a span of few days, which affected 12 barangays of Alamada. Brgy. Dado, the centerfold

of the crisis had the biggest number of cases.

Oxfam sent two staff to Alamada for the rapid assessment of the situation and to attend the coordination meetings called for by the municipal government of Alamada and the Integrated Provincial Health Office (IPHO).

Based on the feedback from the ground, the number of families affected and the increasing number of cases, the Country Management Team decided to have a small yet quick intervention on May 22 to support the LGU.

5,000 families as direct

beneficiaries of A

CHORES

9people

died

370 admitted to hospital

and at least 1000

outpatient

18 days it took Oxfam and

SIM-CARDD to do implement a quick response

13 staff members of the Alamada

Cholera Outbreak Response

(A CHORES)

The A-CHORES Hub

Three staff members were immediately deployed on May 23. They were composed of a technical person, a team leader and a coordinator. They stayed in the neighboring municipality, a 30-minute drive to Alamada. Two staff members from partner organization SIM-CARRD were mobilized along with five full time Oxfam volunteers. A warehouse was located in Poblacion Alamada.

An overnight planning and a day full of learning sessions and meetings were conducted to reach the targets and contribute significantly to the reduction and control of diarrheal cases and mortality.

Other members of the team arrived afterwards doing logistics, distribution and water quality monitoring.

Prior to the distribution of the essential non-food items and the cholera awareness campaign, there was a series of fast-paced consultation among the stakeholders at different levels.

Recruited staff and volunteers were briefed on the nature of the response, and on Oxfam’s ways of working and engaging with authorities, other actors, and the beneficiaries.

The contents of the distributed items and the strategies and approaches for the cholera awareness were also discussed with the WASH Cluster members, the IPHO, MHO, RHU, LGUs and with the beneficiaries.

Warehousing, repacking & transporting non-food items (NFIs).The team found a warehouse closest to the intervention areas considering safety of goods and staff. Warehousing was a challenge considering the bulk of items to be stored. Some of the items had to be sorted out or repacked accordingly. There were volunteers working in the warehouse and those that helped in the transportation, unloading and distribution.

Help & feedback desk. During the distribution, a help and feedback desk was put up to assist those who need assistance, to raise issues, concerns and complaints, or simply give their messages. Beneficiaries had the option to contact Oxfam through a hotline especially for those who have mobile phone connectivity. Community groups organized by Oxfam also facilitated concerns and complaints.

There was an express lane for people with disability, pregnant and lactating women and elderly. Community volunteers were already mobilized to help the beneficiaries from listing to queuing and moving out of the crowd.

Water kits and hygiene kits. Prior to the actual distribution, the beneficiaries were briefed on the proper use and maintenance of the items.

With additional support from UNICEF, there were 5,249 families served. Each family received water kits containing two jerry cans and four bottles of water disinfectant Hyposol plus a hygiene kit containing a bucket with lid, ten bars of handwashing soap, ten long bars of laundry soap, a nail cutter, and a water dipper.

Prepping the team for action

A collaborative effort: More than just kit distribution

Gearing up for a quick response

Moving every mountain. The team utilized every possible venue and strategy to inform people and make them understand the nature of cholera and its management and prevention.

The team literally climbed mountains and crossed rivers to reach as many vulnerable communities as possible. It was a race against time due to the virulent nature of the disease. They brought along with them their loudspeakers, flyers, pictures, and tarpaulin for information awareness.

At the barangay level, a community volunteer group called Brigada Kontra Kolera (Brigade Against Cholera) or BKK was formed in areas where Oxfam and its partner SIM-CARRD

Connecting with communities to raise awarenessworked such as Dado, Lower Dado, Pigcawaran and Macabasa. There are 192 members of this group in 57 Sitios & Puroks. They are composed of ordinary women (100) and men (92) oriented on cholera management, control and prevention. They are linked to the barangay council, Rural Health Unit and Municipal Health Office at the municipal level.

Most of the BKK groups already made their work plans, which aimed at preventing the occurrence of diarrheal diseases including cholera.

In less than two weeks, there were more than 8,000 individuals reached for the campaigns in 27 venues in five barangays.

Working with children. The team engaged children to promote sanitation and hygiene practices to the community. In collaboration with the Rural Health Unit, two campaigns were launched in two elementary and high schools in Dado. The children were delighted with the Proper Hand Washing Dance number performed by the team.

Water quality testing was done to check which area needs sanitation. The results were shared with different stakeholders, which helped analyze how different factors contributed to the water contamination and to the spread of diarrheal diseases.

The results showed that from the water point up to the point of use at the household level, there is a consistency that water is contaminated by E.coli bacteria. There is a need to improve water sources sanitation and hygiene practices of the local communities.

Aside from organizing the Brigada Kontra Kolera (BKK) in 57 Sitios & Puroks as support system for the LGU and the RHU at the community level, Oxfam also supported the LGU through the Municipal Disaster Risk Reduction and Management Council (MDRRC) and the IPHO by the provision of more than a thousand Lifesaver water filters. This will enable the local authorities to deliver safe drinking water to thousands of families at a great speed. The IPHO has identified five municipalities prone to water and sanitation related diseases including diarrhea and cholera. As of this

Keeping an eye on the water quality

writing, two municipalities adjacent to Alamada (Pigcawayan and Banisilan) are being monitored when cases of diarrhea were reported at the local health units.

Each of the 64 Sitios and Puroks in four operational areas of SIM-CARRD and Oxfam will receive the water filter including all the health stations in the 17 barangays. An assembly of the BKK groups to be participated by the LGUs and RHU/MHO staff will be organized to do follow up activities in the control and prevention of cholera.

Drivers: Gilbert Bruno Kasim Alba Reynald SuyoCommunity Mobilisers: Jayson Kris Fortunado Kris Valerie Esleta Pacasirang Lumbatan Louies Tabayoyong

Khanmen Lataza Senior Community Mobilisers: Marie Vic Guingguing Keeza Marie Salva Distribution Officer: Charnie Ebol Water Analyst: Abie Ayao Logistician: John Mark Dionson Jonathan de

Jesus Warehouse Assistant: Marjorie Doromal Coordinator & Logistics Support: Noel Pedrola Management Support: Dante Dalabajan Ana Maria Caspe Finance & Logistics Support: Judith Manigo

Remote Admin Support: Mila Bulawan Project Manager: Vincent Malasador Technical Person for Distribution & Mobilisation: Abdullah Ampilan WASH Adviser: Enamul Hoque Layout by: Mervin Concepcion Vergara

Written by: Duoi Ampilan

The Alamada Cholera Outbreak Response Team

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