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Fecha: 
Fri, 02/05/2016

MSF-OCBA, 5 FEBRUARY 2016 / WEEK 5

ETHIOPIA
Operations
Measles has been reported in different locations of the country, including project sites.
Degabur is reporting an increase of measles patients (currently there are 38, and yesterday 8 admissions). Vaccination of the main pockets of cases in Degabur are being negotiated, and vaccines are being cleared in customs. The Ministry of Health is providing the vaccines necessary to cover the main areas affected. Cases have been reported in Degamadow, and negotiations are taking place to vaccinate and treat patients in the area.
In Fiq, measles cases are being managed at the hospital by the MSF team but there it is impossible to access the rural areas. In Afar, cases are being reported and treated. In the coming days, MSF and the MOH will begin vaccinating 18,000 children under 15 against the disease.
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GUINEA BISSAU
Operations
The medical team in the Bissau Paediatric Emergency Care project have finalised a first medical assessment of the national hospital Simao Mendes, where MSF will set up operations. The team will be prioritising needs and organising an action plan in the coming days.
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MALI
Context
In Timbuktu, there have been car bomb and mortar attacks on MINUSMA sites. The attacks also targeted the hotel where UN soldiers and police were staying. OCP is present and treating wounded people in the hospital there. In Kidal, a large contigent of GAITA pro-government fighters arrived to negotiate with CMA (Tuareg independence movement).
There has been a lot of tension in Kidal these past two days as GATIA arrived with many armed men and vehicles as a show of force. So far there have been no confrontations or conflict. The two sides are negotiating different elements of an agreement to allow for peaceful co-existence in the North of Mali.
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MEXICO
Context
Two hundred two homicides have been reported in Guerrero, just for January. The government will deploy more than 3,500 troops and 250 police officers in Tierra Caliente to stop escalating violence in the region. The Minister of Health recognises that more than 16 health centres have been closed due to violence in Tierra Caliente, and estimates that more than 45 medical doctors and 60 nurse positions are vacant due to threats from organised crime.

Operations
On the Chagas project, the team is re-starting diagnostic activities and will be sampling 100% of pregnant women. Thanks to adjustments in the cold chain procedure, blood samples can now be delivered to the decentralised lab at Puerto Angel within 24 hours.
For the migrants project, assessment of different locations, refuges and hostels in Guanajuato State continues, with a view to establishing relevant psychosocial activities.
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NIGER
Context
Only two weeks remain until elections, and tensions are running high. Yesterday a large rally assembled by one of the biggest opposition candidates was dispersed with tear gas by police in Niamey. Meanwhile there is a growing risk of a large meningitis outbreak in the coming weeks. Niamey will be a challenging environment in which to lobby for health related priorities.

Operations
An outbreak of meningitis is being assessed in Konni district, Tahoua region.
There have been 18 reported cases with five deaths. Two of the cases have been confirmed as Meningitis C. A small number of suspected cases in Bouza are also being investigated. In Diffa, the project is beginning activities for a preventive cholera vaccination campaign. The first round of vaccinations should take place next week (10 to 14 February).
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NIGERIA
Context
A bloody attack by Boko Haram on 30 January killed more than 100 and injured 250 in a village in Borno state. The village is very close to one of the IDP camps 15km south of Maiduguri. Tenuous security did not allow NGOs to assist, but the ICRC was able to move dead bodies to Maiduguri main hospital. The military have launched a new wave of operations, and are asking civilians to leave one village in Borno.

Operations
Small numbers of Lassa Fever cases continue to pop up: two have been confirmed in Osun State in the southwest. The teams are continuing to monitor the situation and are advancing on the proposed Lassa project in Taraba state.
Activities in the ER started last Monday, and the teams received patients wounded by an explosive device south of Kukarita. Numbers of consultations are stable. The teams have started to receive patients from Borno state, closer to Kukerita.
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SOUTH SUDAN
Operations
The situation remains tense and volatile in some parts of Western Equatoria (namely Ezo, Source Yubu and Mundri). The MSF assessment team is in Ezo monitoring population movements and assessing the conditions of the primary health care centres in the area.
For Mundri, the IGAD is reporting "starvation" after their field visit to the area. It is not clear what the rumours are based on. Our team is monitoring the situation and preparing a nutritional assessment in the area for next week.
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SUDAN
Context
Since the month of January a military campaign is being carried out in the Jebel Marra area. Initial UN data of IDPs suggests that around 34,000 people are affected by the bombing. In Tawila level, around 11,000 IDPs have arrived in two of the camps since 23 January. In Sortony, around 16,000 IDPs have been registered so far.

Operations
In response to this situation in Tawila, the teams have distributed more than 1,200 non-food item kits, installed two water bladders, constructed 130 latrines, carried out a screening for malnutrition and reinforced community-level health promotion activities.
The mission is also negotiating with the authorities to do a massive measles vaccination for children under 15, polio for under fives and a vitamin A distribution.
For Sortoni, an assessment team has gone to the area. The team is monitoring other areas where IPDs may have settled.
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SOUTH SYRIA
Context
Fighting continues in Sheik Miskin and Attaman. There have been Russian bombings in Attaman and Nueymeh, two areas where OCBA supports clinics. Attaman clinic is functioning, seeing patients in the basement. IDPs are moving eastward from the area.
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SYRIA
Context
Organised armed groups have retaken control of IS villages in Azaz District with the support of shelling from the Turkish border. With a rapid ground offensive launched on 2 February, the government of Syria managed to connect Bashkoy with the enclave of Nubl and Zahra on the night of 3 February. Russia backed the ground offensive with high intensity airstrikes in the surrounding areas controlled by opposition groups. Large numbers of people have fled toward Azaz town and the Al Salamah border point and village, and up to 40,000 people are expected to gather at the border. The camps there are at maximum capacity and the response from humanitarian actors is not sufficient.
The main medical and relief networks inside East Aleppo City are working to replenish warehouses with medical supplies, fuel, food and other items in case the city comes under attack.
The Maskan Emergency Health Centre (a former MSF facility) has been targeted by a Russian air strike. No casualties were reported but the facility is now out of service. The area has been declared a military zone and the main hospitals along the frontline are now closed for security reasons or out of service after being targeted in airstrikes. Medical staff have started leaving and facilities are having to close or limit activities because of a lack of human resources.

Operations
The MSF team from Der Jmal and Tal Rifat moved on 4 February, joining the people heading to Turkish border. Forty-eight MSF staff families have been registered in Al Salamah for support and 17 have been settled in tents in Al Harameen camp. The services of Al Salamah hospital have been disrupted and the two projects are facing human resources gaps.
In terms of hospital capacity at Al Salamah, as a temporary solution the number of beds has been increased to 36. Further possibilities to extend capacity are being considered.
The teams are providing ad hoc support to Tal Rifat hospital in order to increase their capacity to refer complicated cases. They have completed a donation of medical supplies for supported health facilities in East Aleppo City and the north countryside sufficient for three months. They will also distribute 3,000 kits of essential goods for new IDPs.
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VENEZUELA
Context
The government has run out of dollars because of the extremely low price of oil and inflation is around 720%. Violent crime is out of control and Caracas has been categorised as the most violent city of the world in terms of homicides, reaching 120 cases per 100,000 inhabitants. The National Assembly is working out a plan to end Maduro´s presidency.
Political confrontation will escalate in the coming weeks, triggering social confrontation and unrest. Depending on the levels of confrontation, the military might decide to intervene to force Maduro’s resignation, but the prospect of clashes between pro-government factions and opposition supporters can not be totally discounted. The Vice-President of the Assembly Health Comission has requested that WHO and MSF intervene in light of the current humanitarian crisis. This statement might hamper our efforts to approach the government, as the HOM just managed to take an appointment with the Deputy Minister of Health for today.
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YEMEN
Context
A UN report calling for an international enquiry into violations of IHL and HRL in Yemen was leaked in late January. Shortly afterward, the Saudi-led military coalition announced the creation of an independent commission that will investigate charges of abuse against civilians.
The Coalition made significant advances into Nhim district, Sanaa governorate, by taking one of the Pro-Houthi military camps and gaining control of parts of the highlands over Sanaa. There are signs of some troops deserting to the Coalition side. Meanwhile, AQAP has made gains in some southern areas. They are controlling more check points and villages from those governorates.
An MSF staff member was victim to a carjacking about 50 metres from the Sanaa office by unknown armed individuals. It is unlikely that it was a targeted attack against MSF. The incident is still under investigation.

Operations
On 3 February, the Coalition bombed an abandoned military base 1.5km from the Abs Hospital, Hajja Governorate. No casualties were reported. Haradh and Midi Districts in Hajja governorate have suffered an increase of war-related activity and casualties. Assessments are being carried out at two health centres near the border with Saudi Arabia.
There have been incursions of Al Houthi troops and significant shelling into Saudi Arabia´s (KSA) border provinces. According to KSA, around 350 civilians have been killed since the start of the conflict in their territory. Fighting continues for the mountain of Adud in Razeh and Shaada districts. MSF´s Al Gumhuri hospital in Saada remains extremely busy, with all 94 beds consistently occupied. A distribution providing NFIs to 340 families in Kitaf has been carried out, and medical kits have been donated to the two health centres.
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PUNTO INFO is a summary of weekly internal operational briefings of the MSF Barcelona/Athens Operational Centre (OCBA). The information contained herein is strictly internal and should not be shared outside MSF. For any questions regarding the use of the content, please contact ocbapuntoinfo@barcelona.msf.org.

Punto Info

Weekly Operational Update Bulletin (for internal use only) presenting a summary of all the operational information shared by the MSF OCBA Operational Cells during their weekly meeting at MSF OCBA Headquarters, in Barcelona. This meeting is open to all MSF Staff members.

Listed below you can find the previously released "Punto Info’s" / Weekly Operational Update Bulletins by publishing date.