US embassy cable - 04DJIBOUTI649

UNCLAS SECTION 01 OF 02 DJIBOUTI 000649 
 
SIPDIS 
 
STATE PASS TO USAID 
 
E.O. 12958: N/A 
TAGS: EAID, PREL, DJ, EINV 
SUBJECT: USG QUICK RESPONSE IN FLOOD AFFECTED  AREAS OF 
DJIBOUTI 
 
1. (U) On the early morning of 13 April, following 
high tides, strong winds and torrential rains in 
almost all districts of Djibouti, the river El Oued 
suddenly burst its banks and flooded several areas 
in Djibouti City affecting over 80 percent of its 
inhabitants.  Water rose over seven feet in many 
neighborhoods, washing away people and belongings. 
Fifty-nine bodies were eventually found and sent to 
the city mortuary, however, it is estimated that 
around 300 people died in this disaster.  Others are 
still missing and unaccounted for. 
 
2. (U) Many houses in the affected areas were destroyed 
causing displacement of several thousands of people who 
sought refuge with relatives in other parts of the city. 
Djiboutian officials have indicated that approximately 
1,500 remain without shelter, although there is evidence 
that many more have not been registered.  These persons 
were relocated to either the military camp of Sheik 
Osman or Balbala 2 primary school in poor sanitary 
conditions and scarce means to make a living.  More 
than one third of the displaced are children. 
 
3. (U) The water and electricity infrastructure was also 
heavily damaged.  With the resulting drinking water 
shortage, broken sewage pipes and environmental damage 
from the flood, the threats of epidemic prone diseases 
such as cholera were pressing health emergency.  It is 
estimated that around 300,000 people were vulnerable to 
these outbreaks. 
 
4. (U) The flood situation also disrupted provision of 
basic health services because of the total or partial 
destruction of four main health care facilities in the 
area.  Medical equipment, drugs, cold chain and 
nutrition supplement stocks were lost.  These centers 
cover around 90,000 of the population.  In addition, 
two health care centers in the outskirts of the 
affected areas faced increased demands of the displaced 
population housed in neighboring schools.  There are 
plans to relocate the displaced to PK12, a neighborhood 
at the outskirts of Djibouti City.  Relocation 
conditions in terms of shelter, water, food and 
latrines are not yet well defined.  On the national 
level, French and American armies were mobilized to 
help save those stranded in trees and roof tops, 
collect dead bodies and animals from the city streets, 
pump standing water away from neighborhoods into the 
sea, repair washed away bridges and railway lines and 
provide potable water to those in need. 
 
5. (U) In the 1994 flood in Djibouti, a cholera outbreak 
of 8,000 cases and 32 deaths were registered.  Another 
cholera outbreak was recorded in 1997 with 3,000 cases. 
The current post-flood situation in Djibouti poses a 
genuine emergency.  The Minister of Health, Dr. Ali 
Kamil, and his health emergency cell, have developed a 
master plan for cholera outbreak.  Four health centers 
in the affected areas have been rehabilitated and water 
restored.  Health services are being provided to the 
needy.  The Ministry of Health (MOH) has also installed 
an emergency surveillance system for epidemic prone 
diseases, such as malaria and cholera, and strengthened 
preparedness for facing an eventual outbreak of cholera 
in the affected area.  The cholera prevention program 
includes regionally pre-positioning Emergency Health Kits. 
 
6. (U) USAID Representative Janet Schulman worked very 
closely with the Minister of Health, his health 
emergency unit, World Health Organization (WHO) 
Representative Jihane Tawilah and Office of Foreign 
Disaster Assistance (OFDA) advisor Mia Beers to order 
critically needed emergency drugs and equipment.  On 
April 28, WHO Geneva sent by charter plane 
approximately 48 tons of emergency diarrhea medication 
which were ordered for Djibouti's MOH.  With the arrival 
of these drugs and equipment, critical stocks lost in 
the centers will be restored to enable the MOH to 
respond to any cholera and typhoid outbreaks.  Some 
USAID funding is being used to support public 
information campaign needs on ways to make water safe 
at the household level using boiling and chlorination 
as well as safe food preparation.  Nonetheless, access 
to safe water remains a basic requirement to prevent 
cholera epidemics; more efforts need to be directed 
towards providing safe drinking water as well as water 
for food preparation and bathing. 
 
7. (U) USAID/OFDA provided resources for WHO to bring 
into Djibouti within two weeks of the disaster: 
- 10 New Emergency Health Kits (NEHK) to cover drugs 
and medical supplies for 10,000 people for 
approximately three months. 
- 40 kits each of WHO Kit D, containing drugs to treat 
100 people affected by diarroheal diseases, including 
cholera, and Kit F, containing medical supplies to 
supplement Kit D. 
-Laboratory Supply for water surveillance and cholera 
testing, plus additional needed medication and supplies. 
- Large water dispensers for administration of bulk Oral 
Rehydration Solution. 
- Public Health Supplies and equipment for cleaning and 
disinfection (cresol, muriatic acid, chlorine and 
others to be locally purchased). 
- Chlorination supplies for water at household level. 
- Support logistics for daily water and health 
facilities surveillance for diarrheal diseases in the 
next three months. 
- Support for the development of public health 
education material. 
 
8. (U) Total USAID support for this disaster is $300,000. 
The Minister of Health and his emergency health unit, 
Schulman, and Tawilah were at the airport on April 28 to 
receive the WHO shipment.  The Djiboutian Presidential 
Republican Guards were on hand to unload the medication 
and supplies and to truck them to the central pharmacy 
under the watchful eyes of two logisticians sent in with 
the drugs by WHO Geneva. 
RAGSDALE