EMERGENCY AND HUMANITARIAN ACTION (EHA)

WEEKLY UPDATE – WHO COUNTRY OFFICE : (Week 23, 01 – 05 June 2009) HIGH LIGHTS :

• In collaboration with the Ethiopian Federal Ministry of Health, WHO and UNICEF supported a day long training/orientation for joint national health and nutrition assessment teams. • According to WFP, early warning data suggests relief food beneficiaries may increase from the current 4.9 million during the hunger season: July until September 2009. • According to official reports from the Federal Ministry of Health (FMOH), 151 new cases of AWD have been reported from 10 districts in 4 Regions this week.

I. GENERAL SITUATION : a) Political, social, security overview for the week • The overall security situation in the country remained stable during this week. No major security incidents involving humanitarian staff members have been reported. b) Main events of interest/ concern for health (displacements, conflicts, disease outbreaks, etc.)

Food security and malnutrition

• In SNNPR, Unreliable rainfall condition was reported in lowland areas of Locka Abaya woreda in Sidama zone and Humbo woreda of Wolayta zone. Generally, rainfall received during the week is highly beneficial for belg crops planted. Green maize harvest has started in some areas of Demba Gofa and Damaot Pulasa woredas. However, the nutrition situation is poor and has been deteriorating in Mareko, Meskan and Shashego woredas as well as in , Dara and woredas.

• Coping strategies to mitigate the impact of food problem include consumption of wild foods and immature enset, seeking support from social networks, increased sells of livestock, out migration in search of labour opportunities, increased practices of charcoal burning and grass and fire collection, begging and selling of household properties. Currently no serious pasture and water problems are reported and the physical condition of livestock is normal in most places. Exceptions are livestock condition in lowland areas of Sidama and Wolayta zone which are reported below normal due to pasture shortages. Prices of staple food crops and livestock are stable compared to the previous week.

• In Region, West and East Harrge zones, only some lowland areas received light rain during the week. Generally the performance of the Belg rain was better in the Eastern part of the Zone in terms of performance and coverage. The south western areas of the have received relatively better rain than other areas of the Zone. As a result of the poor Belg rain performance, especially in lowland areas plants start wilting. • Regarding Meher crop plantation, there was low achievement due to insufficiency of the Belg rain. The food security prospect is not promising in all woredas of East and West Hararghie zones. The malnutrition cases are increasing rapidly. In most woredas of East and west Hararghe zones fire wood and Charcoal sale is increasing and woredas like Doba, , Tullo and Bokee have a high supply of daily labourers and the wage rate decreased by 40%. As per the recently conducted rapid multi agency assessment report, 37,000 beneficiaries from Doba, Meiso, and B/Dhintu woredas need immediate relief food assistance.

• In , the past week had been mostly dry in the region. The belg crops in Dawunt, and Gubalafto woredas have begun to wilt and die. The moisture stress in , and Tarmaber woredas of North Shoa have also caused crops to be stunted in their growth. Meher land preparations and the plantation of

long cycle crops have been adversely affected. For example, of the total 105,326 hectares of land planned for such crops, only 14,255 hectares have been planted thus far. Though the pasture and body conditions of livestock have remained to be stable in most parts of the region, shortages in pasture and declines in body conditions have been reported from , Dawunt, , Mekiet and woredas of North Wollo. This and increasing livestock supply trends have caused livestock prices to decline. Crop prices however, have remained stable.

• WFP reports that its relief pipeline is close to breaking, noting that the situation is critical. Only one round of relief distribution is available for the second quarter given the low level of available resources. The limited food balance available after ongoing dispatches will have to be further prioritized. The Disaster Risk Management and Food Security Sector (DRMFSS) available in-country stock stands at 27,947 MT, including 5,034 MT for relief and 22,914 MT Productive Safety Net Programme (PSNP). WFP inputs to the national relief programme are short by 177,983 MT (US$155.7million); while inputs to PSNP are short by 53,329 MT (US$46.1 million); Targeted Supplementary Feeding shortfalls are 30,565 MT (US$ 26.5 million). The Ethiopian Food Security Reserve Administration (EFSRA) stock stands at 168,254 MT.

Multi agency health and nutrition needs assessment WHO and UNICEF are supporting a multi agency health and nutrition needs assessment in 33 zones in 6 regions (Tigray, Amhara, Oromia, Somali, Afar and SNNPR.). Phase one will be conducted in 5 regions – Tigray, Amhara, Oromia SNNPR and Afar from 8 th to 28th June 2009. The second phase will cover Oromia and Somali from 27 th June to 10 th July 2009. Twelve teams will support this exercise and WHO has provided 4 consultants and will support 1 additional staff from EHNRI as national coordinator.

Briefing field staff on assessment procedures and methodology at EHNRI, Addis Ababa

Acute watery Diarrhoea reported cases by region week 22 • According to official reports from the Federal Ministry of Health (FMOH), 151 new cases of AWD and 3 deaths (CFR 0.02%) have been reported from Oromiya, SNNP, Afar and Harari Regions this week. Of these reported cases, Oromia reported 56 cases and 2 deaths CFR 0.03%, SNNPR 16 case and zero death, Harari Region 12 cases and zero death and Afar 67 case and 1 death CRF 0.01% • A total of 10 districts have reported active cases from Oromiya, SNNP, and Harari Regions and report from Afar Region did not disaggregated the case load by district. • Cumulative cases reported from 13 th April 2009 to epidemic week 22 are 893 cases and 23 deaths (CFR 2. %).

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Influenza A H1N1 • To date no confirm or suspected cases of Influenza A H1N1 have been reported by the Federal Ministry of Health and FMOH continue Zero reporting daily to WHO. WHO in collaboration with the FMOH provided training/orientation for Ethiopian Airlines crew members on the procedure for handling cases of influenza A H1N1 entering the country via air transport and on the notification procedures to the Bole quarantine health officers

. Orientation of Ethiopian Airline crew members Addis Ababa

II. ANALYSIS & HEALTH CONSEQUENCES: Health problems & Needs of affected populations.

Food insecurity and malnutrition • FEWSNET/WFP’s latest food security update reports that the performance of the belg/gu seasonal rains have been below normal so far and, if the rains continue to be poor, a second consecutive below ‐average harvest is expected in the chronically food insecure belg-cropping areas. This will further deteriorate the food security situation of both pastoral and agro ‐pastoral populations. Reports of malnutrition continue to increase in SNNPR (Wolayita, Hadiya, Sidama, Kembata Tembaro, Gurage, Gamo Gofa and Dawro zones) and Oromiya (West Arsi, Bale, East and West Hararghe zones). The reduced relief food ration down from 15 kg to 10 kg and poor belg

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rains, which had limited the availability of root crops, sweet potato and enset normally consumed during the lean season, are among the factors contributing to the situation.

Acute Watery Diarrhoea (AWD) • The technical committee of the Emergency Health and Nutrition Task Force continues to meet with secretariat support from WHO. Reports from Oromia, SNNPR, Afar and Harari indicated that AWD infection is spreading to new districts with weekly CFR below 1 % and indication that case management is improving. • The identified gaps are inadequate CTCs materials and drugs in some districts, poor water supply, inadequate human resources, poor hygiene and sanitation. The needs of affected people are provision of portable water supply, community awareness creation and support for coordination. Government and partners are responding and mobilising more resource to support response. Malaria In Tigray malaria is under controlled with support from partners and effort by the region, but inadequate drug supply is still an issue. In S NNPR e ven though case load decreased in Dabe Gofa woreda in Gofa Zone completeness and timeliness of reporting is still a major challenge. In Oromia Region, Nejo town in West Wolega Zone reported 257 cases reported and zero deaths. III. ACTIONS (in relation or response to the issues mentioned above): a) WHO activities (field trips, assessments, gap filling, coordination, information sharing, training, etc.) & needs (Human resources, material, and infrastructure) and other partners support. Food insecurity and malnutrition • This week WHO has continued its technical support to regions in responding to food and nutrition crisis in Ethiopia. The nutritional survey in has been completed in the seven sample woreda of Filtu, Aysha, Degehabur, Hamero, Bare, Kelafu and Bokh. Preliminary findings reviewed by the Emergency Nutrition Coordination Unit and submitted to the government for endorsement. Acute watery Diarrhoea (AWD) • WHO continues to provide technical support to the affected regions of Oromia, SNNPR, Afar and Harari through provisions of emergency drug kits to government and NGO partners, supporting assessment, assist in monitoring and supervision and strengthening surveillance activities.

WHO consultant on supervision and monitoring at a CTC in Konso, SNNPR

Influenza A H1N1 • WHO continue to provide technical support to the national Government to facilitate preparedness and response at national and regional levels. Current response activities of FMOH supported by WHO includes strengthening surveillance in all regions and in all entry point including Bole International airport. 4

Action by Partners Acute Watery Diarrhoea • UNICEF is supporting SNNPR in the preparation of AWD response plan. IRC, ESHE are supporting the regional taskforce coordination activities.

• Nutrition • UNICEF as the cluster lead continues to support and coordinate all partners’ response in SNNPR, Amhara, Oromia, Afar, Somali and Tigray Regions. • NGOs- MERLIN, IMC, MSF-B, MSF-G, Ethiopian Red Cross are working in partnership with the affected region in providing case management in stabilization centres, appropriate therapeutic response and support for coordination activities and resource mobilization.

V. COORDINATION: • This week, WHO actively participated in the technical officers/UNOCHA, WASH cluster/MoWR, Nutrition cluster and Ethiopian Humanitarian Country Team (EHCT)/UNDP meetings held in Addis Ababa. • WHO is supporting and facilitating the coordination for the preparedness and response of influenza A by the UN country team and AWD by the FMOH and the regional health bureaus. VI. COMMENTS: • WHO is working effectively in partnership with the FMOH, RHBs and partners in strengthening capacity of the federal and regions for better AWD response.

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