South Sudan Humanitarian Situation Report

SitRep #17– Reporting Period 8-14 April 2014 SITUATION IN NUMBERS

Highlights 817,700 People internally displaced since 15

December  Over 3.7 million people in the country, including almost 740,000 children (OCHA, 10 April, 2014) under five, are at high risk of food insecurity. Malnutrition rates are also on the rise, with partners estimating that the lives of as many as 50,000 children could be at risk unless nutrition programmes are urgently funded 437,263* and scaled up. Estimated internally displaced children under 18 years

 As part of the Rapid Response Mechanism (UNICEF, WFP, FAO) multi- sector response has been provided in an additional three locations, Outside bringing the total number of locations reached through rapid response teams to seven, out of the 24 planned. 270,000 Estimated refugees in neighbouring countries (OCHA, 3 April, 2014)  Through the Rapid Response team in , over 4,500 children 6-59 months and 317 infants under 6 months were screened for malnutrition. Over 5,000 IDPs were provided with access to safe drinking water. Priority Humanitarian Funding Tarpaulins were transported to support sanitation interventions. needs January - June 2014 Identification and registration of unaccompanied and separated children is ongoing. Heath, nutrition, WASH and education supplies were airlifted US$ 75.1 million** to meet the immediate needs of the population. * Disaggregated data is yet to be made available, as registration has not been completed across the country.  Following successful family tracing, UNICEF chartered a flight to transport Children under 18 years have been calculated based on the first group of 20 unaccompanied and separated children from census ** This is based on UNICEF’s contribution to the South Sudan Protection of Civilians (PoC) site for reunification with their parents and Crisis Response Plan (CRP). families in Juba Tongping PoC area.

UNICEF’s Response with partners UNICEF Sector/Cluster Target Indicators UNICEF Cumulative Cumulative results Target achieved Cluster Target Target* results (#) (#) achieved (%) (%) WASH: # of target population provided with access to water as per agreed 475,000 241,397 50.8% 500,000 338,333 68% standards (15 litres of water per person per day) Nutrition: # targeted children 6-59 months with Severe Acute Malnutrition 30,891 15,481 50.1% 30,891 15,481 50.1% admitted to therapeutic care Health: # of children 6mo-15y 858,600 240,365 28% 858,600 240,365 28% vaccinated for measles Education: # of school-aged children 78,400 Total 9,629 165,538 32,800 including adolescents (aged 7 – 18) with 12% (31,160 F; (3,929 F; (79,458 F; (14,821 F; access to education in emergencies, 20% 47,240 M) 5,700 M) 86,080 M) 17,979 M) including supplies Child Protection: # of children reached 1 100,000 22,930 23% 200,000 23,861 12% with critical child protection services *as the CRP is under review, targets will change to reflect the current situation

Situation Overview & Humanitarian Needs

The security situation in the country remains volatile and unpredictable. On 14-15 April, heavy fighting was reported in Bentiu (Unity State), increasing the number of people seeking shelter at the United Nations Mission in South Sudan (UNMISS) base in Bentiou. Clashes were also reported in Kaka, 40 km northwest of Melut ( State) on 7-8 April, causing some preemptive population displacement. In Dethoma camps in Melut, some displaced people were reportedly getting ready to leave in case fighting reached the town.

The number of displaced continues to increase with over one million people estimated to have fled their home. An estimated 817,700 people are internally displaced, including around 62,800 people living in eight UN bases across the country and a further 278,616 have fled to Ethiopia, Kenya, Sudan and Uganda.

The nutrition security outlook is increasingly alarming especially in the most conflict-affected states (Jonglei, Upper Nile and Unity), with little chance that this will improve in the short-term as violence, displacement and general insecurity hampered people’s ability to farm, fish and move with their livestock. The fighting has disrupted the main harvest as well as the forthcoming planting season and in states less affected by the conflict, some populations are still recovering from the negative impact of last year’s floods. Currently, over 3.7 million people, including almost 740,000 children under five, in the country are at high risk of food insecurity. Malnutrition rates are also on the rise, with partners estimating that the lives of as many as 50,000 children could be at risk unless nutrition programmes are funded and scaled up. Family food stocks normally run out during this time of the year, with households turning to markets for food supplies. Many markets have been destroyed by the fighting, or people no longer have access to them due to displacement.

Humanitarian leadership and coordination

UNICEF actively participates in the Humanitarian Country Team and the Inter Cluster Working Group, which lead strategic and cross-sectoral coordination of humanitarian programmes. UNICEF leads the WASH, Nutrition and Education clusters as well as the Child protection sub-cluster. Within the Health cluster, UNICEF provides leadership on vaccination, communication and social mobilization. UNICEF also supports the core supply pipelines for the Education, WASH and Nutrition clusters, providing essential humanitarian supplies to all partners. While continuing to focus on the delivery of life- saving interventions, UNICEF is also investing in providing access to education and a protective environment for affected children.

Humanitarian Strategy: Rapid Response Mechanism

UNICEF continues to expand activities in remote locations through the new rapid response mechanism in partnership with WFP and FAO. Multi-sector response teams (WASH, Health, Nutrition, Education, and Child Protection) have been deployed in Akobo, Melut, Nyal and Mayandit with follow up interventions in Akobo, Melut and Nyal. UNICEF has teams in. Haat, Kodok and , and two teams are planned for intervention in Lankien and Pochala. Through the Rapid Response mechanism UNICEF aims to reach more than 400,000 people, including a minimum of 200,000 children, with an integrated package of interventions by June in 24 priority locations1.

The Rapid Response Mechanism provides an opportunity to respond to the immediate needs while assessing the situation and developing strategies to scale up the response through mobilizing additional partnerships with local or International NGOs and follow up missions.

In Kodok, 28,000 people (11,000 households) were registered. 4,526 children 6-59 months were screened for malnutrition (MUAC), of which, 202 children were identified with severe acute malnutrition (SAM) and 611 with moderate acute malnutrition (MAM). Key messages on infant and young children feeding (IYCF) messages were also given to all lactating mothers. More than 5,000 IDPs were provided in Kodok with access to safe drinking water. Documentation and registration of unaccompanied and separated children is ongoing with options being identified and a Family Tracing network has been established. In terms of education response, 270 primary school children (120 girls and 150 boys) and 37 pre-school children (22 girls and 15 boys) were registered. A total of 10 teachers have been identified so far and will be trained on provision of life saving messages, life skills education and provision of psychosocial support.

1 Ganyel, Akobo, Nyal, Mayendit, Lankien, New Fangkak, Ayod, Mabio, Waat, Haat, Duk, Old Fangkak, Moto, Walgak, Yuai, Melut, Kodok, Pagak, Maiwut, Mathiang, Nasir, Ulang 2

Summary Analysis of Programme response

HEALTH: Through the rapid response mechanism, Figure-1: Proportionate Morbidity due to Priority Diseases, ARI 6,679 children 6 months to 15 years were Week 4 - 14, 2014 (Source: Health Cluster) vaccinated against measles and 7,177 children 18.0% Bloody Diarrhea under five were vaccinated against polio during the 16.0% Malaria integrated immunization campaign in Nyal. A total of 14.0% 5,096 children 6–59 months received vitamin A 12.0% Suspected supplementation and 4,549 children 12–59 months 10.0% Measles were dewormed. UNICEF has also supported 8.0% Watery implementing partners (county health department 6.0% Diarrhoea and NGOs) to conduct cold chain assessments and 4.0% 2.0%

micro-planning for vaccination campaigns in consultations all of Percent Kodok, Melut, Haat and Pagak. 0.0% 04 05 06 07 08 09 10 11 12 13 14

UNICEF continued supporting integrated Epidemiologic Week immunization campaigns and routine immunization Decline in under-five mortality rates is observed in all IDP camps. Since the services in PoCs, IDP locations and new locations. epidemiological week 9, under-five mortality is persistently below the emergency threshold (<2/10,000) in all camps except in Bentiu that represents a single case. Malaria and acute Integrated vaccination campaigns were conducted watery diarrhoea continue to account for highest proportionate morbidity. General in Akobo, Cuibet, Nyal and Ulang counties, and declining trend of measles morbidity and mortality continued since week 5 with routine immunization conducted in all PoCs and proportionate morbidity rate at zero and no reported death this week due to continued IDP locations in Minkaman, Nimule, Mahat and expanding and increasing coverage of measles vaccination. Twic, reaching a total of 51,822 children 6 months to 15 years with vaccination against measles and 9,455 children below 15 years against polio. In addition, 5,486 children 6–59 months received vitamin A supplementation and 4,601 children 12–59 months were dewormed.

UNICEF led the planning and implementation of the 1st round of Oral Cholera Vaccination (OCV) campaign in Malakal with MSF Spain and IOM which started on 7 April. Preliminary results indicate that 16,055 individuals (children above one year and adults) have been reached, representing 89.6% of the target population of 17,928. The second round is scheduled on April 23-25. Additional five diarrhoeal disease kits (benefitting 10,000 people per kit) are being procured for prepositioning in all PoCs as well as supporting the Cholera Treatment Centre (CTC) established by MSF.

On Maternal and New-born child health care: 357 women were reached with ANC (cumulative total 4064), 123 women received PMTCT services with counselling and testing for HIV (cumulative total 1,782), and 242 children under five received treatment for various diseases (diarrhoea, malaria and acute respiratory). An additional 1,296 households received at least two Long Lasting Insecticide Treated Nets (LLINs) in Juba, Bor, Nimule, Mahat and Torit.

NUTRITION: Through the Rapid Response teams in Kodok, a total of 4,526 children 6-59 months were screened for malnutrition (MUAC), of which, 202 children were identified with severe acute malnutrition and 611 with moderate acute malnutrition. Provisions have been made for the children with severe acute malnutrition to receive ready-to-use therapeutic food and routine medication while discussions are ongoing with the MSF Spain to establish therapeutic feeding programs, including outpatient therapeutic program (OTP) and stabilization centers (SC), in Kodok

From January to date, the total number of children screened is 295,942. Of these, 14,683 (4.96%) were found with severe acute malnutrition and 36,839 (12.45%) with moderate acute malnutrition.

The cumulative total of new admissions in SAM programme (OTP and SC) from January to date now stands at 15,481 which represents 50% of the January to June 2014 Crisis Response Plan target. The cumulative (January to March 2014) cure and defaulted rates are respectively of 65% and 30% which are below the recommended SPHERE standards. The death rate for the same period is at 1%. Overall programme performance is challenged by several factors such as difficulty in accessing sites due to insecurity and displacements of communities since the start of the conflict. These challenges are being taken into consideration for programme improvement and further bottlenecks analysis will be conducted by programme component (SC and OTP) to identify specific solutions. In collaboration with the cluster assessment-working group SMART surveys2 have been planned in the coming months. These surveys conducted bi-annually (post-harvest and during the hunger gap) are critical for monitoring and assessing the nutrition situation.

During the reporting period 6,201 cartons of plumpynut were provided to partners. This is sufficient for the treatment of over 6,000 children with severe acute malnutrition without complications for a period of 6 – 8 weeks.

WASH: During the Rapid Response mission in Kodok, 1,500 households were provided with WASH supplies (600 collapsible jerry cans, 600 buckets, 60 IEC materials and 1000 PUR sachet boxes). Additional WASH supplies are being transported from Malakal to support 28,000 IDPs. During the mission, critical water treatment products were delivered to the Water Pumping Station to improve the quality of water. In addition, the RRM team

2 Standardized Monitoring and Assessment of Relief and Transitions 3 distributed 300 slabs for the construction of latrines. Hygiene promoters were identified and hygiene promotion materials distributed in collaboration with World Vision International who will work with WASH actors on hygiene and sanitation.

UNICEF and WASH partners continue to increase access to safe water for 241,397 people in Juba 3, Tongping, Bor, Melut and Minkaman PoCs and other IDP locations.

In the Tongping PoC site in Juba, the additional space being allocated enabled the construction of additional elevated latrines: 18 elevated latrines (with septic tank) are being completed, while construction of 36 latrines and showers is ongoing. In Minkaman, works are underway for the construction of 750 new latrines and hygiene promotion in the new IDP location which will benefit 40,000 IDPs. Around 5687 people were reached with hygiene promotion messages. Additional 90 cartons of soap, 374 collapsible jerry-cans and 349 buckets (20lt) with lid distributed to IDPs

In Bentiu, drilling of five boreholes has started to enable access to adequate water in the new IDP site which will benefit 7,000 IDPs. In Bor, the additional borehole constructed enabled additional 15,000lt of water per day available to IDPs. A total of 1,670 people were reached with key hygiene messages in the PoC. In Malakal, UNICEF has provided one sewage tanker to improve desludging in the PoC.

EDUCATION: During the rapid response mission in Kodok, 270 primary school children (120 girls and 150 boys) and 37 pre-school children (22 girls and 15 boys) were registered. A total of 10 teachers have been identified so far and will be trained on provision of life saving messages, life skills education and provision of psychosocial support. Education supplies, including school tents, have also been provided enough for all these students as well pre-positioned to support an additional 1,000 pre-primary and primary and secondary school-aged children.

In Bor, UNICEF established six temporary learning spaces with participation of members of the Parent Teachers Association (PTA) and the community, benefiting 1,200 children (480 girls and 720 boys). UNICEF conducted a training on parent teacher association roles and responsibilities at the PoC School for 11 members of the PTA.

In Melut, registration of learners is ongoing in the PoC and in Dethoma IDP centre, and is expected to be completed by mid-April 2014. A total of 3,005 children (1,353 girls and 1,652 boys) have been registered so far. Education supplies have also been provided though additional materials will be required to cover all students once the total registration process is completed.

School attendance fluctuates from one location to the other: in Malakal, regular monitoring indicates a low daily attendance of pupils and teachers despite a total enrolment of 554 pupils (276 girls and 278 boys) while in Minkaman attendance for pupils increased from 53% to 60% as a result of improved water facilities and regular teachers attendance.

Use of schools by armed forces and IDPs continues to delay resuming of education is some locations. There are 68 schools in eight states out of use for education purposes; 38 are used as a temporary shelter for IDPs, while Armed Groups are present in 30 schools. Advocacy to find alternative solutions to this issue is ongoing at national, state and field levels.

CHILD PROTECTION: Two new Family Tracing and Reunification (FTR) Networks were established in Kodok and Pagak through the Rapid Response Mechanism (RRM) bringing the total number of networks established to fourteen. Through these Networks 130 new cases of unaccompanied and separated (UASC) and missing boys and girls were identified bringing the total number of children identified to 3,216. Following successful family tracing, UNICEF chartered a flight to transport the first group of 20 UASC from Malakal Protection of Civilians (PoC) areas for reunification with their parents and families in Juba Tongping PoC Area at the UNMISS Base. This brings the total number of children reunified to 251. To date, 22,930 children have been reached with critical child protection services supported by UNICEF and implementing partners. Child protection partners in Juba, Minkaman, Bor, Melut and Nyal continue to provide psychosocial support to children through 16 Child Friendly Spaces (CFS). The total number of children participating in CFS activities remained unchanged in Minkaman, Juba PoC and Bentiu, hence the total number of children (children age 5 – 18) years stands at 3,646 children. The Gender Based Violence (GBV) Working Group in Malakal PoC led by UNICEF has developed the GBV referral pathway and next week the Working Group will conduct an assessment of the GBV response services in the PoC. UNICEF is deploying additional capacity to strengthen GBV prevention and response interventions in Malakal, Juba (outside the PoC) and to expand interventions into new locations where GBV is reported to be on the rise. Forty eight (48) Community mobilizers were trained on identification, documentation, tracing and reunification of unaccompanied and separated children (UASC) as well as on monitoring and reporting on child rights violations with a focus on reporting on recruitment and use of children by armed groups. COMMUNICATIONS FOR DEVELOPMEN (C4D): UNICEF developed an integrated Communication for Development (C4D) Humanitarian strategy. Promotion of key lifesaving messages continued in Minkaman through partners on the ground (Health and Camp Coordination and Management clusters). A total of 4,354 individuals were reached with key hygiene and sanitation messages during door to door / tent to tent campaign. About 160 hygiene promoters were trained on garbage collection and waste management by UNICEF partner AWODA. UNICEF and partners reached a total of 1,288 households with hygiene and sanitation messages in the Islands, Yolakot, Kalthok, Wunthou and Ahou by Samaritan Purse. About 500 4 children were reached with key protection messages. In Beintu 22 women groups received solar radios and as part of community listening groups they are listening to SAFE WAYs messages on Miraya FM. SUPPLY AND LOGISTICS: UNICEF chartered two cargo flights carrying over 77 tonnes of Ready-to-use Therapeutic Food (RUTF) landed in Juba over the last five days. The urgently needed RUTF was handed over to MSF-Holland at the airport for immediate distribution in an effort to scale up treatment.

In-country airlifts of essential relief supplies in support of the response are on-going. UNICEF is working closely with the Logistics Cluster who facilitated the airlift of Nutrition, WASH and Education supplies by helicopter to the rapid response team in Kodok. An additional 5.5 tonnes of cargo was airlifted to Bentiu. The cargo includes WASH supplies, mosquito nets and cold chain equipment. Vaccines and RUTF were delivered to the rapid response mission team in Pagak on a UNICEF- chartered flight. Additional rotations to bring in supplies for the ongoing rapid response mission in Pagak, Maiwut and Mathiang are pending flight clearances.

Many locations in Unity, Jonglei and Upper Nile states remain inaccessible by road. Insecurity along road transport corridors continue to hamper the delivery of humanitarian supplies, necessitating the use of expensive air assets. UNICEF is exploring alternative supply routes together with other agencies.

SECURITY: Security Situation within the country is generally calm, however heavy fighting was reported in Bentiu (Unity State), increasing the number of people seeking shelter at the United Nations Mission in South Sudan (UNMISS) base in Bentiu.

MEDIA AND EXTERNAL COMMUNICATION: Ahead of the April 12 Humanitarian Ministerial Meeting in Washington DC, UNICEF issued a press release on the dire nutrition situation of children in South Sudan. UNICEF Executive Director did a studio interview with Al Jazeera. Other media response was active, including interviews with SABC Radio (South Africa), Voice of America, CCTV (China), SBS Radio (Australia), and National Geographic. Human interest stories in process include reunification of children in Juba and field stories from Pagak.

FUNDING: Against the Jan-June requirement of US$ 75,068,165 the inter-agency Crisis Response Plan (CRP), UNICEF’s funding level has increased to US$ 33,231,898. In the course of last week, UNICEF has received a contribution of EUR 4.5 million (around US$6.2 million) from ECHO for nutrition, health, child protection and WASH activities. Funding has also been received from the CERF for health (vaccinations) and nutrition (core pipeline supplies) amounting to US$ 3.4 million. Thematic flexible contributions of around US$ 1.2 million have also been received from the French and German Committees for UNICEF.

UNICEF is deeply appreciative of the funds that have been received so far from both public and private sector donors as well as the donor commitments that are in the pipeline for the current crisis response. Given the revision of the Crisis Response Plan (CRP) that is being initiated in-country as well as the initial estimates for the affected population that requires support from UNICEF and its partners during the course of 2014 UNICEF continues to urge the donors to provide the much- needed funding to meet the critical humanitarian needs.

Funding Requirements for Jan-June 2014 Requirements Funds received Funding gap Appeal Sector US$** US$* US$ % Nutrition 9,000,000 8,620,074*** 379,926 4% Health 17,202,190 4,921,707 12,280,483 71% WASH 28,500,000 12,471,814 16,028,186 56% Protection (CP, GBV &MRE) 10,160,521 4,883,121 5,277,400 52% Education 7,530,164 2,335,181 5,194,983 69% Multi-sector refugee response 2,675,290 - 2,675,290 100% Total 75,068,165 33,231,898 41,836,267 56% * ‘Funds received’ does not include pledges ** The requirements noted above include the indirect cost recovery of 8% as per UNICEF’s Executive Board decision. It also includes a cross-sectoral cost (covering fuel, security, ICT etc) to meet the high operating costs of working in South Sudan. *** Given the increasing level of nutrition needs, UNICEF has presented its initial level of needs amounting to US$38 million for 18 months period (ending in Sept 2015) to the HCT. These needs are only 23% funded ($8.6M). The revised needs will be reflected in the CRP which will be issued in mid-June 2014.

Next SitRep: 22 April 2014

UNICEF South Sudan Crisis: www.unicef.org/southsudan UNICEF South Sudan Facebook: www.facebook.com/unicefsouthsudan UNICEF South Sudan Appeal: http://www.unicef.org/appeals/

Who to contact Jonathan Veitch Ettie Higgins Dominic Stolarow for further Representative Deputy Representative Emergency Specialist information: UNICEF South Sudan UNICEF South Sudan UNICEF South Sudan Email: [email protected] Email: [email protected] Email: [email protected]

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Annex A

SUMMARY OF PROGRAMME RESULTS

Cluster Response UNICEF and IPs Change since Overall Target Total Results Target Total Results last report needs ▲▼ WATER, SANITATION &

HYGIENE # of target population provided with access to water as per agreed 2,480,000 500,000 338,333 475,000 241,897 24,897 standards (7-15 litres of water per person per day). # of target population provided access to appropriately sanitation 2,480,000 500,000 169,166 475,000 163,000 10,500 facilities (as per the Sphere Standards) # and % of population reached with N/A N/A N/A 475,000 245,500 2170* hygiene promotion messages EDUCATION # and % of pre-school children 80,633 19,600 1,197, +37 (aged 3-6_ with access to play 36,338 (17,442 F; 2,052 (977 F; (38,704 F: (7,840 F; 499 F; (+22 F; 18,896 M) 1075 M) and early learning including 41,929 M) 11,760 M) 698 M +15 M) supplies # and % of school-aged children including adolescents 367,327 165,538 78,400 9,629 32,800 (14,821 +1,470 (aged 7-18) with access to (176,317 F; (79,458 F; (31,160 F; (3,929 F; F; 17,979 M) (+600 F; +870 M) education in emergencies, 191,010 M) 86,080 M) 47,240 M) 5,700 M) including supplies # and % of teachers trained to 3,040 1,479 700 1,000 159 provide education in (913 F; 2,127 (444 F; (180 F; (400 F; (25 F; - emergencies M) 1,035 M) 520 M) 600 M) 134 M) # and % of other education personnel and Parent-Teacher 1,700 740 357 300 48 +11 Association members trained to (680 F; 1,020 (296 F; (136 F; 221 (180 F; (18 F; (+1 F;+10 M) support education in M) 444 M) M) 120 M) 30 M) emergencies # and % of classrooms 5,600 2,019 172 1,514 75 +6 established/rehabilitated HEALTH Number and Percent of children 6mo-15y vaccinated for 1,908,000 858,600 240,365 858,600 240,365 51,822 measles Number and Percent of children 6-59 months receiving vitamin 1,908,000 Not Applicable 33,250 362,520 33,250 5,486 A supplement in the past 6 months Number and Percent of children 12 - 59 months receiving de- 1,908,000 Not Applicable 25,675 324,360 25,675 4,601 worming medication Number and Percent of 1,908,000 Not Applicable Not Applicable 79,500 37,670 1,296 households receiving 2 ITNs Number and Percent of pregnant women attending ANC counselled and tested 1,908,000 Not Applicable Not Applicable 20,034 1,782 123

**these targets will change every week, depending on the number of children identified 6

NUTRITION # and % targeted children 6-59 months with Severe Acute 36,613 30,891 13,842 30,891 13,842 +1200 Malnutrition admitted to therapeutic care # and % of exits from 75% (Sphere 75% (Sphere No available this therapeutic care by children 6 - 0 82.9% Standards) Standards week 59 months who have recovered # and/or % of children 6-59 months in the affected areas Vitamin who received the 1,250,356 1,187,838 1,187,838 Vitamin A=16,557 A=16,557 recommended dose of multi- micronutrient supplement # and/or % of pregnant and lactating women in affected Multiple Multiple areas receiving multi 128,447 109,180 micronutrients 109,180 micronutrients Not applicable micronutrient supplement (or =1618 =1618 iron and folic acid) CHILD PROTECTION # and % of unaccompanied and separated children identified Not Applicable 3,216* 1737 2058 551 130 and registered # and % of registered unaccompanied and separated children receiving Family Tracing and Reunification Not Applicable 3,216** 1737 1112 107 20 services and family-based care or an appropriate alternative care services # and % children enrolled in psycho-social activities 449,391 200,000 23,861 100,000 22,930 226

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