COUNTRY OFFICE MONTHLY REPORT EMERGENCY AND HUMANITARIAN ACTION (EHA) / ETHIOPIA PROGRAMME

May 2009

HIGH LIGHT: • 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.

• Increased cases of malnutrition continue to be reported during the month in many woredas of SNNPR, and East and West Hararghe zones in Oromiya. The nutritional problem in parts of West Arsi, and Bale (Oromiya) and Dessie Zuria (Amhara) also remains to be of the main concern.

• According to official reports from the Federal Ministry of Health (FMOH), no case of Influenza A H1N1 has been reported in Ethiopia this month and the situation is being monitored closely.

• Reports from FMOH indicated an upsurge of malaria cases from SNNPR, Tigray and Amhara Regions. Information from the Welayita zone in SNNPR indicated about 78,000 clinical cases of malaria have been reported from 3 districts

GENERAL SITUATION

A, Political, social and security

• The overall political and social situation remains stable including the security situation in the country this month. In Somali Region the security situation remained unpredictable.No major security incidents involving humanitarian staff members have been reported and the humanitarian partners continue to do their job without any problem.

Main events of interest/ concern for health (including food insecurity and malnutrition, disease outbreak, etc):

B. Food insecurity and malnutrition Situation and response in Ethiopia.

• 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),Amhara region Dessie Zuria of South Wello 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 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. Close monitoring of the seasonal rains through the end of the season is 1 required. Similarly a significant increases in severe malnutrition in parts of Oromiya, Amhara and Tigray regions (from Goal, CONCERN and World Vision) raised concern for emergency crisis in these chronically food insecure areas. WFP field staffs are on alert and monitoring the situation closely. • The food insecurity situation in the affected areas of SNNPR, Tigray, Amhara, regions and most of Somali including Afar regions has remained unchanged. Vulnerable households in these regions are depending on food relief and safety net resources. This month, admission rates of malnourished children in outreach therapeutic programmes (OTPs) and Stabilization Centers (SC) have increased rapidly and are alarmingly high in some areas of SNNPR. The nutritional situation in SNNPR is further aggravated by the current outbreak of malaria in many low and midland areas where control operations are underway. • Similarly the food security and nutrition situation in Oromiya region has rapidly deteriorated in Siraro, Shalla, Shashemene and woredas of West . According to the Zonal DPPB, the situation is serious and needs immediate intervention. Screening is ongoing to assess the actual number of malnourished children. New SCs and OTPs are being established in , Shashemene, and Arsi Negele in West Arsi of Oromiya to cope with the rapidly deteriorating nutritional situation. Over 1000 children have been admitted to OTPs in May. Continuous assistance is critical in these areas during this period due to increased pressure on the households to provide labour for the Belg planting that has commenced following the wide spread rainfall received as of end of May 2009. • Relief assistance to over 68,000 people has been dispatched to , pending a rapid assessment of the current needs. Meanwhile, food stress indicators are being observed in woredas of Arsi including Munessa, Shirka, and . A recently deployed joint verification team reported that about 45,000 people are in need of food assistance in the woredas. The regional government has identified a total of 201,000 additional relief beneficiaries following joint rapid assessment missions this month. Following this situation, the regions’ request for one month food ration for additional beneficiaries has been allocated.

• A wide-scale nutrition screening has been completed in West Arsi zone and results are being compiled. Meanwhile, WFP reports that relief rations have been dispatched and targeted supplementary food dispatch will start when the numbers are available. UNICEF supported the Regional Health Bureau implementing the Enhanced Outreach Strategy (EOS) in the five woredas of West Arsi, starting from 25 April 2009. Children under five have been supplemented with one dose of vitamin A and de-wormed. UNICEF also dispatched six tons of Ready-to-Use Therapeutic Food (RUTF), drugs, and non-food items to the zone.

• 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 .

2 Acute Watery Diarrhea(AWD) Situation and Response According to official reports from the Federal Ministry of Health, 625 AWD cases and 20 deaths (CFR 3.2%) have been reported from 17 districts 5 regions (Oromiya, SNNP, Harari, Somali and Afar Regions) in May 2009. Of these, Afar region reported 44.5% of the cases and deaths (278 cases and 12 deaths), followed by SNNPR 30.6% of the cases (191 cases and 0 death), Oromia 21.1% of the cases (132 cases and 4 deaths and Harari 3.8% of the cases ( 24 cases and 0 death).

In response to AWD outbreak and other health emergency, WHO has donated 6 Diarrhoeal Disease kits and 4 inter agency health kits Oromia Region, 2 Diarrhoeal Disease kits and 2 inter agency kits to Somalia Region, 1 Diarrhoeal Disease kits and inter agency health kit to Harari region and Dire Dawe administration each and 2 Diarrhoeal Disease kits MSF- Belgium an 1 for MSF Greece. Additionally, WHO has been supporting coordination of a task force composed of FMOH, UN agencies and international NGOS to improve timely response.

Influenza A (H1N1) • According to official reports from the Federal Ministry of Health (FMOH), no case of Influenza A H1N1 has been reported from Ethiopia and the situation is being monitored closely. • WHO is supporting the FMOH in revising its preparedness and response plan. This month WHO in collaboration with the Ethiopian Health and Nutrition Research Institute (EHNRI) conducted a TOT for 51health staff from the 10 regions consisting of regional health bureau focal points, laboratory staff and hospital medical directors on emergency preparedness and response to influenza H1N1.So far Influenza A H1N1 case definitions have been prepared and distributed to the regions, emergency operating centers have

3 been established, and personal protective equipment have been provided to Bole International Airport Quarantine Directorate staff • In line with the required preparation, the United Nations system has finalized its country plan coordinated by WHO Country Office. About 28 UN agencies took part in this process. Five (finance, logistics, security, communication and technical) working groups have finished their work and the plan have been endorsed by SMT for operation. • FMOH has identified 32 hospitals nationwide to support any required response to influenza A H1N1 and has identified national requirements and presented to partners for funding. The FMoH has reactivated the national taskforce and established various sub groups. Conducting daily monitoring of surveillance reports disseminated standard case definition and alert to all regions and health institutions in the country. • Press briefing provided on 3 occasions and trained health personnel from all regions on preparedness and response. • Strengthened surveillance and screening activities at Ports of entry especially at Bole International airport with isolation and quarantine facility in place. In addition air lines staff were given orientation and PPE. Questionnaires were developed for incoming travelers and message being relayed at the Airport. • FMOH has strengthened the capacity of the national laboratory. There is capacity to do PCR in place. • A total of 100,800 treatment courses of tamiflu were donated to FMOH by WCO Ethiopia, AFRO and HQ Geneva. In addition WHO provided 32,095 PPE to the Federal Ministry of Health. • According to official reports, no case of Influenza A H1N1 has been reported from Ethiopia. The United Nations system in collaboration with the Federal Ministry of Health has been producing regular situation report shared with partners. The UN system influenza working group conducted a town hall information sharing meeting on prevention and control of influenza A H1N1 for UN staff members in the country .

Influenza A H1N1: Dr. Fatoumata Nafo-Traoré WR Ethiopia donating Tamiflu toFederal ministry of Health Ethiopia

4 Malaria • Malaria has occurred at the level of epidemic and according to wereda health offices, the prevalence rate has reached around 62% in West Badawacho, 57% in Gomboro, 30% in East Badawacho, 30-60% in Konso. Gomboro and Konso have reported 7 and 8 deaths due to malaria outbreak. DDT spraying, mosquito nets distribution and supply of anti malarial drugs are some of the measures undertaken to contain malaria. • Reports from FMOH indicated an upsurge of malaria cases from SNNPR, Tigray and Amhara Regions. Information from the Welayita zone in SNNPR indicated about 78,000 clinical cases of malaria have been reported from 3 districts. An estimated150, 000 daily laborers are expected in Umera woreda in Tigray Region for the next 3 months and without urgent action malaria outbreak is highly probable. Assessment conducted in affected districts of Amhara Region has identified the following gaps:  Shortage of ant malarial drugs- Coartem &Shortage of ITNs and under utilization  Inadequate follow-up of malaria monitoring chart and taking timely action.  Limited social mobilization to increase the utilization of ITNs and managing the identified mosquito breeding sites.  The regional Health Bureau has planned to conduct DDT spraying in the affected communities. Community mobilization and Health education is being conducted. Most of the ITNs supplied to the communities are no longer effective and needs replacement. An additional team was deployed to Oromia region to assess malaria outbreak in Finchewa sugar factory and to give technical assistance.

2- Implementation of Work Plan: Key Results achieved (Products, Services, and other)

Emergency Health Action – Strategic Objective 5

Emergency stock, provided WHO provided emergency3 health kids for Harari Region and East Hararge zone of Oromia Region. In addition 1 emergency health kit for 10,000 people was provided to MSG-Greece

Epidemic preparedness and response strengthened at in disaster prone Regions WHO has continued its technical support by recruiting 2 consultants for Oromia and SNNPR in May 2009 in responding to health & nutrition crisis in the 2 regions.

Health needs assessment supported . WHO is supporting a multi agency health and nutrition needs assessment in 33 zones in 6 regions (Tigray, Amhara, Oromia, Somali, Afar and SNNPR.) in 2 phases from 8 th June to 10th July 2009. Twelve teams will 5 support this exercise and WHO has provided 4 consultants and will support 1 additional staff from the Ethiopia Health and Nutrition Research Institute as national coordinator. The purpose of this assessment is to determine the health and nutrition requirements of the country from July to December 2009.

Other activities conducted • Regular EHA weekly and monthly activity reports have been produced and shared with partners. • WHO continue to contribute to UNOCHA weekly humanitarian bulletin and monthly bulletin (Focus). • Supporting UNCT and cluster lead coordination meetings. • Provide technical support to the Ethiopia Health and Nutrition Research Institute (EHNRI) in the preparation of the country influenza A H1N1 preparation activities – contingency planning and support for resource mobilization. Constraints : • Insufficient funding for emergency preparedness country level. • The continuous security problems in Somali Region are still a challenge for UN and NGO partners.

WHO Activities with other sectors than Health e.g. water. • WHO continue to support the WASH Task Force chaired by the Federal Ministry of Water Resources and nutrition task force in coordinating WASH related nutrition and AWD interventions. • Coordinated the reactivation of the emergency health and nutrition task force with 1 meeting at EHNRI chaired by the government9 EHNRI).

3- Partnerships in Health and Resource Mobilization . a-Partnerships within the UN System • WHO is closely with the UN agencies in coordinating the nutrition response, multi agency health and nutrition needs assessment in 5 regions, AWD outbreak response in SNNPR, Oromia, Afar and Harari regions.

b-Partnerships with other multi laterals/bilateral/NGOs • Partnership with NGOs, multilateral and bilateral donors continue to be strengthened through the UN country team, humanitarian coordination meetings, personal contact and advocacy by WHO Country Representative. c-Resource Mobilization Memorandum understanding has been sent to OCHA head office on measles, malaria, emergency drugs and AWD proposals this month for approval. A total of USD 1, 155,730 has been mobilized.

4- Emergency Preparedness and Response including Epidemics : • Two consultants recruited in May 20009 supporting 2 regions ( Oromia and SNNPR

5- Administration and Finance issues including Budget situation: • Administration and finance continue to support by providing regular update on fund utilization and necessary support required not to loose these funds.

6- Any required support from AFRO / Inter Country Team / HQ: • Technical support in emergency preparedness, resource mobilization and quarterly supervision . • Technical support for the VRAM project requested by FMOH

7- Any other business :

6