Cameroon Humanitarian Situation Report

©UNICEF /2019

SITUATION IN NUMBERS

Highlights October 2019 2,300,000 • In initial response to serious flooding in Zina and Kai Kai districts of # of children in need of humanitarian Far , UNICEF distributed emergency supplies including assistance WASH and Dignity Kits, plastic sheeting, water filters and aqua-tabs benefitting over 2,000 people. 4,300,000 # of people in need • Over 18,400 school aged children in the North-West, South-West, (Cameroon Humanitarian Needs Overview 2019) Littoral and West regions are attending education with a teacher trained in psychosocial support, conflict and disaster risk reduction Displacement using the UNICEF umbrella-based methodology. 536,107 • In response to the ongoing armed conflict impacting districts # of Internally Displaced Persons (IDPs) in adjoining NE , UNICEF provided psychosocial support to the North-West and South-West regions 3,314 children (1,407 girls and 1,907 boys) in community-based Child (IOM Displacement Monitoring, #16) {Does this include the ones in Littoral and West? If yes, this should be Friendly Spaces (CFS) and other secure spaces through its clarified} implementing partners in Logone-and-Chari, Mayo Sava and Mayo 381,444 Tsanaga divisions of Far North Region. # of Returnees in the North-West and South-West regions (IOM Displacement Matrix, August 2019) UNICEF’s Response with Partners 372,854 # of IDPs and Returnees in the Far-North region Sector Total UNICEF Total (IOM Displacement Tracking Matrix 18, April 2019) Target Results* Target Results* 106,418 WASH: People provided with 374,758 43,651 75,000 23,376 access to appropriate sanitation # of Nigerian Refugees in rural areas (UNHCR Fact Sheet, September 2019) Education: Number of boys and girls (3 to 17 years) affected by 363,300 2,415 217,980 0 crisis receiving learning materials UNICEF Appeal 2019Total funding Nutrition**: Number of children US$ 39.3 million requirement aged 6-59 months with SAM 60,255 53,886 65,064 56,216 available 25% admitted for treatment Funds Child Protection: Children received $ 6.6M reached with psychosocial support 563,265 182,983 289,789 92,740 through child friendly/safe spaces Carry-over C4D: Persons reached with key $ 3.2 M 541,791 2019 funding life- saving & behaviour change 385,000 requirement: messages $39.3 M *Total results are cumulative. ** UNICEF targets can exceed that of the sector because the nutrition sector does not cover refugee camps, whereas UNICEF covers both the camps and out-of-camp Funding gap refugees. $ 29.5M

Situation Overview & Humanitarian Needs UNICEF participated in two interagency missions in South-. On 10 October, UNHCR, UNDP and UNICEF travelled by road from to Mamfe town (Mamfe subdivision, Manyu division) located 64 km from the border with Nigeria. The mission objective was to conduct a security assessment of the road and the town, and to identify actors on the ground with potential to scale up humanitarian delivery through UN agency support, including UNICEF. The mission also identified potential accommodations facilities to enable future, longer-term missions. On 17 October, UNICEF, UNDP, OCHA and UNDSS conducted programme monitoring/assessment mission from to Konye town and Diongo Centre (Konye subdivision, division). Destruction was evident in the centre of Konye with part of the population displaced to the forest. The mission observed damaged and abandoned shops, houses including the government school and health centre. Konye District Hospital and Konye health centre were abandoned and vandalized. Although a functional health centre is 5 km away, people prefer to travel to town, 40 km from Konye, due to dilapidated road infrastructure including an unsafe bridge leading to the health center. There is a functional health centre in Diongo Centre, however it reported shortage of drugs. Though unverified, cases of unaccompanied children have been reported in both locations. Some humanitarian assistance is being provided in both locations, including UNICEF-supported WASH activities for Diongo Centre and mobile health services for IDPs in the adjacent forest since April. UNICEF together with clusters will investigate on ways in providing more comprehensive and adequate assistance. Needs in health and WASH sectors were identified as priorities, while further assessment is needed for child protection.

In the North-West and South-West regions over 4,100 public primary schools and 744 secondary schools remained closed or non-operational, representing 90 per cent of public primary schools and 77 percent of public secondary schools. This is attributed mainly to the unavailability of teachers, or parents’ fear sending their children to school in an insecure environment or a combination of both. In the South-West Region, UNICEF observes higher attendance rates by both students and teachers. In North-West Region, despite an increase in attendance (from 31,000 children to 52,200) in primary and secondary schools as compared to the last school year, the educational situation remains extremely bad with an estimated 517,818 (91%) primary and secondary school aged children still out of school.

Towards 2020 Education Cluster planning, cluster partners have proposed to target 70% of the estimated ‘People in Need’ – namely 656,000 (328,000 girls), including 333,000 with access to formal and non-formal education in 2020.

To improve cluster-wide strategic education response for conflict affected adolescent school aged children, the cluster drafted an ‘Adolescent in Emergencies Strategy’, with the support of national level Education in Emergency (EIE) working group partners including from other clusters. The strategy aims at increasing relevant education opportunities for conflict affected adolescents in the North-West and South-West regions.

On 18 October, the Education Cluster aligned its strategic objects of 1) improved psychosocial wellbeing of conflict affected children, 2) increased access to quality education through formal and/or non-formal learning for crisis affected children, 3) enhanced response capacity of the affected teachers, schools/learning environment and communities, and 4) improved safe learning environment in conflict affected areas. These objectives are embedded in the draft HRP 2020 overall goals of saving lives and alleviating suffering, supporting affected populations to meet their basic needs, enhancing the resilience of vulnerable populations, and improving the protection of civilians.

Under the leadership of UNICEF an education needs assessment is being planned in Yaounde to identify the needs of urban IDPs.

During the 29 October, Local Education Group (LEG) meeting in Yaounde, a platform coordinated by UNICEF under the Global Education Partnership, development partners were requested to coordinate with the Education Cluster when planning development interventions in the North-West and South-West regions. This recommendation was

2 made in view of conflict sensitivity and the risk level of education interventions which, if not considered, could compromise access to beneficiaries, and the safety of partners.

In the Far North Region, an extended rainy season led to some of the most significant flooding in several years. Conditions had deteriorated in late September and grew progressively worse by mid-month. The localities of east (District of Zina) and south of Lake Maga (District of Kaï Kaï) were flooded when the burst its banks. UNICEF participated in a series of localized needs assessments undertaken by government, UN agencies, international and local NGOs to communities in the affected areas. Affected areas ranged over a distance of 150km from north to south. Though no deaths were reported, there were significant losses both in terms of infrastructure and material. Initial reports cited significant damage and destruction of houses and more than 47,000 hectares of and sorghum fields damaged. Around 40,000 people were reported directly affected in the districts of Zina (Logone and Chari), Maga and Kai-Kai (Mayo Danay) including 19,000 displaced according to OCHA, moving to higher ground along river dikes. Initial needs identified were access to health care, safe drinking water, hygiene and shelter as the most urgent areas for response. The flood impact on the next harvest is likely to be significant. Over 10 schools were reported damaged or destroyed.

In initial response, UNICEF supplied WASH and Dignity Kits, water filters and aqua-tabs benefitting approximately 2,000 people, along with plastic sheeting for 200 households and support for the construction of 50 latrines. Additional emergency supplies were moved up from the emergency warehouse for rapid distribution including water containers, chlorine, ECD kits, essential drugs, LLINs. Physical access was a major constraint with most of the affected villages reachable only by boat/pirogue with journeys of 4-5 hours.

UNICEF is developing a 90-day plan for the response and early recovery. Priority concerns are the high risk of water borne diseases due to standing water and contamination. Child nutritional status will be at risk in coming months due to crops losses.

In addition to the flooding crisis, the Far North region continues to register cholera cases. According to WHO, rapid access to treatment is essential during a cholera outbreak. Oral rehydration should be available in communities, in addition to larger treatment centres that can provide intravenous fluids and 24-hour care. With early and proper treatment, the case fatality rate should remain below 1%. As of 21 October, 478 cases were registered since 1 January 2019 with 19 deaths, a 4.0% case fatality rate.

Estimated Population in Need of Humanitarian Assistance

*Cameroon Humanitarian Needs Overview 2019 **SMART Survey 2017 & UNHCR Standardised Expanded Nutrition Survey (SENS) 2016 Start of humanitarian response: November 2013 Total Male Female Total Population in Need* 4,300,000 2,000,000 2,300,000 Children (Under 18) * 2,300,000 Children Under Five** 523,000 258,000 265,000 Children 6 to 23 months** 163,000 80,500 82,500 Malnourished Pregnant and lactating women** 18,000 - 18,000

Humanitarian Leadership and Coordination • The Humanitarian/Resident Coordinator leads the overall humanitarian coordination, supported by OCHA. • At the national level, UNICEF and the Government are co-leading the Nutrition, WASH and Education sectors, as well as the sub-sectoral group for Child Protection. • In the Far North, OCHA leads inter-sector coordination which addresses particularly challenges and gaps both for refugees, IDPs and host communities, while UNHCR oversees coordination in the regions of the East and Adamawa.

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• In response to the crisis in the North-West and South-West, clusters have been activated and UNICEF is the lead for the WASH, Nutrition, Education clusters and the Child Protection Area of Responsibility. • Note that where relevant, UNICEF, as cluster lead agency, is responsible for information management of the cluster and sharing overall results achieved by the cluster collectively. Humanitarian Strategy UNICEF’s 2019 humanitarian strategy is organised around four pillars designed to strengthen the linkages between humanitarian action and development programming: 1) building a protective environment and supporting community peacebuilding; 2) preventing and responding to violence against and exploitation of children; 3) increasing access to basic services; and 4) strengthening emergency preparedness and response systems. The strategy is implemented using three operational modalities. First, UNICEF strengthens government systems in communes and build community capacities. The goal is to establish linkages between community-based mechanisms and government structures to reinforce local resilience. Second, where community structures are unable to absorb shocks, UNICEF supports community-based associations and sub-regional governments to deliver services and establish coordination mechanisms. This will strengthen social cohesion by ensuring that both affected populations and host communities can access services. Third, UNICEF and partners provide an integrated, rights-based assistance package to the most conflict-affected populations. In all aspects of its humanitarian response, UNICEF strengthens accountability to affected populations, including by meeting with communities directly, where possible, and working through third-party monitors to ensure effective programme delivery. An OCHA led task force, with UNICEF and WFP support, was established earlier this year to advance common efforts towards the prevention of sexual exploitation and abuse and to protect affected populations. During the month, UNICEF began developing its 2020 humanitarian plan in tandem with its contributions to the 2020 Humanitarian Needs Overview (HNO) process that will culminate in the 2020 Humanitarian Response Plan, coordinated by OCHA. Summary Analysis of Programme Response UNICEF humanitarian assistance primarily focuses on IDPs, out-of-camp Nigerian refugees and host communities affected by the Lake Basin (LCB) crisis, and the North-West and South-West crisis.

Lake (LCB) Crisis Nutrition1 In September 2019, 2,981 children aged 6 to 59 months with severe acute malnutrition including 46 Nigerian refugee children from Minawao camp were admitted to 360 UNICEF-supported health centres in the Far North region. The average cure rate recorded was 90.5%.

Also, in September, 10,253 children aged 6-23 months received micronutrient powder for home-based food fortification programme in 9 health centres from the Health Districts of and Kousseri in Logone et Chari Division. The other health centres are covered by the WFP blanket supplementary food program (BSFP). It is important to note that 3 other districts ( 1,2,3) are planned to be enrolled before the end of the year. In October, 164,763 children aged 6-59 months were screened for malnutrition in 2 health districts (Mada and Makary) by AHA (implementing partner), health workers CHWs and 1,970 trained MUAC-led by mothers. Through these actions 1,021 children were detected with severe acute malnutrition (SAM) and 1,787 with moderate acute malnutrition (MAM), with subsequent referral to the nearest outpatient therapeutic centres.

Appropriate food preparation demonstrations were organised in the health district of Mada and Makary with the participation of 1,383 women and 587 men. Also, 63 IYCF education sessions were conducted by nutrition support groups with the participation of 2,278 women and 1,247 men.

1 Due to the reporting system of the ministry, the admission data of the concerned month is reported in the following month (i.e. January data are reported in February). 4

A Nutrition Working Group coordination meeting was held in Maroua on the 30th of September under the leadership of the Ministry of Health and UNICEF with the participation of all the implementing partners working in the Far North region. The main objective was to strengthen the response mechanism and data collection in the Basin crisis and to discuss about the flood that occurred in Zina (Logone et Chari) and Kai-kai (Mayo Danay) and resulting rapid assessment.

Health A total of 15, 000 LLINs were distributed to 21,094 IDPs in Logone and Chari villages of , , Sagmé, Hilé Halifa and Logone Birni.

In response to the vaccine-derived polio epidemic discovered in Chad, Mandelia health district, UNICEF supported health delegation staffing in Maga and Kousseri health districts in planning two response rounds to take place in November and December 2019 targeting 172, 067 children from 0 -59 months.

WASH In partnership with national NGO partner ACDC, the implementation of Community-Led Total Sanitation (CLTS) continued in Blangoua sub division (with an estimated population of 78,900 people hosting over 3,350 IDPs) in Logone and Chari Division, in the Far North region. During the reporting period, the adoption of good hygiene and sanitation practices was promoted in 79 villages in which 5,708 people (including 2,752 women) were sensitized on the importance of immunization.

A persistent cholera outbreak continues affecting communities in the North and Far North regions. During the month, 98 cases with no deaths were recorded in the North region and 41 cases and no deaths recorded in the Far North Region. Since the beginning of the year 2019, 698 cases including 44 deaths have been reported in the North and Far North regions (MOH report, week 43).

Despite mounting funding gaps, UNICEF continue to support WASH and community sensitization activities. In partnership with national NGOs, AAEDC, UNOADD and AP2D, prevention and response activities were carried out in 6 Health Districts (Kaele and Moutoura in the Far North region, , , 1 and Garoua 2 in North region). During the reporting period, a total of 91,211 people (16,469 in Far North and 74,742 in the North) attended sensitization events to increase awareness on the risk of cholera, especially as it is associated with poor hygiene practices and diarrhea case treatment. Informed by this sensitization, 1,133 households (307 in the Far North and 826 in the North) have constructed and are using latrines. Thirty-two (32) cases of diarrhea detected in communities (18 in the Far North and 14 in the North) were referred to health centers for proper care. Over 343,500 Aquatab tablets were distributed to 1,145 households (709 in the Far North and 436 in the North), to allow for potable water.

Additionally, in collaboration with Far North Region health counterparts, a workshop was organized with the technical and financial support of UNICEF in Maroua from October 9 to 11, 2019 to elaborate a multisectoral plan to fight cholera. This workshop brought together 70 stakeholders from the government, National and International NGOs, WHO and UNICEF. Action points from this workshop are being progressively implemented. A similar workshop is planned for the North region in Garoua from November 4 to 6, 2019.

In response to flooding in Zina and Kai Kai sub division of the Logone and Chari Division in Far North region, UNICEF distributed 300 WASH kits and Dignity Kits to 182 families (1,481 inhabitants of which 1,050 children) of the Kai-Kai community and 118 families (995 inhabitants of which 730 children) of Zina community.

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Education During the month, 94 koranic teachers from Goulfey and Blangoua (40% females) in the Logone and Chari division received capacity building on the need to integrate formal education and linkages between the Convention on the Rights of the Child (CRC) and the Koran.

In response to the flooding, UNICEF conducted a rapid needs assessment which highlighted that six primary schools in the Kai-kai commune are hosting IDPs including 429 children (245 boys and 184 girls).

Child Protection During the month, UNICEF provided psychosocial support to 3,314 children (1,407 girls and 1,907 boys) through community-based Child Friendly Spaces (CFS) and other secure spaces undertaken by implementing partners (CODAS Caritas, CLiRA and ALDEPA) in the Divisions of Logone-and-Chari, Mayo Sava and Mayo Tsanaga. Out of the 3,314 children, 1,411 are internally displaced (732 girls and 679 boys), 1,861 are from the host community (653 girls and 1208 boys) and 42 are refugees (22 girls and 20 boys).

Six unaccompanied children (4 boys and 2 girls) and 43 separated children (15 girls and 28 boys) were identified in October in Logone-and-Chari, Mayo-Sava and Mayo-Tsanaga divisions by CODAS Cartitas, CLiRA, ALDEPA and IMC. Forty-seven of children are internally displaced (30 boys and 17 girls) and 2 (boys) are refugees. Each child benefited from psychosocial support and material assistance (hygienic kits and clothes). Sensitisation actions are ongoing with the members of the host communities to ensure full reintegration and prevent stigmatisation.

In addition, 24 children (all boys) aged 10 to 17 were identified within vigilante committees by CODAS’ animators and social workers in the villages of Fotokol, Blangoua, Kobro, Goufey and Dougoumachi in Logone-and-Chari division. IMC identified 3 girls formerly associated with armed groups in the village of Amchide ( sub-division, Mayo- Sava). These children received psychosocial support and close home visit/follow-up. Follow-up is ongoing for their integration into adolescent clubs and participation in life skills activities through social workers from CODAS Caritas. In parallel, continuous sensitization sessions are carried out within these communities to prevent stigmatization. UNICEF implementing partner ALDEPA assisted in retrieving pending birth certificates from the Civil Registration Office in Logone-and-Chari in the Far North Region and distribute them to their owners. This benefited 45 children (19 girls and 26 boys).

Communication for Development (C4D) Scale-based sensitization on cholera prevention and response was carried out during the month. Some 250 community actors from three NGO partners visited 18,198 households in five cholera affected health districts in North and Far North regions to sensitize populations on cholera prevention and response. This covered health districts in North (Garoua 1, Garoua 2, Bibémi, and Pitoa) and in Far North (Kaélé) regions. Altogether 305,671 people were sensitized. In addition, social outreach was also carried through 22 radio stations in North region (10) and Far North region (12) for the broadcasting of related key messages, targeting an estimated 2.9m listeners. North-West and South-West Crisis Preliminary findings from the Multi Sector Needs Assessment (MSNA) in support of the 2020 Humanitarian Needs Overview (HNO) indicates that over 55% of the assessed communities don't have enough water for their needs and more than 40% practice open defecation. With regards to access to health care, only 65% of the facilities were reported to be functional with the main barrier of access to health care being distance. IDPs and poor households in urban areas remain in Crisis (IPC Phase 3)2. This is expected to have a significant impact on the nutritional of children aged 6-59 months.

2 Integrated Phase Classification (FAO) 6

Nutrition In October, UNICEF continued to support nutrition partners to implement a basic nutrition interventions package which includes screening, referral, vitamin A supplementation, out-patient management of SAM and nutrition sensitization.

UNICEF partners Reach Out and Cameroon Baptist Convention Health Services (CBCHS) screened 2,482 children (NW-1,408 and SW-1074) under 5 years for acute malnutrition among which 21 (NW -12 and SW-9) were diagnosed with uncomplicated SAM and 105 (NW- 77 and SW-28) were diagnosed with MAM.

The SAM cases are being managed as outpatients in line with national protocol for the management of SAM. At this time there is no MAM treatment or prevention programme currently running and caregivers for MAM cases receive only nutrition education and counselling. Since 1 July, 54 children with SAM have been identified and are receiving treatment.

During October, 1,939 persons were sensitised on key messages on infant and young child feeding (IYCF) practices. Through the third-party monitors (TPM) and partners, UNICEF is monitoring for the distribution of breast milk substitutes (BMS). So far, no BMS distribution has been reported.

On 17th October 2019, UNICEF participated in a joint mission between OCHA and UNDSS to Konye, the capital of Konye subdivision, and Diongo Village, also in Konye subdivision. The overall humanitarian situation was assessed with needs identified for scaled up nutrition response based on observed increased number of children with malnutrition (visible wasting) compared to previous months.

The Nutrition Cluster coordination meeting for the South-West Region and the Strategic Advisory Group (SAG) took place on the 10th and 16th of October 2019 respectively. Both meetings recommended fast-track implementation of capacity building initiatives by different organisations, address the inadequate response of MAM treatment and the need to strengthen preventative programme for addressing undernutrition.

Health From the last week of September to the third week of October, implementing partners Reach Out and the Cameroonian Baptist Convention (CBC) conducted life-saving based interventions in Ekondo Titi subdivision (South- West) and subdivision (North-West) respectively. In South-West Region, Reach Out provided 271 children (130 males and 141 females) with treatment for acute respiratory infection, 144 children (68 males and 76 females) were provided with treatment for diarrhea and 829 persons (378 males and 451 females) with treatment for uncomplicated malaria in 22 communities in Ekondo Titi Subdivision. In the North West, CBC provided treatment for 55 children (30 males and 25 females) for acute respiratory infection, 200 children (98 males and 102 females) were provided with treatment for diarrhea, and 118 persons (70 males and 48 females) including 61 children and 57 adults received treatment for uncomplicated malaria. CBC vaccinated 950 children (450 males and 500 females) against measles and administered Vitamin A treatment for 3,136 children (927 males and 2,209 females) in Tankum, Nkavekeng, Kiyan, Bankikai, Melim and Ndezenji. In addition, 142 pregnant and lactating women (including 77 adolescent girls) received maternal care kits and 52 new born kits were given to 3 adolescent girls and 49 women caregivers. In Tankum, Kiyan, Bankikai and Melim, 1,468 households were provided with long-lasting mosquito nets (LLINs).

WASH In October, 7,886 people (3,296 males and 4,590 females) were reached with community sensitization on good and safe wash practices and 16 latrines were constructed. An estimated 31,889 people were reached with community sensitization and education messages on various WASH topics.

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UNICEF facilitated a two days training/refresher of 25 Caritas staff (national coordinator, field supervisor, social worker, WASH technician) on WASH related standards and topics.

UNICEF continue to provide support to WASH cluster/sector coordination activities at national and regional level. The WASH Cluster conducted a North-West and South-West Strategic Operational Framework (SOF) and Validation workshop in Douala on 24 October 2019.

Education In October, the Education Cluster continued to map spontaneous non-formal education initiatives targeting school- age children in North-West and South-West regions with at least 2,936 children identified as attending non-formal education. According to the Education Cluster, a number of community-based organizations provided learning materials to 1,953 children and built the capacity of 29 (18 females and 11 males) facilitators to support emergency content, facilitating learning in emergencies and helping home based learning for conflict affected children.

The number of school aged children who are attending education with a teacher trained in PSS and school aged risk mitigation, increased to 18,683 students in the North-West, South-West, Littoral and West regions. Thanks to the efforts of the Delegations of Education of West region, 60 new teachers in schools hosting IDP children, were trained in psychosocial support (PSS), conflict and disaster risk reduction (C/DRR) using the UNICEF umbrella-based methodology. An estimated 4,200 children (48% girls) have been reached by these teachers with PSS and C/DRR. UNICEF radio education scripts for literate children were successfully tested in Batoke in the Limbe II subdivision and Mbalangi in the subdivision, South-West Region. The exercise was led by members of the Education Cluster Strategic Advisory Group (SAG). Reportedly, those tested found the scripts relevant and suitable for their situation and recommended that it could be broadcast/narrowcast based on context specificity of each community. UNICEF has identified a private radio station in Douala which will be used for recording the prototype in November. Child Protection3 Child protection activities picked up in earnest during the month of October. LUKMEF, a new UNICEF implementing partner for both North West and South West Regions commenced project implementation. Additionally, DRC, a UNICEF implementing partner for the South West Region, commenced project implementation. This brought to four the number of active CP implementing partners. This represents a significant increase in the number of children reached during this month compared to the month of September. During the reporting period, UNICEF implementing partners DRC and LUKMEF working in Division, Reach Out working in Division of the South West Region and CBCHS working in Bui Division of the North West Region reached a total of 8,899 children (4,752 girls and 4,147 boys) with psychosocial support services in Child Friendly Spaces including other safe spaces and individual Psychological First Aid (PFA). A further 42 (26 girls and 16 boys) benefitted from case management services for unaccompanied and separated children (UASC). In order to increase UNICEF’s visibility in the field, the Child Protection Specialist undertook a field mission to Kumba Town in Meme Division of the South West Region to carry out programmatic monitoring of the UNICEF-supported Caritas Kumba programme as well as to carry out a Final Partnership Review of the recently ended partnership. Two Child Friendly Spaces serving over 500 children were visited.

The Child Protection Area of Responsibility (CP AoR or ‘sub-cluster’) participated in the HNO Multi-Cluster/Sector Initial Rapid Assessment (MIRA) in Littoral and West Regions to assess the numbers and needs of IDPs from North West and South West Regions. Psychological distress, unaccompanied and separated children, child labour, sexual exploitation, early pregnancies and the lack of civil identification documents were identified as some of the key child protection issues. A detailed report of the assessment is under compilation. After the MIRA, CP AoR, with assistance from the Child Protection, Yaounde, held a one-day workshop to brainstorm and draft a Child Protection sectoral analysis to feed into the HNO-HRP process.

3 Figures reported in HPM and narrative for this month are provisional. These figures will be confirmed in September. 8

Communication for Development (C4D) During implementation of WASH and Nutrition RRM activities, community health workers continued sensitizing the populations. A total of 18,236 persons in Ekondo-Titi Sub-division were reached with life-saving messages on water, hygiene and sanitation, infants’ nutrition and vaccination.

A total of 172 feedbacks and 14 complaints were received from various individuals and groups in localities of Ekondo- Titi Sub-division through implementing partner, Reach Out, interventions. Actions were taken to address complaints received.

Security In October, the security context in the Far North region remain unchanged with no improvement, consistent to the previous month. continued its activities with the same trends, characterized by acts of criminality including abduction, looting, and predatory attacks in the region. At least 23 attacks were attributed to Boko Haram and its affiliates resulting to 10 people killed, 14 injured, more than 200 oxen stolen, 40 houses and shops looted. In addition, 4 children were injured by an Unexploded Ordnance device (UXO).

The number of attacks increased in the Mayo-sava division from 11 attacks in September to 17. On 7th October, Boko Haram elements entered Kerawa village, abducting 20 civilians. Security forces recovered 3 civilians injured and the remains of 1 male and 1 female civilian earlier killed. One female seriously injured was brought to a military camp hospital for treatment. Two days after, on 09th October, an unknown number of Boko Haram members carried out an incursion into the location of Galda, killing 2 civilians, with 3 others injured, and stole food and valuables. On 15th October, armed men attacked the location of Kassa, killing one civilian and injuring another while 2 others were abducted. During the same night, the head of Tarmoua village was killed in a Boko Haram attack, with several houses looted, and stolen. Civilians in multiples locations repeatedly attacked by terrorist groups have fled to safer areas in the Mora’s subdivision while abandoned villages continue to be infiltrated by armed group individuals.

In the Mayo-Tsanaga division, the situation remains constant in number of incidents, with 5 attacks reported. On 13th October, the location of Ngosi was attacked by an unknow number of Boko Haram elements in which an elderly male civilian was killed. Multiple other raids occurred with persons injured and household assets stolen. On 18th October, a dozen armed men conducted an incursion in the location of Goledje, surrounding farmers from Moskota who had come to collect the harvest, killing 4 persons and 1 other injured. In addition, two girls and 1 woman were abducted. On 24th Boko haram ambushed 2 military members riding motorcycles with 1 military killed while the other escaped. The attackers also stole ammunitions and guns before withdrawing into the mountains.

A relative calm is observed in the Logone-and-chari division. However, one significant incident has been reported in the location of Blame on 20th October, 4 children guarding livestock were injured when they accidentally detonated an abandoned grenade they had picked up in the bush believing it was a toy. They were transferred to Kousseri’s hospital for further medical treatment. The Logone-and-Chari is one of the most affected divisions by the UXO presence. So far this year, three recorded incidents have been recorded in which children were killed or injured.

In the South-West Region, clashes, raids and random shootings were the most common kind of incident reported, frequently with civilian casualties. The Meme and Manyu division accounted for more than 75% of these incidents. In the North-West Region, abductions were the most commonly reported type of incident, followed by clashes and random shootings. Humanitarian workers were affected by many of these events though no UN personnel were directly affected. The division concentrated 91% of all the incidents reported in the North-West region.

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Funding UNICEF expresses its gratitude to the Governments of Japan, United States, Sweden, as well as CERF, DFID, Global Thematic Partners and UNICEF Spanish committee for their contributions to the 2019 humanitarian response. However, additional funding is required urgently to allow UNICEF to reach children in Cameroon affected by multiple humanitarian crises. As of 31 October, the funding gap for the 2019 Humanitarian Action for Children (HAC) plan is 75%, exposing children and their care-takers to major threats to their well-being. Short-term implications of underfunding include:

• Scaling back of cholera response activities especially in North and Far North regions—UNICEF is presently supporting 4 local NGOs in water treatment, community sanitation and hygiene awareness; current project agreements funded until end November. • Inability to respond to assessed needs for NW IDPs in Banyo and Bakim divisions of Adamaoua region (OCHA led assessments in July; UNICEF Field Office response planning mission in September) • Continued short-term humanitarian personnel status in key positions including child protection for victims of Boko Haram raids in Far North region, enhanced humanitarian coordination and response for NWSW response (Buea) • Inability to replenish emergency stocks released from Douala warehouse in late October for Far North flood response (emergency drug kits, water tanks and containers, aqua tabs and purification materials, buckets, latrine squatting plates, cholera and AWD kits, plastic sheeting, LLINs, soap, WASH and dignity kits, early childhood development and recreation kits). This will impact capacities to respond to new emergencies including epidemics.

Total UNICEF Funding Funds available* Funding gap Appeal Sector Requirements Funds Received Carry- Total available $ % Current Year Over Nutrition 6,739,200 500,039 0 500,039 6,239,161 93%

Health / HIV 5,313,886 389,926 360,610 750,536 4,563,350 86%

WASH 10,355,676 600,000 186,498 786,498 9,569,178 92%

Child Protection 9,291,240 1,860,001 27,203 1,887,204 7,404,036 80%

Education 4,181,177 1,896,358 0 1,896,358 2,284,819 55%

C4D 1,427,756 80,000 0 80,000 1,347,756 94%

Emergency Preparedness 2,021,760 1,325,065 2,600,464 3,925,529 0 0% and Response

Total 39,330,695 6,651,389 3,174,775 9,826,164 29,504,531 75%

* Funds available includes funding received against current appeal as well as carry-forward from the previous year. Non-emergency funds utilised to support emergency programming for the LCB crisis. LCB Funding Funds available* Funding gap Appeal Sector Requirements Funds Received Carry-Over Total available $ % Current Year Nutrition 3,000,000 0 0 3,000,000 100% Health / HIV 1,715,781 0 0 0 1,715,781 100% WASH 3,390,660 0 0 0 3,390,660 100% Child Protection 2,080,000 757,869 0 757,869 1,322,131 64%

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Education 1,268,233 0 0 0 1,268,233 100% C4D 571,496 0 0 0 571,496 100% Emergency Preparedness 70,403 0 0 0 70,403 100% and Response Total 12,096,573 757,869 0 757,869 11,338,704 94%

NW/SW Funding Funds available* Funding gap Appeal Sector Requirements Funds Received Carry-Over Total available $ % Current Year Nutrition 500,000 500,039 0 500,039 -39 0%

Health / HIV 1,907,044 389,926 360,610 750,536 1,156,508 61%

WASH 4,414,500 600,000 186,498 786,498 3,628,002 82%

Child Protection 2,915,000 1,102,132 27,203 1,129,335 1,785,665 61%

Education 1,446,152 1,896,358 0 1,896,358 -450,206 -31%

C4D 616,416 80,000 80,000 536,416 87%

Emergency Preparedness 8,285,000 1,325,065 2,600,464 3,925,529 4,359,471 53% and Response

Total 20,084,112 5,893,520 3,174,775 9,068,295 11,015,817 55%

Next SitRep: November 2019 UNICEF Cameroon: https://www.unicef.org/infobycountry/cameroon.html UNICEF Cameroon Facebook: www.facebook.com/unicefcameroon UNICEF Cameroon Humanitarian Action for Children Appeal: http://www.unicef.org/appeals/index.html

Who to Jacques Boyer Arsene Azandossessi Robert McCarthy Representative Deputy Representative-Programme Chief of Field Operations and Emergencies contact for Yaounde, Cameroon, Yaounde, Cameroon Yaounde, Cameroon further Tel: +23722223182 Tel: +237222505402 Tel: +23722223182 Fax: +23722231653 Fax: +23722231653 Fax: +23722231653 information: Email: [email protected] Email: [email protected] Email: [email protected]

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Annex A SUMMARY OF PROGRAMME RESULTS* National Response Overview Results (Lake Chad Basis Crisis, North-West and South-West Crisis) Sector Response UNICEF Change Overall Change since National 2019 Total 2019 Total Needs since last last Target Results Target Results report ▲▼ report ▲▼ WATER, SANITATION & HYGIENE Number of affected people with a sustainable access to safe drinking water to address their 1,296,709 811,386 107,257 8,722 110,000 14,000 0 vulnerabilities Number of affected people with an access to adequate basic sanitation to meet their 755,119 374,758 48,949 5,298 75,000 23,456 80 vulnerabilities Number of people provided with WASH kits 1,349,195 649,109 212,625 7,918 270,000 111,944 1,950 EDUCATION Number of out of school boys and girls (3 to 17 1,051,000 519,000 5,783 1,408 311,400 1,847 0 years) affected by crisis accessing education Number of school aged boys and girls (3 to 17 years) affected by crisis receiving learning 557,600 363,300 4,368 1,953 217,980 0 0 materials Number of boys and girls (3 to 17) affected by crisis attending education in a classroom where 1,051,000 476,200 24,083 4,433 260,520 18,450 4,200 the teacher has been trained in psychosocial support and/or conflict and disaster risk reduction HEALTH Number of children (6 months to 15 years) 152,587 746 526,565 204,706 0 0 266,492 vaccinated against measles Number of families / households that have 51,747 4,261 222,227 70,118 0 0 62,739 received at least 1 LLIN NUTRITION Number of children aged 6 to 59 months with 58,415 4,684 62,545 60,255 4,529 65,064 60,874 SAM admitted for treatment Performance of integrated program for severe ≥ 75% ≥ 75% 180% 0 ≥ 75% 180% 0 acute malnutrition treatment: cured rate Number of primary health facilities that deliver 809 809 839 0 702 839 0 IMAM services CHILD PROTECTION** # of children reached with psychosocial support including through child friendly/safe spaces (girls 1,007,213 563,265 204,230 21,247 289,789 105,004 12,264 and boys) # of Unaccompanied and Separated Children (UASC) identified and/or placed in alternative 9,661 7,596 7,087 321 2,611 1,832 96 care arrangements and/or who benefited from individual follow-up (SC/UAC; girls / boys) # of Unaccompanied Children reunified with 1,951 171 54 4 1,211 37 0 families (girls and boys) # of children suspected or verified associated with an armed group (including children released TBD 69 384 27 47 313 27 from detention) provided with temporary care or family / community reintegration support # of conflict affected children provided with Birth 15,121 7,030 4,218 348 4,780 1,114 45 Certificate # of children facing protection risks who receive 105,227 5,497 465 465 5,000 465 86 case management services Communication for Development (C4D) # of people reached with key life- saving & 865,698 323,907 385,000 behaviour change messages

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# of people reached by mechanisms to voice their 210,000 1,137 0 needs/concerns *All results are cumulative.

Lake Chad Basin Crisis Sector Response UNICEF and IPs Change Change Overall since since Sector 2019 Total 2019 Total needs last last Target Results Target Results report report ▲▼ ▲▼ WATER, SANITATION & HYGIENE Number of affected people with a sustainable access 179,181 165,423 49,500 0 30,000 1,500 0 to safe drinking water to address their vulnerabilities Number of affected people with an access to adequate 205,424 122,903 26,901 0 25,000 20,101 0 basic sanitation to meet their vulnerabilities Number of people provided with WASH kits 205,424 132,338 88,920 1,950 40,000 13,165 1,950 EDUCATION Number of out of school boys and girls (3 to 17 years) 440,000 213,000 2,048 0 127,800 1,048 0 affected by crisis accessing education Number of school aged boys and girls (3 to 17 years) 220,000 149,100 2,415 0 89,460 0 0 affected by crisis receiving learning materials Number of boys and girls (3 to 17) affected by crisis attending education in a classroom where the teacher 440,000 213,000 5400 0 127,800 0 0 has been trained in psychosocial support and/or conflict and disaster risk reduction HEALTH Number of children (6 months to 15 years) vaccinated 140,277 199,066 78,289 0 against measles Number of families / households that have received at 9,535 65,569 16,392 0 least 1 LLIN NUTRITION* Number of children aged 6 to 59 months with SAM 31,533 31,282 34,217 2,966 31,282 34,752 2;935 admitted for treatment in Far North Performance of integrated program for severe acute ≥ 75% ≥ 75% 90.5% 0 ≥ 75% 90.5% 0 malnutrition treatment in Far North: cured rate Number of primary health facilities that deliver IMAM 351 351 360 0 351 360 0 services CHILD PROTECTION** # of children reached with psychosocial support including through child friendly/safe spaces (girls and 501,883 273,715 152,128 8,152 133,636 74,570 3,314 boys) # of Unaccompanied and Separated Children (UASC) identified and/or placed in alternative care 1,951 1,951 2,200 149 129 525 49 arrangements and/or who benefited from individual follow-up (SC/ UAC ; girls / boys) # of Unaccompanied Children reunified with families 1,951 171 54 4 1,211 37 0 (girls and boys) # of children suspected or verified associated with an armed group (including children released from TBD 69 384 27 47 313 27 detention) provided with temporary care or family / community reintegration support # of conflict affected children provided with Birth 15,121 7,030 4,218 348 4,780 1114 45 Certificate Communication for Development (C4D) # of people reached with key life- saving & behaviour 250,000 812,997 305,671 change messages # of people reached by mechanisms to voice their 150,000 0 0 needs/concerns *UNICEF targets for Nutrition can exceed that of the sector because the nutrition sector does not cover refugee camps, whereas UNICEF covers both the camps and out-of-camp refugees.

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North-West and South-West Crisis Sector Response UNICEF and IPs Change Change Overall since since Sector 2019 Total 2019 Total needs last last Target Results Target Results report report ▲▼ ▲▼ WATER, SANITATION & HYGIENE Number of affected people with a sustainable access to 938,347 480,540 46,757 8,722 50,000 11,000 0 safe drinking water to address their vulnerabilities Number of affected people with an access to adequate 344,271 128,952 18,598 5,298 25,000 3,355 80 basic sanitation to meet their vulnerabilities Number of people provided with WASH kits 938,347 384,432 123,230 5,968 190,000 98,779 0 EDUCATION Number of out of school boys and girls (3 to 17 years) 466,000 214,000 2,936 1,408 128,400 0 0 affected by crisis accessing education Number of school aged boys and girls (3 to 17 years) 279,600 149,800 1,953 1,953 89,880 0 0 affected by crisis receiving learning materials Number of boys and girls (3 to 17) affected by crisis attending education in a classroom where the teacher 466,000 171,200 18,683 4,433 102,720 18,450 4,433 has been trained in psychosocial support and/or conflict and disaster risk reduction HEALTH Number of children (6 months to 15 years) vaccinated 122,792 122,792 12,310 746 against measles Number of families / households that have received at 86,540 28,847 42,212 426 least 1 LLIN NUTRITION Number of children aged 6 to 59 months with SAM admitted for treatment in South West and North West 2,500 2,500 54 8 2,500 28 18 regions CHILD PROTECTION* Number of children reached with psychosocial support including through child friendly/safe spaces (girls and 400,103 266,734 47,464 8,457 136,153 25,796 8,457 boys) Number of Unaccompanied and Separated Children (UASC) identified and/or placed in alternative care 4,553 4,553 4,754 39 2,000 1,174 39 arrangements and/or who benefited from individual follow-up (SC/ UAC; girls / boys) Communication for Development (C4D) Number of person (IDPs and host communities) reached with information about WASH / health / nutrition / education services (behavior/best practices) 135,000 52,701 18,236 through community-based social mobilization and/or outreach activities Number of community leaders (traditional leaders, local political leaders, religious leaders, teachers/principals, 60,000 1,137 0 etc) participating as agents of social mobilization at community level * Figures reported in HPM and narrative for this month are provisional. These figures will be confirmed in September.

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