EMERGENCY AND HUMANITARIAN ACTION (EHA)

WEEKLY UPDATE –WHO COUNTRY OFFICE : (week 48, 24 – 30 November September 2008) HIGH LIGHTS : • An estimated 97,000 people are affected by flooding in in the . • WHO with the logistics support from WFP is allocating Emergency Health Kits of 33.33 cbm (9,514 Kgs), valued 77,580 USD to Somali Region. • No new cases of Acute Watery Diarrhea (AWD) reported for the last two weeks, but prevention interventions remain paramount in the wake of floods.

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 insecurity and malnutrition situation. • According to WFP, although food security indicators such as livestock body condition and production are improving in the pastoral and agro-pastoral areas, recovery of drought-affected households in these areas including Oromiya and Somali regions, Afar and South Omo in SNNPR will take time as most drought affected households lost significant proportion of their livestock during the height of the drought in 2008. In crop growing areas such as East and West , parts of Bale zones in Oromiya Region, eastern and southern Tigray, Wag Humra, North/South Wello and North zones in , food insecurity continues to deteriorate due to crop failure.

• In Afar, recent report by FEWSNET indicate that critical water shortage continue to pose a challenge in the chronically water insecure areas. Regeneration of pasture is poor in most areas due to inadequate rains, which also adversely affected crops in the agro-pastoral woredas including Abala and Dulecha. The situation is anticipated to further deteriorate as the seasonal rains are not expected until March.

• According to the Emergency Nutrition Coordination Unit (ENCU), during the week, a total of 2,103 new admissions were reported from the six regions - SNNPR, Oromiya, Afar, Tigray, Amhara and Somali. New admissions continued to decline in SNNPR and some partners have started handing over TFP sites to government health facilities. Reporting rates are not consistent in the remaining five regions, which poses a challenge in analyzing the admission trends. Rapid assessments conducted by Samaritan Purse in Semurobi hotspot woreda in Afar; Goba Lafto and Mekedela by GOAL in Amhara; Wadela, Delanta and Meket hotspot woredas by SC UK indicated a need for emergency nutrition interventions in these areas. Preparations are underway to undertake nutrition interventions. Meanwhile, GOAL is planning to conduct standard nutrition assessment in Mekedela woreda in Amhara Region to ascertain the nutrition situation following rapid nutrition assessment that indicated higher levels of proxy GAM and SAM.

• Cereal prices have continued to decline since September 2008, despite over 50% increase in the price of fuel, FEWSNET and WFP report. The decline is attributed to meher harvest, availability of government subsidized wheat in the market, continued food aid programs and the extension of the PSNP program that switched most beneficiaries from cash to food beginning in July 2008. Nevertheless, despite the recent decline, the prices remain extremely high when compared to the five year average (2003-2007) and the normal year, reports WFP and FEWSNET. According to FEWSNET report, the price is anticipated to remain high throughout the coming year as the starting price for cereals following the recent harvest were about 100 percent higher compared to that of the 2007 prices. If the high prices persist, or rise, food security conditions will continue to deteriorate,

particularly for the poor urban populations; poor market ‐dependent farmers; and pastoral and agro pastoral populations that rely heavily on purchase of food. • Total case load in need for relief assistance (national) is estimated to 6.4 million by the and the total children aged under five years old in need of therapeutic feeding program is estimated to 84,000 nationally. According to WFP:  Total national requirement for relief (national): 655,815 Metric Tones (MT)  Total amount of WFP food allocated (relief): 335,632 MT  Total WFP food dispatched (relief): 293,666 MT  Total (WFP) PSNP food beneficiaries: 4 million and  Total Targeted Supplementary Feeding beneficiaries: 737,017.

Food insecurity and malnutrition response. • As of 24 th November, 16 MT of food has been airlifted and 343 MT dispatched from Nazareth by road to Gode. Approximately 90% of the October relief food allocation has been dispatched to various food distribution points countrywide. In Somali Region 12,000 MT has been dispatched to the food distribution points – 61% of October and 4% of November allocations. Outstanding logistics constraints including limited trucks and access constraints continue to impact timely distribution. • Meanwhile, during the week approximately 397 MT of blended food was provided to 15,740 beneficiaries in Oromiya and Somali Regions. • The outstanding shortfalls for relief and targeted supplementary food stand at 50,380 MT, amounting to USD 53.5 million, which has declined from the previous week following confirmed contribution amounting USD 646,831 by Finland Government.

Acute watery Diarrhoea (AWD): • No new cases of AWD have been reported nationally in the past two weeks, although the number of districts expected to report active cases stand at 7. From 1 st of January to 23 rd of November 2008, total cumulative cases and deaths nationally were 3,804 cases and 23 deaths (CFR 0.6%) reported from 54 districts in 6 regions and Municipality: 25 districts of Amhara, 14 in Oromiya; 8 in Tigray; 3 in SNNPR, 2 in Afar; 1 in Somali and 1 in Addis Ababa Municipality. Currently only 7 districts are reporting actives cases in 4 regions: 3 districts of Amhara; 2 in Tigray; 1 in Oromiya and 1 in SNNP Region. The epidemic is controlled in 47 districts.

Flooding in SNNP and Somali Regions • The recent flood from Omo river has displaced 3,045 households (about 15,225 individuals) in Decebech district. Flood affected 6 kebeles which includes Darole (1,184 households), Arkole (241 households), Agolchis (460 households), Salagn (360 households), Siyes (400 households), and Toltolee (400 households). An estimated 97,000 people have been affected by the flooding of the Wabi Shabelle river in Gode, Somali Region. Government, UN and NGOs are investigating the extent of the damage caused by the floods. The most affected areas include , and woredas in Gode zone while flooding has also hit communities in East and West Ime, , Dollo Bye and woredas.

II. ANALYSIS & HEALTH CONSEQUENCES: Health problems & Needs of affected populations. Food insecurity and malnutrition • Preliminary information from assessment teams indicated that the heavy rains in parts of the country in October and November have damaged crops and led to pre-harvest losses, which will further affect households’ recovery from acute food insecurity. In Somali region, Approximately 117,200 flood affected people in Gode, Liben, , and identified by the region to require emergency assistance.

Acute Watery Diarrhoea (AWD) • The continuous presence of risk factors such as poor quality water supply, inadequacy of health services in some districts, inappropriate sanitation, inadequate hygiene and inadequate food safety explained the persistence of the epidemic in Ethiopia.

Flooding in SNNP and Somali Regions • The floods may contribute to an alleviation of stress upon livelihoods by increasing the availability of

pasture and grazing land for livestock, however, reports indicate that there has been widespread loss of assets as well as significant damage to crops placing livelihoods under further strain in the short term.

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, infrastructure) Food insecurity and malnutrition • This week WHO has continued its support to regions in responding to food crisis in Ethiopia: a total of USD 14,295 has been allocated to Amhara Region to support assessment and health staff training on SAM management. In addition USD 6,900 is provided to Harari Region for training of health workers on SAM management.

Acute watery Diarrhoea (AWD) • WHO trained health staff on AWD case management, surveillance and community education. WHO has provided essential drugs and medical supplies to health facilities in AWD affected districts.

Flooding in SNNP and Somali Regions • WHO has deployed investigation team to Decenech district in SNNPR to evaluate the magnitude and needs of the population. WHO with the logistics support from WFP is allocating Emergency health kits of 33.33 cbm (9,514 Kgs) valued USD 77, 580 to Somali Region in response to flooding in Somali Region.

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.

IV. COMMENTS: • The zero report of acute watery diarrhea cases nationally called calls for more vigilance and strengthening of prevention aspect in order to ensure full control of the epidemic in Ethiopia. Zero report as been recorded the same period of last year and cases reoccurred eight weeks latter in Somali Region.