UNICEF Mauritania Monthly Situation Report September 2013
Highlights $20,222,932 is required to respond to the humanitarian needs of children in Mauritania in 2013. A further $7,029,653 is needed to fill the funding gap of 35% to save the lives of children affected by the Malian refugee crisis and malnutrition. Mauritania is the largest recipient of refugees fleeing the conflict in Mali. 69,676 refugees* are living in the Mbéra camp, a remote desert location on the border with Mali with significant security challenges. 57% of the refugees are children and many have been in the camp for over a year, resulting in overlapping emergency and medium term needs. UNICEF, in coordination with UNHCR and partners, are providing formal and non-formal education in the camp for 7,166 children (49% girls) in six schools and psychosocial stimulation for around 5,000 children at six child friendly spaces. In 2013, 2,865 children have been treated for Severe Acute Malnutrition (SAM) by UNICEF and other nutrition actors. More funds are urgently needed to get all children back to school in the new academic year commencing in October. Communities hosting the refugees are very poor and suffer high levels of food insecurity and malnutrition. UNICEF is helping to reinforce basic services, including malnutrition treatment. The expected national caseload of Global Acute Malnutrition (GAM) in 2013 is 122,719 children under five years, including 23,901 cases of SAM. Results from the lean season nutrition survey (SMART methodology) show national rates of 12.8% GAM and 2.0% SAM, as bad as last year (lean season 2012: 12.0% GAM and 1.7% SAM). Preventative blanket feeding, cash transfers and programmes to build longer term resilience are being implemented alongside life-saving nutrition interventions providing therapeutic food and medicines. A multi-sectorial package of services is being scaled up from 291 to all 488 nutrition centres. This includes health and ‘WASH in Nut’ interventions to reinforce nutrition outcomes. Flooding affects start of new school year Heavy rains in much of southern and central Mauritania have caused flooding, particularly in urban areas, such as the capital Nouakchott. Many schools, which are due to open for the new academic year are affected and funds are being urgently sought to restore and sanitise school facilities and replace damaged materials. Special report on page 9
* http://data.unhcr.org/SahelSituation/country.php?id=132 , updated 31 August 2013. Situation Overview & Humanitarian Needs The size of the refugee population (69,676 refugees, 57% of which are children) has remained around the same level since the beginning of the year when 20,000 new arrivals crossed the border following the French military intervention. Life-saving interventions, such as treatment for acute malnutrition, measles vaccinations and the provision of clean water continue to be needed. With the camp now more than a year old, there are also medium term needs, such as more stable education facilities, that UNICEF, in coordination with the Government, UNHCR and partners, are addressing. The remote area of Mauritania, which is hosting the refugees, is very poor, suffers high levels of food insecurity and malnutrition and has limited government services. The needs of these communities are also being addressed and assistance given to reinforce basic services.
Malian Refugee Crisis – Refugees – Estimated Affected Population (Estimates calculated based on initial figures from: http://data.unhcr.org/SahelSituation/country.php?id=132 updated 31 August 2013; and SMART Nutrition Survey, January 2013) Total Male Female Total Affected Population 69,676 31,145 38,531 Children Affected (Under 18) 39,437 19,649 19,788 Children Under Five 14,354 7,177 7,177 Children 6 to 23 months 4,306 2,153 2,153 Pregnant women 3,275 3,275 Children Under Five with Severe Acute Malnutrition (SAM) 3,430 1,681 1,749 Children Under Five with SAM and medical complications 275 135 140 Children Under Five with Moderate Acute Malnutrition(MAM) 4,620 2,264 2,356
Malian Refugee Crisis – Host Communities – Estimated Affected Population (Estimates calculated based on initial figures from: Mauritanian Census 2000; results from the SMART Nutrition Survey, January 2013) Total Male Female Total Affected Population 48,639 23,911 24,728 Children Affected (Under 18) 24,319 11,955 12,364 Children Under Five 8,999 4,424 4,575 Children 6 to 23 months 2,203 1,083 1,120 Pregnant women 1,175 1,175
Children Under Five with Severe Acute Malnutrition (SAM) 224 112 112 Children Under Five with SAM and medical complications 46 23 23 Children Under Five with Moderate Acute Malnutrition( MAM) 1,754 877 877
The numbers of malnourished children being treated and benefitting from related WASH and protection interventions is also expected to rise steeply in the next few months. Chronic and recurrent acute malnutrition throughout the country is driven by underlying food insecurity, insufficient access to health care, clean water, sanitation and hygiene, poor feeding practices and lack of education on nutrition. Addressing the drivers of malnutrition requires longer term funding for resilience programmes to be implemented alongside emergency programmes.
Nutrition in 2013 – Estimated Affected Population (Estimates calculated based on initial figures from: Mauritanian Census 2000; results from the SMART Nutrition Survey, January 2013) Total Male Female Children Under Five with Severe Acute Malnutrition (SAM) 23,901 11,833 12,068 Children Under Five with SAM and medical complications 2,390 1,183 1,207 Children Under Five with Moderate Acute Malnutrition(MAM) 98,818 48,922 49,896
2 Inter-Agency Collaboration, Partnerships and Coordination UNICEF continues to work closely with the Government of Mauritania, UN partners and NGOs. For the nutrition response, UNICEF and the Government of Mauritania are co-leading nutrition, WASH and education sector coordination. In January, a CERF was funded for rapid response actions in the first six months of 2013.
Malian Refugee Crisis 2013
UNICEF and partners Sector Estimated # / % Sector UNICEF Cumulative % of Target Sector Cumulative % of Target coverage Target results Achieved Target results Achieved Children < 5 years with Severe Acute 860 730 85% 3,430 2,865 84% Malnutrition admitted to Therapeutic care Nutrition Children < 5 years with Severe Acute 690 379 55% 2,745 2,388 87% Malnutrition discharged recovered Partners: Ministry of Health, WFP, UNHCR, Médecins Sans Frontières Number of people with access to functional 24,930 a 24,930 a 100% a 68,391 68,391 100% latrines Number of people with WASH access to sufficient 11,667 a 11,667 a 100% a 68,391 68,391 100% safe water Partners: Ministry of Water Resources and Sanitation, UNHCR, Solidarites International, Intermon Oxfam, Mauritanian Red Crescent Children aged 6 months to 15 years 27,629 24,365 88% vaccinated against measles Health Households with two or more insecticide 7,309 7,087 96% treated mosquito nets (ITNs) Partners: Ministry of Health, UNHCR, WHO, UNFPA, Médecins Sans Frontières and NGOs Emergency affected children provided with Child 7,377 5,000 68% 7,700 5,000 65% psychosocial support Protection at CFSs Partners: Ministry of Social Affairs, Ministry of Health, UNHCR, UNFPA, WFP, Intersos Children with continued access to 17,000 7,166 c 42% c 31,300 7,166 c 23% c Education formal or non-formal education Partners: Ministry of Education, UNHCR, Intersos, ESD, FLM, Mauritanian Red Crescent, SOS Desert, MASEF. a Results based on provision of materials. Construction and operation of facilities are led by UNHCR and implemented with partners in the camp. b Households with one or two inhabitants received one net, households with three or more inhabitants received two nets. c Results unchanged from last month as children have been on summer holidays.
3 UNICEF and partners’ programming
Nutrition From January to September 2013, 2,865 children suffering SAM (84% of the expected case load for the year) have been admitted in nutrition units in Mbéra. UNICEF has supported the regular provision of ready to use therapeutic food (RUTF) and medicine to support the management of acute malnutrition. No stock-outs have occurred in 2013. The January 2013 nutrition survey using the SMART methodology found that 13% of children under five years were suffering from GAM. Another nutrition survey using the SMART methodology will be conducted in October in Mbéra camp to assess nutritional status, led by the Ministry of Health with technical and financial support from UNICEF in collaboration with WFP, WHO and UNHCR.
WASH UNICEF continues to make a valuable contribution to the WASH activities in the camp, which are led by UNHCR. UNICEF, through its implementing partner Solidarites International, has supported water treatment and distribution, sanitation infrastructures (showers and latrines) construction and rehabilitation, and the regular hygiene promotion sessions in the camp. Water consumption, in the zones 1 and 2 covered by Solidarities International, is around 12 liters per person per day. This month, 8 latrines and 5 showers have been rehabilitated and 127 showers constructed. 2,057 public information sessions have been conducted with participation of 18,487 people. A Knowledge, Attitudes and Practices (KAP) survey has also been conducted during this month. The main results will be shared on the next report. 18 garbage bins were installed to support the waste management in camp. To ensure the quality of water distributed in the camp, bacteriological analysis has been supported by UNICEF. 503 samples were analyzed and appropriate actions (hygiene promotion, checking of residual chlorine at water points and household level) have been taken to address those contaminated. UNICEF is supporting a national NGO (ADICOR) and MSF-B for implementation of a WASH in Nutrition programme providing hygiene materials and education for the mothers of children affected by SAM and MAM. Working closely with the National Department of Water Resources and partners, UNICEF has supported the local coordination activities (meeting, collect and sharing of information) for host communities. Through IOM and Oxfam Intermon, UNICEF has supported the distribution of water treatment product at household level (PUR sachets) to 1,231 host families, ensuring access to safe drinking water for 3 months. By signing this month, partnership agreement with Oxfam Intermon, UNICEF will support WASH activities (hygiene promotion, water point construction and/or rehabilitation, CATS) in 15 host community villages.
Health Expanded Programme on Immunization (EPI) routine activities performed at Mbéra camp continue to improve immunization coverage. The number of children less than one year of age vaccinated are: BCG: 2,787 (95%); OPV3: 2,700 (95%); Penta3: 2,559 (90%); Measles: 2,510 (88%) and a further 13,483 12 months to 18 years. 3,968 pregnant women have been protected against Tetanus receiving at least two vaccinations. 7,087 households have been provided with long-life, insecticide treated mosquito nets to prevent malaria among pregnant women and children under five. Households with one or two inhabitants received one net, households with three or more inhabitants received two nets. 811 births have been attended by qualified health workers in 2013.
4 As of August 2013, 8,380 children under 15 years received measles in Fassala transit camp vaccine before their transfer to Mbéra camp, Thanks to health kit and other basic drugs and materials that were distributed to health centers in the camp and host communities by UNICEF, many children suffering from malaria (1,576), diarrhea (9,272) and respiratory acute infection (29,576) received adequate treatment. UNICEF is working with a national NGO (AMAMI) to support Government in routine immunization in Mbéra camp as well as sensitization and integrated high impact intervention delivery in the host community. In the host community, AMAMI continue to support district team to organize outreach integrated activities. The population living in villages between Mbéra camp and the reception centre at Fassala have been given particular attention. In the last month, 104 children under one year have been vaccinated against tuberculosis, 374 with OPV3 / PENTA3 and 145 against measles.
Child Protection Together with UNHCR and Intersos, psychosocial services were provided to more than 5,000 children at six child friendly spaces in the month of September in Mbera camp. 5,684 malnourished children (SAM and MAM) received emotional support through the reinforcement of the mother-children connection in seven nutritional centres in September in Mbera camp. Training on case management and determining the best interests of children was provided with the support of the regional office to 30 participants from 7 child protection actors in Mbéra (NGOs and UN agencies).
Education UNICEF, in coordination with UNHCR and partners, is strengthening efforts to provide formal and non-formal education to children and youth in the refugee camp following the Malian curriculum. Summer courses closed on the 31 August for 1,457 primary school students. 84 candidates of secondary school continued their preparation for Malian curriculum exams, which were held on 25 September to 4 October in partnership with the ministries of education of Mauritania and Mali with support from UNICEF and UNHCR. Pre-exams exercises were held over the summer break. Preparation of the next academic year is underway including meetings with principals and preparation of supplies. 28 additional local tents are in pipeline to be used while semi-permanent classes are being constructed as funding becomes available. Youth activities in secondary school, non-formal education (literacy and vocational training) and youth accompaniment through young to young sensitizations on life skills and recreational activities are continuing. A one-day workshop was held with ESD team in Bassikounou to enhance its capacity on education implementation in a refugee’s camp context and prepare the new academic year.
C4D 48 community relays disseminate hygiene promotion messages through awareness sessions and households visits. More than 15,000 people have been reached this year.
NUTRITION RESPONSE 2013
UNICEF and partners Sector Estimated # / % Cumulative Sector UNICEF % of Target Cluster Cumulative % of Target coverage results ( #) Target Achieved Target results ( #) Achieved (Jan. to Jun.)
5 UNICEF and partners Sector Estimated # / % Cumulative Sector UNICEF % of Target Cluster Cumulative % of Target coverage results ( #) Target Achieved Target results ( #) Achieved (Jan. to Jun.) Children < 5 years with Severe Acute 23,901 6,888a 28% a 23,901 6,888 a 28% a Malnutrition admitted to Therapeutic care Children < 5 years with Severe Acute 17,925 3,695 a 21% a 17,925 3,695 a 21% a Nutrition Malnutrition discharged cured Number of health centres with SAM 488 398a 88% a 488 398 a 88% a treatment Partners: Ministry of Health, Action Contre la Faim, French Red Cross, Terre des hommes, Counterpart, World Vision, AMAMI, WFP, WHO, FAO, Ministry of Social Affairs, Committee on Food Security, UNFPA Numbers of mothers and children affected by SAM who received 23,901 5,413 b 22% b 23,901 6,205 b 26% b a WASH kit and hygiene promotion WASH Number of nutrition centres delivering the 291 105 36% 291 118 49% WASH minimum package Partners: Government of Mauritania, AMAMI, Ecodev, Moundi, Action Contre la Faim Emergency affected children provided with 15,400 9,617 62% 15,400 9,617 62% psychosocial support at CFSs Child Establishment of Protection CFSs at Nutrition 40 41 103% 40 41 103% centres Partners: Terre des Hommes Lausanne, Save the Children Espagne, Coordination des ONG et Associations de Nema (COAN), Actions a Based on partial data reported from health posts. Data is yet to be reported from some regions. National consultants have been hired to improve data collection and reporting on a regular basis b This number includes distribution of WASH kits in Gorgol to children affected by MAM as well as SAM.
UNICEF and partners’ programming
Nutrition Mauritania’s expected caseload of SAM in 2013 is 23,901 children under five, exceeding the 2012 caseload. Results from the July nutrition survey using the SMART methodology show a GAM prevalence of 12.8% and 2.0% SAM prevalence in children under five years of age. This reflects the summer peak in malnutrition with the lean season expected to continue until the September harvest. The same seven regions of Mauritania exceed the emergency thresholds in 2013 as in 2012 (GAM > 15% or SAM > 2%). In these seven regions, UNICEF provides technical support through seven qualified Nutritionists assisting the Ministry of Health on the ground to scale-up activities addressing malnutrition and improve the quality of care. Their technical support helps the Ministry of Health to increase the number of health structures with SAM activities. 43 additional health structures have commenced SAM treatment activities since the beginning of the summer lean season. To strengthen monitoring of nutrition, the National Health Information Service organized training on the new software for health information management targeting Regional health
6 directors, health information system managers, and nutrition focal points from all over the country. 34,441 children aged 6 to 23 months have benefited from blanket feeding to reduce risk of malnutrition. UNICEF continues to collaborate and coordinate the response with partners including the Government, UN agencies and national and international NGOs.
WASH UNICEF continues to support a WASH in Nutrition programme in close collaboration with the National Department of Water Resources. 183 nutrition centres were supported. This month, 496 couple mothers and children received WASH kits and instruction on how to use the supplies provided. During this month, 4,490 mothers of malnourished children benefitted from sensitization activities (hygiene promotion sessions). Also, 26 Nutrition centres have received a WASH kit of 18 kgs of soap, 15 litres of bleach, chlorine, protective clothing for cleaning (boots, gloves and masks), buckets and hand washing devices. Assessment of additional needs for existing nutrition centres not yet covered by the WASH in Nutrition programme was conducted.
Child Protection The Ministry of social Affairs, Child and Women conducted training for 150 people reinforcing the capacities of civil society and publics actors in Aleg , Boghe and Kiffa on psychosocial support for vulnerable children and child friendly space management. In Assaba, Brakna, Guidimakaha and Hodh Chargui psychosocial support through child friendly spaces and nutritionals centers was provided for 880 malnourished children (184 SAM, 696 MAM) in 6 nutritional centres. 2,548 Children attend to recreational activities in child friendly spaces. 3,272 persons attended information sessions on a package of child protection information organised in Hodh Chargui.
Education A programme monitoring the nutritional status of students and increasing awareness of malnutrition in parents associations and school management committees through local NGOs is being finalised. Much of the preliminary work has been done for the provision of snacks in 233 preschools for 9,600 children (57% girls) aged 3 to 5 years. Implementation is expected to commence in the new academic year.
HIV and AIDS UNICEF has developed a partnership with an NGO to operationalize the prevention of mother to child transmission (PMTCT) interventions in six districts including two regions affected by the food crisis and four in peri-urban areas of Nouakchott. Anti-retroviral treatment (ART) and HIV diagnosis tests are supplied to support prevention and treatment of around 100 HIV positive children and 500 HIV positive pregnant women.
SUPPLY & LOGISTICS
Supplies with a value of USD 4,218,219 have been provided in 2012 and 2013 to respond to the Mali and Sahel nutrition crises in Mauritania. This includes supplies with a value of USD 1,804,009 from 1 January 2013 to 15 September 2013. Supplies delivered contained essential commodities such as recreation kits, school-in-a-box kits, RUTF, hygiene kits, basic family water kits, water purification tabs, squatting plates and tarpaulins.
7 Funding Update
UNICEF Mauritania’s revised mid-year requirement for its’ Humanitarian Action for Children (HAC) in 2013 is USD 20,222,932. This is an increase of USD 1,336,996 from the initial requirement of USD 18,885,936 and reflects additional needs, such as the establishment of a sub-office in Bassiknou to meet the needs of children in the refugee camp and host communities. The total funding requirements include USD 16,950,981 in the revised CAP for Mauritania.
Funding Requirements Requirements Funds received in Funding gap Appeal Sector July 2013 2013 $ $ $ % NUTRITION 6,148,529.50 5,280,718.85 867,810.65 14% HEALTH 2,969,904.00 2,000,148.84 969,755.16 33% WASH 4,066,100.50 1,560,184.00 2,505,916.50 62% C4D 160,027.00 110,000.00 50,027.00 31% EDUCATION 4,104,577.00 2,358,767.47 1,745,809.53 43% CHILD PROTECTION 1,955,044.00 995,164.17 959,879.83 49% SECTOR COORDINATION 818,750.00 871,548.12 (52,798.12) -6% Unallocated 16,747.87 (16,747.87) Total* 20,222,932 13,193,279 7,029,653 35%
UNICEF wishes to express its deep gratitude to all public and private sector donors for the contributions and pledges received, which have made the current response possible. UNICEF would especially like to thank National Committees and donors who have contributed ‘unearmarked’ funding. ‘Unearmarked’ funding gives UNICEF essential flexibility to direct resources and ensure the delivery of life-saving supplies and interventions to where they are needed most – especially in the form of longer-term and predictable funding and in strengthening preparedness and resilience building. Continued donor support is critical to continue scaling up the response.
8 *** FLOODS IN NOUAKCHOTT AND SURROUNDING REGIONS ***
Weeks of heavy rains since mid-August have resulted in significant flooding in the capital Nouakchott, and the regions of Assaba, Brakna, Gudimakha, Tagant and Traza. Eight people have died as a result and 2,305 people have been displaced (OCHA). The communities that have been most affected by the disaster are those of the district of Moudjeria in the Tagant region in south-central Mauritania, where 40% of families have lost their homes (Mauritanian Red Crescent).
WASH and Education teams have undertaken initial assessments in Nouckchott on 23 and 24 September along with the Government and other partners. Preliminary findings include: Flooding and sewerage contamination of schools and health centers Destruction of archives and records Damage to electrical systems Damage to water supply systems Damage to septic systems
UNICEF’s response includes: Preparing schools to reopen this week for the new academic year by pumping out water, decontaminating buildings, repairing water supply, electrical and septic systems and replacing materials destroyed. 11 schools have been assisted to date. Health and nutrition centers will also be supported Hygiene and sanitation materials are being distributed for 1,500 households (commenced) Water treatment is being provided for 10,000 people Long-life, insecticide-treated mosquito nets are being distributed for 5,000 people (commenced) Additional, targeted community education messages provided
Internal funding and stocks have been reallocated to respond to immediate needs, while further funding is being sought.
Reallocated funding (US$) Nutrition 50,000 Health 60,000 WASH 47,411 C4D 10,000 Education 70,000 Child Protection 50,000 Sector coordination 22,749 Social Policy 19,131 Cross sectorial 26,045 Total 355,336
For further information, please contact
Lucia Elmi Aissata Ba Sidibe Anthea Moore Brahim Ould Isselmou Representative Deputy Representative Resource Mobilisation and Communications Specialist Nouakchott Nouakchott Reporting Specialist Nouakchott Mauritania Mauritania Nouakchott Mauritania Telephone: +222 45 29 01 Telephone: +222 45 29 04 Mauritania Telephone: +222 45 29 98 03 Facsimile: +222 45 25 13 46 Facsimile: +222 45 25 13 46 Telephone: +222 45 29 98 36 Facsimile: +222 45 25 13 46 E-mail: [email protected] E-mail: [email protected] Facsimile: +222 45 25 13 46 E-mail: E-mail: [email protected] [email protected]
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