EHA Weekly Activity Report programme

(EHA/HAC) Weekly Report. Duty Station: Reporting Period: week 26 (23 rd June-29 th June 2008.) HIGH LIGHTS: Drought Food Security Situation The food security situation in SNNP, Somali, Eastern Oromiya and certain areas of Amhara regions continues to be of great concern. In SNNPR such coping mechanisms as reduction of meals, migration, selling of farming tools and begging are widespread. Increased admission rates to Outpatient Therapeutic Programmes (OTPs) have been reported in Kembata Tembaro and Hadiya zones. The food security situation is rapidly deteriorating in Arsi, West Shoa, East and West Hararghe zones of Oromiya Region.

Disease outbreak situation: Acute watery Diarrhoea (AWD): In week 25 a total of 146 cases with no death reported nationally from 3 woredas in 2 regions. Cases have increased by 34% in week 25 as compared to week 24.

Health Sector Coordination meetings. Health Partners Forum and Emergency Health and Nutrition Task Force meetings were held this week to discuss the current emergency. I. GENERAL SITUATION: a) Political, social, security overview for the week The impact of the drought and food security continues to be a major challenge for the government and humanitarian community in the country. Market prices of food commodities have increased and some of the coping mechanisms adopted are temporary migration to nearby towns where people end up working as cheap labourers, selling farming tools and other assets, begging and reducing meals are still being observed. No security incident this week and WHO continues to implement its activities with the FMOH and partners through out the country. b) Main events of interest/ concern for health (displacements , conflicts, disease outbreaks, etc .)

Drought FOOD SECURITY • Oromiya - Food insecurity is becoming worse in Arsi, West Shoa and West districts except for Siraro zone where the situation is now under control due to the ongoing food assistance and nutrition interventions. There is new army worm infestation in 14 woredas of Arsi, although Bale zone now has the armyworm under control. Food insecurity is worsening due to the death of livestock, high grain prices and low livestock prices. In Arsi zone, food aid monitors witnessed wild food ‘sama’ (hard nettle plant) being consumed.

• Southern Nations, Nationalities and Peoples Region (SNNPR ): There was an armyworm outbreak on maize and sorghum crops and pasture land in six zones. Rainfall was reported normal in most woredas. Land preparation for Meher crops has started, although shortage of seeds and fertilizer pose problems. Market prices of food commodities are still high. Some of the coping mechanisms adopted are temporarily migrating to nearby towns where people end up working as cheap labourers, selling farming tools and other assets, begging and reducing meals, are still being observed. Malnutrition seems to be getting worse in Hadiya, Kembata and Tembaro zones with increasing admissions to the outreach therapeutic programmes (OTPs).

• In the : In Jijiga, locally produced food items like maize and sorghum are totally absent in the local markets of Fik and Hamaro due to crop failure. There is limited supply of imported food like rice, wheat flour and spaghetti. Prices of

imported foods are very high compared to what it was in May 2008. Livestock prices have decreased owing to low demand. - In Gode zone rapid increases in the number of malnutrition cases have been reported in all woredas. Five children died in Libahle and Kudale woredas after eating wild fruit because of food shortages. In East Imey woreda, livestock were dying after eating pasture with armyworm lava. Availability of local food has declined as a result of failed local production. Imported foods, including rice and wheat flour, whose prices are increasing, are used as staple foods. The most affected are families with limited livestock and low-income before the drought. The April 2008 relief food allocation which was dispatched has minimized food insecurity; however, it appears that a short-term improvement is unlikely to fully meet increased needs of the affected communities.

- Degehabur – There is no general water shortage as recent Gu rains have replenished water points for the time being, although the quantity of water in birka (local water source) dependent areas is of concern. Livestock conditions remain poor due to inadequate pasture during the poor Gu season combined with the effect of the long dry Jilaal season. Pastoralists are migrating out in search of pasture. Demand for livestock is low, especially cattle for restocking, as people fear the animals may not survive. Zonal authorities in Degehabur reported severe food shortages in some kebeles (villages), which have been exacerbated with people migrating here from parts of Gode and Fik zones.

- Kebredehar – An increased number of severely malnourished children in Kebredehar hospital was reported by the woreda health bureau. Most of the local water sources (Birkas) have dried up in the pastoralist Birka dependent areas. Livestock body conditions have not recovered. Begging, reduction of meals and selling personal assets continue as coping mechanisms in the area.

Acute watery Diarrhoea (AWD): In week 25 a total of 146 cases with no death reported nationally. Out of the total cases reported 121 cases & Amhara 25 cases. Three woredas are reporting AWD cases currently ( & Hawas from Oromia & Takusa woreda from Amhara region). An increase in the number of reported cases have been observed from weeks 23 to 25 (see table and graph below). As of week 25 a cumulative total of 767 cases and 9 deaths have been reported from 17 districts in 4 Regions. Major of these cases (56%) have been reported from Oromia Region. Increases in the weekly incidence of the disease have been observed from weeks 23 to 25 nationally with 19% of the cases reported in week 25 ( see table 1 below). The number of affected districts reporting cases has been fluctuating from 4 districts in week 22, three districts in week 23, and five districts in week 24 and 2 districts in week 25.

Table 1. Distribution of AWD cases and deaths by Region and epidemic weeks. Regions Week 22 Week 23 Week 24 Week 25 Cumulative total

14/1- 15/6/2008

Case death Case death case death case death case death

Amhara 14 1 37 0 35 0 25 0 239 3 (CFR1.3 %)

Oromia 25 0 0 0 16 0 121 0 429 1 (CFR0.2%)

Somalia 0 0 0 0 0 0 0 0 84 5 (CFR 6.0%)

Total 39 1 37 0 51 0 146 0 767 9 (CFR 1.2%)

Source: FMOH June 2008

(Indicate affected areas, populations (number and type), access and (potential) effects on WHO activities)

II. ANALYSIS & HEALTH CONSEQUENCES: Health problems & Needs of affected populations. Drought: FOOD SECURITY • WFP plans to resource some 80 percent of the annual relief requirements (591,000 mt) for 4.6 million beneficiaries. The current shortfall for the national relief operation amounts to some 380,000 mt. The current shortfall for WFP’s input to the national relief requirements amounts to 262,000 mt valued at US$212.4 million. Due to shortage of food, WFP was obliged to support the government to prioritize assistance to the most acutely affected districts. It was reported that only half of the relief caseload can be reached in June/July 2008. Based on the hot spot list, WFP has been working with the Disaster Prevention and Preparedness Agency (DPPA) to prioritize relief distributions during June to September 2008, considering the inadequate resources. Priority was given to woredas which are priorities 1 and 2.

• Further food assistance to drought-affected PSNP beneficiaries will depend on the availability of food resources to the programme. WFP’s contribution to the PSNP faces a shortfall of 90,000 mt of cereals valued at US$72 million for three months’ food assistance.

• WFP finalized a proposal for a grant of US$10 million from the Central Emergency Response Fund (CERF) for general relief food distributions. During January to June 2008, some 113,065 mt of mixed commodities (cereals, pulses, oil and blended food) have been allocated under the relief component, and an amount of 67,722 mt dispatched to date. Acute watery diarrhoea: AWD is still being reported from three woreda of Oromia & Amhara three regions. The risk factors contributing to the transmission of AWD (inadequate safe water, poor personal & environmental hygiene) are still the major challenges to combat the problem in the affected communities. The needs of the affected population are access to adequate health care, portable water supply, proper sanitation facilities and improved hygiene practices.

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) Acute watery diarrhoea The Health Partners Forum of the health cluster meeting led by WHO was held on the 26 th of June 2008. Most of the participants raised & discussed in detail the recurrence of AWD & activities so far conducted to address this problem. It was noted that the interventions so far conducted has not brought impact on the risk factors contributing to the transmission of AWD. Therefore the participants agreed to work with FMOH to assess the situation & strengthen coordination, surveillance & hygiene promotion activities.

Other health threats Measles : Three cases of measles have been reported from N. Shoa zone of Merabete woreda. As of 22 June 2008, the cumulative total has reached 7251 cases & 17 deaths with CFR of 0.2%. WHO in collaboration with UNICEF, FMOH and RHBs are planning for mass SIAs in Western and central Oromia, Gambella and Benzangul Gumuz.

Coordination The Health Partners Forum of the health cluster meeting led by WHO was held on the 26 th of June 2008. Most of the participants raised & discussed in detail the recurrence of AWD & activities so far conducted to address this problem. It was noted that the interventions so far conducted has not brought impact on the risk factors contributing to the transmission of AWD. Therefore the participants agreed to work with FMOH to assess the situation & strengthen coordination, surveillance & hygiene promotion activities. In addition the participants discussed the current decentralisation of moving SAM cases from TFCs to OTPs and stabilisation centres. The meeting agreed that humanitarian partners should continue to work with FMOH to be able to reach these children where ever they may be. These concerns should be conveyed to both EHNTF and UN technical officers’ coordination meetings. b) Other partners action and ongoing programmes

UNICEF provided support to respond to the deteriorating food security situation in SNNP, Somali & parts of Oromia. They have incorporated emergency preparedness plan on the annual work plan of regions, distributed IEC materials on AWD prevention & control prepared in different languages. In addition Therapeutic foods and drugs have been dispatched to Oromia and SNNPR. They have also worked towards Improvement of water supply in collaboration with Ministry of Water Resources and provided water tankering to water shortage areas of Guraghe zone.

MERLIN: They have deployed team to assess the health & nutrition status of Dire, & Teltelle Woredas of . Plans are under way to assess the situation in SNNPR but since there are other NGOs conducting the assessment, to avoid duplication they are waiting for the result. Ethiopia Red Cross: Four months distribution plan have been prepared for food distribution in Damote & Bolososore Woredas of Wolayta zone in SNNPR . They have distributed the one month food ration. World Vision: Have opened four OTPs & one stabilization centre and admitted 75 malnourished children to the OTPs and 3 in stabilizing centre in Humbo Woreda of Wolyta zone. Provided training for health staffs & orientation to community volunteers and HEWs. Additionally in Hadiya zone Badwacho district established 10 OTPs and 2 stabilization centres that serves 1200 children. Concern: Supporting nutrition programme in 3 Woredas of Wolyta zone. Trained 48 health workers and scaled up establishment of OTPs. Conducted nutritional survey in South Wollo zone Dessie Zuria Woreda and recorded 12% GAM & 0.5% SAM. IV. COMMENTS: