A joint mission report to Gumbi Bordode and Miesso woreda of Date:3-4 June 2020 Participants: Plan International, CARE and OCHA

5 June 2020

Executive Summary

The IDPs in Burka Anani kebele of Gumbi Bordode woreda were displaced from their original place Ta’a Gumbi kebele across the border with Afar region in February 2020. The IDPs counted over three months in this new place. A total of 740HHs(3700 people) were displaced and dispersed in three locations: Burka Anani(240HHs),Sama(255HHs) and Aragessa(245HHs).The IDPs in Burka Anani site is the one visited by the team. According to our observation, these IDPs can be considered as neglected population with critical and huge humanitarian needs among which food and water were put on the top.

The IDPs reported not receiving food for the last 3 months except the one-month half ration they received from town community as a part of people to people support.

Access to water is very challenging. In addition to the need for long travel of over 10 Kms, security remains a major concern hindering/frightening women not to travel alone to fetch water.Reportedly,some armed men has to travel to the river early in the morning(starting from 6am) to patrol the area before the women and children go to fetch the water . The women and children will follow the men starting from 7am and the families who remain at home remain worried until all return around noon.

The IDPs are not getting basic health services. No health post in their current location and outreach services from HEWs based in Gololcha has been compromised due to the security. Reported death of one child due to measles and some 7 who fall sick are under traditional treatment. There was no COVID-19 awareness provided to them. Very few who have access to radio have got minimal information about COVID-19.

The IDPs reported that all their properties were burnt with their houses and women are reporting critical need of cooking materials and NFI needs including clothing, blankets, matts and shelter materials.

Miesso IDPs also reported having critical food shortage and access to water. They only get water once in a week time with no fixed schedule and when it comes is always after the mid-night and very few are chanceful to collect before it goes. The two rotos (10,00lt capacity) in Genda Buno/Mieso IDP resettlement site are empty since WV and IRE stopped water rationing. Hand washing practice during this time of COVID-19 is impractical at this site. Mieso IDPs also claim of critical food shortage resulting in child malnutrition case increase. According to the report from IDPs Women representative, in two weeks’ time,9 children from the site were admitted to SC. Lack of TSF supply for screened MAM children was also raised as a problem aggravating the SAM cases. Contextual Analysis

About 740 IDPs (3700 people) who were displaced on February 23 from Ta’a Gumbi kebele across asphalt road from Bordode to Awash check point bordering with Afar region are scattered in three different sites(Aragessa,Burka Anani and Sama) across the sides of Gumbi mountain and close to Awash river valley. According to the IDPs of Burka Ananai kebele, they used to encounter conflict with the Afar people several times but managed to defend and stay at their original place they inherited from their ancestors. The first round organized attack was made in July 2019 where some of their houses were burnt and left 3 dead but managed to restore. Reportedly, the second-round war which was opened on 23 February 2020 was completely different from all the previous types. According to the IDPs representative-Mr Abdi Asabot, a well-organized and armed people with latest weapons opened a fire on 22th of February early in the morning killing 7 people at a place. He said that they expected similar conflicts they used to but found this time war completely different. Mr Abdi said, “We lost 11 people in half a day. The war longed the whole day and continued the second day. The Police who came to sustain peace were also attacked. They lost 7 of their members. Starting from the 2nd day, we informed our children and women to leave. After 3 days of heavy fight, we were forced to leave our beloved place and scattered in the bush. They destroyed all our properties including School, water and animal health posts estimated to 7 million birr. We used to get food support from WFP a year before and two times from the Government starting from August 2019 until the displacement time. But, for the last three months we didn’t get food and encountering critical challenge in accessing water.”

According to the report from the woreda DRMO, these IDPs are dispersed across three kebeles of the host community: Aragessa kebele-245HHs (1225 individuals);Burqa Aananii kebele-240HHs(1200 individuals) and in Saama kebele-255HHs(1275 individuals).The Burka Ananani kebele chairman reported that they still face threats and living in an insecure condition. He reported that on 2 June,30 of their abandoned houses were burnt by the Afari’s. Access to water is highly compromised due to long distance and insecurity.

On the other hand, measles epidemic is currently the major PHEM of the zone with significant increases in Gumbi Bodode and Miesso woredas. According to zone Health Office report, a total of 2768 measles cases were reported from 192 kebeles in 13 woredas of the zone with 17 deaths. Majority of the cases were reported from Oda Bultum 621 (22%) followed by Gumbi Bordode 301 (11%), 300 (11%), Mieso 259 (9%), Tullo 220 (8%), 213 (8%), 209 (8%) and 191 (7%).New case has been reported from Dobba as well. Following a vaccination campaign conducted in three woredas, currently, the outbreak has been interrupted in Boke, Gemechis and Oda Bultum weredas.69% of the measles cases are children under 5 years of age .51% of the cases were not previously vaccinated at all while 42% were vaccinated at least once. Out of the 17 deaths, Gumbi Bordode counted 7 and Miesso 3. Mieso health office reported that additional 6 community deaths have been reported but to be verified yet.

Low measles vaccination coverage (≤ 51%), vaccine failure (expected 15% of primary vaccine failure when given at 9 months),unexpected (e.g. cold chain problems, poor quality of vaccine, etc.),high population mobility, cultural practice which prevent isolation of infected children and poor coordination were identified as major risk factors for recurrent and further spread of the outbreak. Moreover, shortage of supplies; Antibiotics, Lack of operational costs to conduct mass treatment campaign and lack of supportive supervision and logistics have also contributed to the poor management of the disease. The zone health office also warned that Measles Outbreak could be out of control and associated increase in malnutrition during the hunger season is also an alarming issue as already being reported from some woredas.

On the zonal coordination meeting of 2 June 2020, a joint mission to Gumbi Bordode and Miesso was recommended and a team from Plan International, CARE and OCHA made a visit to Gumbi Bordode and Miesso woreda from 3-4 June 2020.

Mission Objectives

✓ To observing the existing situation of IDPs in Burka Anan kebele and identify needs ✓ To assess the IDP situation in Miesso resettlement site ✓ To assess measles situation in Gumbi Bordode and Miesso woreda

Assessment Methodology ✓ Direct Observation ✓ Key Informant Interview ✓ Small group discussion ✓ Secondary data collection from woreda sector offices ✓ Discussion with woreda sector offices Findings and conclusion IDPs at Burka Ananai kebele

✓ The IDPs at Burka Ananai were displaced from Ta’a Kura kebele on 23 February 2020 by a well organized and armed Afari militia/solder for territory expansion. This was a 2nd well organized attack. The 1st one was in July 2019. ✓ The root cause for the invasion was territory expansion, water and pasture resources strategy for contrabandist’s. The kebele chairman also reported that Ta’aKura was a strategic detour for smugglers to bypass the Awash check point. ✓ The current location is at 27Km from the woreda capital Bordode but in a hard to reach area ✓ The security situation in the area is still critical. Freedom of movement is constrained, and women can’t go to fetch water without the escort of armed men ✓ As already explained in the context analysis, these IDPs (240 HHs) are in critical humanitarian needs ✓ A total of 740HHs (3700 people) were displaced from Ta’a Kura kebele and scattered across three adjacent kebeles: Burka Anani- (240HHs-1200 individuals), Sama (255HHs-1275) and Aragessa(245HHs-1225). ✓ The IDPs reported having critical water shortage after they were displaced from their original village, Gumbi Ta’aa where there was a natural spring called Oda Bute which is suitable for drinking ✓ Access to water is very challenging. In addition to the need for long travel, security remains a major concern hindering/frightening women not to travel alone to fetch water.Reportedly,some armed men has to travel to the river early in the morning(starting from 6am) to patrol the area before the women and children go to fetch the water from Burka river-not clean . The women and children will follow the men starting from 7am and the families who remain at home remain worried until all return around noon.

Priority needs identified by the IDPs in the order of ranks

1. Food and Water 2. ESNFI and household utensils 3. Health services both for human and livestock 4. Peace building by the government of the two regions to let them go back to their original place-local level peace building process has been saturated

Support and Services provision, gaps and recommendations 1. Food ✓ The IDPs of Burka Anani used to get food from WFP until July 2019 when they were at their original place. From July 2019 until February 2020 they received food from the Government only 2 times and no food provided for the last three months of their displacement. But few kilos of rice (10kg/HH) was provided once from Badessa community during the month of Ramadan. ✓ The IDPs reported exercising coping strategies like decreasing of number of meals and meal size, Loan and selling of shoat in low prices during this time of affected market chain due to COVID-19 ✓ Increased report of malnutrition due to food insecurity-the woreda level MAM proxy GAM was reported over 20% ✓ IDP of Miesso are also in critical need of food. WFP stopped providing food without their knowledge and they got food only once during the last three months. The last round was provided 2 weeks a go which is not a full package-lack pulse and CSB.Same is true for resettled IDPs in Gumbi Bordode Recommendation ✓ Woreda and Zone DRMO to urgently consider these IDPs for food assistance as an IDP and to write a letter to RDRMC and FDRMC the criticality of food assistance to this forgotten community ✓ Until this process is finalized, the Zone DRMO in consultation with the RDRMC should provide food from contingency/reserve fund at regional level 2. NFI ✓ The IDPs reported that they lost all their household properties including household utensils and NFI materials ✓ Majority of the IDPs are observed living in a house like makeshifts ✓ Since their arrival, Red cross supported with partial NFI to only 150 HHs. Recommendation ✓ Urgent ESNFI response to the remaining 590HH in the three IDP sites (Burka Anani, Sama and Aragessa) ✓ ESNFI sub-regional cluster to conduct detail need assessment 3. Health • IDPs in all the three sites were not getting basic health services • HEWs outreach visits from Gololcha has been compromised due to security • No HP in the visited kebele • Poor vaccination, Antenatal and post-natal care service provisions • Travel to Gololcha HC to get health service is rare due to long distance • Poor Community Awareness on Hygiene and Sanitation as well about COVID -19. No awareness has been given on COVID-19 • Measles outbreak (8) confirmed cases in the visited kebele with one death report. • They rarely get ambulance services during delivery mainly due to network problem and poor road access. In most of the cases, delivery is done by TBA. • Woreda health office reported that there is a shortage of HEWs mentioning that there is a kebele of 10,000 population with only 1 HEW service. No budget to hire additional HEWs and even no supply of HEWs on the job market (training has stopped) Recommendation ✓ There should be 1 HP at kebele level with the provision of security protection to ensure the safety of HEWs ✓ Outreach service of health service providers should be strengthened from Gololcha to these sites ✓ AAH to expand their MH&N services to the IDP sites apart from the Gumbi Bordode resettlement site or ✓ Need for additional partner with MH&N programs to serve such IDPs with poor health infrastructure ✓ Ensuring immunization and screening coverage in these IDP sites is crucial ✓ Critical need for Awareness creation on COVID-19. The woreda Health office with the support from partners operational in the woreda should reach every corner of the population with COVID-19 awareness creation intervention ✓ Hygiene materials to help prevent COVID-19

4. Water • In the visited IDP site, access to safe drinking water is a critical challenge due to long distance (5-6 hrs round trip) and insecurity • Women and children spent half of the day to look for water under psychological pressure of insecurity • Both human and livestock uses unsecure surface water from the same source-Burka river which is also seasonal • No WTCs has been provided and there is also a problem of water containers • No knowledge, practice and availability of water for hand washing in the light of COVID-19 • WASH response is crucial including WASH NFIs-Jerricans, soap, WTCs etc • Woreda water office mentioned that the entire Water coverage of the woreda is critically low. Only 7 kebeles out of the 29 kebeles of the woreda have access to water. No potential for water system expansion except utilizing the potential of underground water through construction of deep whale • There is a critical water shortage in Gumbi Bordode town. The existing water system was designed 45 years ago for a population of 300HHs.The current population of the town is nearly 1500HHs • A water project to the Gumbi Bordode IDPs resettlement site by CARE from the EHF funding couldn’t be completed due to the critical complaint from the host community. These IDPs are without water since they were moved to the site (over 6 months). • Very poor Facility WASH services. Only 1 out of the three HC in the woreda have water and deliveries in Bordode HC is mostly done without water or using purchase of 1 Jerrican from Hardim for 30 Birr • No water trucking in Gumbi Bordode at the moment Recommendations ✓ Until sustainable solution is obtained, there is an urgent need of water rationing to these IDP sites as well as to IDPs in Gumbi Bordode resettlement site and Mieso site asap during this critical time of COVID-19. ✓ Provision of a 10,000lt roto in the three IDP sites of Burka Anani, Haragessa and Sama ✓ WASH NFI provision for 740 HHs of IDPs from Afar border ✓ Need for hygiene promotion in line with the COVID-19 responses to those IDPs from Afar border ✓ WASH cluster, woreda water office, zonal water office and regional water bureau to critically consider water provision primarily to the IDPs and to other kebeles of Bordode woreda ✓ As a lasting solution, water bureau should consider Bordode woreda as priority I water needy woreda and allocate budget to improve water provision to the remaining 22 kebeles and priority to Bordode town. ✓ Gumbi Bordode woreda administration to resolve the conflict of interest among the resettled IDPs and the host community and let the water project to the IDPs resettlement site of Gumbi Bordode be finalized. The woreda and zonal water office and CARE to critically follow this case. ✓ The woreda and zonal water office should make a though study and produce project proposals for water provisions in Gumbi Bordode woreda ✓ Oromia water bureau to speed up the promised water project to Gumbi Bordode town-need for follow up of the regional WASH cluster

5. Education • No school facilities in the Village. However, the community constructed school through community Contribution in Gumbi kebele • Now, all children are out of school due to COVID-19 and there is no alternative means to educate these children Recommendation • Need to construct 1 first cycle primary school (1-4) at Burka Anani kebele • It is good to consider ABE as these community are pastoralist

6. Protection • IDPs who were displaced from Afar border are still in critical security problem. There is no freedom of movement • Women are escorted by gunmen while they go to fetch water • Burning of houses continued • All the family are under stress condition when a group of the community go for water fetching until they return safe • The IDPs are not getting basic services-health, food, education, shelter • They are in makeshifts and in undignified living condition-insecure from wild animals attack as well • Majority of them are worried about the properties they lost and under psychological pressure of how to fix their distorted life • HLP is a major quest of the IDPs Recommendation • Government to aggressively work on building peace and sustain security • Partners with protection responses to be attracted to the woreda-protection cluster to prioritize this woreda

Issues from Miesso IDP resettlement site

✓ Critical food shortage. WFP is not providing food since last 3 months. Since then, they received one-month ration from the government which was not full basket-lack pulses and CSB ✓ Some 39 HHs are in plastic sheets. Reportedly,24 houses constructed for the IDPs is occupied by border IDPs from Kurfa Sawa kebele and the woreda administration is either not willing or not in a position to solve the problem ✓ Critical water problem in the site. They get water only once in a week time and water rationing has stopped. ✓ WASH responses particularly hygiene materials are the most requested by women ✓ The IDPs are worried about their future and request what livelihood recovery programs are there for them to lead their future life ✓ Increase in malnutrition case reported. Reportedly, in 15 days’ time,9 children were admitted to SC ✓ Access to health service is challenging as they can’t afford to pay and the health clinic around them has no proper medicine except paracetamol. At HC, they are requested to pay. ✓ Need for cash responses to cover some expenses and purchase clothes for the kids during holidays-at least once in a year ✓ Lack of kitchen ✓ Quite large number of mental illness reported by IMC and their health team have helped in treating some of them by bringing psychiatrist ✓ No electricity supply for the IDPs ✓ COVID-19 impacted their means of income from daily labor

Recommendation

✓ DRMO and WFP to ensure consistent and timely food provision ✓ Durable solution WG to be active in the zone and seek ways to livelihood recovery of the IDPs ✓ Possible means of IGAs to be availed to the IDPs as part of durable solution ✓ Possibility of free health service to the IDPs must be sought ✓ Provision of Water rationing at least during this critical time of COVID-10 ✓ Construction of communal kitchen-at least 1 for 4 HHs ✓ Partners with Mental health and psychosocial support needed ✓ SMS support is needed

Figure 1: Discussion with Mieso IDPs in Mieso IDP camp

Update on Measles epidemic 1. Discussion with Mieso woreda PHEM representative o 287 measles cases reported currently with increasing rate in the past 2 months o 3 clinical deaths (Harkoncha, Weltane and Agemse Chele kebeles) and 6 community deaths reported-yet to be verified o The affected kebeles are 17 out of 39 o Mini vaccination campaign has been conducted covering only 50% of the kebeles o Conducting house to house surveillance in 15 kebeles o V-A supplementation done but not enough o Proposal submitted to the zone health office for the need to conduct measles vaccination campaign in all kebeles o Obtained logistic and health equipment from CARE and IMC.

Challenges and gaps

o Ice Pack related challenge o Vaccine carrier o Vaccine shortage (Government role) o Low vaccine efficacy which may be resulted from under dose and cold chain or other technical problems o Shortage of V-A provision o Capacity building for health professionals at all level

Future plan of action

o Waiting for vaccine to conduct mass vaccination campaign especially for under 2 years of age o Strengthen health and nutritional services in Mieso IDP camp considering it as the 34th kebele of the woreda

2. Discussion with Gumi Bordode Woreda Health office head o Measles case is alarmingly increasing since last two months o A total of 334 confirmed cases with 7 deaths reported to the woreda/On the average over 20 cases being reported weekly. This based only on those reports through the line list. The weekly report shows more cases. o 22 kebeles affected out of 29 o Due to many hard to reach areas, measles vaccination coverage has been compromised contributing to this time epidemic. Moreover, poor cold chain management and maladministration have contributed to less efficacy of the vaccine o High malnutrition cases-Over 20% of proxy GAM for MAM cases aggravating the measles cases-some of the measles cases were those children who have been admitted to SC. o Critical WASH shortage both at HH and health facilities Response made so far o Mini vaccination campaign conducted in three kebeles o CARE supported with some Drugs like Amoxicillin, TTC o AAH supported with logistics and campaign in the resettlement site

Challenge and Gaps

o Medicament Planning figure challenge-population figure at woreda and officially known at regional is mismatching. Over 170,000 at woreda level vs 91,000 officially known at regional level!-Census related challenge ➢ Lack/shortage of vaccine and medicines ➢ Lack of budget at woreda level and no support from the zone during the mini-campaigns- woreda couldn’t pay perdiem except fuel cost ➢ Inaccessibility of kebeles in hard to reach areas ➢ Lack NGO with a potential of multipurpose projects ➢ Critical water shortage in 22 kebeles of the woreda ➢ Capacity of HEWs while administering vaccination

Recommended Actions

➢ Health Bureau to provide vaccination as soon as possible to conduct mass vaccination in all affected and surrounding kebeles ➢ Logistic/vehicle support from partners during the vaccination campaign ➢ Reaching on consensus to adjust population figure for planning of medicine and vaccines ➢ Strengthening CMAM programs ➢ Long-term plan by the government for road construction to those hard to reach areas ➢ Capacity building of HEWs on vaccine administration ➢ Improving cold chain management by availing sustainable power for refrigerators-could be use of solar energy at all HCs.

Annex

Assessment team

# Name Organization Position E-mail Telephone Remark 1 Yoseph Kanaa UNOCHA HAO kanaafayissa 0911698989 Team @un.org leader 2 Alemayehu CARE Emergency Alemayehu.G 0966365007 member Gashaw Officer ashaw@care. org 3 Shiferaw Kenea Plan Sub-oofice shiferaw.kan 0916872302 member International head ea@plan- international. org 4 Amadin Gumbi Bordode EW expert 0908323896 DRMO 5 Abdi Miesso woreda EW expert DRMO List of people contacted 1 Abdi Assabot Burka Anani IDP Kebele 0928208303 chairman 2 Zeid Ashenafi Gumbi Bordode Vice woreda 0914451721 administrator 3 Hawa Dadhi Burka Anani IDP Women representative 4 Dagne Hailu Gumbi Bordode woreda health 0936222158 office head 5 Aliyi Mohammed Gumbi Bordode Water office 0918918275 head 6 Cherinet Assefa Miesso woreda DRMO 0910103488 response team head 7 Yasin Mohammed Miesso IDP IDP 0914954165 representative 8 Momina Jibiro Miesso IDP Women 0996214499 representative 9