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Oxfam America In partnership with Rapid Public Health Assessment of Internally Displaced Populations Due to the Conflict in Southern Ethiopia July 6, 2006 Contact Information Jennifer Chan, MD, MPH [email protected] Hani Mowafi, MD, MPH [email protected] Gregg Greenough, MD, MPH [email protected] Mike Van Rooyen, MD, MPH [email protected] Harvard Humanitarian Initiative 651 Huntington Ave. 7th Floor Boston, MA 02115, USA (617) 432-6265 (phone) Section Page Acknowledgements 3 Executive Summary 4 Introduction 5 Background 6 Methodology 9 Results – General 12 Results – Dugda Dawa 13 Results – Arero 16 Results – Qarari 19 Results – Derme 22 Recommendations 25 Limitations 29 Conclusions 30 Appendix Estimate of Household and Total IDP Population A.1 Summary Calculated Needs of IDPs A.2.1 Detailed Calculated Needs of IDPs A.2.2 Dugda Dawa data summary table A.3 Arero data summary table A.4 Odo Shakiso-Qarari data summary table A.5 Odo Shakiso-Derme data summary table A.6 List of Humanitarian Actors and their Capacity in Region A.7 Notes from discussion with MSF-Greece re: MSF-Greece Plans in Odo Shakiso A.8 region Acknowledgments We are very grateful for the kind assistance and support we received throughout the preparation, field assessment, and completion of this public health rapid assessment in Southern Ethiopia. Sincere thanks to the Oxfam America staff in Addis Ababa whose experience in the region, patience during our assessments and stamina for long days of interpretation provided invaluable assistance to the success of this project. As part of Harvard Humanitarian Initiative (HHI) we are grateful for the opportunity to assist Oxfam America (OA). We hope that this assessment will aid in its response to internally displaced populations affected by the Southern Ethiopia conflict. In addition to thanking the OA Ethiopia staff, OA Boston staff, Ethiopian Red Cross Society and its dedicated volunteers, and internally displaced communities, we would like to thank the following individuals: Abera Tola, Nazareth Fikru, Salehu Sultan, Dawit Gatato, Osman Hassan, Liz Lucas, Brett Eloff, Gregg Greenough, and Mike VanRooyen. Sincerely, Jennifer L. Chan, MD, MPH Hani Mowafi, MD, MPH 3 Executive Summary A humanitarian crisis is developing in Southern Ethiopia with tens of thousands of people internally displaced due to the recent conflict in the Guji and Borena Zones. The Ethiopian Disaster Prevention and Preparedness Committee (DPPC) estimates up to 150,000 people have been displaced since the outbreak of violence on May 30th, 2006 (the actual number may be closer to 100,000.) The intra-ethnic and inter-ethnic violence represents a marked change in the pattern of an ongoing low-level conflict. As a result, large populations have been displaced over thousands of square kilometers between the Guji and Borena Zones with internally displaced persons (IDPs) moving towards areas where their clans predominate. The movement has resulted in severe disruptions of livelihoods and thousands of people left without food, shelter and essential non-food items such as water carrying containers, blankets and materials for cooking. Humanitarian Condition of IDPs In several locations people have been displaced for over a month and are beginning to show signs of under-nourishment and illnesses associated with exposure to harsh environments and degraded living conditions. Many fled for their lives leaving behind all assets; others have had their assets taken during their displacement. Others have brought livestock with them although looting, lack of access to water and heavy pressure on grazing lands in their new locations have contributed to severe losses of livelihoods. Humanitarian Needs An immediate response plan is needed to meet the emergency relief needs of this population including food aid, blankets, jerry cans and plastic sheeting for temporary shelter construction. Technical assistance will likely be needed in the areas of water and sanitation, especially for IDPs settled in or near urban areas. Many IDP communities are currently at critically low survival levels of water consumption (2-3L/person/day). Excreta disposal remains a problem for populations that are in close quarters with their animals. Although no outbreaks of disease were observed, risks for communicable diseases are a real risk. Protection will be a crucial issue for IDPs, both in their current locations as well as in their home villages. There is a perception by many that they are being pressured by the Ethiopian government to return to their villages; most remain fearful of violence and state that they don’t feel adequate measures have been taken to ensure their safety upon return. Peace-building efforts have not yet begun and it is clear that the displacement will last for weeks to months. Plan for Action Oxfam America (OA), its affiliates and its local partners are well positioned to take a lead in assisting this vulnerable population. The Rapid Public Health Assessment (RPHA) below developed by the Harvard Humanitarian Initiative (HHI) for OA highlights the most pressing needs of these communities and of vulnerable sub-groups within them. OA’s local partner, the Ethiopian Red Cross Society (ERCS), has a long history of assisting populations displaced by conflict and drought in the Southern regions of Ethiopia. 1) OA and ERCS can do much to meet the immediate needs of the IDP population through provision of non-food items. (See Recommendation and Appendix for specific Needs Estimates by region) 2) OA should concentrate it’s response in the Borena Zone (Arero, Dugda Dawa) as the RPHA team has ascertained that MSF-Greece is active in Odo Shakiso and will support that region with resources of all MSF organizations in Ethiopia. Preliminary coordination efforts have been made with them and a summary of our discussions with them is attached. (see Appendix A.8) 3) OA’s affiliate, Oxfam Great Britain (OGB), can bring significant expertise to bear on the water and sanitation problems faced by the IDP communities. 4) OA should collaborate with other organizations with expertise in disease surveillance and provision of healthcare services. 5) OA should conduct monitoring and evaluation both of initial response as well as the impact of the displacement on the health and livelihoods of affected host communities where OA partners are active. 6) OA’s partners in the regions, Gayo Development Pastoralist Initiative and Action for Development (AFD), can provide assistance to IDPs for land use management, livestock restocking, and livelihoods promotion. 7) OA should work to support host communities whose natural and administrative resources are being strained by the large influx of displaced persons and livestock to their areas OA should continue to advocate to the Ethiopian Government, other humanitarian actors and the international community on behalf of the victims of this crisis especially with regards to protection and the provision of emergency food aid, as well as to push for lasting peace-building efforts to speed the safe return of the IDPs to their homes and livelihoods. 4 Introduction Objectives • Obtain information using a rapid public health assessment tool to provide Oxfam America and its affiliates guidance on how to appropriately and effectively respond to the needs of IDPs affected by the Southern Ethiopia conflict. • Determine and prioritize immediate humanitarian needs of IDPs in affected regions. • Identify vulnerable sub-groups and their immediate needs, and begin to investigate the underlying causes of vulnerability. • Identify immediate advocacy issues to communicate to the Ethiopian and international humanitarian community. • Provide recommendations to direct resources to areas of greatest need. • Provide baseline information to assist in future assessments, monitoring, and evaluation. • Provide information for bilateral and governmental organization to respond, coordinate and collaborate. Itinerary Date Location Activities June 23trd Addis Ababa Request from Oxfam America to HHI for a rapid public health assessment of IDPs due to the Southern Ethiopian Conflict. June 24th-26th Addis Ababa HHI begins collecting secondary information. Communications begin with non-governmental organizations (NGOs) and bilateral organizations. Preliminary planning begins to create the assessment tool. June 27th Addis Ababa – Dila The Rapid Public Health Assessment (RPHA) team* departs. June 28th Dila – Dugda Dawa RPHA meets with OA media team in Hagere Mariyam and then departs to Dugda Dawa. Rapid assessment of Dugda Dawa completed. Departure for Yabello. June 29th Yabello-Arero Travel to Arero. Completion of rapid assessment of Arero-1 IDPs. June 30th Yabello-Arero Return to Arero. Rapid assessment of Arero-Dureti IDP communities completed. July 1st Yabello-Shakiso Rapid assessment of Odo Shakiso-Qarari completed. July 2nd Shakiso Rapid assessment of Odo Shakiso-Derme completed. Return to Addis Ababa. July 3rd Shakiso-Addis Arrival in Addis Ababa. HHI analyses and compiles information. July 6th Addis Ababa Report presented to Oxfam America. * HHI and OA staff 5 Collaborating Partner- Ethiopian Red Cross Society1 “The Ethiopian Red Cross society has been operational in the particular areas of Borena and Guji zone since 1994 and actively involved in providing relief assistance for refugees, internally displaced peoples and drought affected communities of 100,000 in Borena and Guji zones. They are also involved in ongoing development interventions in the water and sanitation sector. The ERCS has offices in its Odo Shakiso and Hagere Mariyam sub- branches in potential areas for interventions in the Borena and Guji zones. The Red Cross has also zonal coordination offices at Negelle and Yabello.” Background General Background Figure 1 ERCS Registration in Odo Shakiso-Qarari Ethiopia, located in the Eastern horn of Africa, is one of the poorest countries within the Sub-Saharan region. The annual per capita income is less than US$ 120 and the life expectancy is 43 years. The Map 1 Oromiya Area of Southern Ethiopia 6 Southern Ethiopian conflict has been occurring in the Borena and Guji zones of the Oromiya region of central and southern Ethiopia.
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