Oxfam America

In partnership with

Rapid Public Health Assessment of Internally Displaced Populations Due to the Conflict in Southern

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 – 13

Results – 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 -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 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 (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 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. (Map 1). The Borena and Guji Zones are approximately 300 miles (480 km) and 250 miles (400 km) from Addis Ababa, respectively.

The Oromiya region with a population of 25 million (1/3 of the national population) is the largest and most diverse region of Ethiopia. There is wide variability in population characteristics and health services. Although the region has 912 health posts, areas within the Borena region such as Moyale have less than 50% functioning health posts. The woredas (districts) affected by the Southern Ethiopia conflict are located in both lowland and highland regions where agro pastoralist and pastoralist communities co-exist.

Table 1 Population Description HH Population Location Population Description Estimates Estimates (DPPC) (DPPC) • Agro-pastoralist and pastoralist Dugda Dawa 3,000 98,175*

• Located in forests and pasture with livestock • Agro-pastoralists and pastoralists. • Polygamous families with large household size ji Clan Odo Shakiso • Located near villages, forests and pasture with 2,232 20,708 Gu livestock • Very widely dispersed and in remote locations • Agro pastoralists, pastoralists, and semi-urban / a a s • HH crowding in buildings, and also in forests and r Arero 2,500 15,686

ren pasture Clan Gab

Bo • Near village and in remote locations Yabello • n/a 9,338 37,449

* Large discrepancy between number of households and population total reported by woreda DPPC. Observation and ERCS estimates most consistent with household number.

Pastoralism, Drought, and Conflict

Pastoralism is “a range of livelihoods including pure nomadism and mixed agro-pastoral practices [which relies strongly] upon natural resources making [the population] vulnerable to natural and human disasters.”2 The livelihoods of the Guji, Gebra and Borena clans of Southern Ethiopia are predominantly agro-pastoralists and pastoralists. Conflict, lack of resources and drought adversely affect one another. Often lack of pasture and water will contribute to inter- and intra-clan disputes. Conflict and subsequent displacement influence a pastoralist community’s ability to survive as displacement affects their access to available water and pasture.

The 2005-6 Humanitarian Crisis

Ethiopia has experienced numerous droughts affecting food security and livelihoods from as early as 1973. Approximately 11% of the population remains permanently dependent on external food aid.3 The most recent humanitarian drought crisis occurred in 2005-6. 2.6 million people were affected by

1 Joint Humanitarian Response Concept Note, Oxfam International & Ethiopian Red Cross Society, Guji-Borena Zonal Branch, June 2006 2 Horn of Africa – M ulti-Sectoral Interventions in Pastoralist Communities, USAID Fact Sheet #2, FY2005. www.usaid.gov/.../disaster_assistance/countries/horn_of_africa/fy2005/hoa_mipc_fs02_09-30-2005.pdf Accessed May 30, 2006. 3 Ethiopian Red Cross Society. Partnerships in profile 2002-03. http://www.ifrc.org/cgi/pdf_profile.pl?etprofile.pdf , Accessed July 2006. 7 the drought, of which two-thirds were located in the Borena and Somali zones. Drought affected regions in the Borena zone included Yabello, Arero, and Dugda Dawa, all regions affected by the current Southern Ethiopia conflict. 4

History of Clan Conflict within Southern Ethiopia

Conflict among the Guji, Gebra and Borena clans preceded the current conflict. Land reapportionment in the Guji and Borena zones four years ago contributed to increasing tensions among the three clans. Similar conflict between Guji and Gabra clans also occurred in 2005. Early in 2006, “increased tribal conflict between different groups occurred.” (e.g. Borena and Gari, Borena and Gebra, Guji and Borena, Guji and Gedeo, etc.)5

The 2006 Southern Ethiopia Conflict

Reports indicate the conflict between the Borena, Guji and Gebra clans began after changes in the Borena/Guji Zone lines early in 2006. Land formerly within the Borena zone was incorporated into the Guji Zone, and subsequent movement of Guji clans into this region was thought to instigate conflict. Reports of increasing tensions occurred during early May. Deaths from violence were communicated to the UN Department of Safety and Security in Addis Ababa on June 2nd. During the subsequent week conflict continued with an increase in the number of deaths. ERCS received reports of focal areas of conflict in Yabello, Arero and Finchewa.6

Locations of Internally Displaced Populations

Table 2 Zone IDP Clans Affected by 2005/6 Drought Odo Shakiso Guji Borena/Guji/Gebra X Dugda Dawa Borena Guji X Yabello Borena Borena** X Arero Borena Borena/ Gebra X ** Determined from secondary data only

4 Action Plan Ethiopia – Borena / Guji Ethnic Conflict 2006, Internal Communications, Oxfam America. July 2006. 5 Action Plan Ethiopia – Borena / Guji Ethnic Conflict 2006, Internal Communications, Oxfam America. July 2006. 6 Joint Humanitarian Response Concept Note, Oxfam International & Ethiopian Red Cross Society, Guji-Borena Zonal Branch, June 2006 8

Methodology

In order to obtain data on the IDPs from this conflict, a Rapid Public Health Assessment (RPHA) team comprised of physicians and public health professionals from the Harvard Humanitarian Initiative (HHI), along with humanitarian coordinators from Oxfam America (OA) and their local partner the Research Center for Civic and Human Rights Education (RCCHE) were dispatched to the four woredas where IDPs reportedly settled. Initial reports gave wide-ranging numbers for the total displaced population and little information was available regarding the specific humanitarian needs or state of health of the IDPs.

The RPHA team employed a variety of data collection methods including direct observation, proportional population sampling, focus group discussions of IDP communities, key informant interviews with government officials and clan leaders, and secondary data collection from government and local NGO sources. OA and RCCHE team members were fluent in , locally spoken Oromo, and English.

Every effort was made to ensure that the data collected was representative of the population assessed. The number sampled within the population and the population distribution (clans, villages of origin, etc.) were calculated to provide as accurate a reflection of the state of the Figure 2 Sampling in Arero population’s health as possible given their wide geographic dispersal. Special care was taken to assess for possible sources of variation including length of displacement, original home village, and relative proportions of clans within each population. Resources of IDPs prior to displacement, resources on hand, and presence of local support networks (relatives, etc) were also rigorously assessed.

In addition, much care was devoted to identifying and assessing particular groups at greater risk for vulnerability in this conflict and displacement. Vulnerable groups specifically assessed were children (defined as age <15 yrs), elderly and those with decreased mobility, pregnant and breastfeeding women, those who lost all assets and whose livelihoods were completely disrupted, female heads of households with no male assistance, and those who showed evidence of acute on chronic under-nutrition. Whenever possible, interviews were conducted with both male and female members of the household to ensure that data regarding the health of women and children in the household was accurately reflected.

The populations assessed were largely comprised of pastoralist and agro-pastoralist communities. Their displacement resulted in widely dispersed groups located over thousands of square kilometers. Many were found in remote locations accessible only by traveling off-road for many kilometers or on foot. An attempt was made by the RPHA team to assess groups that either had not been or would not likely be assessed by other aid organizations as well as vulnerable groups who were reported to have no shelter or limited access to water.

9 Table 3

IDP Settlement Direct Randomized Convenience Focus Key Secondary Name (closest village) Observation Population Population Group Informant Data Proportional to Proportional to Interviews Size Sampling Size Sampling (R-PPS) (C-PPS)

Dugda Dawa X X X X

Arero-1* X X X X

Arero-Dureti X X X X

Yabello X

Odo Shakiso-Qarari X X X X X

Odo Shakiso-Derme X X X X X

*Arero-1- Vacated Health posts

Secondary data provided by the woreda DPPC and local NGOs was widely divergent ranging from 60,000 total IDPs at the start of the assessment increasing to 90,000 on the second day and totaling as high as 150,000 IDPs upon completion of the field assessment. It is unclear how the DPPC numbers were estimated but it is clear that no other agencies or NGOs have been able to conduct independent assessment of the total number of IDPs and are widely quoting the DPPC circulated estimates. It is apparent from our sampling that the woreda DPPC numbers likely closely represent the magnitude of the displacement and in some cases may even represent an underestimation especially if there are population pockets that are yet undiscovered and thus un-assessed.

Dugda Dawa - Finchewa

The population around Dugda Dawa was widely scattered over two districts or pastoralist associations (PA), and living in make-shift shelters in the forest. Most IDP communities here could only be accessed by off-road foot travel for several kilometers. Due to a lack of accurate maps of the region, intermittent insecurity and, according to clan elders, a lack of discrete concentrations of large numbers of IDPs in that area, the RPHA team elected to conduct convenience sampling of approximately 5% of the estimated total IDP households using clan leader estimates of the number of households present in the area. The results of this sampling were coupled with direct observation of the living conditions and apparent health status of the IDPs themselves, observation of the major watering points, and key informant interviews with clan elders and local government administration (woreda) staff to compile the data used for the assessment.

Arero-Vacated Health Posts

There were two groups of IDPs in Arero – one large, discrete group of highly affected IDPs gathered on the outskirts of the village; and a second more widely dispersed group that remained in the bush with livestock. At the time of the assessment, the ERCS had initiated a registration of 1500 households (out of a total 2500 IDP households by DPPC estimate). The concentration of IDPs, presence of clan leaders with reliable information on the number of households from their clan present, as well as the registry allowed for a careful sampling of this population.

10 The numbers of households were obtained from the ERCS registry as well as the clan leaders estimates to establish the proportions of the different clans. These were ranked by size and a sampling interval was determined that would yield approximately 75 households, or 5% of the confirmed ERCS registry. Names were called out at each interval and clan leaders assisted in locating each household. Whenever possible both the male and female heads of the household were interviewed together to increase completeness of the data. If a family could not be located the next name on the list was called until a respondent could be found. Sampling then continued at the same pre-specified intervals.

In addition to calculating the proper number of total sample points necessary, the proportions were maintained to reflect the proportions of each clan. If the end of a clan’s list was reached without the proper number of sampling points being obtained the list was cycled back from the beginning. This was important as clans had come from different villages, had differential durations of displacement, and left under different conditions (some fled without any belongings while others had some livestock and belongings.)

Arero-Dureti

At the time of our assessment several IDP communities in the countryside were holding meetings of the household heads. There was a widespread perception that they would be pressured by the government to return home and the meetings were held to debate whether they should go back to their villages of origin or to another location to decrease the pressure on the grazing land (a concern voiced by the local community as a result of the sudden increase of livestock in the area). Since the household heads were already gathered, the RPHA team elected to conduct a focus group discussion to assess the health and relief needs of the population as well as to establish where they might be traveling. This qualitative data was coupled with the information obtained from key informant interviews with local community leaders as well as data obtained from the government offices (woreda) and the local health post.

Odo Shakiso-Qarari

The Oxfam RPHA assessment occurred prior to registration of IDPs by the ERCS. At the time of assessment woreda DPPC household and population data were unavailable. An estimate by a local NGO conducted one week prior reported 260 households in Qarari. An estimate was made that a 5% sample, or roughly 25 families, should be interviewed. The IDPs were classified by village of origin and their relative proportions were obtained in order to proportionately represent each migrant group. In the end, 27 households were sampled. The information obtained was then coupled with the results of a focus group discussion held subsequently among the IDP households present. It became clear during the focus group discussion that the total number of IDPs may be significantly different than originally estimated. While the number appeared reasonable to the assessment team based on the numbers of households observed, some household heads indicated that there were almost twice as many as originally estimated. The ERCS registration began that day but was not completed due to MSF-Greece’s commitment to providing a response in this area. Further data from this organization and other multiple sources are needed before making numerical need projections based on population size.

11

Odo Shakiso-Derme

The RPHA, working closely with the ERCS, traveled to Derme. The ERCS, which had just completed registration of a large percentage of the IDP population there, indicated that they were so widely scattered around that PA that it would not be feasible to map and travel to the households individually. Instead ERCS volunteers and local health post staff assisted the RPHA in gathering IDP households to the central village health post. There again, relative proportions of different groups of IDPs were established and then proportional samples of each were obtained with a goal of reaching a 5% sample of the total estimate 260 households (DPPC data), or 13 households. This data was coupled with a focus group discussion of present male and female household heads to further assess perceived needs and any potential plans for repatriation to their home villages or travel to other locations in search of pasture. The ERCS registration was still ongoing and will be used to re-assess the total number of households for purpose of total needs projections.

Results

Projecting the humanitarian needs of IDP populations is highly dependent upon the assessment of total population numbers. Independently assessing IDP population numbers was outside the scope of this RPHA but efforts to obtain and collate existing estimates were made. Data was collected from:

1) Several iterations of population estimates from woreda and zonal DPPC reports 2) Local and international NGO estimates of IDP populations in individual PAs 3) Village and clan leader estimates 4) Independent observations of HHI-OA RPHA team

This data was then placed through several checks by calculating average household sizes for plausibility, cross-referencing data obtained from multiple sources, comparing formal DPPC reports with verbal reports from government officials, and comparing IDP populations with estimated local populations by the communities in the proximity where they have settled. Figure 3 Branch shelter Dugda dawa Based on the DPPC data displayed in Appendix 1 (Displaced Population and Household Estimates) the estimates for the population of IDPs due to this conflict range from 90,000 – 150,000. Using these estimates and the data obtained from the HHI-OA RPHA population sampling, the following projections have been made to estimate the total relief needs for the displaced population from the conflict in Southern Ethiopia, June-July 2006. (Appendix 2.1 and 2.2, Calculated Needs) From prior experience in emergencies the ERCS suggests that 50% of the reported DPPC initial estimate is a reasonable benchmark for the total number affected IDPs. This is the number used in appendix A.2.1, Summary Calculated Needs of IDPs. There is also a more detailed calculation based on actual numbers registered to date by the ERCS as well as the total DPPC estimates.)

12

Dugda Dawa

Population Description

Dugda Dawa, located in eastern Borena zone, is approximately 30 km from Hagere Mariyam and 60 km from Yabello (Map 1). According to woreda DPPC reports, 19 PAs from within Dugda Dawa, Arero, and Yabello were displaced to Dugda Dawa totaling approximately 98,175 people. ERCS volunteers stated their registration only yielded 933 households in Dugda Dawa around Finchewa. IDPs were from the Guji clan and had been displaced for approximately 1 month. Of the 22 households (154 people) sampled in Finchewa 01/02, the average household size was 7.3 people with approximately 5 children, two adults, and less than one elderly person per household. Approximately one third of households reported a pregnant female member. The ability to Figure 4 “Shelter” being used by single mother of four children construct shelters and corrals for livestock from leaves and branches indicate that these communities were likely agro-pastoralist or pastoralists. The presence of livestock and non-food items may indicate that these communities were not at the center of the conflict and able to gather belongings prior to their displacement.

Shelter

IDP communities in Dugda Dawa resided primarily in open/closed shelters constructed from leaves, branches, and plastic sheeting. No household sampled had a closed shelter (e.g. clay hut, concrete building). Shelter type varied with some households living in the open environment, while others lived within multiple huts with plastic sheeting (Figure 4). Nearly all households had purchased plastic sheeting; 10% of households did not have any form of shelter.

13

Food and Nutrition

There was minimal variation in food consumption among all households. Maize consumed once per day was their only source of food. Milk production for household consumption was not reported but one household described selling available milk to the market for maize. This practice is a coping mechanism among the agro- pastoralist and pastoralist communities during periods of stress.7 No receipt of emergency food provisions from government stocks or NGOs was reported.

Direct observation of the sampled IDP populations in Dugda Dawa revealed the presence under-nutrition. Several children and adults exhibited peripheral muscle wasting (arms and legs) as well as abdominal swelling or edema that results with severe protein malnutrition (Figure 5). Both adults and children Figure 5 Marked peripheral wasting and abdominal swelling were observed but no formal nutritional associated with protein deficiency and under-nutrition assessments (weight/height, Z-scoring, anthropometrics, etc.) were conducted. The observations may indicate chronic under-nutrition with overlying acute under-nutrition due to displacement.

Water

A spring and motorized pump well provided water to the Dugda Dawa displaced and host populations. A spring located 5 km from the sampled population was unimproved, unprotected, turbid and in close proximity to livestock (Figure 6). The host community reported intermittent hand digging of the spring to access additional water. The motorized-pump well was improved and protected (Figure 7). Although not directly observed, reports from the community indicated little turbidity and discoloration. There was a 1 Birr fee required for its use and collected by the local water committee, which IDPs reported as an obstacle to its use. Figure 6 An unprotected spring is the major water source in Dugda Dawa

7 Horn of Africa – Multi-Sectoral Interventions in Pastoralist Communities, USAID Fact Sheet #2, FY2005, www.usaid.gov/.../disaster_assistance/countries/horn_of_africa/fy2005/hoa_mipc_fs02_09-30-2005.pdf Accessed May 30, 2006. 14

Water collected by the sampled community was used almost exclusively for personal consumption with an average of 3.4 L/person/day and an average of 2-5 hours spent in collection. (Minimum Sphere standard for personal consumption is 5L/person/day and 15L/person/day for drinking, cooking and personal hygiene) There was no chlorination or filtration used at the household level.

No assessment was made regarding the future availability of each water source or potential alternative water sources. Discussion with the key informants indicated that the spring had not dried up in previous years when utilized by the host community. Figure 7 Motorized, pump well in Dugda Dawa town with access fee payable to the local water committee

Sanitation

There was no community latrines or dedicated defecation areas among the Dugda Dawa IDP population. Animal presence and waste was observed in close proximity to shelters (Figure 8). Corrals were observed adjacent to households and in close proximity. Households interviewed did not report using soap to wash clothing. There was little solid waste in the form of garbage but there was a large amount of animal waste present in and around the living space.. There were no observed dedicated refuse containers among clusters of huts.

Vector Control

Direct observation and household reports indicated the presence of flies and mosquitoes. No areas of stagnant water were observed in close proximity to shelters or corrals.

Non-Food Items

The IDP population in Dugda Dawa had more non-food items than IDPs in Arero and Odo Shakiso. 80% of households had one jerry can between 10-20L in volume. Almost all households had at least one blanket, pot, cup and bowl, but did not have any bed nets or tents. Almost all households reported having plastic sheeting and site visits revealed they were often used for shelter. All households had access to wood fuel. These results may not fully represent all households in the Dugda Dawa area as households were not randomly sampled.

Figure 8 Corral for goats with surrounding animal waste immediately in front of family shelter 15 Livelihoods

Many households had cattle, goats, and young kids present around the household shelters. Although not all households were queried about livestock death/loss or current livestock numbers, one third of households reported an average of 1 livestock death since the conflict. Given that replies ranged from 1- 9 deaths, the non-uniform questioning does not likely reflect an accurate number of livestock deaths or current livestock among this IDP population. Households did report the lack of adequate milk production among the living livestock and attributed this to inadequate pasture. In addition some households reported selling water and firewood. According to the DPPC, this IDP population is displaced from regions affected from the 2005-6 drought and their livelihoods and asset possessions have not fully recovered.

Health

A local health center/post was located within 5 km of the IDP population, but it was unclear what the current human and resource capacity and fee for service was at the time of site visit. No deaths were reported among the community in the preceding 2 weeks, and mortality due to the conflict prior to displacement was not assessed. The most common diseases reported were diarrhea (40% of households) and upper respiratory symptoms (20% of households). Oral rehydration packets (ORS) were not available.

Arero

Population Description

Arero located in eastern Borena zone is approximately 75 km from Yabello and 120 km from Shakiso (Map 1). According to woreda DPPC reports, 2500 displaced households (15,868 people) were displaced in the Arero woreda. It is unclear from these reports from which woredas this population originated. The IDPs were primarily from the Borena clan and had been displaced for approximately 1 month. Two populations were assessed in the Arero region. One sampled population was residing in vacated health posts; the majority of displaced populations in Arero were dispersed widely outside of the village. In addition there was one village visited with approximately 1100 IDPs from the Gabra clan. Figure 9 Abandoned health post around Vacated Health Posts Adjacent to Arero Village (Arero-1) which IDPs settled

Of the 61 households (562 people) sampled in Arero-1, the average household size was 9.4 people with approximately 6 children, 3 adults, and less than one elderly person per household. Less than 50% of households had an elderly member and reported that due to the conflict many families left elders behind in other villages. Approximately 40% of households reported a pregnant female member. Of all households queried about livelihood, all reported 100% loss of livestock. Interviews revealed that their prior assets were largely comprised of livestock, shops and cash

16 Figure 10 Meeting of Clan leaders Arero-Dureti on hand – which are characteristics of an agro-pastoralist or peri-urban origin. Their total losses of all assets resulted from their very close proximity to the conflict.

Areas surrounding Arero Village (Dureti)

The Dureti community of IDPs located approximately 20 km from the village, were not sampled randomly, rather a focus group of village elders was conducted instead (Figure 10). Of the people present elderly, children, women and men were equally distributed. The focus group reported 700 households in the area. Many households still had livestock with them.

Shelter

IDP communities in Arero differed between the vacant health post region and the surrounding areas. IDPs in Arero-1 resided in closed concrete buildings, adjacent open areas, and very few branch huts. 40% of households sampled had closed shelter in vacated concrete buildings (Figure 11) while the remaining 60% of households had no shelter. Some households had received plastic sheeting from the ERCS and were using it as floor covering in the concrete rooms or as plastic covering for branch shelters. IDP communities in Dureti had branch-leaves shelters often with plastic sheeting. Figure 11 IDPs in vacant buildings at Arero outskirts Food and Nutrition

There was minimal diversity in food consumption among all households in Arero-1. Maize or food obtained from begging was consumed less than once to once/day. There was no livestock for milk consumption and only two households reported providing milk for children. Some households reported receiving maize from an NGO thought to be World Vision but provisions were running out or had been used up at the time of this assessment. There were no reports of households receiving emergency food provisions from government stocks.

In Dureti, clan elders reported distribution of 110 quintile of wheat to 570 households from the safety net program and 90 quintiles of maize to 450 households at the end of May as a one-off distribution. No consideration was given to family size and there was no further distribution. They reported that these provisions were now running out. Little milk was being produced from existing livestock due to poor pasture and whatever milk was available was being shared among the community and given to young children.

Direct observation of the sampled IDP population in both Arero-1 and Dureti did not reveal the presence of acute on chronic under-nutrition.

Water

In Arero-1 traditional singing wells and hand pump wells provided water to the Arero displaced populations. Traditional singing wells located approximately 5 km from the Arero-1 sampled

17

Figure 12 "Éle" or traditional "singing well" near Arero population were unimproved, unprotected, turbid, and discolored, and in close proximity to livestock (Figure 12). There were numerous singing wells clustered in close proximity and the host community reported that these wells were being primarily used by the IDP populations.

Two hand-pump wells located approximately 5 km from Arero-1 were improved, with little turbidity or discoloration; however they were not protected from livestock or drainage field protection (Figure 13). There was a fee required for their use and reports from the host community indicated that this was prohibitive for the IDP population.

Water collected by both Arero IDP populations was used almost exclusively for personal consumption with an average of 5.3 L/person/day (Minimum Sphere standard for personal consumption is 5L/person/day and 15L/person/day for drinking, cooking and personal hygiene) an Figure 13 Protected, improved hand pump at Arero average of 2-4 hours per day were spent in collection from Arero-1 and likely more from the Dureti community.

No assessment was made regarding the future availability of each water source or potential alternative water sources if both the traditional and improved wells fail.

Sanitation (Excretion disposal, solid waste and drainage)

There were no latrines or dedicated defecation areas utilized by either Arero IDP population. Four pit latrines were located adjacent to the concrete building in Arero-1 (Figure 14) but the sampled population stated that they were not using them. Animal presence and waste was observed in close proximity to shelters in the Dureti community. Corrals were observed adjacent or in close proximity to households. There was solid animal waste located among the shelters and at farther distances. There were no observed dedicated refuse containers among clusters of huts.

Vector Control

Direct observation and household reports indicated the presence of rodents, flies and mosquitoes in Arero-1. Flies were observed in the Dureti community. No areas of stagnant water were observed in close proximity to shelters or corrals.

Non-Food Items

The IDP population in Arero-1 had little or no non-food items prior to the ERCS distribution. All households reported using jerry cans; 50% of households were borrowing cans from the host or IDP community. The

18

Figure 14 Latrines at Arero-1 average volume of jerry can was 20L. At least 50 % of sampled households in Arero-1 had one pot and blanket, and 30% of households had plastic sheets which were likely distributed days earlier from the ERCS. No households had bed nets or tents. All households had access to wood fuel.

In Dureti, clan leaders reported 20% of households had jerry cans of unclear volume; 30% of households had plastic sheeting and cooking utensils.

Livelihoods

The livelihoods of IDPs sampled in Arero-1 were significantly impacted with nearly total loss of livestock, cash and other assets (shops). Reports total number of livestock losses due to conflict averaged 14.7 with a range from 1 to 126 livestock losses.

IDPs in Dureti had livestock, but clan leaders were concerned about lack of pasture. Households were collecting water and firewood to sell in the market, a reflection of coping mechanisms seen in agro- pastoralist and pastoralist communities8 Clan leaders reported the lack of adequate milk production among the living livestock and attributed this to lack of adequate pasture.

Health

A local health center/post was located within 5 km of the Arero-1 population, but it was unclear if this was staffed, and if so, whether a fee for service system was in place at the time of the site visit. Two deaths were reported among the community in the preceding two weeks. Many households reported suspected deaths due to the conflict but the actual numbers were not formally assessed. The most common diseases reported were diarrhea (50% of households), respiratory tract infections (70%) and febrile illnesses (70%). There was no availability of ORS. Mortality and morbidity were not assessed in the Dureti community.

Odo Shakiso-Qarari

Population Description

The IDP population in Qarari (Figure 15) was largely comprised of pastoralists and some agro-pastoralists. Many had come with livestock although they all described significant livestock losses en route to their site of displacement. Most had not brought many possessions and at the time of assessment had been settled near Qarari for almost one month. Nearly every family had an elderly member as well as a breastfeeding mother. One in three families had a member who was pregnant. Figure 15 IDPs at Qarari

8 Horn of Africa- Multi-Sectoral Interventions in Pastoralist Communities. USAID Fact Sheet #2, Fiscal Year 2005. Accessed May 2006. 19

Shelter

The vast majority of households in Qarari described having no form of shelter. Few described having constructed shelters with branches and leaves. Only one household from 27 sampled had any form of plastic sheeting for protection from the elements. The weather in the area is cold with frequent light rain.

Food and Nutrition

All households sampled described eating one meal a day composed largely of maize. IDPs described purchasing maize with small amounts of cash they had brought with them during their flight from conflict. Others were spending much of the day gathering and cutting firewood to be sold in the nearby village of Dawa (7km) in order to purchase maize. Some families reported that they were consuming milk from their livestock although many stated that the grazing pastures had been so depleted that many animals had stopped producing milk. There were no overt signs of under-nutrition observed by the RPHA team in the assessed households that included small children.

Water

There were problems of both water access and quality of water. All IDPs described obtaining their water from the river at the Dawa village, 7 km away (Sphere standard is 500 m maximum distance to nearest water source). The distance traveled to fetch water was described as a significant obstacle to obtaining enough water to meet household needs. Beyond distance however, all households sampled reported further no structural impediment to obtaining water (access fees, etc.)

Only half of the households reported having even one jerry can, although all reported having access to water carrying devices that they borrowed from neighboring households (Sphere standard – 2 water containers, 10-20L each, per family.) The average water usage was calculated to be 3.3 L/person/day, (just over the level of basic survival needs, 2.5-3L/person/day for drinking and food) and almost entirely used for consumption (drinking, cooking, etc). (Minimum Sphere standard for personal consumption is 5L/person/day and 15L/person/day for drinking, cooking and personal hygiene)

There was no formal water quality assessment conducted by the RPHA team. We directly observed however, that the river at Dawa village was an unimproved and unprotected water source with moderate turbidity and green color. There were animals observed at the water points where villagers and IDPs were gathering water. The river flowed briskly and did not reveal stagnant pools. There was no reported use of chlorine or any other purification or filtration either at the water source or household..

Sanitation (Excretion disposal, solid waste and drainage)

Open defecation was the rule for this IDP population. There was no dedicated defecation field in place. IDPs reported defecating far from their resting area although animal waste was observed near the site of assessment. Only few households reported being able to wash personal items and clothing at the river, sighting the distance as the major obstacle. No households reported having any soap and few were able to bathe regularly (at least once a week.) There was very little evidence of solid waste beyond animal excreta in the IDP area outside of Qarari. The IDPs were largely settled in upland areas with good drainage away from the site.

20

Vector Control

IDPs reported widespread presence of flies and mosquitoes, and the same was observed by the RPHA team. The large presence of flies and animal waste raises concern over increased risk for transmission of diarrheal illness due to fecal-oral contamination. There was no evidence of standing water that might promote proliferation of mosquitoes. There was no report of malaria in that medium to high elevation region. There were also no reports of vermin at Qarari and the risk for plague and other vermin transmitted diseases is believed to be low.

Non-food Items

There was a marked paucity of all non-food items. Most concerning was the lack of plastic sheeting and blankets. Only 1 in 10 households reported having blankets, cups, utensils, or cooking items and only one household from all sampled reported having any plastic sheeting to protect their shelter.

Livelihoods

The IDPs at Qarari were pastoralists and agro-pastoralists, many of whom had brought some percentage of their livestock with them. Most were very concerned over the lack of adequate pasturage for their livestock. Households described over-grazing due to the high pressure placed on the land by the large number of livestock that had been brought to the area around Qarari. Clan leaders indicated that the lack of pasturage and poor access to water may force the IDPs to relocate closer to the river at Dawa which may result in the same problems being replicated at that site, namely increased tensions between the IDP and local populations as resources become more scarce.

Health

IDPs at Qarari had relatively higher numbers of cases of diarrhea as well as respiratory infections. Half of all households reported cases of diarrhea in the last two weeks. There was an average of two members per household reporting cases of respiratory infections. The lack of shelter and blankets coupled with the presence of flies and widespread animal waste close to the location of IDPs have contributed greatly to these problems. There was no health post within 5km of the IDP population and the rate of vaccination is reportedly very low in the region (~40% Guji and as low as 9% Borena Zones for measles for example9 10)

9 Immunization and health campaign protects drought-affected children in Southern Ethiopia, UNICEF, April 4, 2006, http://www.unicef.org/infobycountry/ethiopia_33157.html, last accessed July 7, 2006. 10 Measles Mortality Reduction Activities, Ethiopia, 2006, Powerpoint presentation posted to internet, World Health Organization, www.who.int/entity/hac/crises/eth/sitreps/Ethiopia_Measles_Update_24Mar2006.pdf , last accessed July 7, 2006 21

Odo Shakiso-Derme

Population Description

IDPs around Derme were pastoralists who were widely dispersed in the countryside surrounding the village. On the whole they had significant livestock herds as compared to IDPs at other sites, despite describing significant losses during their displacement. The families on the whole had a larger average household size, mostly due to polygamy. Each household on average had 1-2 pregnant women, 1-2 additional breastfeeding mothers as well as an elderly member of the household. The average number of children per household was 14, approximately three times the number of children as households in other IDP communities sampled. The total number of IDPs at this location has not been well characterized with a wide range of data reported. As such the need projections from this region should be re-assessed as additional data becomes available. Figure 16 OA & ERCS volunteers crossing river to reach IDPs Shelter

All IDP households reported no shelter and were living in the open under tree cover in the bush near Derme. Unfortunately, logistical difficulties prevented the RPHA team from independently observing the households in their living space so no confirmation could be made of the lack of even informal huts. No households reported having access to plastic sheeting of any kind. Their livestock was reported to be kept in makeshift corrals. At the time of assessment the weather near Derme was overcast and cool with occasional rain.

Food and Nutrition

Households near Derme reported consuming one meal of maize porridge daily. Focus group discussions revealed that food security was a major concern for IDP families. Few families reported supplementing their diet with milk from livestock despite the presence of a relatively larger percentage of households with livestock than in other IDP locations. Of the families sampled and those participating in the focus group discussions there was no evidence of acute or chronic under-nutrition. It must again be stressed that since the sampled households came in to the village to be assessed it may be possible that the most weak or under-nourished children and adults remained at the site of their displacement and thus would be under-represented in the sample.

22 Water

While the water point was relatively closer to the IDP population near Derme than at other sites sampled (~3km) it remains well above the Sphere standard goal (maximum of 500m to closest water point). Only half of all households had any form of water carrying container and were on average much smaller (7.5 L) than what is necessary to meet the needs of such large families. The amount of water available per person is at a critical survival threshold of 2.4L/person/day (Minimum Sphere standard for personal consumption is 5L/person/day and 15L/person/day for drinking, cooking and personal hygiene).) There was no formal water quality assessment conducted by the RPHA team. From observation it was seen that the river near Derme was an unimproved and unprotected water source with low turbidity and green color. There were animals observed at the water points where villagers and IDPs were gathering water. The river flowed briskly and did not reveal stagnant pools. There was no reported use of chlorine or any other purification or filtration method.

Sanitation (Excretion disposal, solid waste and drainage)

Open defecation was the norm for this IDP population. There were no defecation fields in place. No direct observation was Figure 17 Focus Group at Shakiso Derme with HHI, Oxfam America, ERCS, Govt officials made of the reportedly widely dispersed IDP collection sites. If the population density was as low as reported, then human and animal excreta may be of lower concern. There is, however, a higher incidence of diarrhea near Derme, as well as reports of bloody diarrhea at the local health post in the preceding two weeks, indicating that fecal-oral contamination remains a significant concern. There was very poor solid waste disposal within the village itself with trash littering the street and blocking drainage ditches. IDPs were reportedly settled in upland areas with good drainage away from the sites.

Vector Control

IDPs reported widespread presence of flies and mosquitoes, and the same was observed by the RPHA team at the village near Derme. The large presence of flies and animal waste raises concern over increased risk for transmission of diarrheal illness due to fecal-oral contamination which is consistent with the health data obtained from the IDP sample data. IDPs reported no standing water and there was no report of malaria in that medium to high elevation region. There were also no reports of vermin at Derme and the risk for plague and other vector-borne transmitted diseases is believed to be low.

Non-food Items

There was a severe lack of all non-food items. Most concerning was the lack of plastic sheeting and blankets. No households reported having any form of blankets, cups, utensils, or cooking items and only one in three households had access to any plastic sheeting for shelter or protection of belongings.

23 Livelihoods

IDPs around Derme were pastoralists who were widely dispersed in the countryside surrounding the village. On the whole they had significant livestock herds as compared to IDPs at other sites, despite describing significant losses during their displacement. Again lack of grazing pastures was listed as a concern but no families reported severe grazing pressure.

Health

IDPs at Derme had significantly higher numbers of cases of diarrhea, upper respiratory infections and febrile illness. In this admittedly smaller sample, there were on average 4.4 cases of diarrhea per household in the preceding two weeks. This was a rate almost ten times that of all the other IDP sites surveyed. This was confirmed by the increased prevalence of diarrhea noted at the local health post – including reported cases of bloody diarrhea. Similarly the rate of respiratory infections was anywhere from two to ten times the rates observed at other IDP locations. Moreover, the rate of febrile illness of any type was six to ten times the rates observed at other IDP locations. There was a functioning, staffed health post present in the village near Derme and the IDPs reported that they did have access to its services. The rate of vaccination was unknown but is historically low in the region and is of particular concern in this population with a high density of children.

24 Recommendations

The following recommendations are being made based on 50% of the DPPC woreda population estimates. ERCS’ experience in previous emergencies suggests that this is a reliable benchmark. In appendices A.2.1 and A.2.2 summary and detailed estimates be found for Calculated Needs for all Non- Food Items. These calculations take into account what assets are already held by IDPs.

General • Immediate food aid is needed in all three woredas - Dugda Dawa, Arero, and Odo Shakiso. • Collaborate with Oxfam Great Britain (OGB) to evaluate the water and sanitation situation in Arero. • Coordinate with Médecins Sans Frontières (MSF) Greece who will provide humanitarian response in Odo Shakiso, and allow OA to focus upon Dugda Dawa and Arero in Borena Zone. • Coordinate with other agencies to better characterize needs of un-assessed IDPs in Yabello. • Further assessment of the Gebra clan in Arero is needed as they are an underrepresented clan. • Distribution activities should be preceded by registration of IDP households. This will allow for ongoing monitoring of population numbers and geographic distribution for better resource allocation as well as assisting in tracking IDP movements. • Monitor and evaluate the impact of OA’s interventions on the IDP and host communities by using key impact indicators.

Shelter • There is an immediate need for plastic sheeting and other shelter material for all locations. • Immediate provision of shelter material is needed in all three woredas in the form of a total of 15,500 units of reinforced plastic sheeting & 25,600 meters of rope to secure shelter. • Longer-term alternatives for shelters among host communities should be assessed.

Dugda Dawa • 2000 reinforced plastic sheets are needed. • 4500 meters of rope are needed for securing shelter Arero • 2100 reinforced plastic sheets are needed. • 3750 meters of rope needed for securing shelter • Additional shelters are necessary and can be established adjacent to buildings for IDPs living in the vacated health posts to decrease crowding. Odo Shakiso • 2200 reinforced plastic sheets are needed. • 3350 meters of rope needed for securing shelter

Food and Nutrition • Urgent food aid is needed in all three woredas. OA should advocate for involvement of organizations with capacity to respond as soon as possible. • OA should lobby for release of emergency food stocks to the three woredas assessed. • IDPs in all woredas describe diets comprised of primarily of maize. Food assistance should include greater diversification to prevent malnutrition and under-nutrition

25 • Formal nutritional assessments are needed and interventions should be collaborative with food distribution efforts.

Dugda Dawa • Organizations with experience in nutritional assessment and interventions should urgently collaborate with food distribution efforts to assess under-nutrition because the RPHA team observed evidence acute on chronic under-nutrition.

Water • 4700 – 25 liter jerry cans should be urgently distributed to all locations. • Efforts should be made to identify water sources closer to populations in all areas. • Education should be provided to protect existing water sources as most communities were accessing unprotected unclean water sources. • Consideration should be made to provide water purification tablets and education for their use to disinfect water. • Identify existing NGO’s (e.g. CARE) involved in assessing the future availability of water in the coming months due to potential for drought.

Dugda Dawa • 1800 jerry cans are needed to improve access to water which is currently at critically low levels of human water consumption (based on Sphere standard). • Further assessment is necessary to evaluate viability of existing improved protected water sources as source for IDPs to prevent overall depletion of water sources for the host/IDP community. • Further investigation is needed to enable IDPs to access local clean water sources associated with usage fees. Arero • 1500 jerry cans are needed. • Further assessment is necessary for the viability of existing improved protected water sources to prevent overall depletion of water sources for the host/IDP community. • Further investigation is needed to enable IDPs to access fee associated clean water sources. Odo Shakiso • 1300 jerry cans are needed to improve access to water which is currently at critically low levels of human water consumption (based on Sphere standards).

Sanitation • 9700 kilograms of soap should be provided to the 3 regions. (See appendix) • Focus should be made to improve overall access to water to improve hygiene (bathing, washing clothing) in IDP communities. • Sanitation education should be provided to IDP communities specifically regarding human and animal excreta disposal. • Education should be provided to households to encourage separation of livestock from living space. Arero • Functioning pit latrines exist in Arero-1 but are not used by the population. However, there are insufficient numbers to meet Sphere standards of 20 people per latrine. Vulnerable groups (e.g., 26 handicapped, elderly) may be prioritized for their use and defecation fields may be established as an immediate solution for human excreta disposal.

Vector Control • Monitor for evidence of large stagnant water sources and sentinel surveillance for outbreaks of febrile illness which may indicate malaria or yellow fever. • Rodents were reported in Arero-1 and site should be reassessed for vermin.

Non-Food Items

Totals are also attached in Appendix 2.2.1 and 2.2.2

Dugda Dawa • 1500 blankets, 1500 cups, 1500 pots, 750 utensil, 2900 bowls are needed Arero • Urgent distributions of non-food items are needed for IDPs in Arero due to complete loss of all non-food items. • 1900 blankets, 2000 cups, 625 pots, 1250 utensil, 2400 bowls are needed Odo Shakiso • 2200 blankets, 9300 cups, 4700 pots, 4700 utensil, 3500 bowls are needed

Livelihoods • Identify local partners with expertise in livelihood assistance to aid IDP/host communities with livestock to manage the utilization of pasture.

Arero • Collaborate with local partners to assist in the reestablishment of livelihood for IDPs ( e.g. restocking or cash-for-work programs) as theses peri-urban and agro-pastoralists are particularly vulnerable due to total losses of livelihood.

Health • Determine measles vaccination rates among each IDP population. • Monitor number of cases of diarrhea, respiratory or febrile illnesses per household over specific intervals to identify spikes which may represent disease outbreaks. • Collaborate with organizations with expertise in disease surveillance and provision of health services.

Arero • Urgently determine prior measles vaccination coverage of this IDP population to determine need for vaccination programs. Odo Shakiso • Further assess the health status and needs as higher cases of diarrhea, respiratory and febrile illness cases were reported.

27 Logistics • Communications were unreliable and lack of communication with main offices hampered NGOs and IOs in their assessments. Reliable alternative communications should be secured including satellite telephones for OA teams operating in the area. • Plan for distribution of goods using smaller vehicles and consider utilizing animal transport to IDP populations as many are located in areas with poor road access. Odo Shakiso • Carrying containers (e.g. durable sacs, bags) should be provided to each household to allow them to transport distributed items to their homes.

• Additional personnel and transportation may be required to assess, monitor and evaluate the needs of Odo Shakiso IDPs due to their remote and widespread location.

Security/Protection • Advocate for protection of IDPs in their current settlements and for those IDPs returning home. • Consider additional security assessments to create proper guidelines for OA field operations and travel. • Urge the government to provide security in the region for OA, its partners and other organization providing assistance to IDPs.

Collaboration/Coordination • Strengthen communication between the field teams and headquarters. • Identify a lead OA Addis staff member to communicate with other organizations involved with response to coordinate efforts listed above and identify changing IDP locations and needs. • Work with local organizations and other NGOs to build long lasting peace efforts. • Engage with government/bilateral/NGO collaborative and coordinating efforts to prevent duplicative efforts and avoid missing IDP groups.

Monitoring/Evaluation • The initial RPHA tool should be used by OA and its partners in the field, (e.g. ERCS volunteer) at the time of registration or goods distribution to obtain information about the larger population, identify changing needs and for sentinel disease surveillance • Specific indicators that should be collected include: o Number of IDP households registered for distribution of goods ƒ Allow for more accurate assessment of actual need ƒ Assess IDP distribution o Number of cases per household in preceding two weeks of: a) diarrhea b) respiratory illness c) fever ƒ Sentinel surveillance for disease outbreaks o Number of Jerry cans per household, number of trips to fetch water and number of household members ƒ Tracking water use per person per day o Number of households with shelter and type ƒ Assess impact of shelter materials distribution o Number of non-food items per household (blankets, pots, bowls, soap) ƒ Assess impact of distribution o Number of livestock per household ƒ Assess vulnerability and livelihood resilience 28 • A follow up assessment should be conducted to evaluate the impact of initial interventions made by OA and its partners. (For example, the provision of jerry cans and its affect on water accessibility, bathing and its impact on hygiene can be measure indirectly by declining cases of diarrheal illnesses.)

Limitations

As in any assessment or study, there were limitations encountered in the conduct of the HHI-OA Rapid Public Health Assessment. Factors limiting the scope of this assessment included the urgent need for rapid assessment of the population;, the migratory nature of the pastoralist and agro-pastoralist IDPs; the wide dispersal of the IDPs over thousands of square kilometers; intermittent insecurity; lack of communications with poor GSM and land-line telephone communications from network outages; lack of baseline census government data as well as lack of consistent information on the total number of IDPs; and the lack of detailed maps revealing the locations of IDP centers. Overall needs projections may be modified up or down by newer, more complete information.

Within these limitations, every effort was made by the RPHA team to assess the most vulnerable IDP populations and to ensure that samples of the population were representative. Population proportion sampling was conducted whenever possible with a goal of obtaining a five percent sample of the total estimated population at each sample site. Where possible, selection for sampling was done according to a pre-selected sampling interval to ensure that groups were not over-represented due to non-random factors such as local power, clan affiliation, family relationship to clan elders, etc.

The data obtained from Dugda Dawa was a convenience sample of consecutive households since the wide dispersal of IDPs and lack of registry or geographic data precluded randomization. .

The data from the IDPs in the bush surrounding Arero was obtained from focus group discussions and key informant interviews in addition to direct observation by the RPHA team. Those communities were similar to the Dugda Dawa community—widely dispersed without registry or geographic data and not given to easy randomization. The RPHA team was able to directly observe the living conditions of the IDPs in that area and survey individuals who were present at their shelter site. In the majority of locales, community elders (both male and female) were gathered for discussions on whether they should move to a different location in search of pasture or bow to perceived government pressure and risk returning to their villages of origin. The use of focus groups lends itself better to capturing this information than individual sampling methods.

The IDP community at Qarari was sampled in a randomized fashion in order to obtain data most reflective of the total population. One clan was apparently off fetching wood and not available to be included in the sample. Because there were no reliable population estimates for that clan and because the clan elders were quoting population estimates orders of magnitude larger than the other clans and clan population could not be triangulated, the DPPC data served to be the sole source.

An attempt was made to gather the community scattered in the hills around Derme to the central village from where they could be sampled. We cannot guarantee that all IDP groups were equally notified or were equally able to come to the meeting. Of particular concern is whether the most ill were absent. This would mean that they would escape observation by the RPHA team just as the team was unable to independently assess the living conditions of the IDPs at the sites where their households had collected in the forests. 29 Lastly, the need projections being made are being extrapolated to the total population using census data obtained from woreda DPPC primarily with cross-referencing to verbal reports from NGOs, community health post data, and clan elders. Every attempt was made to triangulate the data from multiple sources to give a reliable estimate of the total population upon whom projections can be made from the sample data. That said, the data has been incomplete and changing rapidly (likely due to increased awareness and reporting of the IDP problem.) The experience of the ERCS in past emergencies with data reported from the DPPC is that the actual number of displaced is roughly 50% of the quoted value since they do not routinely gather the data primarily but rather rely on the communities themselves to provide estimates that are then collated. As such, the need projections may need further modifications in the coming days to weeks as more robust data of greater detail becomes available. Recommendations were based on the 50% estimate. Conclusion

The results of this rapid public health assessment of the internally displaced populations in the Borena and Guji Zones of Southern Ethiopia, conducted by Harvard Humanitarian Initiative for Oxfam America, confirms that there has been a large scale displacement of people fleeing conflict in their home villages. The immediate needs of the population are primarily food aid, reliable water sources and adequate sanitation, provision of shelter as many are still without any form of shelter one month into their displacement, and non-food items. At this time there is no evidence of widespread disease among the displaced population, although they remain vulnerable to such conditions due to their exposure to the environment and poor sanitation at many IDP settlement sites. The peace-building is slow and a resolution to the conflict that would allow for IDPs to return home will take weeks to months. Oxfam America and its partners should act urgently to address the immediate needs of this population as well as to implement on-going monitoring to assess their changing location, health status and humanitarian needs.

30 A.1 Estimate of Total Displaced Population Size (Based on DPPC Data)

HH Population HH Population Dugda Dawa - Orig. PA Below Bikkoo Goroo Baalii (DD) 5,800 Gamee Kuraa (DD) 7,500 Biyyoo Qunnii (DD) 7,000 Heema Kinshoo (DD) 3,045 Derruu Danfilee (DD) 4,485 Baya Gundii (DD) 5,852 Dada Odaa Budhuu (DD) 3,980 Haadha Goraa (DD) 4,555 Fincaawaa 01 (DD) 3,700 Burqituu Magadaa (DD) 4,533 Biressoo Gullee (Y) 9,143 Bildim Rasoo (Y) 8,435 Tuula Waayyuu (Y) 8,350 Malkaa Sooddaa (DD) 4,575 Fincaawaa 02 (DD) 3,300 Dhedhertu (Aanaa Yaaballoo) (?) 4,700 Gallaba (A) 3,974 Hirmaye (A) 2,789 Madar (A) 2,459

Subtotal Dugda Dawa ** 3,000 98,175

Arerro - Orig. PA Below Guttoo n/a 1,618 Kgumata n/a 1,260 Orottoo n/a 2,110 Hallona n/a 2,117 Fuldowaa n/a 987 Haroo Dimtuu n/a 1,540 Reenjii n/a 2,131 Silaalaa n/a 1,222 Kafarra n/a 2,883 Vacant Health Center 683 4,232 Surrounding Areas

Subtotal Arerro 2,500 15,868 683 4,232 Estimate of Total Displaced Population Size (Based on DPPC Data)

HH Population HH Population Yabello - Orig. PA below Diida Yaaballoo 580 1,738 Diida Haraa 500 1,916 Carii 595 2,898 Dhaddiim 1,033 5,871 Suruphaa 978 4,892 Tulaa Waayyuu 793 4,808 Dildiim 2,848 4,848 Haroo Bakkee 559 3,054 Dhedheertuu 507 2,778 Areerii 510 2,471 Others 435 2,175

Subtotal Yabello 9,338 37,449

Shakiso Haroogarrii 770 6,426 Buriii Edjersaa 411 3,321 Derme 260 1,953 Harra agerssaa 768 8,726 Fiiga Bikkee 23 282

Subtotal Shakiso 2,232 20,708

TOTAL ALL REGIONS 17,070 172,200

Total All Regions Less Yabello 7,732 134,751

* When number of households not available approximation was made based on 10 members per household

** Large discrepancy in number of households and number of displaced reported by DPPC in Dugda Dawa. Observations and ERCS registration most consistent with the household number reported A.2.1 Summary Calculated Needs of Non-Food Items Based on 50% of DPPC Estimate of Displaced Households by Region

# Jerry Cans Soap (kg) Blankets DPPC Estimate (20L) (250g/person/mo) (1/HH)Pots (1/HH) Cups (2/HH) # IDP Actual Total Actual Total Actual Total Actual Total Actual Total Subtotals Households** Need Need Need Need Need Need Need Need Need Need

Dugdadawa 3,000 1,800 3,000 3,750 same 1,500 3,000 0 1,500 1,500 3,000

Arerro 2,500 1,500 2,500 3,125 same 1,875 2,500 625 1,250 2,000 2,500

Yabello*** 9,338 5,603 9,338 11,673 same 9,338 9,338 4,669 4,669 9,338 9,338

Shakiso 2,232 1,339 2,232 2,790 same 2,232 2,232 4,669 4,669 9,338 2,232

Total All Regions 17,070 10,242 17,070 21,338 same 14,945 17,070 9,963 12,088 22,176 17,070

Total All less Yabello 7,732 4,639 7,732 9,665 same 5,607 7,732 5,294 7,419 12,838 7,732

* Actual need = Total Need - Estimate of population actual assets on hand **When number of households not available approximation was made based on 10 members per household *** Yabello not assessed directly by RPHA team. ERCS has identified 400 IDP households in Yabello. Needs further assessment A.2.1 Summary Calculated Needs of Non-Food Items Based on 50% of DPPC Estimate of Displaced Households by Region

Reinforced Plastic Sheets Rope meters Bowls (3/HH) Utensils Bednets (3/HH) (2/HH) (3m/HH) Actual Total Actual Total Act. Total Actual Total Act. Total Subtotals Need Need Need Need Need Need Need Need Need Need

Dugdadawa 2,857 4,500 750 1,500 7,500 1,857 3,000 4,500

Arerro 2,381 3,750 1,250 1,250 6,250 2,134 2,500 3,750

Yabello*** ? 14,007 4,669 4,669 23,345 9,338 9,338 14,007

Shakiso 3,348 3,348 4,669 1,116 5,580 2,232 2,232 3,348

Total All Regions ? 25,605 11,338 8,535 Same 42,675 15,561 17,070 Same 25,605

Total All less Yabello 8,586 11,598 6,669 3,866 Same 19,330 6,223 7,732 Same 11,598

* Actual need = Total Need - Estimate of population actual assets on hand **When number of households not available approximation was made based on 10 members per household *** Yabello not assessed directly by RPHA team. ERCS has identified 400 IDP households in Yabello. Needs further assessment A.2.2 Detailed Calculated Needs of Non-Food Items Projections based on a) actual registered by ERCS to date b) 50% of DPPC Estimate c) Total DPPC Estimate of Displaced Households by Region # HH # Jerry Cans (20L) Est. Pop. Est HH Reg. Based on DPPC DPPC Location (DPPC) (DPPC) (ERCS) ERCS Reg. Estimate Estimate Act. Total Actual Total Actual Total Subtotals Need Need Need Need Need Need

Dugdadawa 3,000 98,175 933 1,120 1,866 1,800 3,000 3,600 6,000

Arerro 2,500 15,868 1,550 1,860 31,736 1,500 2,500 3,000 5,000

Yabello*** 9,338 37,449 459 551 74,898 5,603 9,338 11,206 18,676

Shakiso 2,232 20,708 2,071 2,485 41,416 1,339 2,232 2,678 4,464

Total All Regions 17,070 172,200 5,013 6,015 149,916 10,242 17,070 20,484 34,140

* Actual need = Total Need - Estimate of population actual assets on hand **When number of households notyy available approximation was made based on 10 members per household further assessment A.2.2 Detailed Calculated Needs of Non-Food Items Projections based on a) actual registered by ERCS to date b) 50% of DPPC Estimate c) Total DPPC Estimate of Displaced Households by Region Soap (kg) (250g/person/month) Blankets (min. 1 per HH) Based on ERCS 50% DPPC DPPC Based on ERCS Based on 50% Based on DPPC Location Reg. Estimate Estimate Reg. DPPC Estimate Estimate Act. Tot. Actual Total Actual Total Actual Total Actual Total Actual Total Need Need Need Need Need Need Need Need Need Need Need Need

Dugdadawa 2,333 same 3,750 same 7,500 same 933 1,866 1,500 3,000 3,000 6,000

Arerro 3,875 same 3,125 same 6,250 same 2,325 3,100 1,875 2,500 3,750 5,000

Yabello*** 1,148 same 11,673 same 23,345 same 918 918 9,338 9,338 18,676 18,676

Shakiso 5,177 same 2,790 same 5,580 same 918 4,142 2,232 2,232 4,464 4,464

Total All Regions 12,532 Same 21,338 same 42,675 Same 5,094 10,026 14,945 17,070 29,890 34,140

* Actual need = Total Need - Estimate of population actual assets on hand **When number of households not available approximation was made based on 10 members per household *** Yabello not assessed directly by RPHA team. ERCS has identified 400 IDP households in Yabello. Needs further assessment

A.2.2 Detailed Calculated Needs of Non-Food Items Projections based on a) actual registered by ERCS to date b) 50% of DPPC Estimate c) Total DPPC Estimate of Displaced Households by Region Pots (min. 1 per HH) Cups (2 per HH) Based on Based on 50% Based on DPPC Based on ERCS Based on 50% Based on DPPC Location ERCS Reg. DPPC Estimate Estimate Reg. DPPC Estimate Estimate Act. Total Actual Total Actual Total Actual Total Actual Total Actual Total Need Need Need Need Need Need Need Need Need Need Need Need

Dugdadawa 0 933 0 1,500 0 3,000 933 1,866 1,500 3,000 3,000 6,000

Arerro 775 1,550 625 1,250 1,250 2,500 2,480 3,100 2,000 2,500 4,000 5,000

Yabello*** 459 459 4,669 4,669 9,338 9,338 918 918 9,338 9,338 18,676 18,676

Shakiso 459 2,071 4,669 4,669 9,338 9,338 918 4,142 9,338 2,232 18,676 4,464

Total All Regions 1,693 5,013 9,963 12,088 19,926 24,176 5,249 10,026 22,176 17,070 44,352 34,140

* Actual need = Total Need - Estimate of population actual assets on hand **When number of households not available approximation was made based on 10 members per household *** Yabello not assessed directly by RPHA team. ERCS has identified 400 IDP households in Yabello. Needs further assessment

A.2.2 Detailed Calculated Needs of Non-Food Items Projections based on a) actual registered by ERCS to date b) 50% of DPPC Estimate c) Total DPPC Estimate of Displaced Households by Region Bowls (3 per HH) Utensils Based on DPPC DPPC Based on 50% DPPC DPPC Location ERCS Reg. Estimate Estimate ERCS Reg. Estimate Estimate Actual Total Actual Total Actual Total Actual Total Actual Total Actual Total Need Need Need Need Need Need Need Need Need Need Need Need

Dugdadawa 1,777 2,799 2,857 4,500 5,714 9,000 467 933 750 1,500 1,500 3,000

Arerro 3,772 4,650 2,381 3,750 7,300 7,500 1,550 1,550 1,250 1,250 2,500 2,500

Yabello*** 1,377 1,377 ? 14,007 ? 28,014 459 459 4,669 4,669 9,338 9,338

Shakiso 1,377 6,212 ? 3,348 ? 6,696 459 2,071 4,669 1,116 9,338 2,232

Total All Regions 8,303 15,038 ? 25,605 ? 51,210 2,935 5,013 11,338 8,535 22,676 17,070

* Actual need = Total Need - Estimate of population actual assets on hand **When number of households not available approximation was made based on 10 members per household ***Yabello not assessed directly by RPHA team. ERCS has identified 400 IDP households in Yabello. Needs further assessment A.2.2 Detailed Calculated Needs of Non-Food Items Projections based on a) actual registered by ERCS to date b) 50% of DPPC Estimate c) Total DPPC Estimate of Displaced Households by Region Bednets Reinforced Plastic Sheets (2 per HH) Based on 50% DPPC DPPC Based on ERCS Based on 50% Based on DPPC Location ERCS Reg. Estimate Estimate Reg. DPPC Estimate Estimate Act. Total Act. Total Act. Total Act. Total Actual Total Actual Total Need Need Need Need Need Need Need Need Need Need Need Need

Dugdadawa 4,665 7,500 15,000 1,120 1,866 1,857 3,000 3,714 6,000

Arerro 7,750 6,250 12,500 2,635 3,100 2,134 2,500 4,267 5,000

Yabello*** 2,295 23,345 46,690 918 918 9,338 9,338 18,676 18,676

Shakiso 10,354 5,580 11,160 4,142 4,142 2,232 2,232 4,464 4,464

Total All Regions Same 25,064 Same 42,675 Same 85,350 8,814 10,026 15,561 17,070 31,122 34,140

* Actual need = Total Need - Estimate of population actual assets on hand **When number of households not available approximation was made based on 10 members per household ***Yabello not assessed directly by RPHA team. ERCS has identified 400 IDP households in Yabello. Needs further assessment A.2.2 Detailed Calculated Needs of Non-Food Items Projections based on a) actual registered by ERCS to date b) 50% of DPPC Estimate c) Total DPPC Estimate of Displaced Households by Region Rope meters (3m per HH) Based on 50% DPPC DPPC Location ERCS Reg. Estimate Estimate Act. Total Act. Total Act. Total Need Need Need Need Need Need

Dugdadawa 2,799 4,500 9,000

Arerro 4,650 3,750 7,500

Yabello*** 1,377 14,007 28,014

Shakiso 6,212 3,348 6,696

Total All Regions Same 15,038 Same 25,605 Same 51,210

* Actual need = Total Need - Estimate of population actual assets on hand **When number of households not available approximation was made based on 10 members per household ***Yabello not assessed directly by RPHA team. ERCS has identified 400 IDP households in Yabello. Needs further assessment Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Dugdadawa pg.1 Date June 28, 2006 Source of displacement Location Dugda dawaa Woreda- Finchawaa1,2 PA Road Access Dirt Road . People off-road in bush, approachable only by foot * Very widely dispersed population. Convenience Clan Mix Guji sample conducted of households with goal of Estimated Total Pop. 500 families, ~3500 people 7000 people 5% of clan elders estimate of 500 households in Source Clan Elders Est. DPPC village area NGOs, Govt presence Nearby ERC, WFP/OCHA establishing Sample Household # 1 2 3 45-8 9 10 11 12 13 14 15 16 17-18 19 20-22 Total Avg Total Pop. (HH) 6 5755551110117811911757667 154 7.3 Adults (not Eld/prg) 2 20222224222211221122 38 1.8 Children <15yrs 2 35333296755788334445 99 4.7 Elderly 2 02100000101100101000 10 0.5 Pregnant 0 00000000100102101100 7 0.3 Breastfeeding 0 00000000000000000000 0 0.0 Water Source 1 Spring, open unprotected, hand-dug deeper due to over use, animals and waste at collection Distance (est. km) 5 Improved? 0 Protected? 0 Quality (T/C/A) TCA Fee? 0 Source 2 Motorized Pump, protected with concrete apron, barbed wire perimeter, spouts, hoses, local village water authority w/ fee Dist. Est. (km) 2 Improved? 1 Protected? 1 Quality (T/C/A) 1 Fee? 1 # Jerry Cans 2 22111111111111(1) (1) 11(1) (1) 0.8 Avg Jerry Can Vol. 10 10 10 10 10 10 10 20 10 10 10 10 10 10 20 20 20 10 20 20 20 13.3 # trips fetch water 1 11111122323244222122 1.9 Vol (L)/HH/day 2002020101010104020302030204080151520204040 24.1 Vol (L)/person/day 3 43222242334247233376 3.4 Chlorination?/Filtration? 0 00000000000000000000 0 0.0 defecation area? 0 00000000000000000000 0 0.0 Open Defecation? 1 11111111111111111111 21 1.0 Hygiene Soap? 0 00000000000000000000 0 0.0 Water for bathing? 0 00000000000000000000 0 0.0 water for washing? 0 00000000000000000000 0 0.0

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:14 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Dugdadawa pg.2 Environemental Standing water? 0 00000000000000000000 0 0.0 Carcasses? 1 11111111111111111111 21 1.0 animal waste? 1 11111111111111111111 21 1.0 desig. area for animals 1 11111111111111111111 21 1.0 Vermin/pests FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM Non-Food Items # Blankets 0 21111131101000003112 20 1.0 Pots 1 11111121111111101221 23 1.1 Cups 2 21100033000310212000 21 1.0 bowls 1 11100034220312101000 23 1.1 Utensils 1 01000020002010001111 11 0.5 Bed nets 0 00000000000000000000 0 0.0 Tents 0 00000000000000000000 0 0.0 Plastic sheeting 1 11111101111111001100 16 0.8 Fuel w wwwwwwwwwwwwwwwwwwww w Shelter # estab bldgs 0 00000000000000000000 0 0.0 Tents 0 00000000000000000000 0 0.0 Plastic Sheet/branches 2 11111112111113111100 23 1.1 Open/no shelter 0 00000000000000000011 2 0.1 Medical Health ctr w/in 5km 1 11111111111111111111 21 1.0 In preceding 2 wks: # cases diarrhea 0 00000000101004101000 8 0.4 # URI 0 00000010000000111000 4 0.2 # febrile illness 0 00000000000000000000 0 0.0 # deaths 0 00000000000000000000 0 0.0 # births 0 00000000000000000000 0 0.0 Availability of ORS 0 00000000000000000000 0 0.0 Food Food Type Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Meals/day 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.5 1.0 1.0 0.5 1.0 1.0 1.0 1.0 1.0 1.0 1.0 0.5 0.5 21 1.0 Livelihoods # livestock deaths NA NA NA NA NA NA NA NA 4 Many NANA2922NANANANANA1 20 0.9 # livestock current NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0 0.0 General Comments *Food insecurity, apparent acute on chronic under-nutrition notable in some children, *very poor sanitation, *need improved access to clean water or water treatment, need larger jerry cans ** Numbers in brackets indicate borrowed jerry cans

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:14 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Arrero pg.1 Date June 29, 2006 Location Arero- Vacant Health Post on outskirts of village Source of displacement Road Access Dirt road, some hazards (road cuts etc), IDPs collected near road WayoBoda, Sokomarata, Okete, Hirmayee, Safara, Oda, Angara, Dawa Clan Mix Borena *Sampled from subset of ERCS list of 430 households to Estimated Total Pop. 1500 households 2500 households obtain ~75 HH (5%) Source ERCS Registered DPPC *Unclear which actors beyond ERCS have future plans for NGOs, Govt presence ERCS, IMC, Save the Children, ICRC, World Vision distribution or support Household # 1 234567891011121314151617181920212223H1 Total Pop. (HH) 15 12 8 10 8 10 5 10 9 14 9 13 9 17 9 11 5 5 10 12 10 10 8 10 Adults (not Eld/prg) 2 22024222525262422232324 Children 10 96864387876787733878665 Elderly 2 10101000001020000010000 Pregnant 1 00101000101010000010101 Lactating 1 1 n/a 1 n/a 1 1 1 n/a 1 n/a 1 n/a 0 n/a 1 n/a 1 n/a 1 n/a 1 n/a Water Source 1 All used "Singing wells" which were hand dug, approx 4meters deep, 3 meters across, numerous, open unprotected, animals used same, very turbid with algae and waste nearby Distance (est. km) 4 5565655565656465656565? Improved? 0 Protected? 0 Quality (T/C/A) TCA Fee? 0 Two hand pumps available - improved w/ concrete aprons & spouts but no permimeter from animals nor drainage field protection, fee to use from local water authority occ. Source 2 enforced, need eval. Of ability to sustain additional population pressure from IDPs to avoid conflict w/ community Distance (est. km) 4 5565655565656465656565? Improved? 1 Protected? 1 Quality (T/C/A) 1 Fee? 1 # Jerry Cans 1 1 (1) 11(1) (1) (1) 1 (1) (1) 1 (1) 1 (1) 1 (1) 11(1) (1) (1) (1) 1 Avg Jerry Can Vol. 25 25 25 20 25 25 20 20 25 25 25 25 25 25 25 20 25 8 26 20 25 10 20 20 # trips fetch water 4 24424322222222222222422 Vol (L)/HH/day 100 50 88 80 50 100 60 40 50 50 50 50 50 50 50 40 50 16 52 40 50 40 40 40 Vol (L)/person/day 6.7 4.2 10.9 8.0 6.3 10.0 12.0 4.0 5.6 3.6 5.6 3.8 5.6 2.9 5.6 3.6 10.0 3.2 5.2 3.3 5.0 4.0 5.0 4.0 Chlorination?/Filtration? 000000000000000000000000 Sanitation Improved? 000000000000000000000000 defecation area? 000000000000000000000000 Open Defecation? 111111111111111111111111

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Arrero pg.2 Hygiene Soap? 000000000000000000000000 Water for bathing? 0000000001 00000000000000 water for washing? 0000000001 00000000000000 Environemental Standing water? 000000000000000000000000 Carcasses? 000000000000000000000000 animal waste? 111111111111111111111111 desig. area for animals 111111111111111111111111 Vermin/pests FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR Non-Food Items Blankets 1 1111000.51100010010100010 Pots 0 00020100000000000000010 Cups 1 00000000000000000000000 bowls/plates 0 00020000000000000000000 Utensils 0 00000000000000000000000 Bed nets 000000000000000000000000 Tents 000000000000000000000000 Plastic sheeting 1 n/a0010000000010000000010 Fuel wwwwwwwwwwwwwwwwwwwwwwww Shelter # est bldgs 1 110100110001000111000n/an/a Tents 000000000000000000000000 Plastic Sheet shelter/Ma 1 0000000000001000000000n/a Open/no shelter 0 0010110011101110001111n/a Medical Health ctr w/in 5km 111111111111111111111111 In preceding 2 wks: # cases diarrhea 0 0100500000002000000000n/a # URI 3 0040200100310010000010n/a # febrile illness 4 0030500010301010000010n/a # deaths 0 0000000000000000000000n/a #births 0 0000000000000000000000n/a Availability of ORS 0 0000000000000000000000n/a Food Food Type Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz ? Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz n/a Meals/Day 1 111.510.511111.5?11.50.510.5111111n/a

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Arrero pg.3

Livelihoods # Livestock Deaths/Loss n/a 24 17 n/a 35 n/a 29 85 126 n/a 52 n/a 2 n/a 11 n/a 18 n/a 30 n/a 18 n/a 13 n/a # Current Livestock n/a 00n/a00000000000000000000 General Comments

*People on outskirts of village in very close conditions-potential for outbreak of disease, *Relatively good access to water but need improvement of unimproved sources (protection from animals, cover, etc) *Very poor shelter conditions *Moderate Sanitation conditions likely secondary to lack of animals

**Numbers in brackets indicate borrowed jerry cans

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Arrero pg.4 Date June 29, 2006 Location Arero- Vacant Health Post on outskirts of village Road Access Dirt road, some hazards (road cuts etc), IDPs collected near road Clan Mix Borena *Sampled from subset of ERCS list of 430 households Estimated Total Pop. 1500 2500 households to obtain ~75 HH (5%) Source ERCS Registered DPPC *Unclear which actors beyond ERCS have future plans NGOs, Govt presence ERCS, IMC, Save the Children, ICRC, World Vision for distribution or support Household # H2 H3 H4 H5 OD1 OD2 OD3 OD4 OD5 OK1 OK2 OK3 OK4 OK5 OK6 OK7 SK1 SK2 SK3 SK4 SK5 SK6 SK7 SK8 Total Pop. (HH) 8699577497896136101391113781012 Adults (not Eld/prg) 343834222542242242452237 Children 325023426245464867665563 Elderly 100100000002020020010001 Pregnant 101000101000010010110111 Lactating n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 0 1 n/a 1 n/a n/a n/a n/a n/a n/a Water Source 1 Distance (est. km) 666666666666665565666666 Improved? Protected? Quality (T/C/A) Fee?

Source 2 Distance (est. km) 666666666666665565666666 Improved? Protected? Quality (T/C/A) Fee? # Jerry Cans (1) 221(1) (1) (1) (1) (1) 1111111(1) (1) (1) 111(1) (3) Avg Jerry Can Vol. 20204 202025252020202020202025252020102525102020 # trips fetch water 222211122211132122214252 Vol (L)/HH/day 40 80 16 40 20 25 25 40 40 40 20 20 20 60 50 25 40 40 20 25 88 15 100 120 Vol (L)/person/day 5.0 13.3 1.8 4.4 4.0 3.6 3.6 10.0 4.4 5.7 2.5 2.2 3.3 4.6 8.3 2.5 3.1 4.4 1.8 1.9 12.5 1.9 10.0 10.0 Chlorination?/Filtration? 000000000000000000000000 Sanitation Improved? 000000000000000000000000 defecation area? 000000000000000000000000 Open Defecation? 111111111111111111111111

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Arrero pg.5 Hygiene Soap? 000000000000000000000000 Water for bathing? 000000000000000000000000 water for washing? 000000000000000000000000 Environemental Standing water? 000000000000000000000000 Carcasses? 000000000000000000000000 animal waste? 111111111111111111111111 desig. area for animals 111111111111111111111111 Vermin/pests FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR Non-Food Items Blankets 100000000010111100000010 Pots 100000000010102200000000 Cups 000000000020212200000000 bowls/plates 200000000040422200000000 Utensils 000000000000000000000000 Bed nets 000000000000000000000000 Tents 000000000000000000000000 Plastic sheeting 100000100 1 0 11100000000 Fuel wwwwwwwwwwwwwwwwwwwwwwww Shelter # est bldgs 110011100000000000001110 Tents 000000000000000000000000 Plastic Sheet shelter/Ma 000000000000000000000000 Open/no shelter 001100011111111111110001 Medical Health ctr w/in 5km 111111111111111111111111 In preceding 2 wks: # cases diarrhea 001000001010100021320201 # URI 110001000400210001311301 # febrile illness 111001000000100000611321 # deaths 000000000000200000000000 #births 000000000000000000000000 Availability of ORS 000000000000000000000000 Food Food Type Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz MzMi Mz Mz Mz Mz Mz Mz Meals/Day 1111111111111 10.50.510.5111111

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Arrero pg.6

Livelihoods # Livestock Deaths/Loss 23 8 0 11 8 8 7 6 15 13 1 3 10 12 1 13 7 28 11 9 15 ? ? # Current Livestock 0000000000000 00000000 00 General Comments

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Arrero pg.7 Date June 29, 2006 Location Arero- Vacant Health Post on outskirts of village Road Access Dirt road, some hazards (road cuts etc), IDPs collected near road Clan Mix Borena *Sampled from subset of ERCS list of 430 households Estimated Total Pop. 1500 2500 households to obtain ~75 HH (5%) Source ERCS Registered DPPC *Unclear which actors beyond ERCS have future plans NGOs, Govt presence ERCS, IMC, Save the Children, ICRC, World Vision for distribution or support Household # SK9 SK10 SK11 D1 D2 D3 SF1 SF2 SF3 SF4 SF5 A1 A2 Total Avg Total Pop. (HH) 9151096 8 9 9 9108105562 9.4 Adults (not Eld/prg) 384 1212222231178 3.0 Children 433 7477778664334 5.6 Elderly 132 000000000025 0.4 Pregnant 111 100000001025 0.4 Lactating n/an/an/a110100111121 0.4 Water Source 1 Distance (est. km) 666 5555555555 5.4 Improved? Protected? Quality (T/C/A) Fee?

Source 2 Distance (est. km) 666 5555555555 5.4 Improved? Protected? Quality (T/C/A) Fee? # Jerry Cans (1) (1) 1 (1) 1 (1) (1) 11(1) 111 0.0 Avg Jerry Can Vol. 20 20 20 20 25 25 20 25 25 3 25 25 25 21.1 # trips fetch water 222 2421121121 2.1 Vol (L)/HH/day 40 40 40 40 100 50 20 25 50 3 25 50 25 45.9 Vol (L)/person/day 4.4 2.7 4.0 4.4 16.7 6.3 2.2 2.8 5.6 0.3 3.1 5.0 5.0 5.3 Chlorination?/Filtration? 0000000000000 0 0.0 Sanitation Improved? 0000000000000 0 0.0 defecation area? 0000000000000 0 0.0 Open Defecation? 111111111111161 1.0

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Arrero pg.8 Hygiene Soap? 0000000000000 0 0.0 Water for bathing? 0000000000000 1 0.0 water for washing? 0000000000000 1 0.0 Environemental Standing water? 0000000000000 0 0.0 Carcasses? 0000000000000 0 0.0 animal waste? 111111111111161 1.0 desig. area for animals 111111111111161 1.0 Vermin/pests FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR FMR Non-Food Items Blankets 011 010111011128 0.5 Pots 002 020222022227 0.5 Cups 002 020222022226 0.4 bowls/plates 002 020222022234 0.6 Utensils 002 00000000002 0.0 Bed nets 0000000000000 0 0.0 Tents 0000000000000 0 0.0 Plastic sheeting 000 010111011117 0.3 Fuel wwwwwwwwwwwww w w Shelter # est bldgs 001 001011101024 0.4 Tents 00000000000000 0.0 Plastic Sheet shelter/Ma 000 00000000002 0.0 Open/no shelter 110 110100010136 0.6 Medical Health ctr w/in 5km 1111111111111 In preceding 2 wks: # cases diarrhea 110 110100000028 0.5 # URI 011 001110000041 0.7 # febrile illness 101 000000000040 0.7 # deaths 000 00000000002 0.0 #births 000 00000000000 0.0 Availability of ORS 000 00000000000 0.0 Food Food Type Mz Mz Mz Mz MzMi Mz AnythAnythAnythAnythMz Mz Mz Mz Meals/Day 111 11110.50.50.510.50.555 0.9

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Arrero pg.9

Livelihoods # Livestock Deaths/Loss ? ? ? 71720187 814226027869 14.7 # Current Livestock 000 00000000000 0.0 General Comments

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Qarrari pg.1 Date July 1, 2006 Source of displacement Galeba, Tula Wayo, Delu Location Shakiso - Dada Oda Bolu PA - Qarari Village Road Access Very rough dirt road w/ hazards, ~7km from Dawa village, ~50km from Shakiso Clan Mix Guji Estimated Total Pop. 800 Households (?reliable) In Progress In progress Source Clan Elders Est. ERCS DPPC NGOs, Govt presence ERCS registering for distribution. Sample Household # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 Total Avg Total Pop. (HH) 4 6 11 22 19 10 17 7 13 9 10 8 14 9 6 2 11 17 10 11 16 15 10 12 8 12 13 302 11.2 Adults (not Eld/prg) 11263 2 1 2 7352231137371334 533699 3.7 Children <15yrs 34815155165 5645944161044 294 5497173 6.4 Elderly 01110 2 0 0 001031001020 122 210021 0.8 Pregnant 00001 1 0 0 100101101010 010 0000 9 0.3 Breastfeeding 01111 0 2 1 111001001021 011 122022 0.8 Water Source 1 , open, used by animals, waste drains into river, mildly turbid, brown color, unprotected Dist. Est. (km) 7 Improved? 0 Protected? 0 Quality (T/C/A) TA Fee? 0 Source 2 Dist. Est. (km) Improved? Protected? Quality (T/C/A) Fee? # Jerry Cans (2) 11 (1) (2) (1) (2) (1) (1) (1) (1) (1) (1) 11121(1) (1) (1) (1) 1111 (0.2) Avg Jerry Can Vol. 5 5 5 2025252510101010102020202020202020202020202020 16.9 # trips fetch water 213 2 2 2 2 222222111121 111 1111 1.5 Vol (L)/HH/day 20 5 15 40 100 50 100 20 20 20 20 20 40 20 20 20 40 40 20 20 20 20 20 20 20 20 29.6 Vol (L)/person/day 511 2103142223143102242 112 2322 3.3 Chlorination?/Filtration? 000 0 0 0 0 000000000000 000 0000 0 0.0 defecation area? 00000 0 0 0 000000000000 000 0000 0 0.0 Open Defecation? 11111 1 1 1 111111111111 111 111127 1.0 Hygiene Soap? 00000 0 0 0 000000000000 000 0000 0 0.0 Water for bathing? 00000 0 0 0 000000000000 000 0000 0 0.0 water for washing? 00000 0 0 0 000000000000 000 0000 0 0.0

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Qarrari pg.2 Environemental Standing water? 00000 0 0 0 000000000000 000 0000 0 0.0 Carcasses? 00000 0 0 0 000000000000 000 0000 0 0.0 animal waste? 11111 1 1 1 111111111111 111 111127 1.0 desig. area for animals 11111 1 1 1 111111111111 111 111127 1.0 Vermin/pests FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM FM Non-Food Items # Blankets 00000 0 0 1 000000000100 000 0100 3 0.1 Pots 00010 0 0 0 000001111000 000 0100 6 0.2 Cups 00000 0 0 0 000000000000 011 0100 3 0.1 bowls 00000 0 0 0 000000000000 000 0000 0 0.0 Utensils 00000 0 0 0 000000000110 000 0000 2 0.1 Bed nets 00000 0 0 0 000000000000 000 0000 0 0.0 Tents 00000 0 0 0 000000000000 000 0000 0 0.0 Plastic sheeting 00000 0 0 0 000000000000 000 0100 1 0.0 Fuel wwwww w w w wwwwwwwwwwww www wwww Shelter # estab bldgs 00000 0 0 0 000000000000 000 0000 0 0.0 Tents 00000 0 0 0 000000000000 000 0000 0 0.0 Plastic Sheet/branches 00000 0 0 0 000000000000 000 0100 1 0.0 Open/no shelter 11111 1 1 1 111111111111 111 101126 1.0 Medical Health ctr w/in 5km 00000 0 0 0 000000000000 000 0000 0 0.0 In preceding 2 wks: # cases diarrhea 10200 0 0 0 112210000010 010 010114 0.5 # URI 04010 0 5 0129221101000011000 000159 2.2 # febrile illness 00000 0 0 01200000000000 000 000113 0.5 # deaths 00000 0 0 0 000000000000 000 0000 0 0.0 # births 00000 0 0 0 000000000000 000 0000 0 0.0 Availability of ORS 00000 0 0 0 000000000000 000 0000 0 0.0 Food Food Type Mi/MzMi/MzMi/Mz Mi/Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Mz Meals/day 1##1.52##11 1 111111111111 111 111130 1.1 Livelihoods # livestock prev unk unk unk unk unk unk unk unk 18 10 2 7 10 8 10 2 6 many 7203664553132 4.9 # livestock current 51300 3 3 11052610110269410344 4532116 4.3 # livestock deaths unk unk unk unk unk unk unk unk 850107000unk310022 002141 1.5 General Comments *Cold weather - exposure concerns, *Have some livestock * numbers in brackets indicate borrowed jerry cans *Vulnerable to distant water and poor grazing, may move closer to Dawa village concern over crowding Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Derme pg.1 Date July 2, 2006 Location Shakiso - Derme PA - ??? Village (across branch bridge) Source of displacement Hirmayee, Deru Road Access Very rough dirt road w/ hazards, ~70km from Shakiso town *Only 80 households were present at time of sampling, 10% of Clan Mix Guji present were sampled (3% DPPC est) limited by time Estimated Total Pop. 400 Households 260 households *Sampling followed by focus group discussion with all households Source ERCS Estimate DPPC estimate present to assess needs and plans for return NGOs, Govt presence ERCS registered for distribution. Nearby in HarroGari MSF(Greece?) reportedly making assessment for response Household # 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425Total Avg Total Pop. (HH) 17 33 11 29 11 18 32 16 167 20.9 Adults (not Eld/prg) 34245666 36 4.5 Children <15yrs 11 28 9 23 5 9 21 6 112 14.0 Elderly 31010101 7 0.9 Pregnant 00011253 12 1.5 Breastfeeding 02021332 13 1.6 Water Source 1 River water, moderate flow rate, used by animals, turbid, no color, animals and waste Dist. Est. (km) 33 Improved? 00 Protected? 00 Quality (T/C/A) TA TA Fee? 00 Source 2 Dist. Est. (km) Improved? Protected? Quality (T/C/A) Fee? # Jerry Cans (1) 1 (2) 31(1) (1) (1) (0.1) Avg Jerry Can Vol. 5 5 5 5 10 10 10 10 7.5 # trips fetch water 26246467 4.6 Vol (L)/HH/day 10 30 20 60 60 40 60 70 43.8 Vol (L)/person/day 11225224 2.4 Chlorination?/Filtration? 000 00 00 0 0.0 defecation area? 00000000 0 0.0 Open Defecation? 11111111 8 1.0 Hygiene Soap? 00000000 0 0.0 Water for bathing? 00000000 0 0.0 water for washing? 00000000 0 0.0

Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM Rapid Assessment Tool for IDP settlements from Conflict in Southern Ethiopia, June 2006 Derme pg.2 Environemental Standing water? 00000000 0 0.0 Carcasses? 00000000 0 0.0 animal waste? 11111111 8 1.0 desig. area for animals 11111111 8 1.0 Vermin/pests FM FM FM FM FM FM FM FM FM Non-Food Items # Blankets 00000000 0 0.0 Pots 00000000 0 0.0 Cups 00000000 0 0.0 bowls 00000000 0 0.0 Utensils 00000000 0 0.0 Bed nets 00000000 0 0.0 Tents 00000000 0 0.0 Plastic sheeting 00001100 2 0.3 Fuel wwwwwwww Shelter # estab bldgs 00000000 0 0.0 Tents 00000000 0 0.0 Plastic Sheet/branches 00000000 0 0.0 Open/no shelter 11111111 8 1.0 Medical Health ctr w/in 5km 11111111 8 1.0 In preceding 2 wks: # cases diarrhea 5431421 42 35 4.4 # URI 17 4 3 2 2 1 7 6 42 5.3 # febrile illness 05344134 24 3.0 # deaths 00000000 0 0.0 # births 00000000 0 0.0 Availability of ORS 00000000 0 0.0 Food Food Type Mz Mz Mz Mz Mz Mz Mz Mz Mz Meals/day 1 1.5 1.5 2 1.0 1 1 1 10 1.3 Livelihoods # livestock prev 30 55 4 11 100 25.0 # livestock current 35 5 6 5 0 0 3 4 58 7.3 # livestock deaths unk unk unk unk 30 55 1 7 93 11.6 General Comments * Cold weather - exposure concerns * Greater prevalence of URI, diarrhea * Have some livestock * Several cases of bloody diarrhea reported at village health post-not specifically IDP population *** numbers in brackets indicate borrowed jerry cans Harvard Humanitarian Initiative-Oxfam America 7/7/2006 4:15 PM A.7 Organizations and Capacity for Humanitarian Response-Southern Ethiopian Conflict-2006

Emergency Response Activities Regional Humanitarian Activities Assessment Conflict Food Aid Non F/A Water Health Advocacy M&E Assessment Conflict Food Aid Non F/A Water Region Mitigation Sanitation Mitigation Sanitation OA Shakiso/DD/A X X X X Harvard Humanitarian Initiative Shakiso/DD/A X XX OGB X X IO OCAA ERCS XX XX?X RCWDA XX? SEDA XX? GTF PCAE XX HfH X AFD CDI XXXXX OSHO XX GPDI XXX RCCE XX ACDI/VOCA CARE X XX Danish Church Aid D/A/Y X (has provided) Organization CISP DCA D/A/Y XX DPPC XX FAO FHI GOAL XXX ICRC XX IMC 5 woredas listed supplementary by UNOCHA X (nutrition) X a feeling MSF Belgium X X MSF CH MSF_H MSF-Greece Shakiso X XXX ?X XX NCA RCCE XX SAVE X SCUSA SOS SOS Sahel UNHCR? UNICEF X UNOCHA X X USAID WFP X WHO World Vision Arero X (provided) X Acronyms: AFD Association for Development PCAE Pastoralist Concern Association in Ethiopia ERCS Ethiopia Red Cross Society RCCE Research Center for Civic and Human Rights Education CDI Centre for Development Initiative RCWDA Rift Valley Children and Women Development Association DPPC Distaster Prevention and Preparedness Commision SEDA Selam Environmental Development Association GPDI Gayo Pastoralist Development Initiative UNICEF United Nations Childrens Fund GTF Gudina Tumsa Foundation UNOCHA United Nations Office for the Coordination of Humanitarian Affairs HfH Hope for The Horn WFP World Food Program ICRC International Committee of the Red Cross IMC International Medical Corps OGB- Oxfam Great Britian OSHO Omo Self Help Organization

Additional Organizations at UNOCHA meeting SOS CISP SCUSA USAID WHO MSF_H DCA ACDI/VOCA MSF CH MSF Belgium NCA FHI

OXFAM-AMERICA/ HHI Rapid Health Assessment Southern Ethiopia Conflict Phone meeting with MSF-Greece July 6th, 2006 Participants Jennifer L Chan Manuel ( )

Contact Information Email- [email protected]

REGION

Woreda-Shakiso Kebeles- (5)

Haroogarrii Dawa (2) Darmee Harrragerssaa Fiiga Bikkee

METHODOLOGY • Focus Groups • Interviews • Secondary Data

POPULATION ESTIMATES

• no independent assessment. Information from DPPC, key informants, and community leaders. • 3-4 wk ago a registry prepared and given to zonal DPPC from community leaders ( completed after 1 week displacement, with continue incoming IDPs • 20,700 pple registered 1st week after conflict. • MSF estimates 30,000 people in Shakiso • Assume average HH size 10 pple

COMMUNITY MOVEMENT • No plans among the communities to return to original communities which is thought to burden government local agencies

DAWA

Population Characteristics

OXFAM-AMERICA/ HHI Rapid Health Assessment Southern Ethiopia Conflict Phone meeting with MSF-Greece July 6th, 2006 • Met with IDPs on road, collected information (populations they met ranged from 400-1500 pple) • 3,300 registered after 1st week of conflict • MSF >8,000-12,000 estimated by figures from clan leaders/administration • Spoke to many not registered on list.

Health • Superficial health assessment. • No serious situation. Suspected infection among community were prevalent due to lack of water for sanitary purposes. o Estimated 3-5 km to water source • Many children with conjunctivitis/vomiting, reports of fever

Nutrition • Assessed nutrition status, children<5, • No moderate malnutrition- assessed by MUAC- plans for more in depth assessment • Only 2 children were in the orange side of MUAC, most in green and few in yellow.

Food • Little food reserves, eating corn, communities sharing food, some with sugar cane/bread. • Selling cattle for food.

Trauma ( Physcial/Psychosocial) • One IDP with signs of subacute trauma • No formal assessment of psychosocial trauma, but looting and burning reported and sense of psychological stress due to conflict and displacement

HAROOGARRII/ HARRRAGERSSAA ( this may be incomplete)

Population Characteristics • Estimates of 5,000 pple in each location • Difficult to obtain accurate numbers • Widely dispersed over large areas • Groups of 80-120 people clustered, with many communities carrying guns

Health • Health conditions were better than that of Dawa- less duration of displacement • Infections- ( unclear type) • 1 reports of peri/post partum death • Fevers, headaches

Security- community with guns, but visible conflict

OXFAM-AMERICA/ HHI Rapid Health Assessment Southern Ethiopia Conflict Phone meeting with MSF-Greece July 6th, 2006 Population Movement • Some communities were moving- unclear reason.

MSF Response

• Current focus upon Guji IDP population within Shakiso

Activities • Distribution of non food item kits ( 3000 HH) • Resources from other MSFs working in Ethiopia • Obtained from emergency MSF stocks • Transportation of essential drugs • Medical Screening (unclear if all 5 Kebeles) o Will measure wt/ht, 25 ? survey to assess medical issues, check measles vaccination coverage. Reports of malaria outbreak/typhoid fever in the past, will monitor.

Dawa Specific Activities • Child screening to received cards that will provide basic data of households, medical data and allow for organization • Will recruit pregnant women elderly, sick to return for re-evaluation.

Resources • 3000 Kits from Emergency stocks ( 1 per HH) • Essential drugs • 15 trucks • 6 medical personel (internal from MSF Ethiopia) • ? Translators • Drivers • Logistician • Health Educator

Kits with carrying sac • Plastic sheeting ( 8m x 2m/kit) • 6 blankets • 1 Jerry Can ( ? vol) • Rope ( unclear length) • Plastic rugs for sleeping • Washing basin • Plastic jar • 3 plastic cups

OXFAM-AMERICA/ HHI Rapid Health Assessment Southern Ethiopia Conflict Phone meeting with MSF-Greece July 6th, 2006 • Body soap (unclear wt) • 5.5 L pot • 2.5 L pot • Small tea pot • Traditional tray.

Coordination • with other MSFs involved in Ethiopia • Emergency stock kits • Personnell

Timeline • First Phase July 10th-21st • Will distribute to first registered, and urging new families to register with DPPC, • Second Phase- End July-august.

Aware that additional health services are needed for the Borena region. MSF will have discussions with staff to determine capacity.

OCHA meeting this afternoon, will present findings of UN assessment At 3pm at OCHA