EMERGENCY AND HUMANITARIAN ACTION (EHA) WEEKLY UPDATE – WHO COUNTRY OFFICE ETHIOPIA: (Week 12, 16 – 22 March 2009) HIGH LIGHTS : • Reports of significant increases in severe malnutrition in parts of Amhara and Tigray regions (from Goal, CONCERN and World Vision) suggest a growing crisis in these chronically food insecure areas. WFP field staffs are on alert and monitoring the situation closely. • No new cases of Meningitis have been reported nationally this week. Both the alert and epidemic thresholds have not been reached in any district so far. As part of the preparedness for this year, vaccines, medical supplies and fund for training and supervision have been allocated /prepositioned in the high risk regions. I. GENERAL SITUATION: a) Political, social, security overview for the week • The overall security situation in the country remained stable during this week. No major security incidents involving humanitarian staff members have been reported. b) Main events of interest/ concern for health (displacements, conflicts, disease outbreaks, etc.) Food insecurity and malnutrition situation • Whist awaiting for the onset of belg rains, land preparations for planting of belg crops have continued in most belg producing parts of the country and farmers in parts of Tigray, Amhara, SNNP and Oromiya regions have started planting in anticipation of the onset of belg rains, indicates recent WFP food security update. In SNNPR, farmers have started planting maize, Irish potato, sweet potato and other root crops. Meanwhile, parts of Oromiya Region including East and West Hararghe and Borena zones remain dry. There is an outstanding emergency seed and agricultural inputs requirement among farmers in Borena zone due to adverse impacts of poor crop performance of the past two consecutive production seasons, notes CARE. , According to UNICEF water shortages continue to be of high concern in parts of Somali Region including Ferfer, Denan, Adadle and East Imey woredas of Gode zone requiring water trucking interventions and preparedness activities. Critical water shortages continue to be reported from Elidaar, Kori, Bidu and Erepti woredas of Afar.. • The 2009 WFP Market Watch report indicates a 28.1 per cent increase of general inflation in January 2009 (45.6 per cent) compared to rates in January 2008, which is attributed to the increase in food Consumer Price Index (CPI) by 44.8 percent, of which cereals increased by 77.6 percent and non-food increased by 27 percent. In January 2009, general inflation based on the monthly moving average stood at 45.6 per cent, food inflation at 60.9 percent and non-food inflation at 23.4 per cent. Across the regions, Harar recorded the highest increase in food index with 63.7 per cent while Benshangul Gumuz recorded the lowest food CPI increase of 36 per cent. The report further indicates that prices of local and imported major staple food items continue to decrease following the commencement of new harvest; price stabilization programs conducted by the Government and continued food aid interventions. Local prices show between 2 per cent to 25 per cent decrease for wheat; 9 percent to 15 per cent decrease for sorghum while maize shows a slight increase of 3 per cent to 10 per cent compared to prices in December 2008. The domestic prices for wheat and sorghum still remain above the import parity prices across the markets whilst import parity price is above local prices for maize. Nevertheless, the trend for local prices may start to increase as the season progresses into the hungry season and out of the peak marketing season. Meanwhile, the Government continues importing cereals from the urban price stabilization: some 300,000 MT of cereals is produced as part of a fourth urban price stabilization round. • WFP inputs to the national Relief program (80 percent of the overall requirement) for 2009 stand at a shortfall of 282,300 MT valued at US$ 235.7 million; the Productive Safety Net Programme is short of 54,600 MT valued at US$ 47.2 million; and Targeted Supplementary Food is short of 35,000 MT amounting to US$ 30.3 million. Meanwhile, a total of 179,674 MT of mixed commodities comprising 162,244 MT of cereals; 4,926 MT of pulses; 10,008 MT of blended food and 2,496 MT of oil, are expected to arrive in country during March to June 2009. Total WFP in-country stock at present amounts to 18,042 MT, including 10,352 MT in hubs in Somali Region. DMFSS in-country stock currently stands at 61,679.5 MT including 13,164.193 MT non-allocated stocks while Ethiopian Food Security Reserve Administration (EFSRA) stocks amount to 177,971 MT. • Food dispatch reports from WFP show that 90 per cent of 54,623 MT of food allocated for relief for December 2008 has been dispatched, including 20,143 MT to Somali Region (84 percent). Overall, 1,318 MT of supplementary food commodities have been dispatched to 47,346 under five children and pregnant and lactating women in SNNP, Somali (49 percent) and Tigray Regions as of 10 Mach 2009. Under the Productive Safety Net Programme, 6,684 MT of food to Afar (January allocations) has been dispatched; 1,848 MT of food dispatched to Oromiya. Acute Watery Diarrhoea (AWD) Situation: • According to official reports from the Federal Ministry of Health (FMoH), 31 cases of AWD have been reported from Oromiya and Somali regions from 9 th to 15 th March 2009. Twenty nine cases and no death from Moyale woreda of Borena zone, Oromiya and two cases and no death from Moyale woreda of Liben zone, Somali region. From 1st January to 27 th February 2009, a total of 196 AWD cases and 7 deaths (CFR 3.5%) were reported from Moyale districts of Liben Zone in Somali Region and Borena zone in Oromiya region. II. ANALYSIS & HEALTH CONSEQUENCES: Health problems & Needs of affected populations. Food insecurity and malnutrition • The Amhara Child Survival Task Force meeting also recommended a rapid nutritional assessment in Ziquala woreda of Waghimra zone, following reports of deteriorating nutritional situation reported to the federal ENCU by SC-UK, notes ENCU. Seqota and Tselemt are among identified woredas of concern in the region. Acute Watery Diarrhoea (AWD) • Continued presence of risk factors such as poor quality of water supply, inadequate health services in some woredas, poor sanitation and hygiene and inadequate food safety practices contribute to the persistence of the epidemic in the country. Moreover, the risks of AWD outbreak due to recent rains in some parts of the country continue to increase. Areas of concern which needs much attention and focus are the private state farms and Holy water sites which attracts thousands of people and do not have adequate portable water supply, sanitation and health facilities..Efforts are under way to ensure better preparedness in these sites with technical support from WHO. • Since 2006 to this reporting week AWD a dreaded waterborne disease remains a troubling yard stick of 2 inadequate access to safe drinking water and sanitation. AWD epidemic is an indicator of widespread contamination of drinking water with human faeces in the affected areas of Ethiopia. • The needs are improved multi sectoral coordination, access to clean water and sanitation facilities, better case management in CTCs and staff training in prevention and control measures. Meningococcal meningitis • No new cases of meningitis have been reported this week. Both the alert and epidemic thresholds have not been reached in any district so far. As part of the preparedness for this year, vaccines and medical supplies and fund for training and supervision been prepositioned in the high risk regions. III. ACTIONS (in relation or response to the issues mentioned above): a) WHO activities (field trips, assessments, gap filling, coordination, information sharing, training, etc.) & needs (Human resources, material, infrastructure) Food insecurity and malnutrition • This week WHO has continued its technical support to regions in responding to food and nutrition crisis in Ethiopia. Following a request by the Somali Regional Authorities, the Government in collaboration with stakeholders is planning to conduct standard nutrition assessments in the region under the coordination of Ethiopian Health and Nutrition Research Institute (EHNRI). Preparations to conduct the assessment are well underway. In February 26 th 2009, a steering committee was formed comprising of UNICEF, WFP, WHO, CSF UK, DFID, EHNRI and OCHA. A technical team comprising EHNRI, FMOH, EWRD/DMFSS, WHO, ENCU, UNICEF and SC-UK is charged with providing technical support to the regional authorities on the planned survey. A preparatory meeting for the Somali Region Nutrition Survey was held at the Bureau of Health in Jijiga with DPPB, WFP, UNICEF, ENCU, WHO and SCF- UK last week. It was proposed to conduct the survey by livelihood zones rather than the administrative borders, which are representative for the whole region instead of selected woredas. Resource mobilization and sector contributions are being finalised to start training and field work. Acute watery Diarrhoea (AWD) • WHO continues to provide technical support for regions to strengthen surveillance, early warning system, assessment of AWD response, and on job training of health workers to improve the quality of AWD management. WHO has provided funds and drugs to the Somali and Oromia regions to support the response activities. Meningococcal meningitis • As part of the preparedness for this year vaccines have been distributed to the following high risk regions as follows: Oromia 400,000 doses, SNNPR 400,000 doses Tigray 300,000 doses Amhara 300,000 doses and Addis Ababa 200,000 doses. The vaccines are expiring in January 2010. • Medical supplies, laboratory reagents and drugs have also been prepositioned in these high risk regions. The sum of $US252, 072 and $US113, 159 has been provided to the high risk regions to support the vaccination exercise and training and supervision of health workers.