EMERGENCY AND HUMANITARIAN ACTION (EHA)

WEEKLY UPDATE – WHO COUNTRY OFFICE : (Week 19, 4 – 10 May 2009) HIGH LIGHTS :

• According to official reports from the Federal Ministry of Health (FMOH), no case of Influenza A H1N1 has been reported from Ethiopia and the situation is being monitored closely.

• The food security situation in some areas of SNNP, Amhara, Tigray, Somali and eastern Oromiya regions is gradually declining. Due to the delayed start and generally poor performance of the belg rains, the area planted this year has significantly decreased. • WHO supported TOT training of 51 health workers in influenza A H1N1 preparedness and response activities. 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 security and malnutrition.

• The food security situation in some areas of SNNP, Amhara, Tigray, Somali and eastern Oromiya regions is gradually declining. Due to the delayed start and generally poor performance of the belg rains, the area planted this year has significantly decreased. The below normal rains received during the last two dekads of April (11- 30 April) have also affected the development of belg crops as well as the germination of long-cycle meher crops planted in some areas. The situation in the belg-crop producing parts of the country is expected to deteriorate further during the July to September lean season.

• In the pastoral region of Afar, where rains have been below normal during the past two seasons, performance of the sugum (March to May) rains has been poor and the remainder of the season is forecasted to be below normal. Physical condition of livestock, terms of trade and livestock productivity are expected to decline until the main seasonal rains (karma) begin in July. In Somali Region also, although the start of the gu rains have been timely (early April), they have so far performed poorly in most areas.

• Admissions of acutely malnourished children to Stabilization Centers (SCs) and Outpatient Therapeutic Programs (OTPs) have increased in parts of SNNPR and West Arsi, East and West Harerge zones (Oromiya). The nutritional situation in SNNPR is further aggravated by the current outbreak of malaria in many low and midland areas where control operations are underway. New SCs and OTPs are being established in , Shashemene, and in West Arsi of Oromiya to cope with the rapidly deteriorating nutritional situation. A wide-scale nutrition screening has been completed in West and results are being compiled. Meanwhile, WFP reports that relief rations have been dispatched and targeted supplementary food dispatch will start when the numbers are available. UNICEF supported the Regional Health Bureau implementing the Enhanced Outreach Strategy (EOS) in the five woredas of West Arsi, starting from 25 April. Children under five have been supplemented with one dose of vitamin A and de-wormed. UNICEF also dispatched six tons of Ready-to-Use Therapeutic Food (RUTF), drugs, and non-food items to the zone.

Influenza A H1N1

• To date no suspected cases of Influenza A H1N1 have been reported by the Federal Ministry of Health. In line with the required preparation, the United Nations country Team has started revitalizing its country plan coordinated by WHO Country Office. About 22 UN agencies are taking part in this process. Five ( finance, logistics, security, communication and technical) working groups have been formed to support this process and are providing weekly brief to the SMT chaired by the Designated Officer (DO) of the UNECA. • WHO is supporting the FMOH in revising its preparedness and response plan. This week WHO in collaboration with the Ethiopian Health and Nutrition Research Institute (EHNRI) conducted a TOT for 51health staff from the 10 regions consisting of regional health bureau focal points, laboratory staff and hospital medical directors on emergency preparedness and response to influenza H1N1. So far Influenza A H1N1 case definitions have been prepared and distributed to the regions, emergency operating centers have been established, and personal protective equipment have been provided to Bole International Airport Quarantine Directorate staff.

II. ANALYSIS & HEALTH CONSEQUENCES: Health problems & Needs of affected populations.

Food insecurity and malnutrition

• Admissions of acutely malnourished children to Stabilization Centers (SCs) and Outreach Theurapidic Centers (OTPs) continue to increase in many parts of SNNPR, West Arsi, East and West Harerge zones (Oromiya). New SCs and OTPs are being established in Seraro, Shashemene, Shala and Arsi Negele (West Arsi) to cope with the rapidly deteriorating nutritional situation. Serious nutritional situation is also reported in Agarfa woreda of Bale Zone. The nutritional situation in SNNPR is further aggravated by the current outbreak of malaria in many low and mid altitude areas where control operations are now underway. In summary, the poor performance of the current rains will exacerbate the situation unless assistance interventions are timely and adequate.

Acute Watery Diarrhoea (AWD)

• The technical committee of the Emergency Health and Nutrition Task Force continues to meet with secretariat support from WHO. Reports from partners, and Somali RHBs reported AWD infection spreading to new districts. The identified gaps are poor case management, inadequate CTCs materials and drugs, poor water supply, inadequate human resources, poor hygiene and sanitation. High movement of Internally Displaced People (IDPs) is a major challenge for the control of the disease. The needs of affected people are drugs, water treatment chemicals, awareness creation and trained health staff to support proper case management. Government and partners are responding and mobilising more resource to support response.

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, and infrastructure) and other partners support.

Food insecurity and malnutrition

• This week WHO has continued its technical support to regions in responding to food and nutrition crisis in Ethiopia. The nutritional survey in Somali Region has been started as of 12 April 2009 under the leadership of the Ethiopian Health and Nutrition Research Institute (EHNRI). WHO is member of the Technical working group for the survey and has provided both financial and technical support to the survey.

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Acute watery Diarrhoea (AWD)

• WHO continues to provide technical support to the affected regions of Somali and Oromia Regions through provisions of emergency drug kits, assessment and strengthening surveillance WHO is coordination health partners’ support through weekly technical task force meetings in WHO office chaired by the FMOH.

Influenza A H1N1

• WHO is coordinating the revision of the influenza contingency plan for the UN Country Team to facilitate the preparation of the pandemic response. Different task forces have started working on the document with the participation of all UNCT agencies. The preparatory work meeting is conducted on daily basis for the last one week chaired by WHO. In addition technical support is also given to the national Government to facilitate preparedness and response at national and regional levels.Current response activities of FMOH supported by WHO includes enhancing surveillance in all entry point including Bole International airport, supported TOT for 51 health staff from the regions and laboratories in the country, distribution and orientation on standard case definition, public education on personal hygiene and advised to seek medical attention if they develop symptoms of influenza –like- illness.

V. COORDINATION: • This week, WHO actively participated in the technical officers/UNOCHA, WASH cluster/MoWR, Nutrition cluster and Ethiopian Humanitarian Country Team (EHCT)/UNDP meetings held in Addis Ababa. • WHO is supporting and facilitating the coordination for the preparedness and response of influenza A by the UN country team. VI. COMMENTS: • With the current belg rains in many parts of the country, there is high probability that the AWD outbreak will affect more regions. WHO is reflecting on how to work effectively in partnership with the FMOH, RHBs and partners in strengthening capacity of the federal and regions for better AWD response.

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