EMERGENCY AND HUMANITARIAN ACTION (EHA)

WEEKLY UPDATE – WHO COUNTRY OFFICE : (Week 13, 23 – 29 March 2009) HIGH LIGHTS :

• Food security in the belg crop producing parts of the country is threatened by a delayed and erratic start of the belg rains. If the rains remain unchange, a second consecutive below-average harvest will occur in these already chronically food insecure parts of the country. Close monitoring of the seasonal rains through the end of the season is required.

• According to official reports from the Federal Ministry of Health (FMOH), 175 cases of AWD have been reported from Oromiya and Somali regions from 16 th to 22 nd March 2009. One hundred forty five cases and no death from woreda of Borena zone, Oromiya region and 30 cases and no death from Moyale woreda of Liben zone, . 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

• Ethiopia continues to face high levels of food insecurity, with an estimated 12.4 million people considered currently food insecure. A total of 7.5 million people will be covered under the Productive Safety-Net Program (PSNP), whilst 4.9 million people require emergency food assistance from January to June 2009.

• A delay of belg rains continues in belg-growing areas of the country, particularly in eastern Amhara, southern Tigray as well as in parts of SNNP and Oromiya regions. Most farmers in these areas have completed land preparation while some have started planting in an anticipation of the onset of rains. The recent Afar region food security update reports that despite one day shower in parts of the region during late January, woredas of Elidar, Kori, Bidu, and Erebti continue to face serious water shortages for human and livestock consumption as the Jilal (long dry season) continues. Pasture availability in the region has deteriorated resulting in poor livestock physical condition and intra-woreda movement of livestock in search of graze.

• The national inflation rate in February 2009 was 46.1 per cent, with food inflation at 61.1 per cent and non-food inflation rate of 24.2 per cent. The price of maize, the food most widely consumed by the poor, is 130 per cent higher than the 2004 – 2008 average and 47 per cent higher than that of February 2008. The food security of households that spend a significant proportion of their income on food will continue to be negatively affected due to the high and rising staple food prices.

• WFP presently faces a total shortfall of 371,693 MT of food resources amounting to US$ 313 million. WFP inputs to the national relief programme (80 per cent of the overall requirement) for 2009 stand at a shortfall of 282,093 MT valued at US$ 235.5 million; the Productive Safety Net Programme(PSNP) 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. Total WFP in-country stock at present amounts to 17,036 MT, including 7,400 MT in Hubs in Somali region. Disater Management and Food Security Section (DMFSS) in-country emergency food stock as of 20th March 2009 stands at 26,832 MT, including 20,554 MT non-allocated stocks whereas the free stock for PSNP amounts to 64,696 MT. On the other hand, the Ethiopian Food Security Reserve Administration (EFSRA) stocks amount to 198.849 MT. Sixty six per cent of 33,212 MT of food allocated for relief for February 2009 has been dispatched. Similarly, 20,143 MT of food has been dispatched to the seven zones of Somali region (84 per cent) through the Hubs and Spokes System.

Acute Watery Diarrhoea (AWD) Situation:

• According to FMOK reports this week 145 cases and no death reported from Moyale woreda of Borena zone, Oromiya region and 30 cases and no death from Moyale woreda of Liben zone, Somali region. • . From 1 st January to 21st March 2009, a total of 371 AWD cases and 7 deaths (CFR of 1.9%) were reported from Moyale districts of Liben Zone in Somali Region and Borena zone in Oromiya region. FMOH has sent a team to the region to assess the situation and assist the local health authorities in their response activities. Inadequate Water and sanitatioin facilities, poor public awareness, inadequate access to health services and security remain the main challenges

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

Food insecurity and malnutrition

• On 16 th March, the Emergency Nutrition Coordination Unit/Early Warning and Response (ENCU/EWR) Directorate presented the updated list of hotspot woredas in the country. The update indicated that the number of hotspot woredas under priority one in the country have decreased by 30 per cent, from 216 in 2008 to 151 in March 2009. Updated list of hotspot woredas will be used by the nutrition cluster and other stakeholders in resource allocation and prioritization of humanitarian interventions. The list will continue to be updated at regular intervals to accommodate variations. • The estimated 12.4 million people considered currently food insecure; 7.5 million people will be covered under the Productive Safety-Net Program (PSNP), whilst 4.9 million people require emergency food assistance from January to June 2009.

Acute Watery Diarrhoea (AWD)

• The technical committee of the Emergency Health and Nutrition Task Force conducted a meeting chaired by FMOH at WHO office on the 25 th March 2009. Information on the AWD situation and response in Moyale districts of Oromiya and Somali regions was shared by partners supporting the response. The Information showed that the disease is spreading to new districts in Oromiya and Somali Regions. The major risk factor is the inadequate access to safe drinking water and sanitation in the area. Urgent action is required now.

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 districts need technical assistance, drugs, water treatment chemicals, provision of standard cholera treatment centres, logistic and coordination support • Partners working in the areas have started sharing information on activities and gaps, to facilitate development of an action plan to assist case management, capacity building, prevention and control of the disease. 2

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. Preparations to conduct the planned nutrition survey in Somali region are progressing. Consultations under the leadership of the Ethiopian Health and Nutrition Research Institute (EHNRI) have continued. Meanwhile, on 18 th March 2009, the EHNRI presented details of estimated resources required or the survey and requested humanitarian partners to extend pledges on personnel, logistical and financial supports.

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 regions to support the response activities. In addition emergency 6 drugs kits have been allocated to Somali and Oromia Regions to support the AWD response. • MSF Belgium is supporting Borena Zone of Oromia Region and LIben Zone of Somali Region. Together with the health bureau for Borena zone 4 kebeles in the districts of DAS and MIRA were visited and increased diarrhoea cases were reported. Investigations are under way to verify the cause and type of diarrhoea. In addition MSF-Belgium has received a good support from Oromia water bureau in Addis who ensured that chlorine is available in the factory and also contacted the regional water bureaus to push to release water guard for the community mobilisation in the affected areas. MSF-Belgium will transport some of the items for the Somali Region as their water bureau does not have the capacity to pay for transport.

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. The main challenge remains how to improve sharing of laboratory diagnosis results in time. V. Coordinatio n:

• 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 supported the multi agency nutrition survey technical meeting in Jijiga to develop proposal for the nutrition assessment. • WHO is facilitating the coordination response of the current AWD outbreak in Libe Zone and 3

Moyale districts of Somali and Oromia Regions respectively.

VI. COMMENTS: • Th ere is a need for continued monitoring of food security and provision of necessary assistance based on the findings of the multi-agency meher season needs assessment mission. • Continue more vigilance and strengthening of prevention aspect of AWD to prevent another prolong epidemic with the start of the rainy season. The private investment farms and Holy water sites which continue to serve as foci of infection needs a strategic and multi sectoral approach. This will be one of WHO’s focus areas for AWD preparedness and response.

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