UNICEF HUMANITARIAN SITUATION REPORT

ETHIOPIA

Humanitarian Situation Report

SitRep # 4 - Reporting Period April 2019 SITUATION IN NUMBERS Highlights  The Government announced its strategic plan to return, 4.89 million reintegrate and resettle all conflict related Internally Displaced # of children in need of humanitarian assistance Persons (IDPs) by the end of June 2019. UNICEF is currently (Ethiopia Humanitarian Needs Overview 2019) engaged in providing humanitarian support to the internal displacement in-country and is responding to the life-saving 8.86 million needs of returnees and the displaced by prepositioning support # of people in need and advocating for voluntary, safe, dignified and sustainable (Ethiopia Humanitarian Needs Overview 2019) return/relocation of the conflict-displaced population.  UNICEF’s Humanitarian Action for Children appeal was revised 3.19 million to US$ 143.5 million to reflect the increasing needs as set out in Internally displaced persons in Ethiopia the Ethiopian Humanitarian Response Plan 2019. (Ethiopia Humanitarian Needs Overview 2019)

 In April 2019, floods in four regions of Ethiopia have resulted in further displacement of people, damage to property and death of 919,938 Registered refugees and asylum seekers in livestock. Ethiopia UNICEF’s Response with Partners (Ethiopia, refugees and asylum seekers (UNHCR, 31 August 2018) and UNHCR Eritrean influx update of 20 UNICEF Sector/Cluster October 2018) UNICEF UNICEF Cluster Cluster Target* Results** Target Result** UNICEF Appeal 2019 Nutrition: Children under 5 years with SAM admitted 503,696 50,230*** 487,696 51,064*** US$ 143.5 million treatment Health: Number of Medical consultations in priority Funding Status 441,000 112,056 locations (Afar and Somali Funds received 2019 to date: regions) US $9 m (6%) WASH: People accessing Carry-over: sufficient water of appropriate US$ 12 m quality and quantity for drinking, 1,850,000 1,065164 5,500,000 4,884,042 (8%) cooking and maintaining personal hygiene Child Protection: Vulnerable children provided with 2019 Funding psychosocial support, including Requirement: 77,000 53,570 42,000 55,707 access to child-friendly spaces $143.5m with multi-sectoral programming interventions Education: School-aged Funding gap: children, including adolescents, 370,017 27,250 2,346,922 27,250 US $122.5 m accessing quality education (85%)

* UNICEF target includes new arrivals of refugees and has been revised with the release of HRP Overall funds available for 2019 includes funding received for the ** Results are cumulative for the year current appeal year as well as the carry-over forward from the *** Nutrition results are in lieu by eight weeks. Results reflected are at February 20191 previous years.

UNICEF ETHIOPIA HUMANITARIAN SITUATION REPORT

Situation Overview & Humanitarian Needs Following the release of the Ethiopia Humanitarian Needs Overview (HNO) and Ethiopia Humanitarian Response Plan (HRP), which were developed by the United Nations Office for Humanitarian Coordination (UNOCHA) in collaboration with the National Disaster Risk Management Commission (NDRMC) in March 2019, UNICEF revised its Humanitarian Appeal for Children (HAC) requirement from US$124.1 to US$143.5 million. The HAC requirement is costed by considering the needs, targets, and the capacities of UNICEF partners. Accordingly, UNICEF will target three million people, including 1.59 million children, through interventions in Nutrition, Health, Child Protection, Water, Sanitation and Hygiene (WASH), and Education. The increase in targeted beneficiaries is a result of the rising number of conflict-induced IDPs and the adverse effects of consecutive years of severe droughts in parts of the country, coupled with expected drought conditions from June onwards predominantly in the southern part of the country. The cost of reaching new refugee arrivals is also included.

The disaggregated figures on population in need is depicted in the below table:

Estimated Population in Need of Humanitarian Assistance and Population Targeted through Humanitarian Response Plan (Estimates calculated based on initial figures from Ethiopia Humanitarian Needs Overview 2019 and Ethiopia Demographics and Health Survey 2016)

Start of humanitarian response: In Need Targeted Total Male Female Total Male Female Total Population in Need 8,860,000 4,456,580 4,403,420 8,300,000 4,174,900 4,125,100 Children (Under 18) 4,890,000 2,459,670 2,430,330 4,580,926 2,304,206 2,276,720 Children (Under Five) 1,302,420 655,117 647,303 1,220,100 613,710 606,390

According to the International Organization for Migration (IOM)’s Displacement Tracking Matrix (DTM) round 16 (conducted March – April 2019) and rapid assessments, there are 3.1 million IDPs in Ethiopia. Conflict was reported to be the primary cause of displacement (2,505,832 million) followed by displacement due to climate induced factors (498,841 million). Displacement trends in 2019 are depicted in the table below: Causes of Internal Displacement in Ethiopia April 2019

2,481,726 Conflict 2,505,832

508,228 Climate induced 498,841

55,485 Other 72,389 DTM Round 15 DTM Round 16

On 8 April, the Government of Ethiopia, through the Ministry of Peace (MoP) and the National Disaster Risk Management Commission (NDRMC), presented its strategic plan for IDPs to donors and international agencies. The strategic plan builds on assessments it conducted on damage and loss of properties, and intention of the displaced, and incorporates the return of displaced to the areas of origin, re-integration in the current area of displacement, and relocation to other areas within the region. Furthermore, the plan will adopt a three-phased, sequential approach; 1) prioritizing those ready to return to areas of origin within two months (June 2019); 2) prioritizing those who will be ready to return in the intermediate term which is envisaged within four months; and 3) prioritizing those who’ve lost livelihoods and assets, including those whose places of origin are deemed viable for return but who still choose not to return. To realize this, the Government has requested support from donors and international agencies worth US$ 700 million.

According to the Famine Early Warning Systems Network (FEWSNET), the delayed and below average performance of the Gu/Gana rainy season in southern and south-eastern pastoral areas of Southern Nations, Nationalities and Peoples Region (SNNPR), and Somali regions, is expected to cause significant food insecurity and water scarcity in these areas. As a result, these areas are expected to remain in Crisis (IPC Phase 31) through September 2019. The national level of acute malnutrition is also likely to deteriorate through September due to the seasonal reduction in food access during the lean season, intermittent humanitarian assistance, and shortage of specialized nutritious foods for children under five and lactating and pregnant mothers in displacement sites and drought-affected areas. The graph below depicts the projected food security outcomes across the country.

1 Integrated Phase Classification (IPC) phases are used to illustrate thresholds and classify the severity of the current or projected food security situation. The phases range from IPC 1- 5 ranging from minimal food insecurity to famine. 2

UNICEF ETHIOPIA HUMANITARIAN SITUATION REPORT

Projected food security outcomes, April to May 2019 Projected food security outcomes, June- September 2019 Source: FEWSNET Food Security Outlook Update Source: FEWSNET Food Security Outlook Update

A flood alert by the National Disaster Risk Management Commission (NDRMC) reported that flooding on 15 April forced three rivers to change their natural course and inundated farmlands, destroying houses in Silti Woreda in SNNPR. As a result, 5,615 people were reported to have been displaced with deaths of livestock that further exposes the community to economic insecurity and restricts their access to basic services. In April, damage to 407 houses, three schools, and six woreda administration offices was reported due to floods, heavy rain and wind in in seven woredas of three regions (Amhara, Gambella, and Tigray). The country is projected to experience further floods and the below graph depicts areas prone to flood. The country is projected to experience further floods. The visual on the left illustrates flood-prone areas and current internal displacement sites.

Flood prone areas in the Ethiopia Source: DTM round 16

The national Public Health Emergency Operations Center (PHEOC) at the Ethiopian Public Health Institute (EPHI) was activated on 1 April to better coordinate the health sector’s preparedness and response efforts for IDPs. This platform will include representatives from EPHI, different Directorates of the Ministry of Health (MoH) and other Government sectors, WHO, CDC, UNICEF, and other partners who are current members of the PHEOC.

Humanitarian Leadership and Coordination The humanitarian response in Ethiopia is led by the National Disaster Risk Management Commission (NDRMC) through the federal and regional Disaster Risk Management Technical Working Groups (DRMTWGs). UNOCHA coordinates the humanitarian response of UN agencies and NGOs in support of the Government-led humanitarian response. The Government prioritizes its emergency response based on targeted hotspot woredas2.

2 Districts, or woredas, are the third-level administrative divisions of Ethiopia. They are further subdivided into a number of wards (kebeles), which are the smallest unit of local government in Ethiopia.

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UNICEF ETHIOPIA HUMANITARIAN SITUATION REPORT

Prompted by global efforts and commitments to address structural causes of crises following the 2016 World Humanitarian Summit, the post-El Niño drought context in Ethiopia is increasingly defined by development programming and financing with a view to reducing humanitarian needs, risks and vulnerabilities. The Humanitarian Needs Overview is complemented by a Humanitarian Response Plan that documents the Government’s humanitarian asks and highlights those most in need using severity criteria3.

Humanitarian Strategy A participatory review of the UNICEF IDP response in 2018 was conducted on 14 March and provided key lessons learnt for implementation in 2019. Accordingly, UNICEF will focus on providing an integrated and convergent response to internal displacement triggered by conflict and seasonal climatic shocks. This includes preventing disease outbreaks, addressing malnutrition and ensuring the centrality of protection in all programme interventions, including prevention from sexual exploitation and abuse. UNICEF will support people in need and hard-to-reach populations through its eight field offices and UNICEF-supported mobile teams, leveraging its cluster leadership role to influence how partners prioritize resources and interventions.

The response will prioritize life-saving services, including the detection and treatment of severe acute malnutrition (SAM) and the prevention and treatment of diseases by providing essential medicines, strengthening response systems and developing the skills of health professionals. The WASH response will focus on life-saving activities and building resilient water and sanitation infrastructure. UNICEF will invest in mitigating and preventing gender-based violence to address the protection risks faced by refugees and IDPs, particularly girls. Through the Ministry of Education and regional education bureaus, UNICEF will advocate for flexible, accelerated access to education for displaced children. In line with the United Nations’ New Ways of Working and the Grand Bargain commitments, UNICEF will establish and strengthen new and existing partnerships to invest in durable solutions.

Summary Analysis of Programme Response Nutrition UNICEF, in close collaboration with the Federal Ministry of Health and respective regional health bureaus, continued to support the treatment of children with SAM across the country. In February4, 25,692 children were admitted for community-based therapeutic care treatment to Stabilisation Centres (SCs) and Outpatient Therapeutic Programmes (OTPs) at a reporting rate of 86 per cent. The number of admissions in February showed a four per cent increase compared to January (24,541 at a reporting rate of 86.5 per cent). This is largely understood to have been fuelled by the prolonged displacement of people in the Gedeo and East and West Wollega zones, with irregular food distributions and increased screening coverage by partners. Programme performance indicators compare well with the targets and acceptable standards, with 90.7 per cent cured, 0.2 per cent deaths, and 1.5 per cent defaulting.

UNICEF, through its partners, continues to support the rapid nutrition response across the country through 19 field-based UNICEF staff and 47 monitors in the Community-based Management of Acute Malnutrition (CMAM) and Infant and Young Child Feeding in Emergencies (IYCF-E) pogrammes. The monitors provide technical support and mentoring for CMAM services quality assurance and 49 Mobile Health and Nutrition Teams (MHNT) to address the hard-to-reach community. In April, six CMAM monitors were deployed to displacement sites in Gedeo Zone in SNNP Region to support the emergency operation. Additionally, 900 cartons of Ready-To-Use-Therapeutic-Food (RUTF), 40 cartons each of F100 and F75, 30 cartons of SC treatment kits and 200 packs of amoxicillin have been prepositioned in the Gedeo Zone health department to reach up to 1,000 IDP children to mitigate and respond to expected increases in malnutrition.

Health In March5, UNICEF, through the MHNTs and Sustainable Outreach Services (SOS), provided medical consultation to 43,147 people – 20,313 in Afar and 22,834 in . Of these, 18,655 were children under the age of five, 14,146 women, and 10,346 men. The MHNT programme accounted for 39,978 of the consultations while the remaining 3,169 were done through SOS.

UNICEF continues to support regional health bureaus with measles vaccinations. In April, 34 South Sudanese refugee children under the age of 14 received measles vaccinations at entry points in the Gambella Region. As of April 2019, a total of 5,089 South Sudanese children have been vaccinated (1,251 upon entry and 3,838 in refugee camps). Additionally, UNICEF dispatched three emergency drug kits that will benefit 7,500 people for three months to the Benishangul-Gumuz Regional Health Bureau to meet the needs of the IDPs.

3 Severity criteria is an approach to analyse the severity of needs among populations in humanitarian settings. This analysis conducted at a multi-sectoral level helps in identifying the population most in (a) severe, (b) critical and (c) urgent need of response. 4 Information on nutrition programme response is delayed by two months due to lengthy data collection and verification process from the kebeles to federal 5 Information on Health programme response is delayed by one month due to lengthy data collection and verification process from the field to federal level 4

UNICEF ETHIOPIA HUMANITARIAN SITUATION REPORT

WASH UNICEF’s WASH humanitarian intervention continues to focus on provision of safe drinking water, sanitation and hygiene to IDPs and host communities across the country. In April, UNICEF rehabilitated six shallow wells in Gedeo Zone, installed water tanks in Kamashi Zone in Benishangul Gumuz, and trucked water in Bale, West Guji, East and West Hararghe and Guji zones in Oromia Region, benefiting 177,785 people, including 711 IDP returnees from Amhara to Benishangul Gumuz Region. Water shortages remain critical in the Somali Region with 93 per cent of woredas experiencing water stress.

In April, UNICEF reached 262,652 people with hygiene promotion activities, with a total of 513,706 people reached in Amhara (5,225), Oromia (176,678), SNNP (249,427), Somali (11,868) and Tigray (70,508). The construction of semi-permanent latrines in Quera site, SNNP in April benefited 1,600 IDPs. Additionally, sixteen blocks of emergency latrines are currently under construction in Erer/ in Somali Region to prevent potential disease outbreaks among IDPs.

Child Protection In April, 13,757 people (7,655 girls, 6,102 boys) received psychosocial support (PSS) through child-friendly spaces (CFS). The SNNP region accounted for 6,821 girls and 4,786 boys, Oromia 250 girls and 270 boys, Somali 117 girls and 417 boys, and the Benishangul-Gumuz Region 467 girls and 629 boys. In Benishangul-Gumuz, the support was provided to refugees in Gure Shamola Refugee Camp whereas the rest were Ethiopian nationals, including IDPs.

UNICEF, through its partners, continued to support the identification and care of unaccompanied and separated children, with the goal of family tracing and family reunification. In April, 115 children in the Oromia Region (57 girls, 58 boys) unaccompanied and separated children were supported, 21 (15 girls, 8 boys) with family tracing and re-unification services and 92 (42 girls, 50 boys) with alternative care arrangements. Additionally, 16 refugee children (9 girls, 7 boys) were placed in alternative care in Gure Shamola Refugee Camp in Benishangul Gumuz Region. In SNNPR, the total caseload of unaccompanied and separated children and other vulnerable children reached 3,154 (1,321 girls, 1,833 boys). Best interest assessments6 were conducted for 1,638 children in SNNP region that aided the prioritization of cases for dedicated response.

In April, 2,653 IDPs (1,471 women, 1,182 men) were reached with communication messages on child protection and gender- based violence (GBV); 487 in Oromia (267 women, 220 men) and 2,166 (1,204 women, 962 men) in Somali Region. Furthermore, 40 cases of GBV (21 girls and 19 women) were identified by social workers across three woredas (Qoloji, Adadle and Dakasuftu) in the Somali Region and referred to services. The GBV survivors were provided with PSS, medical treatment and legal aid services. Furthermore, UNICEF, in partnership with International Rescue Committee, provided life skills training for 289 adolescent girls in Sherkole and Bambasi refugee camps and also reached 5,000 community members (2,235 women, 2,765 men) through awareness sessions on GBV prevention and risk mitigation across all refugee camps in Benishangul Gumuz. These sessions are designed to equip the refugees with the knowledge to take specific steps to prevent GBV in the camps.

Communications for Development (C4D), Community Engagement & Accountability UNICEF utilizes an integrated approach to community engagement, incorporating elements from nutrition, health, child protection, and WASH. This puts into practice a commitment to a people-centred approach where those in need are engaged as individuals with needs across multiple sectors. All UNICEF’s communications and community engagement activities are coordinated through the relevant bureaus, clusters and sub-cluster working groups. UNICEF continues to support the regional health bureau in prevention and control of disease outbreak. In April, UNICEF C4D Technical Assistants provided technical support to the Somali Regional Health Bureau to sensitize communities on polio through social mobilizers in 99 woredas. The social mobilization was conducted with the participation of kebele Social Mobilization Committees, clan leaders and women groups in preparation for the launch of the Bivalent Oral Polio Vaccine (BOPV) which was held on 25 April 2019. The mobilization was supported with mass media messages and Information, Education and Communication (IEC) materials. UNICEF has also initiated a Project Cooperative Agreement (PCA) with local partners to reach the IDP community in Gedeo and Guji zones of SNNP and Oromia regions, respectively. The PCA is aimed at improving child health outcomes through tailored hygiene and sanitation, nutritional, and health seeking behaviour messages.

Security In April, inter-ethnic and inter-communal conflicts were reported in Gambella, Benishangul-Gumuz, Afar, Oromia and Amhara regions which resulted in fatalities, displacement of people as well as loss of or damage to properties. Access to humanitarian services was affected as a result of these conflicts and insecurities with movement to the refugee camps and displacement sites restricted in Benishangul-Gumuz, Gambella and Amhara regions.

Funding UNICEF Ethiopia is appealing for US$ 143.5 million in 2019 to support humanitarian action for children. The cost per sector incorporates the needs on the ground, agreed targets and UNICEF and partner capacities to deliver. Since January 2019,

6 The best interests procedure is a mechanism used to ensure that the best interest principle (set out in Article 3 of the UN Convention on the Rights of the Child) is respected in work with individual children. 5

UNICEF ETHIOPIA HUMANITARIAN SITUATION REPORT

UNICEF has received US$ 9 million. With a carry-over fund of US$ 12 million from 2018, the current funding gap stands at US$ 122.5 million. The below table depicts UNICEF Ethiopia’s funding status.

UNICEF Ethiopia funding status as of 30 April 2019 Requirements Funds Available US$ Funding gap (Revised) Appeal Sector Funds Received US$ Carry over* US$ % Current Year Nutrition 61,222,849 1,927,340 9,562,211 49,733,298 81% Health 14,492,865 266,421 434,769 13,791,675 95% WASH 56,200,000 6,582,773 1,109,407 48,507,820 86% Child Protection 3,687,192 258,066 325,197 3,103,929 84% Education 7,918,851 0 542,380 7,376,471 93% Total 143,521,757.00 9,034,600 11,973,964 122,513,193 85% * Funds available includes funding received against current appeal as well as carry-forward from the previous year.

Next SitRep: 10 June 2019

UNICEF Ethiopia: www.unicef.org/ethiopia Facebook: https://www.facebook.com/UNICEFETH Twitter: https://twitter.com/UNICEFEthiopia UNICEF Ethiopia Humanitarian Action for Children Appeal: https://www.unicef.org/appeals/ethiopia.html

Adele Khodr Alhaji Bah Victor Chinyama Who to Representative Chief-Field Operations and Chief-Communication, Advocacy,

contact for UNICEF Ethiopia Emergency Partnerships further Tel: +251 11 5184001 UNICEF Ethiopia UNICEF Ethiopia Fax: +251 11 5511628 Tel: +251 11 5184082 Tel: +251 11 5184068 information: Email: [email protected] Fax: +251 11 5511628 Fax: +251 11 5511628 Email: [email protected] Email : [email protected]

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UNICEF ETHIOPIA HUMANITARIAN SITUATION REPORT

Annex A SUMMARY OF PROGRAMME RESULTS

UNICEF and IPs Cluster Response

Change Change Overall 2019 Total since last 2019 Total since last

needs Target Results* report Target Results* report ▲▼ ▲▼ NUTRITION Children under 5 years with SAM 609,961 503,696 50,230 25,692 487,696 51,064 26,526 admitted treatment Children received vitamin A - 1,029,497 - - - - - supplementation HEALTH Number of medical consultations in priority locations (Afar and Somali 441,000 112,056 43,147 regions) People affected by acute watery diarrhoea accessing life-saving curative 15,000 13 - interventions Children immunized against measles 760,270 5,089 34 Number of insecticide-treated bed nets 400,000 135,000** - distributed in Malaria- endemic areas. Number of people with access to health care facilities stocked with emergency 320,000 70,000 7,500 drugs and supplies for 3 months. WATER, SANITATION & HYGIENE People accessing sufficient water of appropriate quality and quantity for drinking, cooking and maintaining 9,243,666 1,850,000 1,065,164 177,785 5,500,000 4,884,042 934,204 personal hygiene. This is principally through durable, long lasting infrastructural investments. People reached with key messages on 7,260,454 1,750,000 513,706 262,652 5,000,000 2,009,258 206,933 hygiene practices People have access to emergency NFIs (including household water 7,260,454 3,000,000 1,275,913 1,275,913 5,000,000 2,273,527 2,273,527 treatment chemicals) CHILD PROTECTION Vulnerable children provided with psychosocial support, including access 592,648 77,000 52,474 12,661 42,000 57,503 13,757 to child-friendly spaces with multi- sectoral programming interventions Unaccompanied and separated girls and boys reunified with their families 592,648 4,400 944 115 5,000 988 131 and/or placed in appropriate alternative care Children and women provided with risk mitigation, prevention or response 1,028,910 95,500 54,168 7,985*** 52,000 89,810 47,710 interventions to address gender-based violence EDUCATION School-aged children, including adolescents, accessing quality 2,616,444 370,017 27,250 - 2,346,922 27,250 - education *Total results for Sectors are cumulative ** The indicator for insecticide-treated bed nets distributed in malaria- endemic areas has changed to numbers distributed as opposed to households with access to. *** Total result in April 2019 includes three GBV survivors that were referred to the Gondor hospital, Amhara region for medical services in the March 2019.

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