Cameroon Humanitarian Situation Report No. 09 Reporting Period: September 1 – September 30 2020 Situation in Numbers Highlights 2,000,000 children in need of humanitarian assistance (UNICEF HAC 2020) • For the sixth consecutive month, UNICEF received no contribution for its humanitarian response (non-COVID-19). In Far North region, 2 attacks on 6,200,000 health facilities were reported. Only 4% of UNICEF’s response for victims people in need of Boko Haram attacks is presently funded with health and WASH sectors (HRP June 2020) worst impacted. • In the Far-North, 11,682 children and caregivers benefitted from mental 450,268 IDPs in the NWSW regions (OCHA health and psychosocial support. • In the North-West and South-West regions, UNICEF partners provided MSNA, August 2019) IYCF counselling to 48,364 parents and caregivers. 203,634 Returnees in the NW/SW • Immunization coverage to prevent child killing disease in conflict areas (OCHA December 2019) remains low, especially for measles. Urgent funds mobilization is needed to support these activities unreached through routine immunization 321,886 IDPs in the Far North program. Some 65% of children in the North-West Region are (OIM, June 2020) unvaccinated and 47% in the South-West. 123,489 Returnees in the Far North (IOM, June 2020) UNICEF’s Response and Funding Status SAM admissions 72% * UNICEF Appeal 2020 Funding Status (in US$) * Nutrition Funding status 2% * Measles vaccination 14% Requirement: $45.5m Available $7.2m (16%) Health Funding status 6% Safe water access 33% WASH Funding status 21% Carry- forward MHPSS access 56% US$ 3.4 M Received Child Funding status 26% US$ 3.8M Protection Funding gap Education access 38% US$ 38.2M Funding status 7% Education 0% 20% 40% 60% 80% 100% *achieved through non-HAC funding sources 1 Funding Overview and Partnerships In 2020 UNICEF is appealing for US$ 45,445,000 in support of lifesaving and protection-based response for children and women in Cameroon. As of 30 September, UNICEF has received US$ 3,800,000 against this humanitarian requirement from the following donors: Japanese government, Swedish SIDA, UN CERF and ECHO. UNICEF expresses its continuing appreciation to these donors for their support. However, the 84% shortfall continues to seriously limit program response. If not resolved, the scenario of staffing cutbacks becomes more likely.1 In May, considering the consequences of under-funding for children in emergency need in Cameroon, UNICEF issued a ‘Donor Alert’ to Yaounde embassies and donor representatives highlighting critical life-saving and protection-based activities to be implemented over the next five months (May-Sept), for which $10,608,000 is urgently required for displaced, refugee and returnee and host community children. Vital activities have been curtailed for lack of funding including measles vaccination, access to lifesaving essential drugs, support for safe water and sanitation and mental health and psychosocial services. The impact of underfunding is further noted in the sector progress reports below. Situation Overview & Humanitarian Needs The onset in early March of the COVID-19 pandemic in Cameroon introduced new threats to children and vulnerable communities with humanitarian response immediately complicated by restrictions on group events and movement. An additional 2.3 million people were estimated to be in need of humanitarian assistance due to the impact of COVID- 19, bringing the total number of people in need from 3.9 million prior to the COVID-19 outbreak to 6.2 million. This was reflected in the updated Cameroon HRP, issued in early June. The requirement includes over three million children in need of urgent humanitarian assistance as a consequence of violence and conflict, disease outbreaks including measles, cholera and the COVID-19 pandemic. Continuing armed confrontations in September displaced over 1,906 people across the North-West and the South- West regions. Concurrently, 2,729 IDPs returned to the North-West and the South-West regions due to the perceived poor living conditions in the location of displacement and perceptions of security improvements in their areas of origin. Lockdowns and sporadic clashes between both parties of the conflict restricted the access especially to and in Bamenda, leaving project locations cut off from supplies or support. Implementing partners are facing greater threats from NSAGs due to looming suspicion of spying for the Government. Since early September, flooding across Far North region has reportedly displaced up to 160,000 people (CRC, September 2020). Heavy rains fell, especially in Logone et Chari and Mayo-Danay divisions damaging and destroying houses, cultivated areas, roads and bridges and further reducing access to services Assessed needs were prioritized as shelter, medical care, protection and food security. Civilians remain the first victims of Boko Haram attacks (violence, kidnapping and looting) mostly cross-border in origin. The epicenter of violence is shifting from Logone-and-Chari to Mayo-Sava department. Presently there are over 150,000 children displaced by the violence and children are particularly vulnerable. On 9 September, 6 children were injured by UXO’s they found and mistook for toys in the bush in the Mayo-Tsanaga. On 24 September a group of international NGOs issued a statement deploring the absence of donor support to a forgotten, multi-layered humanitarian crisis. Summary Analysis of Response Nutrition2 Boko Haram Violence (Lake Chad Basin Crisis) In the Far-North region, UNICEF worked collaboratively with the Regional Delegation of the Ministry of Public Health and NGO partners ALIMA, HKI, IEDA, ACF, IMC to ensure the availability and access for the treatment of severe acute malnutrition in 366 health centres with the provision of nutrition supplies (RUTF, therapeutic milk, essential drugs) and WASH kits. Over 2,722 children aged 6 to 59 months including 46 Nigerian refugee children from Minawao camp were admitted to these UNICEF-supported health centres for treatment. Following the community training of mothers on how to detect malnutrition in their children with MUAC tapes and oedema measurements, out of the 43,647 children from 6 to 59 months screened, 306 were screened using this method. Of the total screened, 424 SAM 1 In parallel, against a COVID-19 response requirement of US$24,007,500 as presented in the UNICEF global COVID-19 HAC, US$16,271,528 has been received. 2 Due to the reporting system of the ministry, the admission data of the concerned month is reported in the following month (i.e. April data are reported in May). 2 (severe acute malnutrition) cases were detected with 2,031 cases of MAM (moderate acute malnutrition). All were referred for treatment. UNICEF partners and Health District services pursued the joint community-based prevention of malnutrition (IYCF) and COVID-19 reaching 12,404 (10,328 women and 2,076 men) caregivers. In 9 health districts (Maroua 1,2,3, Mokolo, Guidigis, Kaele, Karhay, Mindif and Moutourwa) 69,404 children aged 6-23 months were enrolled in the Home-based food fortification programme and each receiving a micronutrient powder sachet every other day. In response to flood-induced displacements, UNICEF and nutrition sector partners work collaboratively to ensure referral to the nearest accessible nutrition services. North-West/South-West Crisis UNICEF partners (Reach Out, CBCHS, Mentor, Caritas) screened 37,632 (19,066 girls and 18,566 boys) children, among whom 96 (0.2%) were identified with SAM and referred to the 15 UNICEF supported health facilities for treatment. UNICEF partners sensitised 26,248 (17,312 women and 8,936 men) caregivers on key messages on infant and young child feeding practices and COVID-19. In Mutengene (Fako division), from 2nd – 4th of September 2020, 40 health workers received a joint training on SAM Management and COVID-19 specific modules on nutrition. UNICEF also supported the community training of 2,378 caregivers on detection and referral of children suffering from SAM to treatment services. Health Boko Haram Violence (Lake Chad Basin Crisis) UNICEF conducted the training of 90 health workers in 7 health districts and 156 community health workers in 3 health districts on IPC and COVID-19 prevention (Moulvoudaye and Maroua 3 health districts). From 18 to 20 September 2020, UNICEF supported the 1st round of the Local Immunization Days mOPV with over 96% of the targeted children aged 0-59 months vaccinated (2,137,119). North-West/South-West Crisis UNICEF partners Cameroon Baptist Convention Health Services (CBCHS), CARITAS Bamenda, CARITAS Kumba and CARITAS Mamfe supported the delivery of basic health services to internally displaced persons and host communities in hard to reach areas in 11 health districts in North-West and South-West regions. A total of 8,095 children 6-59 months were vaccinated with routine vaccination against the most prevalent child killing diseases, including 2,080 children who received MR (measles/rubella) vaccination. Also, 3,123 children received Vitamin A supplementation and 2,331 children received a deworming tablet. 3,411 children (1,519 males and 1,892 females) were provided with anti-malaria drugs. 1,741 children (692 boys and 1,049 girls) were treated for ARIs and 452 children ( 201 boys and 251 girls) were treated for diarrhoea and 6,128 households received treated mosquito nets. Mapping of measles immunization coverage for children under five years old financed by UNICEF (AVS, PIRI for the NWSW) WASH North-West/South-West Crisis 3 UNICEF partner EPDA facilitated access to basic sanitation for 8,300 people through the construction of 42 latrines (2 cabins each). Education Boko Haram Violence (Lake Chad Basin Crisis) UNICEF mobilised teaching and learning equipment (school tents, learning materials, and hygiene materials) to allow more than 5,000 flood affected children to safely resume school starting October 5. Parallelly, UNICEF pursued its advocacy in mobilizing towards the mobilization of education sector actors for COVID-19 safe-school protocols.