EMERGENCY AND HUMANITARIAN ACTION (EHA) WEEKLY UPDATE – WHO COUNTRY OFFICE ETHIOPIA: (Week 22, 25 – 31 May 2009) HIGH LIGHTS : • According to official reports from the Federal Ministry of Health (FMOH), 90 new cases of AWD have been reported from Oromiya, Southern Nations, Nationalities and Peoples’ Region (SNNPR) and Harari Regions last week. • Acute malnutrition cases continues to rise in many woredas (districts) of SNNPR, and East and West Harerghe of Oromiya Region The nutritional problem in parts of West Arsi and Dessie Zuria of South Wello and Agarfa in Bale and the rapidly deteriorating food security in Seru woreda of Arsi remain to be a serious concern. • The Oromia regional government has identified some 201,000 additional relief beneficiaries following joint rapid assessment missions. Following the regions request for these additional beneficiaries, a one month food ration has been allocated. • The Government is scaling up nutrition programmes in response to increasing severe acute malnutrition cases in parts of SNNPR and OromiaAccording 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. 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 • FEWSNET/WFP’s latest food security update reports that the performance of the belg/gu seasonal rains have been below normal so far and, if the rains continue to be poor, a second consecutive below ‐average harvest is expected in the chronically food insecure belg-cropping areas. This will further deteriorate the food security situation of both pastoral and agro ‐pastoral populations. Reports of malnutrition continue to increase in SNNPR (Wolayita, Hadiya, Sidama, Kembata Tembaro, Gurage, Gamo Gofa and Dawro zones) and Oromiya (West Arsi, Bale, East and West Hararghe zones). The reduced relief food ration down from 15 kg to 10 kg and poor belg rains, which had limited the availability of root crops, sweet potato and enset normally consumed during the lean season, are among the factors contributing to the situation. • Food security situation is deteriorating in most parts of Welayta, Kembata Tembaro (KT) southern Hadiya, and some parts of Sidama and Gedeo zones in SNNPR . A total of 862 severely malnourished children were admitted in the outreach therapeutic programmes (OTPs) established in 13 weredas of the region by different NGOs. One hundred new admissions were reported in the week for the 13 stabilization centres (SCs) run by the same NGOs. High admissions are also reported in OTPs run by government in Welayta, KT and Hadiya. To cope, sale of home utensils, sharing and consuming immature enset, increased sale of livestock, high labour flow from rural areas to nearby towns is practiced. Significant yield reduction of the Belg crop production is expected due to the previous long, uninterrupted dry spell. Market prices for grains are significantly increasing. Livestock prices are getting lower, except for Aleta –wondo woreda of Sidama zone. • During the week most woredas of west and east Hararge in Oromia Region have received 2-4 days of heavy rain. This rain has a positive impact on Belg and Meher crops. So far 51% of meher crop lands in West Hararge and 70% in East Hararge have been planted. The achievement is relatively low because of delay in the onset and shortage of rainfall. In most woredas in East and West Hararge, the availability of pasture and water is improving, however, lowland areas are still suffering from rainfall shortage. Field reports show that Miesso woreda and lowland of Beddenno and Gole Oda are facing critical water shortage. Field reports also indicate increases in re- admission rates at OTPs. This is attributed to children not being provided with the supplementary food discharge ration. In Bisidimo hospital 82 severely malnourished children are admitted from Babbile, Fedis, Kersa and other woredas. Due to low supply and influx of traders, grain prices have increased by about 2-4 %. Livestock prices have increased by 3-5 % in most woredas except in Miesso woreda where the price has shown a decrease due to high supply of livestock. • WFP reports that its relief pipeline is close to breaking, noting that the situation is critical. Only one round of relief distribution is available for the second quarter given the low level of available resources. The limited food balance available after ongoing dispatches will have to be further prioritized. The Disaster Risk Management and Food Security Sector (DRMFSS) available in-country stock stands at 27,947 MT, including 5,034 MT for relief and 22,914 MT Productive Safety Net Programme (PSNP). WFP inputs to the national relief programme are short by 177,983 MT (US$155.7million); while inputs to PSNP are short by 53,329 MT (US$46.1 million); Targeted Supplementary Feeding shortfalls are 30,565 MT (US$ 26.5 million). The Ethiopian Food Security Reserve Administration (EFSRA) stock stands at 168,254 MT. Acute watery Diarrhoea (AWD) • According to official reports from the Federal Ministry of Health (FMOH), 90 new cases of AWD have been reported from Oromiya, SNNP and Harari Regions last week. A total of 14 districts have reported active cases from Oromiya, SNNP and Harari Regions in epidemic week 21 • Seven hundred and thirty nine cases of AWD and 20 deaths (CFR 2.7%) have been reported from Somali, Oromiya, SNNP, Harari and Afar Regions from 13 th April to 24 th May, 2009. Two Hundred and Twenty Six cases and 11 deaths from Gewane and Buremudaitu Woredas of Afar Region, five cases and no death from Moyale Woredas of Somali Region, 120 cases and four deaths from Moyale, Dire, Meki, Shashemene, Shashemene Town, Arsi Negele Shala, Kofele, Nansebo, Babile, Dener,Fedis, and Midaga Woredas of Oromiya Region and 361 cases and seven deaths from Konso special Woreda of SNNPR. 2 Map of Ethiopia Showing affected districts by Acute Watery Diarrhea [ AWD] Cases and Deaths as of Epidemic Week 21 [ 24 May 2009 ], Ethiopia Legend Tigray Districts currently reporting active cases Afar List of Districts Currently reporting ( expected to report and newly affected district Amhara Afar * Gewane * Buremudayetu Somali Beneshangul Gumu Gewane * Moyale Bure Mudaytu * Galadi Oromia Amibara Dire Dawa * Moyale Hareri *Dire Awash Fentale Addis Ababa *Meki *Shashemene Woreda * Shashemene Town * Arsi Negele *Shalla Gambela *Kofele Oromia *Nansebo Arsi Negele *Babile Shalla Shashemene Zuria *Dener Kofele Somali *Fedis *Midaga Humbo Nenesebo (Wereka) SNNPR SNNPR * Konso SP Woreda Harari Konso SP Woreda Dire Moyale_SOM Moyale_ORO Analysis/Mapping WHO, EHA and IDSR Units Data Source: FMOH-Ethiopia 01.5 3 6 9 12 Date: June 1, 2009 Kilometers µ Influenza A H1N1 • To date no confirm or suspected cases of Influenza A H1N1 have been reported by the Federal Ministry of Health. In line with the required preparation, the United Nations system has revised and reactivated its countigency plan coordinated by WHO Country Office. About 28 UN agencies are involved 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. • FMOH has identified 32 hospitals nationwide to support any required response to influenza A H1N1 and has identified national requirements and presented to partners for funding. 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 Therapeutic c 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, Oromia 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. Malaria According to official reports from the Federal Ministry of Health (FMOH), a total of 1867 Malaria cases & one death were reported from Tigray region, Kola Temben woreda from 22 nd April to 11 th May 2009. Government and partners interventions have managed to control the disease. 3 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 completed in the seven sample woreda of Filtu, Aysha, Degehabur, Hamero, Bare, Kelafu and Bokh.