UNICEF Mali Situation Report Date: 28 August 2012 Highlights In an attempt to bring stability to Mali a national unity government was announced on August 21, 2012. However the country remains divided after Islamists seized northern regions following the coup earlier this year. There are an estimated 174,000 internally displaced people in Mali and over 200,000 people have registered as refugees in neighbouring countries. In Bamako 57% of IDPs are children and young teenagers (0-17 years old). Now in the height of the lean season, the worst is yet to come for children in Mali. Estimates predict 385,000 cases of moderate acute malnutrition and 175,000 cases of severe acute malnutrition in children under-five years old in Mali in 2012 with 87% of SAM cases expected in the south of Mali. A cholera outbreak in Gao region has to date led to 159 cases and 12 deaths in three communities. To mount a preventative response to the cholera outbreak, and reduce the risk of cases spreading, UNICEF has distributed supplies to treat 2,000 cases of cholera, as well as WASH kits for prevention of diarrhoea at the household level. As part of the regional UNICEF response to the cholera outbreak one diarrhoea kit was distributed to a UNICEF Field Office in Guinea Conakry near the border with Southern Mali. Child protection issues in the north continue to be a major concern with reports of unaccompanied children, association of children with armed groups, sexual violence and victims of unexploded ordinance. There is documented evidence of 137 children associated with armed groups. There were over 300,000 children in schools in the northern regions of Mali (Timbuktu, Kidal, and Gao) before the crisis, whose education has been affected. There are 10,000 students from northern regions in the south, 6,895 of whom are registered in schools. Other children are registered as refugees in neighbouring countries. UNICEF works across the north with established international NGOs and is deploying additional partnerships to access vulnerable children and women. An integrated package of medical supplies, household water, education and child protection in the north has reached 141,000 most vulnerable people (see inter-agency health kits). Specific interventions, such as household hygiene promotion have reached a greater number of beneficiaries, as highlighted in the indicator tables across this report. As of 27 August, UNICEF Mali has only received 34% of the 58 million U.S. dollars from its emergency appeal for 2012. © UNICEF/ Harandane Dicko April 2012, School Sébéninkoro A, B, C, group of students wash their hands with soap, District of Bamako. 1 SITUATION AND HUMANITARIAN NEEDS On 20 August 2012 the interim Malian president, Dioncounda Traore, announced the formation of a national unity government in an attempt to bring stability to a country split in two after Islamists seized northern regions following the coup in March. The national unity government has 31 ministers from a broad range of political parties, including four women. Armed Islamist groups remain in control of the three northern regions of Timbuktu, Gao and Kidal; Mopti region is divided in two with the government not operational in northern districts. The lack of Government allowed a significant degradation in respect of children and women's rights, particularly worrying trends are the continued association of children to the armed Islamist groups, and the start of imposition of sharia law. There have been popular uprisings in Niafunke (Timbuktu) and Ansongo (Gao) circles against perceived rights abuses. Neighbouring countries continue to express concern over the political instability in Mali and discussions continue regarding the deployment of ECOWAS and/or UN sanctioned troops. Floods in Segou and Kayes regions followed the heavy rains. There were 11 villages particularly affected in Tominian and San areas, with 1,772 households made vulnerable, or an estimated at 11,663 people. In the affected areas five people died (drowning and house collapse), with 65 open wells and 523 latrines broken down. Child protection issues regarding recruitment of children to armed groups in the north remain of high concern to UNICEF. There are 137 boys (aged 12 to 18 years) in Gao and Timbuktu regions, whose recruitment or association with armed groups is documented. However, according to unverified estimates the true number of children associated with armed groups is now estimated to be in the hundreds across the three northern regions. Household incomes in northern Mali are lower than usual due to the impacts of food insecurity and conflict. Throughout the Sahel, local cereal prices are higher than the five year average, with market access particularly difficult for rural households*. However, imports of staple foods, primarily from Algeria have allowed urban markets to remain adequately supplied. Although trade volumes are expected to remain lower than usual, adequate quantities of staple foods are likely in urban markets. Prices are likely to drop with upcoming harvests but will remain higher than average. * http://reliefweb.int/country/mli?sl=environment-term_listing%252Ctaxonomy_index_tid_source-529 Estimated Affected Population Total Male Female Total population 13,802,000 7,070,697 6,731,303 Children under 18 1 7,453,080 3,818,176 3,634,904 Children Under Five 3,114,000 1,595,287 1,518,713 Children 6 to 23 months 1,245,600 638,115 607,485 Pregnant women 690,100 Not applicable 690,100 Affected population (food insecurity) 4,600,000 2,346,000 2,254,000 Children Under Five with Severe Acute 175,000 96,250 78,750 Malnutrition (SAM)2 Children Under Five with SAM and medical 11,068 5,670 5,398 complications Children Under Five with Moderate Acute 385,000 194,232 190,768 Malnutrition (MAM)2 Total Displaced Population3 174,000 83,500 90,500 Population of Displaced Children (under 18 99,182 n/a n/a years) 3 Sources: UNICEF Humanitarian Action Update June 2012; 1UNICEF State of the World’s Children 2010 (proportion of total population); 2Cluster Nutrition, June 2012 – CAP, based upon data from the June 2011 SMART survey; 3IOM estimates, the IDP report can be found at: http://mali.humanitarianresponse.info/document/iom-mali-newsletter-sit-rep. The gender and age breakdown of IDPs is an estimate based upon the proportion of IDPs identified through the IOM study in Bamako. 2 INTER-AGENCY COLLABORATION UNICEF is leading the Nutrition, WASH, and Education (co-lead with Save the Children) clusters, and the Child Protection sub-cluster. The Nutrition cluster has launched regional sub-clusters in Kayes and Segou regions both lead by the Malian Red Cross with the Belgian Red Cross in Segou and the French Red Cross in Kayes. A regional Child Protection sub-cluster has been established in Mopti led by UNICEF. UNICEF, UNFPA and WHO are collaborating to cover children’s health needs in the northern regions. UNICEF continues to finance measles and polio vaccination campaigns for children through Groupe Pivot Sante, FENASCOM and MDM-B in Timbuktu, Gao and Kidal regions, integrating vitamin A supplementation and de-worming with Albendazole. CHOLERA RESPONSE To date there have been 159 cases of cholera and 12 deaths in 2012, a case fatality rate of 7.5%. During the same period in 2011 in Mali there were 844 cases and 35 deaths, a case fatality rate of 4.1%. UNICEF has mounted a joint health, WASH, and communication response to cholera, including distribution of five diarrhoeal disease kits, three in Gao to MDM-B, one in Timbuktu to Alima, and the fifth to the UNICEF Guinea Conakry office to support them in their response to a cholera outbreak near the southern Mali border. UNICEF has supported IRC and ACF-E to distribute 6,000 cholera prevention kits to households in Gao region. In Timbuktu a further 7,500 kits were distributed through Solidarités and Alima. To date UNICEF supported distribution of hygiene kits has reached 259,260 people in the northern regions. IRC with UNICEF support has repaired the water distribution network of the city of Menaka benefitting 34,000 vulnerable people to access drinking water. A cholera prevention communication plan has been developed with the Ministry of Health and partners targeting high-risk areas, particularly in Gao region. To kick start implementation of the prevention plan UNICEF is supporting a national TV and radio campaign running from July to September. There are also over 400,000 communication materials, including pamphlets, posters and stickers, which will be ready by next week for use in areas vulnerable to cholera. In Ansongo district, the centre of the outbreak, 25 community volunteers were trained and local radio stations are mobilized. In partnership with Aidemet Antenna UNICEF has equipped 34 health centres in areas vulnerable to cholera for the local production of chlorine by electrolysis. This capacity is to maintain hygiene in the health unit and to promote household water treatment and sound conservation. UNICEF is preparing to provide financial and material support to the government WASH response to cholera in high risk zones of Koulikoro, Kayes, Mopti and Gao regions. UNICEF, with WASH cluster partners, is analyzing how to strengthen the cholera response including through the use of mobile teams to evaluate areas with suspected cholera cases, and monitor the effectiveness of partners’ response and use of supplies in affected areas. The national cholera taskforce led by the Ministry of Health coordinates Health and WASH partners’ activities nationwide to prevent and respond to cases of cholera in epidemic prone areas and coordinate medical and WASH actors. However, with the rainy season and 3 population mobility related to the instability of the country, a high risk of epidemic spread is feared.