Eritrean refugee women and their Ethiopian hosts in the Afar region of Ethiopia ensure children attend school

By Amanda Westfall

Afar region, Ethiopia-On 21 September, in Asayita Woreda, Afar Region, Ethiopia, female community leaders who missed the opportunity for education when they were young, are now ensuring their children don’t follow that same path. Through the UNICEF-introduced and UK-Aid funded Accelerated Readiness Programme, children from both refugee and host communities in Afar Region, Ethiopia are participating in the summer programme to help prepare for primary school.

Zahara Halo, 28, a mother of three from Afar Region, Ethiopia, has never been to school. She was married, had a child at 13, and spent the latter half of her childhood raising her children and performing household chores expected of Afaari women: collecting water, cooking, building huts, tending cattle, and raising children.

Rokiya Mohammed, 35, is an Afaari woman from the Afar region of Eritrea. She also has never enjoyed the benefits of education, having spent much of her life doing household chores and caring for her seven children.
Approximately 13 years ago, Rokiya fled Eritrea to Ethiopia during the war between the two countries. She arrived with other Eritreans to Asayita Woreda where she has integrated into the host Ethiopian community and has received support ever since.

Zahar and Rokiya, although from two different countries, have many things in common. Both have learned to live in harsh desert climates, both are from pastoralist cultures, and both never had the opportunity for school. However, both are determined to change that pattern for their children.

They are part of the community’s Women’s Self Help Group, where they work to change the conditions for women and children in the community. Among other group activities, such as adult literacy classes and providing loans for small business, they are the delegated community leaders who ensure their children go to school.

IMG_8162
Eritrean refugee girls, Aysa, Musa, and Lali, attend UNICEF’s ASR programme at Sembile Primary School along with their fellow refugee and host community classmates. © UNICEF Ethiopia/2018/Tadesse

When these women heard that the new Accelerated School Readiness (ASR) programme was coming to Afar, they were determined to help. As Zahara explains:
“As the group leader (of the Women’s Group) we have difficulties in finding group members who can read and write, and we suffer a lot from this. That is why I am inspired to put my child in school. I do not want him to suffer as I have.”

Accelerated School Readiness(ASR) 

IMG_8895
Eritrean Refugee and Ethiopian host community children participating in ASR at Sembile Primary School © UNICEF Ethiopia/2018/Tadesse

ASR was designed for vulnerable children who never had early learning opportunities (like private or public pre-school) but are of age to begin primary school. It was developed through proven research on the importance of play-based activities (i.e. story-telling, art activities, literacy games) to help develop early literacy and communications skills. ASR gets children excited for school, ready for school, and keeps them in school.

In Ethiopia primary school dropout rates remain unfortunately high, with the highest rates found in Grade 1 (at 18 per cent), which is strongly linked to a lack of quality pre-primary opportunities. ASR is an innovative response to this challenge. In 2015, UNICEF introduced the initiative in rural areas of Ethiopia. Because it is relatively inexpensive (approximately US$13 per child), quick (two months over the summer), and effective, it has become a popular option for disadvantaged areas.

In 2016, ASR was offered to refugees and their host communities in an integrated and equitable approach. When they heard the news that ASR would be coming to refugees and host communities in Afar Region, the Women’s Group was ready and excited to support.

ASR is only possible through female community leaders

In Asayita Woreda, children are anywhere and everywhere – in condensed urban areas and expansive rural communities. In the vast deserts of the Afar Region where the climate is harsh and transportation services are minimal, it can be a major challenge to get children to school – a feat that is only possible by the determined female leaders of the community.

In less than one week, these women helped mobilize 258 children from urban and rural areas of Asayita Woreda, an area that spans almost 1,700 square kilometers.

Zahara explains how they were able to accomplish this: “We go from door-to-door and provide school materials for low income children … thereby giving the parents incentives to send children to school.”

Another Women’s Group member, Zahara Ali adds, “I know all of the mothers. I go knock on doors and say that you better send your children to school. I check up on each of them.”

Equal opportunities for refugees and host community children

Some Eritrean refugees, like Rokiya, have integrated into the local town, but some have decided to stay in the refugee camp just a few kilometers away. When Rokiya heard that ASR is also happening in the camp she was extremely grateful. “We are so happy our brothers and sisters also get this programme. We are grateful to see our children have equal opportunities like the host communities.”

IMG_8974
Zahara and her six-year-old son Zuruson
© UNICEF Ethiopia/2018/Tadesse

Because of determined women like Zahara and Rokiya, positive change is possible for the next generation in Asayita Woreda. As Women’s Group member Misre Ali explains, “We are in the darkness. We never had a chance to be educated and we don’t want this for our children. We want them to know many things.”

Since the introduction of ASR in Ethiopia, UNICEF has directly supported over 45,000 children in addition to the thousands more the Government has helped through their ASR interventions. As a result, hundreds of thousands of children have enjoyed its benefits in becoming well prepared for primary school.

Baby WASH: increasing communities’ awareness through health extension workers

by Hiwot Ghiday, Selamawit Yetemegn, Anina Stauffacher

Sekota Woreda, Northern Amhara region, 5 October 2018– Nigist lives 20km north of Sekota town in the mountainous and remote northern part of Ethiopia. Together with her husband and two children she lives in a one-room rock-built house in the centre of the village. The village is surrounded by rocky crop fields, where the men plough with the help of two oxen.

In early August, during the rainy season, everything looks not lush but pleasantly green. As Nigist takes a seat on a dusty plastic chair, the neighboring children come closer sitting and standing on the gravely dirt curious to hear and see what she is about to tell.

With the youngest child safely on her back, Nigist starts talking about how she cares for him. She explains how she washes the baby’s hands and face three times per day often with soap. “I would always like to wash my baby with soap, but we sometimes find it difficult to afford soap, then I wash him with water only”, she says. “I also wash his body every other day, for my older child it is less frequent”. Nigist’s understanding of the consequences of not properly washing her children’s hands and face with soap seems limited and leads her not to prioritize buying soap rather than other items.

UNICEF in collaboration with the BBC Media Action is currently piloting an EU-funded Baby WASH project in Zequalla and Sekota Woredas, Wag Himra Zone, northern Ethiopia. The aim of the Baby WASH project is to reduce the microbial burden encountered by young children in their play and feeding environments. In addition, the project aims to reduce trachoma and other disease exposure of children and therefore help reducing child stunting [1].

In August 2018, health extension workers were trained to work with the communities to change hygiene practices improving early childhood development. The focus lies on safe disposal of child feces, handwashing with soap, face hygiene, shoe wearing, protective play areas and food hygiene.

During the training, health extension workers learnt about Baby WASH activities and how to work with the communities to effectively change behavior. Listening groups and group discussions at community level using radio recordings are part of the methods the health extension workers use to raise Baby WASH issues in their own community. Additionally, during public discussion led by the local health office, key expectations were raised and discussed.

Debessa, a health extension worker describing the training on Baby WASH activities and how she plans to work with mothers in her community ©UNICEF2018Stauffacher
Debessa, a health extension worker describing the training on Baby WASH activities and how she plans to work with mothers in her community ©UNICEF/2018/Stauffacher

Debessa is one of the two health extension workers in the kebele where Nigist lives. Debessa says: “I know about safe sanitation and hygiene practices, but these interventions focusing on babies and young children are new for me. It is very interesting and I am learning a lot during the training.” Debessa is happy about attending the training together with other colleagues from Sekota Woreda.

She and her colleague working in the same kebele agree: “we are very motivated to go back home and work with the mothers on the Baby WASH, it is exciting. For the handwashing practices specifically focusing on babies and young children, we will connect it to previous handwashing promotion activities. To encourage families to properly dispose child feces, we expect that it will need some time for the change to be effective because this is a new concept for many in the community. And potties are expensive, it isn’t a priority for the families to spend money on potties particularly at this time of the year where families invest most of their money in farming”.

The key actions promoted during the training are summarized in form of pictures with both Amharic and Hemtegna language so training material can be used at community level.

Piloting the EU-funded Baby WASH project in collaboration with the government is a promising way forward to start triggering behavioral change with a focus on pregnant women, babies and children under 3. Shifting from a “have to” approach to a stronger focus of “how to”, Baby WASH requires close integration with existing interventions on maternal, new born and child health, early childhood development and nutrition.

A paper published by UNICEF and John Hopkins University in the Journal of Tropical Medicine and International Health highlighted the need to target interventions to reduce unsafe practices of disposal of baby and child feces. UNICEF Ethiopia WASH has included Baby WASH into its strategy for the new country program to contribute to the improvement of early childhood development.

[1] Stunting is a sign of ‘shortness’ and develops over a long period of time. In children and adults, it is measured through the height-for-age nutritional index. In Ethiopia approximately 40 per cent of children are stunted.

How to improve the quality of education in refugee camps? Qualify the teachers.

In Ethiopia, refugee incentive teachers are on their way to obtaining professional teaching diplomas.

By Amanda Westfall 

On 17 August, South Sudanese and Sudanese refugees Anur, Sami, James, Abdalaziz, and Poch went to college for the first time. They are part of the first group of 42 refugees on their way to becoming professional teachers.

As agents of change for their communities, they will use their new skills to improve the quality of education for refugee children. Abdalaziz Ramada, Sami Balla, and James Jawalla have been refugees for 7 years. Anur Ismael has been a refugee for 20 years. Poch Jackson Petov has been a refugee for 25 years, his entire life.

All five fled the conflict in Sudan and South Sudan. All five lost loved ones, families and friends. Some, like Poch and James, have survived as refugees with no family at all –either lost or killed in the conflict.

All are known as ‘refugees’ to their friends, to Ethiopian host communities, the Ethiopian government, and to the world. With this status they cannot legally work in Ethiopia and have had limited opportunities for college or university to enhance their skills and become professionals… Until now.

In July this year, 42 refugee incentive teachers in Benishangul-Gumuz region were given an opportunity of a life time. Abdalaziz, James, Amur, Sami, Poch, and 37 others were enrolled in the region’s teachers’ college. The refugees rode a bus for eight hours, moved onto the GilGel-Beles College of Teachers Education campus, and are currently studying for their teaching diplomas.

For refugee teachers, long-term opportunities for skills development have been nearly non-existent, since trainings are typically offered as short courses, giving them the minimum skills to educate refugee children. Therefore, and not surprisingly, only 33 per cent of those who teach in primary schools in the region are qualified professional teachers who hold teaching diplomas. This means that the majority of refugee children are receiving their primary education from unqualified personnel, many of whom have not even completed secondary school (23 per cent).

However, the Ethiopian Government has made a commitment to improve the situation for refugees and give them opportunities to integrate within Ethiopian society, as demonstrated by the government’s nine pledges to support refugees and the Comprehensive Refugee Response Framework process in Ethiopia. They understand that it is crucial to provide opportunities to refugees for career growth, especially in the teaching sector, so that the quality of education in the camps can improve and that children have better education, better opportunities, and better skills to make positive contributions to their communities – whether in Ethiopia, South Sudan, Sudan, or where ever they end up in the future.

A Desire for More Opportunities

South Sudanese refugees and current college students, Poch Jackson Petov and Hamid Abdallah Hamad in front of Gilgel-BelesCollege of Teacher Education. © UNICEF Ethiopia 2018 Amanda Westfall
South Sudanese refugees and current college students, Poch Jackson Petov and Hamid Abdallah Hamad in front of Gilgel-Beles College of Teacher Education. © UNICEF Ethiopia/2018/Amanda Westfall

The opportunity arose because of an ambition to expand knowledge. In 2017, Poch, along with his colleagues demanded more opportunities. In the camps, all they earn is 700 Ethiopian Birr per month (about US$25) to ‘volunteer’ full time as teachers in primary schools. With no chances to go to college, become professionals, and earn a decent wage, something had to change.

“We had a meeting with school principals. We asked them, ‘Why can’t we get training to improve our skills?’ We are stuck in one position. Then we waited. Finally, [the opportunity] came and we have a partner to help us continue education.” (Poch)

Because of his ambition to expand his knowledge, as well as his understanding of the Ethiopian language, Amharic, Poch is the group’s student representative at the college. And he fought a hard life to reach this status. After his father was killed in the conflict in South Sudan, his mother fled to a refugee camp in Ethiopia while he was still in the womb. When he was in Grade 2, a conflict broke out in the camp and he was separated from his mother, never to see her again. With incredible determination, he managed to learn Amharic, gain a full primary and secondary education, and become an incentive teacher (in addition to being the best football goal keeper in Sherkole Camp). But just being a ‘volunteer teacher’ with no relevant qualifications was not enough.

Dreams for College Become Reality

In early 2018, UNICEF, UNHCR, and the Ethiopian Government, along with financial support from Education Cannot Wait, made dreams become reality. Posh, Anur, Sami, James, Abdalaziz, the 37 others from the Benishangul-Gumuz Region, and 301 others from Gambella Region were going to college.

In total, the programme brings 343 refugees to study and learn with their fellow ‘host’ Ethiopian students. The courses are taught in English, and they can choose which track to study, from Generalist, to Physical Education, Integrated Sciences, Math, Social Science, or English. They are provided with a full scholarship, which includes education, room and board, health care, and transport services to/from the college or camps. The regional government and colleges support with training, learning and integration at the school, while UNICEF, the Administration for Refugee and Returnee Affairs (ARRA) and UNHCR coordinate, finance, and manage the project.

A Chance for Generational Change

These refugee student-teachers are part of a new movement of change for the refugee communities. With new skills in teaching methodology, classroom management, and course-specific instruction, their knowledge will be passed on to the children in the camps.

As James and Sami explain, “I am proud of this programme. It will enable me to improve the knowledge of my community.” (James)

“Now, we can go back with the diploma and say we are teachers and we are professionals! I now have pride to work at the school.” (Sami)

With their new diplomas, Posh, Anur, Sami, James and Abdalaziz explained that they want to go back to the camps and use their new skills to improve the quality of education for their communities.

As the first group to enjoy this opportunity, they now set an example for future refugee student-teachers, so that each year the quality of education for refugee children continues to improve with an increase in more qualified teachers.

Heads of WFP and UNICEF visit Somali Region of Ethiopia after days of civil unrest

ADDIS ABABA – The heads of the United Nations World Food Programme and UNICEF in Ethiopia have made a joint visit to Somali Region of Ethiopia to see firsthand how people affected by recent violence and civil unrest are being assisted.

WFP Country Director, Steven Were Omamo and UNICEF Representative in Ethiopia, Gillian Mellsop visited the regional capital Jijiga on Monday 13 August, where they assessed what further support was needed and emphasized the importance of strong partnerships in improving the situation.

A humanitarian coordination committee comprising both government and humanitarian partners has been established to identify food distribution points in the city, after thousands of people were forced from their homes amid the disturbances.

“The people here are facing enormous challenges, and we have been doing all we can to support them through food distributions over the past few days,” said Omamo. “It is encouraging to see how the situation is stabilizing through the efforts of the Government and the support of humanitarian partners, and federal and regional authorities.”

“Children and women still face enormous challenges in accessing basic services such as water and health,” said Mellsop. “Working with the regional government and our partners, we are doing our best to ensure that support continues to reach them even as we restore currently-suspended programmes for other vulnerable populations.”

UNICEF is providing high-energy biscuits to children and women, buckets, blankets, soap and water-treatment chemicals. Before the conflict, UNICEF was supporting the treatment of approximately 132,000 children and 110,000 pregnant and breastfeeding women for moderate malnutrition and 8,500 children for severe acute malnutrition. The support is expected to resume once the situation improves.

WFP is providing rice, pulses, oil, corn soya blend, and the supplement Plumpy’Sup to 52,000 people seeking shelter in temporary accommodation. It hopes to resume its regular operations in the coming days as the security situation continues to improve.

WFP usually provides food assistance to some 2 million food-insecure people in the Somali Region. Another 311,000 drought-affected people receive complementary WFP food assistance under the government-led Productive Safety Net Programme.

UNICEF signs annual workplans with the Government of Ethiopia worth US$ 56 million

By Metasebia Solomon

Addis Ababa, 9th July 2018: UNICEF signed annual workplans with the Government of Ethiopia for the Ethiopian Fiscal Year 2011. The workplans were signed by Mr Admasu Nebebe, State Minister in the Ministry of Finance and Economic Cooperation (MoFEC), Ms Gillian Mellsop, UNICEF Representative to Ethiopia and heads of Regional Bureaus of Finance and Economic Cooperation.  UNFPA also attended the signing ceremony, as one of the UN agencies signing annual workplans with the Government of Ethiopia under the UN Development Assistance Framework (UNDAF 2016-2020).  UNFPA was represented by Mrs. Bettina Maas, UNFPA Country Representative to Ethiopia.

AWP signing ceremony
UNICEF Representative to Ethiopia, Gillian Mellsop, Admasu Nebebe, State Minister, Ministry of Finance and Economic Cooperation and Bettina Maas, UNFPA Country Representative to Ethiopia, shake hands after signing the annual workplans. ©UNICEF Ethiopia/2018/Zerihun Sewunet

The workplans will create a platform for the implementation of integrated child-focused development interventions in Ethiopia’s regional states and city administrations. This year, with support from MoFEC, UNICEF has managed to reduce the number of work plans from 143 to 89 by integrating related programmes that are currently being implemented by different implementing partners. The reduction will strengthen collaboration and coordination among implementing partners and will contribute to efficient utilization of resources by reducing operating costs and facilitating joint programme implementation, monitoring and evaluation.

In his remarks, Mr. Admasu Nebebe said the continued support and resources mobilized by UNICEF and UN agencies in the past decades has been valuable to Ethiopia’s development. In particular, he singled out the participatory process used to develop the workplans as a key to enhance mutual accountability and ownership of programmes.

Ms. Gillian Mellsop said UNICEF highly values its partnership with MoFEC and the Regional Bureaus. Appreciating the fact that the vast majority of resources are allocated to the regions, Ms. Mellsop said UNICEF is grateful for the support and collaboration of the regional government partners to deliver results for children and women in general and to reach the most disadvantaged and vulnerable children in particular.

The workplans will be implemented by more than 140 regional and federal government partners covering 12 programme areas that include health, nutrition, water, sanitation and hygiene, education, early warning and disaster preparedness, violence against children, ending child marriage and FGM, birth registration, child rights, communication, public finance for children, evidence generation, and programme coordination, monitoring and evaluation.

Helping health workers save Ethiopia’s youngest children

By Demissew Bizuwerk

Kejelo, Tiro AFETA, Oromia, 14 June 2018: Inside the small room of Kejelo health post, health extension worker Amelework Getachew carefully monitors her stock of medicines stacked on a small wooden shelf. She checks to make sure that an Oral Rehydration Salt (ORS), a fluid replacement used to prevent and treat diarrhoea, Amoxicillin Dispersible Tablet and Gentamicin injection, antibiotics used to treat children with pneumonia and serious bacterial infections, are available in good quantity. She cross checks the numbers on each bin card and the actual quantities on the shelf. “I can’t afford to run out of these medicines,” says Amelework, pointing towards a stock of sachets of ORS and packs of amoxicillin tablets and gentamicin injections. “They are lifesaving.”

After Amelework is done taking inventory, she collects her essential job-aids for home visits and attends to five-month-old Aziza in her home as part of her routine house-to-house visit. This way, Amelework makes sure that pregnant women and newborn babies get health follow-ups.

When Aziza was only 45 days old, she suffered from pneumonia, the common killer of infants in Ethiopia. “I was so worried when my child was sick,” says Rawda, Aziza’s mother. “She was struggling to breathe and had it not been for ‘doctor’, my child would not have survived.”

“I was so worried when my child was sick. She was struggling to breathe

Amelework, whose name also means “a golden character,” is a committed health worker. Her nine-year journey as a health extension worker started in a remote village of Kereyu Dodo when she was given the daunting task of changing people’s attitudes on a range of health-related misconceptions.  It wasn’t easy for her to convince people to dig toilets or use bed nets to keep them safe from malaria. “They used to call us names like the ‘toilet controllers’ or ‘bed net checkers,” she remembers.

CNBC Jimma, Oromia
Amelework examines five months old Aziza. When Aziza was 45 days old, she suffered from Pneumonia. But now she is growing up healthy. ©UNICEF Ethiopia/2018/Demissew Bizuwerk

But Amelework is now dubbed ‘doctor’, a name bestowed to her out of love and respect by the village women.  She is key to the livelihoods of the community, saving mothers and newborns including little Aziza in the small village of Kejelo.

Although Ethiopia has managed to significantly reduce its under-five child mortality, newborn deaths have declined at a much slower pace.  Twenty-nine newborn babies die out of every 1,000 live births from preventable causes such as complications due to prematurity, birth asphyxia, and infections like sepsis, and pneumonia[1]. Newborn deaths also account for a greater and growing share of all deaths among children under 5; almost 44 per cent.

Supported by UNICEF, the Government of Ethiopia introduced the Community Based Newborn Care (CBNC) strategy in 2012. CBNC aims to empower health extension workers, such as Amelework, with skills to provide maternal and child health services during pregnancy, childbirth and postnatally. Heath extension workers are also trained to identify and treat newborns with severe bacterial infections or sepsis where referral is not possible. They provide treatment for sick children both at the health post and in houses during their regular visits.

“The treatment we are providing is free of charge,” says Amelework. “This is encouraging mothers to bring their children early when they are sick.  It is also helping us to save young children from serious illnesses like pneumonia.”

Amelework is trained to provide CBNC services by JSI Research & Training Institute, Inc/ The Last Ten Kilometers Project (JSI/L10K), which is implementing the programme with technical and financial support from UNICEF.  She also gets constant support and follow-up from the CBNC supervision team who regularly visit her health post to make sure that she is applying the standard operating procedures.

CNBC Jimma, Oromia6658
Wosen Darge, the CBNC Regional Technical Officer from JSI/L10K supports Amelework with regular visits to her health post. ©UNICEF Ethiopia/2018/Demissew Bizuwerk

“We train and support Amelework to deliver her very important work by effectively identifying sick children in the village during her regular immunization outreach work and when she is providing house-to-house postnatal care,” says Wosen Darge, the CBNC Regional Technical Officer from JSI/L10K.  “We also monitor and evaluate her records to ensure key information is recorded and stored in the treatment book.”

Amelework is also provided with guidance and support on supply management. She keeps track of her medical supplies to avoid shortages of crical drugs that she needs for immediate use.

“Nothing is more fulfilling than seeing a mother’s happy face when her child is recovering from such illnesses”

UNICEF is supporting the scaling up of CBNC services with funds from the Margaret A. Cargill Foundation. Working in coordination with the Ministry of Health, it is expected that the positive experiences observed in villages like Kejelo will be expanded to pastoralist areas.

CNBC Jimma, Oromia
Amelework is the indispensable medical person for Kejelo village mothers and children. She is dubbed ‘doctor’ by the local women for saving their children. ©UNICEF Ethiopia/2018/Demissew Bizuwerk

A humble hard worker such as Amelework embodies Ethiopia’s hope to end preventable newborn and child deaths within this generation. “Nothing is more fulfilling than seeing a mother’s happy face when her child is recovering from such illnesses,” she says, “I am a mother myself and I know the feeling.”

Aziza is growing up healthy, her mother’s wish is to see her daughter becoming a ‘doctor’, like Amelework. “She [Amelework] saved my child’s life and I want my daughter to also do the same when she grows up,” says Rawda, with eyes full of hope to see a bright future for her baby daughter.

[1] EDHS 2016

Mass distribution of mosquito nets to South Sudanese refugees in Ethiopia

By Dorosella Bishanga and Bisrat Abiy

Kule Refugee Camp, Gambella, Ethiopia, 29 May 2018: Nyaluak Kun, 24, is a refugee at Kule Refugee Camp in Gambella, western Ethiopia. Originally from South Sudan, the mother of six has just received three long-lasting insecticide treated mosquito nets for her family. She says malaria has been a threat to her health and that of her family since the rainy season started.

“I am happy to receive these mosquito nets. I hope this is the right time that we have received the mosquito nets. Several times I have been sick with malaria. There was no solution for me. I get medicine, after a few weeks, I get sick again because of mosquito bites.”

Distribution of mosquito nets - Gambella
Nyaluak Kun and her child at Kule Refugee Camp in Gambella, Ethiopia. ©UNICEF Ethiopia/2018/Dorosella Bishanga

For Nyaluak, the mosquito nets will not only keep the family safe from mosquito bites but also from other poisonous insects that enter homes during the rainy season.

Malaria is endemic to the Gambella Region and is one of the top three causes of sickness and death across all the refugee camps.  The epidemic occurs mostly from April to June and September to November every year. Mosquito nets, in-door and out-door residual spraying, and environmental management are the most recommended malaria prevention and control interventions.

The standardized expanded nutrition survey of 2017 indicates that the proportion of households with access to at least one mosquito net is below 50 per cent in all the refugee camps, except for Kule at 54 per cent and Pugnido II at 60 per cent. With inadequate mosquito nets, malaria is rampant: last year alone, 128,520 cases and 33 deaths were recorded, 25 of them children under the age of five.

Distribution of mosquito nets to vulnerable groups, such as under five and malnourished children, pregnant and lactating women, and newly arrived refugees, is ongoing in all the refugee camps of Kule, Tierkidi, Nguenyyiel, Jewi, Pugnido I, Pugnido II, and Okugo.

However, the 2018 blanket distribution, targeting 386,000 refugees, started on 29th May in Kule Refugee Camp. It was combined with general food distribution using lists obtained from UNHCR population and household databases. With the overall coordination of the Administration for Refugee and Returnee Affairs (ARRA), UNHCR and UNICEF, refugees received mosquito nets at distribution centres managed by MSF-Holland, an implementing partner. Upon presentation of a mosquito net coupon obtained at the food registration centre showing the family size, the refugees would receive a mosquito net free of charge based on the UNICEF standard of one mosquito net for every two individuals.

UNICEF monitored the distribution exercise and conducted awareness and demonstration on slinging the mosquito nets. The awareness was done by Community Outreach Agents. Special messages with visuals were developed for under five children and pregnant and lactating women. The monitoring team also conducted interviews with refugees to ascertain their knowledge levels on utilisation of mosquito nets.

Distribution of mosquito nets - Gambella
Nyaluak Kun after demonstrating how to hang the mosquito net. ©UNICEF Ethiopia/2018/Dorosella Bishanga

Nyaluak says the demonstrations were important although the refugees faced difficulties in fixing the nets because of the type of housing and beddings they had.

In all, 163,000 mosquito nets were distributed. They were procured by UNICEF with funds from the European Commission (ECHO) under a project to provide lifesaving and resilience-building health and nutrition interventions for South Sudanese refugees and host communities in Gambella.