MIESSO, SOMALI, 15 January 2017 – “When the borehole was broken for a year and a half, I used to go to the nearby river for water, which is 12 km away from here. I have five children but I only managed to get one or two jerry cans of water for my family. I was not able to clean or bathe my children regularly at that time. That was difficult,” says Fathiya Ali Aadan, a 32-year-old mother of five living in Miesso town.
Miesso is a small, remote town in the same-named woreda (district) located about 150 km west of the administrative city, Dire Dawa. Out of five non-functional water supply systems in Miesso woreda, one borehole was rehabilitated in the town by the Regional Water Bureau (RWB) in December 2016 with assistance from UNICEF, from the generous support of the Office of U.S. Foreign Disaster Assistance (OFDA). The emergency water, sanitation and hygiene (WASH) intervention benefits 3,500 households in the town as well as the school and health centre.
The Miesso woreda administration office reports that there are currently 86 non-functional boreholes in the woreda, a key intervention necessary to improve the water situation, which is only one part of the challenges facing families in the region. Since most of the region is prone to drought and pastoralist livelihoods critically depend on water, non-functionality of water schemes requires immediate response to save lives of people and their livestock. It also affects children’s opportunity to learn.
At Mulli School, which includes grades one through twelve, a 14-year-old, grade eight student Ibrahim Mohamed explains, “Before, we had to return back home to get water when there was no water at school. It was a big interruption of class.” The impact of water scarcity also causes some schools to close, such as last year after the failure of deyr rains (October-December). Additionally, pastoralist families may move in search of water, thus taking children and even teachers away from school.
“Now we can drink water, keep our clothes clean, wash our hands after using the bathroom and most importantly for me, there is no longer need to go back home to get water during class. Girls need water for menstrual hygiene at school as well,” says Hayat Yusuf Adan, a 13-year-old, grade eight student.
Thanks to the rehabilitated borehole, Hayat’s school managed to remain open. While water supply at school tends to be neglected during emergency, it is clear that water availability contributes to retaining children in school. UNICEF is committed to support the Government of Ethiopia and implementing partners to improve the WASH situation for schools and families across Somali region to protect the futures of children and the livelihoods of their families.
GASHAMO, SOMALI, 15 February 2017 – Under the shade of a tree and settled on plastic mats, the mobile health and nutrition team (MHNT) is in full operation. An array of bright coloured fabric represents the crowd of mothers and children gathered around them, all in varying stages of screening, vaccinations, treatment or referral. In the rural Somali region, Gashamo woreda (district), 63 km off the paved road, the MHNT has been operating as a static clinic for the past two months as part of the response to the Horn of Africa drought caused by the negative Indian Ocean Dipole (IOD).
Facing food and grazing shortages and in need of water, drought-affected pastoralist families and their livestock began traveling long distances in search of water. As one of the most vulnerable communities across the country, unique interventions are required to provide them a safety net in times of emergency.
The Government of Ethiopia (GoE) has provided a swift response by setting up five temporary sites in Gashamo woreda, which offer health and nutrition services as well as food and water. This arrangement is crucial and specific to pastoralist communities, where families are scattered across hundreds of kilometres of harsh semi-arid desert.
28-year-old Mohammed, a senior clinical nurse by training, works alongside two nurses who treat and manage cases, in addition to two health extension workers (HEWs) who screen patients and conduct community health education. Mohammed and his team were assigned to this hotspot priority one site by the Somali Regional Health Bureau (RHB), following a recent updating of hotspot woredas, which are most affected by malnutrition according to the latest meher seasonal assessment.
“My family is 200 km away and I am not sure when I will visit them. Probably when the drought is over,” says Mohammed. “But our work here is very important, there are thousands of people who otherwise would not have access to any health services. Especially during a severe drought, our services save lives.” He explains further that while the Ethiopian health system is highly developed, utilizing catchment areas for a tiered health facility structure is not feasible in pastoralist communities.
“Pastoralists are always on the move in order to provide grazing and water for their livestock, so expanding health facilities in these remote areas does not add value. Right now, there are over two thousand families in this location, so why not set up a permanent health post to serve them? Because perhaps in one or three months, there will be 20 families here, or none. Across the region, there are remote areas where people come and go, so the normal health system does not serve its purpose [in this context].”
This is the reason MHNTs were created and why they have helped improve the health and nutrition situation of pastoralist families for the past decade. From regular risk assessments and categorization of vulnerable woredas by the Ministry of Health and partners, including UNICEF, MHNTs are deployed for a minimum of three months, depending on the emergency situation and needs. With the onset of a sudden disease outbreaks or other emergencies, the MHNT will temporary relocate to the affected area to provide initial rapid response and then return to their assigned woreda.
The MHNTs work six days per week, traveling from location to location and setting up mobile clinics along the way. They make contacts with social mobilisers, volunteers from the community, to ensure everyone knows the day and place where the MHNT will be. The social mobilisers know their community well, even those families that are spread out across a vast terrain, and they guarantee everyone receives the information. Every time, a crowd of mostly women and children are gathered, anticipating the needed treatment and care.
The MHNTs conduct screening for malnutrition, provide routine immunizations and basic healthcare treatment, ante-natal care and emergency delivery services, common illness management, health education and promotion, as well as refer patients to higher levels of care as and distributing household water purification supplies as necessary. When the latter happens, they often utilize their vehicles to bring patients to the nearest health facility, as it would be near impossible for timely care otherwise.
UNICEF supports the GoE’s MHNT programme with the generous effort from donors, through vehicle provision, transportation allowances, emergency supplies and technical guidance. There are 49 MHNTs currently operating in Somali and Afar regions, moving around their respective regions according to the identified need.
Our visit is cut short as the team has just identified two children who are not responding to malnutrition treatment – as per the protocol, severe acute malnutrition (SAM) cases should return to the MHNT on a weekly basis to record progress or be referred to higher levels of care. These cases have been escalated to SAM with medical complications and the mothers are encouraged to gather their belongings and take the MHNT car to the nearest stabilisation centre about 30 km away. “Working in a static clinic may be nice,” says Mohammed, who has been working on the MHNT for nearly seven years, “and over time, as Somali region becomes more developed, the health system may be able to cover all areas. But until then, I know there is a great need and I am proud to be working on this team.”
HARSHIM, SOMALI, 19 January 2017 – “For three months, the borehole was not functional and people suffered a lot. There was little rain, so most of the birkas became empty. Additionally, water from birkas is usually contaminated so we suffered from diarrhoea,” Muse Hassan Ali, 45-years-old recalls the time that he and his neighbours did not have access to safe and sustainable water in his town. Birkas are underground water storage systems intended to collect rain water during the rainy season and store for use during the dry season. Birkas can also be used to store water transported by trucks during emergencies.
According to the Harshim woreda (district) administrator, Sied Abraham, this borehole in Harshim town is the only sustainable water source that survived the 2015 El-Niño drought. It was drilled by the Somali Regional Water Bureau (RWB) following a UNICEF groundwater mapping in 2009 to identify potential drilling sites. The depth of the borehole is 535 meters, one of the deepest in the Somali region. After this borehole became non-functional due to electromechanical failure last year, UNICEF, with generous financial contribution from European Commission’s humanitarian aid department (ECHO), supported the RWB to rehabilitate the borehole by replacing a submersible pump, generator and an electric cable.
An immediate rehabilitation of the only sustainable water source in the woreda was crucial not only for Harshim town, but a large part of the region. It typically benefits over 9,000 people in Harshim and neighbouring woredas as well as people who cross the border from Somalia. At the end of 2016, it also served people in far-reaching woredas when drought conditions worsened once again due to the negative Indian Ocean Dipole (IOD). The RWB and partners began providing emergency water trucking, using this borehole as their source. Thus, its well-functioning affects a high number of direct and indirect beneficiaries across the region.
Roda Ahmed, 35 years old, is with her five children collecting water. “This is a source of life. Now I can cook and feed my children,” she says. Another woman from Harshim town also with five children, Rahma Ahmed, explains, “Since this borehole has been working, we stopped drinking water from birkas.”
In addition to people collecting water near the borehole, the on-site trough draws in many pastoralists and their livestock. It takes more than a day for Farah Aden, 60 years old, to walk to the Harshim borehole with his 10 camels. “We are grateful for this borehole. Water is always a great cost for livestock. The functionality of this borehole has impacted our life a lot.” Indeed, during drought periods such as this one, entire herds may be wiped out, as evidenced by dozens of dead carcasses along the roads across the region.
As he contemplates this grave issue in his region, Muse pauses before emphasizing, “Still, this is not enough. There is a great pressure on this borehole. The generator is working 22 hours every day.”
UNICEF and partners will continue efforts to support the Government of Ethiopia to increase water coverage and functional water schemes in the Somali region to save the lives of children, their families and their livestock and contribute to a better future for all.
GASHAMO, SOMALI, 15 February 2017 – Mutas does not look at his mother. He is not looking anywhere, rather he lays still, his unfocused pupils covered occasionally by heavy eyelids. While we talk, his mother, Bedra Dek, keeps her eyes entirely on him. Her one-year-old son is suffering from severe acute malnutrition (SAM) and despite the food and water shortage and her two other children, she explains that all her thoughts are focused on him improving.
“When your child is well, spiritually you feel happy. This is what I am waiting and hoping for. Nothing else is in my mind except this,” Bedra speaks softly, her eyes never wavering from her son.
About six months ago, Mutas became sick with a cold. Since then, he has fought that illness and intermittent diarrhoea while they lived in remote rural areas. Living in remote areas means even farther than where we are now, which is over 300 km from the regional capital and 63 km off the paved road through desert sand – no roads. Bedra walked yet another 15 km to the settlement just outside Al-Bahi kebele (sub-district) after hearing that there was a mobile health and nutrition team (MHNT) providing lifesaving services. She knew Mutas was not improving, and indeed, shortly after her arrival, he had become lethargic and largely unresponsive.
At 21-years-old, Bedra has 7- and 4-year-old daughters in addition to Mutas. They are a pastoralist family, living in a rural village and often traveling vast kilometres in search of water and grazing land for their livestock.
While the semi-arid Somali region is often dry, the drought brought on by the negative Indian Ocean Dipole (IOD) in the past few months is beyond anything Bedra has experienced. Her family’s herd of over 200 goats and sheep is now down to four, and their physical appearance is too poor to sell in the market.
Upon arriving in Al Bahi, she went to the MHNT, which has temporarily set up as a static clinic in the site to service the hundreds of families in the area. MHNTs were initially set up over a decade ago in this region as a unique and necessary component of the emergency health service delivery system to reach nomadic families such as Bedra’s. They respond to disease outbreaks, provide routine immunizations and basic healthcare including treatment of common illnesses, conduct screening and manage uncomplicated cases of malnutrition as well as refer to higher levels of care as necessary. Here, the team has encountered high levels of malnutrition and the majority of children have low immunization status. The team is both responding to emergency care needs as well as conducting mass immunization and other preventative measures to ensure that a temporary settlement like this does not create further disease and suffering.
Once a child is diagnosed with SAM, they are provided with ready-to-use-therapeutic-food (RUTF) and medications which should help them to quickly improve. To ensure progress, mothers are instructed to come weekly to have their children checked. We meet Bedra, as she waits with Mutas for his weekly check.
UNICEF continues to support the GoE’s MHNTs through vehicle provision, transportation allowances, emergency supplies and technical guidance. UNICEF emergency health and monitoring consultant, Kassim Hussein, was present when Mutas was referred. When asked about his role, he explained how he roves around the region providing technical support. “During emergencies, things may be done in a haste, there may be staffing or technical knowledge gaps, or the situation may reach extreme levels and the team is too busy to report. I make rounds to all the teams, providing technical support and ensuring standards of care and supplies are available at adequate levels. I then report back to UNICEF and the regional health bureau,” explains Kassim.
Now Mutas is being seen by Mohammed Miyir, the team leader of the MHNT in Al-Bahi temporary settlement. Originally, he diagnosed Mutas with SAM; now his condition has developed medical complications, making him unable to receive fluids or medicine. This development signals the need for him to be sent to a stabilization centre (SC) at the Gashamo woreda (district) health centre, where he will receive in-patient advanced care until he reaches a minimal level of improvement in his responsiveness and weight.
Bedra is perplexed. Just minutes before they told her this news, she had said she wanted anything for him to improve. Now that it may happen, a new reality hit her. Her two daughters will need to be left behind – there is no room in the MHNT car. This is often an issue mothers out here face. With husbands caring for the grazing livestock, if they need to go to a SC for further treatment, who will take care of their other children? Some find neighbours to watch their kids, other mothers choose to stay and hope for the best, concerned about finding their children again as people are so mobile.
For Bedra, she has another 10 minutes to decide until the car will be ready for her.
Project Taps into Existing Groundwater to Bring Sustainable Water to Community
By Ayuko Matsuhashi
SHINILE, SOMALI, 17 January 2017 – Munasib Omer, Chief of Bisle kebele (sub-district) in Shinile woreda (district), tells how excited the community is about the ongoing drilling work of a borehole in the kebele. “Thank you! Thank you to those who are providing the water to this kebele.”
He continues, “Since I was born, there has been no sustainable water supply in this community. We are entirely dependent on rainfall and travel 15 km one way to get water from a dried river bed. Here, we can use our hands to dig through the sand and find some water. But in the last 10 years, we have suffered from water shortage. NGOs and the government have been providing water through trucking but this is not enough and not predictable as the road condition is so difficult for trucks to access. Our primary problem has been always water.” He points to the road from which the UNICEF car arrived. “As you may have seen, there are many empty houses [along the way]. People left because of the water shortage.”
A mother of four children, 32-year-old Fadumo Ali talks about how difficult it is to raise children without a secure water source. “Sometimes there is no water to give to our children. We cannot wash them.”
UNICEF’s implementing partner, Hydro, began drilling a borehole in November 2016 at a location 1.5 km outside the Bisle community, which has a population of 11,000 people. This crucial drilling work is made possible by the DFID emergency fund. While it is difficult to find water by drilling in lowland areas due to the nature of the hydrogeological complexity in the Somali region, water was found at a depth of 210 meters and the drilling was completed at depth of 299 meters. According to a pump test, the borehole is providing more than 30 litres per second. The post-drilling construction is planned to be completed by March 2017. This news has brought hope for a better future to the Bisle community.
Fadumo is now looking forward to the day that she will no longer need to worry about water. She will have a few extra hours per day once the borehole is functional as she will not travel in search of water. “When I have regular water and more time, I want to do more about sanitation and hygiene for my children. I will clean my children more often.”
Through the generous contribution of donors, UNICEF will continue to support regional water bureaus across the Somali region to implement similar sustainable interventions that will support children and their families.
Addis Ababa, 06 February 2017 –As the world observes International Day of Zero Tolerance on Female Genital Mutilation/Cutting (FGM/C), UNICEF Ethiopia commits to accelerate its efforts to end the violent practice of FGM/C through strengthened partnerships with key actors in support of the national theme, “Let us keep our promise and fulfil our commitment by ending FGM/C.”
“FGM/C is a harmful practice inflicted on girls which deprives them of their rights to sexual and reproductive health, endangers their health by causing complications during delivery and even untimely death,” said Gillian Mellsop, UNICEF Representative to Ethiopia. “In order to fast-track the elimination of the practice once and for all, we need to work at grass roots level, at scale and hand in hand with communities – boys and girls, women and men, and most importantly, traditional and religious leaders who are influential communicators with the potential to reach the hearts and minds of millions of people. We also believe that it is equally important to address health and psychological complications caused by FGM/C- by providing the necessary health services for survivors to help them lead a healthy life.”
According to the 2016 Ethiopian Demographic Health Survey (EDHS), FGM/C among the age group of 15-49 is most prevalent among the ethnic groups of Afar and Somali regions (98 per cent and 99 percent, respectively), followed by Welaita and Hadiya (92 per cent for both). In addition, 54 per cent of urban women have experienced FGM/C as compared to 68 per cent in rural areas. FGM/C is less prevalent among women with higher education and those in the highest wealth quintile. The 2016 EDHS shows a decreasing trend in FGM/C nationwide with the prevalence in 15-19 year olds down to 47 per cent as compared to 65 per cent in the 15-49 age group.
UNICEF supports the Government’s efforts through enhancing capacity to implement both preventive and responsive programmes at scale, and strengthening coordination mechanisms at different levels. UNICEF works with the National Alliance to progress ongoing roadmap development to end FGM/C and Child Marriage. It also, supports the involvement of faith based, traditional and community leaders, as communities usually link this harmful traditional practice to cultural and religious norms. In this regard, UNICEF signed a Memorandum of Understanding (MoU) in August 2016 with major religious institutions in the country to improve the lives of children, women and adolescents by promoting positive behaviour and social norms and to bring about the necessary societal shifts in communities.
UNICEF supports the Government in the health sector in the Afar and Somali regions to address FGM/C related complications by providing training to health workers; raising the communities’ awareness on health risks caused by FGM/C; identifying girls and women affected by FGM/C; developing training materials; recruiting gynaecologists and equipping selected hospitals with basic FGM/C care equipment.
Malnutrition poses “silent threat” to children, agency’s 2017 appeal says
NEW YORK/GENEVA/ADDIS ABABA, 31 January 2017 – 48 million children living through some of the world’s worst conflicts and other humanitarian emergencies will benefit from UNICEF’s 2017 appeal, which was launched today.
From Syria to Yemen and Iraq, from South Sudan to Nigeria, children are under direct attack, their homes, schools and communities in ruins, their hopes and futures hanging in the balance. In total, almost one in four of the world’s children live in a country affected by conflict or disaster.
“In country after country, war, natural disaster and climate change are driving ever more children from their homes, exposing them to violence, disease and exploitation,” said UNICEF Director of Emergency Programmes, Manuel Fontaine.
UNICEF’s Humanitarian Action for Children sets out the agency’s 2017 appeal totaling $3.3 billion, and its goals in providing children with access to safe water, nutrition, education, health and protection in 48 countries across the globe.
An estimated 7.5 million children will face severe acute malnutrition across the majority of appeal countries, including almost half a million each in northeast Nigeria and Yemen.
“Malnutrition is a silent threat to millions of children,” said Fontaine. “The damage it does can be irreversible, robbing children of their mental and physical potential. In its worst form, severe malnutrition can be deadly.”
The largest single component of the appeal is for children and families caught up in the Syria conflict, soon to enter its seventh year. UNICEF is seeking a total of $1.4 billion to support Syrian children inside Syria and those living as refugees in neighbouring countries.
In total, working alongside its partners, UNICEF’s other priorities in 2017 are:
Providing over 19 million people with access to safe water;
Reaching 9.2 million children with formal or non-formal basic education;
Immunizing 8.3 million children against measles;
Providing psychosocial support to over two million children;
Treating 3.1 million children with severe acute malnutrition.
In the first ten months of 2016, as a result of UNICEF’s support:
13.6 million people had access to safe water;
9.4 million children were vaccinated against measles;
6.4 million children accessed some form of education;
2.2 million children were treated for severe acute malnutrition.
UNICEF Ethiopia’s 2017 Humanitarian Appeal for Children (HAC) is for US$110.5 million, which includes US$17.3 million required to provide assistance to refugees. Together with the Government of Ethiopia and humanitarian partners, UNICEF Ethiopia aims to reach 9.2 million children and their families with access to safe water and hygiene, nutrition, health and protection services and give hope for the future by providing education in emergencies.
“In 2017, UNICEF Ethiopia prioritizes humanitarian needs of those affected by the Horn of Africa drought while continuing to support development initiatives to ensure all children and their families have clean water, adequate sanitation as well as access to nutrition and health services. Additional priorities are to support education for children facing emergencies and to protect children against violence and abuse,” said Gillian Mellsop, UNICEF Representative to Ethiopia. “Our ability to respond adequately to the needs of millions of children contributes to future growth and stability in Ethiopia. Through linked humanitarian and development programming, the Government of Ethiopia, UNICEF and our partners’ investments helps build families’ and communities’ resilience against future emergencies.”
While the funding will be critical to UNICEF’s ability to respond to immediate needs, it will also be used to take appropriate action to strengthen preparedness, improve early warning systems and reduce vulnerability as well as contribute to more resilient communities.
In 2016, UNICEF raised US$108.7 million to provide around 7 million children and their families with life-saving humanitarian assistance to mitigate the impact of the El Niño-induced drought. With severe water shortages, malnutrition and disease outbreaks, the anticipated humanitarian need in 2017 has reduced only slightly, from 9.7 to 9.2 million people.
Though an adequate 2016 ‘kiremt’ rainy season was recorded in many areas of the country, drought conditions and residual effects from the El Niño emergency continue to cause water shortages, malnutrition, disease outbreaks and related protection and education issues, including the closure of hundreds of schools in drought-affected areas.
A new drought expanding across the lowland areas in the Horn of Africa, induced by another weather phenomena, the Indian Ocean Dipole (IOD), is further exacerbating humanitarian needs in the south and south eastern regions of Afar and Somali, as well as parts of Oromia and SNNP. Neighbouring country Somalia is also severely affected, causing 1,325 refugees crossing into the Ethiopian Somali region in the first 17 days of January. Ethiopia is already one of the top refugee-hosting countries in Africa, with 783,401 refugees as of November 2016 hailing from South Sudan, Somalia, Eritrea and Sudan.