Giving a village in the Amhara region its own water supply transforms lives

By Ayuko Matsuhashi

WOIRU DIKALA, Amhara region, 7 August 2016 – The women of Woiru Dikala kebele (sub-district) used to spend much of their day searching for water, a mission that grew even more difficult as drought ravaged Ethiopia’s Amhara Region over the past year.

Women and children often walked for more than six hours to get the water their community needed, searching for scarce rivers and ponds among the dry, rugged gorges of Raya Kobo woreda (district).

Local women at Raya Kobo woreda, Woiru Dikala Kebele -Amhara National Regional State enjoys the newly inaugurated water supply.
Women in Woiru Dikala kebele spend much of their time looking for water.   Now they can easily access clean water thanks to the multi-village water supply system built with UNICEF’s support.  ©UNICEF Ethiopia/2016/Mersha

This area, near the borders of Tigray and Afar regions, is full of migrants from these parts of the country also searching for water for their family and herds and fleeing the recurrent droughts.

So it was with great rejoicing that the people of Woiru Dikala welcomed a joint UNICEF and DFID project introducing a multi-village water supply system drawn from a deep well with a total of eight water points around the village – including one for the primary school.

Comments we received from community members included “We can avoid the risks of abuse of women and children as they travel to collect water from the gorges including at night time,” and “Our children and even adults have been frequently affected by diarrheal diseases and intestinal parasites. We feel happy that our life will be changed.”

The new water system will help 5,000 people over the next 20 years, including the 2,100 living in Woiru Dikala kebele.

The El Niño-driven drought has hit much of the country over the past year, but eastern Amhara has been especially hard hit, with over 1.5 million people suffering from a critical shortage of water.

The shortage also has severe health implications. The kebele has seen an outbreak of the itching menace of scabies because the lack of water means poor sanitation and personal hygiene.

IMGL0844
Boys and girls in Woiru Dikala kebele can grow healthily as they have unrestrained access to clean water. They can also attend school more regularly without worrying about fetching water. ©UNICEF Ethiopia/2016/Mersha

The condition breeds in cramped, dirty conditions and can move quickly through a population causing a great deal of distress among children, who make up half the population of the kebele.

Poor water quality also led to an outbreak of Acute Watery Diarrhoea, which can be fatal for the young and infirm.

Regular access to clean water is key to combatting these diseases. There is no health facility in the kebele.

The inauguration of the new water supply for the area was attended by several regional officials as well as representatives of UNICEF.

“This water supply system provided from a deep well should support local resilience in times of climatic uncertainty,” said Jane Bevan, UNICEF’s manager for rural Water, Sanitation and Hygiene.

Ms. Gillian Mellsop, UNICEF Representative to Ethiopia visits and inaugurates the UNICEF/DIFID supported community emergency water supply scheme at Woiru Dikala Kebele, Raya Kobo woreda, Amhara region.
Attending the inauguration of the new water system were Ato Woldetnsae Mekonnen, head of the Water, Irrigation and Energy Department for North Wollo Zone, Jane Bevan, UNICEF’s Rural WASH Manager, Ato Ayenew Belay, head of Amhara’s Bureau of Finance, Ato Kedir Mustefa, administrator of Raya Kobo woreda, Gillian Mellsop, UNICEF representative to Ethiopia, Ato Yimer Habie, deputy head of Amhara’s Bureau of Water, Irrigation, and the Bureau of Energy. ©UNICEF Ethiopia/2016/Mersha

 

Volunteers Blast Hygiene Message to Halt Acute Watery Diarrhea

By Bethlehem Kiros

ADDIS ABABA, 30 September 2016 – Mickias Fikre, a taxi driver keeps soap in his car and makes sure to wash his hands thoroughly before he eats. According to him, it is a new habit he developed after he saw his friend suffer from Acute Watery Diarrhea (AWD). “He was so sick that I thought he would not recover,” he remembers. His friend got better after few days and Mickias learned from the local health centre how to protect himself from the disease. Mickias adds, “It is really helpful that volunteers are travelling throughout our community on trucks, spreading the message on how to stay safe.”

UNICEF and partners response to Acute Watery Diarrhoea outbreak in Ethiopia
ERCS volunteers in Akaki/Kaliti sub-city perform a traditional dance to draw the attention of the community and raise awareness on AWD prevention. © UNICEF Ethiopia/2016/Ayene

Ayantu Dadi, 20, is one of the volunteers who is helping communities protect themselves from AWD. A recent college graduate and an Ethiopian Red Cross Society (ERCS) volunteer of over five years, she has been spending the last three months on the UNICEF and ERCS-supported audio truck that drives around the Nefasilk Lafto sub-city.   Since July 2016, UNICEF and ERCS have been conducting mass public awareness campaigns using 10 audio trucks deployed in each of the 10 sub-cities of Addis Ababa.

Ayantu and seven other volunteers meet early in the morning at the Nefasilk Lafto ERCS branch office, then visit the sub-city health office to obtain instructions on the exact locations they need to cover for the day. These locations are selected based on reported cases of AWD, as well as observed risk factors such as poor hygiene and sanitation practices. The volunteers spend about eight hours reaching out the public with awareness-raising messages on how to prevent AWD and recognize its symptoms. “We play music for few minutes to attract people’s attention and then we broadcast the Public Service Announcements on hygiene and sanitation,” she elaborates.

They also stop at designated priority locations, such as crowded locations where they can reach a large number of people, to distribute flyers, put up posters and have one-on-one talks with people who have questions about AWD. “We especially take time to talk with street food vendors and people in economically impoverished communities where the problem seems to be most prevalent,” she explains. According to Ayantu, the outreach helps prevent new cases of AWD as well as identify existing cases. “It is quite satisfying when you find out that your actions actually impact people’s lives. It is what encourages me to keep passing this message every day,” she says.

UNICEF and partners response to Acute Watery Diarrhoea outbreak in Ethiopia
Ayantu Dadi, 20, an ERCS volunteer, teaches a street vendor about AWD. “I only graduated last month so this is what I do full time.” ©UNICEF Ethiopia/2016/Ayene

Since the AWD outbreak was reported in November last year, 7,769 cases have been identified in Addis Ababa alone.

The coordinated response by the Federal Ministry of Health (FMOH) and partners including UNICEF, cases have now continued to decline however, we should not let our guard down.

UNICEF and partners response to Acute Watery Diarrhoea outbreak in Ethiopia
Sintayehu Tsegaye, who had AWD and has recovered, washes the hands of her son Michael, 3, before she gives him orange. “I always keep soap next to the tap so that I wash my hands when I come from outside or from the toilet. I also try my best to drink boiled water and make the rest of my family do the same.” ©UNICEF Ethiopia/2016/Ayene

Sintayehu Tsegaye 45, is among the thousands affected by AWD and was treated for a week in the local AWD case treatment centre (CTC). A mother of two, she has a small business selling potato chips, flowers and grass that is used in Ethiopian coffee ceremonies. “It is hard to be clean all the time when you touch grass all day, use community latrines and live with a big family that does not have the same hygiene practices as you,” she explains, adding that after her recovery from AWD, she has become more careful about practicing proper hygiene measures such as handwashing with soap.

“People in the community don’t always take the information seriously unless they are personally affected by it, but with repeated teaching, I believe many will listen,” says Sintayehu. “Is especially important to spread the message in communities like mine that use shared latrines.”

In addition to public outreach, UNICEF is also supporting the Government of Ethiopia’s efforts to contain and prevent the spread of AWD  by providing supplies for case treatment centres, technical support for case management and infection prevention, and water treatment supplies to safeguard drinking water for households and communities.

UNICEF and WFP Regional Directors visit El Niño driven drought response in Ethiopia

Afar Region – Ethiopia Ms Leila Pakkala and Ms Valerie Guarnieri, UNICEF and WFP Regional Directors for Eastern and Central Africa, have visited the ongoing government-led drought response where UNICEF-WFP are closely collaborating. The drought is affecting six regions in Ethiopia, and 9.7 million people are in need of urgent food relief assistance including approximately 5.7 million children who are at risk from hunger, disease and lack of water as a result of the current El Niño driven drought.

In Afar Region, where an estimated 1.7 million people are affected by the drought, including 234,000 under-five children, the Regional Directors visited UNICEF/WFP/Government of Ethiopia supported programmes. These included the targeted supplementary feeding programme (TSFP) and an outreach site where one of Afar’s 20 Mobile Health and Nutrition Teams (MHNTs) provides preventive and curative health, nutrition and WASH services to a hard-to-reach community in Lubakda kebele.

Ms Leila Pakkala and Ms Valerie Guarnieri, UNICEF and WFP Regional Directors for Eastern and Central Africa in Ethiopia visit

The Mobile Health and Nutrition Team provides Outpatient Therapeutic Programme (OTP) and targeted supplementary feeding programme (TSFP) services to remote communities. The TSFP is integrated with MHNT services that address under five children and pregnant and lactating women with moderate acute malnutrition, and link them to TSFP when they are discharged from OTP. This solves the challenge in addressing the SAM–MAM continuum of care and preventing moderate acute malnourished children deteriorating into severe acute malnutrition.

The Directors also visited a multi-village water scheme for Afar pastoralist communities in Musle Kebele, Kore Woreda (district) which suffers from chronic water insecurity.

“Valerie and I are hugely impressed by the work of the WFP and UNICEF teams in Afar,” said UNICEF’s Pakkala.  “The quality of the work being done in such difficult circumstances – from the mobile health and nutrition teams, to WASH, protection, education and advocacy – is remarkable. We were also immensely impressed with the national level partnership between UNICEF and WFP, and our credibility with government and donors. The relationship and collaboration is a model for other countries to learn from and emulate.”

“Ethiopia is showing us that drought does not have to equal disaster,” said Valerie Guarnieri of WFP.  “We can clearly see the evidence here that a robust, government-led humanitarian response – supported by the international community – can and does save lives in a time of crisis.”

UNICEF and WFP continue to support the Government in responding to the current drought with a focus on the most vulnerable and hard to reach communities by using proven context specific solutions and approaches.

ONEWASH  – UNICEF Ethiopia’s pivotal role 

By Dr Samuel Godfrey

Two months ago, I asked five friends of mine two critical questions; one where does the water that flows out of your tap come from and second where does the waste that is flushed down your toilet go to? Answers like, from a river or “my toilet waste is flushed down a sewer pipe…where it goes, I don’t know?” These answers are symptomatic of many educated peoples understanding.  Last month, I asked five inhabitants of the northern Ethiopian town of Wukro the same question. All five respondents gave me an articulate description of borehole water as well as the exact location of all the septic tanks.

Water and Sanitation are a daily priority for most of the world and the Sustainable Development Goal (SDG) number 6 has been designed to ensure that everyone, everywhere has access to water and sanitation by 2030.

In Ethiopia, UNICEF was ahead of the SDG curve and in 2013 developed a programme called the ONEWASH which was designed to pull all financial resources from the government, aid agencies, development banks and the UN around ONEPLAN.

To develop the ONEWASH programme, UNICEF Ethiopia was delegated by the Government of Ethiopia to design the strategy for a 10 year plan to ensure that the 50 million people gain access to water and 70 million people gain access to sanitation in every house in every town, city and village across Ethiopia. The ONEWASH is the biggest water and sanitation initiative in Africa and requires an estimated investment of US$2.4 billion. See http://www.unicef.org/ethiopia/OWNP_LEAFLET.pdf.

The ONEWASH programme has: ONE plan, ONE Budget, ONE Procurement system, ONE monitoring system and ONE report. Led by the ONEWASH Coordination office in the Government of Ethiopia  Ministry of Water, Irrigation and Electricity  and with financial and technical collaboration with the Ministry of Finance, Education and Health, the ONEWASH was a “showcase” at the 2016 Sanitation and Water for All High Level Meeting.

UNICEF Ethiopia also teamed up with the key financiers in the WASH sector in Ethiopia such as the World Bank, African Development Bank, DFID, Government of Finland and others to set up a Sector Wide Approach (SWAp) pool fund called the Consolidated WASH Account where funds are blended together. To ensure all UNICEFs financial rule and regulations were respected, UNICEF Ethiopia developed a Fiduciary Risk Assessment tool. This is now been worked into a Programme Operational Manual and is used to guide the sector investments.

The SDGs present an opportunity and challenge for UNICEF Ethiopia. If ONEWASH is successful it will improve sanitation and hygiene facilities in hospitals, schools and health centres and will provide essential water supply for areas affected by climate change and drought. It will ultimately result in reducing undernutrition in children and improving the cognitive performance of school goers.

We are working in the WASH sector to complement and partner with other sector financiers to ensure that all children and all women, everywhere: rural and urban – development and emergency -have the right to water, sanitation and hygiene in communities, health centres and schools…..ONEWASH for all…

Dr Samuel Godfrey is Water Supply, Sanitation and Hygiene (WASH) Section Chief at UNICEF Ethiopia

South-South Cooperation as a new approach for WASH sector development in Ethiopia

By Samuel Godfrey and Michele Paba 

South – South Consultative Meeting Addis Ababa, Ethiopia
(LR) Ms.Gillian Mellsop, UNICEF Representative to Ethiopia, Ato Kebede Gerba State Minister MOWIE, Octavio Henrique Cortes Brazilian Ambassador to Ethiopia. Signed a trilateral program document to cooperate on WASH under South-South initiative. ©UNICEF Ethiopia/2016/Tesfaye

In the effort to improve delivery of essential services to women and children, South-South cooperation provides a platform for lower income countries to learn from middle income countries that have recently addressed developmental challenges similar to their own. Ethiopia’s aspiration to reach middle income status by 2020 means that its five-year Growth and Transformation Plan II is heavily reliant on exploring the economic and social development models of China, Brazil, Cuba and other Latin American Nations.

The need to address rapidly urbanizing small and medium sized towns is central to Ethiopia’s growth. UNICEF in its new Country Programme (2016-2020) has identified urbanization as one of the key challenges being faced by women and children. How do lower income households get access to equitable and affordable services such as health care, education, water supply and sanitation? How will the rights of out-of-school children in urban areas be protected?

To answer some of these questions, UNICEF Ethiopia has supported the South-South partnerships between the Government of Ethiopia and the Governments of Brazil and Cuba in two strategic areas, Urban Water, Sanitation and Hygiene (WASH) and Integrated Water Resource Management.

The cooperation initiative with Brazil was initiated in 2014 with the support of UNICEF Ethiopia and Brazil Country Offices and the UK Government, under the ONEWASH Plus Programme, with the aim of supporting the water and sanitation sector in Ethiopia in two key pillars, namely, the development of the sanitation sector in towns, with particular focus on technology transfer for the treatment of waste water generated by densely populated housing facilities such as condominiums, and the establishment of an independent regulatory framework for WASH services at all levels.

Given the extensive experience of the Cuban Government in river basin and water resource management, the recently established collaboration with the Ethiopian authorities, supported by UNICEF and the US Government, will definitively generate great impacts on the watershed management plans and riverine resources conservation initiatives across the country.

The two South-South initiatives were reviewed, through a consultative workshop held in Addis Ababa on 26 May 2016, by high level officials from the Ministry of Water Irrigation and Electricity, the Embassies of Brazil and Cuba, UNICEF as well as other sector institutions and development partners including  the UK and US Governments. The workshop culminated in the signing of the three-year project document between Ethiopia and Brazil. Together, the partnerships with Brazil and Cuba will help Ethiopia strengthen the WASH sector to be able to better deliver services for children and communities.

During the event, the State Minister of Water Irrigation and Energy, H.E. Ato Kebede Gerba, underlined the importance of the integration of different forms of cooperation, both North-South and South-South, in order for the sector in Ethiopia to get the required exposure and learning from different experiences and practices.

Dr. Samuel Godfrey is Chief of WASH and Michele Paba a WASH Specialist at UNICEF Ethiopia

Baby WASH – the missing piece of the puzzle? 

By Samuel Godfrey

Mustapha and his one year old daughter Meia-Teza Wota Health Center Clinic
Mustapha and his one year old daughter Meia at Teza Wota Health Center ©UNICEF Ethiopia/2012/Getachew

The January 2016 Huffington Post article entitled Why are Indian kids smaller than Africa kids: hint its not race authored by Sanjay Wikesekera, UNICEF Global WASH Chief and Werner Shultink, UNICEF Global  Nutrition Chief, highlighted the link between child stunting[1] and lack of access to toilets. Children growing up in an environment where people are defecating in the open will result in kids crawling around on dirty floors, putting feacally contaminated material and objects in their mouths and ultimately will results in children having high rates of diarrhea which will result in their stunted physical and mental development.

To understand this better, UNICEF Ethiopia WASH team and John Hopkins University undertook a systematic review of more than 1000 peer reviewed academic articles with the aim of identifying interventions that health and WASH professionals can take or promote to reduce the contact of children with feacally contaminated material. The review identified strong evidence on the linkage between open defecation, stunting and early child development (See figure below from Ngure et al (2014).

Picture1

The review also notes good knowledge of how to do hygiene and sanitation promotion to safe disposal of adult feaces but limited evidence on safe disposal of baby feaces.

UNICEF Ethiopia is using the review to design specific Baby WASH interventions that can complement our current Infant Young Child Feeding programmes. Ethiopia has substantially reduced Open Defecation during the last 25 years. In 1990, an estimated 9 out of 10 people were “pooing” in the open and by 2015, this had reduced by 64 per cent to less than 1 in 3 people. However, despite this progress, almost half of children were recorded as ‘stunted’ or not achieving their full physical and mental growth by 2015. The literature suggests that Baby WASH, as we have termed it, may be one of the key “missing pieces” in reducing stunting. Baby WASH comprises of a ‘menu’ of physical and promotions activities which will reduce the exposure of the BABY to ingestion of feaces and ultimately reduce stunting and improve Early Childhood Development.

Watch this space for more details on field evidence on Baby WASH from UNICEF Ethiopia as we work closely with the Government of Ethiopia and development partners to expand this intervention throughout Ethiopia in our new Country Programme of Cooperation between 2016 and 2020. For the time being, UNICEF Ethiopia is using its own financial core resources. Interested development partners are welcome to join this groundbreaking initiative.

UNICEF Ethiopia is collaborating with the US based Johns Hopkins Bloomberg School of Public Health, Department of International Health, Program in Global Disease Epidemiology and Control. A researcher from the school was an intern in the UNICEF Ethiopia WASH section in 2015 and has collaborated with the WASH section on producing a paper entitled Evidence on Interventions Targeted at Reducing Unsafe Disposal of Child Feaces: A Systematic Review.

UNICEF Ethiopia’s rural wash activities are supported by the UK Department for International Development (DFID), the Government of Netherlands, the Government of Canada and the UNICEF National Committees from Germany, UK and New Zealand.

Dr. Samuel Godfrey is Chief of WASH for UNICEF Ethiopia, and has a PhD and MSc in Civil Engineering and Water and Waste Engineering.

[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.

Water trucking brings relief to remote communities and helps revive local education

By Paul Schemm

UNICEF-supported water trucking helps revive education
Ababa Abraha had to leave school to work when her family ran out of food amid a severe drought. © UNICEF Ethiopia/2016/Hema Balasundaram

When the drought came to the remote kebele (sub-district) of Gonka, Ababa Abraha’s family held out as long as they could, in their picturesque village set among the sharp mountain peaks and deep valleys of the Tigray Region.

With no crops and food, however, they finally had to leave to find temporary work in nearby towns and pulled 14-year-old Ababa out of Grade 7 to work as a house cleaner.

Then came word that there was water being supplied and a Government feeding programme at the Gonka Complete Primary School, a rough stone building in the village, and Ababa was allowed to return.

“I like school a lot,” said Ababa, who dreams of studying finance at university one day. “But I can’t learn without food. If there is no food, I have to work to help my family.”

Gonka Kebele, which is near the arid Afar Region, was hard hit by the drought affecting much of the country. With its two wells failing, it received a 10,000 litre-capacity water bladder that is refilled every other day by a truck that makes an arduous journey over the treacherous gravel road.

Trucking water for the hardest hit

UNICEF-supported water trucking helps revive education
Every other day, a truck transports 10,000 litres of water through mountainous terrain to the drought-affected community in remote Gonka Kebele © UNICEF Ethiopia/2016/Hema Balasundaram

The current drought has rendered some 5.8 million people nationwide in need of access to safe water. As long term solutions to water scarcity are developed, the Government of Ethiopia, supported by UNICEF, has started trucking in water to the most severely drought-affected communities.

UNICEF’s 100 trucks are operating in the Afar, Amhara, Oromia, Somali, SNNP and Tigray regions and have already delivered 15 million litres of water to 300,000 people in the last month.

“It is the first of its kind, UNICEF providing full water services to beneficiaries,” said Getachew Asmare, the UNICEF Water and Sanitation Specialist in Tigray, where 110,000 people including school children have benefited from 4.6 million litres of water in one month.

In some communities, people are surviving on just 5 litres of water a day, a quarter of the Government-recommended 15 litres a day and a far cry from the 100 litres a day consumed by the average citizen of a developed country,” said Getachew.

The case of Gonka Kebele shows how water scarcity doesn’t just affect hygiene and crops but also education.

A lifeline for the school

Haftu Gebreziher, the 26-year-old director of the Gonka Complete Primary School described how he was losing students by the day before the start of UNICEF-supported water trucking and Government feeding programme. Some were spending the day walking for hours fetching water at the distant river, others couldn’t pay attention in class.

Students also complained about the difficulty of getting a drink and the lack of regular showers due to the water scarcity

“There was a drop in attendance and a rise in tardiness,” he said, estimating a 60 per cent absentee rate. “This was interfering with school but now with the water and feedings, that has stopped.”

UNICEF-supported water trucking helps revive education
A water truck hired by UNICEF fills a 10,000-litre water bladder next to the school. © UNICEF Ethiopia/2016/Hema Balasundaram

The large yellow water bladder donated by the Government of Ireland sits right outside the school, next to the hut where the children’s midday meal is prepared. The students swarm around the water taps connected to the bladder and drink whenever they want instead of taking a long trek by foot or camel to a river in the distant valley.

The €110,000 (ETB 2.6 million) worth of donated water containers marks the latest support from Ireland, which so far has given Ethiopia €9.1 million to combat the drought. The water tanks and jerry cans will be used by UNICEF in the worst affected woredas (districts) nation-wide.

As the WASH cluster lead, UNICEF also supports the Government of Ethiopia and other partners in the rehabilitation, maintenance and construction of new water supply systems, provision of water purification and treatment chemicals, and provision of sanitation and hygiene facilities in schools. UNICEF is also exploring innovative ways to use satellites to detect deep groundwater for large scale, multiple-village water supply systems.

These efforts are helping ensure that students affected by the drought don’t have to forfeit their education. For 14-year-old Silas Hagos at Gonka Complete Primary School, this means that she can once again work towards her dream to become a pilot for the national carrier Ethiopian Airlines. When the drought came, she had to leave the eight grade to work.

She sold soap and packaged biscuits in nearby town for weeks until the feeding programme and the new water bladder allowed her to return and once again dream of flying.

“If we get the opportunity to learn, it is good – an educated person is better than an uneducated one,” she said with a smile.