In Ethiopia, below-average rainfall has worsened the situation in the Somali region, already severely affected by protracted drought. Access to water, sanitation and health services critically low and livestock deaths have further reduced communities’ capacity to cope, resulting in food and nutrition insecurity.
When drought strikes women and children suffer the most. Mothers have to travel long distance to find water and food and they often struggle to feed their children. In stories below, we are celebrating strong mothers who go extra mile to keep their children safe and their families together.
BOLOSO SORE, SOUTHERN NATIONS, NATIONALITIES AND PEOPLE’S REGION, 26 January 2017 – It was a sunny afternoon at the Chamahinbecho health post and the trees planted by health extension workers 10 years ago provided much needed shade in the compound. A group of mothers were sitting under the trees discussing how to best feed their toddlers and among them was Beyenech.
The cheery Beyenech, a mother of three, came to the health post to get her 1-year-old son weighed as part of the growth monitoring and promotion session that they attend on a monthly basis.
“I bring my son here every month and the health extension worker measures his weight and gives me advice,” says Beyenech. “She teaches us how to prepare meals for our children using different foods. I can see that my child is growing healthy and am glad to hear that [confirmed by] the health extension worker.”
Beyenech is among the many mothers in Chamahinbecho kebele (sub-district) who are benefiting from a project supported by the European Union called EU-SHARE. The project aims to contribute to improved nutritional status of children under five, adolescent girls and pregnant and lactating women through strengthening nutrition outcomes of Government health, food security and livelihood programmes. The strategy involves integration of the multi-sector interventions at the household level to create synergetic effects that will maximize programme results.
Nutrition services for adolescents
It is not only Beyenech’s son who is benefiting from the nutrition services at the health post; her 15-year-old daughter has participated in the deworming campaign organized for adolescent students in the kebele. Beyenech speaks of her daughter, “Wubalem received a deworming tablet from the adolescent deworming campaign at her school last year. She also told me about the nutrition and hygiene practices that she heard from group discussion sessions during the campaign.”
Deworming of intestinal worms and schistosomiasis is an important service for young students, as both ailments affect the health and education of children and adolescents. A student with worms will be too sick or tired to attend school or will have difficulty concentrating in school. If left untreated over time, they may face stunting or malnutrition due to anaemia, as well as impaired cognitive development.
The Government-led programme, which is supported by EU-SHARE, contributes to the health and nutrition status of adolescents while improving school attendance rates. EU-SHARE project supports the programme through procurement of deworming tablets, provision of information, education and communication as well as behavioural change communication materials that are helpful to create awareness and initiate discussion on nutritional requirements during adolescence. The programme also includes technical support to health workers who carry out the deworming campaigns. Students like Wubalem have a better chance to succeed with their education due to initiatives like these.
Improving dietary diversity through backyard gardening
EU-SHARE also includes nutrition-sensitive agriculture interventions which is implemented by FAO as part of the Government’s commitment to integrate nutrition into the agriculture sector. Promotion of backyard gardening is among the initiatives being implemented in the kebele.
After meeting the eligibility criteria targeting vulnerable families, Beyenech has been selected among the 1,960 beneficiaries targeted for seed supplementation led by the woreda agriculture office. She received vegetable seeds and began growing carrots, cabbage and tomato in her backyard garden. Beyenech explained, “I started preparing a porridge mixed with vegetables from my garden, using what I learned from the cooking demonstrations at the health post. I also prepare roasted vegetables along with shiro wot [chickpea stew] for the rest of my children.”
Beyenech aspires for her children to have a better future. She wants them to be top students and become teachers or doctors so they have the knowledge and skills to impact the next generation in the community.
“Such type of nutrition interventions that consider integration as a cornerstone by addressing the different aspects of nutrition are a key weapon to combat the problem of malnutrition in a sustainable manner,” said Israel Mulualem, the nutrition focal person in Boloso Sore woreda health office.
The four-year EU-Share programme has been operational since 2015 and continues to support children, mothers and their families in seventeen woredas located in SNNP, Oromia and Amhara regions. Together with the Government of Ethiopia and donors such as the European Union, UNICEF is able to support existing initiatives of Government programmes so that children such as Wubalem, Setot and Teketel may have a bright future.
SOMALI Region, 20 April 2017 – When Basazin Minda was requested to support the acute watery diarrhoea (AWD) response in Somali region, he did not hesitate. In fact, within one week, he handed over his duties to colleagues in UNICEF Oromia team and was in Jigjiga office.
Complex emergencies are not new to him. He was in Gambella when a South Sudanese refugee influx necessitated immediate WASH response. And when an AWD outbreak threatened lives in the southern cross-border town of Moyale, Basazin led the AWD WASH response and coordinated joint Kenya and Ethiopia control mechanisms. This is part of why he loves working with UNICEF – there is full support and resources to take quick action as well as the flexibility to respond where needed when communities are facing crisis, such as the AWD outbreak.
One lesson he learned from those past emergencies was that to have an impact, it required extensive human resources in the affected areas. Recently hired WASH Information Management Officers (IMOs) were available to support his team and he soon learned about UNICEF Health section’s C4D (Communication for Development) consultants, which could help spread the critical WASH messages to stop the spread of AWD.
AWD describes infections that can result in easily transmitted and potentially deadly diseases. The spread of such disease is very high in areas with water scarcity and can have a devastating impact on children who may already be undernourished. Additionally, those living in crowded spaces with poor access to WASH facilities, like the many temporarily displaced families, also face a higher risk.
The recent AWD outbreak peaked in Somali region in February 2017 and now more than 50 per cent of the woredas (districts) are reporting active cases. Particularly due to the current Horn of Africa drought, there are refugees coming from neighbouring Somalia, as well as temporarily displaced Ethiopian Somalis, as people move in search of water, food and pasture for their livestock. The predominately pastoralist Somali region is the worst drought-affected area in Ethiopia with over 30 per cent of the region’s population requiring food assistance in 2017. Living conditions of these temporarily displaced people are often inadequate and widespread open defecation poses a risk of the spread of AWD, among other disease outbreaks.
Upon arrival, Basazin began a series of discussions with people from UNICEF, the Regional Water Bureau (RWB) and the zonal command post. What he learned immediately on the ground was a little different than he had prepared himself for. He came for mass chlorination of boreholes to stop the spread of AWD. However, he identified that boreholes are protected. “This is what can be so interesting about emergencies. You go in with one mind set and task and immediately are faced with a reality that may differ. The problem was not the water sources, so the contamination had to be happening at some point after water is collected, either during collection or storage,” Basazin explains.
Like detectives, Basazin and the newly formed team began contacting local water office staff and meeting with various community members to pinpoint where this contamination was coming from. The team concluded that contamination was occurring from water trucking, during the transport of water (usually by donkey cart) and at the household level, where dirty jerry cans were utilized repeatedly. Now the task has shifted to a multi-effort approach including mass chlorination of water trucks, community awareness campaigns to ensure clean jerry cans and training sessions for local water staff on chlorination standards.
The RWB staff know about chlorination, however at this critical time of drought and AWD, with a mobile team equipped with testing kits, jerry cans and barrels of HTH chlorine solution, everyone was eager to learn more from practical demonstrations. A key lesson that was missing before now was how to calculate correct measurements of chlorine according to the container size to ensure disinfection. Referencing UNICEF WASH guidelines, Basazin prepared a guideline of chlorination and turbid water purification with these specific calculations included and it was subsequently distributed to all water offices in the region.
The feedback was positive after the training and RWB staff proliferated the learning by sharing demonstration photos through their Viber group, a mobile messaging application utilized by all Somali RWB staff.
One water office participant commented after a demonstration, “Assistance has come through here and sometimes guidance is offered, but not like this. Receiving evidence-based participatory training makes a big difference.”
Basazin did not always explain the calculations and guidelines. Another lesson his work has taught him is to tailor his WASH messages according to the audience. “AWD bugs will attack the water if it finds it without chlorine and consequently the attack will reach to human beings.” There was laughter when Basazin used this metaphor.
The team is working through Good Friday, the big Easter holiday and weekends to curb the outbreak and spirits remain high. Basazin’s energy and commitment to ensuring his work has impact is easily detected as he speaks. “I like to learn today and implement for tomorrow,” he says. “Perhaps another idea coming from this mission is that we should highlight a jerry can and water truck washing day, just as we promote handwashing day.” He is also quick to admit this is not a one-man show. With the UNICEF Jijiga and Addis team and the community, mass chlorination is taking place exactly where needed to curb the AWD outbreak.
DANOT, SOMALI, 15 February 2017 – “A woman never tells her age,” says Sadeh Abdihayii with a smile, affirming that this taboo is common around the world. She then admits to be 40 years old. We continue, asking her how many of her children are in school. With eight children ranging from nine months to 20 years old, none of them, including Sadeh, have been to school. Ever.
Sadeh had hoped one of them could go to school, but circumstances did not allow. “It seems sensible to learn, but we have not been able to,” says Sadeh.
Living through drought
Sometimes Sadeh’s family lives in the vicinity of an organized village or town, such as now just outside Qorile kebele (sub-district), yet often they can be far away from any organized services including healthcare and schools. This is the life of a pastoralist family.
Sadeh’s family is one of the over 800 families that have temporarily settled in Danot woreda (district), in the eastern horned-tip part of Ethiopia. The Government of Ethiopia (GoE) has set up these temporary sites to provide life-saving medical and nutrition services, water and food during this drought period for one of the most vulnerable communities in the country, livestock-raising pastoralists.
Drought has hit these lowland areas across the Horn of Africa many times over the years, but Sadeh has never experienced one that devastated her livestock to this extent. Due to the negative Indian Ocean Dipole (IOD), a weather phenomenon, the December rains failed, making it 12 months since many villages in the area have experienced rain.
It is understandable why school has not been possible for many of these children, whether considering the current food and water shortages, or the nomadic patterns of their life. The regular school system does not fit into this lifestyle and it is a reality that is not often at the forefront of parents’ worries. With little or no safety net, pastoralist mothers and fathers are concerned with water, food and grazing land.
The GoE however, in partnership with UNICEF, has developed alternative methods to reach children, even those in remote areas.
Adapting education to the pastoralist context
With support from UNICEF, the Ministry of Education (MoE) has developed a pastoralist education strategy which is implemented across Somali and Afar, as well as some parts of Oromia and Southern Nations and Nationalities and Peoples’ (SNNP), regions where pastoralists are prominent.
The core intervention is a school equivalence programme, adapted for children ages 7 to 14, where students learn the equivalent of the first four grades of primary school before transitioning into formal schools. This Alternative Basic Education (ABE), is based on the national education system but has altered facets wherever necessary to make it feasible for the pastoralist context. Such alterations include low-cost construction of schools as well as flexible locations and schedules to accommodate children who herd their families’ animals or move in certain seasons.
While ABE is the most commonly implemented strategy for inclusion of pastoralist children, reaching 276,777 students over a period of six years, the GoE encourages families to enrol their children in formal schools whenever possible. UNICEF supports this initiative by identifying and addressing barriers to children joining school. Such interventions range from rehabiliting WASH facilities at schools to ensure proper toilets and water is available, to constructing temporary learning spaces or formal schooling in addition to providing exercise books for families who cannot afford the expense. Additionally, the GoE implements a school feeding programme to encourage school attendance, currently in 252 schools across Somali region.
More than ever, these crucial interventions are needed now , particularly as hundreds of ABE schools across Somali region are currently closed due to drought conditions.
‘Maybe somehow one day’
Families gathered near Qorile, such as Sadeh’s, are encouraged to enrol their children in the Qorile primary school, which is within walking distance, even if it may only be for short term. While the drought situation is dire, there is now an opportunity for thousands of children to attend school while their families are receiving temporary assistance to keep their livelihoods afloat.
Sadeh’s eldest child, Halimo Bandais, comments, “I thought about school sometimes. But I have always been looking after the animals and we are moving here and there. How could I? But some of us will, perhaps my child.” Perhaps he will attend school one day. For now, hundreds of school-age children such as the girls neighbouring Sadeh’s tent, Feysa and Isthel, may be able to finally start their education while in the temporary settlement sites with adequate funding.
UNICEF is committed to the right of every child to receive an education. With contributions from international donors, the GoE, along with UNICEF and other education partners can expand programmes such as ABE or temporary learning spaces to ensure children such as those temporarily settled in Qorile, have an opportunity to access education.
On 03 April 2017, UNICEF, WFP, and UN-OCHA went on a joint one-day field visit with the German Minister for Development Cooperation (BMZ) to Kebri Dahar and Waaf Duug Temporary Resettlement Site in Doolo Zone, Somali Region, Ethiopia. The Minister was accompanied by 16 German journalists, BMZ officials, German Embassy partners, GiZ and KfW. The Somali Regional President and key regional government counterparts have also joined the field visit. The visit was part of the German Minister’s visit to Ethiopia to discuss the Marshall Plan for Africa with Ethiopian Government and AU Officials.
The Minister and his delegation visited the Urban WASH programme (borehole and water trucking) in Kebri Dahar town, as well as UNICEF’s emergency Health, Nutrition and WASH programmes in the Waaf Dhuug Resettlement Site for drought displaced people. More specifically, the Minister was able to see a Mobile Health and Nutrition Team operating with the German funded vehicles, a stabilization centre for severely malnourished children that utilizes German funded Ready to Use Therapeutic Food (RUTF) and a water point. The Minister also visited WFP’s school feeding programme at the Waaf Dhuug primary school and a WFP food distribution.
Waaf Dhuug Temporary Resettlement Site (TRS) hosts 4,500 host community and 3,882 drought displaced people, of which more than 85 per cent are women and children from surrounding grassing areas. The site was established in January 2017 and is one of the 58 Temporary Resettlement Site established by the Somali Regional Government in response to the drought emergency. Majority of the pastoralist community have moved into the TRS due to extensive loss of livestock as a result of the drought. They have left their villages in search of water and health and nutrition services for themselves and their children. Discussing with the Minister, Kadar Kaydsane, 35 years old and a mother of 10 said, “We walked for five hours to get to Waaf Dhuug and we lost all our livestock on the way. We came here to find water and other services provided by the Government.”
The Minister and German development partners recognized the importance of investing in building resilience, for instance through funding water schemes and strengthening Government systems, such as the Health Extension Programme. The Minister further appreciated the German Government’s strong partnership with UNICEF and was impressed by the integrated drought emergency response at the resettlement site, but recognized that the challenges are very complex and the required funding remains significant. As a response to the dire need of the people affected by the drought, the Minister announced that German funds for the Horn of Africa drought response will be increased from 100 million Euro to 300 million Euro.
OROMIA and SOMALI, February 2017 – Poor menstrual hygiene management (MHM) negatively impacts the education, health and empowerment of girls and women, as well as the environment. The impacts are compounded during emergencies, such as the protracted drought crises across Ethiopia. What fuels these negative effects of managing menstruation are cultural taboos and other societal barriers.
Girls across Ethiopia face social, cultural and economic barriers related to menstruation which not only prevents their right to dignity, but often prevents their right to education due to inadequate menstrual hygiene education, insufficient WASH facilities and poor access to sanitary materials.
With support from the Netherlands Government, UNICEF Ethiopia, in partnership with regional health and education bureaus (RHB, REB), is implementing an MHM programme to break the silence and bring change in beliefs and attitudes towards menstruation. The programme aims to support girls and women across the country to overcome the barriers that prohibit them from managing menstruation with dignity.
Menstrual hygiene management is a complex and sensitive issue that requires a contextualized, multi-sectoral approach to adequately support girls and women across Ethiopia. A package of services that leads to improved MHM includes private, minimum-standard toilets, handwashing stations and adequate waste disposal in addition to allowing the safe space for discussion to increase awareness amongst men, boys and girls utilizing social and behavioural change communication (SBCC) methods. In addition, improvements in the supply chain for sanitary pad production complements the community- and school-based efforts in MHM.
In collaboration with UNICEF, the Ethiopia Ministry of Health developed a national MHM guide based on the package of services, which is designed to address the topic across the contexts of schools, communities and workplaces as well as in emergencies.
By working with both the RHB and the REB, and supporting the development of a sanitary supply chain, improved MHM facilities and services will keep girls in school where they can reach their full potential.
On 15 February 2017, UNICEF kicked off the community- and school-focused MHM training of trainers (ToT) workshops for a total of 120 staff of the RHB and the REB in Oromia and Somali regions. These were the first of such trainings made possible by support from the Netherlands Government.
The TOT workshop established coordination between the education and health sectors and equipped focal persons with global, national and regional menstruation facts. It also introduced participants to the MHM package of services: SBCC activities concerning menstruation, establishing safe spaces to enable girls to receive peer support, counselling and emergency kits as well as improved WASH facilities and sanitary pad production.
Throughout the training, participants highlighted the lack of discussion on this important topic, with one male participant explaining, “In our societies, the lack of information about menstrual hygiene creates a culture of taboos and misinformation about menstruation and therefore potential health problems. Now we know what to do from this training and how to react.”
The regional and woreda (district) focal persons who participated in the ToT, in turn will cascade the training to health extension workers (HEWs), school management committees and school club coordinators (teachers). The trained HEWs and teachers will then facilitate activities for the Health Development Army and the WASH, gender and girls’ club members in their respective areas.
The sanitary supply chain
The sanitary pad supply chain component of the programme establishes women’s groups to produce reusable sanitary pads and provides support to local manufacturers through partnerships to improve the production, packaging, distribution and use of sanitary pad products in target regions. On the manufacturing end, partner companies will engage in backward integration of the production of raw materials such as absorbents and liners. On the sales end, pharmaceutical and family planning outlets, such as pharmacies, drug stores and clinics, will be utilized at local and regional levels to bring the improved products to communities.
Additional MHM training and launch workshops are planned to kick off in March and April 2017 in Gambella, SNNP and Afar regions. Together with Government partners, UNICEF will support the positive change in the dynamics of MHM in Ethiopia and contribute to better futures of girls across the country.
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.