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.

In Ethiopia, Community-Based Approaches Help to Improve Nutrition among Women and Children

By Victor Chinyama and Tiguaded Fentahun

South Gondar Zone, Ethiopia: Enalem Asnakew (40) had no idea why her one-year-old son Misganaw Asmare would not stop vomiting. His arms, legs, and abdomen were swollen and his appetite was failing. After about a month, she had had enough and decided to bring him to the local hospital.

“He was put on blood transfusion for three days,” she says in a barely audible voice.Then, they administered [therapeutic] milk through his nostrils in addition to [intravenous] medicine. The nurses frequently visited my child and now, after nine days, the swelling has disappeared, the vomiting is almost gone, and my child takes therapeutic milk orally.”

Misganaw was diagnosed with severe acute malnutrition, a serious but entirely preventable and treatable condition which the WHO estimates accounts for 35 per cent of deaths among children under five globally. Typically, severe acute malnutrition is treated in a hospital but the advent of ready-to-use therapeutic foods has enabled children like Misganaw to be treated at home if they have no underlying medical complication requiring hospitalization.

In general, Ethiopia has made strides in reducing undernutrition in children, with stunting in particular dropping from 58 per cent in 2000 to 38 per cent in 2016. However, the number of children with severe acute malnutrition spikes up during the ‘lean’ season between June and August, the period when most households will have exhausted their food stocks as they await the next harvest beginning September. Prolonged and chronic humanitarian crises, such as droughts and floods, also contribute to increased malnutrition in children.

Inadequate food however is not the only cause of malnutrition. Multiple factors, such as the child’s size at birth and the mother’s weight, predispose a child to malnutrition. Acute illnesses and poor feeding practices are other contributing factors. The key to preventing malnutrition therefore lies in improving the nutritional status of the mother, ensuring the child has access to an improved and diverse diet, providing safe water and sanitation, improving hygiene, and building a strong and supportive system at community level.

In 2011, with a US$ 50 million grant from the Government of Canada, UNICEF embarked on a project to improve nutrition in children and women in 100 food insecure districts in the Amhara, Oromia, and SNNP regions of Ethiopia. The six-year project, later extended for another year, was to improve the use of health and nutrition services by children, adolescent girls, and breastfeeding mothers, and increase the availability of water and sanitation services. The project focused on the community level, where efforts were made to increase the scope and coverage of nutrition activities. These included multi-media campaigns, education of mothers and caregivers on nutrition, promotion of breastfeeding, and increasing production of local complementary foods. Wells were drilled to supply safe water to communities and households were encouraged to construct their own improved latrines.

To improve service delivery, 2,000 community-based health extension workers responsible for mobilizing people and agriculture development agents were trained in nutrition. Water was supplied to health posts and committees to oversee water, sanitation, and hygiene activities were established at kebele level (smallest administrative unit in Ethiopia).

Students line up to receive deworming tablets at Gurumu Koysha Primary and Secondary School in the SNNP Region of Ethiopia. Deworming of adolescents became a national programme after being introduced through the Canada-funded project.
© UNICEF Ethiopia/ 2016/ Meklit Mersha

In total, the number of community-based nutrition activities doubled and 24 per cent more households cultivated a garden (the largest increase was observed among the poorest households). Nutrition knowledge among health workers and health extension workers increased from 51 to 80 per cent while exclusive breastfeeding increased from 71 to 80 per cent. The proportion of mothers stating that water should not be given to babies under six months of age increased from 61 to 78 per cent.

The project also marked a milestone as the first ever in Ethiopia to target nutrition for adolescents (children aged between 10-18 years). Deworming of adolescents was first introduced under the project as a pilot but was subsequently scaled up to national school deworming campaigns, reaching 3.9 million school children.

These results were achieved against a backdrop of unforeseen challenges, such as the civil unrest of 2016 which limited travel and access and the El Nino drought in 2016 which shifted attention and resources.  Notwithstanding, a survey at the end of the project showed that stunting among children had declined from 40 per cent to 35 per cent and the prevalence of underweight children from 22 per cent to 17 per cent. Put differently, the odds of children in the 100 districts being stunted or underweight had been reduced by 19 per cent and 20 per cent respectively.

The education, mobilization, and support given to the 100 districts in Amhara and the other two regions will ensure that mothers like Enalem will never have to wonder again why their children are vomiting, or why their abdomen and limbs are swollen. They will also ensure that children like Misganaw can grow up healthy and strong, free from dangerous yet preventable conditions like malnutrition.

Ethiopia inaugurates model water supply and waste management project

26 May 2018, WUKRO, Tigray region – Today marks another major milestone in the Water Supply, Sanitation and Hygiene (WASH) sector in Ethiopia with the inauguration of a model water supply, sanitation and waste management system in Wukro Town, Tigray Region. Part of the One WASH Plus programme, the system integrates innovative and resilient solutions to provide WASH services to 73,000 people, including 35,000 children under the age of 15, residing in the town and its satellite villages.

Attending the inauguration were His Excellency Dr. Negash Wagasho, State Minister of Water Irrigation and Electricity, Dr Christian Rogg, Head of the UK’s Department for International Development (DFID) in Ethiopia, Ms. Gillian Mellsop, UNICEF Representative in Ethiopia, officials from the Tigray Regional Government and Wukro Town administration officials.

“Ethiopia’s rapid urbanization and population growth has resulted in increased water stress,” said Dr. Negash Wagasho. “The development of adequate, resilient, sustainable and inclusive WASH services is therefore a must to ensure sustainable development of rapidly growing towns. Thus, what we are seeing today is what can be achieved when we put our concerted efforts together.”

“The UK is the largest bilateral donor in the Ethiopian WASH sector and we are proud to fund the excellent work taking place in Wukro, which is supplying vital water and sanitation services to the town and its surroundings,” said Dr Rogg. “I hope the progress in Wukro can serve as an example to be emulated on a national scale.”

UNICEF Representative Gillian Mellsop said the project was one of the greatest achievements of the One WaSH Plus programme and stands as a testament to the tremendous good that can be achieved when everyone pools their resources together towards one common purpose.

“Investments of this nature, both in Wukro and elsewhere in Ethiopia, are not just improving access to essential services but are changing entire lives,” said Dr. Samuel Godfrey, Chief of WASH at UNICEF. “Women and girls no longer have to walk long distances and spend many hours fetching water. Girls can go to school and attend to their schoolwork while mothers have enough time to spend with their children and engage in other productive activities. For communities, a safe and clean environment means fewer disease outbreaks.”

The Wukro project involved expanding the capacity of the town’s existing system to supply water to the town and five satellite villages, integrating it with a “full chain” system for managing liquid sludge and waste (from containment to recycling), improving water and sanitation in institutions such as schools and health facilities, and establishing a business model for managing the facility comprising the local administration and private operators. The low-cost technology deployed in treating domestic liquid waste in selected social housing developments in the town was sourced through a partnership with the Government of Brazil.

The One WASH Plus programme, fully funded by DFID, is implemented by UNICEF in collaboration with the Ministry of Water, Irrigation and Electricity, regional sector bureaus, and the Water Resource Development Fund. The programme also works with the Ministry of Health, the Ministry of Urban Development and Construction, and respective Sector Regional Bureaus, as well as town administrations and town water supply and sewerage utilities.

The programme, which began in 2013, will benefit 250,000 people in eight small towns and surrounding rural villages in Amhara, Oromia, Somali and Tigray regions with a total investment of some US $36 million by targeting communities living in towns and in peri-urban areas. Models such as the one in Wukro, some large and others medium sized, are now a key component of the One WaSH programme across more than 1,000 towns in the four regions in Ethiopia.

Ethiopia’s rapid urbanization and urban development has resulted in increased water stress and high potential for disease outbreaks. The development of adequate, resilient, sustainable and inclusive WASH services is therefore a must to ensure sustainable development of the rapidly growing towns to meet the targets set in the SDGs.

Linking One WASH National Programme and Water Resources Management: UNICEF Ethiopia’s Leverage in the Sector

By Kaleab Getaneh and Jorge Alvarez-Sala

There is a high interdependence between Water, sanitation and hygiene (WASH) services and Water Resources Management. A sustainable supply of good quality drinking water highly depends on how properly the water sources are managed. Similarly, if WASH services provision is not sustainably managed it will have a huge negative impact on the water resource.

The UNICEF and USAID supported project to strengthen the Water Sector Working Group (WSWG) Secretariat started in July 2015 with the aim of establishing a well-functioning platform for the water sector consisting of the WASH and Water Resources Management (WRM) subgroups that contribute to the sustainable development and management of the water resources in the country.

The project has been supporting the reactivation of the WRM Sub Group and the organization of the first-ever Joint Technical Review (JTR) for the WRM sub-sector. The main purpose of the JTR is to bring various stakeholders together and ensure a sustainable coordinated development and management of water, land and related resources in order to maximise the economic and social welfare of the population. This is the basis for the ongoing and future water sector interventions in general and One WASH National Programme in particular.

Developing climate resilient sustainable WASH services under the umbrella of One WASH National Programme require looking into the bigger water resources management picture, including the protection of water sources and the overall water governance issues. To this end, the reactivation and capacitation of the WRM subgroup and the launching of the JTR is significantly contributing to the development of a clear and common agenda for the water resources sector in Ethiopia.

The WRM sub-group has been able to bring together three concerned Ministries: Ministry of Water, Irrigation and Electricity (MoWIE); Ministry of Agriculture and Livestock Resources (MALR); and Ministry of Environment Forest and Climate Change (MoEFCC) and key development partners (DPs), academia and civil society organizations (CSOs).

The priorities established by the WRM sub-group include: 1.Irrigation for growth; 2.Legislation of groundwater use; 3. Conflict resolution; 4. Communication/Management Information System; 5. Institutional and Human Capacity; 6. Water quality; and 7. Water Charges/Tariff and Scheme Sustainability. Following the identification of the priority areas, six WRM technical working groups have been established to further pinpoint key bottlenecks and gaps.

Opening speech by H. E. Ato Kebede Gerba, the state Minister of MoWIE. © UNICEF Ethiopia/2018/Jorge Alvarez-Sala

On the 19th April 2018, the WRM JTR kick-off meeting was successfully held by involving more than 85 participants from academic institutions, CSOs, development partners, basin authorities, concerned federal ministries, and regional bureaus of water, environment and agriculture. The workshop was attended by H.E. Ato Kebede Gerba, the state Minister of MoWIE and H.E Ato Kare Chewicha, the state Minister of MoEFCC. It has laid the foundation by bringing the three ministries (MoWIE, MoEFCC and MoANR) together to talk about water resources management in the country.

 

Currently, the six working groups are actively organizing a field mission to review the state of WRM in three selected river basins (Awash River Basin, Rift Valley Lakes Basin and Abay River Basin) and come up with high impact implementable actions. The findings of the field mission will feed into the upcoming Multi Stakeholders Forum, which will bring both WASH and WRM subsectors together for the first time.

The whole process of JTR and MSF is expected to culminate in the preparation of a National WRM Programme document, which is currently being developed with technical and financial support from UNICEF.

UNICEF’s support to the Water Sector Working Group (WSWG), and its sub-groups is possible thanks to the generosity and support of USAID. The JTR kick-off meeting was also financially supported by JICA and the Italian Cooperation Agency.

In Ethiopia, Child Victims of Sexual Violence Communicate through Art Therapy

UNICEF and Government Communication Affairs Office Provide Training on Ending Violence Against Children

By Frehiwot Yilma

ADAMA, OROMIA REGION, 26 March 2018 – The explanation of the first picture immediately grabbed everyone’s attention in the room as psychologist Mekonnen Belete described how the child that drew it was showing that she had been abused by an uncle.

Here at the UNICEF-supported One-stop Centre in Adama Hospital in the Oromia region, counsellors are using a model adapted from the Thutuzela Care Centres of South Africa to provide timely and comprehensive medical and counselling services to victims of Violence Against Women and Children.

IMG_2972“Usually when children draw disfigured faces it indicates the people they are drawing are not very helpful. As you can see the woman’s mouth is wider than usual to indicate the woman (the child’s mother) was laughing at her when she told her of the abuse she experienced by the uncle who came from the rural areas indicated by the child in a form of a hut,” said Mekonnen, who noted that most of the children he counsels are abused by acquaintances, stepfathers and relatives.

The Adama One-stop Centre was introduced in 2013, the second to be established in Ethiopia after the centre in the Gandhi Hospital in the capital Addis Ababa and it has been successful in rehabilitating survivors as well as prosecuting the perpetrators by offering medical and legal services to victims of sexual violence. In the Oromia region, there are two other such centres in Shashemene and Jimma towns that were established and supported by UNICEF.

The centre is staffed by three prosecutors and four female investigative police officers. Clinical and counselling services are managed by a medical doctor, nurse and a psychologist provided by the hospital. Overall management of the centre is entrusted to the Justice Office, which coordinates through a multi-sectoral steering committee comprising, but not limited to, representatives from the Women, Children Affairs Office, the Health Office, the High/Woreda Court, the Adama Police Commission, the Education Office and selected child care institutions, showing how protecting women and children cannot be left to one party – everyone has a role to play. Concerted efforts bring tangible and sustainable change to ensure that not even one case is treated as the norm.

The second picture, in the sequence of the five pictures drawn by the child as she recovered from the trauma of the abuse by her uncle, is brighter than the first one but still has traces of uncertainty. According to Mekonnen, the flag in the picture indicates the medical and legal services she received. Until the girl gains confidence in these services, the flag remains at the side of the picture, showing her doubt about the system surrounding her.

Before the establishment of the One-stop Centre, victims of sexual violence were hidden for a number of reasons, including the families believing their children (especially if they accused family members), the stigma around sexual violence, blaming the victim, the lack of victim friendly services, denial that the actions took place and the difficulty of proving the abuse.

IMG_2975“The number of victims we support has been increasing from year to year,” said Inspector Etenesh Deresse of the Adama Police, the focal person for women and children cases. “This is not because children were not abused before, but people are now putting their trust in the confidentiality, speed, victim friendly and accuracy of the services provided in the centre. Now, parents and caregivers are bringing alleged reports (to us) just to make sure.”

UNICEF helped the Oromia Police College to revise its curriculum to include issues of violence against children as well as have courts include social workers on the government payroll. Currently, 40 courts have child-friendly benches and the One-stop Centre service has been scaled up from three to 17 hospitals in the region.

In the final picture the child drew, a new thought, the product of several counselling sessions, has emerged – hope for her and justice for her uncle. She was finally able to put herself in the picture and imagine and dream again.

IMG_2971When Mekonnen showed pictures drawn by children who were not abused, the difference in the attitude and aspirations was evident. Those who were not abused were able to write about the subjects they were learning, draw their house or a landscape in a free and lively way, but the ones with some trace of abuse tend to focus on one particular aspect of their life and sometimes were not even be able to depict that.

UNICEF has provided critical support to improve child justice in Ethiopia by providing equipment, supplies and capacity building trainings to the centres as well as other child friendly services such as child friendly courts, child protection units and justice offices in different regions. UNICEF works with the bureau of justice, Women and Children Affairs, the Supreme Court and police to prevent violence against children.

Sweden contributes US$ 3 million to UNICEF’s 2018 humanitarian appeal for children in Ethiopia

30 April 2018, Addis Ababa: The Government of Sweden has provided US$3 million to UNICEF Ethiopia’s 2018 Humanitarian Action for Children. The funds will be used to meet the needs of internally displaced populations in the Oromia and Somali regions of Ethiopia.

“We are grateful to the Government of Sweden for this contribution, which confirms Sweden’s continued commitment to supporting populations affected by humanitarian emergencies,” said UNICEF Representative Gillian Mellsop. “This is the first such significant contribution to our funding appeal in 2018. It will enable us to alleviate the hardships currently faced by populations living in IDP sites where access to basic services remains low and where conditions, especially for children, are simply unbearable.”

Current estimates place the number of persons internally displaced by climatic and conflict factors at around 1.7 million. The displaced are settled in 916 sites across the country.

The contribution from Sweden will enable UNICEF to provide critical and much-needed water and sanitation, nutrition, and health services to displaced populations in the two regions. Other services will include education and child protection.

Specifically, Sweden’s support will go towards:

  • Trucking of water to IDP sites and construction or expansion of water supply systems;
  • Diarrhoea treatment, vaccination of children against measles, and distribution of mosquito nets;
  • Treatment of children with acute malnutrition and provision of high protein biscuits to prevent malnutrition in children and pregnant and lactating women;
  • Provision of emergency education, including early childhood development;
  • Reunification of separated and unaccompanied children with their families and preventing and mitigating risks faced by children, especially girls.

While the Government continues to prioritize the return and resettlement of the IDPs, thousands of displaced people are still in need of urgent life-saving assistance. UNICEF’s US$ 112 million humanitarian appeal for children targets 3.1 million people with support, out of which 1.5 million are children. Presently, the appeal has a shortfall of US$ 86 million, with nutrition, health, and education having the most significant gaps.

EU and UNICEF launch a photo book on the success story of reducing malnutrition in Ethiopia

25 April 2018, HAWASSA – Today, the European Union (EU) and UNICEF launched a photo book entitled “Ending malnutrition in Ethiopia – A SUCCESS STORY” which illustrates Ethiopia’s success story in ending malnutrition, through the voices, stories and images of Ethiopians.

The nutrition photo book launch and photo exhibition held in the presence of Dr Abreham Alano, Head of the SNNP Regional Health Bureau, H.E Ambassador Johan Borgstam, Head of the European Union Delegation to Ethiopia, Ms Gillian Mellsop, UNICEF Representative to Ethiopia and other key stakeholders from the Government and other partners is a celebration of the success achieved so far in the reduction of malnutrition in Ethiopia while advocating for continued multi-sectoral efforts since malnutrition among children and women in Ethiopia remains a major concern.

It is also a celebration of how Ethiopia has managed to sustain improvements in nutrition, yet also a reminder of all the work that needs to be done to ensure everyone enjoys optimal nutrition.

On the occasion, Dr Abreham Alano, Head of the SNNP Regional Health Bureau thanked the EU and UNICEF for their support in results gained thus far in reducing stunting and  malnutrition, on the health care utilization as well as maternal and child mortality reduction and urged them to continue their support until the targeted results are achieved.

Ambassador Johan Borgstam, Head of EU delegation to Ethiopia on his part said, “It is an honour for me to open this photo book and exhibition launching event today on a topic of malnutrition which is a priority of both the Government of Ethiopia and of the EU’s development cooperation policy. Malnutrition is not only a major health problem affecting children and adults in partner countries, it also has important economic and social dimensions challenging their development by deteriorating the well-being of their entire population.”

Ethiopia has experienced rapid and sustained improvements in nutrition during the past 15 years. For instance, the country has seen a steady reduction in stunting – the fastest rate of improvement in Africa – as well as a significant decline in the percentage of underweight and wasted children. Yet, Ethiopia remains in a precarious situation, with large absolute numbers of affected children: 5 million children are stunted and 1.3 million children under five suffer wasting.

“I would like to highlight the importance of long-term investments to ensure that progress is sustained in ending malnutrition in Ethiopia. While the achievements we recognize today are indeed a success story, we cannot afford to rest on our laurels. Undernutrition still remains a challenge and it requires us all to redouble our efforts to ensure that every child enjoys better health and nutrition,” said Ms Gillian Mellsop, UNICEF Representative to Ethiopia. With the Government’s leadership and the strong commitment of partners, this goal is achievable. Let’s walk together with the same single-minded determination, zeal, and focus to end undernutrition in Ethiopia.”

To further reduce these numbers, the EU has provided €10,000,000 to support vulnerable populations in 17 woredas (districts) in Oromia, SNNP and Amhara regions of Ethiopia through a project entitled “Multi-sectoral interventions to improve nutrition security and strengthen resilience.” This joint action plan which is being implemented by UNICEF and FAO aims to contribute to the improvement of nutritional status of children, adolescents, pregnant and lactating women using the life cycle approach.