Ethiopia: Acute Watery Diarrhoea (AWD) Outbreak - May 2016
AWD outbreak is still ongoing in 10 woredas in six zones of Oromia and Somali regions. By week 20, a total of 1,884 AWD cases and 19 deaths had been reported. During the same week, a new area, Dolo Bay woreda in Somali region was affected. (WHO, 27 May 2016)
Since the Federal Ministry of Health confirmed the first two AWD cases on 9 June, the number of confirmed cases are increasing. The Ethiopian Public Health Institute reported about 2,145 (nationally) and 25 (in Addis Ababa) suspected AWD cases as of 12 June 2016. The Addis Ababa Health Bureau and partners launched an AWD response plan to curb the spread of the outbreak. OCHA, 20 Jun 2016
In week 15 (week ending 16 April 2017), a total of 2,388 suspected cases of AWD/cholera were reported in Afar, Amhara and Somali regions of the country. While some decline has been observed in the trend in the last weeks [4,200 cases in week 14; 4,104 cases in week 13; 4,358 cases in week 12], it is still premature to deduce overall improvement in the situation on the ground, especially with the weak surveillance system. Somali region remains the most affected, accounting for 99% of the new cases reported in the reporting week. On 20 April 2017, WHO elevated the outbreak of AWD/cholera and the humanitarian crisis in Ethiopia to grade 3 emergency. This new grading enables the organization to leverage its global capacity and scale up the response to the outbreak and the humanitarian crisis. (WHO, 21 Apr 2017)
There was a decrease in the number of AWD cases reported in week 24 (week ending 18 June 2017): a total of 661 cases were reported from the three regions compared to 1,080 cases reported in week 23 (week ending 11 June 2017). Since the beginning of 2017, a total of 37,459 cases including 784 deaths (case fatality rate 2.1%) have been reported from six regions of Somali, Oromia, Amhara, Afar, SNNP and Tigray. Eighty-nine percent of the reported cases and 96% of the deaths were reported in Somali Region alone. (WHO, 23 Jun 2017)
The AWD outbreak situation continues to improve. During week 27 (week ending 9 July 2017), 275 new AWD cases were reported from the three regions of Somali (149), Oromia (68) and Amhara (58). Since the beginning of 2017, 38,715 cases including 797 deaths (case fatality rate 2.1%) have been reported from the seven regions of Somali, Oromia, Amhara, Afar, SNNP, Tigray, and Benshangul Gumuz. Eighty-eight percent of the cases and 94% of the deaths were reported in Somali Region alone. (WHO, 17 Jul 2017)
A 27 per cent increase in the number of [AWD] cases was reported nationwide last week, mainly due to spikes in new cases reported in Amhara and Tigray regions and a resurgence of the outbreak in Afar region where community transmission of the disease is widespread. Currently, the major risk factors for the spread of the outbreak are holy water sites where large numbers of Christian pilgrims congregate from around the country, especially in Amhara and Tigray, and seasonal mobility of daily laborers to commercial farms. The high risk for further spread of the AWD outbreak continues due to the degradation of health determinants on the back drop of overburdened local health systems, including inadequate access to safe drinking water and internal and cross-border movements. (OCHA, 03 Sep 2017)
[AWD] cases continue to be reported from Afar, Amhara, Tigray and Oromia regions mainly from religious sites and commercial farms that have poor sanitation facilities and limited access to clean water. Somali region also continues to report AWD cases although at a reduced rate. With the ongoing rains, increased numbers of AWD cases are expected in the coming weeks; particularly in Amhara, Benishangul-Gumuz, Oromia and SNNP regions. (UNICEF, 20 Sep 2017)
The outbreak is showing a downward trend. Only 61 new cases have been reported this week from 4 regions, and the majority of new cases are from Amhara and Somali regions. As of now, 9 regions in Ethiopia have been affected, and 73.6% of the total cases are from Somali region. (WHO, 09 Dec 2017)
Only 11 new cases have been reported this week from 4 regions: Amhara, Somali, Diri Dawa and B.Gumuz regions. Nine regions in Ethiopia have been affected, and 73.6% of the total cases are from Somali region. (WHO, 05 Jan 2018)
Between January and December 2017, a cumulative total of 48 814 cases and 880 deaths (CFR 1.8%), have been reported from 9 regions. In 2018 only, a total of 98 cases have been reported from two regions, Somali and Dire Dawa regions. (WHO, 02 Mar 2018)
In most parts of the country, the situation has stabilized, however, Afar region is experiencing an increase in cases which began since week 18. In week 23, 233 cases were reported, all of which are from Afar region. From week 1 to 23 2018, a total of 728 cases with 18 deaths (CFR-2.5%) has been reported from the following regions: Somali (136 cases), Afar (537 cases with 18 deaths), Tigray (38 cases), and Dire Dawa City Administration (17 cases). (WHO, 29 Jun 2018)
A total of 1407 cases of [AWD] have been reported since June 2018 in Tigray region, affecting some 34 woredas. Currently the number woredas reporting AWD cases is reduced to 16 and 80 per cent of the cases are from four woredas. Central zone and Mekelle have the majority of cases but now it is shifting to Western zone. This week there were 64 patients of which 43 per cent are from Western zone, 35 per cent in Mekelle. Risk factors are mainly due to untreated water consumption which accounts to 70 per cent of the total factors. Government and partners are distributing water treatment chemicals and health supplies, but needs surpass resources being availed. High operational cost for response, low involvement of sectors and low level of response by most partners are among the critical challenges to AWD response in the region. Meanwhile trend of AWD cases is decreasing in all Woredas of Afar region. However, the regional AWD command post identified that provision of safe drinking water remains a major gap in all affected woredas. (OCHA, 19 Sep 2018)
In 2018, cases have been reported from five regions, namely; Oromia, Dire Dawa,Somalia, Tigray and Afar. There has been a general decline since the peak in week 33 when more than 500 cases were reported. In week 41(ending 14 October 2018), 48 cases of AWD were reported from two regions: Oromia (7) and Tigray (41). (WHO, 19 Oct 2018)
No new cases of AWD were reported in the existing hotspots on weeks 46 and 47. In total, 3 090 cases have been reported in 2018. (WHO, 30 Nov 2018)
Most read reports
- ECHO Factsheet – Ethiopia – Last updated 17/12/2018
- Ethiopia Weekly Humanitarian Bulletin, 8 May 2017
- Greater Horn of Africa Region: Humanitarian Snapshot (September - October 2018)
- Ethiopia: Humanitarian Response Situation Report No.19 (November 2018)
- Southern Africa: An Overlay of Drinking Water Supply Systems and Number of Cholera / AWD Cases and Deaths Reported Between January and September 2017
Ethiopia, the second most populous country in Africa, faces a massive internal displacement crisis due to inter-communal violence and conflicts. The displacement crisis started in autumn 2017 and has escalated and spread in the second half of 2018. Meanwhile, there is dramatic political change brought about by the arrival of a new prime minister in 2018, an ongoing refugee influx from South Sudan and Eritrea, and millions of Ethiopians who need emergency food assistance and support to rebuild their livelihoods.
This report has been prepared under the auspices of the Federal Disaster Risk Management Technical Working Group, co-chaired by the National Disaster Risk Management Commission (NDRMC) and OCHA with participation of cluster co-chairs (Government Line Ministries and Cluster Coordinators). It covers the period from 1 October to 15 November 2018.
The killing of four government officials in late September in Benishangul-Gumuz Region aggravated already existing ethnic tensions resulting in a large-scale intercommunal conflict displacing approximately 200,000 people along the Benishangul-Gumuz-Oromia border.
A polio vaccination campaign was successfully conducted in five zones of the Somali region between 23-26 September, reaching 486,816 children under 5 years of age.
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 55 events in the region. This week’s edition covers key new and ongoing events, including:
According to FEWSNET, there was an increase in food production due to the continued rainfall experienced in the eastern Horn of Africa. Average to above-average rains are expected to enhance crop and livestock production, increase demand for agricultural labor, and suppress resource-based conflict. Regardless of this, food insecurity persists due to a combination of factors, including conflict, drought recovery, previous and ongoing flooding.
At mid-year, Ethiopia was faced with an unprecedented caseload of 2.6 million internally displaced persons (IDPs) affected by conflict and drought, mainly along the Oromia regional border with Somali and the Southern Nations, Nationalities and Peoples’ Region (SNNPR) with children constituting more than half of the displaced population. In line with these changes, UNICEF has revised its Humanitarian Action for Children (HAC) for 2018 and raised the resource envelope to US$ 123.8 million.
In the second half of the year, Ethiopia has faced with an unprecedented surge of inter- communal conflict in Gedeo zone (SNNP region) and West Guji zone (Oromia region), which at its height, displaced some 818,000 people.
Summary of Operation Update to emergency plan of action:
The Humanitarian Dashboard is a monthly product which consolidates headlines based on the evolving context, humanitarian needs, response and outstanding priorities. Cluster sections include changes in sectoral needs and progress towards current priorities, which were reviewed and endorsed by the UN Humanitarian Coordinator, Ethiopia Humanitarian Country Team and the National Disaster Risk Management Commission (NDRMC) in August 2018.
Conflict displacement (as of mid-August 2018)
The Ethiopian Humanitarian and Disaster Resilience Plan for 2018, currently estimates that 7.9 million people need food and cash assistance, 6.86 million people need water,sanitation and hygiene support, 6 million are at risk of communicable diseases, an estimated 350,111 children require treatment for severe acute malnutrition, and 340,000 (estimated 90,000 children) vulnerable people require protection from gender based violence and exploitation. Ethiopia has the second largest number of refugees and asylum seekers in Africa, nearly 923,863.
• Approximately 141,410 people were displaced in Somali region after conflict erupted on 4 August. The conflict led to the exodus of government personnel, leaving essential services significantly understaffed. This in turn created pressing and urgent humanitarian needs for children and women in the region.
• Through UNICEF support, 134,446 people in Gedeo-West Guji received essential and life-saving health care services and 30,579 children under 5 years were treated for Severe Acute Malnutrition (SAM).
• Government and partners continue assistance to GedeoWest Guji IDPs.
• The Government and partners are finalizing a new response/recovery plan targeting IDPs returning to their places of origin and at present locations.
Affected population 7.88 m
MAM 3.5 m
# of people displaced due to conflict 1.1 m
# of people displaced due to climatic shocks 0.5 m
15.8M People facing food insecurity
4.1M People displaced
16.3M People affected by drought in the region
1M People affected by floods
Ethiopia is host to the second largest refugee population in Africa, sheltering 905,831 registered refugees and asylum seekers as of 31 August 2018.
So far in 2018, 36,185 refugees arrived in Ethiopia, including 1,626 in August. They are mostly from South Sudan and Eritrea.
Intercommunal conflict in the Somali and Oromia border regions that escalated on 4 August has led to the internal displacement of more than 141,000 people. Shelter and health assistance are among the most urgent needs for the IDPs. The areas most affected by the conflict are Jijiga in Somali region and East Hararghe area in Oromia, where fatalities among the population were reported. With the exception of a reported influx of around 2,000 displaced people into Mekelle Town of Tigray region, there is no other information regarding the impact of the August events on Tigray.
▪ Renewed inter communal violence in Gedeo-West Guji since 3 June has displaced 1,010,934 people.
▪ The government and humanitarian partners have launched a multisector response plan for Gedeo-West Guji with a funding requirement of US$ 117.7 million.
▪ With UNICEF’s support, 140,720 children under five have received treatment for Severe Acute Malnutrition (SAM) between January and May 2018.