Ethiopia

Ethiopia: Complex Health/Food Insecurity Emergency Situation Report #6 (FY 2005)

Attachments

U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT
BUREAU FOR DEMOCRACY, CONFLICT, AND HUMANITARIAN ASSISTANCE (DCHA)
OFFICE OF U.S. FOREIGN DISASTER ASSISTANCE (OFDA)
Note: This report updates situation report #5 dated July 27, 2005.

BACKGROUND

In 2002, failed belg, or secondary rains from March through May, combined with delayed and sporadic meher, or main rains from July through September, led to severe drought conditions and widespread food insecurity in Ethiopia, affecting more than 13.2 million people during 2003. Humanitarian conditions improved in 2004, but the destitution that accompanied the crisis of the previous year complicated recovery efforts. Although relatively good meher rains improved harvest prospects in western parts of Ethiopia, most of the eastern lowlands experienced a poor meher harvest due to below average and erratic rainfall. Further, the situation in some belg-producing areas remained precarious due to poor rains and failed crops. In September 2004, USAID's Famine Early Warning System Network (FEWS NET) reported signs of growing distress in pastoral lowland areas due to drought conditions and shortages of water, pasture, and food in affected areas. The arrival of the deyr rains in October mitigated a widespread disaster in Somali Region; however, overall humanitarian conditions in the region remain concerning. Similarly, inadequate karan/karma (July-September) rains have not improved the situation in Afar Region, where conditions continue to deteriorate. Since early 2005, Ethiopia has experienced worsening food insecurity, rapidly increasing malnutrition rates, distress migration, and erratic climatic conditions. Field assessments confirm widespread food shortages and the likelihood that 12 million people are vulnerable. Initiatives aimed at tackling chronic food insecurity have been undermined by delayed implementation, underestimation of emergency needs, and under-response.

NUMBERS AT A GLANCE
SOURCE
Vulnerable Population in 2005 12 million USAID Field Assessments, May-July 2005
Total Food Aid Requirements in 2005 464,385 metric tons (MT) Government of the Federal Democratic Republic of Ethiopia (GFDRE), May 4, 2005


Total FY 2005 USAID/OFDA Assistance to Ethiopia: $32,207,739

Total FY 2005 USG Humanitarian Assistance to Ethiopia: $490,589,704

CURRENT SITUATION

Pockets of vulnerability remain. In response to increasing humanitarian concerns in Ethiopia, USAID/OFDA deployed a disaster assistance response team (DART) on May 31 to coordinate, assess, report, and respond rapidly to critical needs. In August, members of the team continued to conduct field assessments in priority areas, with travel to North Gondar Zone, Amhara Region; Sidama and Wolayita zones, Southern Nations, Nationalities, and Peoples Region (SNNPR); and Borena Zone, Oromiya Region. While the humanitarian situation in Ethiopia remains critical and pockets of vulnerability persist, the team reported that conditions have begun to stabilize as a result of large-scale nutrition and other emergency interventions, significant improvements in food distributions and financial transfer from the GFDRE's Productive Safety Net Program (PSNP) during July, and the strong performance of the belg and meher rains. Despite these improvements over the last three months, however, chronic needs and endemic poverty persist in much of the country. In addition, FEWS NET reports that record high cereal prices, conflicts, food shortages, and pockets of acute malnutrition are still ongoing threats to food security, and drought-prone areas require continued assistance for the remainder of the year. According to the multi-agency belg/gu assessment led by the GFDRE's Disaster Prevention and Preparedness Commission (DPPC), 3.3 million people will require food aid from August to December 2005. While this represents a decrease from the peak number of 3.8 million emergency beneficiaries in July, it is significantly more than the 1.56 million estimated beneficiaries originally anticipated for this period.

Malaria outbreaks threaten response capacity. According to the GFDRE's Ministry of Health (MOH), malaria is the leading cause of morbidity and mortality in the country, and accounts for 30 percent of the disease burden in all age groups annually. Heavy rains in April 2005, followed by several weeks of dry weather created ideal conditions for malaria in the lowland areas of the country. In response to reports of malaria outbreaks in Dale and Aleta Wondo woredas, Sidama Zone, the USAID/DART public health advisor and an epidemiologist/malaria advisor seconded from the Centers for Disease Control and Prevention (CDC), visited malaria-prone areas of the zone from August 8 to 11, to determine the extent of the outbreaks, assess the current response, and recommend further actions. The team noted that poorly managed water harvesting schemes, limited spraying activities, inadequate distribution of insecticide treated nets (ITNs), and poor surveillance and monitoring have contributed to a malaria epidemic in parts of the region. In visits to local health facilities, the USAID/DART encountered alarming rates of malaria, with Chuko Health Center already documenting 9,444 cases of malaria this year, compared to 9,115 cases in all of 2004. With the peak transmission season continuing to October, the health center has erected two large tents to accommodate the overflow of patients.

On August 9, OCHA reported that 77 administrative zones across the country have seen increased rates of malaria transmission, with the highest number of cases reported in Afar, Amhara, Benshangul Gumuz, Oromiya, Somali, and Tigray regions. In Tigray, officials confirmed malaria epidemics in two locations. In response to the sharp rise in malaria cases, OCHA cautioned that Ethiopia may be inadequately prepared to confront a major epidemic. U.N. agencies are coordinating with the GFDRE to provide logistical support in distribution of anti-malaria supplies. The U.N. World Health Organization (WHO), in collaboration with the MOH, is conducting a rapid assessment in the affected areas. Other assistance will focus on estimating the shortfall in drug supplies and treated nets, procuring quinine, and improving epidemic surveillance.

Agencies expand therapeutic feeding programs. Throughout August, USAID/DART health advisors visited several community-based therapeutic care (CTC) sites throughout Sidama, Wolayita, and Kambata zones, SNNPR, in response to reports of severe malnutrition in hotspot areas. The team assessed the malnutrition situation and the capability of CTCs to respond to local needs. At each of the CTCs visited, the USAID/DART encountered knowledgeable, organized, and committed staff. In spite of their efforts, however, health workers at some sites were overwhelmed by the large numbers of malnourished women and children. At most CTCs, the team confirmed shortages of therapeutic food, potable water, antibiotics, and soap. In addition, a growing malaria threat is exacerbating already precarious conditions in the region, and will likely lead to rising malnutrition levels among the affected population. During August, USAID/OFDA-partner non-governmental organizations (NGOs) opened more than 30 new CTC outreach therapeutic program (OTP) sites in SNNPR in cooperation with the Regional Health Bureau, and plan to open another 20 sites in the coming weeks. Additional CTC programs will open or receive technical assistance in Oromiya, Amhara, and Somali regions by mid-September.

Hotspot areas amid general stability in Oromiya. In August 2005, members of the USAID/DART traveled to Oromiya to assess the overall humanitarian situation in hotspot areas as a follow-up to May and July visits to the region. The team reported that despite good harvests and healthy livestock in much of the region, pockets of food insecurity remain, particularly in East Hararghe Zone. According to surveys conducted in July by USAID/OFDA partners GOAL and CARE, high levels of malnutrition and serious signs of food shortages persist in Grawa, Bedeno, Kurfe-chelle, and Fedis woredas. In contrast to other parts of the region, rains in these woredas have been inadequate and erratic, which has resulted in stunted crop growth, particularly maize-one of the main staple grains in the region. With funding from USAID/OFDA, GOAL conducted rapid assessments and began emergency interventions in East Hararghe. GOAL will open a CTC in Fedis and will fund CARE to provide technical assistance to MOH-administered CTCs in affected woredas.

The nutrition situation also remains concerning in some formerly surplus areas of Bale Zone, particularly isolated villages in Goro, Ginir, Menangetu, and Guradamole woredas, in spite of general improvements in the zone as a result of emergency food distributions. In late July, USAID/OFDA partner Concern established a CTC program in Bale, with five OTP sites planned for Goro and Ginir, and three sites planned for Menangetu. In the first 2 days of operation, more than 135 children were admitted to Concern's facilities despite the lack of referral and outreach services. From July 16 to 17, Concern conducted a training workshop in CTC best practices for 30 MOH staff, including the head of the Regional Health Bureau.

Ethnic clashes hamper humanitarian response. Sporadic insecurity caused by ethnic clashes and long-running disputes over land and cattle in and around Miesso Woreda, West Hararghe Zone, as well as parts of East Hararghe and Borena zones, have undermined relief efforts. The locally-based Ethiopian Human Rights Council (EHRCO) reported on August 23, that up to 73 people were killed, 45 others wounded, and 80,000 residents displaced in clashes so far this year between rival Oromo and Somali ethnic groups. According to EHRCO, tensions in the area remain high but fighting has stopped due to the increased military presence.

Flooding in Afar and Oromiya. On July 26, the Awash River overflowed its banks and flooded 5 villages in Assaita Woreda, Zone 1, Afar Region, affecting an estimated 8,700 people. According to OCHA, no casualties directly related to the flooding were reported, but people and livestock from evacuated villages were stranded on higher ground where they were left after being rescued. Local authorities have assessed damages but provided limited relief commodities to date. Flooding of the Awash and Meki Rivers during the week of August 22 also reportedly left up to 7,000 people homeless in Dugida Bora Woreda, East Shoa Zone, Oromiya Region. Regional authorities reported that the flooding caused 1 death and 23 livestock losses, destroyed more than 814 hectares of farmland, and displaced an estimated 7,000 residents.

Elections concluded. On August 21, residents of Somali Region participated in legislative elections to fill the remaining 23 seats in Ethiopia's 547-member parliament, as well as select 168 regional legislators. Although elections took place in the rest of the country on May 15, polling was delayed in Somali Region due to security concerns, poor communications and infrastructure, and heavy rains in April/May, which made some areas of the region inaccessible. The voting was reportedly calm although violent clashes occurred in the region prior to Election Day. On July 24, a series of grenade attacks on bars and residences in Jijiga killed five people, including one child. Government officials attributed the attacks to groups seeking to disrupt the electoral process. On September 5, the GFDRE released final election results confirming that Prime Minister Meles Zenawi's ruling coalition government won contested parliamentary polls. The National Electoral Board of Ethiopia issued final results for 545 out of the 547 seats in the federal Parliament, with the ruling coalition winning 327 seats.

Congressional Delegation visits Addis Ababa. On August 17, Representative Christopher Smith, Chairman of the House Subcommittee on Africa, Global Human Rights and International Operations, concluded a visit to Ethiopia as part of a three-country trip to the region. During his stay in Addis Ababa, Congressman Smith met with government leaders and members of the United Ethiopian Democratic Forces (UEDF) opposition party, visited patients with HIV/AIDS, and toured a hospital treating women with fistula.

U.N. Special Envoy travels to Ethiopia. On August 25, Martti Ahtisaari, the Special Envoy of the U.N. Secretary General for the Humanitarian Crisis in the Horn of Africa, arrived in Addis Ababa for a four-day visit. Making his fifth trip to the country since his appointment in June 2003, the Special Envoy met with GFDRE officials, donors, the U.N. Country Team, and NGOs to discuss the humanitarian situation, the GFDRE's new food security initiatives and the challenges they present, as well as strengthening partnerships within the relief and development community.

USG HUMANITARIAN ASSISTANCE

On October 12, 2004, U.S. Ambassador Aurelia E. Brazeal redeclared a disaster in response to the continuing health and food insecurity emergency in Ethiopia. Heavy flooding in localized areas of Somali Region prompted the Ambassador to issue a second disaster declaration for floods on May 25, 2005. On June 4, USAID/OFDA airlifted emergency relief supplies including 500 rolls of plastic sheeting, 10,000 blankets, and 5,000 water containers to assist residents affected by the flooding.

To date in FY 2005, USAID/OFDA has provided more than $32.2 million through 3 U.N. agencies and 18 NGO partners to support humanitarian activities in Ethiopia.

USAID/OFDA's programs focus on emergency response in the sectors of emergency health, nutrition, food security and agriculture, and water and sanitation, while strengthening the local capacity of early warning and crisis management structures to respond rapidly to crises and mitigate the impact of future disasters.

The USG is the largest donor of food assistance to Ethiopia. To date in FY 2005, USAID's Office of Food for Peace (FFP) has pledged 958,310 MT through a combination of P.L. 480 Title II emergency food assistance, valued at more than $324.1 million, and Bill Emerson Humanitarian Trust (BEHT) valued at approximately $130.1 million through the U.N. World Food Program (WFP) and NGO implementing partners' Protracted Relief and Recovery Operation (PRRO) and Joint Emergency Operation (JEOP) to support the 2005 Humanitarian Appeal, as well as areas targeted for the PSNP. The emergency food assistance provided through BEHT is funded as part of the $414 million famine prevention initiative for the Horn of Africa announced by President George W. Bush on June 7, which is part of a broader $674 million assistance package to address urgent humanitarian needs in Africa. The commodities provided by USAID/FFP include a combination of cereals, pulses, and vegetable oil, as well as corn soya blend for therapeutic and supplementary feeding. USAID/FFP assistance is provided to vulnerable populations through direct distribution, food-for-work programs, emergency school feeding, maternal and child health, and therapeutic and supplementary feeding programs.

In FY 2005 to date, the U.S. State Department's Bureau of Population, Refugees, and Migration (State/PRM) has contributed more than $4.1 million for programs in Ethiopia, including $500,000 to WFP to ensure full rations for Sudanese, Somali, and Eritrean refugees; more than $2 million to the U.N. High Commissioner for Refugees (UNHCR) for refugee assistance countrywide; and approximately $1.6 million to the International Rescue Committee (IRC) for refugees in Shimelba camp, Tigray Region, and in Yarenga and Sherkole camps, Beneshangul Gumuz Region.

MAP: Ethiopia: FY 2005 Programs

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