UNICEF Humanitarian Action: Ethiopia donor update 12 Jul 2005

Emergency health and nutrition programmes only have 25% of their funding. Without treatment, up to 170,000 children could die this year from severe acute malnutrition.

Water and sanitation interventions only have 18% of their funding for this year. Emergency water tankering for 280,000 people in vulnerable areas is under threat.

UNICEF urgently needs US $42 million to:

• Quadruple the number of therapeutic feeding centres in Ethiopia
• Step up life-saving vitamin A, de-worming, measles and nutrition interventions for 6.8 million children
• Extend emergency water and sanitation interventions to 1.2 million people

1. EMERGENCY OVERVIEW AND ISSUES FOR CHILDREN

Ethiopia's malnutrition crisis

Severe acute malnutrition among Ethiopia's children has reached alarming levels across the country.

The scale of the problem is confirmed by numerous nutrition surveys and nutritional screening carried out under Ethiopia's UNICEF-supported Enhanced Outreach Strategy (EOS)(1). New data suggest that critical levels of severe acute malnutrition are still occurring across Ethiopia.

The most alarming situation recorded since the last donor update was at Fugnido and Bonga refugee camps in Ethiopia's Gambella region where WFP and UNHCR recorded global acute malnutrition levels of over 29% and severe acute malnutrition levels of 7% - well past the critical level. More representative information came from Fik zone in the Somali region in June when Save The Children UK recorded global acute malnutrition rates of up to 20 %, of which 2.4% were severe cases. Field workers in SNNPR and East and West Haraghe in Oromiya region confirm admissions to therapeutic feeding programmes have increased over the past three months.

Existing EOS data show severe acute malnutrition levels at twice average levels in many areas. Once extrapolated, that suggests 136,000 Ethiopian children are currently severely malnourished and another 360,000 moderately malnourished (or at risk of becoming severely malnourished) - figures that mean up to 170,000 children could die by the end of the year if not treated. The death rate could accelerate if additional shocks including measles, malaria, diarrhoea and pneumonia outbreaks are not prevented or treated rapidly.

The deteriorating situation has been exacerbated by erratic pastoral rains, the delayed implementation of the government's Productive Safety Net Programme (2), poor main Meher rains in eastern Ethiopia in 2004 and the continuing impact of the 2002-3 drought. Poor rains have affected household food stocks in the first part of 2005 and resulted in limited pasture and loss of livestock. The situation could worsen depending on the Belg rains, since funding of UNICEF-supported emergency appeal for 2005 is inadequate and because of delays in the roll out of the Safety Net. The nutrition of 480,000 people in resettlement areas, including 75,600 children under 5, also remains fragile and requires close monitoring.

Water and Sanitation

UNICEF's emergency and sanitation programmes remain badly under-funded. From the US$ 15 million that UNICEF appealed for earlier this year, only US$ 2.7 million or 18% has come in.

This is having a major impact on UNICEF's ability to provide life saving emergency water tankering to some of Ethiopia's worst-hit areas. UNICEF originally hoped to reach just under 420,000 people with tankering. To date it has only been able to serve a third of that figure. UNICEF has only been able to fund 18 % of its planned new water and sanitation responses, 5.8 % of its planned rehabilitation schemes and 13.7 % of its proposed sanitation interventions. In total, out of 1.5 million people originally targeted by these services in Afar, Somali region and other hotspots, almost 1.2 million are currently not covered.

The shortfall has also limited UNICEF's ability to prepare for unforeseen water and sanitation emergencies. One emergency that UNICEF was able to respond to was the flood which left an estimated 130 people dead from late April in Ethiopia's Somali region. Preliminary results from a joint UN/DPPC assessment mission showed that more than 11,000 households (or 55,000 people) were heavily affected by the flood and lost family assets, while a larger number are at high risk of contracting malaria and water-borne diseases.

2. UNICEF RESPONSE: ACTION AND IMPACT

Nutrition

Severe malnutrition treatment

UNICEF has helped almost double Ethiopia's facilities to treat severely malnourished children over the past two months. The country now has resources to treat 5,350 severely malnourished children at any one time. UNICEF has plans to provide support for another 3,000 centres in the next 60 days, building up to a national capacity of 19,400 places by the end of the year. In total, UNICEF now supports 18 therapeutic feeding programmes (TFC and OTP) through NGOs and 30 therapeutic feeding units integrated in health facilities, providing the necessary drugs, equipment, technical assistance and therapeutic products.

Live-saving intervention

More than 3.7 million children received a life-saving package of vitamin A supplementation, de-worming, measles catch-up, nutritional screening and referral to supplementary of therapeutic feeding programmes where appropriate during June. The assistance was given during the third round of the UNICEF-supported Enhanced Outreach Strategy in SNNPR, and the second round of the strategy in Tigray and Amhara. In total, more than 6.8 million children will be reached by this programme every six months.

Surveillance and coordination

UNICEF has taken action to strengthen nutrition surveillance in Ethiopia and coordinate nutrition response. It recruited seven additional staff members, including one international expert, to join the government's Emergency Nutrition Coordination Unit (ENCU). UNICEF has also bought computers and office equipment.

Nutrition programme spotlight

UNICEF needs US$ 4.85 million to reach all 6.8 million children covered by Enhanced Outreach Strategy with a further round of live-saving interventions and screening before the end of the year.

Health

Measles

More than 271,000 children, aged 6-59 months, received measles vaccinations in Afar in June. Thanks to good mobilisation and community based outreach, almost 95% of the targeted children in these pastoral communities were covered. (Almost 92 % also received Vitamin A supplementation). A further measles campaign should reach about 400,000 children in East and West Hararghe in October.

Malaria

On top of its efforts to prevent malaria in the Somali flood, UNICEF also moved to protect people living in resettlement sites across Ethiopia from the disease. More than 123,300 KO-tab re-treatment kits have been procured to top up insecticide levels in mosquito nets. By August, this should provide protection for more than 250,000 children and pregnant women, thus saving the lives of nearly 1,000 children who would otherwise have become fatally infected with malaria.

Polio

UNICEF has supported two national vaccination programmes, supplying vaccines and technical expertise. Both have exceeded targets in terms of children reached. The first in April reached 15,425,000 children under 5. The second reached 14,780,277 in May and June - the Somali region leg started on July 4. Further national campaigns should take place in October and November. The WHO covered operational costs.

Health programme spotlight

UNICEF needs US$ 620,400 to provide insecticide treated nets for 330,000 children and pregnant women in East Haraghe, Oromiya region, where communities are exposed to malaria transmission for more than three months. More than 13,700 people, who would otherwise have become fatally infected with malaria, should be saved through this intervention.

Water & sanitation

UNICEF continues to be the only agency providing water tankering for about 6,000 internally displaced people in Hartisheik, in the Somali region. Emergency water treatment and sanitation interventions have also been set up with the cooperation of local NGOs to alleviate conditions following the severe flooding.

More than 12,000 people have benefited from new wells and rehabilitated water supply schemes in Gambella region. The rehabilitation of 17 shallow wells in Boricha district, SNNPR - one of Ethiopia's current hotspots for severe acute malnutrition - has benefited 23,000 people. UNICEF-supported water tankering interventions in Afar region are benefiting up to 18,200 people in Elidar, Berhale, Yalo and Dallol woredas. UNICEF has also supported the drilling of additional 20 shallow wells in drought affected areas since the beginning of the year. Those should benefit more than 10,000 people.

Water & sanitation programme spotlight

UNICEF needs US$ 2 million in the next three months to provide water supplies and sanitation for health institutions in hot spot areas, particularly where new therapeutic feeding centres have just been established.

3. 2005 REQUIREMENTS AND RECEIPTS

* We also have confirmed pledges from OFDA amounting to USD 2,000,000

Notes:

(1) Full name - Enhanced Outreach Strategy / Targeted Supplementary Feeding for Child Survival Interventions. The largest ever partnership between UNICEF, the WFP and the Ethiopian government targets 6.8 million children under 5, as well as pregnant and lactating mothers, in 325 drought affected districts. It provides a child survival package twice a year of vitamin A supplementation, de-worming, measles catch-up, nutritional screening, referral to supplementary or therapeutic feeding programmes and, increasingly, malaria nets.

(2) The Productive Safety Net Programme is an Ethiopian Government initiative, supported by main aid agencies, which aims to provide cash or food for work to 4.23 million chronically food insecure people.

Details of the Ethiopia Programme can be obtained from:

Bjorn Ljungqvist
Representative
UNICEF Ethiopia
Tel: +251-51-51-55
Fax: +251-51-16-28
E-mail: bljungqvist@unicef.org

Olivier Degreef
UNICEF EMOPS
Geneva
Tel: +4122 909 5655
Fax: +41 22 909 5902
E-mail: odegreef@unicef.org

Gary Stahl
UNICEF PFO
New York
Tel: + 1 212 326 7009
Fax: + 1 212 326 7165
E-mail: gstahl@unicef.org