UNICEF Emergency Programmes: West Timor Donor Update 18 March 2000

1. Emergency Background and Response Overview
Violence, confusion and mass movement marked the weeks that followed the 30th August 1999 popular consultation on independence in East Timor. Of the total population of 890,000 approximately 300,000 people fled or were forced to cross into neighboring West Timor. The majority of these refugees went no further than the border districts of Belu and Timor Tengah Utara (TTU). Now, six months later, approximately 142,000 people have already returned to East Timor. The total number of registered refugees remaining in West Timor is estimated at 152,654 (as of 7 February 2000). Of these, 87,720 are in Belu district, 12,786 in TTU district and a further 35,482 in Kupang city and surrounding district.

UN agencies and international NGOs launched an appeal in October 1999 (United Nations Consolidated Inter-Agency Appeal) which sought to mobilize US$ 199,046,099 for the Timor crisis. Within this overall figure, UNICEF targeted US$ 2,738,265 for West Timor, which has now been fully received. The amount was intended to cover a nine-month period, October 1999 to June 2000. However, numbers of returnees have been less than anticipated and UNICEF will not only need to extend the duration but also offer services to a greater number of beneficiaries than originally planned. Subsequent assessment has also identified further needs among the refugees and it is now estimated that at least 80,000 refugees may choose to settle in West Timor. Because of all these factors combined, UNICEF is at present reviewing its West Timor emergency programme. New plans and budgets will be prepared within the next month.

2. UNICEF's Response: Activities, Achievements and Constraints

Assistance is primarily being provided out of the UNICEF sub-office in Atambua, the main town of Belu district, and directed towards refugees in camps in Belu and TTU districts. The challenge of this emergency response has been the scattered locations of the refugee camps, and that many of the campsites are small. In Belu district there are over 120 campsites, 30 of which have populations of over 1000 and with only two camps over 5000.

Health: Over the five months since the arrival of the refugees in West Timor, close to 700 deaths have been reported. While the health and demographic surveillance system is still largely unreliable, some initial efforts at surveillance by UNICEF as well as CDC Atlanta and UNHCR indicate that the crude death rate is still at a normal "acceptable" level of 0.23 per 10,000 per day (average for Indonesia is 0.19). The most vulnerable group remains the very young, with malaria, diarrhoea and acute respiratory tract infections taking their toll, especially during the rainy season that is now coming to an end.

In response to health sector needs, UNICEF has collaborated with a church-based NGO Perdhaki, as well as with the local health services and other NGOs. With Perdhaki, 11 doctors and 24 nurses were recruited for 24 health posts in Belu and TTU districts, initially for the period November 1999 to January 2000. This service has now been extended until April 2000, and expanded to cover more camps. Medical supplies, midwives kits, essential drugs, examination beds, drug cupboards and tents for health posts were also procured. Overall, the number of medical personnel is still considered to be inadequate, given the number of refugees and the geographical conditions.

Complementary food "Vitadele": While food distribution is being undertaken by the Government of Indonesia, WFP and NGOs, UNICEF has focused on the nutritional needs of the very young. Forty tons of Vitadele, a nationally-produced micronutrient-fortified complementary food, has been provided for children under two years at all camps in Belu and TTU. Vitadele is also being distributed in Kupang though in reduced quantities, given the lower level of needs. Distribution has been carried out in collaboration with the Family Welfare Movement (PKK), a national voluntary agency with grass-root level contacts. PKK has limited capacity and to ensure that Vitadele is distributed regularly and with full coverage, other partners have been identified. Distribution will henceforth be carried out in collaboration with international NGOs such as CARE, CRS and MSF as part of their supplementary feeding programmes. This additional nutritional service has been added as a direct result of the findings from two nutritional surveys undertaken by UNICEF in December and January (see box below).

Nutritional Assessment in Belu and Kupang Districts

A survey by UNICEF in Belu District of West Timor found that an estimated 24% of refugee children under the age of five are suffering from moderate and severe malnutrition. The result of the survey, conducted in late December 1999 in collaboration with the Ministry of Health, indicates that 4% of refugee children under five are severely malnourished. The survey also found a high rate of morbidity, with two thirds of the children being reported sick from diarrhoea and respiratory infections. In response to these findings, UNICEF plans to expand the distribution of Vitadele with special emphasis on the needs of children aged 6 to 24 months. UNICEF is working with GOI, WFP and UNHCR to take immediate action to implement the survey team's other recommendations, which are: i) improvement in the distribution of the basic rice ration to ensure that it reaches all refugees equally, and an adequate monitoring system to be put in place that keeps track of the frequency of distribution in each camp and the amount received per family; ii) an increase in the general food ration from the current 1440 kcal per day to a minimum 2100 kcal per day, comprised of a proper mix of carbohydrates, fat and protein. In the Indonesian setting, this improvement could be achieved by adding beans, dried salted fish and oil. A similar survey in Kupang district, conducted early January 2000, revealed a prevalence of 11% moderate and 1% severe malnutrition among children under five.

UNICEF collaborated with local government counterparts to intensify regular tetanus and polio vaccination by making November a "Month of Immunization for School Children". UNICEF provided auto-destruct syringes and some logistics support. By end December 1999, of the estimated 47,287 IDP children under 14 years in Belu 28,734 or 61% had been immunized against measles through clinics and health posts. From the host community, where only children under 5 are targeted, a further 17,990 or 70% have been immunized. An analysis is presently underway of remaining pockets of refugees who have so far not been reached by either medical teams or immunization services. Based on the findings, extension of coverage with a mop-up round will be undertaken.

Water and Sanitation: Altogether 785 latrines and 102 dug wells have been constructed with UNICEF assistance in West Timor and 28 water tanks installed. The majority of these are situated in Belu district (671 latrines and 69 dug wells). The first batch of 33 camp sanitation cadres were trained in February 2000. These cadres are expected to motivate their fellow refugees on the importance of safe water and adequate sanitation, and to maintain a clean environment. Although UNICEF has accelerated construction efforts, inadequate water and sanitation facilities remain a major problem in most camps. Experience has shown that local NGOs and private sector contractors are best able to respond quickly and construct water-sanitation facilities in a short time period. Only a few other agencies are working in the sector and therefore UNICEF has had to extend operations over a wider area than originally targeted. With the dry season about to start, water will again become a major problem Water supply and sanitation facilities are also being provided to host communities throughout West Timor as part of UNICEF's regular assistance to the province.

Education and Psychosocial Services: It is estimated that there are at least 40,000 school-aged refugee children in West Timor. UNICEF, as the only agency currently working in the education sector, has been able to accommodate over 4,000 students (6-12 years) in 109 classrooms provided by UNICEF's "camp schools" - constructed in part from local materials. School supplies have been provided for each school. Over 130 teachers, recruited from among the refugees, have been trained in multi-grade teaching and active learning methods. Sixty three teachers have been further trained in basic psychosocial counselling techniques. Twenty-two "counsellors" were also trained to support the school-based psychosocial activities to create an atmosphere of normalcy and play for primary school-aged children. UNICEF is currently working closely with the Education Department to ensure that a longer-term programme is prepared in order to integrate, into the regular school system, children of those refugee families who choose to remain in Indonesia.

Coordination and Collaboration: UNICEF has worked closely with GOI/local government counterparts and, under the overall coordination provided by UNHCR and OCHA, with other UN agencies, international NGOs (ICRC, WVI, CARE, CRS, MSF & CFSI) and national and local NGOs. UNICEF Atambua has been requested to act as local coordinator and facilitator for health, water and sanitation, and education sector activities. Weekly coordination meetings have been held in Atambua, Kupang and Jakarta. However, the coordination mechanism still needs to be enhanced to increase the effectiveness of the emergency response.

3. Funding as of 28 February 2000

4. Future Plans

UNICEF is currently revising the emergency programme for West Timor to extend the duration to December 2000, as well as to expand and intensify the sectoral programmes, especially in health and nutrition. A joint planning exercise will be held in March with UNHCR and other agencies, as well as with the provincial government to ensure that a well-coordinated transitional programme in designed. By end 2000, UNICEF's emergency programme will be integrated into the regular UNICEF programme for women and children in the province of Nusa Tenggara Timor (NTT). The revised plan will indicate additional funding needs as well as define an exit strategy for the emergency programme.

Further details of the West Timor Emergency Programme can be obtained from:

Stephen Woodhouse
UNICEF Representative
Indonesia
Tel: + 62 21 570 551
Fax: + 62 21 571 1326
E-mail: swoodhouse@unicef.org

Robin Medforth-Mills
UNICEF EMOPS
Geneva
Tel: + 41 22 909 5554
Fax: + 41 22 909 5902
E-mail: rmmills@unicef.org

Dan Rohrmann
UNICEF PFO
New York
Tel: + 1 212 326 7009
Fax: + 1 212 326 7165

E-mail: drohrmann@unicef.org

For more information on UNICEF, visit its website at http://www.unicef.org