IFO 2 was opened in July 2011, to accommodate Somali refugees who escaped escalating violence in Somalia and drought. The three existing camps, IFO 1, Hagadera and Dagahley, could not accommodate more refugees as they were designed to accommodate 90,000 people in early1990’s though by July 2011, they were hosting more than 400,000. The Government of Kenya (GoK) was hesitant to allocate additional land for camps expansion, citing threat to national security, environmental degradation and unsustainable extraction of underground water resources. IFO 2 was designed to accommodate 120,000 people; 60,000 in East and 60,000 in West. The camps currently hold 77,000 people. The GoK halted Registration of new arrivals after the closure of the border with Somalia.
KRCS Entry into IFO2 Camp
There was a sub-agreement between United Nations High Commission for Refugees (UNHCR) and International Federation of the Red Cross and Red Crescent/ Kenya Red Cross Society (IFRC/KRCS) that covered key sectors in IFO 2 West on operational partner basis. The UNHCR requested KRCS/IFRC to cover health and nutrition services to IFO 2 East on a “Temporary Stop Gap Measure”, until a separate sub-agreement was done.
Situation in IFO2 Prior to Entry
There was a humanitarian emergency in IFO 2 when KRCS took over. Two disease outbreaks affected the refugee complex; an outbreak of Cholera where 1,265 cases were line-listed between August 2011 and February 2012 across the five camps. The outbreak killed three people. There was also an outbreak of Measles where 1,638 cases have been line-listed since January 2011. This outbreak has not been fully controlled in the camps.
The humanitarian crisis in Dadaab was evidenced by images of children with Severe Acute Malnutrition. A nutrition survey was conducted by UNHCR, United Nations Children’s Fund (UNICEF) and their nutrition partners between September and October 2011 and the results showed the Global Acute Malnutrition was at 38.3 percent against the Emergency threshold, which is 15 percent according to World Health Organisation (WHO). The prevalence of malnutrition was higher in children who had arrived less than three months prior to survey (GAM 43.7 percent). Mortality rates were also an evidence of the emergency. The Crude Death Rate was 1.23 per 10,000 people per day. This means that 13 people are dying each day in a population of 100,000. Under Five Mortality was at 3.02 per 10,000 people per day (30 children under the age of five years dying each day in a population of 100,000).
In the Sanitation Sector, between eight and 12 families were sharing communal latrines. This followed the filling up and collapse of latrines following the October-November- December rains. The Security situation deteriorated following the abduction of Medicins Sans Frontiers (MSF)-Spain expatriates in mid-October 2011. A series of remote controlled and pressure-operated Improvised Explosive Devices (IEDs) heightened insecurity between October 2011 and January 2012. The UNHCR in a bid to safeguard the security of its staff and those of its partners halted the operations in the camps except the life-saving activities. These included health and nutrition, water and Sanitation and food distribution.
Current Situation - Nutrition
KRCS is running two nutrition programmes: One is the Out Patient Therapeutic Feeding that targets 3,372 children with Severe Acute Malnutrition in IFO 2. Beneficiaries in this programme peaked in January with 3,314 children with a coverage of 94 per cent. The other programme is the Supplementary Feeding Programme (SFP), which targets 2,807 children with Moderate Acute Malnutrition and 2,819 pregnant and lactating women. The beneficiaries in SFP in April 2012 were 2,217 children, 797 pregnant women and 668 lactating women.
Current situation- Health and Nutrition
The IFO 2 camp is out of the emergency phase and GAM has improved from 38.3 per cent in October to 13.1 per cent. Severe Acute Malnutrition has also improved from 18.8 to 4.5 percent. The Crude Mortality Rate has stabilised from 1.23 deaths per 10,000 people per day, to 0.2 per 1000 people per month. Under five years mortality has also improved from 3.02 deaths per 10,000 persons per day to 0.6 per 1,000 per month 1000 per month. Further, camp management function has significantly improved. KRCS is coordinating partners in the camp with bi-weekly meetings co-chaired with UNHCR field office.
Current situation health Tabulated
The table below shows the nutrition situation in 2011. The results of Mass MUAC carried out in March is provided for ease of comparison. These results are only indicative:
It is important to note that a nutrition survey is required to give the levels of malnutrition in the camps based on weight for height criteria.
Current situation - Sanitation
KRCS is putting up 6,680 family latrines in IFO 2 West. A total of 3,031 latrines have been completed and in use in Sections T and U. In addition, 214 latrines are under construction and 6500 slabs have been cast so far by the contractor. Out of these, 3300 slabs are ready for use. Further, at least 1,200 pits have been excavated and awaiting construction. Between 25 and 30 latrines are constructed each day. The refugee community is carrying out pit excavation and the tools are provided by KRCS. KRCS is also providing slab, labour and construction of sub structure and superstructure. Some 456 communal latrines, which were filled up, have been demolished. The water sub-sector will be handed over to KRCS by Oxfam soon after completion of contracted works.
Facing the Future
The UNHCR has requested the KRCS to continue with health and nutrition services in IFO 2 East as an implementing partner. The UNHCR has also requested KRCS to take over camp management function in IFO 2 East beginning July 2012. Further, KRCS and MSF Spain have agreed that the KRCS will complete the hospital in IFO 2 East. The construction of this hospital started in 2010 but was stopped by the GoK as approval for IFO 2 as a camp had not yet been granted. The KRCS staff who are offering humanitarian services are accommodated in tents in two locations; a Base camp in Dadaab and at the Agencies compound in IFO2.
Future of IFO 2 Camp
KRCS targets to further lower the GAM rate to less than five percent by August 2012, when the nutrition survey will be conducted. The Society plans to complete the hospital and provide 24-hour service coverage. KRCS also plans that each family in IFO 2 West to have its own latrine by end of 2012.
The security situation remains unpredictable in Dadaab and the future remains unknown. There is potential for increase in Dadaab population if dry conditions persist in Somalia. Shelter also remains a key problem in IFO 2. Further, refugees are still using tents issued in August 2011, which have a lifespan of six months.
A word from the community
On Exclusive breastfeeding, a mother said, ‘I have four children; the youngest child was exclusively breastfed after receiving advice from a Red Cross health worker. I am happy that the child is very healthy, and has had no illnesses like his siblings. I, therefore, believe exclusive breastfeeding is beneficial.’
Another said, ‘It is every mother’s dream to do everything they can to ensure proper growth of their children. The challenge comes when they do not have enough food to feed themselves and have no income to allow them to be able to buy nutrient dense foods’
On the KRCS E-Plus ambulance services, one participant said: ‘The ambulance is not like the sun, which can shine the world at the same time, but they try as much as possible to serve all the patients in need despite heavy work load.’