The first half of 2017 has been marked by a deepening nutrition crisis across the Arid and Semi-Arid counties lands with the five counties in the country reporting global acute malnutrition rates above 20% since February. The June 2017 prevalence of acute malnutrition in Turkana is comparable to that of the 2011 drought emergency. Since February, five counties in the country have reported GAM in excess of 20%.
Since From January to June, 37,121 children have been admitted for SAM treatment through UNICEF support, meeting 44% of UNICEF’s target for SAM treatment admissions in 2017. This is largely a result of significant scale up of outreach services across the most affected counties.
With UNICEF support, 53 strategic water points in drought-affected counties have been repaired benefiting 96,836 people, including more than 7,500 school children, with permanent access to clean water.
Multiple disease outbreaks continued in various parts of the country over the past six months with cholera remaining the most persistent with over 1,100 cases reported since January and affecting twelve counties.
Insecurity and inter-communal conflict has severely constrained humanitarian access over the past few months, especially in East Pokot sub-county.
UNICEF Kenya’s humanitarian requirements for 2017 remain underfunded with a funding gap of 44 per cent. Without additional funding, UNICEF will be unable to support the drought emergency response, and mitigate risks of a worsening drought situation for children.
Situation Overview & Humanitarian Needs
Drought: During the first half of 2017, drought conditions deteriorated following below-average performance of the rainy seasons in 2016, mostly in the Arid and Semi-Arid Lands (ASAL) of the country. By February, the number of food insecure people requiring humanitarian assistance rose to 2.6 million up from 1.3 million in August 2016. As a result, the Government of Kenya declared ongoing drought a national disaster and called for increased humanitarian assistance. The drought resulted in widespread crop failures, declining livestock productivity (especially in pastoral areas), acute water shortages, increasing malnutrition rates, escalating conflict and insecurity due to drought-induced displacements, and disease outbreaks, particularly cholera. As of June 2017, it is estimated that 3.5 million people are in need of humanitarian assistance as per the 2017 Long Rains Mid-season Assessment. Drought conditions were further worsened by Fall and African Armyworm infestations that have already affected about 69,000 hectares of croplands. Additional households are expected to move into food crisis (IPC Phase 3) after the harvest from August onwards, as household food availability and consumption is expected to decline. Staple food prices in both urban and rural markets have steadily risen since January and are 20 to 60 percent above the five-year average, prompting the Government to intervene by subsidizing sifted maize flour and authorizing the importation of about six million bags of maize to offset the deficit and stabilize prices. With the ongoing drought, children are increasingly vulnerable to separation from their families, at a high risk of dropping out of school, of partaking in child labour, child marriage, being sexual exploited, becoming pregnant and finding other negative coping mechanisms including Female Genital Mutilation and Cutting (FGM/C). There is evidence of increased numbers of children on the streets who left their homes to seek livelihood opportunities in towns and cities. During the first half of 2017, about 13,195 children (7,769 boys and 5,516 girls) were identified as separated while 1,629 children (757 boys and 972 girls) as unaccompanied minors in Garissa and West Pokot Counties. In addition, a total of 15,957 children (6,005 boys and 9,952 girls) have been displaced over since January due to direct impacts of the ongoing drought.
Malnutrition: With a deteriorating food security situation due to the drought, the nutrition situation worsened in the first half of 2017. By February, five counties (Turkana, Marsabit, Mandera, Isiolo and Baringo) reported prevalence estimates prevalence of >20 percent GAM. Preliminary findings from the June/July nutrition surveys indicate a further deterioration in the nutrition situation in parts of Turkana (>30 percent GAM and 6-12 percent SAM), a sustained high prevalence of acute malnutrition in Marsabit (>30 percent) with concerning levels also being reported in West Pokot and Samburu (15-20 percent GAM). Given the high levels of acute malnutrition, the risk of increased mortality is also high. However, mortality surveys from Turkana are not currently showing elevated mortality levels, meaning the impact of the scaled up nutrition and health response in protecting children against malnutrition related mortality has been successful. Nonetheless, with outbreaks of measles and cholera also occurring in the same counties affected by the nutrition crisis, the risk of mortality still remains high for young children. Two major risk factors that continue to affect the emergency nutrition response since January have been: ongoing insecurity that is hampering access to life-saving services by the affected communities in East Pokot, and parts of Turkana and Mandera; and the country wide strike by nurses that began in June which has largely affected service delivery at facility level as well as at the integrated outreach activities in many ASAL counties, resulting in a decline in the numbers of newly admitted children with acute malnutrition as well as declining reporting rates.
Disease Outbreaks: In January 2017, an active cholera outbreak was ongoing in Tana River County, and later spread in various other counties including Garissa, Nairobi, Muranga, Turkana and Nakuru. As of June, over 1,131 cases of cholera (with 172 confirmed by laboratory tests) were recorded in the country in 2017. Of the total cases, there were 12 deaths reported giving a Case Fatality Rate (CFR) of 1.05 per cent. The outbreak has affected twelve counties so far this year but as of June is only active in five counties (Garissa, Nairobi, Muranga, Turkana and Wajir).
A dengue fever outbreak affected Mombasa and Wajir Counties, with over 1,015 cases, and one death (CFR 0.1) reported since January 2017. A measles outbreak was also reported in Garissa (mainly Dadaab refugee Complex) and Mandera counties with 44 cases and no deaths reported to date in 2017. In Marsabit and Wajir counties, a Kalaazar outbreak has resulted to 277 cases and 7 deaths (CFR 2.5 per cent). A key challenge in controlling disease outbreaks has been the protracted doctors and nurses’ strike which has largely affected quality and access to health services including integrated outreach services across all levels of care.
Conflict and insecurity: In East Pokot sub
Conflict and insecurity: In East Pokot sub-county (of Baringo County), humanitarian access has been severely constrained in 2017 due to ongoing intercommunal conflict and security operations by government forces. UNICEF and partners suspended nutrition SMART surveys planned in June 2017 due to the insecurity. Health service delivery has also been affected with about fifteen health facilities in the area remaining closed, and another nineteen facilities operating sub-optimally. In Fafi Sub-county of Garissa County, four health facilities along the Kenya-Somalia border remain closed due to insecurity. Refugees: Kenya continues to receive refugees from South Sudan, with 10,772 new arrivals from South Sudan between January and June 2017. The majority of new arrivals (69.7%) are from Central Equatoria region of South Sudan. The refugee situation in Kakuma, Kalobeyei and Dadaab Refugee camps has been further aggravated by twin outbreaks of cholera and measles, the latter only in Dadaab. However, the Somali refugee population in Kenya reduced with voluntary repatriation of over 33,000 Somali refugees in the first half of 2017.
Elections: Kenya will hold General Elections on 8th August 2017, and risks of electoral violence exist due to the intense political competition realized during and after party primaries. The humanitarian partners in Kenya together with the government developed a four-pillar $31 million contingency plan to prepare for an effective and timely response to humanitarian needs that may result from the electoral process. Twenty nine out of Kenya’s 47 counties are classified as high or medium risk counties for election violence.1 Humanitarian partners project that some 409,000 people might require humanitarian assistance. This includes some 220,000 people who might be displaced, particularly in high-risk counties. UNICEF has developed an election response plan and is currently leading humanitarian hub coordination roles in Kisumu and Garissa zones. Supplies have also been prepositioned in the Zonal Offices as well as in Nairobi to ensure seamless delivery if and as needs arise.