UNICEF Humanitarian Action: Madagascar Donor Update 3 Apr 2007

Originally published



- 450,000 people in need of humanitarian assistance after five major cyclones

- A sixth cyclone, expected on 3 April, is feared to cause further extensive damage and human suffering



Madagascar, an island in the Indian Ocean, is one of the poorest countries in the world with a poverty rate of 68% in 2005. Children under 18 represent 52% of the population. Only 35% have access to safe water and only 3% to adequate sanitation. Hygiene, therefore, is poor and the general environment is unclean. In 2005, 17% of children under five died from diarrhoeal dehydration and diseases. Malaria is the single largest cause of childhood mortality, responsible for one-third of all child deaths and killing about 30,000 children annually. Malnutrition continues to pose a serious threat. Nearly half of all children under five suffer from retarded growth and during poor harvest times 13% of under-five year olds suffer from severe malnutrition. Moreover, Madagascar, through its geographic location, is prone to natural disasters, including recurrent cyclones, flooding and endemic droughts, all creating additional hardship for an already vulnerable population.

Since December 2006, Madagascar has been hit by five cyclones, the worst series of cyclones in many years, causing deaths, severe flooding, property and agricultural destruction and population displacement. Some communities in the northwest report the worst flooding and loss of life and property since 1959. On 15 March 2007, Cyclone Indlala, the fifth of the cyclones, struck the north-eastern coast of Madagascar. Arriving with winds of more than 230 km/h and torrential rains, Indlala crossed the northwest and ended its course in the central highlands. Seven regions were affected: Diana, Sava, Sofia, Analanjirofo, Vatovavy Fitovinany, Atsimo Antsinanana and Aloatra Mangoro; 48 out of 111 districts in the country have felt the impact of the five cyclones and two other unusually intense tropical storms. Areas affected by Indlala were already suffering from the effects of the previous storms, especially the coastal areas of the east. Assessments by the National Bureau of Risk and Catastrophe Management (BNGRC) on 28 March indicate that 88 people are reported dead, 30 are missing and 126 injured. 30,856 people have lost their homes and are in need of urgent humanitarian assistance. Field reports suggest that eventual mortality figures are likely to be higher. According to the BNGRC over 13,000 homes were destroyed or flooded. Infrastructure was severely damaged, with 357 administrative buildings and 55 schools (over 140 classrooms) out of order/use and 150 traditional rice field irrigation structures destroyed. Over 36,000 hectares of agricultural land were seriously damaged, primarily rice paddies. Communications have been disrupted. Of greatest concern is the damage to the national road system that is now hampering access to health centers, schools and basic services and is posing logistical challenges to relief efforts. It will be some time before all primary road links are restored. The risks of water-borne diseases and epidemic outbreaks are high. The most urgent needs are food, potable water, essential drugs, shelter and sanitation, cooking utensils, and education materials. The heavy rains and flooding in largely populated and cultivated areas throughout the country after four cyclones affected more than 293,000 people, including an estimated 125,000 people who are in immediate need of food due to losses of agricultural production in the south-eastern regions – where up to 70-90% of the rice harvest was lost. As a result, food insecurity is increasing and a looming nutritional crisis is threatening larger numbers of children. In Antananarivo, some 18,000 people were made homeless, of whom over 9,000 continue to survive in extremely difficult conditions. After Indlala struck, an additional 157,000 people were affected, bringing the cumulative total to about 450,000 people. Another cyclone, Jaya, landed today, affecting the north of the country.

UNICEF has been at the forefront of the Madagascar emergency response in the past four months. With a comparatively limited number of INGOs active in the country, a quick response capacity to cope with frequent natural disasters is essential. Through an ongoing investment in emergency preparedness and response capacity in the last few years, UNICEF has increasingly positioned itself as an important actor in humanitarian response within its core commitments for children in emergencies: ensuring access to basic health care, safe water and sanitation, nutritional rehabilitation, emergency education and child protection. In the present situation, the challenges on UNICEF to respond in a timely and effective manner require the strongest possible donor support.

Following each disaster, rapid assessments are conducted by joint teams composed of BNGRC, UN, NGO’s and local authorities. A standard multi-sector form called "EIMA" has been in use for several years by the CRIC (Reflexion Committee for Catastrophies) under the umbrella of the Interior Minister. UNICEF has participated in all immediate assessments following the earlier cyclones Bondo, Clovis and did a specific assessment of the displaced camps in Antananarivo prior to the WASH intervention. After Indlala, due to the isolation of many areas affected, UNICEF and the Government jointly organized and carried out an assessment in both Diana and Sofia regions via helicopter. On 3 April, the Prime Minister called on national and international communities to support stronger coordination at the national and regional levels and to boost the response to the humanitarian crisis with additional human and material resources.


Flooding impact epidemic outbreaks and water-borne diseases

In all the flood affected regions, there is a looming risk of increased maternal and child mortality linked to malnutrition, lack of sanitation and poor access to basic health services. There are high risks of water-borne diseases and epidemic outbreaks spreading rapidly. Madagascar has a traditional high vulnerability to cholera. Malaria, already an endemic problem in 9 districts of the South, is now a major risk in all regions affected by the cyclones and floods, in effect most of the country. Flash flooding has destroyed or damaged large numbers of borehole wells and traditional water points, knocking out systems, washing away piping and power points and contaminating fresh water sources. In Sofia region affected people are drinking surface water, and very few boreholes are seen. Surface water is extremely turbid due to floods, some rivers are carrying dead bodies, and pools of stagnant water in all affected regions pose a high risk in terms of public health. In Sofia, Sava and Diana Regions, many health centres have not received replenishment of bi-monthly essential drug supplies since December as roads have been cut, disrupting transport. While no disease outbreaks have been reported in the north, the situation is fragile and conditions are unfortunately conducive to increasing morbidity unless there is an effective, scale-based emergency water and health response. So far, the breakdown of damages on health structures is unknown for the 7 districts of the SOFIA region. In this context, it is even more critical that the vaccination and prevention activities of the "National Child and Mother Week", scheduled to start on April 23, are maintained in all affected areas. Children and pregnant women will receive Vitamin A and deworming treatments. They will also receive routine immunization and measles vaccinations will be given in the most affected districts of the North. UNICEF and partners need assistance to ensure that the most vulnerable and seriously affected children and mothers receive care. The bases UNICEF are setting up in the North will be a logistical asset to reach the affected population.

Flooding impact on food insecurity and nutritional crisis

The nutritional status of children under 5 years is precarious under normal situations, with the last Demographic and Health Survey finding 13% to be affected by acute malnutrition and among them 3% to be severely malnourished. In the present situation, food insecurity is increasing and we expect acute malnutrition among vulnerable groups to increase dramatically in the coming weeks. In addition to the 260,000 people affected by the reported loss of up to 80% of crops in the southeast after cyclone Clovis, Indlala inflicted heavy crop damage in the northern and central highlands. UNICEF assessments have found that many families have lost the secondary harvest (January) and entered the February to May lean season with little or no food reserves. Food insecurity in the August to November lean season will worsen, as predictions indicate that the principal May/June harvest will also be negatively impacted. There is therefore now an imminent risk of a nutritional crisis that can affect most regions of Madagascar. UNICEF’s emergency nutrition response in the South, soon to be expanded to the South-East, are reaching good coverage rates. Additional interventions are needed, however, to avoid increased maternal and child mortality amongst the vulnerable groups, including prioritization of high risk families and ensuring availability of Plumpy nut and BP5 at all key sites. In the South, UNICEF, the Ministry of Health and the National Nutrition Office are particularly concerned by the already fragile nutritional status of women and children in three regions, declared "food insecure" at the end of 2006 due to drought. Nutrition surveys conducted in December 2006 showed a Global Malnutrition rate of 10%, rising to 20% in some municipalities. Since January 2007, nutritional screening activities in Androy, Anosy and Toliary regions have begun targeting children and women who will qualify for a nutrition rehabilitation program. Thus far, 40,000 children and 4,200 women have been screened, though heavy rains have brought some delays. Currently 4,772 children under five are under treatment for acute malnutrition, of which 505 are severe cases. This ratio can be inversed if there is a delay in the distribution by WFP or other partners of both supplementary ration (PREMIX) to the 4,237 moderately malnourished and of family rations to all children admitted to nutrition rehabilitation programs. In the Vatovavy Fitovinary region (South East) hit by cyclone Indlala, UNICEF and government partners (MoH and NNO) are putting the nutritional emergency response into place and will carry out further assessments this week. To date, 50,000 children under five in Nosy Varika are estimated to be at risk. The objective is to ensure that the active screening and early detection of malnutrition in Nosy Varika will be extended to other districts and lead to appropriate treatment and systematic follow-up.

Homelessness, child protection and schooling

The impact of the extreme cyclone season has affected about 420,000 people and temporarily displaced 64,000. Although most have been accommodated by relatives and local communities, some communities in the Indlala affected areas of the northwest have reportedly lost all household possessions, including shelter, clothing, cooking items, etc. In some areas, the displaced have been quartered in schools, churches and public buildings. There is need for shelter assistance in Sava, Diana, Sofia, Anala Jirofo and Atsimo Atsinana. Although figures concerning Indlala are being updated on a daily basis, 26,000 people have had their house totally or partially destroyed together with their domestic food stock and all their other belongings. Meanwhile, their fields were flooded and blocked in sand or mud, leaving the next harvest expected for July compromised. Sectoral assessments are undertaken in the accessible areas to determine the losses more precisely. 166 classrooms were reportedly destroyed or rendered unusable in the North following cyclone Indlala, while another 1,200 classrooms were damaged in the previous cyclones. Some schools require only replacement of school and learning supplies, while others require furniture and rehabilitation to structures.

In the Malagasy context, insufficient attention is paid to the psychological effects of natural disasters on children. Training of key actors for the provision of psychosocial support of children is still at an early stage of development. Capacity is therefore lacking in most affected communities. Although some training has occurred at the district and community levels in some parts of the country, efforts are required to ensure an understanding of Government and other counterparts of the importance of psychosocial support, and to enhance existing capacity for psychosocial programming.

Details of the Madagascar emergency programme can be obtained from:

Bruno Maes
UNICEF Representative
Tel: +

Pierrette Vu Thi
Tel: + 41 22 909 5601
Fax: + 41 22 909 5902

Gary Stahl
New York
Tel: + 1-212 326 7009
Fax: + 1-212 326 7165
Email :