UNICEF Humanitarian Action: Niger Donor Update 19 Sept 2005

- To date 88,600 malnourished children have been admitted to UNICEF-supported therapeutic and supplementary feeding programs.
- UNICEF and WFP have ensured that an additional 133,000 siblings of children admitted to feeding programs receive protection rations to prevent malnutrition.

- UNICEF and WHO have developed a national protocol for the management of moderate and severe malnutrition, and have trained 203 health professionals to respond effectively to the nutrition crisis.

- UNICEF is collaborating with the government and WHO to contain the cholera outbreak.

1. EMERGENCY OVERVIEW AND RECENT DEVELOPMENTS

Niger's acute nutrition crisis is caused by a variety of structural factors, such as rapid population growth, unsustainable farming practices, massive poverty, lack of access to essential health services, and intrahousehold inequities that disfavour women and children, including poor child feeding and childcare practices.

These are further compounded by negative regional trends in cereal prices, as well as conflicts that hinder labour migration during the lean season. Due to these structural causes many children continue to suffer from acute and chronic malnutrition.

Localized nutrition surveys in the most affected areas (Tahoua, Maradi and Zinder) found that an estimated 20% of children under five years old suffer from acute malnutrition (3% severe malnutrition and 17% moderate malnutrition). These rates are comparable to those observed in some of the world's worst emergencies, including in conflict zones. In the areas most affected by the food crisis, as many as 192,000 children under the age of five are affected by acute malnutrition. UNICEF's response is targeting these and other areas exhibiting high malnutrition rates among children.

In order to respond to the structural causes of the current crisis UNICEF, together with the government of Niger and other partners, is developing a national nutrition strategy that will address the food and non-food determinants of children's nutrition status.

2. UNICEF RESPONSE: ACTIVITIES, ACHIEVEMENTS AND CONSTRAINTS

UNICEF regular and emergency nutrition programs have been scaled up to provide support for the government and to coordinate a network of 20 national and international NGOs in their efforts to reach a minimum of 192,000 children suffering from acute malnutrition. In line with its Core Commitments for Children in emergencies, UNICEF's overall emergency response focuses on nutrition, health, water and sanitation and protection activities.

Nutrition

As lead agency for the nutrition sector response, UNICEF chairs weekly meetings with Government and national and international NGO representatives in Niamey to review progress and constraints. Similar region-based coordination meetings are held in affected regions (Zinder, Maradi, Tahoua, Tillaberi). UNICEF has also coordinated with the Ministry of Health, UN agencies, and NGO partners for the development and adoption of a national protocol for the management of acute malnutrition and the development of a national capacity building strategy to train front-line workers in the management of acute malnutrition.

UNICEF is working with 20 national and international NGO partners, including Action Contre la Faim (ACF), African Muslims Association (AMA), BALD, CARE, CONCERN, French Red Cross, International Federation of Red Cross and Red Crescent Societies (IFCR), GOAL, Hellen Keller International (HKI), Islamic Relief, Mercy Corps, MSFBelgium, MSF-Spain, MSF France, MSF-Netherlands, MSF-Switzerland, PLAN Niger, Save the Children-UK, Samaritan's Purse, World Vision. UNICEF provides therapeutic foods (F75, F100, Plumpynut), supplementary foods (Unimix and oil), micronutrient supplements, essential drugs, impregnated mosquito nets and anthropometric materials through fixed and ambulatory nutrition centres in the affected zones. All partners provide weekly reports on the establishment of nutrition programs and the number of children treated for severe or moderate malnutrition.

As of September 15th, there were 398 child feeding programs operating across the country. Since July 1st, 88,600 malnourished children have been admitted to these feeding programs: 26,300 children with severe malnutrition and 62,300 children with moderate malnutrition. In partnership with WFP, an additional 133,000 children under five who are siblings of children admitted to feeding programs receive protection rations to prevent malnutrition. Protection rations are made of CSB (Corn-Soya Blend), oil and sugar. This ration ensures an average (additional) 500 Kcal/day to siblings of children admitted to feeding programs.

UNICEF, CDC, the Government of Niger and other UN agencies are collaborating on a nutrition survey to assess the extent and severity of the current nutrition crisis, document the non-food components of the crisis as they affect children (feeding, care, health, water, hygiene and gender), and provide an evidence base for advocacy and planning.

UNICEF – in coordination with WHO and the Ministry of Health (MOH) – also provides support for the training of trainers and health workers in dealing with malnutrition. This newly-acquired technical capacity is put to use in government and NGO nutrition centres throughout the country. So far, 203 health workers have been trained and a roll-out plan for the training of an additional 105 workers has been developed to ensure that training benefits all regions.

Health

The health protocol established for the treatment of severely and moderately malnourished children includes measles vaccinations, verification of immunization status and other vaccinations if needed, treatment of acute respiratory infections (ARI), skin, eye, malaria and diarrhoea if needed, and free distribution of impregnated nets.

UNICEF is working to protect children from malaria through the free distribution of impregnated nets to malnourished children and pregnant women. Out of a total of 130,000 bed nets under procurement, 50,000 are currently being distributed to nutrition centres and to ante-natal care health services located in areas affected by the food crisis. 31,000 severely malnourished children and 19,000 pregnant women are targeted for this first distribution.

As we are currently facing the peak period for malaria, UNICEF has ordered anti-malarial drugs to treat 8,000 severe cases. The MOH and UNICEF are also planning to organize massive campaigns to re-treat bed nets with insecticide, targeting 500,000 households (a total of 1,000,000 bed nets) in the areas affected by the crisis.

In addition, UNICEF is expecting a donation of 1,800,000 bed nets from the Global Fund to Fight AIDS, Tuberculosis and Malaria. The nets will be distributed during the polio NIDs (National Immunisation Days).

UNICEF is also collaborating with the government and WHO to contain the current cholera outbreak. As of September 12th, 404 cases and 40 deaths have been registered in the Tahoua region. UNICEF has ordered stock for the treatment of 1,000 cases in addition to ORS, calcium hypochlorite, ranger lactate and spraying equipment. A joint MOH/WHO/UNICEF assessment mission will take place this week (19-24 September) in the affected areas to better respond to the outbreak.

Free Access to government health services

UN agencies, bi-lateral donors and the government of Niger are discussing the establishment of a "Solidarity Fund" which would enable free access to health services during this crisis. Many malnourished children have been unable to obtain adequate treatment due to the recovery cost charged by government health centres.

UNICEF is spearheading this initiative with US$ 110,000 to immediately facilitate free access for malnourished children to 4 government hospitals and 6 health centres in Niamey, where few NGOs are operating. This is in addition to providing drugs, vaccines, impregnated bed nets, therapeutic and non-therapeutic supplies in government hospitals and health centres.

Food Security

UNICEF is supporting cereal banks at the village level to enhance food security and empower women in the management of food. Since April, UNICEF has delivered 614 T of cereals to 200,000 people, including 40,000 children and 12,000 pregnant and lactating women. We have also delivered 6 T of cereal seeds and gardening seeds to 25 women's groups.

Water and Sanitation

Water supplies such as jerry cans, buckets, soap and water purification tablets will be provided to the mothers of malnourished children upon their discharge from health and nutrition centres.

A UNICEF consultant is currently undertaking an assessment mission across the country to review the water and sanitation situation at health and nutrition centres. Early reports indicate that where limited water is available, sanitation is more problematic and requires prompt action.

UNICEF has initiated water and sanitation technical meetings with government, bi-lateral, and NGO participation.

The group has urged the dissemination of hygiene promotion messages and the repair of community-based water points.

Protection

UNICEF has developed a leaflet on the code of conduct for humanitarian workers and the protection of women and girls from sexual abuse. The leaflet will be disseminated to all humanitarian workers in the affected regions.

3. APPEAL REQUIREMENTS AND RECEIPTS

UNICEF launched an appeal for US$ 14,616,000 on 28 July to respond to the immediate and medium-term needs of children and women, especially in the field of nutrition, health, water, sanitation and protection activities. As of 15 September, UNICEF has received generous contributions totalling USD 17.4 million. The situation in Niger remains of concern, however, and UNICEF's appeal requirements may increase in the future in order to respond to thes longer-term needs of children and women.

The list of donors and contribution as of 15 September is as follows:

Details of the Niger Programme can be obtained from:

Aboudou K. ADJIBADE
UNICEF Representative
Niger
Tel : (227) 723008 – 723724
Fax : (227) 733468
E-mail : aadjibade@unicef.org

Olivier Degreeef
UNICEF EMOPS
Geneva
Tel: + 41 22 909 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