Somalia: Acute Watery Diarrhoea (AWD) outbreak DREF MDRSO006 operation final report

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A. Situation analysis

Description of the disaster

Somalia is prone to a cycle of natural disasters such as drought, flooding and tropical cyclones because of climate-change phenomena of La-Nina and El-Nino. Early indications of the country experiencing food insecurity emerged in September 2015 and in February 2016. The Somaliland and Puntland authorities subsequently issued separate alerts with Appeals to humanitarian agencies and donors for support to the drought response. The drought conditions continued through 2016 and worsened from November, affecting more that 50 percent of the population. Country-wide, the cumulative total displacements, directly attributable or related to drought between 01 November 2016 and 31 March 2017, was 535,624 (UNHCR, April 2017). Loss of livelihoods, mainly livestock, shortage of water, pasture and food due to the drought have been responsible for these displacements.

Drought naturally contribute to trigger increases in epidemics such as Acute Watery Diarrhoea (AWD)/Cholera and measles, some of which are cross-border outbreaks. A total of 77,133 case of AWD and 1,159 deaths were reported in different parts of Somalia from January to September 2017. Of these cases, 58.8 per cent have occurred in children below five years of age.

There has been a gradual reduction in the number of new AWD/Cholera cases in all regions of Somalia since August 2017. No cholera related deaths have been reported across this same period in any region across Somalia.

The number of AWD/Cholera cases has declined from a peak, at the beginning of June (week 22), of 5,306 cases to the latest reported and lowest number of 93 cases in the third week (week 33) of August. Similarly, the AWD Case Fatality Rate (CFR) has decreased from its peak of 4.7 percent in February 2017 to zero per cent in August.

As at 2 April 2017, Puntland had a cumulative reported case of AWD/cholera since the beginning of the year at 1,674 and 57 deaths, indicating a case fatality rate (CFR) of 3.4 percent. In Somaliland, the AWD outbreak reported as at 10 April in the Buuhole community on the Somaliland/Ethiopian border was 291 cases and 14 deaths, indicating a CFR of 4.8 percent. Since the beginning of the year, communities with most reported AWD cases in Puntland were Goldogob, Jariban and Galkayo (IDP camps) in the Mudug Region, Bosaso (mainly in the Tawakal IDP Camp) in the Bari region and Garowe (Washington IDP camp), Eyl and Burtinle in the Nugal Region. In Somaliland, the reported cases were in the Buuhole district as well as pockets of Teleh in the Sool region areas in the Toogdheer and Awdal regions respectively. This brought the total number of affected regions in Somaliland and Puntland to six.

The IFRC has supported the National Society to respond independently to the reported outbreaks so far, this year, including chlorination, case management and social mobilization or to collaborate with partners such as UNICEF, WHO and the Ministry of Health as well as other actors such as WVI, SCI, HPA and IOM in the responses in Puntland and Somaliland.

The AWD outbreaks appeared not to be abating and hence the need to scale up the National Society’s preparedness, response and social mobilization capacities. Priority areas of focus in this regard were the provision of AWD/cholera supplies, training of staff and volunteers in case management, active surveillance with tools to undertake that, provision of sanitation equipment to target communities and enhanced community mobilization interventions with support of the DREF.