UNICEF Ethiopia Humanitarian Situation Report No. 8: September 2021

Medicine
October 22, 2021

Highlights

Since January UNICEF reached almost 4 million people with safe water provision and treated over 330,000 children against malnutrition.
A total of 2,105,387 IDPs have been found to be displaced across Tigray, Amhara and Afar regions so far, out of whom 44 per cent are children and 51 per cent are women.
In September, 17,491 girls, boys, women and men were reached with child protection and gender-based violence (GBV) prevention and response services across the three conflict-affected regions of Tigray, Amhara and Afar.
Over 58,000 people have been affected by flooding and landslides in SNNPR Region. UNICEF delivered 200 cartons of High Energy Biscuits to reach 375 children and 225 pregnant and lactating mothers affected.
Altogether 4,800 displaced people in Somali region have been provided access to sanitation.

Situation Overview and Humanitarian Needs

Conflict-affected communities in Tigray region continue to see a breakdown in pre-existing social structures and justice mechanisms, which has resulted in safety threats including gender-based violence (GBV) and family separations. Women, girls, at-risk children, unaccompanied and separated children (UASC), and persons living with disabilities are disproportionately impacted by the risks presented by the conflict and by the absence of community support structures In line with these structural factors, the conflict in Tigray has driven an increment in reported GBV cases, which is believed to represent a small proportion of the GBV incidents that have taken place, given the lack of access to medical facilities in many parts of the region, as well as social stigma around reporting. Similarly, there has been a rise in the number of reported cases of family separation to access basic services.

A rapid assessment of the health system led by the health cluster in Tigray categorized 142 out of 249 health facilities (57%) as ‘priority 1’, indicating the severe looting and vandalism of the facilities and through which only basic services can be provided by mobile health and nutrition teams (MHNTs). Another 56 health facilities (22%) were defined as ‘priority 2’, which have recommenced some essential health care, but which lack some basic medical equipment. The remaining 51 health facilities (21%) are considered as ‘priority 3’ facilities, as they continue to provide most essential services, but which do not have adequate supplies and equipment as per the required minimum standards. The limited capacity of healthcare services in the region is further compounded by a vaccine stockout, preventing critical measles and polio campaigns from taking place for children under five.

The Ministry of Health September 2021 Emergency Response Plan noted that as of 6 September 2021, the data collected shows that nearly 17.5 per cent (175) of woredas in the country are affected by conflict. Around 271 health centers and 1,143 health posts giving service to more than 6.5 million people have ceased providing primary health care services to the community and more than 22 hospitals are currently not providing health care services.

In Tigray by the of end of September, UNICEF in collaboration with partners, has screened 1,117,352 children under five since the start of the conflict, albeit some children were screened more than once. Of the number screened, proxy sever acute malnutrition (SAM) averages around two per cent and moderate acute malnutrition (MAM) around 16.2 per cent. UNICEF and partners also conducted 276,768 screenings of Pregnant and Lactating Women (PLW) for whom proxy MAM averaged still significantly high, at 53.3 per cent.

In Amhara, according to the latest Therapeutic Feeding Program data reporting (August TFP), a total of 3,857 children U5 were admitted to the programme, which is 8.6 per cent higher compared to July data (reporting rate: 72.8%.). This current rise of SAM admissions does not reflect the true status of children in the region who are suffering from severe acute malnutrition. This is because 22 to 25 per cent of caseload reporting zones were missed due to siege and service interruptions/inaccessibility due to active conflict in Waghimra, North Wollo and some woredas of North Gondar zones. As for Afar, according to August 2021 Therapeutic Feeding Program data report, a total of 2,083 children suffering from SAM were treated showing a 4.5 per cent increment from July 2021.

In Afar region, the food security situation in the region is deteriorating. This is especially true in IDP sites. According to a recent Rapid Nutrition Assessment (RNA) conducted by Disaster Prevention, Preparedness, and Food Security Coordinator office (DPFSPCO) and UNICEF in Abala woreda and in the nine IDP sites in Fenti Resu zone, the result showed a deteriorating food security situation and critical malnutrition status. The malnutrition status (SAM) of children aged 6-59 months was found to be 2.7 per cent in Abala woreda, 21.3 per cent in Chifra woreda and 20 per cent in EwaAwra IDP site. A Rapid Nutrition Assessment is ongoing by regional ENCU in conflict affected woredas/IDP sites in Golina, Awra and Yalo woredas and IDP sites. As for Amhara, a find-and-treat campaign will be launched to assess all accessible conflict-affected woredas, led by UNICEF in collaboration with the RHB, to conduct a nutritional assessment and determine the needs.

Schools are about to reopen across Ethiopia; however, the Education Cluster’s unofficial estimate indicates that around 2.7 million children remain out of school due to the recent conflict across the northern area. In September, the Afar Regional Education Bureau led a multi-agency assessment together with UNICEF in woredas affected by the conflicts (6 woredas from Zone 4, 1 woreda from Zone 1 and 6 woredas from Zone 2). The assessment identified that over 450 schools are affected by the conflict; 38 primary schools and 6 Alternative Basic Education (ABE) centers were destroyed following the conflict. In general, a total of 88,846 (42% female) students enrolled in 455 schools and 2,515 (17% female) teachers from 13 woredas of Zone 1, 2 and 4 are affected by the current conflict and 44 schools in four woredas of Fenti zone (Yallo, Ewa, Awra and Gulina woreda) require reconstruction of classroom blocks and refurbishment. In addition, 82 primary and seven secondary schools in Fenti zone Teru woreda, Awsi zone Chifra woreda and SemeraLogiya town administration where 14,595 (46% female) and 6,381 students (40% female) respectively were damaged by IDPs occupying the schools as shelter, and require maintenance work, while 15 schools in Fenti zone (Yalo, Ewa, Awra, Gulina and Teru woreda) and Awsi zone Chifra woreda continue to serve as IDP shelters. Student registration in Zone 4 woredas has been suspended due to the damage forcing children to stay out of school until IDPs are relocated and schools are rehabilitated.

The damage to WASH infrastructures would require replacement of looted or destroyed electromechanical (switch boards, generators and pumps) and extension of the network to areas hosting IDPs. Based on RWBs assessment conducted and estimated in hard-to-reach areas, around 2 billion ETB (US$51 million) is required to fix the damages and restore WASH services, including both water and sanitation facilities. Recent assessments in war affected areas of Amhara and Afar regions have indicated similar levels of damages to water supply infrastructure, with up to 57 per cent of the boreholes reported as damaged/looted or non-functional. The operational constraints in Tigray has led to a significant reduction in water trucking operations reported to be 98 trucks in June and now only 36 are operational. It is estimated that in most IDP locations water per capita is as low as 6 liters per day

Based on an assessment conducted by the Oromia Disaster Risk Management Commission, approximately one million people (16% children) in Bale, East Hararghe, West Harargie, West Arsi, East Bale, Guji, West Guji and Borena zones are facing critical water shortages. The drought conditions observed since mid-April continue to affect communities and their livelihoods following water rationing measures across affected communities. There are increasing immediate needs, as the need to accelerating early detection and treatment of malnutrition, providing access to clean and safe water and case management services for the most vulnerable children. The data from the Displacement Tracking Matrix (DTM) Site Assessment Round 26 indicates that Oromia region now hosts over 490,000 IDPs, however new displacements in the region have been observed as continued unidentified armed groups (UAGs) attack civilians and active military operations has triggered further displacement of individuals.

The Southern Nations Nationalities and People’s Region (SNNPR) Disaster Risk Management Commission (DRMC) reported that over 58,000 people have been affected by flooding and landslides due to heavy rain and winds in Halaba zone (Atote Ulo, Wera and Wera Dijo woreda), Keffa Zone (Chena, Giwata and Gesha woredas), Wolayta zone (Kindo Didoye and Kindo koysha woreda), Silte zone (Belosso Bomabe, Damot Woyde, Alicho Wereo woreda), Gamo zone Gaco Baba woreda, Gurage zone (Geta, Gunnera and Gedbama woreda). In South Omo zone Dasenech woreda, flooding was due to the overflow of Omo river and the back flow of Lake Victoria. Currently, out of the total people affected, more than 36,000 people are displaced, including over 5,600 children under the age of five and over 1,200 pregnant and lactating mothers from 32 kebeles of Dasenech woreda to three IDP sites (Lebemuket, Neberemus and Selegn IDP sites). The flood has also had an impact on school preparation for the upcoming academic year, as well as the education of an estimated 232 pre-primary students (109 girls) and 1,076 primary school children (370 girls) enrolled in the flood affected schools.

In IDP sites in Konso zone and returnee sites in Gedeo zone, there are more than 24,000 children who are in need of multisectoral services, such as child protection, health, education, nutrition, and psychosocial support (PSS). Although partners continue to provide services, some sectors, including education and GBV, are severely constrained due to funding shortages and lack of specialized partners operating in the affected areas.

An assessment on availability of education service for asylum seeking children was conducted by UNICEF at the Pagak entry point in Gambella. The result of the assessment indicated that approximately 1,000 school-aged children have not been accessing education for the last year due to the unavailability of education services and lack of support for children. Furthermore, UNICEF conducted an assessment at nearby host community school and there is a lack of facilities and teachers to accommodate the asylum seekers.

UNICEF conducted a joint multisectoral assessment between 13 and 26 August 2021 in Siti zone, where nearly 32,500 people were displaced from Garbocise and its surroundings due to the conflict with Afar. The situation also affected over 161,000 people across the zone who are hosting IDPs in Ma’ayso, Afem, Erer and Bike woredas. The displaced populations settled in 12 sites across the four woredas. Most IDPs are hosted by the community while others are sheltered in schools and woreda administration buildings. Additionally, more than 8,280 school age children currently displaced in the conflict devastated villages of Adeyti, Undufo, Garbocise and Dallahelay have had no access to education. In most of the affected areas, people are experiencing drastic shortages of water supply and very poor access to sanitation facilities.

In this reporting period the number of IDPs in Benishangul Gumuz has reached over 368,000, about 2,000 new IDPs are displaced from Odda Bidiiglu woreda in Assosa zone. From the total IDPs, about 57,200 are under 5 children and approximately 20,000 are pregnant and lactating women. Over 280,000 IDPs have settled in Metekle zone 7 woredas in 19 collective sites and the rest have settled in 5 woredas in Kamashi zone and 3 woredas in Assosa zone. From the affected woredas only five are fully accessible (Pawi, Dangur, Bambasi, Assosa, Sherkole), 4 woredas are partially accessible( Mandura, Dibate, Bullen, Bildiglu) and the remaining 7 woredas (Sedal, Yasso/Zai, Kamashi, Mijiga/Below and Agalomiti/Dembe, Guba and Wombera) are fully inaccessible. Due to the conflict in the region, is estimated that about 16,000 under one-year children and 57,000 under five children do not have regular access to routine immunization and essential health and nutrition screening services in the past 6 months.

Ethiopia continues to report COVID-19 cases. By the end of September 2021, a total of 345,674 confirmed cases with 5,582 deaths (case fatality rate (CFR) =1.62%) were reported since the onset of outbreak in March 2020. A total of 312,806 (90.5%) patients were reported to have recovered. was A progressive increasing trend of confirmed cases has been recorded in the last two months. The monthly report of August and September showed sixfold and ninefold increment of confirmed case respectively compared to the month of July. As of 30 September, a total of 7,940,790 COVID-19 vaccines doses have been received in country and 8,073,805 doses are in the pipeline. Altogether 3,753,523 doses were administered to 2,881,533 people, of whom 1,693,977 people received the full dose.

Source: UN Children’s Fund