joint assessment: afar idps situation€¦ · executive summary there was a joint assessment...
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UNICEF, UNOCHA & WFP
April 2020
JOINT ASSESSMENT: AFAR IDPS SITUATION
EXECUTIVE SUMMARY
There was a joint assessment mission from 26 March -1 April 2020 in zone 1 and 3 woredas in Afar. The
purpose was to understand the current IDP situation, identify needs and gaps including durable solutions.
The monitoring team identified some 35, 406 people who have been displaced from Bordering areas of
Issa to a different site within the zones since December 2019 and they are living with the host
communities. The mission was undertaken by UNICEF, WFP and OCHA and the monitoring team
discussed with woreda authorities, sector offices, IDP communities, AMREF, and SCI. The team also
interviewed IDPs in Haruka and Gelalo IDP sites in zone 3 and had direct observations in the settlement
sites. During the assessment, there are very few humanitarian partners providing support to the affected
communities, however, the regional government providing food with the National Disaster Risk
Management Commission (NDRMC) with both relief and PSNP and water trucking.
Key Findings and Recommendations:
• Based on the bilateral discussion with government and Partners (AMREF and SCI) zonal convid-19
task force established, and meetings have been held in zone three. The meeting is led by the
government (zonal administration) and co-chaired by NGOs working in the zone. The task force has
the plan to establish the Isolation Center in Berta hospital.
• Some 35,406 new IDPs influx are living within the host community and in different collective sites
will require urged humanitarian assistance and protection support in zone 1 and 3 woredas.
• Food, Health and Nutrition, WASH and ES/NFIs are a top priority as most IDPs are living in a
crowed situation in a temporary shelter and others live without shelter in the Kebeles and Woredas
towns together with the host community. The regional government in collaboration with NDRMC
distributed emergency food assistance but Still, huge gaps remain in food and Non-food items.
• Mainstreaming protection principles in the provision of service delivery across all humanitarian
sectors is vital to maximizing the impact of interventions for the affected population, by enhancing
the safety and dignity of the community and ensuring meaningful access to services.
• The durable solution includes providing livestock, livestock feed, materials for housing and cash to
restore their livelihood is needed.
BACKGROUND
The conflict between ethnic groups of Afar and Somali/Issa community on pasture and water has long
history mainly in Zone one and three woredas but the nature of the recent conflict is an exception as
described in the region, woreda and community level. The conflict since the beginning of October 2019
escalated and resulted in the loss of many lives, displaced many people and damaged their properties and
assets. according to the Afar regional Disaster Prevention, Preparedness, and Food Security Coordinator
office (DPFSPCO), the number of IDPs reported 46,225 people from seven woredas in zone one and three
of the region but inaccessible due to security situation. As a result, movement, communication, and trade
between the two communities are not possible. Thus, the humanitarian needs of the displaced peoples did
not assess well. According to the recent joint assessment report, which was conducted by the regional
DPFSPCO, IOM and IRC in the first week of March 2020 a total of 35,406 new IDPs influx are identified
due to the recent conflict since two to three months.
Table 1. Number of IDPs due conflict in Afar Region,
S/No
Zone
Woreda
IDP sites
No HHs IDPs
Individual
Causes
Remark
1
Awsi Rasu (zone
1)
Mile
6
670
4020
Conflict
Visited by the team
2
Awsi Rasu (zone
1)
Garani* (new woreda)
11
1944
11664
Conflict
Visited by the team
3 Awsi Rasu (zone
1) Chifra 1 100 600 Conflict
4
Awsi Rasu (zone
1)
Afambo
1
360
2160
Conflict
Visited by
the team
Subtotal 19 3074 18,444
5 Gabi Rasu (Zone
3) Gelalo 2 700 4200 Conflict
Inaccessib
le due
conflict
6 Gabi Rasu (Zone
3) Gewane 1 200 1200 Conflict
7
Gabi Rasu (Zone
3)
Hanruka** (new woreda)
5
1927
11,562
Conflict
Sub Total 7 2827 16,962 Conflict
G/total 26 5901 35,406 Conflict
WATER, SANITATION AND HYGIENE
WASH situation
This assessment was conducted by physically present to three of the seven woredas affected by the
conflict. The assessment was conducted with the main purpose to identify major existing available water
supply sources and sanitation interventions, interventions to-date and with the final aim of providing
conclusion and context specific recommendations to the IDP situations. To collect primary information,
woreda water offices and woreda health offices were contacted by physically presenting to the IDP sites.
Information regarding types of water supply sources, availability of both batch community water supply
and household water treatment chemicals, availability of household and community level water supply
storage, types of sanitation facilities, to-date interventions and potential WASH partners for future
interventions were collected.
Responses
It is identified that all the IDPs in Amibara and Hanruka woreda are 100% dependent on water trucking
by the government as permanent water sources are very far from where they settled. Except one newly
established IDP, the rest of the IDPs in Gelealo have settled in four kebeles were three kebeles are accessed
by a Burka multi-village which is under construction by UNICEF and the other kebele has a permanent
water supply scheme. The team has learned from Mille that it is only 15% of the IDPs have access to safe
water and the rest depend on river Awash. However, one of the hosts kebele has permanent water supply
which is currently non-functional. It is also learned that all previously UNICEF supplied household water
treatment chemicals were distributed to more than 500 households in Amibara woreda.
Sanitation and hygiene wise almost 100% of the IDPs visited practice open defecation and as there is high
shortage of water supply, hygiene practices are very poor. However, it is learned that the respective woreda
health offices have provided health education through their health extension workers and provided hygiene
messages through previously UNICEF supplied IEC/BCC materials. Additionally, the respective woreda
health and water offices have provided laundry and body soaps and household water storage materials to
15% of the IDPs in Amibara and Hanruka and 25% of the IDPs in Mille.
GAPs
➢ IDPs in Amibara, Hanruka, more than 85% of the IDPs in Mille, Chifra, Afambo and 100% Gerani
woreda lack access to safe water.
➢ There are no available both community and household level water treatment chemicals leaving
the more IDPs directly use water from unprotected sources with any treatment.
➢ There are no available community and household level water storage mechanism. Most of the IDPs
doesn’t have water container to be used both for storage and chemical treatment. Though there are
supply and distribution of household water treatment chemicals, not all the IDPs have the
appropriate containers at household level.
➢ Almost 100% of the IDPs in hosted by community and those settled separately practiced open
defecation.
➢ As there is lack of availability of water supply, the hygiene status of the IDPs is found to be very
poor.
Potential NGO partners in WASH
The team had also accessed the availability of potential partners in each respective woredas currently
implementing WASH interventions along with other sectors in line with UNICEF intervention areas. As
a result, the team has learned that AMREF and SCI are present in Amibara implementing a multi-sectoral
intervention along with WASH. CARE Ethiopia is implementing WASH interventions and currently
provided household water storages and water treatment chemicals including the provision of the transport
service during the distribution. It is also learned that the woreda health and water offices are mostly happy
by what AMREF health Africa is doing in Amibara. There is another local NGO called Rohi Wedu which
is under establishment planning to implement health and WASH interventions in Amibara woreda. As
Hanruka is a new woreda separated from Amibara, there are no NGOs operating and moreover, the
government structure is still not existent. In Mille CARE used to be the major NGO providing permanent
WASH interventions but currently phased out and there are no other partners.
Recommendations
Short Term
Immediate provision of life saving safe water supply through water trucking in Amibara, Mille,
Garani, Gelealo and Chifra.
Provision of batch chlorination for IDPs receiving water supply through the means of water trucking
and establishment of water quality monitoring system in place.
Provision of water treatment chemical mainly PUR for IDPs depending on river water in Mille and
Afambo.
Rehabilitation and maintenance of Ferede water supply scheme in Mille.
Supply and installation of Emergency Water Kit in Afambo and Mille.
Provision of household water storage and community level water storages with a minimum of 10,000
liters.
Provision of key messages on sanitation and hygiene through available means including key messages
in prevention and control of COVID-19.
Supply and distribution of sanitation materials/kits including body and laundry soaps and menstrual
hygiene materials for women and adolescent girls.
Long Term
Most of the IDPs settled in other communities and are stressing the available water supply in the
host community. Therefore, additional borehole drillings are required.
Drilling of one borehole in Hanruk which was planned to be drilled by the Afar Pastoralist and
Agricultural Bureau through the Italian Development Cooperation Fund.
Regional health bureau and respective woreda health office to provide a community mobilization
for a collective decision to end to an open defecation practices in communities where IDPs settled
and where the IDPs going to settle for permanent time.
Rehabilitation of non-functional community water supply schemes in Mille, Chifra and Amibara.
Provision of permanent water supply system in Afambo, Garani, Gelealo, Amibara and Hnaruka
through drilling of boreholes and multi-village construction.
HEALTH & NUTRITION
Health service in the assessed woredas with IDPs has been provided in two hospitals,12 health centers, 37
health posts, one MHNT and 285 all type health workers and 84 health extension workers.
At present there are no health facilities damaged by the conflict. But in Millie woreda four health HPs and
some MHNT sites are affected and not functional due to the conflict. The MHNT in Gelaelo woreda is
not working since the car is damaged by accident. due to this some IDP sites and 11 kebeles in the woreda
are deprived the basic preventive and curative health and nutrition services. According the Amibera health
office report the insecurity in Gedamaitu health center (an area more Esa-Somalias found ), hampered the
connection between the woreda health office and the health center and interrupted the support for the
health center as a result of the conflict and did not able to provide medical supplies to the health center.
During the visiting time there was no reported outbreak in the woredas with IDPs. However, there were
reported outbreaks of measles and dengue fever in Millie woreda and chicken Guinea in Amibrea woreda
at the host community in the last months. The risk of disease outbreaks such as AWD, measles and malaria
are very high due to the lack of enough shelter, poor access to safe water and sanitation, and suboptimal
access to essential health care services. Meanwhile Amibera woreda reported that there was unusual
increment of malaria cases in the woreda 500 cases per week and the woreda tried to conduct outdoor
residual spray in selected areas and distributed around 3000 ITNs to the kebeles which had prevalent
problem. The situation might be aggravated by emergencies including the volatile conflict situation and
floods, as there are some IDPs in the woredas displaced by flood which can overstretch the humanitarian
assistance.
Health service treatment in the woredas with IDPs is provided in the host community health facilities with
treatment cost for the IDPs including the persons injured by the conflict and referred and admitted in
Adama and Mohammed Aklie hospital. Persons from the IDPs cannot afford the treatment payment and
specially the injured persons referred and admitted in different hospitals inside or outside the region. The
IDPS are accessing and using the health services of health centers and health posts in the host community
out of their kebeles and villages by walking an average of above two hours. Deployment of IDP focused
health workers and health extension workers should be considered by the woreda health office. The health
service access of the IDP especially access to services for children, pregnant and lactating mothers need
more focus and outreach health and nutrition services should strengthen using different modalities like the
available MHNT and establish temporary mobile teams in the woredas, by the woreda through the support
of different partners working in the areas. Strengthening of the health facilities in the woredas with IDPs
by enough drugs availability and capacitate the HWs and ensuring the free treatment for those they cannot
afford the treatment cost. In most of the visited woredas, the woredas have reported that pneumonia,
malaria, typhoid, upper respiratory tract infection/URTI, diarrhea and malnutrition are the most causes of
diseases morbidity in the woredas with IDPs.
Most of the woredas mentioned that they had shortages of drugs like Amoxa syrup, paracetamol, anti-
malaria (coartem), RDT, anti-acid, oxytocin and others in the last three months.
Prepositioning and provision of vaccines, Emergency Drug Kits/EDK, ITN, cholera CTC kits and
strengthen the surveillance system and monitor the health emergency response in the woredas with IDPs
is basic thing.
Immunization:
The EPI service is provided in the all the visited woredas including the IDPs though the coverage is not
satisfactory specially in the hard to reach areas where the IDPs and hosting communities are living. They
have a challenge on reaching the remote areas with IDPs. The visited woredas with IDPs have reported
that they did not encounter any vaccine shortage and they have functional cold chain system in the
woredas. The immunization program has been provided by static and outreach approach in the kebeles
including the IDPs. But to strengthen the outreach program needs support in operational cost aspect.
Vaccine preventable measle disease outbreak was occurred in Millie woreda in the last month and sample
collected and sent to EPHI. mini campaign vaccination intervention was also undertaken in the woreda to
control the outbreak. So, ensuring Measles vaccines availability in the woredas with IDPs is essential
since the woredas are very susceptible to measle outbreak and to strengthen the preventive care of EPI.
Table 2: Woredas with IDP sites with Type and number of health facilities and HWs, HEWs and MHNT
Name of
woreda
Total
number of
health
professional
in the
woreda
Number of HFs Functionality of the health facility Number
of HWs
all type
available
Number of
HEWs
/FLHW
available
MHNT
Hospital HC HP Hospital HC HP
Amibera 1 5 20 1 5 20 190 36 0
Gelaelo 0 3 13 2(one HC is
damaged by
flooding)
8(2 HPs
damaged
by flood)
53 32 1(not
functional)
Millie 1(nonprofit) 5 15 1 5 9 42 16 1
Total 2 13 48 2 12 37 285 84 2
Nutrition key findings of the assessment:
Screening of children and pregnant and lactating women:
Nutritional screening is conducted by HEWs in most of the visited woredas with IDPs using
MUAC to identify the nutritional status of children and PLW. Screening is conducted on quarterly
basis. The latest screening was conducted in the visited woredas in Jan,2020 showed that the level
of malnutrition was high in the host communities. Separate IDP focused screenings have not been
conducted in the woredas and the screening is undertaken with the hosting community: The proxy
Global Acute Malnutrition (GAM) prevalence was 15.9%, 13%, and 15.9 % in Amibera, Gelaelo,
Millie respectively. The MAM caseload for children 6-59 months reaches 645 in Amibera and 638
in Gelaelo and 1,797 in Millie woredas respectively. Nutrition situation for PLWs is also seriously
concerning in the IDPs and host communities in the woredas. Treatment of children and PLW with
MAM is a big challenge in Amibera and Gelaelo woreda as the there is no TSF program since the
Amibera woreda is priority two woreda and Gelaelo woreda is P1, but it is reprioritized due to
shortage of TSFP supply. Therefore, the children and PLW identified with MAM in Amibera and
Gelaelo woredas are not covered by TSFP. Millie woreda has TSF program and children and PLW
identified with MAM malnutrition are treated with TSFP. Relief food distribution and PSNP
program are implemented in all the mentioned woredas. Meanwhile children detected with sever
acute malnutrition/SAM during the screening are referred to the TFP sites.
Nutritional screening was operated in the visited woredas with IDP in the host community in
January 2020 and the result of the screening using MUAC:
Table 3: CHD screening result for children 6 -59 months based on January 2020:
Woreda
Population
Children 6-59 months age
Target
population
(6-59
months)
No of
children
screened
(6-59
months)
screening
coverage
%
No of
children
with
MUAC
>=12
No of
children
with MUAC
11 -11.9 cm
No of
children
with
MUAC
<11 cm
No of
children
with
bilateral
edema
% of children
screened
with MUAC
11-11.9 cm
% of children
screened with
MUAC less than
11cm
% of
GAM
Afambo 29,625 3970 2842 72 2,784 41 17 0 1.4 0.6 2.0
Millie 113,911 11505 11394 99 9,587 1,797 10 0 15.8 0.1 15.9
Amibara 85,500 11457 10351 90 9,609 645 94 3 6.2 0.9 7.1
Gelaelo 39,141 5245 5163 98 4,490 638 35 0 12.4 0.7 13.0
268,177 32,177 29,750 92.46 26,470 3,121 156 3 10.5 0.5 11.0
Table 4: CHD screening result for PLW based on January 2020:
Woreda
Pregnant and lactating women (PLW) screening result January, 2020
Percentage of MUAC <23
cm PLW
Target
population PLW
Number of PLW
screened
Screening
coverage Number of PLW with MUAC <23 cm
Afambo 1,037 959 92 90 9.3
Millie 3,987 3,220 81 1,709 53
Amibara 2,993 1,855 62 580 31
Gelaelo 1,370 1,368 100 777 57
9,386 7,402 79 3,156 43
Micronutrient supplementation programs: Vitamin A supplementation and deworming
The woreda health offices reported that they have provided Vitamin A supplementation and
deworming with collaboration of RHB and UNICE through the CHD campaign integrated along
with nutritional screening of children and PLW for the host community and IDPs dispersed in the
hosting community in January 2020. But there was no any separate vitamin A supplementation
and deworming provided focusing on IDPs and there is no separate data for the IDPs. 30,011
children 6-59 months were supplemented with vitamin A (83.51 %), and 20,130 children 24-59
months received mass deworming prophylaxis (84.3 %) in the visited woredas who have IDPs.
Table 5: Results of vitamin A supplementation and deworming in the woredas as January 2020.
S
N wareda
Total
populatio
n
Vitamin A Supplementation Deworming
Target
population
(6-59
months)
No of
children 6-
11 months
supplemen
ted with
Vit. A
No of
children
12-59
months
supplemen
ted with
Vit. A
Totally
supplemen
ted
Vit. A
supplementat
ion coverage
% (6-59
months)
Target
populati
on (24-
59
months)
No of
children
deworm
ed (24-
59
months)
Dewormi
ng
coverage
%
1 Afambo
29,625 3,970
387
2,455
2,842
71.6
2,514
2,009
79.9
2 Mille
113,911
15,264
1,526
9,849
11,375
74.5
10,138
8,651
85.3
3 Amibera
85,500
11,457
1,508
9,136
10,644
92.9
7,610
6,050
79.5
4
Buremedait
u/Gelaelo
39,141
5,245
569
4,581
5,150
98.2
3,484
3,420
98.2
Total
268,177
35,936
3,990
26,021 30,011 83.51
23,868
20,130
84.3
Community based management of acute malnutrition/ CMAM
The woredas mentioned that, the woreda health offices with collaboration of RHB, UNICEF and
other partners is delivering life-saving nutritional services, which include the treatment and
management of severe acute malnutrition/SAM in children under the age of five in the host
community and the IDPs dispersed in the host community are also benefiting from that . In the
visited woredas with IDPs, 46 health posts and six MHNT OTP sites are providing OTP services
and there are nine health center and one hospital which is providing inpatient management of SAM
in SCs. There is no damaged health facility by the conflict. But there four health posts and some
MHNT sites interrupted its nutritional services due to the conflict in Millie woreda and MHNT in
Gelaelo woreda is not functional given the car is damaged by accident.
Table 6: Woredas with IDP sites with Type and number of health facilities, Nutritional centers, HWs,
HEWs and MHNT
Name
of
wored
a
Total
number
of
health
professi
onal in
the
woreda
Number of
HFs
MHN
T
Numbe
r of SC
center
Number
of OTP
center
static
MHNT
OTP
Number
of HWs
all type
availabl
e
Number
of HWs
trained
in
CMAM
Number of
HEWs/FL
HWs
available
Number
HEWs/FLH
W/HW
trained in
CMAM/OT
P
Hosp
ital
H
C
HP
Amibe
ra
1 5 20 No
MHN
T
4 26 No
MHNT
190 5 32 47
Gelael
o
0 3 13 1(not
functio
nal)
2 8 Not
functiona
l
53 2 32 4
Millie 1(no
npro
fit
5 15 1 3 12 6 42 6 16 19
Afamb
o
0 No No
MHNT
Total 1 1
3
48 2 9 46 6 285 13 80 70
UNICEF is providing nutritional supply such as RUTF, F-75 and F-100 TM, Resomal,
Mebendazole, Amoxicillin, SC Kit, TFP Opening Kit, OTP card, Multi-chart and registration book
for the SAM treatment program in the woredas with IDPs. Based on this the woredas are taking
their nutrition supply on quarterly basis and distributed the supply to the lower level health
facilities in the host community. CMAM monitors has been supporting the woredas which were
providing technical support and coordination. But the CMAM monitor in Amibera is phased out
since March 2020. It is reported that in 2019, 2,426 and since August 2019 where the displacement
started and to end of February 2020, 1,297 children received treatment for SAM in the visited
woredas inclusive the IDPs. We have assured that Health and nutrition outreach services are not
strong in the visited IDP sites to enhance the response for the IDPs. Children and PLW identified
with MAM are not linked to TSFP rather only counseling is offered to the care givers and there
are no NGOs who are supporting CMAM program in Amibera and Gelaelo woredas.
WFP has the supplementary feeding for the management of MAM in Gin Millie woreda of the
host the community and integrated the MAM treatment into the MHNTs including the MHNT
found in Gelaelo and Millie woredas of host community. Mobile health and nutrition teams are
operated in Gelaelo (for now interrupted) and Millie woredas to provide emergency health services
and referral, and treatment of SAM and MAM by the supply and financial support of UNICEF.
There is also a beginning to integrate the MAM management into the health system program in six
selected woredas and Millie is one of them. But it is not operationalized to the ground yet.
Capacity building activities on CMAM based on the new acute malnutrition guideline has been
provided for the HWs and HEWs by regional health Bureau with the support of UNICEF and other
nutrition partners like SCI, plan international and AMREF to manage and treat children with severe
acute malnutrition in the woredas with IDPs. Additional Training on CMAM based on the newly
endorsed AM guideline in Amibera and Gelaelo woreda is pending due to the COVID-19
pandemic.
UNICEF is supporting the provision of the food for caregivers for SAM children admitted in the
SCs to reduce the defaulting from treatment and improve service outcome. Additional food for
care givers is also on bidding process in the regional health Bureau by 589,000 ETB for the whole
region. But this is not enough, and other partners should support on this area.
Nutrition supply prepositioning and management:
For now, there are enough CMAM nutrition supplies in the visited woreda stores. But this is not
enough in case there is sudden increase of cases in the woredas due to the IDPs influx. So, UNICEF
Afar should request nutrition supply to Addis Ababa and preposition the supply in the regional
store and distribute to the woredas. Stop gap ration of high energy biscuit BP5 is not availed in the
woredas for the IDPs. however, 72 cartons of stop gap BP5 high energy biscuit was distributed to
the IDPs displaced by flooding before months in Gelaelo woreda. So enough BP5 high energy
biscuit should be requested and distributed to the woredas to prevent the further deterioration of
nutritional status in the IDPs since the food distribution is periodic in the IDPs.
Infant and young child feeding in emergency/IYCF-E
The regular C-IYCF is continuing through the MTMSG facilitators and HEWs in the host
community. But there is no special activity in the IDP woredas /sites to provide counseling in
IYCF-E. The mothers of children in the IDPs look depressed by the conflict and this can affect
feeding of children including exclusive breast feeding and initiation and introduction of
complementary feeding and access to diversified complementary foods. We have also identified
that Anker milk that is 48 sachets per household was distributed to the IDPs in Amibera woreda
by the DPFSPCO and the woreda mentioned that some of them were expired and recollected. This
is breast milk substitute/BMS and may be used for under six-month children given all the
community members cannot have adequate knowledge on this regard.
To mitigate the use of Breast Milk Substitutes (BMS) by under six month children the Anker milk
sachet should be removed from the general food ration or the woreda DPFSPCO should work
closely with the woreda health office to raise the awareness of the care givers not to give the Anker
milk to under six month age children. mobilization of partners that can support in IYCF-E to
transfer key messages is also important.
Table 7: Presence of NGOs working in the woredas with IDPs:
List of NGO
Woredas and area of work for the NGOs
Amibera Main activity Gelaelo Main
activity
Millie Main activity Afambo Main
activity
SCI Yes Multi sectoral
(health, education,
WASH, Nutrition,
livestock
No No No
AMREF Yes Health Yes Health Yes Health No
Plan international
Ethiopia
No No Yes CMAM
Care Ethiopia Yes WASH Yes WASH Yes WASH No
Rohi wodu (Local) Yes Health and WASH
(on launching stage
No No No
ICAP No Yes Malaria Yes Malaria
CHI No Yes EPI No
GIZ No No Yes WASH No
Medicine
DEMOND
No No Yes HIV
Transformation
WASH(T-WASH)
(PIE, SNV, PSI and
IRC)
No No Yes Transformation
WASH
Needs
Health:
• Deploy IDP focused health worker and HEWs in the IDP sites to have temporary mobile
clinics and improve the health service access in the IDP sites
• Operate Outreach based health services like vaccination programs in the IDP sites through
provision of operational running cost to the woredas with IDPs
• Distribute ITN and conduct IRS in the IDP sites to prevent malaria out break
• Provide health treatment in the host community health facilities free of charge for the IDPs
through provision of emergency drug kit for the woredas with IDPs.
• Well established referral linkage for the persons injured by the conflict by assigning
ambulance.
• Provide essential drugs and medical supplies for the woredas with IDPs. There is shortage
of drugs like Amoxa syrup, paracetamol, coo Artem
• Prepositioning of enough vaccines supply in the woredas to control vaccine preventable
diseases.
• Prepositioning and provision of Emergency Drug Kits/EDK and cholera CTC kits.
• Strengthen the surveillance system and monitor the health emergency response status every
time in the woredas with IDPs to identify outbreaks and to intervene timely.
• Strengthen health and nutrition coordination meeting in the woredas with IDPs
• Improve the intersectoral collaboration among the sectors on the issue of the IDPs
• Functionalize the MHNT in Gelaelo woreda and support the kebeles with IDP sites. This
MHNT in Gelaelo is not operating MHNT program due to damaging of the car by accident.
Nutrition:
• Secure emergency nutrition supplies (RUTF, F-75 and F-100 therapeutic milks, SC kit, SC
opening kit, routine medicines and Vitamin A supplementation capsule) in the woredas in
conflict and with IDPs given the roads are not secured all the time. There was nutrition
supply stock out in Gelaelo woreda due to the insecure road. Now this is solved, and others
will take lesson from this.
• Procure and distribute stop gap BP5 high energy biscuit to prevent further deterioration of
nutritional status of children and PLW since the food distribution is periodic
• Operate Outreach based nutritional services in the IDP sites
• Strengthen the referral linkage with SCs in the IDP sites
• Conduct separate nutritional screening for children and PLW in the IDPs to know the real
nutritional status of the IDPs and to have quality screening.
• There is no separate nutritional data like screening data for the IDPs as the IDPs are
dispersed in the host community and there is no separate report for the IDPs. So, prepare
separate report for the IDPs.
• Deploy HWs and HEWs in the IDP sites
• Provide training for the health workers and HEWs on CMAM and IYCF-E based on the
newly endorsed AM guideline to manage and treat children with SAM in case there is IDPs
influx. This is pending Amibera and Gelaelo and Amibera woreda due to COVID -19.
• Children and PLW with MAM are not addressed as there is no TSF program in Amibera
woreda. So, find a solution for the TSF program to treat children and PLW with MAM.
• Mobilize partners to the woredas to support the IDPs
• Enhance health and nutrition coordination meeting in the IDP woredas.
Key gaps:
• There is no IDP specific data in the social service sectors like health, education and others
• Inadequate inter sectoral information exchange on the IDPs in the woreda level and less
coordination among the sectors regarding the IDPs
• The mobile livelihood nature of the community as they may move from one place to
another place following the lean season. This leads to difficulty of identifying IDPs from
the host community and may be normal nature of movement.
• There are partners in the woredas. But they are not supporting the IDPs
• Lack of TSF program to manage MAM children and PLW in P2 woredas
• Shortage of drugs in the woredas with IDPs
• Health service treatment in the woredas with IDPs is provided in the host community health
facilities with treatment cost for the IDPs including the persons injured by the conflict and
referred. Persons from the IDPs including the injured persons referred and admitted in
different hospitals inside or outside the region are not getting free of cost health service
treatment.
Conclusion and recommendations
According the woredas report most of the IDPs displaced by the conflict among Afar – Esa Somali
are found dispersed in the hosting community except few sites where only IDPs are found. The
mobile livelihood nature of the community needs to be approached in a systematic way to identify
and aid the IDPs as the pastoralist community may move from one place to another place following
the lean season to search water and pasture. The IDPs are sharing the resources of the hosting
community to save their life. However, the hosting communities have limited resources to share
their resources for the IDPs specially during influx of IDPs, drought season and occurrence of
additional emergencies like flooding in the woredas. Therefore, the health and nutritional status of
the IDPs might be rapidly deteriorated. As a result, we recommend the following health and
nutritional interventions:
Nutrition:
Immediate
• The food distribution is periodic in the IDP sites. So, stop gap ration of BP5 high energy
biscuits for the woreda IDPs children and PLW is recommended.
• Request and preposition enough nutrition supply in the woredas specially in Amibera and
Gelaelo due to the unsecured road access to the region due to the conflict as result nutrition
supply interruption could occur. This was realized in Gelaelo woreda. The woreda did not
have supply in the woreda stock during the visit. But at present Gelaelo and Amibera
woreda has requested supply and prepositioned in the woreda.
• Strengthen capacity building activities on community management of acute malnutrition/
CMAM based on the newly endorsed guideline to admit and treat children with severe
acute malnutrition/SAM
• Strengthen the IYCF-E activities to promote breast feeding specially the EBF activities for
under six-month age children and introduction of complementary feeding in the IDPs
displaced by conflict
• Monitor and assure the implementation of the new AM guideline in the woredas where
IDPs are found
• Accelerate the implementation of IMAM in Millie woredas as Millie woreda is one of the
six IMAM woredas.
• Advocate for moderate acute malnutrition management coverage in priority two woredas
and treat the reported MAM cases in the woredas by mobilizing partners to support in TSF
program in Amibera woreda
• Monitor and supervise the nutritional status of the IDPs
• Relocate the CMAM monitors/Emergency nutrition officers to the woredas with IDPs
• To Mitigate the use of breast milk substitute/BMS by infants, we recommend the removal
of Anker milk from the general Food ration.
Long term
• Peace building and mediation should be given priority side by side with the humanitarian
assistance
• Strengthen the linkage of nutrition sensitive activities with the nutrition specific activities
• Resettle the IDPs in one area and expand the social infrastructures
Health:
Immediate:
• Health services are lacking in some visited IDP sites and where they exist services, the
services are on and off due to the turnover of the health worker. Establishment of
temporary health post by iron sheet and assign health HWs, HEWs and medical supplies
in order to provide health service for the IDPs.
• Shortage of drugs are reported in the visited woredas with IDPs. So, Preposition of drugs
and medical supplies in the woredas with IDPs to fill the shortage of medical supplies in
the woredas.
• The IDPs are pastoralist and loss their lives stock by the conflict. We are recommending
that provide free health service treatment for the IDPs as the IDPs are paying to get health
service treatment specially for the treatment of the injured persons referred and admitted
in Adama and Mohammed Aklie hospital. UNICEF should provide emergency drug
kit/EDK to the woredas with IDPs to improve the health services in the woredas
• The woredas with IDP are outbreak prone woredas due to its geographical occurrence
around the Awash river. So, surveillance of malaria, AWD, measles and other outbreaks
in the IDP sites should be strengthened.
• Functionalize the MHNT in Gelaelo and relocate the MHNT in Millie woreda to
reconsider the IDP sites in their weekly program.
• Strengthen the monitoring and early requesting of essential drugs in the IDP woredas
• Assign ambulance to provide priority for the IDPs and transport injured people during the
conflict as the situation is very volatile.
• Invite partners working on health in the woredas to support the IDPs intervention.
• Prepositioning of medical supplies and drugs needed to control out breaks in the IDP sites
• Strengthen outreach-based health services like immunization in the IDP sites by providing
operational cost support to the woredas
• The IDPs are living in area which is prone for malaria outbreak. ITN distribution is
required for the IDPs
• Peace building and mediation should be given priority side by side with the humanitarian
assistance
• Mobilize resources for the of health and other sectors to support the IDPs
• The mobile livelihood nature of the community needs to be approached in a systematic
way to aid with the IDP as they may move from one place to another place following the
lean season.
• Continued monitoring of health responses through strengthened coordination at all level
• Response should be provided using the combination of kebeles and IDP sites depending
on the context of the sector.
• Closely monitor the health emergency responses in the IDP sites.
Long term:
• Peace building and mediation should be given priority side by side with the humanitarian
assistance
• Resettle the IDPs in one area and expand the social infrastructures
• Equip the health facilities with human resources, drugs and medical equipment’s
Supply annex1:
Health:
Supply Item Unit Quantity Cost (USD)
EDK kits
CTC kits Kits
Measles vaccine Vials
ITN each
Sub-total cost
Total
Nutrition: BP5 high energy biscuit supply need for IDP by conflict
Beneficiaries
Beneficiaries-
Including 10%
contingency
For Adults For Children (6-59 month)
Regi
on
wored
a
Total
HH
displa
ced by
confli
ct
Total
populati
on
displace
d by
conflict
PLW
Childre
n (6-59
month)
TOT
AL
PL
W
Childr
en (6-
59mo
)
TOT
AL
benef
iciary
Ration/
Day/A
dult
(#
Bars)
#
Days
Ration/
Adult
for
Duratio
n of
Support
Qty
Requi
red
for
Adult
s
(#
Carto
ns)
Ration/
Day/Chi
ld
(# Bars)
#
Da
ys
Ratio
n/Chi
ld for
Durat
ion of
Supp
ort
Qty
Require
d for
Children
(#
Cartons)
Total
Qty
Requir
ed
(#
Carto
ns)
Total
Qty
Require
d (USD)
Afar
Millie 190 1140 40 153 193 44 168 212 395
14 5,530 26 672 14 9,410 44 69
USD
3,112.53
Chifr
a 100 600
21 80 101 23 88 112 208
14 2,911 13 354 14 4,953 23 36
USD
1,638.18
Dubti 1048 6288
220 843 1,063 242 927 1,169 2,179
14 30,503 141 3,707 14
51,90
4 240 382
USD
17,168.0
7
Afam
bo 360 2160
76 289 365 83 318 402 748
14 10,478 49 1,274 14
17,83
0 83 131
USD
5,897.43
Gelae
lo 400 2400
84 322 406 92 354 446 832
14 11,642 54 1,415 14
19,81
1 92 146
USD
6,552.70
Gewa
ne 200 1200
42 161 203 46 177 223 416
14 5,821 27 708 14 9,905 46 73
USD
3,276.35
Amib
era 1927 11562
405 1,549 1,954 445 1,704 2,149 4,006
14 56,087 260 6,817 14
95,43
7 442 702
USD
31,567.6
3
Total 4225 25,350 887 3,397 4,284 976 3,737 4,713 8,784
14 122,973 569 14,946 14
209,2
49 969 1,538
USD
69,212.8
9
10% contingency is added for
each group
Annex 2: source of information
Zone Woreda Name of person Mobile
Zone 1 Millie Solomon 0914142952
Zone three Amibera Ali Bela 0913280896
Kibrom Feleke 0921250220
Gelaelo Gizaw 0914610051
Zelalem 0912986964
Amare 0932549430
CHILD PROTECTION
The team has assessed IDP sites located in Amibara, Gelalo, and Mille woreda. In all assessment
areas except Gelalo site, IDP’s settled integrated with the host community members. The
assessment team look to obtain detailed and segregated data to identify specific needs of children
in the IDP’s sites. Unfortunately, this was not collected and recorded. In all IDP sites, there was
no disaggregated data recorded that shows the status and number of children (Unaccompanied,
separated, orphaned, disabled…).
On the assessment, primary data collection tools FGD, key informant interview and direct
observation conducted to identify the protection concerns of children. Participant children on the
FGD and key informant interview explain that, there were children who were separated from their
families and children who lost their parents during the conflict. Protection concerns of the
separated and orphan children was assessed during the assessment. Fortuitously all separated and
orphan children are accompanied by their relatives and community spontaneously without
involvement of external support. This meaningfully reduce exposure of the separated and orphan
children for further risks.
Similar discussion with the IDP at Gelalo woreda revealed that, parents placed (voluntary
separation) their young children with their relatives who are living in safe place due to frustration
and volatile nature of the conflict. The conflict causes physical/injury, deat, and mental abuses,
losses of properties and livestock including burning houses, and post conflict trauma on the
community. The conflict affects the community members differently. Moreover, in some sites,
IDPs expressed concerns regarding their safety and security threats because of the proximity of
the site and possibility of re-attack of Issa. All this situation, however resulted cause of trauma and
psychosocial distress specially for women and children.
Regarding the conflict potential risk assessment there is no reported cases of GBV and sexual
violence yet. Even though there is no reported GBV case the conflict, it is useful to remind most
GBV cases are unreported and conflict can exacerbate the existing challenges that women and
adolescent girl has faced. Women and adolescent girl are facing challenges in keeping their
personal hygiene due to absence/limited access to water which further reinforced by lack of
personal hygiene materials/dignity kit. Women were also seen disproportionately engaging in
constructing their house.
Response
The response of government pertinent to child protection and GBV varies from woreda to woreda
and from site to site. NFI has been distributed for IDPs. In some IDP site (Mille and Gelalo), the
government has mobilized and constructed houses for IDPs, awareness raising activities has been
conducted on HTP and GBV. In Mille, identification and registration of orphans is undertaking,
provision of revolving fund for vulnerable household as part of economic empowerment was
undertaken and the IDP has access to formal government structure for protection and other reason.
As woreda government officials confirmed, there is no NGOs or CSO working in child protection
and GBV area.
GAP
The women and Children Affairs Office have doing some activities, over all service provision in
IDP sites are insufficient and fragmented. Limited ownership on CP-GBV concerns and limited
capacity of women and children Affair structures at all levels coupled with absence of active
partner operating on CP-GBV resulted no comprehensive efforts on the prevention of and response
to child protection and GBV concerns.
There are no available services in areas of psychosocial support, child friendly space (it may not
be recommendable due to COVID-19), and case management. Absence of documentation and
compilation of data about children, absence of Social work service and birth registration were gaps
observed in IDP sites.
Recommendation
Short term recommendation
• Provide psychosocial services including children and women- for traumatized girls, boys,
women and men who have witnessed or personally experienced physical injuries including
death.
• Conduct detail data on the states, number, age, sex, special need/disability of children and
record systematically in according to the national and global standard.
• Addressing the immediate food and nonfood items needs of children.
• Establishing child protection committee by using this emergency as entry opportunity from
the community members with composition of different groups in the community working
on addressing the needs of children including GBV.
• Strengthen coordination with different stake holders like government bodies such as law
enforcement bodies, UN agencies, NGO, CBO, voluntaries and others on responding
comprehensive needs of children with different needs and women.
• All regional sector bureaus should provide a clear direction and guideline to their respective
zonal and woreda offices on the roles and responsibilities they have in supporting the IDPs
in their respective areas.
• Strengthen the capacity of Woreda women and Children Affairs office to provide outreach
protection services including GBV in the IDP sites.
Long term Recommendation
• Establishing committee from the community working on this and provide technical and
financial support to the committee by organization/BoWCA.
• Identifying and inviting child protection agency interested on addressing the protection
issues of children in the area.
• Advocating the issues of children to regional and national government.
• Coordination and data management – advocate IDPs agenda and CP-GBV issue to take
the central stage in existing coordination mechanisms at all levels and establish
information management and availability of good quality data (e.g. IDP profile
disaggregated by sex and age, the status of children including educational data and
response)
EDUCATION SECTOR
In all visited sits, it was difficult to get age segregated data that shows the number of IDP students
who have accessed education including those who are living together with the host community
and those who have not accessed. Because of this, there is no reliable figures on IDP students that
would help to estimate the need and gap that is required for the immediate and long-term response.
Generally, it was observed that all IDP sites were not providing education to children. Some
children in few IDP sites however are accessed education in open areas-under tree.
Response
Some visited woredas has taken actions to address educational need of IDP children. Amibra
woreda has deployed teachers and provide educational materials to continue education service in
one IDP site. However, they have faced high turnover of teachers due to frustration resulted from
the security situation in the area and disruption of school feeding programme due to shortage of
water. In other visited sites, there are volunteers who are teaching children under shade. In the rest
of the site there is no active response to address educational needs of IDP children.
GAPs
Absence of qualified teachers, classrooms and education materials were gaps identified in IDP
sites.
Recommendation
Short term
• Identify and generate quality data for IDP children who are not accessed education.
FOOD CONDITION
Food is basic human need that is imbued with social meaning. It is a marker of class, signifier of
health and a symbol of caring.
In the visited 5 woredas food is the first and the most needed priority of the community, as per the
discussion with the woreda officials and experts and community discussions. The combination of
the widespread use of coping strategies by IDP households, high rates of unemployment, low
incomes, and high reliance on cash to purchase food indicates that current levels of food
consumption are unlikely to be affordable in the longer term.
Only one-time food dispatched to the IDPS including NFI, but as the situation is very serious it
needs continuous monthly food dispatch.
As most of the IDPS are pastoralists and they also lost their livestock due to the conflict the need
for food become high and needs immediate response.
The total IDPs in seven woredas in the region reached 35, 000, the food need for this population
is calculated below.
NO Food items Quantity per
person per
month in KG
Total
population
One-month
ration in
Quintal
Six-month
ration in
Quintal
1 Cereal 15 35000 5250 31,500
2 Oil 0.45 35000 157.5 945
3 Pulse 1.5 35000 525 3150
4 CSB 4.5 (30% of the
total population)
35000 472.5 2835
5 Total 6,405 38,430
• Government (BoE) and partners should give serious attention and help students who
dropped out of school through integrating with the existing education system and, provide
them all the required support. (stationery materials, uniforms and school feeding. Besides,
temporary school provision will be necessary for children who are unable to go to school
in some sites
Long Term
• Strengthen the capacity of Woreda Education Office to help respond education need of IDP
children.
• Coordination and data management – advocate IDPs agenda and education issue to take
the central stage in existing coordination mechanisms at all levels and establish information
management and availability of good quality data (e.g. IDP profile disaggregated by sex
and age, the status of children including educational data and response)