6-Month Progress Report: Horn of Africa

UNICEFs Response to the Horn of Africa Emergency
A Six Month Progress Report, April 2012

1
A Six Month Progress Report, April 2012
The Situation
At the height of the crisis in July 2011, more than 13 million people in
Somalia, Kenya, Ethiopia and Djibouti were impacted by severe drought.
The situation was exacerbated by conict and limited humanitarian access
in Somalia that displaced many people from their homes and into neigh-
boring countries. In July and August, the UN classied parts of Southern
Somalia as famine zones. UNICEF declared the crisis a Level 3 emergency
triggering a massive mobilization of staff and resources through January
2012 and, in the case of Somalia, until May 2012.
A combination of favorable rains in much of the eastern Horn of Africa in
late 2011 and a signicantly scaled-up aid response have improved the
dire conditions of affected communities including displaced and refugee
children. This was especially evident in the containment and progressive
easing of previously declared famine conditions in six areas of Southern
Somalia.
However, as of the end of March 2012 over 8 million people remain in
need of urgent humanitarian assistance and the projection of below-aver-
age seasonal rains from March to May 2012 highlight that the prospects
for a sustained recovery are precarious. The tentative gains of the 2011
emergency response are in jeopardy as vulnerable communities face
renewed shocks and disruptions. The chronic and often acute vulnerability
of these affected communities highlight the need for a sustained humani-
tarian response in 2012 which places resilience building and disaster risk
reduction approaches at its center.
UNICEFs Response
Children are at the center of this crisis. UNICEFs response has demanded
rapid scale-up of a diverse set of emergency interventions accompanied
by the timely mobilization of skilled personnel and life-saving supplies.
PHOTO COVER
Women prepare to ll
jerrycans with water
from a collection tank in
the ground, in Melbana
Village, Mio District, in
the drought-affected
Borena Zone. The collec-
tion tank has just been
lled by a tanker truck
delivering emergency
water supplies. Water
delivery is supported
by the Borena Zone
Emergency Water Task-
force, of which UNICEF
is a member.
UNICEF/NYHQ2011-1566/
Tibebu Lemma
Thanks to the generous response to our 2011 appeal, UNICEF and partners
have been at the forefront of delivering life-saving assistance and responding
to the protection and education needs of thousands of children and women
throughout the region.
With sustained support in the crucial months ahead, we can continue our
vital interventions on nutrition, health, water, sanitation and hygiene, educa-
tion and child protection to bolster and protect the gains made so far. These
interventions must be accompanied by efforts to address the underlying
development challenges and vulnerabilities that have placed children at such
high risks of suffering.
Together we are making a difference.
Elhadj As Sy, UNICEF Regional Director for Eastern and Southern Africa &
Global Emergency Coordinator for the Horn of Africa Crisis
2
This has only been possible due to a robust donor response, the UNICEF
National Committees, and private sector support. UNICEF raised $405.7
million by the end of 2011 or 95.5 percent of its total required amount of
$424.7 million for the four-country response. This outpouring of support
enabled life-saving actions including the procurement of more than 3,000
tons of ready-to-use therapeutic food, the vaccination of 7.9 million chil-
dren, and the delivery of improved water sources to 3.2 million people.
Key results of this unprecedented intervention include:
h Somalia, UNCEF geared up liIe-savihg ihIervehIiohs Ihrough
its network of close to 140 partners mostly local. Interventions
included the vaccination of more than one million children
against measles, support for the provision of safe water to close
to 1.8 million people, and the treatment of over 107,000 children
for severe acute malnutrition.
h Kehya, almosI 60,000 severely malhourished childreh beheII-
ted from nutrition programs and close to 1.1 million people were
provided with access to safe water.
h EIhiopia, over 171,000 severely malhourished childreh were
treated and more than 6.7 million children were vaccinated
against measles, including children at very high risk within the
Dollo Ado camps.
h D|ibouIi, almosI 6,000 severely malhourished childreh beheII-
ted from UNICEFs nutritional programs and over 3,200 children
were vaccinated.
Across Ihe vasI aIIecIed area ih Ihe Horh oI AIrica, childreh
received essential protection interventions such as cash trans-
fers to encourage school attendance and measures to prevent
abuse and gender-based violence.
Furthermore, UNICEFs central role in building alliances in program part-
nerships has added value to its increased emphasis on strengthening
the humanitarian response by positioning disaster risk reduction within
longer-term development responses. This has simultaneously accelerated
the effectiveness of interventions and stimulated greater resilience of
local populations vulnerable to multiple challenges to their survival and
development.
Central to ensuring sustainable progress and to better linking emergency
and development interventions is the transitioning of humanitarian
response to the provision of longer-term investments for children. UNICEF
will further develop its programming responses in three broad areas:
Livelihood opporIuhiIies IhaI ihclude improved Iood securiIy
and access to safe water;
GreaIer access Io basic social services, ahd
Access Io proIecIive saIeIy heIs IhaI are respohsive Io seasohal
factors and external shocks.
3
UNICEF will also ensure that children are part of the agenda in national
and inter-governmental initiatives to promote human security, economic
recovery, and growth in these chronically high-risk environments.
UNICEF extends its deepest appreciation to governments, implementing
partners, donors and all the people of goodwill who have joined efforts to
overcome the formidable challenges to child survival and development in
the Horn of Africa.
Responding to Somalias Immediate Needs
The 2011 famine in Somalia was a childrens crisis, with children account-
ing for half of the tens of thousands of people thought to have died in
southern Somalia before famine was declared in two regions in July 2011.
By September, six regions were famine-stricken and the overall number
of people in crisis had risen from 2.4 million in January to a peak of four
million people.
By mid-November, the trend changed. As a result of the combination of a
massive scale-up in humanitarian assistance, substantial ows of food aid
commodities into local markets, the arrival of the main rainy season and
off-season cereal harvests, the famine status for three of the six regions
was lifted. However, these regions remain at critical pre-famine levels, with
continuing high malnutrition and child mortality indicators.
UNICEFs response focused heavily on reaching the most vulnerable chil-
dren and their families despite continuous barriers to access. This required
a major scale-up of traditional UNICEF-supported programs, and the
introduction of new approaches to overcome the challenges to access. By
the end of December, this massive effort had begun to bear fruit, revealing
positive progress for children and women in southern Somalia.
PHOTO RIGHT
In July 2011, people
collect water during a
distribution in a camp for
people displaced by the
drought, in Mogadishu,
the capital. The water
is being distributed by
troops from AMISOM (the
African Union Mission in
Somalia) from their base
supplies. AMISOM was
established by the United
Nations to support peace,
stability and the safe
delivery of humanitarian
aid in the country. UNICEF
works on all sides of the
long-running conict.
Kate Holt
4
Nutrition
UNICEF responded to the famine with a three-pronged strategy of:
Ehhahced BlahkeI SupplemehIary Feedihg Programs (BSFPs) Io
prevent people from reaching famine conditions by providing a
monthly take-home ration;
WeI Ieedihg Io provide Ihree daily hoI meals maihly Io ihIerhally
displaced persons (IDPs) eeing their homes and in transit; and
TherapeuIic ahd IargeIed supplemehIary Ieedihg Ior acuIely
malnourished children.
To enhance access to food in the Central and Southern Zone (CSZ) and
compensate for the lack of general food distribution, UNICEF introduced
BSFPs rapidly in August. These reached 109,066 households (about
660,000 people) by December with at least one monthly food ration in the
worst affected CSZ regions. UNICEF-supported wet feeding programs
provided a daily average of 10,000 hot meals from August to December,
to 51,363 households (including 47,206 children under the age of ve)
comprising mostly IDPs and those in cross-border transit to Ethiopia
and Kenya.
From July to December, UNICEF reached a total of 241,469 malnourished
children in Somalia. During the same period, the number of UNICEF-sup-
ported nutrition sites increased from 973 to over 2,100 across Somalia.
Health
Following the famine declaration, UNICEFs scale-up strategy included
the expansion of the number of supported health facilities and increased
outreach and access through community-based interventions to address
the top causes of illness and death in children as well as prevent and con-
trol contagious diseases. UNICEF supported community case manage-
ment of pneumonia, diarrhea, malaria, the provision of emergency medical
supplies for health centers throughout Somalia, the provision of routine
and emergency measles and polio vaccines, communication strategies
and health education messages, and preparedness and response to out-
breaks of measles, malaria, acute watery diarrhea, and cholera.
Between July and December, 1,074,331 children under the age of 15
were vaccinated against measles in CSZ, while 1,009,401 children under
the age of ve received Vitamin A and 426,354 received deworming
tablets. In addition, 465,505 children were vaccinated against polio and
210,611 women of childbearing age were vaccinated against tetanus.
To ensure access to treatment of common diseases, UNICEF has,
since July:
Epahded iIs supporI (ihcludihg Ihahcial supporI Ior ihcehIives
and training of health service providers) from 120 to 183 Mater-
nal and Child Health (MCH) centers, from 200 to 323 health posts
(HPs) and to an additional 23 hospitals; and
DisIribuIed 395 healIh kiIs (cohsisIihg oI drugs, medicihe, ahd
medical equipment) through its partners to 120 maternal and
child health centers, 200 health posts and 23 hospitals across
In July 2011, 14-year-old
Ahmed, who has
encephalitis, is helped
off a stretcher by his
father and his aunt, at a
water point in Mogadishu,
the capital. There are no
health facilities where
they live, so they are
taking him to a health
centre located on the
grounds of the AMISOM
(the African Union
Mission in Somalia) base.
AMISOM was established
by the United Nations to
support peace, stability
and the safe delivery of
humanitarian aid in the
country. UNICEF works
on all sides of the long-
running conict.
Kate Holt
5
CSZ to serve an estimated 1.2 million people with basic emer-
gency obstetric and neonatal care, and antibiotics to treat major
infections such as respiratory infections, acute watery diarrhea,
dysentery, and typhoid.
Water, Sanitation and Hygiene (WASH)
From July to December, approximately1.8 million people across central
and southern Somalia were benetting from UNICEFs efforts to provide
access to safe water. Specically, UNICEF oversaw the construction and
rehabilitation of 400 water systems which provided access for 480,534
people. Temporary measures such as providing water vouchers to fami-
lies, delivering water by trucks, and chlorinating local water sources pro-
vided access to water for 1,280,220 people.
A major hand washing promotion campaign in October reached over
1.5 million people countrywide, and included hand washing demonstra-
tions, life-saving messages on cholera prevention, and the distribution of
essential supplies such as soap, buckets, and water purication tablets.
These interventions assisted in the response to cholera, especially in
areas with existing, newly arrived, and transiting displaced people.
Child Protection
The escalation of hostilities, the movement of people and ongoing military
interventions all heighten the risk of childrens recruitment into armed
groups, separation from their families, neglect and exploitation, and leaves
women and girls more vulnerable to abuse and sexual violence.
Giveh Ihe risks Io childreh ih mass populaIioh movemehIs, UNCEF is
supporting partners in their delivery of an Identication, Documentation,
Tracing and Reintegration (IDTR) system for unaccompanied and sepa-
rated children in transit areas. By December, 378 separated and unaccom-
panied children were registered at transit points, with information shared
on the Kenyan side to expedite childrens transport and access to services.
Children are placed in interim care with host families while efforts are
made to reunite them with family members.
A total of 353 new Child Friendly Spaces were established in camps for
internally displaced people (IDP), transit points and host communities in
famine-affected regions and are now providing 34,356 children (34 percent
girls) with safe spaces to play and learn and to access improved water and
sanitation facilities. The centers enable facilitators to address child protec-
tion issues and to register and respond to child protection cases.
Education
From September to December, UNICEF supported the reopening and
running of schools by providing training on education, psychosocial sup-
port, and life skills to 6,747 teachers (of whom 5,371 received incentives)
and distributing school supplies including textbooks to over 260,000
children. This facilitated the enrolment of 420,271 children (42 percent
girls) to exceed the target of 300,000 across 2,230 schools in CSZ.
Children and women
queue for a food distribu-
tion, in the Badbado camp
in Mogadishu, the capital.
The camp, established
three weeks ago, shelters
almost 30,000 people who
have been displaced from
rural areas more affected
by the drought.
Kate Holt
6
During the school break (June to September) some 37,000 children (at
least 40 percent girls) continued their education through 155 IDP schools,
where UNICEF provided supplies and teacher incentives.
Support to Community Education Committees (school management bod-
ies of teachers, elders, parents, and students) continued throughout the
school year to ensure effective governance and management of schools in
CSZ areas that lack education authorities. Over 12,000 Committee mem-
bers were trained (23 percent female).
Almost 30,000 children in 318 schools received monthly food vouchers
that their families can redeem through local merchants to increase school
attendance using an incentive ration.
Responding to Kenyas Immediate Needs
The food security and nutrition situation in most of the arid and semi-arid
areas of Kenya improved signicantly in the nal quarter of 2011, due to
above average rainfall between September and November and the con-
cerIed scale-up oI humahiIariah programs by Ihe GoverhmehI, UNCEF
and other partners.
The marked decline in malnutrition rates in the greater Turkana County
demonstrates the impact of well-coordinated humanitarian efforts, illus-
IraIed by Ihe reducIioh oI Global AcuIe MalhuIriIioh (GAM) ih Turkaha
North East from 37 percent in May to 13 percent by December. Localized
ooding in North Eastern and Western areas following heavy rainfall,
hecessiIaIed a cohcerIed humahiIariah respohse by Ihe GoverhmehI, local
civil society and UNICEF. Investments in cholera preparedness meant that
no cholera cases were reported in hotspots in drought-affected areas,
despite the heavy rains and poor sanitation levels.
PHOTO RIGHT
In August 2011, a boy
drinks a high-nutrition
porridge at Catholic
Integrated School in the
drought-affected district
of Wajir, in North Eastern
Province. Hundreds of
children are receiving
porridge at the school,
part of a national policy
to continue school
lunches during the sum-
mer vacation to ensure
children are fed. For
many children, it is the
only meal of the day.
The lunch programme is
funded by UNICEF and
implemented by the inter-
haIiohal NGOSave Ihe
Children. In the worst-hit
areas of Wajir, up to half
of all households need
food aid.
Antony Njuguna
7
Insecurity challenged humanitarian operations in Dadaab refugee camps,
preventing access to the camps that house 463,000 refugees for all but life-
saving humanitarian missions for weeks at a time. UNICEF worked closely
with the UN High Commissioner for Refugees (UNHCR) and other partners
to develop continuity plans and more robust security arrangements to
enable the continuation of life-saving services and mitigate risks to staff.
Amidst these challenges, UNICEF and UNHCR nalized a joint Education
Strategy with partners to guide education improvements in Dadaab in
coming years, and reached an agreement to proceed with multi-year child
protection and gender-based violence prevention strategies.
Nutrition
UNICEF scaled-up high impact nutrition interventions in drought-affected
areas Ihrough iIs eisIihg sysIems wiIh Ihe GoverhmehI ahd 19 Noh-
GoverhmehIal OrgahizaIioh (NGO) parIhers. From July Io December 2011,
34,482 severely malnourished children were provided with treatment, as
were 80,284 moderately malnourished children. The 22 Nutrition Support
Ofcers deployed to support capacity building, mentoring, and coordina-
tion at the district level played a pivotal role in strengthening program
performance. By the end of December, 75 percent of the health facilities
in arid and semi-arid lands were offering high impact nutrition services.
Nutrition monitoring systems were reinforced with 13 nutrition surveys
carried out between September and December.
Despite the volatile security situation since October 2011, UNICEF main-
Iaihed Iechhical ahd supply supporI Io UNHCP ahd NGO parIhers workihg
in the Dadaab refugee camps to detect and treat severely malnourished
children. UNICEF initiated additional technical and nancial support to
improve infant feeding practices in the camps and, from July to December,
24,282 children were treated for severe acute malnutrition.
Health
UNICEF strengthened routine immunization coverage for measles and
polio in drought-affected areas. It also scaled up maternal and child health
activities. Surveillance systems were strengthened to ensure early detec-
tion of cases and early warning of possible disease outbreaks. UNICEFs
rapid response to the malaria upsurge resulted in low malaria cases as
well as the prompt management of other feverish epidemic diseases,
including dengue fever. A polio outbreak in Nyanza prompted UNICEF to
launch two polio campaign rounds in 32 districts, followed by two rounds
that were expanded to 129 districts.
UNICEF worked with key partners along the border between Kenya and
Somalia to provide health stabilization support to refugees en route to
Dadaab refugee camps. Integrated vaccination, deworming, and Vitamin A
supplementation campaigns for refugee and host communities prevented
disease outbreaks in and around the Dadaab camps.
In July, a Somali child
waits with others to
register for aid in the Ifo
refugee camp in North
Eastern Province, near
the Kenya-Somalia bor-
der. The camp is among
three that comprise the
Dadaab camps, located
near the town of Dadaab
ih Garissa DisIricI.
Kate Holt
8
UNICEF supported the procurement of vaccines and the necessary cold
chain equipment to store them for the Dadaab refugee camps, increas-
ing routine measles immunization coverage to 100 percent and drasti-
cally reducing outbreaks. In addition, UNICEF helped train 152 community
health workers on community-based tracking and management, contribut-
ing to the prompt detection and management of cholera cases.
Water trucking and the repair and rehabilitation of water sources enabled
UNICEF to provide 1.1 million people (654,000 children) with access to
safe water. This includes 270,000 people accessing emergency nutrition
services in 85 health centers and 88,000 children accessing supplemen-
tary feeding programs (SFPs) in 172 schools. Rapid hygiene promotion
activities reached 1.3 million people, including 43,000 school children in
222 schools providing SFPs, and just over one million people accessed
nutrition services in 254 health centers. In addition, 30,000 school children
in 51 schools gained improved access to WASH facilities, including gender
sensitive latrines, water supply and hand washing facilities, and hygiene
promotion messages. UNICEF also helped train around 2,600 community
health workers in cholera prone areas.
In consultation with the Somalia program, UNICEF Kenya provided safe
water to refugees in transit from Somalia to the Dadaab camps by estab-
lishing strategic water points along their main routes, beneting at least
10,000 refugees and 122,500 people in the host communities. An esti-
mated 18,000 refugee families (90,000 people) living in makeshift shel-
ters while waiting to enter the camps beneted from WASH supplies and
hygiene promotion activities. UNICEF is working with UNHCR to construct
four new boreholes as well as pumping equipment and infrastructure in
the new camp of Ifo West as part of more sustainable long-term efforts to
ensure access to safe water for an estimated 60,000 refugees.
Child Protection
The drought crisis saw an increase in the number of children living on the
street and separated from their families. UNICEF provided support and
supplies to drop-in centers and programs supporting 5,507 street children.
This includes active Identication, Documentation, Tracing, and Reinte-
gration (IDTR) from October 2011 for separated children that, by the end
of 2011, had identied 346 vulnerable children in Eldoret, Kitale and West
Pokot. In addition, 89 children were either reunited with their families or
provided with alternative care.
UNICEFs cash transfer program began focusing on vulnerable children in
15,000 households in seven drought-affected districts. The program pro-
vides approximately $30 to each family per month to protect children at risk
of family separation and/or reliance on child work due to household food
insecurity, and to help households recover from the effects of the drought.
The transfer program is building local capacity to identify vulnerable chil-
dren, and gathering evidence to support the planning of a focused national
social protection response to vulnerable families in future emergencies.
In July, Fatima holds
her baby son in their
makeshift shelter on the
outskirts of the Dagahaley
refugee camp in North
Eastern Province, near the
Kenya-Somalia border.
The camp is among three
that comprise the Dadaab
camps, located near the
town of Dadaab in
Garissa DisIricI.
Kate Holt
9
UNICEF deployed specialized child protection and gender-based violence
personnel to Dadaab to scale-up its existing child protection partnerships
and establish new partnerships to provide legal advocacy and support
to refugees. Insecurity in Dadaab has had an impact on service outreach,
although integrated missions have travelled to the camps as the security
situation has allowed. While 50,046 children were reached through Child
Friendly Spaces in recent months, attendance dropped dramatically in
November and December due to security incidents. Inter-country col-
laboration with UNICEF Somalia improved support to children with acute
proIecIioh problems. UNCEF parIhered wiIh NGOs workihg ih Ihe border
areas to identify and provide services to unaccompanied and separated
children and survivors of sexual violence.
Education
An estimated 508,000 children have seen their education disrupted in
drought-prone areas of North and North Eastern Kenya. UNICEF partnered
wiIh NGOs Io provide educaIioh ahd boardihg school supplies ahd mobile
school kiIs Ior 105,100 droughI-aIIecIed childreh. The GoverhmehI's Emer-
gency Preparedness and Response Plan (EPRP) developed with UNICEF
supporI ahd ih place sihce 2010 - has ehabled GoverhmehI-led coordi-
nation and UNICEF collaboration with the Ministry of Education (MoE)
for a rapid assessment in the 39 arid districts most affected by drought,
strengthening existing government systems for emergency response
countrywide.
Support to boarding schools is a key means of providing both food secu-
rity and education to children in Kenyas drought-stricken areas. With
the MoE, UNICEF developed a disaster risk reduction (DRR) manual for
low-cost boarding schools and reinforced the capacity of 236 school head
teachers and heads of boarding houses on disaster preparedness and
management for future droughts.
UNCEF worked wiIh NGOs Io supporI educaIioh access by providihg
49,100 children with Early Childhood Development (ECD) materials, teach-
ing and learning materials, and recreation kits. UNICEF also developed the
capacity of 930 primary school teachers including refugee teachers in
Dadaab on how to create a child-centered teaching and learning environ-
mehI ih schools. UNCEF collaboraIed wiIh UNHCP ahd NGOs Io improve
access and quality of education in the camps, leading to the MoEs devel-
opment of a government policy on refugee education in Kenya.
In September, a boy
reads during the rst
day of classes at Yathrib
Primary School, in the
easIerh Iowh oI Garissa.
UNICEF is increasing its
support to schools in
drought-affected areas,
distributing education
kits to schools, bedding
and mosquito nets to
boarding schools, and
temporary learning cen-
tres to refugee camps.
Antony Njuguna
10
Responding to Ethiopias Immediate Needs
Dry weather worsened Ethiopias humanitarian situation in 2011 and
triggered an emergency response to both drought-affected areas and to
areas that hosted the inux of refugees from Somalia. Drought, increased
food prices, and insufcient resources for preventive measures escalated
the rates of child malnutrition. Admissions of children under the age of
ve into therapeutic feeding programs more than doubled to over 40,000
between January and May.
By July, a government-led multi-agency assessment found that 4.5 million
people required food assistance, a 42 percent increase since April. Short-
ages of clean water, exacerbated by poor access to health services, contrib-
uted to outbreaks of acute watery diarrhea, measles and malaria. As fami-
lies left their homes in search of water and other resources, an estimated
87,000 children dropped out of school and more than 300 schools closed.
The second half of 2011 saw improvements in drought affected areas
due to seasonal rains, declining food prices and on-going humanitarian
assistance. Between May and November, Therapeutic Feeding Program
admissions declined by 46 percent. There were fewer outbreaks of
acute watery diarrhea and meningitis in the second half of 2011, due to
ehhahced eIIorIs by Ihe GoverhmehI oI EIhiopia ahd iIs humahiIariah
partners. Those estimated to need food assistance in the rst half of
2012 fell to 3.2 million people.
By the end of 2011, more than 142,000 Somali refugees were living in ve
refugee camps and one transit center in the Dollo Ado area of the Somali
Region. Approximately 97,000 refugees arrived in 2011, placing signicant
strain on basic services in host communities. A daily average of 120 refu-
gees continued to arrive in December. One quarter of the camp population
is under the age of ve and two-thirds are under the age of 18.
PHOTO RIGHT
A UNICEF-supported
mobile health and nutrition
team member speaks to a
woman during a distribu-
Iioh oI GoverhmehI- ahd
UNICEF-provided supplies,
in the village of Dabaka-
tur in the eastern Somali
Region. UNICEF supports
many health and nutrition
teams in drought-affected
pastoral areas of Ethio-
pia. These teams provide
nutrition monitoring and
treatment for malnour-
ished children, and other
vital services.
Malene Kamp Jensen
11
Nutrition
Ethiopias response to acute malnutrition among women and children was
strengthened substantially during the past months. Emergency nutrition
interventions are integrated increasingly into general health service deliv-
ery, with over 10,000 health centers across the country now able to treat
acute malnutrition, up from 8,900 in July. Between July and December,
164,785 children were admitted into therapeutic feeding programs. In addi-
tion, 440,629 children under the age of ve were admitted to supplemen-
Iary Ieedihg programs. UNCEF supporIed Ihe GoverhmehI by mohiIorihg
the quality of services, training health extension workers, providing techni-
cal assistance, and distributing 2,271 tons of ready-to-use therapeutic food.
UNICEF supported the response to acute malnutrition in Dollo Ado by pro-
curing and distributing essential nutrition supplies, and promoting healthy
infant and young child feeding practices. Some 6,281 children under ve
were admitted to therapeutic feeding programs between July and Decem-
ber 2011. Another 9,962 children under the age of ve were admitted into
supplementary feeding programs to treat moderate malnutrition.
Health
Support to health programs in 2011 contributed to the development of a
more robust health system that is better able to respond to emergencies.
UNCEF supporIed Ihe GoverhmehI's subhaIiohal measles supplemehIary
immunization campaign, launched on September 25, 2011, reaching 6.7
million children under the age of 15 years.
UNICEF provided vaccines and supplies, technical support and intensive
social mobilization efforts. Mobile Health and Nutrition Teams (MHNTs)
continue to reach pastoralist populations in Afar and Somali Regions that
would otherwise have limited access to basic health services. MHNTs
conducted 169,178 consultations, including 69,838 for children. UNICEF
provided MHNTs with 164 essential drug kits and 82 renewable kits, 3,919
clean delivery kits, and nutritional, hygiene and other supplies. UNICEFs
prepositioned supplies and technical support helped facilitate the rapid
response, within 72 hours, to 14 acute watery diarrhea outbreaks.
UNICEFs WASH drought response focused on the inspection and rehabil-
itation of critical water points, water trucking, and coordination. Some
114,400 people, including 18,304 children, were reached by water trucking
operations between July and December. The need for trucking decreased
in Ethiopias Oromia and Somali regions during the October to December
rainfalls and increased again towards the end of 2011. Continued support
for the inspection, rehabilitation and expansion of water sources ensured a
sustained water supply for an estimated 395,500 people since July.
UNICEF is working closely with key partners to respond to the inux of
refugees from Somalia. As part of this response, UNICEF provided on-site
technical support and emergency WASH supplies and equipment.
On 3 August 2011, a
health worker unpacks
ready-to-eat therapeutic
food at a health centre in
Odoleka Village, Oromia
Region. The food was
supplied by UNICEF to
treat malnourished chil-
dren in the village.
Jiro Ose
On 5 August, Kalkidan
Yimam, a health exten-
sion worker, uses a
mid-upper arm circum-
ference (MUAC) armband
to measure the arm of
10-month-old Firdoze
Liben, who is sitting in the
lap of her mother, Berida
Jateni, at their home in
Meleb Village, in Oromia
Region. The red portion
of the armband indicates
that Firdoze is severely
malnourished. Firdoze
weighed 5.7 kilograms
when admitted to the
outpatient programme
two weeks ago; now she
weighs 6.4 kilograms
and continues to recover.
Beside them on the
ground is a rst aid kit
bearing the UNICEF logo.
hdrias GeIachew
12
UNICEF procured and delivered ve water treatment kits, 20 pillow tanks,
water storage containers and soap, reaching 28,183 refugees. Communica-
tion materials on proper hygiene, healthy behaviors, toilet usage, and hand
washing, were developed, reaching an estimated 137,692 people between
July and December.
Child Protection
Following previous long-term work in Tigray Region, UNICEF supported
regional bureaus to develop and establish a community care framework
for drought-affected communities. Between July and December, 121,000
people were reached through 50 Community Care Coalitions that enhance
the protection of vulnerable children and their families through early iden-
tication and timely community-based interventions. In late 2011, UNICEF
supported the training of 160 para-social workers to manage protection
issues in the Somali Region.
Since July 2011, UNICEF has been working with key partners in Dollo Ado
to support the response to the refugee inux from Somalia, focusing on
establishing a child protection stafng structure for efcient program
delivery in Bokolmayo, Hiloweyn, Kobe and Melkadida refugee camps.
This includes registering unaccompanied minors and separated children
and their receipt of suitable alternative care services, plus family tracing
and reunication assistance. Between July and December, 2,204 separated
and unaccompanied children were veried and documented. All separated
children were reunited with their families or provided with kinship care,
while all unaccompanied children were placed in formalized foster care
within the camps.
Education
UNICEF ensured the continued education of 91,000 children (45 percent
girls) in seven drought-prone regions between July and December by pro-
viding learning spaces, materials, advocacy and teacher training. Essential
learning materials were provided to the federal and regional education
authorities, and included 300 Early Childhood Development (ECD) kits, 200
teachers kits, 1,000 learners kits, 190 recreational kits, and 1,500 hygiene
kits for adolescent female students.
In Dollo Ado, UNICEF provided enough education supplies to support
Education in Emergency Interventions for 30,000 refugee children. More
than 17,000 refugee children from Somalia are continuing their basic and
early childhood education in safe temporary learning spaces, assisted
by UNICEFs procurement of 256 school tents. To facilitate regular school
attendance, UNICEF supplied 2,500 hygiene kits to benet 12,500 ado-
lescent female students. UNICEF also delivered 35,000 learners kits, 200
School-in-a-Box kits to provide 8,000 children with schools supplies, and
100 ECD kits sufcient for 4,000 children aged three to six years.
13
Responding to Djiboutis Immediate Needs
More than 165,000 people in Djibouti, or some 20 percent of the population
were affected by the drought. Of these, 120,000 needed urgent humanitar-
ian assistance making Djibouti proportionately the second most affected
country in the Horn of Africa. Cases of severe acute malnutrition increased
between August and November 2011, from around 4,000 to 7,000 cases.
Since September, arrangements were established to provide education
to an additional 33,000 school aged children in drought-affected areas,
including in the refugee camp of Ali Ade.
Nutrition
UNICEF supported seven therapeutic feeding centers in Djibouti and 35
supplementary feeding centers through the training of 80 community
workers and the provision of Plumpynut, the peanut-based therapeutic
food for malnourished children. In addition, 22 community-based malnutri-
tion management sites are supported in both the capital and rural areas.
Overall, the UNICEF-supported national nutritional program treated 17,581
children suffering from moderate acute malnutrition and 5,836 children
for severe acute malnutrition.
Health
UNICEF strengthened the health information management system by
delivering 60 phones to 55 health sites and ve regional health centers,
ve fax machines to the ve regions, and a telephone for a cholera treat-
ment center in a peripheral area of Djibouti that holds one of the largest
IDP populations.
UNICEF continued assistance to the Ministry of Health to treat 498 acute
watery diarrhea cases near the capital city of Djibouti and provided sup-
port to mobile health clinics. Following measles outbreaks in June and
August, which resulted in the deaths of two children under the age of
PHOTO RIGHT
A severely malnourished
child lies in a crib with
his mother beside him,
in the UNICEF-supported
therapeutic feeding centre
in the main hospital in
Djibouti, the capital. The
hospital has seen an inux
of malnourished children
since the drought began.
Michael Kamber
14
ve, UNICEF supported an immunization campaign that vaccinated 3,213
children against measles, and 70 against polio and tuberculosis. In addi-
tion, more than 3,000 children received vitamin A. In December, UNICEF
and the World Health Organization supported the launch of a mass immu-
nization campaign by the President of Djibouti against measles and polio,
alongside deworming and vitamin A. The campaign vaccinated 113,316
children under ve years of age in Djibouti and the ve regions.
In addition, UNICEF provided 26,400 long-lasting insecticide-treated
malaria nets to 24,000 children under the age of ve and 2,400 pregnant
women (12,000 families) in 16 malaria prone localities of Djibouti city and
all ve regions.
Water trucking assistance reached 110,700 people countrywide, and 36,000
liters of water were distributed daily to 500 vulnerable households living in
informal settlements in Djibouti peri-urban areas. To improve household
water storage, 150 highly vulnerable households in Balbala peri-urban area
beneted from 650 200-litre barrels and 800 20-liter jerry cans. Access
to sanitation was improved with the construction of 150 family latrines
with community participation and 120 emergency latrines to benet 720
women in Djibouti peri-urban areas.
A joint action plan by the World Food Program, UNHCR and UNICEF was
put in place to respond to the drought crisis. With the recent increase in
the number of refugees, UNICEF is supporting humanitarian interventions
in the Ali Addeh refugee camp, by improving water access and quality as
well as helping to treat and prevent malnutrition in the camp through the
provision of additional ready-to-use therapeutic and supplementary foods.
UNICEF is also supporting the camp-based primary school through the
construction of classrooms and provision of learning materials.
Child Protection
Since the onset of the crisis, 700 orphaned and vulnerable children
received conditional cash transfers and school kits in two phases, in order
to improve their livelihood and facilitate continued school attendance.
Children and women
queue to receive water
at a UNICEF-supported
distribution point in
Bouldougo, a slum
area on the outskirts of
Djibouti City, the capital.
In Somali, Bouldougo
means knocked out;
the area is missing even
the most basic services.
Some 400 families live
in the area, including
refugees arriving from
Somalia and Ethiopia.
Barrels of water bear
the UNICEF logo.
Najwa Mekki
15
UNICEF has saved more childrens lives than
any other humanitarian organization in the
world. Working in more than 150 countries,
UNICEF provides children with health and
immunizations, clean water, nutrition, educa-
tion, emergency and disaster relief, and more.
The U.S. Fund for UNICEF supports UNICEFs
work through fundraising, advocacy, and
education in the United States.
UNICEF is at the forefront of efforts to reduce
child mortality worldwide. There has been
substantial progress: the annual number of
under-ve deaths dropped from more than
12 million in 1990 to 7.6 million in 2010.
But still, 21,000 children die each day from
preventable causes. Our mission is to do
whatever it takes to make that number zero
by giving children the essentials for a safe
and healthy childhood. For more informa-
tion, visit www.unicefusa.org.
U.S. Fund for UNICEF
125 Maiden Lane
New York, NY 10038
1.800.4UNICEF
www.unicefusa.org
Rebuilding Lives with the Future in Mind
For the people of the Horn, the drought and the crisis that followed were
unprecedented emergencies, unique in their magnitude, depth, and scope.
UNICEF pledged to do anything and everything to support families as
the region struggled with unimaginable circumstances.
Despite the perfect storm of hurdles, the technical, material, and nancial
resources mobilized in response to the crisis were exceptional in their own
right. Rebuilding the lives and livelihoods of millions is by no means an
easy task. But signicant progress has been made by committed national
and international stakeholders from both the public and private sectors.
Recovery is moving forward. Hope and resiliency are returning. Our com-
mitment to the children of the Horn is in full force. We remain champions
for children even when faced with adversity.
We dedicate this report to everyone who has supported us, and to the
children who have given us courage and hope along the way. Thank you
for investing in our commitment to all of the children and families affected
by the crisis. By joining us you are helping to ensure that they are able to
move on and continue living healthy, productive lives.

6-Month Progress Report: Horn of Africa

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6-Month Progress Report: Horn of Africa

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UNICEFs Response to the Horn of Africa Emergency

A Six Month Progress Report, April 2012

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