UNICEF Chad Humanitarian Situation Report 31 August Cluster Target. Cumulative 182,545 54, , , , , , ,532

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1 /Chad/Fafin A. Diguera Chad Humanitarian Situation Report 31 August Chad Chad Humanitarian Humanitarian Situation Situation Report Reporting period: August Highlights 147,532 SAM children admitted in supported health facilities to date; 13,016 children including 6,913 girls have benefited from psychosocial activities beginning of ; 2,574 pregnant women counselled and tested for HIV in the targeted regions (0.9% prevalence); As of end of August, HAC has only received 36% of the US$54.2 million appeal for. An additional US$ 34.9 million is required for to meet the needs of vulnerable children and women through an integrated multisectoral response. s Response with Partners WASH: Number of crisis affected people who have access to quantity potable water and hygiene promotion activities in line with the standards (15L/per/Day). Nutrition: Number and % of children 6-59 months with Severe Acute Malnutrition (SAM) admitted for therapeutic care and benefitting from promotion of nutrition practices Child Protection: Number of displaced children with access to psychosocial support, including in child-friendly spaces Education: Number of school aged boys and girls (3 to 17) affected by crisis receiving learning materials Cumulative Sector/cluster Cluster Cumulative 182,545 54, , , , , , ,532 37,550 12,783 77,257 12, , , , ,754 SITUATION IN NUMBERS SITUTION IN NUMBERS 31 August 2,500,000 Children in need of humanitarian assistance ( HAC ) 268,837 Under 5 children with Severe Acute Malnutrition targeted in out of the burden of 362,682 (Nutrition Cluster ) 129,010 People displaced (IDPs, returnees, refugees) in the Lake Region (UNHCR July ) Appeal US$ 54.2 million Funding available US$ 19.3 million Funding status * (US$) Funds received: 12.3 M Carry over: 7.0 M (13%) Required: 54.2 M Funding gap: 34.9 M *Funds available include funding received for the current appeal year as well as the carryforward from the previous year 1

2 Chad Humanitarian Situation Report 31 August Situation overview and Analysis New CAR refugees in the South: There has not been any population movements from CAR in the month of August. The last wave of refugees arrived in June. 548 people were registered in June by UNHCR in Motoho and were transferred to the refugee camp in Maro. UNHCR, WFP and the National Commission for Refugee Reinsertion (CNARR) continue to monitor the borders to identify potential asylum seekers. From December 2017 to August, a total of 21,539 new refugees including more than 14,000 children have fled violence between armed groups in Northern CAR. Epidemic Outbreaks: The country continues to be affected by the measles outbreak that was declared in May this year. The highest number of cases (237) was reported in mid-august and to date, a total of 2,457 cases have been reported with 77 deaths (3.1% fatality rate). 103 out of the 117 districts have reported at least one case of measles and 33 of those have reached epidemic levels. There is a significant gap in the response, and to reach the remaining 70 districts, supported the Ministry of Public Health (MSP) in drafting a response plan and a request for US$ 1.4 million funding was submitted to the Measles and Rubella Initiative (MRI). No case of cholera has been reported in the country beginning of the year despite the cholera epidemic in the neighbouring countries of Cameroon and Nigeria. Nevertheless, has prepositioned NFI and WASH kits in 13 districts with funding from ECHO and is supporting the MSP and implementing partners in prepositioning cholera kits in areas with a high risk of transmission. Three additional kits are available for distribution in s warehouse and three more are available at WHO. Humanitarian Leadership and Coordination The Water and Sanitation structures sustainability thematic group held a meeting to present tools for the management and sustainability of infrastructures to the cluster members. These tools, namely the Water Points Management Committees Manual, the Craftsmen s Manual, the Spare Parts Dealers Manual, were elaborated for the Ministry in charge of water with the technical and financial support of. The electronic version of these tools has been shared with the different WASH partners and a guide on how to use them is being developed. The humanitarian planning process for 2019 has started. Three crisis groups (population movement, health crisis and food insecurity crisis), were established to analyze the vulnerabilities and define the humanitarian planning assumptions for Clusters under lead are participating in this process by leading or co-facilitating crisis group meetings. The different programmes of are also contributing with sectoral analyses that highlight the situation of children with the aim of designing programmes that respond to their needs. Humanitarian Strategy As part of its humanitarian strategy, Chad is putting forward an integrated and coordinated approach to provide life-saving assistance to children by offering preventive care such as infant and young child feeding support alongside curative nutrition interventions, including SAM treatment to under 5 children in the Sahel belt and the south of the country. Some of these children and their families are receiving a life-saving WASH package, including hygiene promotion and supplies. is reaching conflict-affected people with access to water, as well as people affected by displacement and epidemics with hygiene information, including illness prevention and locally-adapted solutions to water access. The health system is being reinforced with personnel and supplies in the Lake region and the south, and nutrition data management is being strengthened using rapid SMS. is reaching children in displaced communities with access to education by providing both permanent and semi-permanent learning spaces and by distributing learning materials. is also rolling out sustainable solutions for compensating community teachers and standardizing alternative learning. Furthermore, is supporting unaccompanied and separated children with protection and family reunification measures. s efforts to bridge humanitarian and development programming remain paramount, including through support to the Government s emergency preparedness capacity, and building community and institutional resilience. Summary Analysis of Programme Response Nutrition In July 1, there was a slight increase (14%) in the number of admitted cases compared to June. As of August, a total of 147,532 SAM children have been admitted in supported health facilities. This increase in SAM cases is 1 Nutritional data are collected by the national health system and normally take more than a month to be reported 2

3 concentrated mainly in N Djamena, Ouaddai, Kanem and Lake with over 58% of the total number of admissions. N'Djamena alone represents 21% of these admissions. provided supplies and medicines to 624 Out-patient Therapeutic Programme (OTP) and In-patient Therapeutic programme (ITP) and supported the training of 44 health workers (11 women) on the guidelines for the management of acute malnutrition in the Tandjile region. A mass screening using Mid-Upper Arm Circumference (MUAC) tapes was organized in the Lake and Logone Oriental regions and in N'Djamena. 116,137 children were screened, of whom 2,108 (1.8%) were severely malnourished and were referred to supported health facilities. 28,850 people benefited from sensitization on essential nutrition actions. continues to monitor the RUTF stock and secured 275,500 cartons of RUTF, leaving a gap of 19,000 cartons to cover needs up to December. Medical supplies such as Amoxicillin 250 mg tablet, mebendazole, folic acid etc, for systematic treatment, remain underfunded. Health continues to support the MSP in its response to the measles outbreak. Nine of the affected 33 districts have benefited from vaccination campaigns and to date 452,752 children aged 6 months to 9 years have been vaccinated in the Sila, Batha, Hadjer Lamis, Tandjile and Tibesti (the age limit was 59 months) regions. More efforts are being made to ensure all the remaining districts are reached with an adequate response. Water, Sanitation and Hygiene (WASH) continues to support the implementation of WASH in Nut activities in the regions characterized by population movements. In August, 469 mothers and their children were sensitised on good hygiene practices and received WASH kits in supported nutritional structures in the south (457 children) and in the Lake regions In the Lake region, 75 people have been given access to drinking water through fifteen newly installed bio-sand filters. Furthermore, and its partner IAS have drilled eight boreholes that will be equipped with manual water pumps. These boreholes will benefit approximately 4,000 people. In addition, as part of setting up of system of sustainability, and its partner ADRA trained 28 members of Water Point Management Committee Associations (ACGPE) and four repairmen on the management of associations and the maintenance of water infrastructures. Lastly, is also improving access to sanitation through the construction of latrines. In the Lake region, 445 people are now newly accessing 89 functional latrines constructed by s partner IHDL. In the south, two nutritional structures (Bangar and Djar) benefited from the construction of two blocks of two latrines each. Education To reinforce the Early Childhood Development (ECD) programme, in partnership with the Ministry of Women, Early Childhood and National Solidarity organized a training of trainers in the Mandoul and Lake regions. 88 pre-school and nursery facilitators including 60 women were trained. The training focused on defining the different concepts of ECD, the advantages of pre-school education, childhood intellectual behavior and how to prepare them for primary school, and preparing reading a writing lessons for children aged 4 to 6 years. A mission to explore the feasibility of the implementation of a learning programme through radio to reach out-of-school children and drop-outs was conducted in the Lake region. An audience analysis was conducted as part of the mission with the participation of 272 children (141 girls), 142 of whom had never been enrolled in school and 93 parents including 40 women. This analysis was done in the IDP sites of Yakoua and Taga. A report presenting results and the possibility of implementing an educative radio programme in emergency situations will be available in September. will resume activities targeted at reaching school going children in October when government schools reopen. Child Protection s efforts to facilitate family tracing and reunification for Unaccompanied and Separated Children (UASC) continue. On 31 August, s partner IHDL reunited six unaccompanied children including four girls from Don- Bedara with their families in Bedankoussang and two separated children were also reunited with their parents in the same district. In total, 11 Unaccompanied Children (UAC) have been reunited with their family beginning of the year. To support Identification, Documentation, Tracing and Reunification (IDTR) of children affected by the CAR crisis, deployed four child protection officers to Logone Oriental and Moyen Chari. These officers roles will be to strengthen the capacities of implementing partners, carry out evaluations of the situation to inform decision, and to support data collection. and its implementing partners also facilitated access to services for Gender Based Violence (GBV) survivors; two girls in Bekan received psychosocial and medical support while two additional cases were referred to services in Don 3

4 Bedara. also established community-based child protection mechanisms and referred three cases of GBV in Bedankoussang to receive care. continues to provide psychosocial and recreational support to children affected by the conflict. In the South, 569 children (249 girls) were newly registered in 8 Child Friendly Spaces (CFS) while 1500 children (891 girls) were newly registered in 13 CFS in the Lake region. 52 CFS volunteers (26 female) were also trained in the Lake region, to enhance their skills to animate CFS activities. In total, 13,016 children (6,913 girls) have benefited from psychosocial activities since the beginning of. HIV/AIDS In the Wadi Fira in the east of Chad, visited three refugee camps to monitor Prevention of Mother To Child Transmission (PMTCT) and pediatric care (PECP) activities. The main purpose of the visit was to strengthen the capacities of PMTCT and PECP service providers and provide them with data collection tools as well as protocols for service provision. Globally in the reporting month, 2,574 pregnant women were counselled and tested for HIV in the targeted regions, 22 tested positive and were put on ARV treatment. In the Guera, one of the regions affected by the nutrition crisis, 3,424 pregnant women and 641 adolescents were tested for HIV. Fourteen women and thirteen adolescents tested positive and were put on ARV treatment. Additionally, twelve children born from HIV positive mothers were put on prophylactic treatment within the required 72 hours. also distributed 1,220 HIV rapid test kits, 30 cartons of ARV (nevirapine), 300 filter papers to ensure testing and care of pregnant women in emergency zones. Three Genexpert machines were given to provincial hospitals in the south to ensure early detection of children exposed to the virus. Security and Social Trends The overall security situation has been calm. In the North, a Chadian rebel group based in Libya attacked the village Kouri-Bougoudi, and later security forces at the Libyan border. The Chadian military responded promptly with air campaigns. The presence of Boko Haram continues to be recorded in the Lake Chad region by their attacks on villages and security forces as well as predatory actions. For now, these incidents have not resulted in a change in the security situation for our personnel, mainly because the targeted areas are known for a low presence of security forces. During the month of August, insecurity has not resulted in restrictions on programme activities. Communication series of posts highlighted the urgency of the response to the deteriorating and acute food and nutrition crisis in Chad. Highlights critical support to mobile clinics in improving and securing access to health & nutrition services for hard-to-reach displaced communities in Lake Chad region. Ursula Mueller, UN Assistant Secretary-General for Humanitarian Affairs & Deputy Emergency Relief mentioned CHAD CERF-funded projects to highlight the importance in responding in the fastest and most effective way to crisis Funding As of August, 36% of the US$ 53.9 million required to respond to the needs of children affected by emergencies in Chad is available. For the humanitarian response in the Lake Chad Basin (LCB), 24% of the required US$ 12.6 million is available. wishes to express its deep gratitude to all the donors whose contribution continue to make a difference in the lives of children and women affected by humanitarian crises. HAC Funding Appeal Sector Requirements Funding Requirements (per Humanitarian Action for Children Appeal, ) Funds Available* Funding gap Funds Received Carryover funds available US$ (%) Nutrition 28,997,102 9,459,172 3,419,181 12,878,353 16,118,749 56% Health and HIV 2,698, , , ,864 2,364,239 88% WASH 6,055,878 1,489, ,125 1,700,668 4,355,210 72% Child Protection 6,858, , ,157 1,005,811 5,852,654 85% Education 6,656, ,006 2,423,836 2,844,842 3,811,240 57% Non-food items and shelter 1,218, ,218, % 4

5 Emergency preparedness 1,412, ,106 80, ,452 1,170,688 54,191,505 12,258,111 7,046,880 19,304,989 34,886,516 64% 62% LCB Funding Funding Requirements (per Humanitarian Action for Children Appeal, ) Appeal Sector Requirements Funds Received Carry over Funds Available* Funding gap (US$) Funding gap (%) Nutrition 2,637, ,912 1,235,635 1,245,768 1,401,414 48% Health and HIV 775, , % WASH 2,054,000 19, ,054,000 99% Child Protection 3,878,155 11, , ,530 3,450,625 89% Education 2,085, , ,515 1,130,015 54% Non-food items and shelter* 1,218, , % 12,648, ,530 2,618,680 2,779,208 8,779,543 76% *all NFI planned are for the Lake region and the fund requirements figure has been corrected to match the overall funding need for NFI Chad Facebook: Chad Chad Humanitarian Action for Children Appeal: Who to contact for further information: Philippe Barragne-Bigot Representative Chad Tel: pbarragnebigot@unicef.org Aissata Ba Sidibe Deputy Representative Chad Tel: asidibe@unicef.org Benny Krasniqi Chief Emergency and Field Operation Chad Tel: bkrasniqi@unicef.org 5

6 Annex A SUMMARY OF PROGRAMME RESULTS Sector/Indicators Overall needs Cluster Response NUTRITION Number and % of children 6-59 months with Severe Acute Malnutrition (SAM) admitted for therapeutic care and benefitting from promotion of nutrition practices 2 % of children with SAM discharged recovered Number of Health Centers with an integrated SAM management programme 3 HEALTH Number of children in humanitarian situations aged 6 months to 14 years vaccinated against measles 4 WATER SANITATION & HYGIENE A number of children under 5 admitted in SAM treatment who received a lifesaving package including messages about appropriate hygiene practices and Nutrition supplies. Number of crisis affected people who have access to basic sanitation facilities (latrines) in accordance with the WASH Cluster s standards and norms Number of crisis affected people who have access to quantity potable water and hygiene promotion activities in line with the standards (15L/per/Day). CHILD PROTECTION Number of unaccompanied and separated children that have access to alternative care, family tracing and reunification services Number of displaced children with access to psychosocial support, including in child-friendly spaces Number of UAC reunified with families EDUCATION Number of out of school boys and girls (3 to 17) affected by crisis accessing education 362, , ,532 25, , ,532 25,553 85% 89% 85% 89% 1, , ,000 13, ,952 42,293 24,589 21, ,174 28,359 21,690 1,627, ,868 12, ,274 54,645 12,305 1,627, ,545 54,134 2, , ,590 8, , ,550 13,016 2,069 77,257 13,016 2, ,579 16,122 17, ,161 19, data is collected by the national health system and normally takes more than a month to be reported health centers with an operational nutrition program supported by and partners in This ID includes results from routine vaccination in refugee camps and returnee sites. The cluster indicator considers only children from 6 to 59 months 6

7 Sector/Indicators Number of boys and girls aged 3 to 17 years affected by crisis attending education in a classroom where the teacher has been trained in psychosocial support Number of school aged boys and girls (3 to 17) affected by crisis receiving learning materials HIV and AIDS Number of pregnant women that have access to HIV and AIDS screening services and prevention of mother-tochild transmission services NON-FOOD ITEMS (NFIs) & SHELTER Number of displaced persons who received non-food items and shelter kits Overall needs Cluster Response 421,016 75,890 7, ,539 9, , , , , , ,631 40,000 29,673 2, ,009 29,260 18, ,175 22,000 and partners response in the Lake Region Sector/Indicators NUTRITION Number and % of children 6-59 months with Severe Acute Malnutrition (SAM) admitted for therapeutic care and benefitting from promotion of nutrition practices Overall needs Cluster Response last report 12,702 22,335 19,527 2,759 22,335 19,527 2,759 % of children with SAM discharged recovered 85% 89% 85% 89% HEALTH Number of children in humanitarian situations aged 6 months to 14 years vaccinated against measles 5 WATER SANITATION & HYGIENE Number of children under 5 admitted in SAM treatment who received a lifesaving package including messages about appropriate hygiene practices and Nutrition supplies. Number of crisis affected people who have access to basic sanitation facilities (latrines) in accordance with the WASH Cluster s standards and norms Number of crisis affected people who have access to quantity potable water and hygiene promotion activities in line with the standards (15L/per/Day). CHILD PROTECTION Number of unaccompanied and separated children that have access to alternative care, family tracing and reunification services 40,000 6, ,702 2, , ,887 75,852 6, ,649 38,720 12, ,887 77,988 10, ,425 65,140 6,555 NA Includes results from routine vaccination in refugee camps and returnee sites. The cluster indicator considers only children from 6 to 59 months 7

8 Sector/Indicators Number of displaced children with access to psychosocial support, including in child friendly spaces Overall needs Cluster Response last report NA 10,150 7,228 1,500 23,200 7,228 1,500 Number of UAC reunified with families NA EDUCATION Number of out of school boys and girls (3 to 17) affected by crisis accessing education Number of boys and girls aged 3 to 17 years affected by crisis attending education in a classroom where the teacher has been trained in psychosocial support Number of school aged boys and girls (3 to 17) affected by crisis receiving learning materials NON-FOOD ITEMS (NFIs) & SHELTER Number of displaced persons received non-food items and shelter kits 176,082 10,000 4, ,082 6, ,879 43,200 7, ,881 9, ,879 60,023 51, ,879 54, ,493 20, ,