CAR HUMANITARIAN SITUATION REPORT AUGUST UNICEF/CAR/2016/LeDu UNICEF/2014/Rich. Cumulative results (#) Cluster Target

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1 UNICEF/CAR/2016/LeDu UNICEF/2014/Rich Central African Republic Humanitarian Situation Report REPORTING PERIOD: 1 AUGUST-31 AUGUST 2016 Highlights During the month of August, 235 cases (119 children under 15 years) of cholera and 25 deaths (including 8 children) were reported - a 7.9% fatality rate. On 13 August, MINUSCA forces stopped a convoy of approximately 35 heavily armed men (including ex-seleka) 50 km south of Sibut that had departed Bangui late on 12 August, exchanging fire with authorities through several checkpoints. As of the end of July, CMP (Commission Mouvements de Populations) reported 384,314 IDPs within CAR, once again confirming the slightly decreasing trend in the country. In July, UNICEF s Rapid Response Mechanism reached 13,226 highly vulnerable persons (4,588 households) with critical non-food items including plastic sheeting, blankets, soap, buckets, plastic mats and mosquito nets. UNICEF s Response with partners Key Programme Indicators Number of affected people provided with access to improved sources of water as per agreed standards Number of displaced children aged 3-17 with access to education in temporary learning spaces Number of children under 5, including those in IDP sites and enclaves with access to essential health services and medicines Number of children aged 6-59 months with SAM admitted for therapeutic care Number of children released from armed forces and groups Number of pregnant women living with HIV who received ARVs for PMTCT UNICEF UNICEF Cumulative results (#) Cluster Sector/Cluster Cumulative results (#) 400, , , ,021 60,000 30,481 70,000 30, , ,389 n/a 29,250 15,348 29,250 15,348 3,000 2,607 5,660 2,643 4,060 1,388 n/a SITUATION IN NUMBERS 1.2 million CHILDREN AFFECTED (2016 HUMANITARIAN NEEDS OVERVIEW) 2.3 million PEOPLE AFFECTED (2016 HUMANITARIAN RESPONSE PLAN) 384,300 INTERNALLY DISPLACED PERSONS (CMP JULY 2016) 467,800 REFUGEES IN NEIGHBOURING COUNTRIES (CHAD, CAMEROON, DRC, CONGO) (OCHA MAY 2016) UNICEF APPEAL 2016 US$ 55.7 million FUNDS GAP US$ 27.1 million 33% of funds received against 2016 needs Funding Gap, $27,162, Funding available Carry-Forward Funds, $10,312,056 Funds received, $18,220,504 Carry-Forward Funds Funds received Funding Gap

2 Situation Overview & Humanitarian Needs Early on the morning of 13 August, MINUSCA forces stopped a convoy of approximately 35 heavily armed men (including ex-seleka) in seven vehicles 50 km south of Sibut. The 35 were believed to include several who are the subject of arrest warrants. The convoy had departed Bangui late on 12 August and exchanged fire with national security forces at several checkpoints en route. These incidents resulted in a number of deaths and injuries. Some of the injured men were handed over to local authorities, and others purportedly escaped. Instability in South Sudan continues to affect south eastern CAR: nearly 300 South Sudanese arrived in Bambouti, Haut Mbomou prefecture, together with armed South Sudanese warning of a possible military attack. More than 4,000 persons are already hosted among the local population. During the month of August, 235 cases (119 children under 15 years) of cholera and 25 deaths (including 8 children) were reported, or a 7.9% fatality rate. As of the end of July, CMP (Commission Mouvements de Populations) reported 384,314 IDPs within CAR, once again confirming the slightly decreasing trend in the country. At the 9th meeting of the International Contact Group (ICG) on CAR, held in Bangui, participants discussed disarmament, demobilization and reintegration (DDR), security sector reform, reconciliation and justice and the return of IDPs and refugees. A meeting held on 2 August in Bangui between the Chadian and CAR governments and UNHCR allowed the three parties to adopt eight recommendations to prepare for a tripartite agreement for the voluntary repatriation of refugees in Chad, of which there are currently 78,100. On August 22, the Sustainable Development Goals (SDGs) Agenda in CAR was officially launched in Bangui, chaired by the Minister of Economy, Planning and Cooperation, Felix Moloua, and attended by the DSRSG and Humanitarian Coordinator, Fabrizio Hochschild. Estimated Affected Population (Estimates calculated based on initial figures from OCHA, May 2016) Start of humanitarian response: January 2014 Total Affected Population Children Affected (Under 18) Children Under Five Children 6 to 23 months Pregnant women Total Male Female 2.3 million 1.1 million 1.2 million 1.2 million 630, , , , , ,000 93,000 91,000 87,000 Humanitarian leadership and coordination UNICEF is intervening in all coordination activities for the cholera outbreak, in addition to WASH, health and C4D interventions in the field. RRM partner ACF was the first actor to respond with WASH activities in Ndjoukou, the epicentre of the outbreak. UNICEF is part of COUSP (Centre des Operations d Urgence de Santé Publique), the Cholera Wash/Health taskforce and the Social Mobilisation Commission and is working in collaboration with state partners (Ministry of Health and Ministry of Social Affairs) and humanitarian actors. A special CHF allocation (US$1.5 million) has been launched to respond to the cholera epidemic in CAR to contribute to reduce critical and urgent gaps, defined in the Epidemic Cholera Response Plan, at community level and in health facilities.

3 Humanitarian Strategy The Rapid Response Mechanism (RRM) is a UNICEF initiative in CAR that provides assistance to acutely vulnerable populations affected by a shock provoking a displacement of population. It undertakes rapid multi-sector needs assessments providing quality information to the humanitarian community while also delivering assistance in NFI and WASH to provide a basic means of survival for vulnerable populations. In addition, UNICEF implements a strategy of mobile teams to expand response in areas affected by humanitarian crisis with an inadequate presence of actors under the principle of equity. To provide durable solutions for IDPs, UNICEF is developing a strategy to respond to return movements, coordinated by the Emergency Task Force and Programme Coordination Meeting (PCM). Summary Analysis of Programme response Nutrition A total of 15,348 children (52% of the annual target) were admitted for treatment of Severe Acute Malnutrition (SAM), including children from host populations and IDP sites. The performance indicators for the treatment of SAM remain within international norms, with an 88.65% cure rate (>75%), a 1.85% death rate (<5%) and a 9.49% defaulter's rate (<15%). There continue to be pockets of high prevalence of acute malnutrition and limited access to nutrition facilities among populations who fled to the bush for a long period. The most recent SMART survey done in Kouango in Ouaka prefecture show a GAM rate of 8.1% and SAM rate of 1.8%. The ongoing process of national capacity building on the integrated acute management has reached 67.2% of the targeted health staff (830 out of 1,235 staff) The 20 sites to be covered by the IYCF qualitative survey have been identified. Education Throughout August, UNICEF continued to support the Ministry of Education to ensure that 30,481 children living in areas affected by the continuing crisis had access to education and recreational activities focused on providing catch up classes with a concentration on recreation and play during what is normally the summer vacation period. UNICEF Education in Emergencies (EIE) programming will continue in areas where insecurity continues to hinder children s attendance in school. In areas where security is improving and schools are reopening for the start of the official school year, UNICEF in collaboration with the Ministry of Education will facilitate the transition of children and teachers who have participated in the temporary learning spaces to formal functioning schools. Part of this transition phase includes carrying out an assessment of the current EIE structures, partner capacity and the status of schools in areas most affected by the crisis. Additionally in August, preparations to ensure the safe return of students to school for the opening of the official school year on 19 September were prioritized by UNICEF and the Ministry of Education. The overall objective is to ensure a mass return of all school aged children to school in CAR. A cholera prevention plan has also been included in the back to school preparations. As the new school year approaches, in close collaboration with the Ministry of Education, UNICEF is diligently striving to reestablish the Education Management Information System (EMIS). Health and HIV/AIDS During the month of August, 235 cases (119 children under 15 years) of cholera and 25 deaths (including 8 children) were reported by the Ministry of Health. Women represent 54.6 per cent of cases. Children under 15 years represent 7 per cent of all cases, and death rates are highest among children under 14 years (8 deaths out of 25, or 30 per cent. Up to date, Institut Pasteur Laboratory of Bangui has confirmed the presence of the cholera virus in seven patients in Bangui. In response, UNICEF continues to provide delivery of essential medical materials. A mission to provide technical support and a supply of drugs to Ndjoukou health centre is currently underway. Constraints include insufficient medical inputs. To address this, UNICEF has launched an emergency order of six cholera kits. In response to two cases of type 1 wild poliovirus detected in Nigeria, synchronized polio vaccination campaigns are being planned in the five countries of the Lake Chad region including CAR. 14 supervisors in Health Regions 4 and 6 received training on 22 August. In addition, 12 supervisors and 24 interviewers were trained in preparation for taking inventory of the cold chain at health facilities countrywide. 12 solar refrigerators were deployed to health centres in Ouham Pende and Bozoum.

4 1,536 HIV positive pregnant women received anti-retroviral therapy (ART) for the prevention of mother-to-child transmission (PMTCT) of HIV, and 1,188 children born to HIV positive mothers were put on ARVs. In addition 1,815 pregnant women, exposed children, adolescents / young people of childbearing age and partners of pregnant women were screened for HIV during a mass campaign in Mobaye. The reporting completeness rate remains low, at around 70 per cent in August, and there continue to be delays in the implementation of activities due to insecurity and logistical constraints. WASH In Bangui, with UNICEF support, ANEA and ACTED continue to maintain improved sanitation and access to drinking water in 11 IDP sites. In response to the cholera crisis, UNICEF is supporting NGO partners IDC, OIM and ACF and the government through distribution of WASH kits (Aquatabs, soap, bucket, Purs, chlorine for disinfection), chlorination of water points and construction of manual boreholes in areas with limited access to water. In addition, UNICEF is supporting community mobilization and sensitization on good hygiene practices, hand washing with soap and ending open defecation. Awareness campaigns were conducted by ANEA on good hygiene practices in 37 villages, districts and IDP sites, reaching 6,335 people including 3,743 women. In Kaga Bandoro, ANEA trained 50 teachers on hygiene, basic sanitation and the use of communication tools on handwashing and household water treatment. In Bambari, nine water point management committees were put in place and seven committees were revitalized. ANEA was provided with hand pumps, spare parts and portable compressors for the repair of 39 pumps to provide water for 12,725 people. With UNICEF support, SODECA continues to provide drinking water (over 9,600 m 3 /month) to an estimated 35,000 people in Bossangoa. TGH built 12 emergency latrines for newly displaced persons at SUCAF industry IDP site and conducted maintenance activities on 874 latrines. In Batangafo, with UNICEF support, Oxfam received 244 plastic slabs for latrine construction on IDP sites. 112 households at Gbazara IDP site in Batangafo received basic family kits (buckets, soap, jerry cans) through ANEA. Child Protection In Ombela Mpoko, 182 children formerly associated with armed groups (including 60 girls) completed training in smallscale trade and farming. In Bangui, 172 children (including 71 girls) successfully completed training and received work starter kits. In total, since the beginning of the year, 2,434 children including 748 girls have been released. In line with the annual MRM programme aimed at addressing countrywide MRM challenges and setting up regional MRM task forces, UNICEF and MINUSCA Child Protection organized two training sessions in Bambari and Bria for 53 people, including 9 women. In addition, a one day MRM training to strengthen the capacity of NGO protection staff took place in Bangui and Ndele for 64 staff. 17 ex-seleka commanders were sensitized by UNICEF and MINUSCA in Tiringoulou (Vakaga) and Bria (Haute-Kotto prefecture) on the six grave violations against child rights. Five unaccompanied children supported by the DDR program were reunited with their families in the locality of Bossembélé. Four children, including one girl, were reunited with their families around Bossangoa. In Ombella Mpoko, 4,485 children, including 1,795 girls participated in recreational activities in child-friendly spaces. 58 children gained access to facilitators or support persons in 16 listening centres. As of August, 52 centres that provide recreational activities and psychosocial support are functional across the country supporting 41,634 children including 18,969 girls. 13 cases of sexual violence (10 women and 2 girls) and 12 cases of physical violence were identified. From 11 to 18 August, UNICEF s psychosocial support consultant conducted face-to-face support sessions for ten survivors of sexual exploitation and abuse (SEA) in Bangui. On 20 August, UNICEF s psychosocial support consultant travelled to Bambari and conducted a five-day training session on psychosocial assistance for SEA victims for 24 social workers from NGOs (Mercy Corps and COOPI), local government officials and community members. Communications for Development (C4D) As part of cholera response, the C4D team supported the Bangui mayor s office to distribute handwashing devices and strengthen the knowledge of 300 heads of city districts on preventive measures against cholera. In collaboration with the Ministry of Health, UNICEF supported the training of 500 Red Cross community relays on cholera eight districts in Bangui, Bimbo and Begoua. 50 hygiene staff from the Bangui Municipality were sensitized on cholera prevention and 3,300

5 sessions were conducted in IDP sites in Bangui. Technical and financial support was provided to the Department of Community Health for social mobilization activities for the polio campaign in Regions 4 and 6. Rapid Response Mechanism (RRM) During the reporting period, the four implementing RRM partners (ACF, ACTED, PU-AMI, Solidarités International) received ten alerts and undertook five exploratory missions in the prefectures of Mamabere-Kadéï, Ouham, Ouham- Pendé and Mambéré-Kadéï and six Multi-Sectorial Assessments (MSAs) in the prefectures of Ouham, Ouaka, Mamabere-Kadéï, Bamingui Bangora, and Nana-Gribizi. Four NFI interventions took place in the prefectures of Ouham, Ouaka, Ouham-Pendé and Haut-Mbomou, reaching a total of 4,588 households (13,226 individuals) with plastic sheeting, blankets, soap, buckets, plastic mats, mosquito nets and kitchen kits. A SMART survey was carried out in Ouaka prefecture: 250 households visited and 272 children analyzed. A WASH intervention carried out for cholera prevention (hygiene promotion, water chlorination, sanitation in public spaces, rehabilitation of water points, installation of emergency latrines and bacteriological analysis) reached 10,545 individuals in Ndjoukou (Kémo prefecture).globally, since 1 January, a total of 23,057 households (102,783 individuals) have received NFI items, and 31,271 individuals have gained access to water and sanitation facilities thanks to RRM emergency interventions. This is a total of more of 134,000 beneficiaries. Media and External Communication During the reporting period, the communications team started working with the education section on the Back to School campaign; participated in the cholera task force and organised interviews for RFI and Radio Ndeke Luka with UNICEF WASH specialists; organised an interview with the representative with a Newsweek journalist on street children; and participated in the World Humanitarian Day celebration. The Facebook and Twitter pages were updated on a regular basis, attracting a growing number of interest and interactions. Supply and Logistics Container movements have reverted back to almost normal levels. Regarding programme supplies, general stock counts have been fully completed both in Bangui and Zone offices. With regards to procurement activities, the LTA related to NFIs is now completed and under implementation. Implementation of the 2016 Supply Plan has increased from 51% to 58%. New construction projects are progressing satisfactorily (out of nine schools to under construction, two are almost substantially completed; the heavy rehabilitation of six schools and construction of eight latrines in health centres is ongoing; out of 13 boreholes, almost ten are completed). Solicitations for additional construction projects are ongoing (29 latrines and 37 boreholes). The Kekereke project, a Japanese funded construction project for 50 schools and over 40 health centres, is officially closed, with four schools still being completed. Security In August, the security situation in August was marked by several incidents including the arrest of a KNK (Kwa Na Kwa, or Work and nothing but work in English) political figure, Francis Bozize, son of the former President Bozize, based on an international arrest warrant issued against him since May Both national and international UN and NGO staff suffered from police harassment, threats and illegal detention. There were also attacks on humanitarian vehicles and supplies, and robberies at the homes of UN and INGO staff within the country. In the north west, in Nana Boukuira, fighting erupted between armed groups and Peuhl cattle herders over cattle thefts. In Bambari, 30 Ex-Seleka that sought refuge at a MINUSCA military camp tried to relocate to Kaga Bandoro, but Anti-Balaka began shooting at the convoy in Grmari. They returned to Bambari and were later relocated to Kaga Bandoro by helicopter. In the east, groups linked to the Lord s Resistance Army continued to terrorize areas around Obo, Raffai and Yalinga. In the north east, Ex-Seleka chief Nourredine Adam reportedly moved back and forth between Ndele and Birao on a regular basis, linked to his involvement with Chinese oil companies.

6 Funding Funding Requirements (as defined in Humanitarian Appeal of January 2016) Funding gap Appeal Sector Requirements Funds available* $ % Nutrition 7,200,000 5,436,191 1,763,809 24% Health and HIV/AIDS 9,250,000 4,069,783 5,180,217 56% WASH 7,227,000 3,594,315 3,632,685 50% Child Protection 123,900,000 5,992,443 6,907,557 54% Education 6,118,000 1,354,049 4,763,951 78% Rapid Response Mechanism 13,000,000 8,085,779 4,914,221 38% Total 55,695,000 28,532,560 27,162,440 49% * Funds available includes funding received against current appeal as well as carry-forward from the previous year. Next SitRep: 1 October 2016 UNICEF CAR on Twitter: UNICEF CAR on Facebook: UNICEF CAR Humanitarian Action for Children 2016: Who to contact for further information: Mohamed Fall Representative Central African Republic Tel: mmfall@unicef.org Speciose Hakizimana Deputy Representative Central African Republic Tel: shakizimana@unicef.org Suzanne Suh Fundraising and Reporting Central African Republic Tel: ssuh@unicef.org Annex A SUMMARY OF PROGRAMME RESULTS 1 Cluster Response UNICEF and IPs WATER, SANITATION & HYGIENE Number of affected people provided with access to improved sources of water as per agreed standards Number of affected people provided with sanitation facilities as per agreed standards Number of internally displaced households provided with WASH NFI kits EDUCATION Number of children who received learning materials Number of displaced children aged 3 to 17 years with access to education in temporary learning spaces with teachers trained in psychosocial support HEALTH 2016 Total Results Change since last report 2016 Total Results Change since last report 700, ,021 12, , ,137 12, , , ,000 77, ,000 49, ,000 8, ,000 54, ,000 46, ,000 30, ,000 30, An adjustment exercise will take place in different clusters and in line with Results-Oriented Monitoring in September and as a result, the HPM will reflect new indicators and targets. Funding needs will be adjusted accordingly.

7 Number of children under 5 immunized against measles in IDP n/a 100,000 14,385 0 sites and epidemic districts Number of children under 5, including those in IDP sites and enclaves, with access to essential n/a 500, ,389 15,733 health services and medicines NUTRITION Number of children aged 6-59 months with Severe Acute Malnutrition (SAM) admitted for therapeutic care 29,250 15,348 4,039 29,250 15,348 4,039 Recovery rate 75% 88.6% % 88.6% 2.3 Death rate <10% 1.9% 0.4 <10% 1.9% 0.4 Default rate <15% 9.5% 1.9 <15% 9.5% 1.9 CHILD PROTECTION Number of unaccompanied and separated children reunited with their families Number of children released from armed forces and groups Number of women and children identified as survivors of sexual violence have access to holistic support HIV and AIDS Number of children born to mothers who are HIV positive who have access to appropriate treatment Number of pregnant women living with HIV who received ARVs for PMTCT PID RESPONSE MECHANISM Number of acutely vulnerable households following a shock that received rapid assistance with NFIs Number of acute acutely vulnerable people following a shock that received rapid and appropriate assistance in WASH 3, ,660 2, ,000 2, , , n/a 4,060 1, n/a 4,906 1,388 0 n/a 40,000 23,057 4,588 n/a 80,000 31,271 10,545