UNICEF Mauritania Monthly Situation Report October 2013

Transcription

1 Highlights UNICEF Mauritania Monthly Situation Report October 2013 $20,222,932 is required to respond to the humanitarian needs of children in Mauritania in 2013, with a current funding gap of $7,029,653 (35% of total requirements) to save the lives of children affected by the Malian refugee crisis and malnutrition. Mauritania is the largest recipient of refugees fleeing the conflict in Mali. 67,844 refugees* are living in the Mbéra camp, a remote desert location on the border with Mali with significant security challenges. 57% of the refugees are children and many have been in the camp for over a year, resulting in overlapping emergency and medium term needs. UNICEF, in coordination with UNHCR and partners, are providing formal and non-formal education in the camp for 7,166 children (49% girls) in six schools and psychosocial stimulation for around 5,000 children at six child friendly spaces. In 2013, 3,134 children have been treated for Severe Acute Malnutrition (SAM) by UNICEF and other nutrition actors. UNICEF is also continuing to support water treatment and distribution, construction and maintenance of showers and latrines and regular hygiene promotion sessions in the camp. Communities hosting the refugees are very poor and suffer high levels of food insecurity and malnutrition. UNICEF is helping to reinforce basic services, including malnutrition treatment. The expected national caseload of Global Acute Malnutrition (GAM) in 2013 is 122,719 children under five years, including 23,901 cases of SAM. Results from the lean season nutrition survey (SMART methodology) show national rates of 12.8% GAM and 2.0% SAM, as bad as last year (lean season 2012: 12.0% GAM and 1.7% SAM). Preventative blanket feeding, cash transfers and programmes to build longer term resilience are being implemented alongside life-saving nutrition interventions providing therapeutic food and medicines. A multi-sectorial package of services is being scaled up from 291 to all 488 nutrition centres. This includes health and WASH in Nut interventions to reinforce nutrition outcomes. Malnutrition Rates Improving in Mbéra Refugee Camp UNICEF/Mauritania/2014/Prieur Collaboration between the Government of Mauritania, UN agencies, NGOs and the refugee community to address malnutrition in Mbéra camp is having a positive impact. Preliminary reports from the October 2013 SMART survey conducted by the Ministry of Health with support from UNICEF, WFP, UNHCR and WHO, show that SAM rates have fallen to 1.4% in the October from 3.2% in January. GAM has fallen to 11.8% from 13.2% in January and 20% in July UNICEF and partners continue to work towards further reducing GAM and SAM. * updated 15 October 2013.

2 Situation Overview & Humanitarian Needs The size of the refugee population (67,844 refugees, 58% of which are children) has remained around the same level since the beginning of the year when 20,000 new arrivals crossed the border following the French military intervention. Life-saving interventions, such as treatment for acute malnutrition, measles vaccinations and the provision of clean water continue to be needed. With the camp now more than a year old, there are also medium term needs, such as more stable education facilities, that UNICEF, in coordination with the Government, UNHCR and partners, are addressing. The remote area of Mauritania, which is hosting the refugees, is very poor, suffers high levels of food insecurity and malnutrition and has limited government services. The needs of these communities are also being addressed and assistance given to reinforce basic services. Malian Refugee Crisis Refugees Estimated Affected Population (Estimates calculated based on initial figures from: updated 15 October 2013; and SMART Nutrition Survey, January 2013) Total Male Female Total Affected Population 67,844 30,869 37,043 Children Affected (Under 18) 39,078 19,471 19,607 Children Under Five 14,247 7,124 7,124 Children 6 to 23 months 4,274 2,137 2,137 Pregnant women 3,189 3,189 Children Under Five with Severe Acute Malnutrition (SAM) 3,430 1,681 1,749 Children Under Five with SAM and medical complications Children Under Five with Moderate Acute Malnutrition(MAM) 4,620 2,264 2,356 Malian Refugee Crisis Host Communities Estimated Affected Population (Estimates calculated based on initial figures from: Mauritanian Census 2000; results from the SMART Nutrition Survey, January 2013) Total Male Female Total Affected Population 48,639 23,911 24,728 Children Affected (Under 18) 24,319 11,955 12,364 Children Under Five 8,999 4,424 4,575 Children 6 to 23 months 2,203 1,083 1,120 Pregnant women 1,175 1,175 Children Under Five with Severe Acute Malnutrition (SAM) Children Under Five with SAM and medical complications Children Under Five with Moderate Acute Malnutrition( MAM) 1, The numbers of malnourished children being treated and benefitting from related WASH and protection interventions is also expected to rise steeply in the next few months. Chronic and recurrent acute malnutrition throughout the country is driven by underlying food insecurity, insufficient access to health care, clean water, sanitation and hygiene, poor feeding practices and lack of education on nutrition. Addressing the drivers of malnutrition requires longer term funding for resilience programmes to be implemented alongside emergency programmes. Nutrition in 2013 Estimated Affected Population (Estimates calculated based on initial figures from: Mauritanian Census 2000; results from the SMART Nutrition Survey, January 2013) Total Male Female Children Under Five with Severe Acute Malnutrition (SAM) 23,901 11,833 12,068 Children Under Five with SAM and medical complications 2,390 1,183 1,207 Children Under Five with Moderate Acute Malnutrition(MAM) 98,818 48,922 49,896 2

3 Inter-Agency Collaboration, Partnerships and Coordination UNICEF continues to work closely with the Government of Mauritania, UN partners and NGOs. For the nutrition response, UNICEF and the Government of Mauritania are co-leading nutrition, WASH and education sector coordination. In January, a CERF was funded for rapid response actions in the first six months of < Additional CERF funding has been provided for underfunded crises through to June The 2013 Consolidated Appeal Process (CAP) for Mauritania has been revised by OCHA. < Malian Refugee Crisis 2013 Nutrition WASH Health Child Protection Education Estimated # / % coverage Children < 5 years with Severe Acute Malnutrition admitted to Therapeutic care Children < 5 years with Severe Acute Malnutrition discharged recovered UNICEF Target UNICEF and partners Cumulative results % of Target Achieved Target Cumulative results % of Target Achieved % 3,430 3,134 88% % 2,745 2,507 91% Partners: Ministry of Health, WFP, UNHCR, Médecins Sans Frontières Number of people with access to functional latrines 24,930 a 24,930 a 100% a 68,016 68, % Number of people with access to sufficient safe water 11,667 a 11,667 a 100% a 68,016 68, % Partners: Ministry of Water Resources and Sanitation, UNHCR, Solidarites International, Intermon Oxfam, Mauritanian Red Crescent Children aged 6 months to 15 years vaccinated against 27, % measles Households with two or more insecticide treated mosquito nets 7,309 7,087 96% (ITNs) Partners: Ministry of Health, UNHCR, WHO, UNFPA, Médecins Sans Frontières and NGOs Emergency affected children provided with psychosocial support 7,377 5,000 68% 7,700 5,000 65% at CFSs Partners: Ministry of Social Affairs, Ministry of Health, UNHCR, UNFPA, WFP, Intersos Children with continued access to formal or non-formal 17,000 c 7,166 d 42% c 31,300 c 7,166 d 23% c education Partners: Ministry of Education, UNHCR, Intersos, ESD, FLM, Mauritanian Red Crescent, SOS Desert, MASEF. a Results based on provision of materials. Construction and operation of facilities are led by UNHCR and implemented with partners in the camp. b Households with one or two inhabitants received one net, households with three or more inhabitants received two nets. c The new academic year is commencing and revised targets will be set. d Results unchanged from last month as children have been on summer holidays. 3

4 UNICEF and partners programming Nutrition From January to October 2013, 3,134 children suffering SAM (88% of the expected case load for the year) have been admitted in nutrition units in Mbéra. UNICEF has supported the regular provision of ready to use therapeutic food (RUTF) and medicine to support the management of acute malnutrition. No stock-outs have occurred in Preliminary results from the October SMART Survey show a decline in GAM from 13.2% to 11.8% and a fall in SAM from 3.2% to 1.4%. The Survey, which was led by the Ministry of Health with technical and financial support from UNICEF and UNHCR in collaboration with WFP and WHO, also found very high rates of anaemia (over 50%) and chronic malnutrition (over 40%). The full results will be available shortly. WASH UNICEF continues to make a valuable contribution to the WASH activities in the camp, which are led by UNHCR. Through its Implementing partner Solidarites International, UNICEF continued to support hygiene promotion activities, construction of sanitation infrastructure and water supply systems. During this month, following activities have been carried out: 1,443 hygiene promotion sessions conducted with the participation of 21,223 beneficiaries. 35,000 were provided with treated water 116 showers have been constructed, and 38 latrines disinfected. Bacteriological analyses have been conducted. 402 samples were analyzed and appropriate actions (hygiene promotion, monitoring of residual chlorine at water points and household level,) have been taken to address those contaminated. Through the Hygiene and Sanitation Committee, a camp clean-up campaign has been conducted. UNICEF has supported distribution of sanitation kits distribution, training and equipment for community mobilizers in 15 host villages through its implementing partner Oxfam Intermon. Water points for rehabilitation have been identified and hygiene promotion sessions are starting in the communities and schools. Through the Regional Department of Water and Sanitation, UNICEF has supported the Community Approach to Total Sanitation (CATS) activities conducted in 13 host villages. Concerning the WASH in Nutrition programs started in the camp and host communities through our partners, all materials required have been received in the field. The distribution of WASH kits and hygiene promotion session for malnourished children and mothers, have started. Working closely with the Regional Department of Water and Sanitation, and WASH partners, UNICEF has supported monthly local coordination meetings, data collection and analysis for host communities. Health Through the Expanded Programme on Immunization (EPI), routine immunization activities at Mbéra continue to improve coverage rates. There is over 100% coverage for all children under 1 years of age for all major diseases 1 :. 4,038 pregnant women have been protected against Tetanus receiving at least two vaccinations. 1,013 births have been attended by qualified health workers as of October Vaccination coverage for children under 1 year of age includes: BCG for 3,030 children (102%); OPV3 for 3,020 children (106%); Penta3 for 2,879 children (101%); Measles for 2,984 children (105%). A further 14,367 children 12 months to 18 years have been vaccinated against measles. 4

5 UNICEF provided health kits and other basic drugs and materials that were distributed to health centers in the camp and host communities. These have enabled appropriate treatment of children in the Mbéra camp suffering from malaria (832), diarrhea (391) and respiratory acute infection (891). UNICEF is working with a national NGO to support the Government in routine immunization in Mbéra camp as well as sensitization and delivering integrated, highimpact interventions in the host community. In the host communities, UNICEF and partners continues to support district teams to organize outreach integrated activities. The population living in villages between Mbéra camp and the reception centre at Fassala have been given particular attention. On 6 to 14 October, seven health workers from the Bassikounou health facilities and Mbéra camp received training on IMCI with a focus on prevention and treatment of Malaria, Pneumonia and diarrhoea. Child Protection Together with UNHCR and Intersos, psychosocial services were provided to more than 5,000 children at six child friendly spaces in the month of September in Mbéra camp. 5,684 malnourished children (SAM and MAM) received emotional support through the reinforcement of the mother-children connection in seven nutritional centres in October in Mbéra camp. Training on case management and determining the best interests of children was provided with the support of the regional office to 30 participants from 7 child protection actors in Mbéra (NGOs and UN agencies). Education UNICEF, in coordination with UNHCR and partners, is strengthening efforts to provide formal and non-formal education to children and youth in the refugee camp following the Malian curriculum. 80 candidates of secondary school i.e. DEF and BACC sat for exams between 25 September and 4 October under supervision of the ministries of education of Mauritania and Mali with support from UNICEF and UNHCR. This was a special session organized by the Malian Ministry of Education for internally displaced persons and refugees following the Malian curriculum. The new Malian academic year opened on 20 October. A community sensitization campaign was held in the lead up to the new academic year for the children enrolment with focus on girls and children with disability. In addition, a meeting with teachers was held in collaboration with UNHCR and implementing partners. Parents Associations committees were refreshed on their roles and responsibilities. 2,955 table benches are being assembled by the Parents Associations and will cover 5,910 students. Another 460 table benches are in pipeline. A three day cultural festival was organized for youth and adolescents in the camp with the objective of enhancing cohesion between ethnic groups. It was also an occasion to sensitize the community on the right to education for all children, peace building, HIV/AIDS awareness and the back to school campaign for the new academic year. Activities also included girls and boys sports competitions. C4D 48 community relays disseminate hygiene promotion messages through awareness sessions and households visits. More than 15,000 people have been reached this year. 5

6 NUTRITION RESPONSE 2013 Nutrition Estimated # / % coverage Children < 5 years with Severe Acute Malnutrition admitted to Therapeutic care Children < 5 years with Severe Acute Malnutrition discharged cured Number of health centres with SAM treatment UNICEF Target UNICEF and partners Cumulative results ( #) (Jan. to Jun.) % of Target Achieved Cluster Target Cumulative results ( #) % of Target Achieved 23,901 9,056 38% a 23,901 9,056 a 38% a 17,925 5,227 a 29% a 17,925 5,227 a 29% a a 85% a a 85% a Partners: Ministry of Health, Action Contre la Faim, French Red Cross, Terre des hommes, Counterpart, World Vision, AMAMI, WFP, WHO, FAO, Ministry of Social Affairs, Committee on Food Security, UNFPA Numbers of mothers and children affected by SAM who received 23,901 5,665 b 24% b 23,901 6,402 b 27% b a WASH kit and hygiene promotion WASH Number of nutrition centres delivering the % % WASH minimum package Partners: Government of Mauritania, AMAMI, Ecodev, Moundi, Action Contre la Faim Emergency affected children provided with 15,400 9,617 62% 15,400 9,617 62% psychosocial support at CFSs Child Establishment of Protection CFSs at Nutrition % % centres Partners: Terre des Hommes Lausanne, Save the Children Espagne, Coordination des ONG et Associations de Nema (COAN), Actions a Based on partial data reported from health posts. Data is yet to be reported from some regions. National consultants have been hired to improve data collection and reporting on a regular basis b This number includes distribution of WASH kits in Gorgol to children affected by MAM as well as SAM. UNICEF and partners programming Nutrition Mauritania s expected caseload of SAM in 2013 is 23,901 children under five, exceeding the 2012 caseload. Results from the July 2013 nutrition survey using the SMART methodology show a GAM prevalence of 12.8% and 2.0% SAM prevalence in children under five years of age. This reflects the summer peak in malnutrition with the lean season expected to continue until the September harvest. The same seven regions of Mauritania exceed the emergency thresholds in 2013 as in 2012 (GAM > 15% or SAM > 2%). In these seven regions, UNICEF provides technical support through seven qualified Nutritionists assisting the Ministry of Health on the ground to scale-up activities addressing malnutrition and improve the quality of care. Their technical support helps the Ministry of Health to increase the number of health structures with SAM activities. 18 additional health structures have commenced SAM treatment activities this month. 6

7 WASH To strengthen monitoring of nutrition, the National Health Information Service organized training on the new software for health information management targeting Regional health directors, health information system managers, and nutrition focal points from all over the country. Nutrition sectorial group organized a joint monitoring visit to monitor the CMAM activities in Brakna, Gorgol and Guidimakha with the participation of UN agencies (UNICEF, WFP, WHO, OCHA), national and international NGOs and Government. Some challenges remind in term of capacity building, accessibility to nutrition centres, quality of care, stock and data management that need to be addressed. A follow-up plan is being finalised and will support the implementation of proposed actions within the three regions UNICEF continues to collaborate and coordinate the response with partners including the Government, UN agencies and national and international NGOs. WASH kits have been distributed to 252 mothers and malnourished children, with instruction how to use each item supplied. Regular hygiene promotion sessions have been conducted in the nutrition centres with the participation of 2,472 mothers of malnourished children. In close collaboration with the Regional Water and Sanitation Department, UNICEF continues to support the implementation of WASH in Nutrition programme : Distribution of WASH kits will commence next month for 5,998 mothers of children suffering malnutrition in the following regions: Gorgol, Assaba, Brakna, Hodh El Garbi, Hodh El Chargui, Trarza, Adrar, Tagant and Guidimaka. Assessment of WASH facilities in nutrition centres in Assaba, Brakna, Hodh El Garbi, and Hodh El Chargui, will be conducted by an external consultant. Child Protection From October, training was held with the Ministry of Social Affairs, Children and Women to reinforce the capacities of 25 professionals working in the Nouakchott child protection system in providing psychosocial support to vulnerable children. In Assaba, Brakna, Guidimakaha and Hodh El Chargui, psychosocial support through child friendly spaces and nutritionals centers is on-going. Psychosocial stimulation was provided for 1203 malnourished children ( 72 SAM, 1,131 MAM) in 6 nutritional centres. 3,849 Children attend to recreational activities in child friendly spaces. In Selibabi 4,443 persons attended information sessions on hygiene information. Education A programme monitoring the nutritional status of students and increasing awareness of malnutrition in parents associations and school management committees through local NGOs is being finalised. Much of the preliminary work has been done for the provision of snacks in 233 preschools for 9,600 children (57% girls) aged 3 to 5 years. Implementation is expected to commence in the new academic year. HIV and AIDS UNICEF has developed a partnership with an NGO to operationalize the prevention of mother to child transmission (PMTCT) interventions in six districts including two regions affected by the food crisis and four in peri-urban areas of Nouakchott. Anti-retroviral treatment (ART) and HIV diagnosis tests are supplied to support prevention and treatment of around 100 HIV positive children and 500 HIV positive pregnant women. SUPPLY & LOGISTICS 7

8 Supplies with a value of USD 4,280,232 have been provided in 2012 and 2013 to respond to the Mali and Sahel nutrition crises in Mauritania. This includes supplies with a value of USD 1,966,022 from 1 January 2013 to 21 October Supplies delivered contained essential commodities such as recreation kits, school-in-a-box kits, RUTF, hygiene kits, basic family water kits, water purification tabs, squatting plates and tarpaulins. Funding Update UNICEF Mauritania s revised mid-year requirement for its Humanitarian Action for Children (HAC) in 2013 is USD 20,222,932. This is an increase of USD 1,336,996 from the initial requirement of USD 18,885,936 and reflects additional needs, such as the establishment of a sub-office in Bassiknou to meet the needs of children in the refugee camp and host communities. The total funding requirements include USD 16,950,981 in the revised CAP for Mauritania. Funding Requirements Appeal Requirements Funds received in July Funding gap $ $ $ % NUTRITION 6,148, ,304, ,382 14% HEALTH 2,969, ,013, ,749 32% WASH 4,066, ,540,184 2,525,917 62% C4D 160, ,000 50,027 31% EDUCATION 4,104, ,346,872 1,757,705 43% CHILD PROTECTION 1,955, ,054, ,626 46% SECTOR COORDINATION 818, ,042 (3,292) 0% Unallocated 2,461 (2,461) Total* 20,222,932 13,193,279 7,029,653 35% UNICEF wishes to express its deep gratitude to all public and private sector donors for the contributions and pledges received, which have made the current response possible. UNICEF would especially like to thank National Committees and donors who have contributed unearmarked funding. Unearmarked funding gives UNICEF essential flexibility to direct resources and ensure the delivery of life-saving supplies and interventions to where they are needed most especially in the form of longer-term and predictable funding and in strengthening preparedness and resilience building. Continued donor support is critical to continue scaling up the response. 8

9 *** FLOODS IN NOUAKCHOTT AND SURROUNDING REGIONS *** Weeks of heavy rains since mid-august have resulted in significant flooding in the capital Nouakchott, and the regions of Assaba, Brakna, Gudimakha, Tagant and Traza. Eight people have died as a result and 2,305 people have been displaced (OCHA). The communities that have been most affected by the disaster are those of the district of Moudjeria in the Tagant region in south-central Mauritania, where 40% of families have lost their homes (Mauritanian Red Crescent). To date, UNICEF s response includes: Preparing schools to reopen since 10 October for the new academic year by pumping out water, decontaminating buildings, repairing water supply, electrical and septic systems and replacing materials destroyed. Four of the 66 schools affected have been assisted to date. Health and nutrition centers will also be supported Hygiene and sanitation materials are being distributed for 1,500 households. Water treatment is being provided for 10,000 people Long-life, insecticide-treated mosquito nets are being distributed for 5,000 people (commenced) Additional, targeted community education messages provided Additional WASH package activities (latrines construction, water point rehabilitation and hygiene promotion sessions including distribution of hygiene materials) will be provided for at least 11,596 people. Internal funding and stocks have been reallocated to respond to immediate needs, while further funding is being sought. For further information, please contact Lucia Elmi Representative Nouakchott Mauritania Telephone: Facsimile: lelmi@unicef.org Aissata Ba Sidibe Deputy Representative Nouakchott Mauritania Telephone: Facsimile: asidibe@unicef.org Anthea Moore Resource Mobilisation and Reporting Specialist Nouakchott Mauritania Telephone: Facsimile: amoore@unicef.org Brahim Ould Isselmou Communications Specialist Nouakchott Mauritania Telephone: Facsimile: bouldisselmou@unicef.org 9