Central African Republic

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1 Central African Republic Humanitarian Situation Report Central African Republic Humanitarian Situation Report UNICEFCAR/2017 Reporting period: 1-31 October REPORTING PERIOD: 1-31 March 2017 Highlights Since the beginning of the year, violent clashes between criminalized armed groups and armed civilians so-called auto-defence groups and attacks on the civilian population have mounted. Marked by widespread human rights violations, entire neighbourhoods and villages have been burned down and whole cities emptied. Overall, the number of IDPs has reached 601,142 nearly half of them children, while one in two people need aid to survive. The Secretary General of the United Nations, Mr. Antonio Guterres, visited the Central African Republic from 24 to 27 October. His visit highlighted the degradation of the humanitarian situation. During his visit, he travelled to the town of Bangassou in the southeast where since May there has been continuous violence and where approximately 1,500 IPDs of one ethnic group are confined to a church where an armed group allows no entry or exit from the site. Students from ETAPEs (Temporary Learning and Child Protection Area) and refugees will now be exempt from tuition fees in schools in the return areas. This measure was taken 12 October 2017, with immediate effect, by the Ministry of National Education, Higher Education and Scientific Research. It responds to a request from displaced families both in Bangui and in the provinces. UNICEF s Response with Partners Key Programme Indicators WASH: Number of affected people provided with access to improved sources of water as per agreed standards Education: Number of children (boys and girls 3-17yrs) in areas affected by crisis accessing education in temporary learning spaces (TLS) Health: Number of children under 5 in IDP sites and enclaves with access to essential health services and medicines. Nutrition: Number of children aged 6-59 months with SAM admitted for therapeutic care. Child Protection: Children (boys and girls) released from armed forces and armed groups who participate in a community reintegration programme. N/A= Not Applicable Sector/Cluster Cluster Target Cumulative results (#) UNICEF Target UNICEF Cumulative results (#) 1,600,000 1,013, , ,292 94,400 56,188 75,000 56,188 N/A 500, ,351 30,521 17,681 30,521 17,681 4,874 3,578 3,500 1,980 SITUATION IN NUMBERS October million Children in need (2017 Humanitarian Response Plan) 2.4 million People affected (2017 Humanitarian Response Plan) 601,642 Internally displaced persons (CMP, 31 Oct 2017) 538,432 Refugees in neighbouring countries (Chad, Cameroon, DRC, Congo) (UNHCR, 31 Oct 2017) UNICEF Appeal 2017 US$ 53.6 million Funding Gap: 29,025,982 Funds received, $16,685,369 Carry-Over: $7,888,649

2 Situation Overview & Humanitarian Needs Violent clashes and inter-communal tensions fuelled by armed groups have continuously increased in the Central African Republic (CAR). In the absence of an effective judicial system and basic security services by the public administration, armed groups have continued to perpetrate violent and destabilizing acts, of which the civilian population is the main victim. The targeting of minorities, including women and children, has resurfaced, with killings and attacks against communities multiplying. Conflict and forced displacement is increasingly widespread and impacting previously unaffected parts of the country. As the crisis further expands towards the southeast and northwest of the country, there are new displacements and there is a significant risk that the condition of people previously displaced that remain in camps will deteriorate. Nearly one family out of four has already been forced to flee or seek refuge in neighbouring countries. During the month of October, the new areas of violence occurred in the northwest (Bocaranga and Niem) and southeast (Pombolo, Dimbi, Gambo, Pavica) of CAR causing new displacements and humanitarian needs. Armed groups have taken over several localities, in particular the cities of Bocaranga and Niem and the ensuing confrontations have caused a large number of displacements. The vast majority of the inhabitants of Bocaranga, 15,000, and those of Niem, 8,000, took refuge in the bush where they cannot access humanitarian assistance. These incidents occurred as acts of violence against humanitarian personnel in the area had also recently prompted several actors to temporarily suspend their activities. Humanitarian access remains a major challenge for an effective response in the southeast in the face of increasing population displacement. The area remains virtually inaccessible to humanitarian aid. Estimated Population in Need of Humanitarian Assistance (Estimates calculated based on revised CAR Humanitarian Response Plan , rev. June 2017) Start of humanitarian response: January 2014 Total Male Female Total Population in Need 2.4 million 1.2 million 1.2 million Children (Under 18) 1.2 million 0.6 million 0.6 million Children Under Five 547, , ,750 Children 6 to 23 months 271, , ,942 Pregnant women 87,000 Humanitarian Leadership and Coordination UNICEF is a member of the Humanitarian Country Team (HCT), UN Country Team (UNCT) and Security Management Team (SMT). UNICEF leads WASH, Nutrition Education clusters and Child Protection sub-cluster. The Government co-chairs WASH and Education clusters, Child Protection sub-cluster and is an active member of the Nutrition cluster. Child Protection (CP) sub-cluster covers all provinces directly or indirectly. Nutrition is paired with health and works through three sub-clusters at the sub-regional level. The Education and WASH clusters are also functional at the sub-regional level. UNICEF is the coordinator of the Rapid Response Mechanism (RRM) and is a member of the Health and, through the RRM Coordinator, Shelter/NFI/Camp Management clusters. The Cluster/Sub-Cluster leads and RRM Coordinator are members of the Inter-Cluster Coordination team (ICC). Humanitarian Strategy UNICEF prioritizes life-saving interventions and risk reduction for crisis-affected, displaced and returning people in CAR. Capacity building and preparedness activities are reinforced. UNICEF tackles preventable childhood illnesses, malaria, HIV and malnutrition, and provides people with access to safe water and improved sanitation. UNICEF focuses on protection needs of children, including their release from armed groups and their reunification with families when separated or unaccompanied, and provides the appropriate psychosocial support to vulnerable children. Children who are out of school due to crisis will gain access to safe learning spaces and quality education. The Rapid Response Mechanism (RRM) provides non-food items (NFIs) and water, sanitation and hygiene (WASH) support to vulnerable people suffering shocks. UNICEF works with line ministries to strengthen government capacity for humanitarian coordination, leadership and response.

3 UNICEF also plays a strong role in health programming and will continue to support education, nutrition, health, NFI and WASH core supply pipelines. Summary Analysis of Programme Response WASH The latest violence in cities of Batangafo, Bria, Pombolo, Bocaranga, Gambo, Kembe has affected vulnerable people including children and women and have created emergency WASH needs for over 123,000 people. To support this response, UNICEF provided a 10 m3 bladder to the ANEA Agence Nationale de l Eau et de l Assainissement for water provision in Kaga-Bandoro. In Bossangoa, AFEB Association des Femmes de l Eglise Baptiste was provided with 60 buckets of 10l, 2,400 bars of soap, 20 sets of spare parts for India mark III pumps, ten sets of spare part kits for hydro- India pump, four complete India Mark II pumps, two complete hydro-vergnet pumps, eight standard toolboxes, eight special toolboxes. In Pombolo, 1,000 jerry cans, 36,000 aquatab tablets and 2,000 pieces of soap was distributed to 2,000 IDPs. In Alindao, DGH Direction Générale de l Hydraulique and ANEA were enabled to build 73 shower cabins, set up and equip 3 hygiene committees for the use of 3,316 households in four IDP sites. In Kaga-Bandoro, Bossangoa and Alindao, 11 water pumps were repaired for approximately 6,512 people. In Bria, Kaga- Bandoro, Bambari, Bossangoa and Bouar more than 18,027m3 of water were produced for 86,896 IDPs. In Pombolo, DGH and ANEA constructed four hand dug wells. Education While the official opening of the school year kicked off on 18 September, many schools remain closed in areas where violence and insecurity persists. According to the Ministry of Education, over 170,000 children not started school by the end of the reporting period as approximately 565 schools had not officially opened. UNICEF and MINUSCA continue to provide support to the Ministry of Education to organize catch up classes and end of year exams in some of the areas where the insecurity prevented children from taking these important tests in June The exams will start on 1 November and end 16 of November. The Ministry has designated 20 November for the official opening of the school year in these areas. UNICEF and education partners are in the process of commencing Education Cannot Wait projects to provide access to education through Temporary Learning Spaces to more than 60,000 children. The Humanitarian Fund launched a call for proposals to provide seven million USD to fund projects in response to the most recent escalation of violence, including Education in Emergency programming. The Education Cluster developed a joint intervention strategy with the Sub Cluster Child Protection. Successful projects will be selected in the first half of November. Child Protection UNICEF and its partners obtained the release of 286 children (118 girls) from armed groups in Birao, Bambari and Kaga- Bandoro. Thirty children of them are currently being cared for in an interim care center in Bambari managed by War Child UK. The majority of the children were released from Ex-Seleka factions as a result of advocacy activities conducted by MINUSCA and UNICEF Child Protection Teams. In six new child-friendly spaces and eight youth club established in Vakaga prefecture by a UNICEF partner, 22,410 children including 12,572 girls, participated in recreational activities. Ms. Jane Connors, the newly appointed UN Victim s Rights Advocate for Sexual Exploitation and Abuse (SEA), visited CAR from 17 to 27 October. The purpose of her visit was to accompany the UN Secretary-General and learn about the SEA prevention and response activities. The major activities organized during her mission were: working sessions with SEA/GBV and child protection implementing partners, field mission to Bambari, and meeting with SEA child survivors. The latter were facilitated by the UNICEF tea in the Bambari Field Office. Her visit was an opportunity to raise concerns about gaps in assistance to survivors, and particularly regarding legal assistance and coordination. UNICEF and its partners also facilitated a meeting between the UNSG and two child SEA survivors.

4 Rapid Response Mechanism RRM partners (Action Contre la Faim, ACTED, Solidarités International and ESPERANCE) received five humanitarian alerts in the south east (Basse-Kotto, Mbomou and Haut-Mbomou), north west (Ouham Pende and Ouham) and centre (Nana- Gribizi) of the country. Assessments undertaken during this period included five Exploratory Missions (MEX) and five Multi-Sectorial Assessments (MSA). During October, a feasibility study on alternative approaches to NFI distribution to populations in need was conducted. Options looked at were NFI fairs using coupons, vouchers or cash, or fairs coupled with distributions of items unavailable in local markets. Preliminary results highlighted the importance of a case by case approach, sensitive to different protection issues in different regions. Alternative approaches to NFI distributions are doable, but under rather restrictive conditions: time required for procurement, logistic and security access, payment method, merchant profile, training and support of RRM partners for the organization of the pilot fairs are the next steps. Health - Maternal, New-born and Child Health (MNCH) In the framework of Lake Chad Polio Response, the Ministry of Health with the support of UNICEF and WHO, conducted a local polio immunization campaign in five most-at-risk districts of polio in the country. A total of 355,928 children aged from 0 to 59 months were vaccinated. Among them, 21 per cent of these children are from special populations that are hard to reach (IDP, nomads, pygmies...). This result was achieved thanks to the support of MINUSCA which transported vaccinators and vaccination materials in areas occupied by armed groups. HIV & AIDS During the reporting period, 662 new pregnant women and 98 children born of HIV + mothers had access to Anti- Retroviral Treatment (ART)in the emergency affected zones (health regions 3, 4 and 5). A final reporting of HIV testing campaign by active case finding in Bimbo and Bangui points out a total of 8,645 children from 5,759 PLHIV families tested with 245 positives cases (2.9%). All cases were oriented for an access to ART services. In addition, technical support has been provided to the Ouham Health district authorities for the training of 28 medical and community health staff, including seven doctors and six nurses, from all health districts of that region. The launching of HIV family testing in three health centres from Ouham (health district of Bouca, Boguila and Bossangoa) to improve the delivering of HIV paediatric care reached 26 families registered for the testing of 63 children with one new positive case. Nutrition Treatment of severe acute malnutrition (SAM) is being implemented in Obo, Zemio, Bangassou, Kaga-Bandoro, Mobaye and Zangba. In Mobaye and Zangba, activities have only been carried out in secured areas focusing on three health facilities: Mobaye hospital, urban Mobaye and Langandji health centers covering 10,000 habitants. Langandji locality has been deprived of access for three months without the capacity to refer SAM cases with medical complications. UNICEF, with support from MINUSCA, supplied Langandji health centre with 250 cartons of ready-to-use therapeutic foods (RUTF) and drugs to ensure integrated care to around 52 SAM cases and continuation of screening activities in this locality hosting around 1,500 nomadic people. Some 14 SAM cases, three with medical complications, have been referred and treated. To prevent a stock-out of RUTF, UNICEF CAR procured 10,600 cartons received at end of October. The distribution will cover three months for implementing partners and the prepositioning in four zonal offices. Preliminary results of a rapid SMART survey conducted by Action Contre la Faim (ACF) in Ngaoundaye indicated a Global Acute Malnutrition (GAM) rate of 6.5 per cent, SAM rate of 2.5 per cent, and stunting prevalence of 43 per cent Communications for Development (C4D), Community Engagement & Accountability C4D efforts have focused on interventions aimed at informing and mobilizing communities on issues pertaining to poliomyelitis during the Local Immunization Days (LID) that took place from 6 to 9 October in five prefectures categorized as at risk of poliomyelitis (Sangha Mbaéré, Mambéré Kadei, Nana Mambéré, Ouham Pendé and Ouham). The communication activities started three days in advance of the LIDs and consisted of door-to-door visits, meetings of local

5 chiefs and stakeholders and mobilization of community radio stations for the production and airing of spots and other programmes. Meanwhile, new partnerships were launched with the Scouts Association and Mentor Initiative to boost communication and social mobilization in conjunction with Government efforts. Theatre interventions were conducted in markets, taxi stands and bus stops in Bossangoa and Bangui. Specific activities took place with nomadic herding communities in the transhumance corridor of the Ouham Pendé prefecture. The Heroes of Vaccination posters, a campaign giving value to those engaged in immunization as well as reinforcing the idea of proximity, have been widely disseminated. All these interventions were conducted in support to the efforts of the Directorate of Community Health (DCH) of the Ministry of Health and Population (MHP). Media and External Communication During the reporting period, the UNICEF CAR External Communications team worked with the UN Communications group to prepare for UN Day and the UNSG visit. The section organized visits to schools and the Pediatric hospital for a BBC journalist (stories to be published at an unknown date). The Chief of communication participated in a Debate on France 24 about the situation in CAR. Security Decreased humanitarian access remains the main difficulty in reaching those in need especially in the North-West and South-East of the country. Almost all International NGOs have left those areas making it very challenging to assist those in need. Armed groups keep on targeting the United Nations Multidimensional Integrated Stabilization Mission in the Central African Republic (MINUSCA) especially while protecting Muslim IDP camps in the South-East. Social cohesion is still very weak as shown by several outbreaks of inter-community violence in Bangui and inside the country. Funding UNICEF wishes to express its deep gratitude to donors for the contributions and pledges received, which have made the current response possible. Most recently, generous funding supports was received from donors such as the Spanish National Committee for UNICEF, OCHA s Central Emergency Response Fund, OFDA and UNICEF's Global Thematic Humanitarian Fund. With the spread of conflicts leading to more displaced children and families in new areas, continued donor support is critical. Child protection, health, WASH, and nutrition needs are increasing while the significant funding gaps ranging from per cent are hampering effective response. Funding Requirements (as defined in Humanitarian Appeal) Funds available Funding gap Appeal Sector Requirements Funds Received Current Year Carry-Over $ % WASH 9,000,000 1,436,263 1,242,788 6,320,949 70% Education * 7,300, , ,952 5,749,440 79% Heath & HIV AIDS 8,100,000 1,030, ,884 6,259,440 77% Nutrition 7,200, ,765 1,498,201 4,776,034 66% Child Protection 9,000,000 1,978,959 1,751,429 5,269,612 59% Rapid Response Mechanism (RRM) 12,200,000 9,789,098 1,810, ,507 5% Cluster Coordination 800, , ,000 6% Total 53,600,000 16,685,369 7,888,649 29,025,982 54% *In addition to the Emergency funds received, the CAR CO has utilized $2,493,947 of other resources - Education Cannot Wait global fund - to cover the education humanitarian needs. Next SitRep: 1 December 2017 UNICEF CAR on Twitter:

6 UNICEF CAR on Facebook: UNICEF CAR Humanitarian Action for Children 2016: Who to contact for further information: Christine Muhigana Representative Central African Republic Tel: Speciose Hakizimana Deputy Representative Central African Republic Tel: Deirdre Kiernan Chief Emergency & Field Operations Central African Republic Tel:

7 Annex A SUMMARY OF PROGRAMME RESULTS NUTRITION Number of children between 6-59m affected by SAM admitted for treatment 1 UNICEF 2017 revised target UNICEF total results as of Oct 2017 Change since last report Cluster 2017 revised target Cluster total results as of Oct 2017 Change since last report 30,521 17,681 1,112 30,521 17,681 1,112 Recovery rate >75% 90.90% 0% >75% 90.90% 0% HEALTH Number of children under 5 in sites for internally displaced persons and enclaves with access to essential health services and medicines 500, ,351 60,507 WATER, SANITATION AND HYGIENE (WASH) Number of crisis affected people provided with access to improved sources of water as per agreed standards. Number of crisis affected people provided with sanitation facilities as per agreed standards. CHILD PROTECTION Number of separated and unaccompanied children reunified with their families. Number of children reached with psychosocial support through CFS. Number of children (boys and girls) released from armed forces and armed groups who participate in a community reintegration programme. 600, ,282 8,512 1,600,000 1,013,553 89, , , , , ,000 [2] , ,000 [3] 102,787 22, , ,402 22,410 3,500 1, ,874 3, Number of women and children identified as survivors of sexual violence who have access to holistic support. EDUCATION 1,000 [5] 317 (W:640 / W:203/ C:360) C , Number of children (boys and girls 3-17 yrs) in areas affected by crisis accessing education Number of children (boys and girls 3-17yrs) attending school in a class led by a teacher trained in psychosocial support 7 RAPID RESPONSE MECHANISM Acutely vulnerable households that received rapid assistance with NFIs following a shock Affected people receiving appropriate WASH interventions after a shock. 75,000 56,188 3,649 94,400 [6] 56,188 3, ,500 51,374 5, ,000 51,374 5,790 28,000 24,030 1,652 80,000 71,449 18,605 1 Cluster and UNICEF results are the same as UNICEF is the sole provider of therapeutic nutritional inputs in CAR for all partners 2 Target revised to 1,000 because initial target of 300 reached 3 Target revised to 100,000 because initial target of 50,000 reached 4 This is the revised HRP cluster target as per revised HRP. Although target has been reached it has not been revised further. Target will be increased in 2018 HRP 5 Initial target of 2,000 reduced to 1,000 because total result as of end of September is 311 survivors far above the target of 2,000 planned initially 6 Cluster target is higher than the HRP mid-yr revision due to increased capacity through additional funds received. 7 # of children calculated by # of teachers trained x 75 (average number of students taught by a teacher).

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