Revised Emergency Plan of Action. Ethiopia: Population Movement

Transcription

1 Revised Emergency Plan of Action Ethiopia: Population Movement Revised Emergency Appeal Operation n MDRET015; Glide n OT ETH Date of issue: 21 September, 2015 Date of disaster: 15 December, 2013 Operation manager (responsible for this EPoA): Jill Clements, Country Representative, IFRC Ethiopia Point of contact: Hagos Gemechu, Deputy General Secretary for Programmes, ERCS. Operation start date: 22 December, 2014 Expected timeframe: 12 months (New end Date:22 December, 2015) Revised operation budget: CHF 756,115 DREF allocated:chf 150,000 Number of people affected: 264,460 refugees Number of people to be assisted: 47,101 (Population of Jewii Camp) Red Cross Red Crescent Movement partners actively involved in the operation: IFRC and ICRC. Other partner organizations actively involved in the operation: UN Refugee Agency (UNHCR), Ethiopian Government Administration of Refugees and Returnees Affairs (ARRA), UNICEF, World Food Programme (WFP) International Organization for Migration (IOM), World Health Organization (WHO), Norwegian Refugee Council (NRC), Danish Refugee Council (DRC), Action Contra Famine (ACF), Medecine Sans Frontiers- France (MSF), ACT Alliance, International Medical Corps (IMC), Oxfam GB, ADRA, Save the Children International (SCI) and RaDo. This revised appeal presents activities planned for the emergency response to South Sudanese refugees in Gambella s newest refugee camp, Jewii, from July to December During the first six months of the appeal activities, the initial three locations were reduced to one (Leitchour) due to funding constraints. In line with a footprint approach, the operations have now shifted from the previous location to the newly opened camp (Jewii) closer to Gambella town. This revised appeal thus presents the adjusted activities to the new location and extends the time frame with three months. This action will enable the Ethiopia Red Cross Society to further enhance the capacity built up during the previous operation, identify a sustainable exit strategy and engage in a contingency plan for Movement support to the Gambella refugees in the future alongside with continuing to deliver lifesaving services to the vulnerable refugee population. With the revision the appeal is 82% funded and an additional CHF 136,100 is needed to fully achieve the operations objectives of delivering health and hygiene promotion and lifesaving emergency health services to 47,101 South Sudanese refugees in Jewii camp. A. Situation analysis Description of the disaster Violence broke out in Juba on 15 December, 2013 between government and opposition forces and quickly spread to other locations in South Sudan. Despite several attempts to sign cessation of hostilities and cease fire between the South Sudan government and the opposition, the conflict still continues, affecting over 3.8 million people and resulting to severe humanitarian crises within the country and in the neighbouring countries. Since December 2013 up to 1.5 million people have been displaced and more than 480,000 South Sudanese have moved across borders whereas within South Sudan itself, there are 1,606,834 internally displaced people (UNHCR 12 June, 2015). An estimated 240,000 1 people have fled into Ethiopia where they are being hosted in Gambella and Benishungul-Gumuz regions. Since Ethiopia were already hosting South Sudanese refugees prior to the December 2013 conflict, this entails that the accumulative number of South Sudanese refugees within Ethiopia s Gambella region is 284,431 individuals including the pre December 2013 arrivals. 1 This figure includes the estimated 10,000 new arrivals in Ethiopia s Benishangul-Gumuz region (Source UNHCR Update June 2015).

2 P a g e 2 As the conflict in South Sudan continues, the humanitarian situation is worsening. New arrivals into Ethiopia continue at a rate of estimated 220 individuals per day of which most quotes food insecurity and violent conflict as primary push factors. As of UNHCR updates on 24 July 2015, humanitarian agencies are warning of 4.6 million people projected to be affected by food insecurity by the end of 2015, mainly in the South Sudanese states bordering Gambella, i.e. Greater Upper Nile (Jonglei, Upper Niles and Unity states). Jonglei and Upper Nile, the origin of most refugees crossing into Ethiopia, is home to a range of ethnic groups, and has a long history of on-going conflict, chronic food insecurity and inter-group violence. Throughout the conflict the Ethiopian borders have remained open to refugees who have been received on a primae facie basis. The South Sudanese refugee population has now become the largest refugee group in Ethiopia, surpassing the Somali refugee population, and making Ethiopia the country in Africa hosting the largest population of refugees (more than ) 2. July 2015 saw the arrival of the second rainy season since the beginning of the crisis. Although the most flood prone camp (Leitchour) has been closed, the humanitarian operations remain critical due to the rains and flooding with a number of entry points cut off from road transport, and exacerbating humanitarian needs. Due to the flooding, the impassability of key transit routes and existing camps having reached their carrying capacity, an estimated 13,816 refugees remain stuck at entry points and transit centers awaiting relocation. Should the food insecurities and conflict continue to deteriorate in South Sudan, it is highly likely that an increased influx of refugees will be seen once the end of the rainy season allows for easier access. A heighted risk of an outbreak of waterborne diseases, especially at entry points and in Jewii camp, remains a significant concern due to challenges with providing minimum standards in water and sanitation in these locations. Refugee Hosting and Management ARRA and UNHCR are the lead coordinating agencies in the Gambella refugee response. UNHCRs 2015 planning figures for its operations across Ethiopia is 812,700 refugees and asylum-seekers. UNHCRs Global Appeal for 2015 funding needs for Ethiopia is critically underfunded (20%).The continued presence and new influx of refugees has created competition in the region for scarce resources and aid pipelines are stretched. Consequently implementing partners are struggling to provide essential services to the refugees in core sectors such as water, sanitation and health. The vastly complex and comprehensive operating environment, and the fluidity of the situation in Gambella and South Sudan, continues to require all actors to apply flexible and agile models of support to the refugee operation. There are five open camps in Gambella. Four of them, Tierkidi, Kule, Pugnido and Jewii are near the northern border with South Sudan, while Pugnido is in the centre of Gambella region. In addition, there are three entry points: Akobo, Burbie and Pagak. Matar is a transit centre. Okugo is located in Dima Woreda, in the southern part of Gambella region. Table 1: Population in camps and entry points as of 24 July 2015 according to the UNHCR Camp Entry point/transit centres Name Total population Comment Pugnido 63,302 Total camp population 216, 535 individuals. Tierkidi 52,026 Note that the difference in the total sum Kule 47,231 represents host communities registered in Jewii 47,101 camps but not as refugees. Okugo 6,734 Average family size is 4. Matar 5,968 Total number of registered refugees awaiting relocation: 10,527 individuals. Pagak 3,939 Burbei 620 Relocated from Burbei and Akobo (Tirgol) on-going. Will be hosted here until the opening of Pugnido II. 2 The number of refugees in Ethiopia is over 650,000 individuals, with the number increasing on a daily basis due to the current influx from South Sudan. The South Sudanese population is now the largest population group, with over 250,000 individuals, followed closely by Somali, with over 245,000 individuals, Eritreans, with over 100,000 individuals, Sudanese, with over 35,000 individuals, and refugees from several other countries, including Kenya, Djibouti, DRC, Yemen, Burundi, Rwanda, and Uganda, with some 4,300 individuals.

3 P a g e 3 Summary of the current response Movement response to Population Movement In responding to the South Sudan population displacement, ERCS participated in one of the first inter-agency assessments in Akobo, a main entry point, in January ERCS and IFRC senior management travelled to Gambela to assess branch capacity and meet with Government and UN officials on potential responses. A few weeks later, the ICRC also carried out an assessment mission to the region to determine how best to support tracing needs and the ERCS branch in light of the refugee crisis. These assessments resulted in an emergency response and DREF in partnership with Swiss RC which included activities in Leitchour camp, Kule camp, two entry points and the medical facilities in Gambella town. As a result of these assessments, efforts were made by Movement partners to coordinate their interventions through the creation of an Addis-based Gambella Taskforce, and similar efforts at Gambella level to improve Movement coordination. Assessments have been on-going, latest was in end of July 2015 in Matar transit centre leading to the deployment of one ambulance for an interim period of one month for referrals to Gambella hospital for critical cases. February 2014, the National Society with support from IFRC s DREF facility and Swiss RC provided ambulance services, hygiene/health promotion and environmental sanitation in Leitchour camp. During the first influx of refugees in early 2014, some of the activities implemented by Ethiopian RC in cooperation with ICRC included water trucking in Kule camp, emergency shelter and ambulance service at entry points, latrine construction and hygiene kit distribution in addition to the core activities in RFL and tracing. In addition ICRC has provided comprehensive support to Gambella Hospital and Blood Bank (essential drugs, war wounded surgical kits, and strengthening of water supply infrastructure) as well as medical supplies to Ninnang and Itang Health Centres including support from their Orthopaedic specialists for war wounded. Furthermore, ICRC supported the DREF directly in funding for the ambulance services and community workers for hygiene promotion from Aug 2014 until the EA took over. In August 2014, a joint assessment team (ERCS, IFRC, ICRC and Swedish RC) spent one week in Gambella reviewing on-going needs for RCRC Movement support in Leitchour camp and to develop an emergency appeal. However, shortly after the UNHCR and the Government of Ethiopia announced the intention to relocate refugees to Dimma Woreda (due to flooding in Leitchour) causing the ERCS and IFRC to hold the launch of an appeal until clarity surrounding the situation could be attained. In response to both the change in status of Leitchour camp and the ongoing complexity of needs of the refugee population, a new Movement assessment effort was initiated in mid-october 2014, when representatives of the IFRC, ICRC, and Austrian RC joined ERCS to undertake a new round of assessments leading to the launch of the Population Movement Appeal. The appeal was launched in late December 2014 built around a two-phase strategy. Phase one aimed at continuing the activities implemented during the DREF (hygiene promotion, disease prevention and environmental cleaning campaigns in addition to ambulance services for referrals in addition to establishing first aid posts) whereas Phase two was set up to expand activities to host communities in the camp areas. Due to the fluidity of the situation and unpredictable state of the conflict in South Sudan, the two phases were not given time frames allowing for maximum flexibility of the support to the refugees and the National Society. Due to funding constraints, uncertainties with the location of new camps and challenges of HR capacity for both IFRC and ERCS, the roll out of Phase two has not occurred. In late May 2015 the relocation of refugees from Leitchour to Jewii camp was agreed and completed by ARRA, UNHCR and IOM. As a result, appeal activities also shifted to the new location which has enabled ERCS to focus their operation and continue to provide support to the same beneficiary group. The relocation resulted in delays for the entire humanitarian community whilst the refugee communities were setting up new homes in Jewii and agencies scaled up their presence in Jewii while closing their operations in Leitchour. Throughout the relocation, ERCS supported the transition with the provision of ambulance services to accompany the most vulnerable being transported by helicopter. Overview of the Ethiopia Red Cross Society ERCS has many years of experience in providing humanitarian and disaster relief to the most vulnerable people affected by conflict and disasters. In the last decade ERCS has assisted more than 100,000 disaster-affected people each year through the provision of food and non-food emergency assistance mostly in drought, flood and conflict affected areas of the country. Most recently ERCS has provided assistance to Ethiopian returnees from Saudi Arabia and to people affected by seasonal flooding.

4 P a g e 4 ERCS Branch The ERCS is represented in Gambella by the Regional Branch Office located in Gambella town. Above and beyond the current refugee influx situation, ERCS regular programming activities include branch development and income generation projects, membership and youth development, dissemination, first aid, RFL, ambulance service for Gambella town, dissemination first aid and emergency response throughout the region as and when emergencies occur. Specific projects currently on-going include child protection in host communities supported by UNICEF, the resilience project supported by Swiss RC and RFL with the ICRC. Compared to the size and scope of challenges facing Gambella and the workload, the ERCS Gambella Regional branch has a relatively small structure and limited resources available, including in terms of staffing. Currently the branch consist of the Branch Secretary, a Programme Coordinator, an acting DVM Officer, an acting Finance and Administrative head, in addition to a number of support staff (drivers, secretaries, storekeeper, guards).a number of staff is dedicated for the resilience project, supported by the Swiss RC. The branch has approximately 30 Red Cross volunteers based in Gambella town available to be deployed in emergency response and who have supported the current refugee The branch has limited physical infrastructure with lacking basic furniture and equipment as well as a not-yetcompleted building to house its main office and warehouse. There are no sub-branches at other administrative levels, leaving the entire region to be covered from Gambella town. As a result, there is a clear gap in capacity to respond effectively and the necessary operational skills to ensure adequate decision making, implementation, follow up, monitoring and supervision of an increasingly complex set of activities. Recent experiences from implementing the DREF supported response showed that the branch was overloaded due to the range of activities it was engaged in, and that there was a lack of operational management experience. Overview of Red Cross Red Crescent Movement in country There is a strong presence of the Movement in country. IFRC has a Country Representation Office though with limited sustained funding. Additionally, IFRC has its Humanitarian Diplomacy/ African Union office in Addis Ababa. ICRC has a delegation with one sub delegation in Tigray and a separate delegation for the African Union. There are quite a few National Societies with partnership arrangements with ERCS including Austrian, Finnish, Canadian, Netherlands, Spanish, Swedish, and Swiss Red Cross Societies based in Addis Ababa supporting with financial and technical support in capacity building, disaster management, water and sanitation, health and resilience. In terms of the Movement engagement in Gambella, Swiss RC recently signed an agreement with ERCS to work on long term capacity building of the regional branch and selected communities including support to local staffing within the branch. ICRC, though not present in Gambella, maintains interest in the region and a commitment to branch capacity development. ICRC does not have a sub delegation in Gambella, but works closely with ERCS Gambella branch in RFL, EPR, Dissemination, First Aid / Ambulance programs, and branch capacity development. In addition, ICRC and ERCS piloted a livelihood (seeds and tools distribution) project for host communities earlier in Movement Coordination IFRC, ICRC and PNSs participate in regular co-ordination meetings convened by ERCS. All issues including potential bilateral and multilateral actions are discussed. IFRC convenes regular co-ordination meetings in Nairobi with ICRC and PNS representatives to share updates on the situation in Ethiopia and neighbouring countries, and Movement action to date. At Gambella level, coordination and cooperation of Movement activities within Jewii is done on a regular basis and the newly established Red Cross site within the camp is used for all such activities (ERCS appeal and RFL).

5 P a g e 5 Overview of non-rcrc actors in country Figure 1: refugee response sectoral partners in Gambella (Source. UNHCR June 2015) There are currently a wide range of INGOs and agencies present in Gambella. UNHCR is coordinating the overall humanitarian response in collaboration with ARRA (Administration for Refugee and Returnee Affairs), and with support from multiple sector lead agencies, under the Refugee Coordination Model. Coordinated responses have been undertaken in all sectors, including: registration, emergency food rations, relief item packages, transportation away from the border areas, water/sanitation, health and nutrition services, protection, education and shelter. Transit centres continues to operate at entry option although a relatively small number of partners are permitted to operate in these areas. During their response in Leitchour, the ERCS has been working with MSF, ACF and other actors in the area of water, sanitation and health in emergencies. The cooperation with MSF France continues in Jewii within primary health sector where as new working relationships have been established with the ACT Alliance and Danish Refugee Council for WASH activities. The National Society has continued its work in child protection with UNICEF support thorough a one-year project aiming at creating child friendly spaces for recreation in host communities. Coordination has been a challenge but there is good intention of the majority of stakeholders to harmonise approaches, and coordinate operations in the new location in Jewii and across the region 18 months into the response. However, with the number of partners involved duplication is a risk, and therefore partners with some flexibility in approaches and funding are needed. The move to Jewii has seen some challenges in zone allocation especially for WASH activities which for the IFRC appeal activities has meant delays in its holistic adaptation to the new setting whilst finalising the official allocation of operational area with the relevant authorities (ARRA and UNHCR).

6 P a g e 6 Needs analysis, risk assessment and scenario planning Needs Analysis Based on the original appeal documents and using the most recent updates and assessments, information from Gambella and camp level coordination meetings, meetings with stakeholders and coordination agencies (ARRA and UNHCR), the following needs were identified: Water, sanitation and hygiene promotion Access to water in Jewii oscillates between 6 to 8 litres per person per day, where as other more established camps (Pugnido, Kule and Terkidi) have reached an average of 14 litres per person per day. The refugees community has reported long queues and days without water in the available water storage whereas resident of the more remote zones within Jewii, access water in the nearby river which is also used for laundry and drainage point for rainwater. According to MSF and WASH partners, the risk of acute watery diarrhoea and Hepatitis E outbreak remains high. During an Acute Watery Diarrhoea (AWD) preparedness meeting, UNHCR highlighted that due to funding gaps it is currently not possible to upscale essential services such as water trucking in Jewii until the arrangements for the permanent water supply is finalised and implemented. Consequently the access to safe water in Jewii remains a significant concern. The latrine/people ratio in most camps have improved significantly since end of 2014 where in Kule, Terkidi and Pugnido household latrines are replacing communal shared latrines as funding is available. UNHCR WASH update as of June 2015 cited the communal latrine rations as follow: Kule 31/latrine, Terkidi 27/latrine and Pugnido 26/latrine. Jewii figures remains unclear, however, according to main WASH partners (DRC and NCA) it is average 60/latrine across all zone of the camp. Partners responsible for hardware are including hand washing facilities and latrine cleaning in their respective zones. During recent assessment in July of Jewii Zone C, it was observed that hand washing stands has still not been added to the low number of latrines constructed by DRC: ERCS has engaged in discussion with UNHCR and DRC on this matter. It should be noted that UNHCR has stated that due to lack of funding, household latrines for Jewii population is currently not feasible. Sanitation and hygiene promotion are a critical priority in all camps where clarities on the accountability matrix continues to hinder more effective implementation. In Jewii, due to low number of latrines, open defecation has been observed throughout the camp with a concentration of open defecation around latrines and on latrine slabs (around hole). Environmental sanitation has switched to community ownership in all camps where the appointed Hygiene Promotion partner in a specific zone is required to ensure this is done to appropriate standard alongside with hygiene promotion activities. In Jewii, solid waste management and communal pits are part of the implementation plans for WASH partners in all zones. MSF health working in Jewii cites poor hygiene practices (no hand washing, no cleaning of water containers, drinking of stagnant water) as reasons for the increased watery diarrhoea rates Based on this data in addition to lessons learned from the intervention since the DREF included technical WASH capacity at Gambella level, ERCS will integrate its health and hygiene promotion activities through 40 volunteers and provide a new round of trainings to enhance the capacity of the volunteers. Additionally Environmental Sanitation (130 ES volunteers in 5 groups across all zones) with an integrated community ownership approach will be implemented during the revised appeal timeframe. Solid waste management in Zone C and communal pits will be included in the revised EPoA to ensure adherence to HP strategy for all WASH partners operating in Jewii. A new round of PHAST and ECV trainings will be included in the revised EPoA. Health and Care The Gambella situation continues to pose a serious public health emergency. Monitoring in Gambella region has shown critical gaps in medical personnel and supplies, as well as funds for public health clusters. Without adequate and timely support, the health system s capacity will likely weaken further, given the increasing refugee influx and growing public health challenges amongst the refugee community.

7 P a g e 7 Preparedness and response plan for Acute Watery Diarrhoea are being finalised by WASH partners working across Gambella region. Jewii camp has been flagged by WASH and Health clusters due to the critical situation with water provision, latrine coverage and currently non-operational primary health facility. Malaria continues to be the leading cause of morbidity in all refugee locations in Gambella followed by respiratory tract infections and diarrheal diseases. In Jewii, malaria, Upper Respiratory Infections and watery diarrhoea are the highest in case load in MSF clinic. Malaria is endemic in Gambella but amongst the refugee population the incidence rate is higher especially at low lying entry point where few households have bed nets. Several distributions of long lasting insecticide nets (LLIN) have been done, although full coverage has not been reached. Poor utilisation remains a concern as nets are used for fishing, rope and as windows for roadside kiosks. Table 2: Crude incidence rates for diseases of epidemic potential Week 26/2015 (Source: UNHCR Health, Food Security and Nutrition cluster meeting, 9th July 2015) Camp Watery diarrhoea Bloody diarrhoea Malaria Jewii 7.16 % 0.46 % 10.54% Tierkidi 1.85% 0.12% 14.35% Kule 3.27 % 0.58% 13.41% Pagak 12.22% 1.78% 50.52% Total 13, Psychosocial support and proper mental health services identified remains a gap throughout the refugee locations which local health facilities are unable to provide. Within Jewii (as well as in Tierkidi and Kule), IMC are providing essential mental health, psychosocial and SGBV support. Inter camp transport of patient within Jewii as well as to secondary health care facilities in Gambella and within the region, continues to be highlighted by the refugee communities as problematic. There are no actors providing first aid in any of the refugee locations. ERCS will continue the provision of one day time and one night time ambulance for transport of referrals in support of the refugees and primary health partners in Jewii camp. ERCS is the only partner providing this service. In addition ERCS will train 10 Community Based First Aid volunteers who will be supporting their communities in Zone C as first responders. ERCS will participate in AWD preparedness and response planning meetings and will retain 50% of the procured soap for prompt response in case of an outbreak. Should this not occur before October, the remaining 50% will be distributed before the end of the appeal timeframe. ERCS will temporarily assign one ambulance for referral services of the most critical cases from Matar to Gambella hospital to support the more than 5000 new arrivals awaiting relocation to a new camp. Meanwhile discussion with ARRA and UNHCR will be held to ensure a solution is found for this after the 1 month deployment of ERCS vehicles and ambulance crew. Nutrition and Food Security Refugees continue to arrive at entry points in a critical nutritional condition, lacking food and drinking water. While the first arrivals were fleeing violence, more recent arrivals have cited food insecurity as their main reason for flight. The continued influx, and presence, of refugees has created a competition in the region for firewood, wild food, water, and other resources, likely increasing the food insecurity of the host communities and stretching resources for services provided to refugees. Food rations for August have been prepositioned in Matar reception centre where as Akobo and Burbei have received High Energy Biscuits for transit rations and welcome package. Feedback from Jewii Refugee Central Community includes inadequate registrations and lack of provision of full GFD rations (pulses were not included in June distributions due to a breakdown in pipeline). A full Food

8 P a g e 8 basket (per family,hh size 4) per month) contains: 16 kg cereal, 1.5 kg pulse, 1.5 kg CSB normal, 0.45 kg vitamin E fortified vegetable oil, 0.45 kg sugar and 0.45 kg salt. Frequent community outreach screenings are done to ensure a continued improvement in the nutrition status of the refugee population. Table 3: Community Outreach MUAC screening Week 26/2015 (Source: UNHCR Health, Food Security and Nutrition cluster meeting, 9 July, 2015) # screened # MUAC <115mm # MUAC >=115 and <125 # MUAC >=125mm- <135mm # MUAC >=135mm % % MUAC >=115 <115mm and <125 % >=125mm % MUAC >=125mm- <135mm Jewii % 8.0% 19.9% 69.2% Tierkidi % 3.0% 26.6% 68.8% Kule % 3.7% 27.7% 66.1% Pugnido % 3.4% 11.8% 76.4% Pagak % 0.9% 43.6% 55.3% Total % 3.6% 26.4% 67.5% Since the onset of the response, GFDs (general food distribution) in the camps and entry points has been inconsistent with many logistical and operational challenges. Over the last two months GFDs, although not standard practice has also been conducted at entry points since these refugees cannot be relocated. Nutrition partners (WFP, GOAL, ACF and Concern Worldwide) provide blanket and targeted supplementary feeding programmes in Tierkidi and Kule camps as well as at entry points/transit centres. However, pipelines breakdowns continue due to resources being scarce as result of the high number of global emergencies. ERCS will not respond in this sector as needs are covered by specialised agencies in this sector. Protection With the majority of the refugee population, including new arrivals, being women and girls who have survived sexual and gender-based violence (SGBV) during the crisis in South Sudan, either at home or during flight. Having witnessed insecurity, violence and killings, the prevalence of mental illnesses related to traumatisation and substance abuse disorders continues to be expected to be high. Activities to prevent and respond to SGBV among women and men, boys and girls remains a priority across the camps and partners with this technical capacity are responding. In Jewii Save the Children are providing education and child friendly spaces although there is still a gap. International Medical Corp (IMC) is operating a women friendly space in this camp as well. Tracing and family reunification remains an area of continued need in all camps and entry points. Whereas there are different approaches and definitions to the scope of this work from different actors, many families were separated during the flight and the need for such support remains high. Services for disabled and the elderly is covered by Help Age and RaDO in Jewii. ERCS, with support from ICRC, delivers RFL services (photos books, Red Cross messages, phone calls etc.) in all camps through a network of 20 social workers support by Gambella regional branch 2 tracing officer. In Jewii camp the social worker operates in the Red Cross site which was set up with support from the appeal. Host community including Livelihoods Gambella region is characterized by a high level of chronic acute food insecurity, with traditional agro pastoralist livelihoods vulnerable to shocks including insecurity and erratic climatic conditions. In 2014, population of Gambella had to cope with late rains followed by flooding, affecting the main cropping season, and the general well-being of the population. Further effects include an increase in disease among human and livestock, adding to the stress of losing livelihoods coupled with the inaccessibility of adequate health care. As a result of the harvest being late, a longer than

9 P a g e 9 normal food gap has been created; the amount to harvest will be decreased and will be unable to cover the 7 to 9 months of family consumption. Communities could be forced to adapt negative coping mechanisms and become less resilient towards additional stressors. The massive refugee influx has resulted in the population of Gambella significantly increasing while resources have decreased. All available services are overstretched with the refugee influx, including the rare functioning health facilities and the schools. With the refugees sharing ethnic ties with the Nuer population residing mostly in the northern area of Gambella, many refugees are living with host families, sharing food and resources. In the border areas refugees have received limited food and no NFIs, putting both, resident and refugee households in a very precarious situation that is worsening quickly. In border areas some refugees do not want to enter camps but choose to live with host communities (for a number of reasons including proximity to cattle and homesteads). Due to funding constraints and issues related to technical capacity, the revised appeal will not include activities with host communities. ICRC has responded to host community needs with seeds and tools and seed distributions in Ninnang in June IFRC Country Representation and Regional Offices will continue to advocate for a balanced response between refugees and host communities from Movement partners in the future. Risk Assessment and operational constraints Since December 2013, 214,348 3, 079 people have arrived in the Gambella region of Ethiopia, and the numbers continue to rise with an average of 255 new arrivals per day. Although it is expected that the number of new arrivals will decrease during the rainy season, it is anticipated that a continuous steady influx will resume once the rains have subsided towards the end of the year. The projections of new influx remains tricky and besides being related to physical access constraints during rainy season, the outcome of the expected signing of the IGAD Plus peace deals may or may not also trigger additional fighting which can result in creased influx. With the outlook for peace and a bleak prospect of returning home, combined with the rainy season and heightened food insecurities in South Sudan itself, the humanitarian situation facing the refugees is significantly under stress. The following constraints for the design and implementation of the refugee response operation can be identified: Whereas flood prone camps (NipNip and Leitchour) have been closed and the population moved to Jewii, the intended smooth relocation to Jewii camp saw major challenges infrastructure and provision of safe water and sanitation in the new location. Consequently the on-going appeal operations are in fact a re-engagement in a phase 1 emergency response due to the conditions in the new camp which is in reality similar to a response to new influx and the camp is still in its establishment phase. Heightened concerns of disease outbreaks (Acute Watery Diarrhoea and Hepatitis E) due to the above lack of adequate provision of essential water, hygiene and sanitation services in Jewii camp. Uncertainty about opening a new camp (Pugnido 2) has meant that entry points (Akobo, Alula, Burbie) and /transit centre (Matar and Pagak) hosts a rising number of new arrivals of new camps beyond the carrying capacity of the humanities response set up in these locations. Significant logistical and access constraints during raining season requiring helicopters or boats to move around. Due to lack of adequate funding WFP helicopters are no longer available for the Gambella response As such, the logistical support to any operation will not only be challenging and expensive and unlikely to be effective due to the underfunded over all response in Gambella for all agencies. Current capacity of ERCS in Gambella is limited by few staff and although joint by a dedicated new Appeal implementation team, the HR resources are stretched. Lack of funding for silent disasters which are not quiet to those impacted, but they often fail to capture the public attention or funds needed to provide essential support for the millions of people affected. Significant resources are required in order to meet the immediate needs and reduce the impact of inevitable risks and shocks, such as diminished nutritional status, disease outbreaks, and lack of basic needs including food, 3 Source: UNHCR Ethiopia: South Sudan Situation Operational Update July The figures quoted refer only to the new caseload in Ethiopia s Gambella region where the activities under this appeal is implemented.

10 P a g e 10 water and shelter, and healthcare. The entire humanitarian sector, including RC movement, is struggling to find resources for this refugee crisis. Scenario Planning Of the 1.4 million IDPs estimated to be in South Sudan, approximately 50% of these are located in the Upper Nile and Jonglei states bordering Ethiopia, from where the refugees to Gambella originate from. With failed peace talks, increased food insecurities and absence of basic services in South Sudan, the outlook for an end to the crisis remains bleak as does the prospects of a safe return to South Sudan for the refugees. In addition, early parts of 2015 saw humanitarian assistance being hampered by insecurity, poor road conditions and difficulty to access IDPs dispersed across large areas. Further to the almost 215,000 South Sudanese refugees having arrived to seek protection in Ethiopia (mid-october 2014) since 15 December 2013, it is therefore expected that up to an additional number of 50,000 new arrivals will be seen in Gambella by end of From January to July 2014, refugees arrived at an average rate of 25,000 per month. The number of arrivals has scaled down during the last rainy season (August to October 2014) and is now estimated to be at 210 daily arrivals. However with no short term solution to the conflict in South Sudan and an imminent food crisis in view, it is expected the refugee population will remain in Ethiopia for a foreseeable future. During UNHCR and ARRAs Contingency planning workshop in the end of July 2015, the most likely scenario was agreed to be 50,000 additional new arrivals by the end of 2015 which is thus the current caseload for the contingency planning by UNHCR, ARRA and their partners. Until the completed relocation from NipNip and Leitchour, all humanitarian operations going forward were based on a number of uncertain scenarios including the necessary flexibility and adaptability to the highly fluid situation. As such, it proved that contingency planning was easier for those actors who have not presently invested heavily in hardware interventions and infrastructure projects. As a result, the Ethiopia Red Cross and its partners concentrated their efforts in the first months building on the gains of the DREF/Swiss RC funded operation with a focus on community based health and hygiene promotion and sanitation in Leitchour camp. These efforts and this strategy, which has allowed for the continued deepening of existing capacities within ERCS at field level in Gambella, will be adapted to the new operational modalities in Jewii. The revised appeal timeframe and required additional resources mobilisation will allow for a continued Movement presence in a key hot spot for humanitarian interventions in the region. During the last 3 months of the operation, the IFRC will support ERCS in a planning exercise for Movement partner support to ERCS and a process of identifying areas where it is feasible to continue support to the refugees in Gambella. Additionally, should it not be possible for ERCS to identify resources for its continued health and hygiene activities in Jewii, discussion with other partners for handover will be commenced and incorporated in the EPoA. Beneficiary Selection The National Society will be working with a total population of some 47,101 individuals (11,776 HH), of which the ERCS will directly target 1800 HH with health and hygiene promotion including community based first aid. Ambulance services and environmental sanitation, however, will be provided to the entire camp population. The revised appeal activities will be implemented in Jewii camp where the previous beneficiaries were relocated to in June. Refugees from other flood prone camps and new arrivals from entry points have also been reallocated to Jewii and therefore there is an increase in the beneficiary numbers covered by the revised appeal activities. Table 4: Estimated target population for ERCS activities under the revised EPoA as of July 2015 based on current ARRA Zone. Activity and location No of people No of households Maximum capacity Jewii total (Ambulance services and environmental sanitation) Jewii Zone C (health and hygiene promotion and community based first aid) 47,101 6,880 11, ,000 people (12,500 HH with average 4 per household) 4 This number fluctuates on a weekly basis.

11 P a g e 11 ARRA and UNHCR are enforcing a Zone allocation in the new camp to facilitate the division and distribution of tasks among partners according to capacity and available funding. Although all refugees are very vulnerable, the ERCS will use the same selection criteria used during the previous NFI distribution such as households with many children, people with disabilities, wounded/injured members, women in labour, lactating mothers and elderly members. As a result the National Society will be working with a total population of some 47,101 individuals, of which the ERCS will directly target 1800 HH with health and hygiene promotion including community based first aid whereas environmental sanitation and ambulance services will support the entire camp population. Health and Hygiene promotion will be integrated and key message disseminated using culturally sensitive IEC materials. Mobile cinema campaigns will be done in cooperation with other WASH partners and UNICEF across tall zones on a bi monthly basis. Video clips have been sourced and finals arrangements are being made for copy right issues by UNICEF. Due to change in hygiene promotion approach agreed by all WASH partners, ERCS Environmental Sanitation volunteers will form 5 clubs (1 per zone) and will support highly vulnerable households (disabled, elderly etc.) with environmental cleaning as well as ensure that the communal areas are maintained. They will also support leading WASH partners in the zones with latrine cleaning and solid waste management as surge. Following a footprint approach, the revised appeal will continue to engage the majority of volunteers trained while in Leitchour during the DREF and first phase of the appeal, while new ones will be recruited as not all of the previous ones are living in the allocated zone of implementation. These volunteers are therefore part of the targeted beneficiaries. They will receive new rounds of PHAST/CBHFA training and refreshers under the revised time frame. Table 5: Age and gender breakdown as of 24 July 2015 (Source UNHCR) Jewii Age cohort Female Male Total ,522 16, ,348 4,440 Total 25,870 21,213 47,101 (22%) B. Operational strategy and plan Overall objective December 2013 to June 2014: To reduce the health risks of the South Sudan refugee population and host communities in Gambella through the provision of first aid, community-based health, and hygiene and sanitation promotion in Leitchour camp, Ningnang and Pagak entry point. July to December 2015: To provide hygiene, health and sanitation promotion and emergency health services for up to 47,101 individuals in Jewii camp for South Sudanese refugees in Gambella region of Ethiopia. Proposed strategy Until date, the planned first phase of the appeal activities has been implemented according to access, capacity and available budget. The first phase focussed on of health and hygiene promotion, propositioning of WASH NFIs and provision of ambulance services in up to 3 locations according to available funding. A detailed outline of progress towards set objectives can be found in the 6 months Operations Update. The scheduled second phase was operationalized during the relocation of refugees from Leitchour (ERCS area previous of implementation) to Jewii Camp. The second phase was set up to cater for adjustments in the event of relocations and other significant changes of the situation on the ground. Reconstitution and adjustment of health & care as well as water, sanitation and hygiene activities are being completed based on new assessment in the specific location allocated to ERCS for implementation. ERCS will continue core activities in health and hygiene promotion,

12 P a g e 12 ambulance service and environmental sanitation activities and start up community based first aid and will require additional funding to continue delivery of these essential services to the refugees population until the end of In addition to the on-going activities, and depending on funding availability and negotiations with ARRA and UNHCR, the revised appeal will include the initiation and scale up Community-based First Aid services through refugee first responders and start up mobile cinema for mass health, hygiene and sanitation promotion campaigns in Jewii camp. The appeal will also seek funding for the construction of basic set up (small store, latrines, generator etc.) at the completed Red Cross site in Jewii camp. It will also support an additional ambulance crew (1 driver, 2 attendants) to increase the daily service from one vehicle to two. This will allow for essential transport of critically ill people from the far away zones to inter camp clinics as well as continuing referrals from Jewii camp to Gambella hospital. Contingency plans for movement support to Gambella branch and support at regional level will also be done during the extension of the appeal time frame. This will identify a coherent and solid exit strategy for appeal activities at the end of 2015 and support the ERCS in identifying possible for continued operations within the camp. Overview of components in revised appeal Areas Common to All Sectors Activities to be continued Rapid assessments with partners (UNHCR/ARRA) as the situation evolve. Regular monitoring visits from IFRC and ERCS Addis management as well as weekly monitoring from ERCS Appeal team (coordinator, finance and PMER) in Gambella to field team in Jewii. A final evaluation with an external consultant will be done in the last month of the appeal implementation period. New activities Setting up a PMER plan (including new templates and revised log frame) and structure for all activities including feedback mechanism for beneficiaries. This will include post distribution monitoring. Health and Care Activities to be continued The revised appeal will continue to support referrals of patients from within Jewii camp and from the camp to Gambella Hospital. Activities under this output may also include temporary assistance to entry points on a needs and capacity basic. First Aid training for 10 refugee community volunteers will be done under the revised appeal. Health and hygiene promotion campaigns (HH visits, FGD and mobile cinema) will continue. Health promotion campaigns (including using IEC material and mobile cinema shows will be done in sync with hygiene promotion activities and aligned with priorities from main health partners within Jewii. A Health RDRT was deployed in the first months of the appeal timeframe. New activities Health and Hygiene promotion activities (including mobile cinema if funding allows) will be integrated and done by the same volunteers to align ERCS implementation methodology with that of other actors in the camp and to follow the accountability matrix allocations from UNHCR and ARRA. Instead of the planned refreshers training, a new round of ECV training for 40 5 refugee community volunteers in addition to First Aid training of 10 refugee community volunteers, 8 ambulance attendants and 8 Gambella branch volunteers. A Red Cross post in Jewii has replaced the plans for having first aid post at entry points. Water, Sanitation and hygiene Activities to be continued. Environmental sanitation activities will continue with a reduced number of volunteers (130) who will focus on facilitation of clean up campaigns across all zones in Jewii. Since WASH partners with commitments for latrine construction, is responsible for latrine cleaning, this activity will no longer be conducted by ERCS volunteers. For this activity ERCS volunteers will be active in all Jewii Zone. Hygiene promotion campaigns will be done in Jewii to decrease risks for diseases and enhance awareness around hygiene practices. IEC material will likewise be used during the campaigns. As mentioned under Health & Care, hygiene promotion will be integrated with health promotion activities. Distribution of already procured soap will be done in Jewii upon completion of discussion with UNHCR/ARRA. Procurement of protective gear for all volunteers will be done under this activity. New activities Instead of the planned refreshers training, a new round of PHAST training for 40 6 refugee community volunteers will be done. Environmental Sanitation volunteers in ERCS allocated Hygiene Promotion Zone (C) will conduct solid waste management activities including construction of and management of communal solid waste pits. The latter has been 5 The total number of health and hygiene promoters engaged with health and WASH activities is The total number of health and hygiene promoters engaged with health and WASH activities is 40.

13 P a g e 13 included as it is a requirement from UNHCR/ARRA that this falls under the WASH partners who is allocated hygiene promotion in a specific zone. 50% of the procured soap will be retained for response to decease out break (Hepatitis E or Acute Watery Diarrhoea). The latter will be distributed in October and November before the end of the appeal timeframe should an outbreak not occur prior to this. Rather the planned prepositioning of hygiene kits, the 1,000 set will be distributed with female headed households 7 in Jewii or another location depending on needs. Disaster Preparedness and National Society Capacity Building Activities to be continued Procurement one refurbished ambulance will be completed and allocated to Gambella branch. Exit strategy, contingency planning and a new capacity building plan for Gambella branch will be done towards the end of the extended appeal timeframe with participation of ERCS HQ and Movement partners. Visibility for volunteers (vests) has been done under this activity. New Activities Procurement of two motorbikes has been moved in to this section. ID cards for all volunteers as well as t-shirts will be added to the revised activities. Operational support services Human resources Based on the lessons learned during the previous DREF operation in Gambella and within the appeal operations during the first 6 months, a robust structure has been completed in June 2015 to strengthen field implementation and monitoring, as well as reporting and accountability. The remaining Field Officer (WASH) for implementation level in Jewii camp will be recruited to enhance the technical aspect of the intervention will be recruited in August. As a result, a three level structure is being proposed: 1. Advisory and overall strategic operational decision making role at headquarter level in Addis Ababa (ERCS senior management and IFRC Country Representative). An ERCS HQ focal point will be in charge of coordinating national level support to the team in Gambella in accordance with requested operational needs, the EPoA and the joint commitments of ERCS/IFRC towards its partners. This also includes facilitating technical support from each specialized sector, conveying information coming from coordination at National level, coordinating financial, administrative and logistical services to the operation, including ensuring adherence to ERCS and IFRC policies and procedures. He/she will also be in charge of updating the ERCS management on the progress and challenges of the operation, and will liaise with the IFRC Country Representative on operational issues at a strategic level. 2. Operational decision making role at Gambella level. A Refugee Coordinator, PMER and Finance Officer was planned and was in place by May The coordinator will be in charge of the overall coordination and management of the plan of action, as well as coordination with partners, financial and logistics oversight, reporting and monitoring, and communication with ERCS HQ. This coordinator will work hand in hand with the finance and PMER officers to monitor level and effectiveness of implementation. The IFRC will support the operation with a mirroring structure of an Operations Support Coordinator (in Gambella) and Finance officer (in Addis Ababa). The IFRC team will work hand in hand with ERCS counterparts to ensure adherence to IFRC procedures, provide technical guidance and operations management support, ensure connectedness with the IFRC country and regional levels and support review and revision of the plan of action as required. The Operation Support Coordinator will work hand in hand with the Refugee Operations Coordinator throughout the whole operation, while an RDRT specialized in Health was be deployed for one months at the beginning to support health technical aspects. This operation structure in Gambella will maintain constant communication with the Branch Secretary. 3. Implementing role at camp and entry point level. Based on lessons learned during the DREF and the first 6 months of the appeal, ERCS will be concentrating its efforts in one location, Jewii, in order to provide the most integrated response possible. A Camp Coordinator has been hired to oversee the Field Officer (Health). It is intended to hire an additional Field Officer (WASH) to ensure adequate supervision and quality control at field level. Field Officers are in charge of organizing the implementation of the activities with the volunteers. 7 Discussion on where and when is on-going with ARRA and UNHCR since the standard Crore Relief Item package on arrival is covered.

14 P a g e 14 Figure 2 Organogram of Advisory, Operations and Implementation structure for the Gambella. IFRC Country Representative ERCS HQ Senior Management IFRC Operations Support Coordinator Finance PMER Branch Secretary In terms of volunteers, the ERCS trained 300 volunteers from the Leitchour refugee population as part of the DREF/Swiss RC operation. Due to the operational modalities and allocated area of implementation to ERCS in Jewii, the revised timeframe under the Appeal, will engage a total number of 180 volunteers (130 Environmental Sanitation, 40 Health and Hygiene and 10 First Aid volunteers). Some new volunteers have to be recruited to follow the ARRA decision that agencies must engage individuals from the zone of implementation. This approach may also contribute to an increased attendance by the volunteers which is currently low. Logistics and supply chain With the support of the Swiss Red Cross, the Gambella branch is in the final stages of setting up a 10x13 metres rub hall that will have the capacity to store pre-positioned stock that will be needed in the following months, as more refugees arrive to the border. The appeal has supported the procurement of 63,000 bars of soap (3,000 body and 60,000 laundry), 1000 hygiene kits and 2 motorbikes. The WASH NFI is currently in temporary storage off site but will be moved to the ERCS branch rub hall upon completion. Discussions with UNHCR and ARRA are on-going for the finalisation of the distributions plans. The procurement and refurbishment of an Ambulance for Gambella branch has been completed and the vehicle is expected to be received in ERCS HQ in August. For the extension appeal timeframe, no further procurement is planned. It should be noted that in the event of a needed rapid upscale of ERCS and Movement presence in the refugee response, lessons learned has shown that ERCS regional branch will need technical logistics support in order to enable ERCS to deliver timely emergency response. Information technologies (IT) Communications in Gambella are a challenge, with cell phone signal and internet irregular and unreliable. The IFRC Operations Delegate has been issued with a satellite phone for remote field trips. In the event of relocation ERCS operations under this appeal, to another location than Jewii, a review of communication equipment needs to be done to ensure adequate implementation and security of the Red Cross movement staff in field level deployments. At the moment, the four ambulances available for Gambella response have no working radios. In such an event and based on available modalities, a communication procedure will be established in partnership with Movement partners, and aligned with to be established security protocols.

15 P a g e 15 Communications IFRC region and zone office will support IFRC Country Office and ERCS with communication and advocacy activities. The purpose of the communication and advocacy activities will continue to raise awareness of: The importance of increasingly silent tragedies like the one taking place in Gambella, Ethiopia. Significant resources are required in order to meet the immediate needs and reduce the impact of inevitable risks and shocks, such as diminished nutritional status, disease outbreaks, and lack of basic needs including food, water and shelter, and healthcare. The entire humanitarian sector is struggling to find resources for this refugee crisis. The dire humanitarian needs of South Sudan population displacement in Ethiopia and the region and the need for a coherent and coordinated response. The specific role and value added of ERCS in community based interventions in health, hygiene and sanitation as well as lifesaving ambulance services for refugees in Gambella. This will be done through collecting human interest stories as well as case studies with key messages, lesson learnt and best practices. ERCS HQs Public Relations and Communication department will visit Gambella during the training of volunteers in order to collect human interest stories and document the activities of the ambulance in Matar transit centre. It is expected that a radio clip will be produced (in Amharic) as well as some material in print (English and Amharic). Security With the influx of refugees, the existing challenging security situation in Gambella deteriorated in terms of inter-ethnic tensions as well as increased competition over resources. Recently pockets of violence broke out in Pugnido camp area, leaving more than 10 people dead/injured, as results of clashes between ethnic groups. Consequently, the delay in opening a second camp in this area has been resulting in overcrowded entry points. Military and police presence in the region has been scaled up in response to this. The relocation to Jewii has allowed for enhanced security monitoring and management given that the camp is located 17 km from Gambella town allowing for ERCS staff (with acceptance of night time ambulance crew) to live at a guesthouse. International staff based in Gambella follow ICRC curfew and IFRC vehicles are not used after 7pm. To ensure access for volunteers, supervisors and staff, the ERCS and the IFRC humanitarian diplomacy personnel will need to closely coordinate with ARRA/Ethiopian Government and the UN s security personnel. The UN has established an Area Security Management Team led by the UNHCR and with key agencies involved, hereunder the UNDSS. The ASMT meets on a weekly basis under normal circumstances, and convenes additional meetings during period of heightened tension or following specific security incidents. Regular updates are provided to heads of agencies, including guidance on movement and security measures to be taken. Planning, monitoring, evaluation and reporting (PMER) Regular monitoring of activities, as well of the overall situation, has been carried out by ERCS and IFRC since the beginning of the appeal operations, in close coordination and partnership with ARRA, UNHCR and partners. An ERCS PMER Officer at Gambella level was recruited and deployed by April 2015 and has been in charge of working with site coordinators and field officers in the development and implementation of the monitoring and reporting tools. Through weekly activity reports and data collection, the most recent information of the evolving situation on the ground has been shared with all decision makers. A revision of the PMER structure to date, reporting formats, monitoring tools and data collection has been done to ensure an adjustment of implementation plans from since the relocation to Jewii camp. To date the ERCS field team has received a support visit from IFRC PMER unit in Nairobi as well as regular monitoring from ERCS HQ and IFRC Country Office. ERCS recently recruited a PMER officer for the appeal based in

16 P a g e 16 Gambella. Due to funding constraints, the Appeal has been unable to support the deployment of a dedicated IFRC PMER delegate. Two monthly visits from ERCS HQ will continue and an external evaluation has been budgeted as part of the operation in order to assess and learn from the response since its start in early Finally, an external evaluation has been budgeted as part of the operation in order to assess and learn from the response since its start in early Administration and Finance The ERCS will be responsible for managing the funds in the country in accordance with the Letter of Agreement to be signed between the National Society and the IFRC for the implementation of the operation. Through the operation, a finance officer will be based in Gambella branch that will be in charge of the accounting and will work alongside the IFRC financial support to monitor the finance of the operation and inform the operations coordinator on over-spending or low implementation risks. The IFRC through the finance officer in Addis will provide the necessary operational support for the review, validation of budgets, bank transfers, and technical assistance to the National Society and also on procedures for justification of expenditures, review and validation of invoices for operational progress. ERCS recruited and deployed a Finance Officer at Gambella level in June 2015 whereas an ERCS HQ Project Accountant has been engaged as well. From the onset of the operations the appeal financial management has been channelled through the Gambella Regional branch as per ERCS policy and procedures.

17 P a g e 17 C. DETAILED OPERATIONAL PLAN *note that new/changed activities are indicated in red below Areas common to all sectors Outcome 1: Continuous assessment and monitor of the situation is carried out in consultation with beneficiaries to inform the design and implementation of the operation. Output 1.1 The emergency plan of action is updated and revised as necessary to reflect needs. Activities planned Month Undertake rapid needs assessments of in camps and entry points. Set up a PMER plan (including new templates) and structure for all activities including feedback mechanism for beneficiaries to ERCS. Ensure weekly monitoring of all activities and situation in camp (Gambella Appeal Team). Conduct monitoring and assessment visits to Gambella (ERCS HQ and Refugee Response task force from Addis). Attend regular coordination / meetings with UNHCR, ARRA and other key stakeholders in Gambella and at camp level (Gambella Appeal Team) Review appeal activities and action plan based on revolving needs at camp level including an exit strategy for completion or handover of WASH and Health activities if needs persists. Conduct a final evaluation including lessons learned with ERCS, movement partners and other stakeholders in Addis and at Gambella level. Health and Care Outcome 1: The immediate risks to the health of affected populations in Leitchour and Jewii camps are reduced. Output 1.1 All the population in Leitchour and Jewii camps has access to referrals and 60% of Leitchour camp and 20 % of Jewii camp (Zone C) has access to Community Based First Aid services. Activities planned Month Establishment of Red Cross Post in Jewii (fence, guard post, latrine, gravel foundations for tents, store, signposts, bill board space and seating area) for volunteers, field operations, first aid and referral services. Conduct first aid training sessions for 10 community based volunteers, 8 ambulance attendants and 7 branch volunteers (25 in total) Procure first aid kits for volunteers (6 in total)

18 P a g e 18 Provide Community Based First Aid in allocated Zone in Jewii Camp through 10 volunteers Determine the best medium for intra-camp transportation of injured/ill persons within the camp (in Leitchour and after relocation to Jewii) Provide ambulance services within camp (1 ambulance) Provide ambulance services for transport of patients from primary to secondary care (1 ambulance) from camps/entry points/transit centre according to needs. Output 1.2 Community-based disease prevention and health promotion is provided to 60% in Leitchour and 20% of population in Jewii. Activities planned Month Recruit new volunteers in targeted intervention areas (20) Deployment of RDRT specialized in health Train volunteers in CBHFA (ECV) methods to deliver key health messages integrated with hygiene promotion (40 in total) Re-production, translation and printing of culturally appropriate Information Education Communications (IEC) materials. Conduct health promotion campaigns Conduct integrated health and hygiene promotion through house to house visits using IEC material with key messages and mass sensitization campaigns using mobile cinema. Procurement of Mobile Cinema equipment and acquirement of material in appropriate languages for health and hygiene promotion campaigns. Train volunteer and ERCS staff in usages of mobile cinema for health and hygiene promotion mass sensitization campaigns activities. Water, sanitation and hygiene promotion Outcome 1: To reduce the risk of water- and vector-borne diseases among affected communities in Jewii. Output % in Leitchour camp and 20% of the population in Jewii camp and is reached with sanitation and hygiene promotion activities and campaigns. Activities planned Month Recruit new volunteers in targeted intervention areas (20) Train volunteers in PHAST-ER methodology to deliver key hygiene messages integrated with health promotion (40 in total). Re-production, translation and printing of culturally appropriate Information Education Communications (IEC) materials. Carrying out hygiene promotion campaigns (house to house visit using IEC material with key messages and mass sensitization campaigns using mobile cinema,) integrated with health

19 P a g e 19 promotion. Identify volunteers for Environmental Sanitation clubs (130 volunteers in 5 clubs across 5 zones) Conduct environment sanitation activities (clearing communal areas, latrine monitoring/cleaning, support to vulnerable HHs, solid waste management etc.) Construct solid waste pit in allocated zone of intervention (2 pits) Procurement of protective gear for volunteers and cleaning materials Procurement and targeted distribution of soap (laundry and body) to households in Jewii camp according to beneficiary selection criteria in coordination with other stakeholders. Procurement and distribution of 1,000 hygiene kits for new arrivals at an entry point Conduct post distribution monitoring (PDMs) for hygiene kits and soap in targeted locations Disaster preparedness and National Society Capacity Outcome 1: The capacity of Ethiopian Red Cross Society to manage the population movement crisis has been strengthened. Output 1.1 Volunteer and staff capacity to deliver assistance in Gambella region is increased. Activities planned Month Review of current NS HQ and Gambella branch capacity Contingency planning for Movement support to South Sudanese refugees in Gambella including a capacity building plan for Gambella branch with all Movement partners Set up SOPs for the Refugee Response (ERCS HQ, branch and field team) Procurement of 1 ambulance for Gambella branch Procurement of 2 motorcycles for Gambella branch Establish a National Society task force at Gambella to coordinate with internal and external partners (Refugee Coordinator, finance, logistics, PMER, field coordinator and key branch staff) and conduct weekly coordination meetings. Appointment of dedicated IFRC staff (Operations Support Delegate at Gambella level and Finance Officer at Addis level).

20 P a g e 20 Budget See attached budget for details. Contact information For further information specifically related to this operation please contact: IFRC country Representation: Jill Clements; Country Representative for Ethiopia; Addis Ababa; Phone , mobile phone: ; jill.clements@ifrc.org IFRC Regional Representation: Finnjarle Rode; Regional Representative for East Africa; Nairobi; Phone: ; finnjarle.rode@ifrc.org IFRC Africa Zone: Lucia Lasso, Disaster Management delegate for Africa; Nairobi; phone: +254 (0) ; lucia.lasso@ifrc.org IFRC Geneva: Christine South, Operations Quality Assurance Senior Officer; phone: ; christine.south@ifrc.org IFRC Zone Logistics Unit: Rishi Ramrakha, Head of zone logistics unit; phone: ; rishi.ramrakha@ifrc.org For Resource Mobilization and Pledges: IFRC Africa Zone: Fidelis Kangethe, Partnership and Resource Development Coordinator, Addis Ababa, phone: +251 (0) ; fidelis.kangethe@ifrc.org For Performance and Accountability (planning, monitoring, evaluation and reporting): IFRC Africa Zone: Robert Ondrusek, PMER Coordinator; Nairobi; phone: ; robert.ondrusek@ifrc.org How we work All IFRC assistance seeks to adhere to the Code of Conduct for the International Red Cross and Red Crescent Movement and Non-Governmental Organizations (NGOs) in Disaster Relief and the Humanitarian Charter and Minimum Standards in Humanitarian Response (Sphere) in delivering assistance to the most vulnerable. The IFRC s vision is to inspire, encourage, facilitate and promote at all times all forms of humanitarian activities by National Societies, with a view to preventing and alleviating human suffering, and thereby contributing to the maintenance and promotion of human dignity and peace in the world. The IFRC s work is guided by Strategy 2020 which puts forward three strategic aims: 1. Save lives, protect livelihoods, and strengthen recovery from disaster and crises. 2. Enable healthy and safe living. 3. Promote social inclusion and a culture of non-violence and peace.