Central African Republic Humanitarian Situation Report Highlights On 5 December heavy fighting and looting broke out in Bangui leading to the displacement of up to 214,000 people, or 25% of the city s population, in more 35 sites in the capital. Fighting in Bossangoa, Bozoum, Bohong and surroundings triggered additional displacement with over 53,000 people taking refuge in 6 sites, and many thought to be hiding in the bush. UNICEF declared a Level 3 emergency in Central African Republic on 9 December. This was followed by the designation of a system wide level 3 by agency principals on 11 December. A new Humanitarian Coordinator, Abou Dieng, was appointed and will be arriving in Bangui on 24 December. An inter-agency 100-day response plan was developed. NFI/WASH and Health/Nutrition clusters are being separated. On 19 December, the AU International Support Mission to CAR (MISCA) took over from the FOMAC. Since then UNICEF has intervened in 13 IDP sites in Bangui where 63% of the displaced population is concentrated, responding to humanitarian needs in health, WASH and Child Protection, and continues to support the displaced in Bossangoa. UNICEF CAR s 2013 funding appeal is 52% funded. Based on the increased needs, UNICEF is requesting US$62 million to meet the humanitarian needs of children in 2014. 2013 Affected population provided with households water treatment and storage material, and key hygiene supplies Children 6-59 months with Severe Acute Malnutrition (SAM) admitted for therapeutic care and benefitting from promotion of nutrition practices UNICEF UNICEF Cluster Sector/Cluster 250,000 310,500 310,500 310,500 14,100 13,645 14,100 13,645 Number of children under 5 vaccinated against measles 740,177 481,466 NA NA 20 December 2013 2.3 million CHILDREN AFFECTED 4.6 million PEOPLE AFFECTED (OCHA, December 2013) 639,000 INTERNALLY DISPLACED (OCHA December 2013) 214,000 NEW IDPS IN BANGUI (OCHA, since 5 December) 70,000 NEW REFUGEES OUTSIDE CAR (UNHCR, since Jan 2013) UNICEF Appeal 2013* US$ 32 million UNICEF funding status US$ 17.2 million UNICEF Appeal 2014* US$ 62 million Primary school children benefiting from education supplies 175,000 31,483 175,000 31,483 Separated children reunified with families 1,200 827 1,200 827 # of affected population reached with information on HIV 24,000 20,706 NA NA 1
Situation overview & humanitarian needs On the night of 4 to 5 December, heavy fighting broke out in the capital Bangui, with looting and arbitrary killings leading to the displacement of more than 25 per cent of the city s population. Up to 214,000 people have taken refuge in more 35 sites in Bangui. 13 children were reported killed and 60 injured (21 of them survivors of sexual violence). According to Amnesty International, 1,000 people were killed in the fighting that began on 5 December in Bangui alone. On the same date, fighting in Ouham and Ouam-Pende Prefectures triggered additional displacement with over 53,000 people taking refuge in six sites, and an unknown number thought to be hiding in the bush. The city of Bossangoa remains largely deserted, with all its population in taking refuge in 3 sites. Services in the areas affected by the fighting from 5 December came to a standstill. In Bangui the Amitié Hospital stopped functioning after armed men entered the hospital and killed ten patients and shot at the injured who approached the hospital. The in-patient nutrition centers in St-Joseph Clinic, Bimbo Hospital and the Pediatric Complex were the only facilities that remained operational in Bangui. Arrangements made to hold the national end-of-year exams on 7 December, had to be postponed indefinitely due to insecurity. Two schools were occupied by ex-seleka in Ouham and Ouham-Pende, and many more are occupied by IDPs. The number of children associated with armed forces and groups in the country has risen to at least 3,500 and could be as many as 6,000. 639,000 people have been displaced since the beginning of the year. Urgent humanitarian needs include health services, Non Food Items (NFIs), WASH and child protection. Estimated Affected Population (Estimates calculated based on initial figures from OCHA/IASC,17 Dec) Total Affected Population Children Affected (Under 18) Children Under Five Children 0 to 12 months Pregnant women Total IDPs 4.6 million Total Male Female 4,600,000 2,300,000 2,300,000 2,272,400 1,136,200 1,136,200 795,800 397,900 397,900 161,000 80,500 80,500 202,400 202,400 639,000 318,000 318,000 2
Humanitarian leadership and coordination United Nations agencies, NGOs, and the Red Cross movement continue to support response to the sudden IDP crisis in Bangui now characterized by 213,000 displaced people sheltering in some 35 locations around the city. The Humanitarian Country Team meets weekly to review the situation and technical response is coordinated by the clusters. UNICEF has participated in initial inter-agency assessments to at least 10 IDP sites in Bangui. In addition, UNICEF proposed a joint inter-agency assessment and response mission this week to Bozoum and Bohong in north western CAR in coordination with UNHCR and OCHA. In both locations, violence and inter-communal attacks have led to the displacement of several thousands of people and little if any international assistance has been provided so far. The UNICEF team will operate from the WFP base in Bouar and is expected to be joined by staff from WFP and WHO. In support of this UNICEF is moving NFIs, medical and WASH supplies this week from Bangui to assist several thousand people. These will be pre-positioned at the WFP warehouse in Bouar. Further clashes in Bangui on 20 December delayed the mission departure. UNICEF staffs in Bossangoa continue to work closely with UNHCR, OCHA and WFP partners in responding to the needs of about 44,000 IDPs. Effective cooperation also exists with the small number of NGOs present including MSF-H, ACF and Caritas. Government involvement in planning, monitoring and coordinating the Bangui IDP response has been limited with the exception of Ministry of Health and Water Authority staff who playing important roles at hospitals and in ensuring water supply. Outside Bangui, government presence is generally limited. This week, UNICEF and UN agencies have finalized inputs to the 100 day plan intended to inform and enable urgent the scaling up of emergency assistance along with deployment to the field to sustain such response. The plan is informed by the Humanitarian Needs Overview that also establishes the needs profile for the 2014 Strategic Response Plan (formerly known as CAP). Humanitarian response strategy UNICEF s strategy is to quickly scale up response to reach as many of the 400,000 children under- five years identified as being in conditions of emergency throughout the country. The present uncertain and volatile context in the country, particularly in Bangui and Bossangoa, means that the response is significantly constrained by impediments relating to insecurity and lack of access to displaced populations in the rural areas. The designation of the crisis as a Level 3 emergency is expected to enable rapid scale-up of UNICEF s response. UNICEF is deploying its Immediate Response Team (IRT), led by a Director level team leader to support the response, released an additional $5 million from UNICEF s internal loan facility, bringing the total of internal funds allocated to $12 million; and is also deploying dedicated cluster capacity with information management where needed. Additional staff have been identified for UNICEF s programme deployment with priority to fill positions at sub-national level. This builds on UNICEF s presence during the crisis facilitated through the three mobile teams operational since July 2013, and the re-establishment of its presence in Kaga Bandoro and Bossangoa, as well as the planned opening of sub-office in Bambari. 3
Summary analysis of programme response Since December 5 th UNICEF has intervened in 13 IDP sites in Bangui where 63 per cent of the displaced population is concentrated. Focus has been on sites with more than 10,000 displaced (6,000 for child protection) or where major gaps and absence of other actors were identified. The Rapid Response Mechanism (RRM) is also providing NFIs such as soap, jerrycans, mats, tarpaulins and blankets to the most vulnerable, including the sick, children under five, pregnant and lactating women and where critical gaps are identified. Child Protection - Five IDP sites in Bangui now have functioning Child Friendly Spaces set up by UNICEF and its partners, COOPI, Save the Children, and Don Bosco for up to 6,250 children to have recreational activities and psychosocial support. - UNICEF has established three Child Friendly Spaces in Bossangoa with partner Caritas, providing recreational and psychosocial support to 1,200 children. Two CFS including with outreach and mobile CFS activities were already functioning in Kaga-Bandoro catering to 7,300 children in partnership with Save the Children. - Since 5 December, 18 children were released from armed groups and transferred to UNICEF and its partners. They are being provided with psychosocial support, temporary care and other specialized services through partners. - From 18-20 December, UNICEF helped organize and accompanied the visit to CAR of the UN Special Representative for Children and Armed Conflict, the UN Special Advisor on the Prevention of Genocide and the Chief of Staff of the UN Special Representative on Sexual Violence in Conflict. The delegation visited Bangui and Bossangoa to assess the security, human rights and humanitarian situation. They met with members of the Transitional Government, UN officials, diplomatic representatives, religious leaders, representatives of the Multinational African Force (FOMAC) and the French military operation SANGARIS, the humanitarian community, members of civil society, and IDP sites and families, including child-friendly spaces where UNICEF and partners are supporting psychosocial and protection activities. The delegation called for urgent and immediate action to prevent the country from plunging into a full-scale sectarian conflict and to protect and assist the civilian population, particularly women and children from on-going atrocities. Children drawing in a Child Friendly Space in Bossongoa UNICEF CAR/2013/PabloGimenez 4
WASH - In Bangui, UNICEF and Direction de l Hydraulique installed six segregated field defecation areas and have restored 24 latrines in 3 IDP sites hosting 21,000 IDPs (19,200 covered). 42 latrines and two segregated field defecation areas were built with IRC in four IDP sites hosting 28,300 people. - 28,000 IDPs have benefitted from soap and hygiene promotion, aimed at reducing the risk of disease in crowded Bangui camps. - UNICEF continues to support SODECA, the national urban water provider, with water treatment, and has secured the provision of free water through the SODECA network to all identified IDP sites in Bangui. - In Bossangoa, UNICEF and its partners are providing the displaced population with drinking water. which is now at an average drinking supply of 7.8 liters per person in the three IDP sites. UNICEF is also finalizing arrangements for SODECA technicians to repair the water net system which would ensure access to safe drinking water to the entire population in this town. Health and Nutrition - In Bangui since 5 December, UNICEF has provided essential drugs and nutrition supplies to care for more than 18,000people, including basic drugs, malaria and delivery kits, in more than ten health and nutrition facilities including the Community Hospital and the Bangui Pediatric Complex. - Countrywide 13,645 cases of SAM have been admitted so far this year with 77 per cent reported recovered and a 2.6 per cent death rate. In the last two weeks, UNICEF has supplied 37.7 MT of RUTF, therapeutic milks and basic drugs through partners to nutritional facilities countrywide. - The interruption of activities of 12 out-patient nutrition facilities in Bangui areas affected by recent fighting put 950 children under treatment for SAM at risk of dropping out. ACF was able to reopen five of these facilities in collaboration with UNICEF, and outreach efforts enabled the return of the 422 children as of 19 December. - The nutrition cluster decided to set up mobile out-patient malnutrition treatment units to screen and treat children with SAM in the Bangui IDP camps. MSF and IMC launched the first mobile units in three of the largest IDP sites, namely, (Airport, Boy Rabe Monastery and Archeveche St Paul). ACF is currently launching in eight additional sites. These mobile units will also focus on recovering SAM treatment dropouts. Rapid Response Mechanism (RRM) - Since 5 December, the RRM has undertaken distribution of the NFI pack (soap, jerrycans, blankets and plastic mats) in three IDP sites to cover the needs of about 21,000 IDPs. Basic NFI (soap and jerrycans) were distributed by RRM partners in other sites to cover the needs of additional 38,300 IDPs. - 12 heath facilities and six in-patient nutrition facilities have received soap for 2,500 patients and blankets for 1,100 patients. - In partnership with MSF Belgium, 5,000 bednets have been prepositioned their clinics at two of the largest sites: Airport and Boy Rabe Monastery. These bednets will be distributed to malaria patients, children under treatment for SAM and pregnant women in pre-natal care. - Première Urgence - Aide Medicale Internationale (PU-MI), IRC, ACTED et Solidarités International (SI) have provided people in five of the major IDP sites in Bangui with emergency shelter that 5
provide 7,580 m 2 of areas covered from the elements for the most vulnerable (children under five, pregnant and lactating women and elders). - To reinforce RRM capacity for the Bangui IDP response, UNICEF has partnered with SI, PU-AMI and MSF-Belgium in addition to the RRM Core Partner (ACF, ACTED). Discussions are taking place with other potential partners. This will boost RRM capacity to intervene in emergency shelter provision, emergency sanitation and NFI distribution in Bangui s main IDP sites right away. Cluster Coordination - On 7 December, RRM, IOM, WFP and OCHA set up an information management cell to quickly gather situation information on displacement and identified needs and gaps. The information and maps produced by this group assisted initial assessments and response, and was then handed over to OCHA as a basis for further updates on displacement in Bangui. - The education cluster has coordinated with government to use a phone tree to regularly collect information from inspectors on the status of schools across the country. This secondary data collection allows to regularly update the situation of closed schools and reports on targeted schools, teachers and students (Monitoring and Reporting Mechanism). - RRM partners promoted an approach to emergency temporary shelter through the Shelter/NFI/WASH cluster that focuses on creating communal shaded areas for the most vulnerable rather than building shelters per family, thus responding to the urgent need to provide cover from the elements. The cluster agreed the criteria for vulnerability to be children under five, pregnant and lactating women and elders. - At the onset of the December events, WASH partners in Bangui were quick to identify needs and gaps, and to coordinate appropriate coverage of WASH needs in sites, with most sites receiving WASH support at this time. - The UNICEF-led WASH cluster in Bossongoa is coordinating the water provision to IDPs, waste disposal management and coverage of sanitation needs. In the last two weeks MSF and ACF have constructed more than 300 latrines and ACF constructed two new waste disposal sites. - A hotline (ligne verte) to report and refer cases of GBV has been established by the GBV subcluster. Gaps and constraints to the response - In recent days some UNICEF teams covering a number of IDP camps have encountered hostility and threats. The operating environment has become more dangerous. - There is a limited presence and capacity of humanitarian actors in Central African Republic. More INGOs with expertise in WASH, Health, Child Protection and Education are needed on the ground. - Humanitarian access is still limited and intermittent, particularly to rural areas where people are believed to be hiding in the bush. Security remains a concern in the most affected parts of the country. - Due to high concentration of population and limited presence of security forces, IDP sites have insufficient space which is a major constraint for installing an adequate number of latrines, child friendly spaces and others. - The continuing absence of security in countless villages, quartiers, and neighborhoods across the country, and especially in Bangui and much of the northwest demands urgent and scaled up 6
presence of security forces. Otherwise there is no hope of reversing the present and expanding crisis. Communication for Development (C4D) - 200 peer educators and 310 community mobilisers have been trained to spread messages on notably prevention of family separation and good health and hygiene practices in 12 IDP sites. Nearly 18,000 children and other community members have been reached with sensitization activities. - To help promote national reconciliation, the UNICEF Representative and Deputy Representative have met with leaders from religious communities. This process will be furthered pursued with Search for Common Ground. - 15 radio journalists were trained on humanitarian principles, peace promotion and conflictsensitive journalism Supply and Logistics - Two separate air lifts containing 105 m3 of emergency supplies (notably medicine and NFIs) have arrived in the last week. - The supply line Douala-Bangui by road was closed due to insecurity and was reopened on 16 December with FOMAC security escort. - Daily delivery of supplies to locations outside of Bangui including Bossangoa is constrained by very limited local transport capacity and inactivity of main logistics service providers. Funding Sector Initial HAC 2013 requirements Additional requirements June 2013* Total 2013 requirements as of the midyear review of the CAP Income through UNICEF and donors* Funding gap Nutrition 1,494,255 3,184,418 4,678,673 2,140,480 2,538,193 Health 1,588,950 6,334,473 7,923,423 5,342,087 2,581,336 Water, Sanitation & Hygiene Child Protection 995,100 6,943,800 9,216,748 1,238,664 7,978,084 5,073,806 1,462,494 6,536,300 3,743,703 2,792,597 Education 1,086,986 2,483,514 3,570,500 4,720,383-1,149,883 Non Food Items (NFI) 1,277,848 (now included in Water, Sanitation and Hygiene above) Total 11,516,945 20,408,699 31,925,644 17,185,317 14,740,327 7
With the year over almost over, the CAP for CAR in 2013 is only 53 per cent funded out of the revised $195 million required to meet needs. Due to a drastic increase in displacement and the deterioration of the humanitarian situation in the country since the military takeover, the humanitarian needs have increased significantly which will be reflected in the stated needs for 2014. UNICEF wishes to express 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 non-earmarked funding. Non-earmarked 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. Continued donor support is critical to continue scaling up the response. SUMMARY OF PROGRAMME RESULTS UNICEF & operational partners Sector / Cluster Sector Indicator UNICEF % of Achieved Cluster % of Achieved Health Nutrition Number of U5 children vaccinated against measles Number of children under - five provided Vitamin A Children 1-5 years receiving de-worming medication 740,177* 481,466* 65% N/A 740,177* 480,494* 65% N/A 656,666* 417,898* 64% N/A UNICEF Operational Partners: IMC, ACF, PU-AMI. Ministry of Health (*) Preliminary data. Children 6-59 months with Severe Acute Malnutrition (SAM) admitted for therapeutic 14,100 13,645 97% 14,100 13,645 97% care and benefitting from promotion of nutrition practices Children 0-59 months children in therapeutic >=10,600** 9,163 86% >10,600** 9,163 86% care recovered from SAM Recovery Rate >=75% 77% n/a >=75% 77% n/a Death Rate <5% 2.2% n/a <5% 2.2% n/a Default Rate <15% 7.6% n/a <15% 7.6% n/a UNICEF Operational Partners: ACF, COHEB, IMC, MSF-F, MSF-E, MSFH, CARITAS,MERLIN, SAVE THE CHILDREN (*) revised from 23,500 representing the burden of SAM in CAR to 14,100 representing the caseload to be reached in 2013 (at least 60% of the burden) (**) revised from 17,600 to 10,600. The previous target included the total amount of hold and new cases of SAM children recovered while the revised target focused only on the children recovered out of the total number of newly admitted SAM children. The total number of recovered children (out of the total number of hold and newly recovered children) is 9,807. The changes in these targets are based on a discussion held with partners and Government to better reflect the situation in the country. For consistency we are including in the note the status of the progress based on the targets agreed in the revised 2013 CAP. 8
UNICEF & operational partners Sector / Cluster Sector Indicator UNICEF % of Achieved Cluster % of Achieved Affected population provided with households water treatment and storage 250,000 310,500* 124% 310,500 310,500* 100% material, and key hygiene supplies Population reached with hygiene promotion messages 250,000 223,000** 89% 250,000 223,000** 89% WASH Child Protection HIV/AIDS Education Affected population provided with access to safe water which benefitted from promotion of key hygiene practices 100,000 152,747 153% 152,747 152,747 100% UNICEF Operational Partners: ACF, ACTED, ANEA, Direction Generale de l Hydraulique (*) Note: including 180,000 benefiting from the water treatment provided by the water municipal company SODECA in Bangui with UNICEF support. (**) This includes 35,000 direct beneficiaries and the remaining amount reached through campaigns. During the last Bangui operation (68,000 IDPs) the standard used was for 2 weeks supply instead of a month. Number of children released from armed 500 200 40% 500 200 40% forces and groups Separated children in emergencies reunified with families GBV survivors who receives holistic assistance 1,200 827 69% 1,200 827 69% 2,000 1,431 72% 2,000 1,431 72% UNICEF Operational Partners: Caritas, COOPI, IMC, Mercy Corps and Save the Children # of affected population reached with information on HIV # of children young people and women access HIV and AIDS prevention, care and treatment (HIV+ pregnant women and exposed children) # of PLWA previously on HIV-related care/treatment continuing to receive care (PMTCT, ART) 24,000* 20,706 86% N/A 14,000** 7,897 56% N/A 16,800*** 12,474 74% N/A (*) revised from 3,000 to 24,000, (**) From 2,000 to 14,000 and (***) From 2,400 to 16,800. Primary school children benefiting from education supplies Out of school children benefiting from child friendly spaces UNICEF Operational Partners: MoE, DRC, COOPI, ACTED, IRC, TGH 175,000 31,483 18% 175,000 31,483 18% 50,000 600 1% 50,000 600 1% 9
Twitter handle: @UNICEF_CAR, #CARcrisis UNICEF CAR Humanitarian Action for Children Appeal: http://www.unicef.org/appeals/car.html Who to contact for further information: Souleymane Diabaté Representative Central African Republic sdiabate@unicef.org Judith Léveillée Deputy Representative Central African Republic jleveillee@unicef.org Linda Tom Communications Specialist Central African Republic ltom@unicef.org 10