Monthly Situation Report 4 November 2012 Highlights - Despite the abundant rainy season and avoidance of a humanitarian catastrophe thanks to the combined emergency response of the Government supported by the humanitarian community with the assistance of donors and technical and financial partners, there is still a need to tackle significant levels of global acute and chronic malnutrition among children. - Analysis of malnutrition trends suggests that coping mechanisms of communities need to be reinforced to respond to recurrent and multiple shocks. Building resilience is a priority. - From January to September 2012, a total of 7,918 children under-five suffering from severe acute malnutrition were admitted within public health facilities run by the Ministry of Health and supported by and partners across the country. This represents 63% of the annual case load of 12,600. - The number of Malian refugees in is now at 108,953. In coordination with UNHCR, the Government, UN agencies and NGOs, continues to support a set of actions in the areas of Nutrition, WASH, Health, Education, and Child Protection. Preparations for the start of the school year are under way. - Planning for the 2013 inter-agency Consolidated Appeals Process (CAP) took place in October. Key priorities for 2013 include emergency support to households that remain vulnerable to malnutrition; building resilience; and responding to the Mali crisis. - Global Hand-washing day events on the 15 th October focussed on vulnerable areas, populations and pupils in schools. The messages reached over 4,500 schools and over 200,000 people through the media. The event also took place in the Mbera refugee camp and the host communities. In health centres, 1,000 hand-washing kits were distributed to mothers who had benefited from hygiene promotion sessions. - The nation-wide polio eradication campaign including the refugees and host communities run by the Ministry of Health with support from and WHO started last week for a period of 3 days, with assistance from all actors engaged in the humanitarian response. A mother and her son at the and Save the Children supported childfriendly space for children recovering from severe malnutrition at the Kaedi hospital in southern. In addition to psycho-social activities, sensitization on hygiene and good care is provided to mothers to prevent malnutrition from reoccurring. /Mauritanie/2012/Azar 1
Situation & Humanitarian Needs Estimated Affected Population Total Male Female Total Affected Population (food insecurity) 700,000 347,200 352,800 Children Affected (Under 18) (food insecurity) 350,000 175,000 175,000 Children Under Five (food insecurity) 120,000 60,000 60,000 Children 6 to 23 months (food insecurity) 31,710 15,855 15,855 Pregnant women (food insecurity) 33,250 33,250 Children Under Five with Severe Acute Malnutrition (SAM) (estimations based on prevalence & incidence) 12,600 6,300 630 38,647 Children Under Five with SAM and medical complications 1,260 Children Under Five with Moderate Acute Malnutrition(MAM) 77,293 Sources: (Estimates calculated based on initial figures from SMART Nutrition Surveys July 2012, n Census 2000,) Estimated Affected Population Malian Crisis, see UNHCR figures from 25.09.2012 http://data.unhcr.org/malisituation/country.php?id=132 Total Male Female Total Estimated Population 108,953 Individuals 46% 54% (21,515 households) ** Projected Children Affected (Under 18) 64% 32% 32% Projected Children Under Five 20% 10% 10% *Projections will be updated based on the results of the registration level 2 which will be carried out in September 6,300 630 38,647 Inter-agency collaboration - The 2013 Consolidated Appeals Process workshop was conducted in October in collaboration with multilateral, bilateral and UN agencies, NGOs, and the Government. The 2013 CAP for will be launched in the second half of November. Programme response Cholera preparedness - has established a cholera contingency stock for 1,500 households and 20 cholera treatment centers. Orders are in process to fill in the gaps. - The cholera contingency stock has been shared with partners through the WASH sector humanitarian group. - The WASH sector humanitarian group is strengthening its operational links with the Government Crisis Committee managed by the Ministry of Health, as well as with NGOs and WHO to increase effectiveness of cholera preparedness. A concept note has been shared. - At the community level, a nation-wide hand washing with soap campaign was launched on 15 October, including in 4,075 schools (public and private) targeting almost 550,000 children of which half are girls. This campaign will continue until the 31 December. - Communication materials have also been developed to sensitize populations, including in the refugee camp in coordination with UNHCR and partners. These materials will be distributed shortly for the prevention of cholera. 2
Nutrition Rains have been plentiful this year, at times resulting in localized floods. Nevertheless, drought is a periodic climatic feature in, which is characterized by a perennially arid and fragile environment. An analysis of Global Acute Malnutrition (GAM) and Severe Acute Malnutrition (SAM) prevalence during the last five years suggests that a new proactive and integrated approach is needed to reinforce the capacity of communities to cope with a nutrition crisis, when this occurs. Rebuilding after such a crisis is a slow process, especially for the poorest. Therefore, while ensuring the emergency response to the nutrition crisis, and partners are working to translate resilience into a practical comprehensive nutrition scale-up plan for 2013. Figure 1. Trends in GAM an SAM from 2008 to 2012 (source: SMART Survey, Ministry of Health, ) Malnutrition Aigue Globale Malnutrition Aigue Severe 14 12.2 12 10 8 6 3 4 2 0 8.4 1 13.1 1.8 6.4 0.5 12.2 10.7 6.5 6.8 1.8 1.2 1.4 1 12 1.7 & partners Sector % of Cluster % of Children <5 with Severe Nutrition* 12,600 7,918 a 62.84% 12,600 7,918 a 62.84% Acute Malnutrition admitted to Therapeutic 300 391 130.3% 1,200 774 b 64.5% care Children <5 with Severe Nutrition* NA 4782 NA NA 4782 NA Acute Malnutrition discharged NA NA NA NA Children <5 with Severe Nutrition* 10,600 3,399 32.02% 10,600 3,399 32.02% Acute Malnutrition discharged recovered 240 74 30.8% 1,110 285 b 25.8% Number of Health Nutrition* 488 291 59.6%** 488 291 59.6%** centres with SAM treatment 1 1 100% 6 4 66.7% Children <5 with Nutrition NA NA NA 57,900 37,891 65.4% Moderate Acute Malnutrition benefiting from Supplementary NA NA NA 2,100 1,990 94.7% Feeding programmes*** Partners: the Government of, Action Contre la Faim, Croix-Rouge française, World Vision, Terre des Hommes, Counterpart International, Médecins Sans Frontières France, Medecins sans Frontières Belgique, Red Crescent, UNHCR for the refugee population and the World Food Program (WFP) for the coordination and treatment of moderate acute malnutrition, WHO * As activities are fully integrated across the sector, and sector figures are equivalent for SAM. ** This rate is partial and comes from 291 Health Centers and Health Posts visited to date. The monitoring of health facilities offering SAM treatment is continuing to cover all 488 health facilities.. *** Supplementary Feeding programmes (SFPs) are supported by WFP which provides bimonthly rations at the community level. However, at the M Bera camp provides technical support through training and equipment. a Data include statics from, Nouadhibou, Brakna, Guidimakha and Assaba for the first semester of 2012 and updated statistics from Brakna and Gorgol for September 2012. b Updating of this figure, which includes both M berra and Fassala health facilities supported by Medicins Sans Frontieres-Belgique, is ongoing. 3
and partners programming - From January to September 2012, over 7,918 children under-five affected by Severe Acute Malnutrition (SAM) were admitted. This represents 63% of the of 12,600. - In October 2012, in the M bera refugee camp, with UNHCR and partners: o 281 severely malnourished children (0-59 months) were admitted and treated within the Ministry of Health health units with support. o 9 community health workers (CHWs) received full training and supervision on activities related to SAM management. WASH & operational partners % of Cluster Sector / Cluster Nutritional centres delivering the WASH minimum package 291 14 4.8% 480 59 12.3% % of The number of hygiene kits with key hygiene messages distributed to SAM affected carer / mother and child 12,600 750 6% 12,600 1,398 11.1% Partners: Solidarités International (SI), Oxfam Intermon, NGO ECODEV, AMAMI and APSD Moundy, Ministry of Water and Sanitation, Ministry of Social and Family Affairs, UNHCR. target is based on U5 children data and partners programming - 3,857 hygiene kits for mothers have been distributed to 2 Regional Directions of Sanitation and Water (Assaba, Hodh El Chargui) for 3,857 households. - 8,100 minimum WASH kits for mothers and children affected by Severe Acute Malnutrition (SAM) have been distributed to 4 Regional Directions of Sanitation and Water (Assaba, Hodh El Chargui, Brakna and Guidimakha) for 8,100 mother-child households.. - and the WASH sector group have supported the Ministry of Water and Sanitation to establish a WASH in Nut monitoring system at national level. - Celebration of Global Hand-washing day on 15 October took place with a special focus on vulnerable areas to population and pupils in schools. o This reached over 4,500 schools across the country and more than 200,000 people through media (television and radio). o The event was also celebrated in the Mbera refugee camp and host communities in collaboration with UNHCR, local authorities, and NGO partners Solidarites and Oxfam. o 1,000 hand-washing kits were distributed to mothers attending health centres in. These mothers have also benefited from hygiene promotion sessions. o s C4D section supported the development of messages and posters on the polio vaccination campaign, sensitization of hand-washing with soap, and birth registration between 18 and 21 st October. - In October, under leadership, the WASH sector humanitarian group has focused on the CAP Process and on establishing bilateral relations with new partners within national civil society, Government and the Red Cross / Crescent Movement. The sector aims to consolidate results obtained in September (harmonization of standard kits and indicators, implementation of a monitoring system at the national level for example) and to work on new areas (elaboration of harmonized assessment tools, establishment of specific committees working on emergency preparedness). - Partnerships with national NGOs (Amami, Ecodev and Moundy) are in place to scale up WASH in Nut activities to reach children in the most affected regions (GAM>10% - Brakna, Gorgol, Assaba, the two Hodhs, Guidimakha and Tagant). These activities focus on nutrition centres (including CRENAM) and the community. Additional partnerships with NGOs are being negotiated and will be activated shortly. 4
Health The Health component delivers a comprehensive package of interventions to the population affected by the Sahel crisis through fixed and mobile activities organized by the local authorities. Regarding refugees and the host communities in Hodh El Chargui the same integrated package is offered by the health facilities located in the camp and Mberra village. technical support in coordination with UNHCR, UN agencies and NGOs has been provided in Bassikounou to contribute to enhancing the implementation and monitoring of activities run by the Ministry of Health. Children <5 receiving measles vaccination Routine : 9-11 months (refugees) Campaign / Routine : 1 to 15 years Nutrition Families receiving 2 ITNs 2,580 28,058 13,000 13,998 & operational partners 625 26,772* 13,000 5,403** % of 24.2% 95.42% 100% 38.6% Partners: Ministry of Health, Médecins Sans Frontières, UNHCR, WHO, UNFPA, NGOs * 1154 children vaccinated during routine activity since the lest campaign ** UNHCR and MSF distributed respectively 4000 and 6000 LLINs and partners programming - provided 20 basic health kits for 200,000 persons over three months, and 20 Malaria kits for 20,000 persons over three months1. These will be distributed to areas faced by the Sahel nutrition crisis and the refugees influx to improve the treatment of children affected by malnutrition and common diseases, especially to address the challenge of malaria among children under-five. - In addition to routine activities, a national immunization day (NID2) against poliomyelitis targeting children under-five years was conducted across the country by the Ministry of Health with support from and WHO. The focus was on the hardest-toreach, including nomads affected by the Sahel crisis, the refugees in the M berra camp and host communities. - continues to support the Ministry of Health and departments within the region to implement and monitor an integrated package of services. These include management of malnutrition, immunization and management of childhood diseases. Child Protection Assistance to the Child Protection Working Group in Emergencies (CPiE) enabled the emergency response to be extended to two other provinces (Gorgol and Guidimakha). Efforts focused on the validation of the Rapid Needs Assessment, the Child Protection (CP) response plan, training, and establishment of CP structures. continues to implement CP interventions in M bera camp in coordination with UNHCR and partners. Children with safe access to community spaces for socializing, play, learning & operational partners % of Sector Sector % of 23100 3708 16% 23100 3708 16% Partners: Ministry of Social Affairs, Wilayas of Guidimakha and Gorgol, Ministry of Health, Save the Children, Terre des hommes- Lausanne, Intersos, a National NGO Actions, UNFPA, UNWOMEN and UNHCR. 1 One Inter-agency Emergency Health Kit is for 10,000 persons over 3 months; 1 Malaria Kit for 1,000 persons over 3 months. 2 Data not yet available 5
and partners programming - 250 children affected by Severe Acute Malnutrition (SAM), including those with medical complications benefited from psychosocial activities established in 4 health and nutritional structures. o and Save the Children have provided assistance to the Ministry of Health in establishing spaces for mothers and their malnourished children at one outpatient nutrition centre (CRENAS) and one inpatient nutrition centre (CRENI) in Kaedi (Gorgol). o Terre des Hommes-Lausanne established two psychosocial support spaces in the health center of El Mina for children affected by acute malnutrition which benefitted 190 children. o also supported the Ministry of Social Affairs to establish provincial CP structures in the two wilayas - Guidimakha and Gorgol - to ensure coordination of the emergency response and incorporation of psychosocial stimulation activities in another CRENI and one CRENAS in Selibabi (Guidimakha). - In Mbera, 918 children from 4 child friendly spaces (CFS) and 700 children affected by Moderate and Acute Malnutrition (MAM) benefited from psychosocial activities. - 4 child friendly spaces were established in Selibabi aiming at targeting at least 1000 children from 7 to 13 years and 500 adolescents and youth. - Three training sessions held on Gender Based Violence (GBV) and psychosocial support benefited 106 provincial and community actors. o A GBV training session held in Kiffa (Assaba) benefited 43 health, Justice/Security, social affairs and NGOs actors from six provinces affected by the nutritional crisis (Gorgol, Brakna, Guidimakha, Hodh Chargi, Hodh Garbi and Assaba). o 63 health and nutritional, community agents of the provincial representation of the Ministry of Social Affairs, Save the Children, ACF and Actions (a national NGO), from Kaedi and Selibabi benefited from psychosocial support training in running the psychosocial (PSS) spaces. - Terre des Hommes-Lausanne with assistance developed three psychosocial support materials (guide and two flipcharts) for the agents in charge of the PSS activities for malnourished and other affected children. - The Child Protection response plan and the Rapid Needs Assessment report have now been validated. Coverage of the assessment was extended to where data collection was completed by Terre des Hommes-Lausanne with assistance. - Availability of kits for PSS activities is crucial for the CP emergency response. 50 kits were ordered offshore and the composition of two local kits was set up to ensure sustainable availability of PSS material for the CFS and emotional stimulation activities. Education and and partners programming Malian refugees in : - The start of the new school year in the refugee camp has been delayed to mid-november. This is mainly due to torrential rains in October that damaged infrastructure, and hindered rehabilitation/ construction. has been identifying solutions with UNHCR and partners, including additional tents and the rehabilitation of latrines in schools. - Formal catch-up courses have been organized for 432 secondary school aged children, including 128 girls and 304 boys, as well as non-formal literacy numeracy courses for 400 youth, based on the Malian curriculum in the M berra camp. This is being done in partnership with UNHCR, local authorities, and NGOs, to support the start of the new school year An information campaign on reopening schools, focussing on girls education, will be conducted. - The Malian curricula, textbooks and teacher guides for primary and secondary schools (except the final class of senior high level) are being distributed for 25,300 children and their teachers in M Bera Camp. Additional school stationery will be provided for the start of the school year. Nutrition crisis: - A training on hygiene and nutrition of 1,000 pre-school and primary teachers from five vulnerable regions is planned for mid- December to mid-january with the Ministry of Education and two NGOs. The preparatory work will include adapting the modules, briefing the trainers, and identifying the beneficiaries.. After the teachers' training, NGO activities will include the sensitization of APE (Associations Parents Elèves), in addition to the work with youth associations in the targeted schools. 6
Communications for Development (C4D) - and partners have supported social mobilization in relation to an integrated mass campaign against polio, coupled with sensitization on hand washing with soap, and birth registration. - has supported social mobilization to promote the consumption of iodized salt to fight against iodine disorders in certain regions of the country, - Sensitization of the population on Key Family Practices is ongoing, using radio programs developed in August/September. Radio stations in areas hit by the nutrition crisis have been the principal channel. - Counseling cards to promote Key Family Practices by community focal points have been made available especially to regions where a Health Community Strategy will be implemented. Supply and Logistics - Around 815 metric tonnes of supplies with a value of USD 2,003,370.38 have been provided to date. Over USD 3,857,593.79 planned with 3,438,919.22 are already committed. - Supplies estimated at USD 177,632 are in the pipeline. Funding Funding Requirements Requirements (as per HAU June 2012* Funds received** Funding gap Appeal Sector $ % NUTRITION*** 3,000,000 3,611,055.7-611,056-20% HEALTH**** 2,170,000 1,453,342.5 716,658 33% WASH 2,800,000 2,076,308.0 726,692 26% C4D 77,000 93,242.4-16,242-21% EDUCATION***** 3,615,000 775,591.7 2,839,408 79% CHILD PROTECTION 450,000 322,482.7 127,517 28% COORDINATION & M&E****** 625,000 530,964.6 94,035 15% TOTAL 12,737,000 8,862,987.5 3,874,012 30% * The total includes a maximum recovery rate of 7%. The actual recovery rate on contributions will be calculated in accordance with Executive Board Decision 2006/7 dated 9 June 2006. **Figures represent Other Resources-Emergency budget allocations at country level, which may have been received prior to 2012 and excludes indirect programme support costs. ***Includes social protection **** includes some funding for HIV/AIDS *****Includes some funding that is joint with child protection ******includes operations support wishes to express its deep gratitude to all public and private sector donors for the contributions and pledges received, which have made the current response possible. would especially like to thank National Committees and donors who have contributed unearmarked funding. Unearmarked funding gives essential flexibility to direct resources and ensure the delivery of life-saving supplies and interventions to where they are needed most especially in the form of longer-term and predictable funding and in strengthening preparedness and resilience building. Continued donor support is critical to continue scaling up the response. Across Sahel, received financial and material contributions from: Andorra, Australia, Belgium, Brazil, Canada, CERF, Denmark, Estonia, European Commission/EC, Finland, France, Ireland, Japan, Luxemburg, Netherlands, Norway, Republic of Korea, Spain, Sweden, United Kingdom, United States of America; and the Argentina Committee for, Australian Committee for, Bulgarian Committee for, Canadian Committee for, Chilean Committee for, Chinese Committee for, Croatian Committee for, Danish Committee for, Finnish Committee for, French Committee for, German Committee for, Hellenic National Committee for, Hong Kong Committee for, Iceland National Committee for, Indonesian Committee for, Italian Committee for, Japan Committee for, Netherlands Committee for, New Zealand Committee for, Norwegian Committee for, Portuguese Committee for, Spanish Committee for, Thai Committee for, United Kingdom Committee for, United States Fund for. For further information, please contact Lucia Elmi Representative Tel: +222 45 29 98 01 Fax: +222 45 25 13 46 Email:lelmi@unicef.org Aissata Ba Sidibe Deputy Representative Tel: +222 45 29 98 04 Fax: +222 45 25 13 46 Email:asidibe@unicef.org Brahim Ould Isselmou Communications Specialist Tel: +222 45 29 98 03 Fax: +222 45 25 13 46 Email:bouldisselmou@unicef.org Miriam Azar Reporting Specialist Tel : +222 22 34 23 49 Fax: +222 525 1346 Email: miazar@unicef.org 7