Kenya Country Office Monthly Humanitarian Situation Report

UNICEF Kenya/2014/Minu Limbu/ South Sudanese refugees waiting at Kenya-South Sudan boarder point. Kenya Country Office HUMANITARIAN SITUATION REPORT July 2014 Kenya Country Office Monthly Humanitarian Situation Report July, 2014 Highlights The overall nutrition situation has deteriorated in the Arid and semi-arid Lands (ASAL) counties. The nutrition situation is very critical in Turkana North, South & East, East Pokot, Marsabit (Noth Horr & Chalbi, Wajir North and Mandera East and Mandera Central with acute malnutrition above 20%.). UNICEF and partners nutrition response scale-up is ongoing to meet the increased needs; As of 6 August 2014, Kakuma refugee Camp hosts to 41,780 1 South Sudanese refugees from the influx triggered by December 2013 fighting in Juba - up to 16% are unaccompanied or separated children. UNICEF through partners continue to provide technical & material support in child protection, health, nutrition, WASH & educators sectors. Funding remains a key bottleneck for the response across all the sectors; Following the ongoing cholera outbreak in South Sudan, and reports of cases closer to the Kenyan border, UNICEF has provided emergency medical kit and prepositioned ORS and emergency WASH supplies in Turkana County. UNICEF has supported training of health management teams on preparedness and response, and also signed partnership agreement with NRC to undertake sanitation and hygiene promotion activities for refugee population at the Kakuma refugee camp. The Kala-azar outbreak reported in Wajir and Marsabit has escalated due to the drought situation which has worsened, leading to reduced immunity of communities, especially children and women. An assessment of the rainfall recorded from 1 March to 28 May 2013, indicates that the rainfall was generally depressed over most parts of the country including several parts of Western Kenya and the Central highlands including Nairobi. Most stations recorded less than 75 percent of their seasonal Long-Term Means (LTMs) for March to May. SITUATION IN NUMBERS Kakuma Kakuma Kakuma 1.29 million # of food insecure population in Kenya (Kenya Food Security Steering Group, Short Rains Assessment conducted in February 2014) 100,000** # of South Sudanese Refugees in Kakuma Refugee Camp by July2014 (**estimate by UNHCR and partners based on analysis of recent trend, 3 April 2014) 67% of 41,780 % of registered arrivals from the South Sudanese influx are children under 18 years (LWF 18 July & UNHCR Aug, 2014) 1,082 And 5,751 # of unaccompanied and separated children respectively at Kakuma camp from the South Sudanese refugee influx (LWF, 17 July, 2014) Situation Overview & Humanitarian Needs Nutrition surveys conducted by Ministry of Health (MOH) and partners in Turkana, Baringo (East Pokot), Samburu, Mandera, Wajir, Garissa, West Pokot and Tana River between May and June 2014 indicate a deteriorating nutrition situation in all areas compared to the same time last year, apart from Tana River. In the Arid and Semi-Arid counties, children requiring treatment for acute malnutrition is 309,547 (170,251 boys and 139,296 Girls). Total caseloads of acutely malnourished Pregnant and lactating women requiring treatment is 37,502. Nutrition response scale-up by UNICEF and its partners is ongoing to meet the increased needs. Total required, 35.34 million Gap, 66% Received, 12 million Humanitarian funding requirements for 2014 Since the outbreak of fighting in South Sudan in December 2013, over 41,780 refugees have been received at the already congested Kakuma refugee camp. According to LWF UNICEF Child Protection partner in Kakuma, cumulative total number of children registered at the reception were 28,314 (15,719 boys & 12,595 girls) of which 21,481 (11,430 boys & 10,051 girls) were with biological parents while 5,751(3,585 boys & 2,166 girls) were 1

separated children and 1,082 (704 boys & 378 girls) were unaccompanied. Registration process for Unaccompanied Minors (UAMs) continued to be prioritized where UAMs are accompanied by a social worker to the Government of Kenya Department of Refugee Affairs (DRA) registration centre. UNICEF through partners on the ground is providing technical and material support in child protection, health, nutrition, WASH and educators sectors. Funding remains a key bottleneck for UNICEF response across all the sectors; Following the ongoing cholera outbreak in South Sudan, and reports of cases closer to the Kenyan border, Turkana County WESCOORD held an emergency cholera preparedness meeting on 11th July 2014 to review ongoing cholera preparedness activities and gaps in the county. UNICEF has provided financial and technical support for training of county and sub-county health management teams on preparedness and response. UNICEF has also provided emergency medical kit and prepositioned ORS and emergency WASH supplies in Turkana. UNICEF has also signed partnership agreement with NRC to undertake sanitation and hygiene promotion activities for refugee population at the Kakuma refugee camp. Since January 2014, some 125 people have been killed and 215,479 displaced internally following armed inter-communal conflicts in several parts of Figure 1 Source: UNOCHA, Kenya the country. The worst affected are Mandera and Wajir counties where more than 210,500 people have been displaced since May 2014 2. Other conflictaffected areas are Baringo, Nyakach in Kisumu, Garissa, Turkana, Samburu and Moyale in Marsabit. Key drivers for the inter-communal conflicts include competition for scarce resources, border disputes and political differences. The displaced populations require multi-sectoral humanitarian assistance, including shelter, food, education, and WASH services to prevent disease outbreaks. UNICEF has provided family kits through the Kenya Red Cross Society for the response, and is also leading sector response coordination in nutrition, WASH and education sectors; Following June attacks by unknown gunmen in various parts of Lamu County, there are three camps currently with over 984 displaced households (HHs) namely; Kipini with 259HH, Mavuno Kitale 225HHs and Hindi Prison where over 3000 (500HHs) displaced people hosted especially at night while during the day they go back to their farms 3. The school learning program is still affected as many schools have not yet resumed. Only class 8 students from Witu together with those from Pandanguo are learning at Witu Primary School. The other schools remained closed due to the teachers absence, as many of them are reported to have left the area, in fear of repeated attacks. In Mpeketoni schools resumed but students are few. In Hindi Division, students from various schools who are between class four and seven go to Hindi Primary school, while class 8 and form four students go to Hindi Secondary School and the rest are (from form one to three) are not schooling. Generally, the below-average long rains resulted in below-average crop development in the high- and mediumpotential areas in western Kenya and the Rift Valley. According to FEWSNET, food consumption will decrease through September in the southeastern, marginal, agricultural areas, Households have to purchase food now while prices have remained high. The majority of households will remain Stressed (IPC Phase 2) but a few areas are likely to enter Crisis (IPC Phase 3) between now and September at the height of the lean season. In pastoral and agro-pastoral areas, rangeland conditions did not fully recover during the March to May long rains. Pasture, browse, and water are being depleted faster than usual, and the lean season is likely to start earlier than normal in July instead of August. Many households will remain Stressed (IPC Phase 2) through September while others likely will enter Crisis (IPC Phase 3). Estimated Affected Population 4 (Estimates calculated based on initial figures from Kenya Humanitarian Strategy Meeting, November 2013 and UNHCR Contingency Plan for South Sudanese Refugee response, July 2014) Start of humanitarian response 5 : Total Male Female Total Affected Population 1,200,000 6 596,500 603,500 Children Affected (Under 18) 645,700 320,970 324,730 Children Under Five 185,640 92,278 93,362 Children Acutely Malnourished (GAM) 192,700 96,350 96,350 2

NUTRITION 9 UNICEF s Response with partners 7 Children in humanitarian situations aged 6 to 59 months affected by SAM admitted to community based management programmes Children in humanitarian situations aged 6 to 59 months affected by moderate acute malnutrition (MAM) admitted to integrated management of acute malnutrition programmes HEALTH 10 Children under 15 provided with an integrated package of high impact maternal, new-born and child health interventions, including measles immunization Children with diarrheal disease having access to life-saving curative interventions including oral rehydration therapy and zinc WASH Emergency affected people provided with access to safe water Children and women that receive critical WASH-related information to prevent child illness 11 CHILD PROTECTION Children and women in humanitarian situations accessing protective interventions, including psychosocial support, legal aid and case management EDUCATION Children in humanitarian situations that have access to formal and non-formal education opportunities Over all target for 2014 UNICEF UNICEF Support to South Sudanese Refugees 8 Kakuma Kakuma Targets results Population reached other than in Kakuma Cluster Target Sector/Cluster Cumulative results (#) 59,817 759 1,269 20,358 59,817 20,358 118,399 950,000 2,586 2,957 118,000 38,153 122,233 932,537 500,700 N/A N/A 139,445 118,399 38,153 200,000 100,000 35,000 32,000 385,980 102,000 200,000 100,000 5,000 22,000 385,980 108,000 65,000 7,500 9,613 705 12 320,250 12,000 4,528 42,822 13 350,000 62,754 Humanitarian leadership and coordination Inter-agency coordination continues under the IASC cluster structure, with clear government leadership in each sector area and co-leadership by UN agencies. UNICEF co-leads the nutrition, education, WASH and Child Protection sectors; and plays a strong role in Non-Food Items and health coordination. UNICEF also co- leads Government of Kenya Ending Drought Emergency (EDE) Human Capital pillar which comprise of Education, Health and Nutrition. UNICEF provides EDE technical support to inter-governmental body on knowledge management, coordination to cross fertilize innovative approaches on EDE. UNHCR and Government Department of Refugee Affairs (DRA) coordinate the refugee operations. UNICEF works closely with UNHCR to support coordination for the refugee operations, and co-chairs some of the sectoral arrangements. UNICEF also sent additional staff to Kakuma to enhance coordination structures for Health, Nutrition and Education Sectors. The Emergency Management Team (EMT) at the Kenya Country Office meets on a weekly basis to review response strategy, plans, progress in implementation, funding and address any bottlenecks. Humanitarian Strategy In 2014, UNICEF is working with the Government of Kenya and partners to meet the humanitarian needs of 1.15 million vulnerable people including the new South Sudanese refugees in Kakuma Refugee Camp. In line with 2014 South Sudan Refugee Emergency Regional Response Plan, revised in July 2014, UNICEF is expanding service provision to new refugees while continuing to reduce vulnerability of the previously targeted humanitarian caseload by supporting preventative action for acute malnutrition and illnesses and strengthening coordination within decentralized structures. UNICEF is also providing technical support in scaling up the Case Management System for children with acute protection concerns and support county government and UNHCR through procurement of vaccines to respond to measles outbreaks and malaria upsurges. 3

UNICEF is also focusing on water, sanitation and hygiene (WASH) in schools, health facilities and feeding centres, and is using schools to disseminate information and promote children s rights. UNICEF also plans to support partners to provide children and women living with HIV with essential HIV-related services, prepare for the rapid provision of a buffer supply of medication and provide HIV information through comprehensive community education initiatives. Particular emphasis has been given to the development of a child protection system that prevents and responds to violence, abuse, neglect and family separation, even during crisis. Recognizing that children are at the centre of the resilience agenda, UNICEF is supporting investments that empower communities and enhance their resilience to multiple and recurrent shocks, to reduce the impact of diseases and lessen chronic vulnerability. Technical support is also being provided to facilitate the inclusion of children s rights, disaster risk reduction and early recovery approaches in the county emergency preparedness and integrated development plans and budgets. UNICEF continues to strengthen its role as sector co-lead in the nutrition, education, WASH and child protection sectors. Scalable strategies for programme delivery in high-risk security environments is being adapted to facilitate the continuation of essential interventions. Summary Analysis of Programme response Nutrition: Drought response: The Cross-sectoral SMART surveys conducted under leadership of Ministry of Health have been completed in Turkana, Samburu, Garissa, Baringo, part of Mandera, Wajir, West Pokot and Marsabit (North Horr and Chalbi). Preliminary results in Turkana show a significant deterioration in the nutrition situation of the county from the same time last year. The prevalence of acute malnutrition in Turkana central, North and South/East, Marsabit (North Horr & Chalbi) indicate a very critical nutrition situation, while the nutrition situation in Turkana West is classified as critical. These results estimate that about 1 in 4 children is acutely malnourished. UNICEF and nutrition sector partners are in the process of scaling up emergency nutrition interventions through increasing active case finding and outreach programmes as well as mobilizing additional nutritional supplies to the ASAL counties. Refugee response: Total admissions of acutely malnourished children in Kakuma nutrition program remained stable reaching 1,269 cases of severe acute malnutrition by May 2014. However, the number of acutely malnourished children in need of intensive nutritional and medical support remains high. UNICEF Kakuma programme is only 25% funded (out of 1.6m USD for nutrition) which will impact on UNICEF s support to the nutrition response in Kakuma over the next 6 months. Health: Drought response: UNICEF has provided technical support to the County Health Management Team (CHMT) in Wajir, Turkana and Marsabit Counties, as well as supply of 200 vials of SSG to each County following Kala-azar outbreak. In Wajir County, 145 cases have been line-listed and treated since the onset of the outbreak in April; 60% of the cases are children aged below 5 years. 96 cases have been treated in Marsabit County. To address critical gaps in availability of medical supplies for emergency response, UNICEF has supplied IV fluids and ORS for casualties and displaced persons following inter-communal conflict along the Wajir/Mandera county border. The conflict has seen dozens killed, scores injured and tens of thousands displaced. UNICEF has supported training of county personnel in Isiolo on emergency preparedness, response and disaster risk reduction, and development of a plan to prevent, mitigate, respond and support early recovery from risks that commonly affect the county. Additionally, UNICEF has supported training of 200 community health workers from Turkana West sub-county, of which 50 are from the Kakuma refugee camp on emergency preparedness and response. The training has equipped the community level health workers with skills to avert disasters through preventive and mitigating community level best practices, prompt identification of events/outbreaks, managing minor cases, and referral of complicated cases to health facilities. The community health workers developed action plans that are to be consolidated into community unit emergency response and disaster risk reduction plans. Key threats prioritized in Turkana West are the refugee influx from South Sudan and consequent risk of epidemics in the host community, particularly with ongoing cholera outbreak in the neighbouring Eastern Equatorial region of South Sudan. Refugee response: UNICEF has consistently provided technical support to coordination and implementation of key lifesaving health interventions in Dadaab refugee camp through a technical officer stationed at Dadaab, and in collaboration with UNHCR and other partners. This has resulted in containment of measles outbreak earlier reported. UNICEF has placed orders for procurement of vaccines to support of immunization of refugee children older than 1 year, at the border entry point. The consignment is expected in country in the August/September, and will be used up to end 4

December 2014. The vaccination will sustain the high population immunity which has resulted in containment of the measles outbreak at the refugee camps and host communities. Water, Hygiene and Sanitation (WASH): Drought response: UNICEF continues to support emergency WASH response through sector coordination (WESCOORD) and provision of WASH supplies and technical assistance in drought and conflict affected areas. A regional WASH learning forum ran from 1st to 3rd July 2014 in Isiolo bringing together WASH actors from Isiolo and Turkana counties to share lessons learnt and best practices developed in emergency WASH response, disaster risk reduction and building resilience for communities. Turkana county WESCOORD held an emergency meeting to review cholera response preparedness, and existing gaps following outbreak in the neighbouring areas of Southern Sudan. UNICEF has dispatched WASH supplies for pre-positioning in Turkana. UNICEF has provided a generator and submersible pump to equip Eldas borehole in Wajir County to serve an estimated 10,000 persons including persons displaced by inter-communal conflict along the border between Mandera and Wajir counties - the population has been relying on trucking for water supply. Additional supplies comprising plastic buckets, water purifier tablets, water floc and disinfectant, chlorine powder, tarpaulins, latrine slabs and community trainers manuals have been dispatched to Kisumu for distribution during hygiene promotion campaigns, and also for pre-positioning in case of emergency requirements. Refugee response: Cholera outbreak in the neighbouring areas of Southern Sudan has heightened risks of spread to the Kakuma refugee camp as a result of the continuing influx, and the normal cross border movements. UNICEF has signed a partnership agreement with Norwegian Refugee Council through which additional hygiene promoters are being recruited and latrines with hand washing facilities constructed for schools and health facilities. This intervention is being implemented with funding from Government of Japan. UNICEF is also working in close partnership with UNHCR at the Dadaab refugee camps, and has pre-positioned WASH supplies for response. Child Protection: Drought response: Change since last reported. Refugee response: With funding from Central Emergency Response Fund (CERF) Rapid Response Window and contributions from the Government of Japan, UNICEF has partnered UNHCR and signed a Programme Cooperation Agreement (PCA) with Lutheran World Federation (LWF) to scale up Case Management systems for child protection in Kakuma refugee camp following the South Sudanese refugee influx. The numbers children including the unaccompanied and separated children (UASC) continues to rise in Kakuma. As of July 17, there were 28,314 newly arrived children (15,719 male/12,595 female) of whom 6,833 fall into the category of unaccompanied and separated child (UASC). Of this population, 1,082 (704 male/378 female) are unaccompanied and 5,751 (3,585 male and 2,166 female) are separated. About 16% of incoming population from the influx are UASC, and it is projected that there will be about 15,000 UASC by end of the year. Unaccompanied minors continue to receive priority for registration and are accompanied by a social worker to the Department of Refugee Affairs (DRA) registration centre at the Kakuma 3 Field Post. As of 17th July, 127 UAMs were residing at the reception centre; UNHCR and the National Council of Churches Kenya (NCCK) are still in the process of identifying areas of the camp that the children can be moved. During the reporting period (21st -26th July), UNICEF and UNHCR held a second case management training on Best Interest Assessments (BIA), Best Interest Determination (BID), and the Child Protection Information Management System (CPIMS) for LWF case workers during the period. The training, which emanates from an Action Plan developed in June, resulted in development of a vulnerability criteria for differentiating interventions for UASC and a more thorough understanding of the definition of UASC. Education: No changes since last reported. Security Incidents of intermittent inter-communal conflicts reported in Mandera, Wajir, Marsabit and Baringo among other counties in the northern Kenya during the reporting period. Following last month s armed attacks by unknown gunmen in Lamu County, UN operations has not been suspended. Travel restrictions to Garsen in Tana River County has been lifted following increased security patrols and a period of relative calm. Terrorist related threats remained elevated across the country in the reporting period. These security incidents and threats have led to restriction on UN staff movement in affected areas, thus affecting programme delivery. Crime, including car-jacking and armed robbery remains a key concern. 5

Sector Funding as of June 30, 2014 Original 2014 HAC requirements Jan-Dec 2014 additional requirements Response to South Sudan Refugees Crisis Revised 2014 HAC Requirements Nutrition 7,700,000 1,577,963 9,277,963 Health 4,000,000 1,896,505 5,896,505 Water, sanitation and hygiene Child protection 4,000,000 790,541 4,790,541 4,900,000 801,472 5,701,472 Education 5,500,000 1,181,665 6,681,665 HIV and AIDS 1,000,000 0 1,000,000 Cluster/sector coordination 2,000,000 0 2,000,000 Total received towards 2014 HAC 6,010,137 1,468,350 14 751,200 15 502,054 16 2,190,418 17-1,171,850 18 Funding Gap % Met 3,267,826 65% 4,428,155 25% 4,039,341 16% 5,199,418 9% 4,491,247 33% 1,000,000 0% 828,150 59% Total 29,100,000 6,248,146 35,348,146 12,094,009 23,254,137 34% NOTE: 79% of total funding requirement for Kenya remains unmet as of 30 June * Funds received does not include pledges Next SitRep: 31 August 2014 For additional information, please contact: Kanyankore Marcel Rudasingwa, Representative, Tel: +254-0708-023-031, mrudasingwa@unicef.org Madhavi Ashok, Deputy Representative, Tel:+254-705-262-285, mashok@unicef.org Fred Ogwal-Oyee, OIC, Emergency/Field Ops, Tel:+254-705-188137, fogwal@unicef.org 1 Kenya Kakuma Operational Update, 1 6 August 2014, UNHCR Kenya 2 www.unocha.org/eastern-africa 3 Kenya Red Cross Society Mpeketoni attack situation update no. 9 (18 th July 2014) 4 Estimated affected Population figures are in line with the UNICEF Humanitarian Action for Children 2014 Appeal. The Kenya Humanitarian Partnership Group (the Inter-Agency Standing Committee in Kenya) during Kenya Humanitarian Strategy in mid-november 2013,) agreed to continue planning for targeted population of 1.1 million for 2014. 5 Male and Female figures are generated using approximation from Kenya National Bureau of Statistics 6 The total affected population figures have been revised to 1.2 million from 1.1 million to include contingency planning figure of 100,000 South Sudanese refugees until December 2014, as per the South Sudan Refugee Emergency Regional Response plan for 2014, revised in July. 7 For the reporting period of January July 2014 8 The blue table reflects UNICEF ongoing response for South Sudanese refugees in Kakuma Refugee Camp in consultation and coordination with other partners on the ground including but not limited to UNHCR. 9 UNICEF and sector targets are the same because UNICEF provides technical and supply support to all integrated management of acute malnutrition programmes. 10 Data awaited from Ministry of Health for population reached through activities implemented by the Ministry with UNICEF support 11 UNICEF supported hygiene promotion activities at Kakuma start in the month of July 2014 in partnership with NRC 12 Persons reached through the Dadaab Refugee interventions and activities 13 Includes 2,918 Alternative Basic Education beneficiaries and 39,904 for peace education. 14 Includes USD 888,788 carried over from 2013 15 Includes USD 342,293 carried over from 2013 16 Includes USD 100,921 carried over from 2013 17 Includes USD 1,799,793 carried over from 2013 18 Includes USD 413,057 carried over from 2013 6