EMERGENCY AND HUMANITARIAN ACTION (EHA)

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1 WHO Country Office Ethiopia EMERGENCY AND HUMANITARIAN ACTION (EHA) WEEKLY UPDATE / ETHIOPIA Addis Ababa ECA New Building Ground Floor World Health Organization (WHO) Week 1 ( April to May ) Emergency and Humanitarian Action (EHA) HIGHLIGHTS Ethiopian Profiles Location: Horn of Africa Population: Approx.,. Surface: 1.1 million sq km Capital city: Addis Ababa Regions: 9; City Administrations: 2 Refugees: 5,3 IDPs: 3, to, Ethiopia Map of Africa showing Ethiopia Team Deployed from WHO, Regional and Zonal Health Bureaus and Negele Hospital to assess the Meningitis Situation in Bore District of Oromiya Region, April - Currently districts of Amhara Region and 3 districts of Oromiya Region are reporting acute watery diarrhea cases in Ethiopia. - The last Health Partner s Forum Meeting was held on 3th of April, 27 at WHO Conference Room I. DISEASE OUTBREAK SITUATIONS IN ETHIOPIA 1. Meningococcal Meningitis Cases in Ethiopia This week there were 7 cases and zero death reported nationally. Cases of the week where from 2 districts of Oromiya Region: Liben (6 cases) and Bore (1). Cumulative cases and deaths as of 27th of April are 21 and respectively; CFR: 3.%. Forty one districts in 5 regions reported at least one case and 3 districts in SNNP and Oromiya Regions have reached the epidemic threshold. Containment vaccination exercises were conducted in parts of Oromiya and SNNPR. Preventive vaccination campaigns are on going in Tigray, Amhara, Gambella, Addis Ababa, parts of Oromiya and SNNPR and will soon start in B. Gumuz region. Regions/Units Provided with Vaccines Vaccines in Doses Supplied to Regions To date a total of 11,91 people were vaccinated against meningococcal meningitis in Ethiopia. The vaccination targeted the population aged 2 to 3 years. The Government of Ethiopia plans to use the entire 69,5 doses of vaccines (A+C) available in the country. The main reasons of these exercises are: Three districts have reached the epidemic threshold and many districts in 5 regions are reporting sporadic cases. WHO alert on possible large scale meningococcal meningitis epidemics in the Africa Meningitis Belt in the year ; The vaccines available in the country expire on 31st of May. Total people Vaccinated To Date SNNPR 17, 1,9 Oromiya, 19,617 Tigray,,726 Addis Ababa 7,,391 Amhara 2,5 17,797 Gambella 3,,57 B/Gumuz 5, Prisons, 11,9 Grand Total 69,5 11,91 NB: Balance of vaccines currently available in regions is slightly less than 277,5 doses because of the wastage Case Treatment Center in Bore Health Center Case Management in Negele Hospital, April

2 2. Malaria Situation in Ethiopia Page 2 The main malaria transmission season in Ethiopia is from September to December. A second but shorter transmission season also exists from April to May following the short rainfall season from February to March. According to field reports currently there is an increase in the number of reported malaria cases in Borecha district, Illuababora zone, Oromiya region and Damot Gale and Bolosore Districts in Wolayta zone of SNNP Region. Out of 25 blood samples taken in Illuababora zone for laboratory confirmation, 17 were positive and Plasmodium falciparum accounted for % and Plasmodium Vivax for 2%. According to the expert from the FMOH Malaria Team who visited the affected villages in Wolayta zone, the increase cases was due to stock-out of Coartem in health posts and absenteeism of health extension workers for a period of 15 6 days from their place of assignment. Currently active case detection and treatment of cases are underway and monitoring of the situation is continuing. Treatment courses of Coartem were supplied to affected districts from the central medical store. However, there is a serious shortage of rapid diagnostic tests. The cumulative number of Long Lasting Impregnated Nets (LLINs) aged 3 years distributed to date in Ethiopia has reached approximately 2 million. The targeted of an average 2 LLINs per household is expected to have been achieved. For the upcoming Indoor Residual Spray (IRS) application season from June to July, preparation is underway for the procurement of insecticides. The Annual Malaria Review meeting was conducted from 21 to 22 April in Hawassa combined with the commemoration of the World Malaria Day on the 23 rd of April. 3. Measles Case Situation in Ethiopia Cases of measles continue to decrease nationally. There was no case reported nationally last week. There were 2 cases in week ; 3 in week 15 and in week 1. Cumulative cases and deaths as of 27 April are 7,33 and 17 respectively; Case Fatality rate:.2%. Surveillance is strengthened in high risk areas; Preparation for undertaking vaccination campaign is undergoing in SNNPR and parts of Oromiya Region where the vaccination coverage is found to be very low. Trend Showing Reported Measles Case/Death By Epidemic Week case Case Death Case Death death. Acute Watery Diarrhea Situation in Ethiopia Oromiya Regional Health Bureau (RHB) has officially confirmed the acute watery diarrhea (AWD) cases in the region. Reports were from 3 districts Munesa (2 cases), Arsi Nejelle (7) and Nonno (); Total cases are 25 and no deaths. The first case reported on 1 April. Amhara Region has reported 2 cases the past week (week 17). Cumulative cases of the region is 6 and no death from districts. A team from central level will be deployed to Amhara Region for support and a regional team to West Arsi of Oromiya Region for further investigation. 5. Epidemic Emergency Preparedness Joint Federal Ministry of Health and WHO support team will be in Amhara Reg. from Thursday May for 1 to 1 days. In addition a joint Oromiya Regional Health Bureau and WHO investigation team plans to leave Addis Ababa on Monday 5 May. The team will visit West Arsi where rumors on AWD case were reported last week. In response to the occurrence of multiple outbreaks in Ethiopia, series of training for better preparedness have been initiated by the regions. Currently training on the Epidemic Emergency Preparedness and Response and Integrated Disease Surveillance and Response in on going in Jijiga town for District Health Office Heads, Surveillance Focal persons, Head of Health Centres and some nurses. The training is funded by Austria Government, and organized and facilitated by the Somali Regional Health Bureau and WHO. The Training of five days will end on th of May. WHO Expert, Dr. Nde, during the Course EHA Ethiopia Weekly Update Week 1 /

3 II. DROUGHT SITUATION IN ETHIOPA Page 3 Oromiya, Somali, SNNPR and Afar are being affected by drought in Ethiopia since months ago. The deteriorating food security situation due to the delay onset and poor performance of seasonal rains continues to be reported in SNNP, Oromiya, Afar and Somali regions. There are reports of increased malnutrition admission rates to Therapeutic Feeding Centers (TFCs). The extended dry season impeded planting of belg crops. The poor performance of the rains combined with crop damage caused by pests resulted in failure of the seasonal root crops that are major gap filling staples during the hunger season between March and June. The situation is anticipated to exacerbate in the coming two-to-three months with poor harvest prospects. The situation has significantly affected markets with limited supply of cereals and root crops. Grain prices have rapidly increased the price of maize has more than doubled over the last six months. Some rains have been received in Oromiya and Somali regions temporarily resolving the critical water shortage. The impact of the rains on pasture regeneration has been, however, limited highlighting the need for continued feed interventions for livestock. The Afar Pastoralist Development Association (APDA) in its latest report also indicated continued water shortage in the chronically water insecure areas as well as increased malnutrition cases and animal disease outbreaks. Besides the increase of admissions in therapeutic feeding programmes, no disease outbreak is reported from drought affected Rare rainfall brought hope but not enough to solve the problem Women and children spend hours looking for water in drought affected areas, Borena Zone / Oromiya areas yet, except slight increase of common diseases. In response to this the DPPA has continued to distribute relief food items in the drought affected areas. Approximately,772 MTs has been allocated to 956, beneficiaries in Somali Region for the first quarter of. To date, approximately, MTs has been dispatched and 2,769 MTs has been distributed. In addition, out of the allocated 26,57 MTs of food (Oct - Dec) to the five zones under military operation, 21,7 MT has been dispatched to the Food Distribution Points (FDPs) while 1,2 MTs has been distributed. During the last six months, WFP undertook monitoring activities in food distribution points (FDPs) in the five zones. Meanwhile, a total of,71 MTs of food has been allocated for approximately 76,767 beneficiaries in B. Gumuz, Gambella, Oromiya, SNNP and Tigray regions for the months of January to April. A total of 1,5 MTs has been dispatched to date and 3,31 MTs has been distributed. The national food aid pipeline faces significant shortfalls in light of rising food needs due to the deteriorating food security situation. The shortfall against the food requirements stands at as follows: Relief food - 57, MTs; Targeted Supplementary Feeding Programme -, MTs; and for the Productive Safety Net Programme 7, MTs. Humanitarian agencies continue to support water tinkering, rehabilitation of damage water points and supply of animal feeds. WHO Expert giving Orientation to Health Extension Workers Food Distribution to Drought Affected Population WHO EHA expert and surveillance officers assigned in Oromiya region are fully supported the region in responding to the situation. Disease surveillance has been strengthened in drought affects districts. III. OTHER AGENCIES ACTIONS & ON-GOING ACTIVITIES A total of 7,175 patients were treated during the 1st quarter of by the 15 mobile teams established by Regional Health Bureau and UNICEF in Somali Region. % of patients were children less than 5 years and the most common disease was diarrheal diseases. The teams assessed the nutritional status of 1,17 children and 13,977 pregnant and lactating women. They provided water purification tabs to,53 families and educated approx. 3,5 people. UNFPA supplied basic clinical delivery kits to 7 mobile health teams in Gode and Afder zones. Reproductive health kits were also provided to Denan, Kelafo, El-Kere health centers and Gode hospital. UNFPA conducted a one-day training on maternal health issues for 2 members of mobile teams in Jijiga town EHA Ethiopia Weekly Update Week 1 /

4 Page IV. COORDINATION Health Partner s Forum of April The monthly Health Partners Forum meeting was held on 31 of April. There were 21 participants from UN agencies and health NGOs. The meeting was held at WHO Conference room. Discussions focused on the implementation of the plan of action of the forum developed months ago and health situations with focus on the situation of Partial View of Meeting Participants, WHO Conference disease with Room,, 31April epidemic potential in Ethiopia. The main concern was the re-occurrence of acute watery diarrhea in some districts in Amhara and Oromiya Regions. The forum has identified 6 majors interven- Health Partners Forum Meeting in progress, Addis Ababa, 31 April tions in order to ensure as soon as possible the containment of this new outbreak of acute watery diarrhea in Ethiopia. The interventions are to: i. Ensure advocacy at high level; ii. Strengthen the water, sanitation and hygiene promotion interventions; iii. Intensify the community mobilization/education; iv. Reinforce the multi-sectoral coordination at all levels v. Enhance AWD surveillance, preparedness and response; vi. Ensure cross border information sharing and interventions. Strategic Disaster Management Team Meeting The Strategic Disaster Management Team (SDMT) Forum comprised of head of Agencies and technical officers met on 2nd of May. The meeting was chaired by Mr. Fidele Selassoro, the Humanitarian Coordinator. WHO was represented by Dr M. Nehemie, Acting Representative and Dr. K. Amey, EHA Technical Officer. Discussion was about the humanitarian assistance in drought affected areas in Ethiopia. There were 3 presentations p e r - formed by WFP on food security situation; UNICEF Participants of the SDMT Meeting of 2 May at UNDP Conference Room. on nutrition and WHO on health situation in drought affected areas. The forum recommended that: A team of 3 persons meet and brief the deputy Premier Minster on the current situation in drought affected in Ethiopia using presentations of cluster leads. A joint assessment mission to drought affected areas must be organized for donors with the participation of UN agencies and Government of Ethiopian (GoE) if possible. A comprehensive relief requirements should be prepared and submitted to donors as soon as possible. This requirements should not include the drought appeal requirements already issued and submitted to donors by the GoE two months ago. UN Technical Meeting at UNOCHA The UN technical Officers met on 1st of May to evaluate the level of implementation of the cluster approach in Ethiopia. WHO was represented by the two technical Officers: Kebba and Amey. V. COMMENTS Disease outbreak and Cross border Initiatives With the experience of the acute watery diarrhea and polio epidemics, cross border initiatives in responding to disease outbreaks remain a necessity in the Horn of Africa. EHA Ethiopia Weekly Update Week 1 /

5 Page 5 VI. ANNEXES 1. Meningococcal Meningitis Situation in Ethiopia Reported meningitis case/death by epidemic week Case Death Case Deat h Acute Watery Diarrhea Situation in Ethiopia Trend Showing Reported AWD Case/Death By Epidemic Week Case Case Death Death AWD Cases by Districts and Epidemic Week from 31 March to 27 April, Ethiopia Amhara Region Oromiya Region Districts Week 1 Week 15 Week Week 17 Total Dera Denbecha Bahir Dar 1 5 Ankesha Sub-Total Munesa 2 2 Arsi Nejelle Nonno 1 15 Sub-Total 9 25 Grand Total For more information please contact: WHO Country Office, Addis Ababa / Ethiopia Tel: (+251) () / who-wro@et.afro.who.int EHA Ethiopia Weekly Update Week 1 /