EMERGENCY AND HUMANITARIAN ACTION (EHA)

WEEKLY UPDATE – WHO COUNTRY OFFICE ETHIOPIA:

(Week 31, 27 July – 02 August 2009)

HIGH LIGHTS:

• The updated humanitarian requirements document for Ethiopia to be finalized by DRMFSS and partners

in August.

• According to official reports from the Federal Ministry of Health (FMOH), no new cases of meningitis

have been reported this week.

• Official reports from the Federal Ministry of Health (FMOH), 736 new cases of AWD and 8 deaths (CFR

of 1.1%) have been reported from 5 regions (Afar, Somali, Oromiya, SNNP and Amhara) Regions.

I. GENERAL SITUATION:

a) Political, social, security overview for the week

• The overall security situation in the country remained stable during this week. No major security

incidents involving humanitarian staff members have been reported.

b) Main events of interest/ concern for health (displacements, conflicts, disease outbreaks, etc.)

Food security and malnutrition

• The Disaster Risk Management Food Security Sector (DRMFSS) and partners are preparing the

humanitarian requirements document based on the final results of the Belg assessment for 2009. The

document is expected to be finalized by August 2009. Meanwhile, the Disaster Risk Management and

Food Security Sector presented to donors revised beneficiary food aid needs for the period June to

December 2009. The needs are based on projections and estimations that the population in need of

relief assistance will increase from 4.9 million to 6.2 million people. The revised national relief

requirements for the second half of 2009 consider four rounds of distributions for some 6.2 million

beneficiaries. Revised requirements total 462,500 mt with a total shortfall of 300,000 mt. Out of the

national requirements, WFP plans to cover some 254,000 mt (including as well non-WFP resources

contributed to the national relief programme) and has a shortfall of approximately 157,000 mt equivalent

to USD130 million. The projections take into consideration the effect of the overall unfavorable

performance of the Belg season coupled by the late start of the Meher rains, particularly in crop

producing areas. The Meher forecast for the north eastern, north and eastern part of the country is near

normal to below normal. This is expected to have an adverse effect on the overall agricultural

production.

• The Ministry of Agriculture and Rural Development (MoARD) has received new reports of a desert

locust swarm in the North Shewa zone (Amhara) and Alamata woreda (Southern Tigray). The maturing

swarm in North Shewa is estimated to cover more than 100 hectares. The Ministry is clearing two

airports at Kombolcha and Shewa Robit for aerial spraying and preparing for ground control measures.

Federal and regional experts are continuing surveillance in the areas reported to be infested. Further

spread of the swarms is anticipated out of local breeding grounds as no comprehensive survey and

control measures have been undertaken since the first outbreak in April 2009.

• The low reporting rate on admissions to Therapeutic Feeding Programmes (TFPs) for the month of June

is limiting comprehensive understanding of the evolving situation. However, as in previous years, TFP

admissions are expected to stabilize at higher levels during the lean season that extends from June to

August. The reporting rate in Tigray Region improved, mainly due to community mobilization conducted

during Enhanced Outreach Strategy (EOS) screening, which includes identification and referral of

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severely malnourished children to TFPs. Consequently, TSF admission significantly increased from 514

in May to 1,248 in June in the region, with a reporting rate of about 63 per cent.

• Meanwhile, following a rapid assessment conducted in Legehida woreda (Amhara), MSF Greece, has

started emergency nutrition interventions. Standard assessments have also been completed in Ziquala

and Lasta hotspot woredas (Amhara) and the preliminary report is expected to be submitted to the

federal-level Emergency Nutrition Coordination Unit (ENCU) next week. GOAL is currently conducting

standard assessments in Boke, Hawi Gudina and Bukadintu woredas in West Hararghe zone

(Oromiya), while ACF is undertaking impact monitoring of its interventions in Chuko Enset livelihood

zone (SNNPR). The Humanitarian Response Fund (HRF) is currently reviewing proposals from Merlin,

Save the Children UK, Save the Children US, IMC, and CARE, submitted under its call for nutrition

proposals, for interventions in priority one hotspot woredas in Amhara and Oromiya regions.

Acute watery Diarrhoea (AWD)

• According to official reports from the Federal Ministry of Health (FMOH), 736 new cases of AWD and

eight deaths (CFR of 1.1%) have been reported from 5 regions (Afar, Somali, Oromiya, SNNP and

Amhara) Regions. A total of 22 districts have reported active cases from the 5 regions in epidemic

week 30.

• A cumulative total of 2,511 AWD cases and 29 deaths (CFR 1.2%) have been reported from Addis

Ababa, Afar, Somali, Oromiya, Harari, SNNP and Amhara Regions from 29th June to 26th July 2009. A

total of 29 districts have reported active cases. Two case and two deaths from Addis Ababa, 150 cases

and two deaths from six Woredas of Afar Region, 486 cases and 11 deaths from four Woredas of

Somali Region, 1,647 cases and 15 deaths from 15 Woredas of Oromiya Region, 27 cases and no

death from Harari Region, 121 cases and no death from Konso special Woreda of SNNPR and 78

cases and one death from Amhara Region. See table 1 below.

Table 1. Distribution AWD cases and death by epidemic week by region Ethiopia July 2009

Week 27 Week 28 Week 29 Week 30 Week 27- 30

Regions #

Dist C D CFR

# Dist C D CFR

# Dist C D CFR

# Dist C D CFR

TOT_C

TOT_D

CFR

Addis Ababa 0 0 0 0 1 2 0 0 0 0 0 0 0 0 0 0 2 0 0

Afar 5 17 0 0.0 5 - - - 6 130 2 1.5 1 3 0 0 150 2 1.3

Somali 4 10 0 0.0 4 140 9 6.4 3 184 1 0.5 3 152 1 0.7 486 11 2.3

Oromiya 12 490 5 1.0 15 394 2 0.5 13 277 2 0.7 14 486 6 1.2 1647 15 0.9

SNNPR 1 38 0 0.0 3 32 0 0 3 34 0 0 2 17 0 0 121 0 0

Harari 1 12 0 0.0 1 11 0 0 1 4 0 0 0 0 0 0 27 0 0

Amhara 0 0 0 0.0 0 0 0 0 0 0 0 0 2 78 1 1.3 78 1 1.3 National Total 23 567 5 0.9 29 579

11 1.9 26 629 5 0.8 22 736 8 1.1 2511 29 1.2

Source: Federal Ministry of Health July 2009.

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Influenza A H1N1update

• According to official reports from the Federal Ministry of Health (FMOH), no new cases of Influenza A

H1N1have been reported this week. The UN clinic reported 2 suspected cases to the FMOH last week

which were later confirmed and the total confirmed cases in the country is now 6 . The national

technical working group is updating the National Influenza Pandemic Preparedness and response plan

in view of the current pandemic phase. WHO supported the orientation of health workers on case

management protocols. Daily coordination meetings continue at the FMoH chaired by the Minister of

health with support from WHO.

Cerebro spinal meningitis epidemic

• According to official reports from the Federal Ministry of Health (FMOH), no new cases meningitis has

been reported this week. A team comprising of the federal, regional and WHO is deployed to the area

and provided technical assistance through assessment/investigation, gap filling, capacity building and

supporting coordination of the response activities. The team supervised and supported the following

activities in the affected district: 19,393 people were vaccinated in the affected communities between

the ages of 5 to 30 years, epidemiological investigation with active case search, community awareness

creation on prevention and control activities. .

II. ANALYSIS & HEALTH CONSEQUENCES: Health problems & Needs of affected populations. Food insecurity and malnutrition

• The nutritional situation in Konso woreda is reportedly rapidly deteriorating. Recent food crop

assessments indicated a total crop failure in this woreda and the population is expected to still

encounter adverse impacts of the crop failure in the coming months. As of 24th. July, total admissions to

the therapeutic progammes have increased from 215 in January to 611 in June 2009, while admissions

to supplementary feeding centres have increased from 8 in January to 48 in May 2009. Approximately

National Trend Analysis Shows AWD Cases and Deaths as of

26 July 2009, Ethiopia

36 30 284 7 14 20

41 38 38 33

134 129115

86 93

53

103

178

222

90

151

353324

199

589567

579

629

736

2 50 0 0 1 1 1 0 0 0

59

2 1 1 04

8 70 3 6

11 9 95

11 5 8

0

100

200

300

400

500

600

7001 2 3 4 5 6 7 8 9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

Epidemic Week 1 - 30 [ 2009 ]

AW

D C

ase

s

0

20

40

60

80

100

120

140

AW

D D

eath

s

CasesDeaths

Analysis: WHO - Ethiopia

EHA/DPC/IDSR Units

Data Source: FMOH - Ethiopia

Date of Production: August 03, 2009

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half of the total population in Konso receives assistance from different programs; approximately 41,000

people are benefiting through relief food, 73,500 people receive food through the Productive Safety Net

Program and 3,300 people are covered through nutrition programs.

Rabies Acute Watery Diarrhoea (AWD)

• At national level the CFR is 1.1% showing the need for improvement in case management and

prevention. CFR in 4 regions (Addis, SNNPR, Oromia and Hareri) in the past 4 weeks is within the

WHO recommended standard of 1 per cent. This is an indication of improved case management in

these regions as WHO continues to provide formative supervision in the AWD affected districts to

improve case management. The situation is different in Somali Region where the CFR is above 2 per

cent.

• Currently WHO and partners are supporting training of health personnel, community awareness

creation, supportive supervision, multi sectoral coordination and team deployment (Health, Water and

Agriculture) at kebele level and immediate need for improvement of hygiene and sanitation at all level,

in particular in investment farms and Holy water sites.

• The ongoing kiremt rains are expected

to further exacerbate the spread of the

disease as number of community

unprotected water sources increase;

already a significant rise in the number

of new cases has been recorded since

the beginning of June. Critical gaps in

the response include lack of CTC

materials and drugs, lack of funds for

operational budgets, inadequate

protection of water sources, poor

hygiene practices and trained health

staff. Case detection and management

is still a challenge in CTCs located

remote community where health workers have little experience in AWD treatment, Preventative

measures in communities also need to be further strengthened.

• The absence of clean safe water supply, proper sanitation facilities, medical care and very poor and

overcrowded living conditions in the state farms and holy water sites serves as an appropriate foci of

infection for AWD transmission within the regions and other areas of the country. WHO and partners are

addressing this issue at federal and regional level through increase supervision and monitoring.

III. ACTIONS (in relation or response to the issues mentioned above):

a) WHO activities (field trips, assessments, gap filling, coordination, information sharing, training, etc.) & needs (Human resources, material, and infrastructure) and other partners support.

Food insecurity and malnutrition

• This week WHO has continued its technical support to regions in responding to food and nutrition crisis

in Ethiopia. WHO in collaboration with EHNRI and UNICEF is preparing the second half of 2009 health

and nutrition requirement. WHO is technically supporting the roll out of OTP traing cascade and the

development of monitoring plan

CTC at Bati Health Centre, Amhara Region, 31 July 2009.

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Acute watery Diarrhoea (AWD)

• WHO continues to provide technical support to the affected regions of Somali, Oromia, SNNPR, Afar

and Harari through provisions of emergency drug kits to government and NGO partners, supporting

assessment, assist in monitoring and supervision and strengthening surveillance activities. Two

Emergency drug and diarrhoeal kits are provided to Oromia regional health bureau to strengthen case

management and save more lives. In addition support for emergency health response coordination

activities are being supported through information sharing, working together and sharing plans and

resources. WHO continues to provide technical and financial assistance to both federal and regional

health bureaus through funds from the Finish Government in AWD preparedness and response

including nutrition response. WHO provided 1 interagency emergency health kit for Afar Region.

V. COORDINATION:

• This week, WHO actively participated in the technical officers/UNOCHA, WASH cluster/MoWR,

Nutrition cluster and Ethiopian Humanitarian Country Team (EHCT)/UNDP meetings held in Addis

Ababa.

• WHO is supporting and facilitating the coordination for the preparedness and response of influenza A

by the UN country team and AWD by the FMOH and the regional health bureaus.

VI. COMMENTS:

• WHO is working effectively in partnership with the FMOH, RHBs and partners in strengthening capacity

of the federal and regions for better health and nutrition response. Currently funds provided by the

Finish Government is supporting WHO emergency response activities.