UNICEF: Without toilets, childhood is even riskier due to malnutrition

Fatuma Nuior, 16, and her cousin Audi Arab, 12, stand by her latrine next to her house in Ber'aano Woreda in Somali region of Ethiopia 12 February 2014. The village is the first village declared ODF (Open Defecation Free) and All but one household has a latrine. While flags fly over each latrine. In Somali Region water supply coverage is estimated at 59.7%, lower than the national average of 68.5%. The need for water supply normally increases in the dry season, especially at the time of drought such as in recent years. However, the technical and organizational capacity of the Somali Regional State Water Resources Development Bureau (SRWDB) the government agency responsible for water supply and facilities management in the region to satisfy the water supply need is not adequate to cope with the situation. Donor agencies and NGOs are making efforts to ameliorate the situation by constructing and repairing water supply facilities across the region, supplying water by water trucks during chronic shortages, but the supply is still significantly below the demand.

Fatuma Nuior, 16, and her cousin Audi Arab, 12, stand by her latrine next to her house in Ber’aano Woreda in Somali region of Ethiopia ©UNICEF Ethiopia/2015/Ose

NEW YORK, 19 November 2015 – Lack of access to toilets is endangering millions of the world’s poorest children, UNICEF said today, pointing to emerging evidence of links between inadequate sanitation and malnutrition.

Some 2.4 billion people globally do not have toilets and 946 million – roughly 1 in 8 of the world’s population – defecate in the open. Meanwhile, an estimated 159 million children under 5 years old are stunted (short for their age) and another 50 million are wasted (low weight for age).

A report issued today, Improving Nutrition Outcomes with Better Water, Sanitation and Hygiene, from UNICEF, USAID and the World Health Organization, for the first time brings together years of research and case studies which demonstrate the link between sanitation and malnutrition. More importantly, it provides guidance for action.  

Lack of sanitation, and particularly open defecation, contributes to the incidence of diarrhoea and to the spread of intestinal parasites, which in turn cause malnutrition.

“We need to bring concrete and innovative solutions to the problem of where people go to the toilet, otherwise we are failing millions of our poorest and most vulnerable children,” said Sanjay Wijesekera, head of UNICEF’s global water, sanitation and hygiene programmes. “The proven link with malnutrition is one more thread that reinforces how interconnected our responses to sanitation have to be if we are to succeed.” 

Diarrhoea accounts for 9 per cent of the deaths of children under 5 years old each year and is essentially a faecal-oral disease, where germs are ingested due to contact with infected faeces. Where rates of toilet use are low, rates of diarrhoea tend to be high. 

Children under 5 years old suffer 1.7 billion cases of diarrhoea per year. Those in low income countries are hit hardest, with an average of three episodes per year. The highest frequency is in children under 2 years old, who are weakest and most vulnerable. Multiple episodes of diarrhoea permanently alter their gut, and prevent the absorption of essential nutrients, putting them at risk of stunting and even death.  

Some 300,000 children under 5 years old die per year – over 800 every day – from diarrhoeal diseases linked to inadequate water, sanitation and hygiene. The poorest children in sub-Saharan Africa and South Asia are particularly at risk.

Intestinal parasites such as roundworm, whipworm and hookworm, are transmitted through contaminated soil in areas where open defecation is practiced. Hookworm is a major cause of anaemia in pregnant women, leading to malnourished, underweight babies. 

Some countries have made significant progress in addressing both access to sanitation and the nutritional status of their children. Many have successfully used UNICEF’s Community Led Total Sanitation approach, in which the affected populations themselves devise local solutions to the problem of open defecation. 

  • Pakistan met the 2015 Millennium Development Goal to halve the proportion of people who in 1990 did not have access to improved sanitation. Using CLTS, entire communities abandoned the practice of open defecation, leading to improved health and nutrition indicators among their children.
  • Ethiopia mobilized community workers and achieved the largest decrease globally in the proportion of the population who defecate in the open. Despite population growth, the practice reduced from 92 per cent (44 million people) in 1990 to 29 per cent (28 million people) in 2015.
  • In Mali the CLTS approach was also used in communities with high malnutrition rates, exacerbated by drought in the Sahel region. Improved access and use of latrines ensued, and improved health and nutrition in children.
  • During the emergency linked to conflict in the Democratic Republic of the Congo, integrated nutrition and WASH interventions were used for displaced communities. Children under 5 years old saw significantly reduced undernutrition and waterborne diseases. Around 60 per cent of the population constructed latrines and some 90 per cent of malnourished children returned to normal weight during a 12-month period.

“There are no excuses not to act on access to toilets, even in the poorest communities, or during emergencies,” said Wijesekera. “On the other hand, there are millions of reasons – each one a child who is stunted or wasted, or worse, who sickens and dies – to treat this with the urgency it deserves.”

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Queen Mathilde of the Belgians, Honorary Chairperson of UNICEF Belgium visits Ethiopia


H.E. Queen Mathilde of the Belgians, Honorary Chairperson of UNICEF Belgium, meets H.E. President Mulatu Teshome of Ethiopia

Addis Ababa, 13 November 2015 – Queen Mathilde of the Belgians, Honorary Chairperson of UNICEF Belgium travelled to Ethiopia from 9 to 12 November to witness first hand programmes where UNICEF supports the Ethiopian Government in order to achieve results for children, especially in the areas of child survival and girls and women’s empowerment. 

On the first day, while visiting Yekatit 12 hospital in Addis-Ababa, the Queen declared: “I am impressed by the commitment of the medical staff, men and women. They provide not only care for babies, they also teach mothers how best to take care of their new-borns. Mothers themselves also receive care. It’s a global approach.” She also stressed the importance of birth registration: “a child who is not registered does not legally exist and cannot be protected.” 

Although huge strides have been made, harmful traditional practices still persist in the country. During her visit to Oda Sentela Primary School in Gursum Town, Oromia Region, the Queen could see how UNICEF, through supporting the Government, contributes to the reduction of child marriage and female genital mutilation. While meeting with young school girls, active in awareness raising, she told them, “I am impressed with your work in changing harmful traditions. I strongly encourage you to go on. You will be a model for the next generation.”

While visiting a water supply scheme in Gursum Town, the Queen witnessed how bringing clean water to communities has an enormous social and economic impact. “Not only can girls, who in the past walked many hours to fetch water, attend school and be safer, clean water obviously dramatically improves the community’s health situation,” she said.  

Queen Mathilde was moved by the sick children she met on the third day of her visit. But she underlined “I know that through the commitment of the health workers, their situation will improve.”

On her last day, she met with H.E. Dr Mulatu Teshome, President of Ethiopia. Speaking in the name of UNICEF Belgium, the Queen thanked the people of Ethiopia for their warm welcome and encouraged them to continue their efforts in the years to come in order to give each boy and girl a fair chance in life.

See pictures here: https://www.flickr.com/photos/unicefethiopia/albums/72157658825665103

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Children’s lives at stake as El Niño strengthens

Dehabo Seyre grandmother of two, walks in to temporary emergency rub hall tent built by UNICEF

Dehabo Seyre grandmother of two, walks in to temporary emergency rub hall tent built by UNICEF to receive recovery assistance after the failure of spring belg and poor summer kiremt rains caused by the climatic phenomenon known as El Niño, the number of people in need of relief assistance in Ethiopia reached 8.1m in October 2015. Government and humanitarian partners are exerting efforts to meet the food and non-food items needs for the affected population. Afar Regional State, Adaytu Wereda © UNICEF Ethiopia 2015/Tesfaye

NEW YORK/GENEVA, 10 November 2015 – An estimated 11 million children are at risk from hunger, disease and lack of water in eastern and southern Africa as a result of a strengthening El Niño, which is also causing droughts and floods in parts of Asia, the Pacific and Latin America, UNICEF warned on Tuesday.

The consequences could ripple through generations unless affected communities receive support amid crop failures and lack of access to drinking water that are leaving children malnourished and at risk of killer diseases, UNICEF said in a briefing note (hyperlink.)

Besides the immediate risks of death and injury, El Niño can lead to significant increases in diseases such as malaria, dengue fever, diarrhoea and cholera – which are major killers of children. When extreme weather deprives communities of their livelihoods, young children often suffer from undernutrition, which puts them at greater risk for illness, delayed mental development and premature death.

“Children and their communities need our help to recover from the impact of El Niño and to prepare for the further damage it could unleash,” said UNICEF Executive Director Anthony Lake. “At the same time, its intensity and potential destructiveness should be a wake-up call as world leaders gather in Paris. As they debate an agreement on limiting global warming, they should recall that the future of today’s children and of planet they will inherit is at stake.”

World leaders will gather in Paris for the 21st United Nations Climate Conference, also known as COP21, from 30 November to 11 December. The goal is to reach a universal, binding agreement aimed at limiting global warming by cutting greenhouse emissions.

El Niños are not caused by climate change, but scientists believe they are becoming more intense as a result of climate change. Many of the countries now experiencing El Niño are those that face the gravest threat from climate change. Many of the areas affected also have high poverty levels.

The weather phenomenon, among the strongest on record, is likely to cause more floods and droughts, fuel Pacific typhoons and cyclones and affect more areas if it continues strengthening as forecast over the coming months.

Some of the countries most affected by El Niño include:

Somalia:  More than 3 million people are in need of support amid crop failures and food shortages, with severe flooding anticipated to exacerbate the situation.

Ethiopia: Currently, 8.2 million people require immediate food assistance and 350,000 children expected to require treatment for severe acute malnutrition by the end of 2015.

Indonesia: El Niño has also exacerbated the impact of peat and forest fires. In August and September alone, haze caused 272,000 people to suffer from acute respiratory infections – which particularly affect children.

Pacific nations: El Niño threatens to leave more than 4 million people without food or drinking water.

Central America: The drought caused by El Niño is one of the most severe on record, with some 3.5 million people affected in Guatemala, Honduras and El Salvador.

Peru: An estimated 1.1 million people, including 400,000 children and adolescents could be affected, according to the Government.

Ecuador: Authorities believe 1.5 million people are at risk, about half of them children.

El Niño is a climate pattern linked to the warming of surface waters in the Pacific Ocean, which can have a profound effect on weather patterns around the world.  El Niño events tend to happen every two to seven years.

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Ethiopia-Brazil South-South collaboration in urban sanitation technology transfer

By Samuel Godfrey

Wukro Town, situated in Ethiopia’s Tigray Region, received two Brazilian experts in the area of sanitary sewerage from 12 to 23 October 2015. The two officials from the Water and Sewerage Company of the State of Ceará (CAGECE), Fabiano Lira and Marcondes Ribeiro Lima, travelled to Ethiopia as part of the Trilateral South-South Cooperation initiative between Brazil, Ethiopia and UNICEF.

© UNICEF Ethiopia/2015  

Mr. Fabiano Lira and Mr. Marcondes Lima meet Ethiopian State Minister of Water, Mr. Kebede Gerba © UNICEF Ethiopia/2015  


In the early 2015, a 2-year tripartite South-South collaboration has been developed between the Governments of Ethiopia and Brazil with the assistance of UNICEF Brazil and UNICEF Ethiopia. The theme is ‘urban sanitation and urban water’ and aims at strengthening Ethiopia’s water supply and sanitary sewerage services, directly benefitting Ethiopian institutions and, in the long term, the country’s urban population.

In 1960, less than 50 per cent of Brazilians lived in urban areas. By 2012, more than 85 per cent of Brazilians lived in urban areas. Africa is urbanizing at a similar rate, with Ethiopia having one of Africa’s quickest urbanization rates. According to the Ethiopian Central Statistics Agency, the urban population is projected to nearly triple from 15.2 million in 2012 to 42.3 million in 2037.

During their visit, the Brazilian officials provided key technical expertise in the development and finalization of the technical project to provide a pilot sewage network in a condominium of Wukro Town, as well as in the identification of a management system for the sewage network. Most of the condominium blocks in Ethiopia are not provided with treatment systems for the waste water produced by residents, whom are systematically exposed to severe risks related to the contaminated environment. The project will therefore contribute to the promotion of better health and quality of life for the residents of the town, with opportunities for expansion.

During the mission, Scoping and technical work was conducted in the field, where key data was gathered for the preparation of the project. The delegates, delighted by the warm hospitality of the people from Wukro, not too different from the semi-arid state of Ceará, presented the drafted project both to the residents of the condominium, requested to play a key role in the management of the proposed facility, local authorities and to Ethiopia’s Ministry of Water, Irrigation and Energy.

© UNICEF Ethiopia/2015  

Brazilian officials, UNICEF staff and Ethiopian officials discuss strategies in Wukro ©UNICEF Ethiopia/2015  

The project proposal was received positively by the Ethiopian Government and local population, signalling a productive first step in the cooperation agreement signed by both countries and facilitated by UNICEF Ethiopia and Brazil Country Offices. The next steps in the cooperation plan will be the building and implementation of the project in Wukro Town, alongside training of institutional partners and eventual expansion into other regions of the country.

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UN @70- UNICEF @63 in Ethiopia

UNICEF EPI Communication Specialist Shalini Rozario with a todler at the Polio NIDs campaign lainch in Jijiga
UNICEF was created in 1946, and began its operation in Ethiopia in 1952. UNICEF Ethiopia’s Country Office is located within the UN-Economic Commission for Africa compound in the capital city, Addis Ababa. The Country Office is supported by zonal offices present in Assosa, Bahirdar, Dollo Ado, Gambella, Gode, Hawassa, Jijjiga, Kabri Dahar, Mekelle, Oromia and Semera.UNICEF Ethiopia employs approximately 400 highly-qualified and experienced staff, both international and national professionals.

The purpose of UNICEF’s work is to support the realisation of the rights of every child, especially the most disadvantaged children – victims of war, disasters, extreme poverty, all forms of violence and exploitation. UNICEF is uniquely positioned to perform this role, given its comparative advantages. These include: an explicit mandate based on the widely ratified Convention on the Rights of the Child; proven capacity in multiple sectors; a strong field presence; and a mandate that embraces both long-term development and humanitarian response.

A key principle underpinning UNICEF’s work is equity, whereby all children have an opportunity to survive, develop and reach their full potential, without discrimination, bias or favouritism. A child growing up in Gambella Region, for example, should have the same opportunities to receive a quality education and access health and protection services as a child growing up in Addis Ababa.

There is increasing evidence that a focus on the most disadvantaged and excluded children, families and communities not only accelerates progress towards fulfilment of the rights of all children and reduces disparities but also brings about social and economic growth. In all of its work, UNICEF takes a life-cycle based approach to child development, which recognises key stages in a child’s life as it grows into adulthood, and designs and implements holistic and integrated approaches to health, education and social protection that are appropriate to each of the key life stages.

Important results to which UNICEF Ethiopia, in cooperation with other partners, has contributed include: achievement in reducing under-five mortality by two thirds between 1990 and 2012- the required reduction for meeting the target of Millennium Development Goal 4 (MDG 4)-three years ahead of schedule; meeting MDG 7c by halving the number of people without access to safe water since 1990 – 57 per cent of the population now using safe drinking water; a reduction in neonatal mortality from 37 deaths per 1,000 live births in 2010 to 27 deaths per 1,000 live births in 2014;a reduction in the proportion of stunted children from 58 per cent in 2000 to 40 per cent in 2014; adoption of the National Social Protection Policy and a commitment by the Government of Ethiopia to end Harmful Traditional Practices by 2025 and establishment of Vital Events Registration structures at national level.

Through the Growth and Transformation plan of the Government of Ethiopia, UNICEF as part of the United Nations Country Team will contribute to four pillars of the United Nations Development Assistance Framework (UNDAF): a) the Resilient, Sustainable, and Green Economy, b) Basic Social Services, c) Governance, Participation and Capacity Development and d) Equality and Empowerment, with the goal of supporting the second Growth and Transformation Plan to progressively realize children’s rights within the framework of the Convention on the Rights of the Child and other international commitments.

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Joining hands to finish the race for polio eradication

Rotary International advocates, UN advocates and Rotaracts gathered to participate in the National Polio Immunizations campaign at Shinile and Dire Dawa.

Rotary International advocates, UN advocates and Rotaracts gathered to participate in the National Polio Immunization campaign at Shinile and Dire Dawa ©UNICEF Ethiopia/2015/Mersha

World Health Organization, UNICEF and Rotary International, on the occasion of World Polio Day 2015, renew their commitment to finish the race for polio eradication and secure a long-lasting legacy for a healthy Ethiopia

Addis Ababa, 23 October 2015 – Marking the occasion of World Polio Day 2015, the World Health Organization, UNICEF and Rotary International, jointly reaffirm their commitment to ensure Ethiopia joins all countries in a polio-free world by 2018 – the global target for polio eradication world-wide. 

Ethiopia has been free of the wild-polio virus (WPV) for the last 21 months, since the last confirmed case in Ethiopia’s Somali Region. The 2013-2014 Horn of Africa (HOA) polio outbreak resulted in 223 WPV cases across Somalia, Kenya and Ethiopia combined. Out of this number, 10 WPV type-1 (WPV1) cases were reported in Ethiopia, all in the Somali Region. The HOA polio outbreak was a devastating setback for the region, Ethiopia as a country and its people.

Due to the aggressive and innovative response led by the Ethiopian Federal Ministry of Health (FMOH) and polio partners, the outbreak was declared successfully interrupted by national and international experts in June 2015. The last reported wild polio virus WPV on the entire continent of Africa was 14 months ago – with the last WPV1 case confirmed in neighboring Somalia in August 2014. While these successes are cause for celebration; we also underline the importance of sustained commitment at every level. 

In an effort to maintain the momentum, we each play our part as polio partners and bring an important and unique contribution to the polio eradication efforts. “Thirty years ago, we told the world what Rotary believes: that we can achieve the eradication of only the second human disease in history. Our belief is close to becoming reality. For every child, let’s make sure that reality is a bright one. On 23 October, Rotary will host its third annual World Polio Day event,” states   K.R. Ravindran Rotary International President in his friendly call to partners and allies to join World polio Day 2015. 

UNICEF Ethiopia, Rotary International and Somali Regional Health Bureau team members with the signed Pledge of Commitment on the Eradication of Polio

UNICEF Ethiopia, Rotary International and Somali Regional Health Bureau team members with the signed Pledge of Commitment on the Eradication of Polio ©UNICEF Ethiopia/2015/Getachew

WHO and UNICEF continue to prioritise quality polio supplementary immunisation activities (SIA); alongside sustained quality disease surveillance; coordination and technical assistance; social mobilisation; vaccine procurement; cold chain and logistic support. Routine immunisation, the backbone to polio prevention, is the flagship programme for FMOH, WHO, UNICEF and other partners.

The National Routine Immunization Improvement Plan 2014-2016, with the objective to achieve national Penta 3 coverage of 95 per cent by 2016, provides focused support to 51 zones, home to the vast majority of unimmunized children of the country.

“In the spirit of the polio legacy, we as UNICEF and as a global polio eradication partner, are working together towards a country with a strong routine immunization system, to protect all children, everywhere against polio and vaccine preventable diseases, paving the way for a better future for all,” states Patrizia DiGiovanni, Officer in Charge of UNICEF Ethiopia.

As we commemorate World Polio Day 2015 alongside the 70th anniversary of the United Nations, we reflect upon and celebrate the polio eradication initiative contribution to themes of development and human rights; and we envision further contributions to an even brighter future. Closing out 2015 we celebrate together in recognising Ethiopia’s achievements made towards the Millennium Development Goals particularly the reduction of under-five mortality; and we look towards a polio-free world by 2018.

WHO Representative, Dr Pierre M’pele Kilebou affirms, “WHO is proud of its contribution towards the success attained so far in achieving MDG 4, interruption of WPV transmission and routine immunization improvement; and our efforts would continue to sustain the gain that Ethiopia have realized.”

Even more ambitiously, we all envision the polio eradication legacy contribution to the 2030 Sustainable Development Goals for equitable health and development for all children and families. The possibilities are endless; the successes are at our fingertips. In partnership, we are almost there. We will continue to work together for a polio-free Ethiopia until the job is done. And then we will keep going.

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A drop to ensure no child is paralysed because of polio – Photo Blog

Rotary International advocates, UNICEF advocates and Rotaracts gathered to participate in the National Polio Immunization campaign at Shinile and Dire Dawa.

Never before in the history of polio have so few children in so few countries contracted the crippling virus – but we cannot rest until the number of cases is zero ©UNICEF Ethiopia/2015/Mersha

Polio vaccination a response of a recent polio outbreak in the Horn of Africa

Over 100 million doses of #polio vaccine procured to respond to the polio outbreak since June 2013 ©UNICEF Ethiopia/2013/Sewunet

A man informs communities about upcoming campaign on Polio vaccination ©UNICEF Ethiopia/2005/Heger

Clinical nurses Ermias Amare (front) and Salah Kedir, traveling on motorcycle between pastoral settlements

Clinical nurses Ermias Amare (front) and Salah Kedir, traveling on motorcycle between pastoral settlements in Tulugulid District, Fafan Zone, Somali Region, to provide polio vaccinations for children five years and younger during the Polio NIDs Campaign, 9 February 2015 ©UNICEF Ethiopia/2015/Getachew

Ayan Hassan and Sahro Ahmed travel long distance to deliver polio vaccination in hard to reach areas

Ayan Hassan and Sahro Ahmed, trained vaccinators, travel long distance to deliver polio vaccination in hard to reach areas in Somali region of Ethiopia. © UNICEF Ethiopia/2013/Sewunet

Polio Administration-Hamer district

A child in Hamer, indigionius community in south omo, SNNPR, Ethiopia, recieves polio vaccine during a nation wide campaign in 2005 ©UNICEF Ethiopia/2005/Getachew

NIDs volunteer Haile Dooch administers Polio Vaccine-Hamer District

National Immunisation Day volunteer Haile Dooch vaccinates child against polio in Karo Duss village, Hamer District, during July/August Polio NIDs campaign in 2005. ©UNICEF Ethiopia/2005/Getachew

Polio vaccination, a response of a recent polio outbreak in the Horn of Africa.

Barwoqo Hassen, 3 years gets polio vaccination in Shinelle zone, Somali region Ethiopia. Polio vaccination, a response of a recent polio outbreak in the Horn of Africa. ©UNICEF Ethiopia/2015/Mersha

Sustaining the Achievements in Polio Eradication in Ethiopia

Dr Kesete Birhane Admasu Minister of Health gives an anti polio drop to a child at Selam Health Centre. Sustaining the Achievements in Polio Eradication in Ethiopia: High level Vaccination Session during the Financing for Development conferince to obtain a better understanding of ongoing routine immunisation efforts to eradicate polio in Ethiopia and advocate for sustained efforts, through a practical demonstration of polio vaccination in Selam Health Center Gulele Sub city, Addis Ababa. Tuesday 14 July 2015. ©UNICEF Ethiopia/2015/Ayene

Health and nutrition

A health professional gives an anti-polio drop to a young refugee 24, June 2014 Pagak South Sudanese refugee reception centre Gambella Ethiopia. ©UNICEF Ethiopia/2014/Ayene

Mother and Child in their home

A child smiles after receiving an oral drop against polio, in Tigray region, Ethiopia. National Polio Vaccination Campaign 2005. ©UNICEF Ethiopia/2005/Heger

Legs of Ayan Yasin Confirmed Wild Polio Virus (WPV-1) case in Degafur rural village

In 1988 UNICEF joined the Global Polio Eradication Initiative (GPEI) and committed to ensure oral polio vaccine would be made available for and reach every child to rid the world of this devastating virus which at the time was paralyzing thousands of children every day ©UNICEF Ethiopia/2013/Sewunet

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