Healthy mothers, healthy children, making healthy communities in Ethiopia

Dugem, Tigray REGION, Ethiopia, 21 December 2017 – In the health post at Dugem village, in Ethiopia’s Tigray region, Berhan Zebraruk, 25, gently strokes her child’s cheek and then gives him a sweet tickle on the tummy. Her first born, Awot Kaleab, is quick to respond to her touch. He cracks a beautiful smile displaying his toothless gums and looks his mother right in the eye for the play to continue. The little boy is restless. He grabs his mother’s cell phone and when that is taken away from him, he turns his attention to the baby next to him.

“My boy likes to play with everything he holds,” says Berhan. “I have to keep an eye on him, otherwise he put things in his mouth.”

Awot is now 9-months-old and it is time for his measles vaccination, which would complete his set of basic vaccinations for children under the age of 1, as recommended by WHO and the Ethiopia National Expanded Program on Immunization.

It is a special day for Berhan. Shortly after Awot received the vaccine, the health extension worker, Genet Desta, registered his name in the vaccine book. Then she called out Berhan’s name and handed her a certificate, a recognition that is given to mothers when their children complete taking the necessary vaccines.

Berhan is applauded by the other mothers in the health post for successfully vaccinating her child. She is also recognized as a role model for her best child feeding practices, including exclusively breastfeeding her son for his first six months.

Berhan attended school up to grade 10. Since she was a little girl, her dream was to become a doctor. Instead, she got married and became a housewife like many other women in her village. Yet, her education is considered an achievement in the eyes of fellow villagers.

“I wanted to become a doctor because I saw health workers treating people in my village,” says Berhan. “That wasn’t meant to happen for me, maybe it will for my son,” she added, gazing down at him.

Berhan understands that her child can only fulfil her unrealized dream if he grows up healthy and well. When she knew that she was pregnant with him, she started her pregnancy follow-up relatively earlier than other mothers.

‘’Berhan attended all of the four antenatal follow-ups and took the iron supplement properly,” says Genet, the health worker. “She was very conscious of her health and that’s why her child is very healthy.”

In Ethiopia, an increasing number of women are receiving care by skilled health workers both during pregnancy and childbirth. In the Tigray region, where Berhan lives, for instance, 90 percent of women receive antenatal care by skilled attendants, at least once, during their pregnancy, which is well over the national average of 62.4 percent.

In addition, 59 percent of the region’s mothers are giving birth in health facilities, instead of the old tradition of home delivery.

The country has seen significant improvement in immunization coverage over the past two decades. In 2000, it was only 14 per cent of Ethiopia’s children under the age of 2 who have received all the basic vaccinations, but in 2016, that number soared to almost 40 per cent.

Owing to its well-established community-based health service provision, Ethiopia is also enjoying a reduction in maternal and child deaths. Maternal mortality which was 871 deaths per 100,000 live births in 2000 has dropped to only 412 in 2016, a reduction by more than half in just 16 years. The same is also true when it comes to child mortality. More children in rural Ethiopia are celebrating their fifth birthday than ever before.

The nearly 40,000 female health workers, together with the women of the Health Development Army, easily access women and children in every household and provide much needed advice and services, including immunization to prevent the most debilitating child illnesses.

UNICEF is supporting the different components of the programme by providing both financial and technical assistance. UNICEF also supports the management of common childhood illnesses including malaria, pneumonia, diarrhoea and severe acute malnutrition at the health post level, contributing to a significant reduction in deaths.

Berhan’s task as a mother, caring and nurturing for Awot, symbolizes the bright future that lies ahead of children in rural Ethiopia. She is well equipped with skills and knowledge that will enable her to provide critical health and nutritional care for her son. Further help is also available since services, even for those in remote communities, are now more accessible.

Ethiopia to Host the fourth Acting on the Call Conference of Ministers and Policy Makers on maternal and child survival

Media Advisory

What: The Ministry of Health will officially announce that Ethiopia will be hosting Acting on the Call conference of Ministers and high-level policy makers on maternal and child survival

When: Friday 18 August 2017, from 2:00 P.M – 3:30 P.M

Where: Ministry of Health, Addis Ababa Ethiopia

Who:
· H.E Prof. Yifru Berhan, Minister of Health, Federal Democratic Republic of Ethiopia
· Dr Ephrem Tekle, Director, Maternal Child Health and Nutrition Directorate, Minister of Health, Federal Democratic Republic of Ethiopia

Why:

Hosted by the governments of Ethiopia and India, 2017 Acting on the Call conference will gather around 500 participants across the world, including Ministers and high-level policy makers from both the public and private sectors from 24 countries. The organization of this conference has been supported by many partner organizations such as USAID, UNICEF, the Bill & Melinda Gates Foundation, NGOs as well as private sector actors. This conference has these objectives:
· Highlight successful approaches to increase the use of high-impact reproductive, maternal, newborn, child and adolescent health interventions (RMNCAH) with equity, quality and sustainability.
· Increase commitment from countries, private sector and NGOs to strengthen the system required to overcome the remaining key obstacles for maternal and child survival both within and outside the health sector.
· Demonstrate global commitment and continued the momentum to move forward towards the goal of ending preventable child and maternal deaths.

UNICEF Signs Ethiopian Fiscal Year 2010 Work Plans with Government

By Metasebia Solomon

ADDIS ABABA, 30 June 2017- UNICEF Ethiopia signed the Ethiopian Fiscal Year 2010 annual work plans with the Federal and Regional Government under the umbrella of the United Nations Development Assistance Framework (UNDAF 2016-2020).  The signing ceremony, held at the Ethiopian Ministry of Finance and Economic Commission’s office, was attended by Heads of United Nations agencies including UNDP, UNFPA and UNICEF and the implementing Federal and Regional Government offices as signatories of the annual work plans.

Mr Admasu Nebebe, State Minister for Ministry of Finance and Economic Cooperation, speaking after signing the work plans, said “Implementation of the signed work plans will contribute to the achievement of Ethiopia’s current Growth and Transformation Plan [GTP II]. The results and activities are linked to the Government’s priorities at all levels.” UNICEF Representative to Ethiopia, Officer-in-Charge, Ms. Shalini Bahuguna, applauded the Government of Ethiopia’s leadership in implementing the annual work plans, saying “A recent review conducted by UNICEF’s global team has identified the annual work planning process of Ethiopia as a model for other country offices, demonstrating principle of alignment with government policy and ownership by stakeholders.”

 

Ato Admasu Nebebe, State Minister for Ministry of Finance and Economic Cooperation shakes hands with Ms Shalini Bahuguna, UNICEF representative to Ethiopia, O.i.C after signing the Ethiopian Fiscal Year 2010 Annual Work Plan. ©UNICEF Ethiopia/2017/Zerihun Sewunet

The work plans were prepared under the logic that the accomplishment of activities will contribute to the achievement of UNICEF’s and UNDAF’s intermediate and higher level results, which are in support of GTP II.  A consultative process was followed during the preparation of the work plans at the Regional and Federal level.  This year, UNICEF Ethiopia signed 143 work plans with more than 140 Regional and Federal Government implementing partners. The work plans cover fifteen programme areas including:

• Health
• Nutrition
• Education
• Early Warning and Disaster Preparedness
• Water Supply
• Sanitation and Hygiene
• Child Friendly Social Welfare
• Social Protection
• Adolescents and HIV/AIDS
• Violence against Children
• Ending Child Marriage and FGM
• Birth Registration
• Justice for Children
• Child Rights
• Public Finance for Children
• Evidence and Coordination

The total budget equals US$ 74,867,075.  Implementation of the work plans will start on the 1^st of July 2017 and will close on the 30^th of June 2018, following the Ethiopian Fiscal Year.

Joint UNICEF and WFP OpED on humanitarian situation in Ethiopia

UNICEF Deputy Executive Director, Omar Abdi & World Food Programme Deputy Executive Director, Ramiro Armando De Oliveira Lopes Da Silva

Wednesday 17 May 2017, Nairobi

This past week we have met countless women and children in the Somali region of Ethiopia who have made astonishing efforts to combat the debilitating drought that is afflicting the area. We saw families displaying incredible strength and resourcefulness.

What we didn’t see was a humanitarian catastrophe like the ones that happened in generations past, because the progress made by these families mirrors that made by Ethiopia in response to food insecurity and drought over the last two decades. Ethiopia now has both the determination and the ability to help its people cope better with a disaster.

And yet as we saw firsthand, Ethiopia’s much celebrated development progress could be at risk in the wake of these successive droughts.

Over the last 20 years, the Government of Ethiopia and the international community joined efforts to improve conditions for millions and millions of Ethiopians. Today a concerted and urgent response is required if these families are to avoid a humanitarian crisis, a quarter of a century later.

In 2016, Ethiopia’s highlands were battered by drought amid the worst El Nino in generations, but managed to avoid a major catastrophe through a well-coordinated response, led by the Ethiopian Government with support from the international community. The country had only begun to recover when a new drought struck the country’s lowlands.  The Somali region, which lies in the east of Ethiopia, has been the hardest hit by the effects of these recurrent droughts, with over 30 per cent of the region’s population now requiring food assistance.

The current rainy season in the lowlands appears to be failing as well.  As a result, food insecurity throughout Ethiopia is forecast to rise sharply from the current 7.8 million people in the next few months. An estimated 303,000 children are expected to suffer from severe acute malnutrition – the type that makes a child nine times more likely to die of diseases including acute water diarrhea and measles. An estimated 2.7 million children, pregnant women and breastfeeding mothers will be diagnosed with moderate acute malnutrition in drought areas; without urgent action, the condition of many of those children could deteriorate into severe acute malnutrition, a life-threatening condition that is harder and more expensive to treat.  It is likely that needs will further increase in the coming months, compounding the current problems.

Sehan Smail brought her child, Saedia Alilahi, 2 to the warder district, Somali region OTP for check up. UNICEF Ethiopia /2017/Martha Tadesse

UNICEF and WFP are committed to supporting the many people we met this week with a well-coordinated response. WFP has mounted a food and nutrition response of significant magnitude and, in partnership with the government, is currently supporting 6.4 million people out of the 7.8 million in need with emergency food assistance.  The remaining 1.4 million people are receiving support from the Joint Emergency Operation (JEOP) – an NGO consortium.  Moreover, WFP is also providing nutrition support to 1.3 million mothers and young children suffering from moderate acute malnutrition.  WFP is also taking the lead in the provision of logistical support to government, UN and international NGO partners which is central to the response.

Across Ethiopia, UNICEF with partners has reached close to seven million people in the first quarter of 2017, with an emphasis on providing safe water and emergency nutrition support. Critically, government with support from UNICEF have just completed a national measles campaign targeting more than 22 million children across the country. And UNICEF is extending its education and child protection interventions that will reach hundreds of thousands of children, focusing on the provision of temporary learning and play spaces, working with communities to prevent and respond to family separation, at-risk migration, child marriage, and gender-based violence.

However, needs far outstrip available resources. Acute funding shortages are hampering our collective ability to act at scale. The international community and the Government of Ethiopia must increase funding urgently or the humanitarian success story of 2016 might be overshadowed just one year later by a story of acute crisis.

UNICEF requires $93.1 million to meet the drought-related needs of children and their families across the country in 2017, in terms of Nutrition, WASH, Health, Child Protection and Education in Emergencies.   WFP currently has only enough food to last through June, and requires a further $430 million to meet the current emergency food and nutrition needs to the end of the year – and both WFP and UNICEF will require additional resources if the needs rise in the next few months as predicted.

Between 2000 and 2016, mortality rates among children under age 5 were cut by a remarkable 40 per cent in Ethiopia, and stunting rates were reduced dramatically from 58 per cent to 38 per cent. It is crucial that the gains made during the last 20 years are not reversed by the current drought.

Strong mothers go extra mile to keep their children safe

By Zerihun Sewunet

In Ethiopia, below-average rainfall has worsened the situation in the Somali region, already severely affected by protracted drought. Access to water, sanitation and health services critically low and livestock deaths have further reduced communities’ capacity to cope, resulting in food and nutrition insecurity.

When drought strikes women and children suffer the most. Mothers have to travel long distance to find water and food and they often struggle to feed their children. In stories below, we are celebrating strong mothers who go extra mile to keep their children safe and their families together.

 Kadar Kaydsane is 35 years old and has ten children, five boys and five girls. She has walked for five hours to get to Waaf Dhug temporary settlement site. She knew that there would be water and basic health and nutrition services.
Her husband and four of her ten children are not with her as they are herding the remaining goats. Most of her family’s livestock have died.

The mother of 9 children who is 40 years old had three of her children affected by AWD. Her 4 year old boy passed away while two remain in care with Plan C interventions. Her biggest worry remain her two children that are still in care. Her family used to own 400 animals of which only 13 are remaining.

Mariema Aden is a Waaf Dhuug local and has two children. She has sold all her livestock in order to survive and has no remaining means of livelihood. Her two children go to Waaf Dhuug primary school, one is in grade 6 and one in grade 8.

The 35 year old Mother of nine children has a 5 years old son that is doing a follow up due to being affected by malnutrition. Deqa says that the medical intervention her children have received was very effective.
Out of the 150 cattle her family owned, currently only 15 remains out of which most are likely to die. She worries about the future as her family’s livelihood, similarly to most, fully depended on cattle.

Amren Mualin is 42 years old and has 13 children (12 girls, one boy).
She used to have 400 goats and sheep of which 200 were ready to be exported. 350 of the 400 animals have died as a result of the drought which has lasted for three years.
Seven of her 13 children are with her including her husband and the other six children who are looking after the remaining livestock.

Seafi Khalif, 46, has two children who are both affected by AWD and received plan A and Plan B interventions. The medical intervention was administered to her children in a nearby CTC and they are back home now.
Just like so many others, her family has lost a significant amount of cattle; now only 20 remain out of 150. Her husband stays a few kilometers away from the IDP camp and looks after the remaining livestock.

Saynaba Sahene, 20,  has three children, including her youngest son who is 18 months old and suffers from acute malnutrition. She says that even though he was previously admitted for medical treatment and was discharged after given care, he currently needs to be readmitted because she was unable to provide him with the nutrition he needs to stay healthy.
She says she stopped breastfeeding her son when he was 6 months old due to health reasons.
Saynaba’s family doesn’t have a lot of cattle. Out of the 14 they have, only one camel has survived. Her husband lives at a different location assisting his father with keeping their livestock safe.

Photo credit: ©UNICEF Ethiopia/2017/Zerihun Sewunet

Drought Emergency Highlights Entire Families Not Receiving Primary Education

By Rebecca Beauregard

DANOT, SOMALI, 15 February 2017 – “A woman never tells her age,” says Sadeh Abdihayii with a smile, affirming that this taboo is common around the world. She then admits to be 40 years old. We continue, asking her how many of her children are in school. With eight children ranging from nine months to 20 years old, none of them, including Sadeh, have been to school. Ever.

Sadeh had hoped one of them could go to school, but circumstances did not allow. “It seems sensible to learn, but we have not been able to,” says Sadeh.

Sadeh Abdihayii, 40-years-old, laughs about her age with her eight children gathered around her. Neither Sadeh nor her children have ever been to school. © UNICEF Ethiopia/2017/Nahom Tesfaye

Living through drought

Sometimes Sadeh’s family lives in the vicinity of an organized village or town, such as now just outside Qorile kebele (sub-district), yet often they can be far away from any organized services including healthcare and schools. This is the life of a pastoralist family.

Sadeh’s family is one of the over 800 families that have temporarily settled in Danot woreda (district), in the eastern horned-tip part of Ethiopia. The Government of Ethiopia (GoE) has set up these temporary sites to provide life-saving medical and nutrition services, water and food during this drought period for one of the most vulnerable communities in the country, livestock-raising pastoralists.

Drought has hit these lowland areas across the Horn of Africa many times over the years, but Sadeh has never experienced one that devastated her livestock to this extent. Due to the negative Indian Ocean Dipole (IOD), a weather phenomenon, the December rains failed, making it 12 months since many villages in the area have experienced rain.

It is understandable why school has not been possible for many of these children, whether considering the current food and water shortages, or the nomadic patterns of their  life. The regular school system does not fit into this lifestyle and it is a reality that is not often at the forefront of parents’ worries. With little or no safety net, pastoralist mothers and fathers are concerned with water, food and grazing land.

The GoE however, in partnership with UNICEF, has developed alternative methods to reach children, even those in remote areas.

Adapting education to the pastoralist context

With support from UNICEF, the Ministry of Education (MoE) has developed a pastoralist education strategy which is implemented across Somali and Afar, as well as some parts of Oromia and Southern Nations and Nationalities and Peoples’ (SNNP), regions where pastoralists are prominent.

The core intervention is a school equivalence programme, adapted for children ages 7 to 14, where students learn the equivalent of the first four grades of primary school before transitioning into formal schools. This Alternative Basic Education (ABE), is based on the national education system but has altered facets wherever necessary to make it feasible for the pastoralist context. Such alterations include low-cost construction of schools as well as flexible locations and schedules to accommodate children who herd their families’ animals or move in certain seasons.

While ABE is the most commonly implemented strategy for inclusion of pastoralist children, reaching 276,777 students over a period of six years, the GoE encourages families to enrol their children in formal schools whenever possible. UNICEF supports this initiative by identifying and addressing barriers to children joining school. Such interventions range from rehabiliting WASH facilities at schools to ensure proper toilets and water is available, to constructing temporary learning spaces or formal schooling in addition to providing exercise books for families who cannot afford the expense. Additionally, the GoE implements a school feeding programme to encourage school attendance, currently in 252 schools across Somali region.

More than ever, these crucial interventions are  needed now , particularly as hundreds of ABE schools across Somali region are currently closed due to drought conditions.

‘Maybe somehow one day’

Halimo Bandais, 20-year-old mother of a toddler, is the eldest daughter of Sadeh. She has never been to school. © UNICEF Ethiopia/2017/Tesfaye

Families gathered near Qorile, such as Sadeh’s, are encouraged  to enrol their children in the Qorile primary school, which is within walking distance, even if it may only be for short term. While the drought situation is dire, there is now an opportunity for thousands of children to attend school while their families are receiving temporary assistance to keep their livelihoods afloat.

Sadeh’s eldest child, Halimo Bandais, comments, “I thought about school sometimes. But I have always been looking after the animals and we are moving here and there. How could I? But some of us will, perhaps my child.” Perhaps he will attend school one day. For now, hundreds of school-age children such as the girls neighbouring Sadeh’s tent, Feysa and Isthel, may be able to finally start their education while in the temporary settlement sites with adequate funding.

UNICEF is committed to the right of every child to receive an education. With contributions from international donors, the GoE, along with UNICEF and other education partners can expand programmes such as ABE or temporary learning spaces to ensure children such as those temporarily settled in Qorile, have an opportunity to access education.

German funds for the Horn of Africa drought response to increase from 100 million Euro to 300 million Euro

On 03 April 2017, UNICEF, WFP, and UN-OCHA went on a joint one-day field visit with the German Minister for Development Cooperation (BMZ) to Kebri Dahar and Waaf Duug Temporary Resettlement Site in Doolo Zone, Somali Region, Ethiopia. The Minister was accompanied by 16 German journalists, BMZ officials, German Embassy partners, GiZ and KfW. The Somali Regional President and key regional government counterparts have also joined the field visit. The visit was part of the German Minister’s visit to Ethiopia to discuss the Marshall Plan for Africa with Ethiopian Government and AU Officials. 

The Minister and his delegation visited the Urban WASH programme (borehole and water trucking) in Kebri Dahar town, as well as UNICEF’s emergency Health, Nutrition and WASH programmes in the Waaf Dhuug Resettlement Site for drought displaced people. More specifically, the Minister was able to see a Mobile Health and Nutrition Team operating with the German funded vehicles, a stabilization centre for severely malnourished children that utilizes German funded Ready to Use Therapeutic Food (RUTF) and a water point. The Minister also visited WFP’s school feeding programme at the Waaf Dhuug primary school and a WFP food distribution.   

Bundesminister Dr. Gerd Müller visits a school for community and settlers at Waaf Dhuug Temporary Settlement Site in Somali Region of Ethiopia. ©UNICEF Ethiopia/2017/Zerihun Sewunet

Waaf Dhuug Temporary Resettlement Site (TRS) hosts 4,500 host community and 3,882 drought displaced people, of which more than 85 per cent are women and children from surrounding grassing areas. The site was established in January 2017 and is one of the 58 Temporary Resettlement Site established by the Somali Regional Government in response to the drought emergency. Majority of the pastoralist community have moved into the TRS due to extensive loss of livestock as a result of the drought. They have left their villages in search of water and health and nutrition services for themselves and their children. Discussing with the Minister, Kadar Kaydsane, 35 years old and a mother of 10  said, “We walked for five hours to get to Waaf Dhuug and we lost all our livestock on the way. We came here to find water and other services provided by the Government.” 

Bundesminister Dr. Gerd Müller discusses with the community at Waaf Dhuug Temporary Settlement Site in Somali Region of Ethiopia. ©UNICEF Ethiopia/2017/Zerihun Sewunet

The Minister and German development partners recognized the importance of investing in building resilience, for instance through funding water schemes and strengthening Government systems, such as the Health Extension Programme. The Minister further appreciated the German Government’s strong partnership with UNICEF and was impressed by the integrated drought emergency response at the resettlement site, but recognized that the challenges are very complex and the required funding remains significant. As a response to the dire need of the people affected by the drought, the Minister announced that German funds for the Horn of Africa drought response will be increased from 100 million Euro to 300 million Euro.

 

Borehole Rehabilitation Contributes to Children’s Education and Futures

By Ayuko Matsuhashi

MIESSO, SOMALI, 15 January 2017 – “When the borehole was broken for a year and a half, I used to go to the nearby river for water, which is 12 km away from here. I have five children but I only managed to get one or two jerry cans of water for my family. I was not able to clean or bathe my children regularly at that time. That was difficult,” says Fathiya Ali Aadan, a 32-year-old mother of five living in Miesso town.

 

Fathiya Ali Aadan, 32 year-old, enjoys an household water connection which comes from the rehabilitated borehole in her premise ©UNICEF/2017/Tsegaye

Miesso is a small, remote town in the same-named woreda (district) located about 150 km west of the administrative city, Dire Dawa. Out of five non-functional water supply systems in Miesso woreda, one borehole was rehabilitated in the town by the Regional Water Bureau (RWB) in December 2016 with assistance from UNICEF, from the generous support of the Office of U.S. Foreign Disaster Assistance (OFDA). The emergency water, sanitation and hygiene (WASH) intervention benefits 3,500 households in the town as well as the school and health centre.

 

The Miesso woreda administration office reports that there are currently 86 non-functional boreholes in the woreda, a key intervention necessary to improve the water situation, which is only one part of the challenges facing families in the region. Since most of the region is prone to drought and pastoralist livelihoods critically depend on water, non-functionality of water schemes requires immediate response to save lives of people and their livestock. It also affects children’s opportunity to learn.

At Mulli School, which includes grades one through twelve, a 14-year-old, grade eight student Ibrahim Mohamed explains, “Before, we had to return back home to get water when there was no water at school. It was a big interruption of class.” The impact of water scarcity also causes some schools to close, such as last year after the failure of deyr rains (October-December). Additionally, pastoralist families may move in search of water, thus taking children and even teachers away from school.

“Now we can drink water, keep our clothes clean, wash our hands after using the bathroom and most importantly for me, there is no longer need to go back home to get water during class. Girls need water for menstrual hygiene at school as well,” says Hayat Yusuf Adan, a 13-year-old, grade eight student.

Thanks to the rehabilitated borehole, Hayat’s school managed to remain open. While water supply at school tends to be neglected during emergency, it is clear that water availability contributes to retaining children in school. UNICEF is committed to support the Government of Ethiopia and implementing partners to improve the WASH situation for schools and families across Somali region to protect the futures of children and the livelihoods of their families.

Rehabilitation of Borehole Saves Thousands of Lives and Livestock during Drought

By Ayuko Matsuhashi

A signboard on the sight of the rehabilitated borehole ©UNICEF/2017/Tsegaye

HARSHIM, SOMALI, 19 January 2017 – “For three months, the borehole was not functional and people suffered a lot. There was little rain, so most of the birkas[1] became empty. Additionally, water from birkas is usually contaminated so we suffered from diarrhoea,” Muse Hassan Ali, 45-years-old recalls the time that he and his neighbours did not have access to safe and sustainable water in his town. Birkas are underground water storage systems intended to collect rain water during the rainy season and store for use during the dry season. Birkas can also be used to store water transported by trucks during emergencies.

According to the Harshim woreda (district) administrator, Sied Abraham, this borehole in Harshim town is the only sustainable water source that survived the 2015 El-Niño drought. It was drilled by the Somali Regional Water Bureau (RWB) following a UNICEF groundwater mapping in 2009 to identify potential drilling sites. The depth of the borehole is 535 meters, one of the deepest in the Somali region. After this borehole became non-functional due to electromechanical failure last year, UNICEF, with generous financial contribution from European Commission’s humanitarian aid department (ECHO), supported the RWB to rehabilitate the borehole by replacing a submersible pump, generator and an electric cable.

An immediate rehabilitation of the only sustainable water source in the woreda was crucial not only for Harshim town, but a large part of the region. It typically benefits over 9,000 people in Harshim and neighbouring woredas as well as people who cross the border from Somalia. At the end of 2016, it also served people in far-reaching woredas when drought conditions worsened once again due to the negative Indian Ocean Dipole (IOD). The RWB and partners began providing emergency water trucking, using this borehole as their source. Thus, its well-functioning affects a high number of direct and indirect beneficiaries across the region.

Roda Ahmed, 35 years old and Rahma Ahmed, 30 years old collecting clean water from the on-site water point ©UNICEF/2017/Tsegaye

Roda Ahmed, 35 years old, is with her five children collecting water. “This is a source of life. Now I can cook and feed my children,” she says. Another woman from Harshim town also with five children, Rahma Ahmed, explains, “Since this borehole has been working, we stopped drinking water from birkas.”

In addition to people collecting water near the borehole, the on-site trough draws in many pastoralists and their livestock. It takes more than a day for Farah Aden, 60 years old, to walk to the Harshim borehole with his 10 camels. “We are grateful for this borehole. Water is always a great cost for livestock. The functionality of this borehole has impacted our life a lot.” Indeed, during drought periods such as this one, entire herds may be wiped out, as evidenced by dozens of dead carcasses along the roads across the region.

Hundreds of livestock come from all over the Harshim woreda and drink water at the on-site trough ©UNICEF/2017/Tsegaye

As he contemplates this grave issue in his region, Muse pauses before emphasizing, “Still, this is not enough. There is a great pressure on this borehole. The generator is working 22 hours every day.”

UNICEF and partners will continue efforts to support the Government of Ethiopia to increase water coverage and functional water schemes in the Somali region to save the lives of children, their families and their livestock and contribute to a better future for all.

[1] traditional water harvesting pond

Mobile Health and Nutrition Teams Providing Crucial Services for Pastoralist Mothers As They Cope with Drought

By Rebecca Beauregard

GASHAMO, SOMALI, 15 February 2017 – Mutas does not look at his mother. He is not looking anywhere, rather he lays still, his unfocused pupils covered occasionally by heavy eyelids. While we talk, his mother, Bedra Dek, keeps her eyes entirely on him. Her one-year-old son is suffering from severe acute malnutrition (SAM) and despite the food and water shortage and her two other children, she explains that all her thoughts are focused on him improving.

“When your child is well, spiritually you feel happy. This is what I am waiting and hoping for. Nothing else is in my mind except this,” Bedra speaks softly, her eyes never wavering from her son.

About six months ago, Mutas became sick with a cold. Since then, he has fought that illness and intermittent diarrhoea while they lived in remote rural areas. Living in remote areas means even farther than where we are now, which is over 300 km from the regional capital and 63 km off the paved road through desert sand – no roads. Bedra walked yet another 15 km to the settlement just outside Al-Bahi kebele (sub-district) after hearing that there was a mobile health and nutrition team (MHNT) providing lifesaving services. She knew Mutas was not improving, and indeed, shortly after her arrival, he had become lethargic and largely unresponsive.

Bedra Dek, 21-years-old, looks at her one-year-old Mutas Abdulahi, who is ill from malnourishment. ©UNICEF/2017/Tesfaye

At 21-years-old, Bedra has 7- and 4-year-old daughters in addition to Mutas. They are a pastoralist family, living in a rural village and often traveling vast kilometres in search of water and grazing land for their livestock.

While the semi-arid Somali region is often dry, the drought brought on by the negative Indian Ocean Dipole (IOD) in the past few months is beyond anything Bedra has experienced. Her family’s herd of over 200 goats and sheep is now down to four, and their physical appearance is too poor to sell in the market.

Upon arriving in Al Bahi, she went to the MHNT, which has temporarily set up as a static clinic in the site to service the hundreds of families in the area. MHNTs were initially set up over a decade ago in this region as a unique and necessary component of the emergency health service delivery system to reach nomadic families such as Bedra’s. They respond to disease outbreaks, provide routine immunizations and basic healthcare including treatment of common illnesses, conduct screening and manage uncomplicated cases of malnutrition as well as refer to higher levels of care as necessary. Here, the team has encountered high levels of malnutrition and the majority of children have low immunization status. The team is both responding to emergency care needs as well as conducting mass immunization and other preventative measures to ensure that a temporary settlement like this does not create further disease and suffering.

Once a child is diagnosed with SAM, they are provided with ready-to-use-therapeutic-food (RUTF) and medications which should help them to quickly improve. To ensure progress, mothers are instructed to come weekly to have their children checked. We meet Bedra as she waits with Mutas for his weekly check.

The homes of pastoralists gathered at the temporary Al Bahi site starting from December 2016, in Gashamo woreda, Somali region. ©UNICEF/2017/Tesfaye

UNICEF continues to support the GoE’s MHNTs through vehicle provision, transportation allowances, emergency supplies and technical guidance. UNICEF emergency health and monitoring consultant, Kassim Hussein, was present when Mutas was referred. When asked about his role, he explained how he roves around the region providing technical support. “During emergencies, things may be done in a haste, there may be staffing or technical knowledge gaps, or the situation may reach extreme levels and the team is too busy to report. I make rounds to all the teams, providing technical support and ensuring standards of care and supplies are available at adequate levels. I then report back to UNICEF and the regional health bureau,” explains Kassim.

Now Mutas is being seen by Mohammed Miyir, the team leader of the MHNT in Al-Bahi temporary settlement. Originally, he diagnosed Mutas with SAM; now his condition has developed medical complications, making him unable to receive fluids or medicine. This development signals the need for him to be sent to a stabilization centre (SC) at the Gashamo woreda (district) health centre, where he will receive in-patient advanced care until he reaches a minimal level of improvement in his responsiveness and weight.

Bedra is perplexed. Just minutes before they told her this news, she had said she wanted anything for him to improve. Now that it may happen, a new reality hit her. Her two daughters will need to be left behind – there is no room in the MHNT car. This is often an issue mothers out here face. With husbands caring for the grazing livestock, if they need to go to a SC for further treatment, who will take care of their other children? Some find neighbours to watch their kids, other mothers choose to stay and hope for the best, concerned about finding their children again as people are so mobile.

For Bedra, she has another 10 minutes to decide until the car will be ready for her.