SOUTH SUDAN REFUGGE CRISIS AT GAMBELLA

Transcription

1 ETHIOPIA

2 GOAL IN ETHIOPIA Ethiopia is in many ways a beautiful country. Unsurprisingly though, most people in the West know it only for its periodic droughts and famines, and its extended bouts of civil conflict. GOAL first began operations in Ethiopia in 1984 in response to a widespread famine. During , GOAL nurses and doctors worked on health and nutrition programmes via missionary organisations and other international NGOs. At that time, the population of Ethiopia was estimated to be 42 million, one million of whom perished during the famine period. In 1987, GOAL registered as an international implementing NGO in Ethiopia, and has been delivering a range of relief and rehabilitation initiatives throughout the country ever since. Within excess of 30 years of experience in implementing all kinds of humanitarian aid there, GOAL has developed a strong capacity to perform appropriate humanitarian programs effectively, efficiently and sustainably, and is now a strong and influential organisation in Ethiopia. In line with its mission, GOAL has supported the planning, design and delivery of development and emergency interventions across all regions of Ethiopia. With adherence to its strict guidelines and policies across its initiatives, GOAL conducts/supports needs assessments, review and evaluation of the outcomes of implemented programs and initiatives. One of GOAL s operating principles in Ethiopia has been improving the ability and capacity of local institutions, organizations and individuals to make effective and efficient use of resources to achieve humanitarian objectives.

3 SOUTH SUDAN REFUGGE CRISIS AT GAMBELLA Since the outbreak of conflict in South Sudan in mid-december 2013, tens of thousands of people have been killed; and 1.86 million South Sudanese have been forced to flee their homes. More than 1.4 million people have been internally displaced; and another 469,000 have fled to neighboring countries. In that time, 193,000 refugees have fled fighting in South Sudan and are now in Ethiopia. This is in addition to more than 50,000 South Sudanese refugees who were already in Ethiopia, bringing the total South Sudan refugee population in Ethiopia to more than 240,000 people. Earlier this year, the UN launched an appeal for $211m to support refugees in Ethiopia. Currently, this appeal is just one third funded at $70m. This is worrying considering that 100,000 new refugees are expected by end of 2014 and a further 200,000 during By the end of 2015, it is expected that there will be 550,000 South Sudan refugees in Ethiopia. At least 95 per cent of the refugees at Gambella are women and children. General health is not good, with respiratory illnesses, diarrheal diseases, measles and malaria prevalent. Many of the refugees have walked for weeks to reach the camps, generally from the Nasir/Malakal areas of South Sudan. Seventy per cent are under 18 years old. People are arriving in a dire state, with some 30 per cent of new arrivals under five acutely malnourished and 10 per cent severely acutely malnourished, meaning that without urgent treatment they are likely to die of starvation. Although the average arrival rate of South Sudanese refugees to the Gambella region decreased slightly due to the ongoing rainy season, there are still a daily average of 100 new arrivals into the Gambella region through the main entry points of Akobo, Pagak and Burbiey.

4 GOAL S RESPONSE TO THE REFUGEE CRISIS GOAL began its programming at Gambella in March, 2014, and is currently implementing a comprehensive nutrition intervention focusing on the screening, prevention and treatment of malnutrition for approximately 90,000 refugees at Kule and Tierkadi refugee camps. To date, we have treated more than 35,500 children and pregnant and lactating women across the two camps. This includes the treatment of more than 2,479 severely malnourished children, and 5,781 moderately malnourished children. A total of 22,975 children and 4,308 pregnant and lactating women have taken part in blanket supplementary feeding programmes run by GOAL.

5 GOAL S RESPONSE TO THE REFUGEE CRISIS GOAL s main activities at Gambella include: Anthropometrics and nutrition/health screening of children and pregnant and lactating women using clinical assessment, mid upper arm circumference, weight for height, nutritional oedema, and body mass index depending on each category and standards; Community nutrition outreach activities: community outreach is a crucial component of nutrition programming, encompassing community sensitization of the different elements of nutrition support provided by GOAL, active case finding, referral and follow-up of absentees or non-responders of program beneficiaries. These activities are conducted by outreach workers called community outreach agents; Out Patient Programme for severely malnourished; Targeted Supplementary Feeding Programme for the moderately malnourished this programme is intended for moderately acutely malnourished children aged 6-59 months as well as malnourished other categories. There is a set criteria for entry based on weight for height, mid upper arm circumference body mass index depending on age; Blanket supplementary feeding for 6-59 months and pregnant and lactating women. This programme supports the nutritional needs of these indicated vulnerable groups by providing a premix flour made up of corn soya blend, oil and sugar; Promotion of appropriate infant and young child feeding practices; Nutrition services for the immediate host populations if necessary; Support and facilitation with nutrition surveys when necessary.

6 OUR MAIN ACTIVITIES IN GAMBELLA Nutrition screening of children and pregnant and lactating women, screening consists of individual assessments; Weight, height, Middle upper Arm Circumference (MUAC) and Z- scores. The Z score is a score that indicates how far a measurement is from the median - also known as standard deviation (SD) score. The reference lines on the growth charts (labelled 1, 2, 3, -1, -2, -3) are called z-score lines; they indicate how far points are above or below the median (z-score 0). Refugees with medical concerns and all those with severe acute malnutrition with complication are admitted to an inpatient facility called a stabilisation centre for 24- hour care. All those with severe acute malnutrition without complications are admitted to GOAL s Outpatient Therapeutic Feeding Programme and those with moderate acute malnutrition are admitted to Targeted Supplementary Feeding Programme. Children 6-59 months and pregnant and lactating are admitted to GOAL s dry blanket supplementary feeding programme. All programme performance indicators are within international and SPHERE standards.

7 STREET LIVING CHILDREN GOAL Ethiopia s ChildSPACE programme is multifaceted, designed to address a complexity of needs. Through ChildSPACE (Supporting Positive Actions for Children s Empowerment), GOAL works with children who live and work on the streets of the capital, Addis Ababa, to realise their own goals by recognising their skills and talents. We provide a variety of services, including our Drop in and Rehabilitation Centre, which offers sport and recreation, non-formal education, medical treatment and education, shower and clothes-washing facilities, life skills and livelihood training, referral to other service provider partners for further medical treatment and legal support where necessary. Where children opt for family tracing and reunification, GOAL supports them through planning sessions, family tracing, clothes provision, family support packages, school materials and school registration fees, and a one year post-reunification follow up. We also provide financial support and entrepreneurial training packages for youth who wish to set-up their own small businesses and households. The project also facilitates different vocational trainings for children/ youth from the street so that they can acquire an employable skill and secure job opportunities such as leather works and general mechanics. We also provide groups of youths beginning training with household set-up materials, rent, living allowances, and psycho-social and health support.

8 BURAMINO REFUGEE CAMP The year 2011 saw the worst drought in the Horn of Africa in six decades. It left millions of people on the verge of starvation. The UN declared a state of famine in some regions of Somalia in July. A subsequent UN report, issued in May, 2013 concluded that the famine claimed the lives of approximately 258,000 people between October, 2010 and April, 2012, including 133,000 children under the age of five. Thousands of Somalis sought refuge in the Dollo Ado region of southern Ethiopia, close to the Somali and Kenyan borders. At one point, more than 3,000 people were arriving in Dollo every week, many of whom were suffering from alarming rates of malnutrition. Thousands had lost family members along the way. Deaths amongst children under five years old were four to five times greater than the internationally acceptable emergency benchmarks. GOAL s response began in July, 2011 with support in the form of nonfood and core relief items such as cooking pots, jerry cans, and blankets. We began conducting nutrition activities at Buramino refugee camp when it opened in November of that year. Today, we continue to treat malnourished children and adolescents at Buramino, including all children under five years of age, and all pregnant and lactating women, regardless of their nutritional status.

9 BURAMINO REFUGEE CAMP Other services that GOAL provides at Buramino include screening for under nutrition on arrival, skilled support for women with breastfeeding problems, while we also focus on encouraging women to take part in exclusive breastfeeding for infants less than six months of age. We also provide therapeutic foodstuffs, baby-friendly rooms, and two infant and young child feeding rooms that help promote the nutritional, physical and mental health of both pregnant and breastfeeding women. GOAL Ethiopia has been recognised by the UN refugee agency, UNHCR, for our work. Background to Buramino refugee: In early 2011, the numbers of Somali refugees in Ethiopia was relatively small. The figure stood at approximately 50,000. Most of these people were living in two camps in Dollo Ado. The famine caused these numbers to increase dramatically, with more than 3,000 people per week arriving in Dollo at one point. As of 30 April, 2014, UNHCR has reported 201,123 refugees or just over 42,867 families are registered in Dollo Ado.

10 HEALTHCARE GOAL Ethiopia s Health sector focuses on key thematic areas of Reproductive, Maternal, Neonatal and Child Health (RMNCH). The Health programme uses four key approaches; Care Groups, Men Health Groups, School Sexual and Reproductive Health Peer to Peer Education and Community Based Reproductive Health Promoters, seeking to identify and change the cultural, attitudinal and structural barriers at household as well as community levels. GOAL aims to provide greater access to quality health services, to help reduce the high incidence and prevalence of serious illness, mortality and disability amongst these broad groups, through strengthening the health system in its programme areas. GOAL trains and engages Community Development Workers (CDWs), and local health facility staff as well as health authority officials to help tackling issues such as poor reproductive health practices amongst men and women of reproductive age, improving the nutritional status of children under five as well as pregnant and lactating mothers, as well as in the prevention of communicable diseases such as diarrhoeal disease and malaria.

11 HEALTHCARE GE is currently implementing integrated rural health programme in two woredas; namely Yabello (in 9 Kebeles) and Teltelle (in 8 Kebeles), of Borena of Zone and in another two woredas; namely Daro Lebu (in 10 Kebeles) and Hawi Gudina (in 9 Kabeles) of West Hararghe Zone in Oromiya region. GOAL uses the Designing for Behaviour Change (DBC) framework as its overarching tool for community health promotion strategy. GOAL is supporting Health Centres in Borena, Oromiya Region to set up and provide quality emergency obstetric services for mothers who develop complications during pregnancy, child birth and postnatal periods. GOAL Ethiopia is also conducting operational research on the use of Misoprostol in the prevention of postpartum haemorrhage as severe bleeding immediately after child birth can risk the life of mothers. The Health programme is integrated with other GOAL programmes; such as the WASH, Livelihoods and Humanitarian Response Programmes (HRP). The WASH programme contributes to the reduction of preventable communicable diseases and supports an improvement in Health outcomes for the same communities. GOAL is also responding to disease outbreaks and epidemics through its Humanitarian Response Programme. The Health programmes in West Hararghe, Borena and HIV in Hawassa are funded by IAPF and Cordaid funds the Maternal Health activities which are undergoing in Borena.

12 HIV AND AIDS GOAL Ethiopia is implementing HIV prevention activities in two forms: a stand-alone HIV project in Hawassa town and as mainstreaming HIV in all programmes. GOAL implements HIV standalone programmes through partnering with a local NGO in the Hawassa HIV Prevention Project; which focuses on IEC/BCC methodologies through awareness creation on HIV prevention methods and referral to services through Peer to Peer Education. GOAL is also working on improving access to livelihoods and economics empowerment opportunities for people living and affected by HIV. The project targets students both in University and primary schools, domestic workers, commercial sex workers (CSW), and PLHIV. The project uses legal brokers and female community association members (Iddir) to address domestic workers.

13 LIVELIHOODS Livelihoods programme is one segment of GOAL Ethiopia Rural Development Programme. It envisioned promoting resilient livelihoods to ensure adequate food availability and income access across rural and urban environment through promoting improved technologies and facilitating local assets utilisation and reinforcing the capacity of institution in partnership with all stakeholders. Livelihoods programme uses value chain approach in the overall implementation of the programme to ensure that farmers get the intended benefit from their products. To improve the household livelihoods and food security of the rural community, the Livelihoods programme focuses on promotion of improved agricultural production (Crop and Livestock), income diversification and improvement as well as strengthening institutional capacity to enhance community and household resiliency. IAPF is the major donor of the Livelihoods programme operating in Borena and West Hararghe Zone of Oromiya region and Sidama Zone and Hawassa town of SNNPR. The Livelihoods activities under IAPF in Hawassa Urban and at ChildSPACE programme focus on youth and women IGA and vocational trainings.

14 WATER, SANITATION AND HYGIENE GOAL Ethiopia WASH Programme responds to construction and behaviour activities under the RUDPs and HRPs. WASH interventions in RUDPs are both in Borena and West Hararghe focusing on improving of access to adequate and safe water supply as well as sanitation and hygiene conditions in households and communal areas whereas the HRP intervention extends to Amhara, Oromiya, SNNP and Afar regions with the major activities of Water trucking, water supply scheme rehabilitation, rain water harvesting, spring development and sanitation facility construction. Community led total sanitation and hygiene (CLTSH), Participatory Hygiene and Sanitation Transform (PHAST) and piloting of Ecological Sanitation (Eco-San) are the approaches the programme uses for triggering the community on hygiene and sanitation. The WASH programme through developing WASH resources, aims to contribute to the community access to safe potable water and appropriate hygiene and sanitation practices. GOAL Ethiopia operates under the IAPF - WASH programmes in Borena and West Hararghe Woredas of Oromiya and EU WASH programmes through partners with LVIA and ACF in Oromiya and SNNP regions where GOAL functions in Boricha and Hawassa Zuriya Woredas of the SNNPR.

15 HUMANITARIAN RESPONSE GOAL Ethiopia (GOAL E) operates a complex, multifaceted, geographically diverse Humanitarian Response Program that responds to crises in the following ways: Implementation of Community Based Management of Acute Malnutrition (CMAM) which includes capacity building through training of local health staff, food distributions, treatment of malnourished children, and nutrition education. In addition to conducting surveys and assessments and contributing to information sharing and early warning systems. GOAL E responds to epidemic outbreaks of malaria, acute-water diarrhea/cholera, and measles through providing logistical support to local health facilities to expedite rapid response and supplying medicines for the treatment and prevention of these outbreaks. In drought/conflict affected areas GOAL E provides water, water source disinfection, hygiene promotion, and the repair/maintenance of water systems. For agro-pastoral communities suffering from acute food insecurity, GOAL E provides seeds and fertilizers, as well as overlap targeting of families with children in nutrition programs to improve medium-term food security. During incidences of localized conflict or natural emergencies that cause displacement of large numbers of families, GOAL E provides non-food items such as blankets, bed sheets, sleeping mats, plastic sheeting, sacks, and cooking/eating utensils. In response to influxes of refugees from neighbouring countries GOAL E provides nutrition response through treatment of Severely Acute Malnutrition and Moderately Acute Malnutrition, Targeted Supplementary and Blanket Feeding program, nutrition education, and promotion of best practices for Infant and Young Child Feeding.

16 CHILDSPACE GOAL Ethiopia's ChildSPACE programme is multifaceted, designed to address a complexity of children's needs. Through the ChildSPACE (Supporting Positive Actions for Children's Empowerment) programme, GOAL works with children who live and work on the streets of the capital, Addis Ababa, and Hawassa City in SNNPR, to realise their own goals by recognising their skills and talents. The ChildSPACE Programme is dedicated to both increase the opportunities available to street living children and youth (SLCY) and their communities in Addis Ababa and Hawassa, and challenge contexts that limit such opportunities through the promotion of 'good practice', child dignity promotion, and sustainable livelihoods. Within GOAL Ethiopia's contemporary sustainable livelihoods understanding of streetism, emphasis shifts from a focus on the street child/youths' vulnerability to understanding of: the child/youth as social and economic agent with rights, within an urban environment that might be as much enabling as exploitative and abusive. Therefore, to achieve its objective, ChildSPACE programme uses three approaches that are strength-, street-, and community-based with greater emphasis on partnership and networking.

17 CHILDSPACE The ChildSPACE programme acknowledges the fundamental importance of local groups in dealing with the problem of streetism, therefore works with local partner organizations, the city and central government and community groups and personalities. To this end, GOAL has totally shifted from direct service delivery to working with likeminded partners, namely Mother and Child Multi-sectoral Development Organization (MCMDO) and Centre of Concern (COC) implementing the ChildSPACE programme in Addis Ababa and Hawassa respectively, and extending services to street living children and youth. Within this strategic direction, GOAL Ethiopia shifted its role to macro level programme coordination, capacity building of both state and non-state actors, building of coalitions and networks, and child dignity promotion; and set-up technical staff at its Head Office in Addis Ababa to accomplish these objectives.

18 CHILDSPACE The ChildSPACE Programme directly serves over 2,500 SLCY per year through educational and rehabilitative services in Addis Ababa and Hawassa at two Drop-in and Rehabilitation Centers (DIRC). These services include basic health services and health education; shower and clothes-washing facilities; life skill livelihoods trainings; guidance and counselling; peer education; group and individual therapeutic sessions; non-formal education; sport and recreation; and referral to other service providers for further medical treatment and legal support where necessary Where children opt for family tracing and reunification, GOAL Ethiopia supports them through planning sessions, family tracing, clothes provision, family support packages, school materials and school registration fees, and a one year post-reunification follow up. GOAL Ethiopia further provides financial and in-kind support and entrepreneurial training packages for youth who wish to set-up their own small businesses and households. The programme also facilitates different vocational trainings for children/ youth from the street so that they can acquire an employable skill and secure job opportunities such as leather works and general mechanics. GOAL Ethiopia's over 20 years of experience working with street children and our highly trained and skilled staff enables us to deliver quality, impactful, and sustainable interventions and become one of the major actors in street children programming in Ethiopia.

19 CROSSCUTTING ISSUES HIV GOAL Ethiopia addresses HIV mainstreaming as an integral part of all its programmes internally and externally with the approach of reducing vulnerability to HIV infection and the impact of HIV on staff, their families and the organisation is minimised. Improved HIV analysis and adaption of core Programme work in response to HIV is also the focus of the mainstreaming. Gender GOAL is committed to contribute to the advancement of gender equality internally through its systems, procedures and policies, and externally through its programmes partnerships and communication. GOAL aims to achieve gender equality throughout the organisation activities in addressing the basic rights and needs of vulnerable populations throughout the developing world by focusing on gender issues across the full range of sectors within existing policies, development strategies and priorities. GOAL has established a Gender Taskforce (GTF) at Head Office and Programme Office Levels with the objective of driving forward both internal and external Gender Mainstreaming programmes.

20 CROSSCUTTING ISSUES Child Protection GOAL considers Child Protection as one of Cross cutting issues in its all programmatic intervention. GOAL is dedicated to ensure all its programs intervention don t cause any harm to children. Child Protection mainstreaming entails integrating basic child protection elements in all organisational intervention during planning, implementation and monitoring. There are two major categories of implementing Child Protection within all GOAL Ethiopia programmes such as prevention and recognition as well as responding to abuse. The prevention aspect includes raising the awareness of staff; children, visitors and other related bodies on child rights in general and the GOAL Child Protection Policy and code of behaviour in particular. Recognition and response aspect on other hand entails putting in place a reporting system both for the children and staff to report any suspected and witnessed child abuse cases as well as procedure to deal with cases if they arise. Environment Environment mainstreaming assists GOAL to achieve the Environmental policy through adopting the climate change mitigation and adaptation approach. On adaptation GE is implementing a systematic approach to the consideration of environmental hazards through Disaster Risk Reduction (DRR) programming by capacitating the KDCs, line offices and local DRM teams at field level, introducing technologies that can assist in adapting to climate change across sectoral programmes.

21 BERHALE, AFAR REGION ERITREAN REFUGEES As of the end of February 2014, Ethiopia is accommodating 87,654 Eritreans refugees in four camps located in the Tigray region and two others in the Afar Region in north-eastern Ethiopia. The population in Berhale Refugee Camp as of 6,900 as of June 2014 GOAL provides humanitarian response for the Eritrean refugees in Berhale, with plans of extending services to Asayita depending on the need. GOAL s humanitarian intervention in the Berhale refugee camp includes the following components: Provision of Blanket Supplementary Feeding to all children ages 6-59 months and pregnant and lactating women. Management of Moderate Acute Malnutrition through targeted supplementary feeding. Management of Severe Acute Malnutrition through the provision of outpatient therapeutic care to severely malnourished children ages 6-59 months without medical complications and through treatment in stabilization centers to those with medical complications. Community outreach activities. Promotion of Infant and Young Child Feeding best practices.