By Dr Samuel Godfrey

Two months ago, I asked five friends of mine two critical questions; one where does the water that flows out of your tap come from and second where does the waste that is flushed down your toilet go to? Answers like, from a river or “my toilet waste is flushed down a sewer pipe…where it goes, I don’t know?” These answers are symptomatic of many educated peoples understanding.  Last month, I asked five inhabitants of the northern Ethiopian town of Wukro the same question. All five respondents gave me an articulate description of borehole water as well as the exact location of all the septic tanks.

Water and Sanitation are a daily priority for most of the world and the Sustainable Development Goal (SDG) number 6 has been designed to ensure that everyone, everywhere has access to water and sanitation by 2030.

In Ethiopia, UNICEF was ahead of the SDG curve and in 2013 developed a programme called the ONEWASH which was designed to pull all financial resources from the government, aid agencies, development banks and the UN around ONEPLAN.

To develop the ONEWASH programme, UNICEF Ethiopia was delegated by the Government of Ethiopia to design the strategy for a 10 year plan to ensure that the 50 million people gain access to water and 70 million people gain access to sanitation in every house in every town, city and village across Ethiopia. The ONEWASH is the biggest water and sanitation initiative in Africa and requires an estimated investment of US$2.4 billion. See http://www.unicef.org/ethiopia/OWNP_LEAFLET.pdf.

The ONEWASH programme has: ONE plan, ONE Budget, ONE Procurement system, ONE monitoring system and ONE report. Led by the ONEWASH Coordination office in the Government of Ethiopia  Ministry of Water, Irrigation and Electricity  and with financial and technical collaboration with the Ministry of Finance, Education and Health, the ONEWASH was a “showcase” at the 2016 Sanitation and Water for All High Level Meeting.

UNICEF Ethiopia also teamed up with the key financiers in the WASH sector in Ethiopia such as the World Bank, African Development Bank, DFID, Government of Finland and others to set up a Sector Wide Approach (SWAp) pool fund called the Consolidated WASH Account where funds are blended together. To ensure all UNICEFs financial rule and regulations were respected, UNICEF Ethiopia developed a Fiduciary Risk Assessment tool. This is now been worked into a Programme Operational Manual and is used to guide the sector investments.

The SDGs present an opportunity and challenge for UNICEF Ethiopia. If ONEWASH is successful it will improve sanitation and hygiene facilities in hospitals, schools and health centres and will provide essential water supply for areas affected by climate change and drought. It will ultimately result in reducing undernutrition in children and improving the cognitive performance of school goers.

We are working in the WASH sector to complement and partner with other sector financiers to ensure that all children and all women, everywhere: rural and urban – development and emergency -have the right to water, sanitation and hygiene in communities, health centres and schools…..ONEWASH for all…

Dr Samuel Godfrey is Water Supply, Sanitation and Hygiene (WASH) Section Chief at UNICEF Ethiopia

By Paul Schemm

ADIGUDOM, Ethiopia, 27 April 2016 – For Kibrom Mekonnen, the itching was the worst at night, all over his hands and chest and keeping him awake.

“When I slept it just kept itching,” said the 14-year-old, sitting in the examination room at the Adigudom Primary Hospital in Hintalo Wejarat Woreda (district) in the Tigray Region. “But I was afraid if I started scratching, it would get worse.”

Kibrom’s instincts were right because he has scabies, a contagious skin infection caused by mites that burrow along the top layer of the skin, lay eggs, hatch and spread throughout causing terrible itching.

The real danger, however, can be in the scratching which opens up sores in the skin.

“By itself, it is irritating and itchy but it also exposes you to other infections,” explained UNICEF Heath Specialist Yayneshet Gebreyohannes. “It can result in systemic infections if left untreated.”

Drought brings scabies revival

Scabies has actually been fairly rare in Ethiopia for the past several years, but with the sharp drop in the availability of water due to the worst drought the country has faced in decades, it reappeared.

Casual contact, a handshake or even a hug, is not enough to transmit the mites. There has to be prolonged skin contact or sharing of clothes, which means that outbreaks often happen within the tight confines of homes and schools.

With less water available to wash and maintain personal hygiene, there have been outbreaks in the country.

In the Tigray Region for instance, there were 27,000 new cases reported between October last year to March this year, and nearly 10,000 of those were in Kibrom’s woreda.

Since then however, there has been a significant drop in the number of cases due to the Government leadership and solid response and also UNICEF support to prevent and treat the disease.

In addition to providing medicated soap and permethrin lotion to treat the disease, UNICEF has distributed brochures and teaching guides to educate people about how to combat it and most importantly, not to stigmatize the victims.

Stopping the itch

Kibrom thinks he was infected by a visiting relative, about his age, when the latter visited from a rural village and shared Kibrom’s bed about a week earlier.

The nurse examines his hands where telltale rashes have appeared in the folds of the skin at the joints.

She walks him through the three-day treatment of soap and medication and promises to visit his family home to advise them on precautions to be taken and provide medication for the rest of the family.

For instance his clothes will have to be treated with boiling water, as will his bed linens and many of the fabrics in the house.

Kibrom is lucky in that his home has piped water, but when water is unavailable, health workers advise people to tie clothes into plastic bags for three days – the lifespan of the mite.

Kibrom is also lucky because his area was targeted by the information campaign so that someone at school identified his condition and explained to him what the horrific itching was all about. Otherwise, he might have just tried to endure – and possibly infected others.

“I kept thinking it was going to go away on its own,” he recalled.

The scabies response is part of UNICEF’s health, communication, and water, hygiene and sanitation  response for drought and flood-affected populations. UNICEF also provides financial support, supplies including medicines and vaccines, and technical assistance to the Government for the prevention and treatment of major causes of childhood illnesses and deaths such as acute watery diarrhoea and other diarrhoeal diseases, vaccine preventable diseases, as well as other diseases such as meningitis.

Giving children the best start in life begins with breastfeeding.  Breastmilk is the natural first food for newborns. It provides children with necessary nutrients for their growth and development and protects them from deadly diseases such as pneumonia and diarrhoea.

There is no better substitute food for a breastmilk. A breastfed child is 14 times less likely to die in the first six months than a non-breastfed child, and breastfeeding drastically reduces deaths from acute respiratory infection and diarrhoea, two major child killers. The longer breastfeeding is delayed, the higher the risk of death for children in their first month of life.

This year when the world celebrates breastfeeding week (1-7 August) emphasis has been made on breastfeeding and its importance to achieve Sustainable Development Goals (SGDs).

Here in Ethiopia, when the event was celebrated at the Ministry of Health the State Minister of Health, Dr Kebede Worku, said that breastfeeding has an ‘all rounded’ benefit that keeps children healthy, happy and more productive at later age. He also stressed that mothers need to be supported to breastfeed their children both at home and in the workplace.

UNICEF Deputy Country Representative to Ethiopia, Shalini Bahuguna, on her part said “optimum breastfeeding to children under six months is an effective resilience measure.”  She also underscored UNICEF’s commitment to promote early and exclusive breastfeeding by engaging fathers, religious leaders as well as members of the community.

According to UNICEF, early breastfeeding rates in sub-Saharan Africa have increased by 19 per cent from 1995 to 2011. This is the highest rate when compared to other regions.  It is estimated that 41 per cent of children in sub-Sharan Africa are exclusively breastfed. When it comes to Ethiopia, the numbers are encouraging. Ethiopia is one of the leading countries with 52 per cent of children exclusively breastfed within the first six month. But still there is a long way to go as the country has high stunting rate.

Breastfeeding and sustainable development

Early and exclusive breastfeeding helps children to survive. That is a fact. Yet, breastfeeding is also linked with national development. Evidence shows that the benefits of breastfeeding extend into adulthood.  A well breastfed child has good sensory and cognitive development which is associated with better educational achievement. Healthy and better educated children will be more productive and positively impact socio-economic development.

Breastfeeding also contributes to poverty reduction. It is a natural and cost effective way of feeding which do not burden household budget as compared with formula feeding. Thus, supporting breastfeeding is the smartest investment nations can make to ensure the wellbeing of their citizens.

It is, therefore, critical to promote optimal breastfeeding and provide support to mothers who have social and commercial pressures that compromises their decision to breastfeed.

የአጣዳፊ ተቅማጥና ትውከት በሽታ በተለያዩ በጥቃቅን በዓይን በማይታዩ ተዋህሲያን አማካይነት አማካይነት የሚከሰት በሽታ ሲሆን ከንጽህና መጓደል በተለይም በተህዋሲያን በተበከሉ ምግቦች፣ የመጠጥ ውሃ እና በሌሎች መተላለፊያ መንገዶች ከሰው ወደ ሰው በከፍተኛ ፍጥነት የሚተላለፍ ነዉ፡፡

በሀገራችን ነባራዊ ሁኔታ በአንዳንድ አካባቢዎች የንጹህ መጠጥ ውሃ አቅርቦት በቂ ያለመሆንና በዓለም ላይ በተከሰተዉ የኢሊኖ አየር መዛባት ምክንያት የዉሃ እጥረትና በሌላዉ በኩል የጎርፍ ችግር መኖር እንዲሁም ፣ ከሕብረተሰቡ የአከባቢ፣ የግል፣ የውሃና የምግብ ንጽህና አያያዝና አጠቃቀም ልማድ አለመዳበር ጋር ተያይዞ የተቅማጥ በሽታዎች ስርጭት በየጊዜው እንዲከሰት አስተዋጽዖ አድርጓል፡፡ በተለይም በጎርፍ ምክንያት ምንጮች፣ ወንዞች፣ የውሃ ጉድጓዶች ስለሚበከሉ በአጣዳፊ ተቅማጥና ትውከት የሚያዙ ሰዎች ቁጥር ይጨምራል፡፡

የአተት ምልክቶች ምንድናቸው ?

በበሽታው የተያዘ ሰው በተደጋጋሚ አጣዳፊ ተቅማጥና ትውከት ይኖረዋል፡፡ በዚህም የተነሳ የሰውነት ፈሳሽና ጠቃሚ የሆኑትን ንጥረ ነገሮች መጠን ያዛባል፡፡ በተጨማሪም

• አጣዳፊ መጠነ ብዙ የሆነ ውኃማ ተቅማጥ
• ትውከትና ቁርጥማት
• የአይን መስርጐድ
• የአፍና የምላስ መድረቅ
• እንባ አልባ መሆን
• የሽንት መጠን መቀነስ
• የቆዳ ድርቀትና መሸብሸብ በመጨረሻም ከፍተኛ የሆነ የሰውነት ድርቀት በማስከተል ህመምተኛው በወቅቱ ካልታከመ ለሞት ሊያበቃው ይችላል፡፡

አጣዳፊ ተቅማጥና ትውከት የሚያስከትለው ችግር ምንድነው ?

በአተት የተያዘ ሰው ከሰውነቱ ብዙ ፈሳሽ ስለሚወጣ በሽተኛው የሰውነት ድርቀት /Dehydration/ ያስከትልበታል፡፡ ይህ ሁኔታ ደግሞ በአተት የተያዘው ሰው በአጭር ጊዜ ራሱን እንዲስት ያደርገዋል፡፡ ከዚህ በተጨማሪ አፋጣኝ የሕክምና ዕርዳታ ካላገኘ በበሽታው የመሞት አጋጣሚው ሃምሳ ከመቶ /5ዐ%/ ነው፡፡ ነገር ግን አስፈላጊው የሕክምና ዕርዳታ ከተደረገለት የመሞት አጋጣሚው ከአንድ ከመቶ /1%/ ወይም ከዚያ በታች ማድረግ ይቻላል፡፡

በሽታውን መለያ መንገዶች

1. ምልክቶቹን በማየት

2. በላብራቶሪ ሊረጋገጥ ይችላል፡፡

ህክምናው

• የወጣውን ፈሳሽ መተካት ዋናውና ቅድሚያ የሚሰጠው ነው
• እንደ ተዋህሲያኑ አይነት በባለሙያ የሚሰጥ ህክምናን ተግባራዊ ማድረግ

መከላከያና መቆጣጠሪያ መንገዶች

• መፀዳጃ ቤት መገንባትና በአግባቡ መጠቀም
• ምግብን በሚገባ አብስሎ መመገብ
• በውኃ /መድሃኒት/ በውኃ አጋር/ የታከመ ውሃ ለመጠጥ መጠቀም ወይም ውኃ አፍልቶና አቀዝቅዞ መጠጣት
• እጅን በውኃና በሳሙና /በአመድ በደንብ አጥርቶ መታጠብ
  • ከመጸዳጃ ቤት መልስ
  • ምግብ ከማዘጋጀት በፊት
  • ምግብ ከማቅረብ በፊት
  • ምግብ ከመመገብ በፊት
  • ሕጻናትን ካጸዳዱ በኋላ
  • ህጻናትን ጢት ከማጥባት በፊት
  • በበሽታዉ የተያዙ ሰዎችን እነክብካቤ ካደረጉ በኃላ

ማንኛውም ከቤት የሚወጣ ደረቅ ወይም ፈሳሽ ቆሻሻ አካባቢን ወይንም ውኃን እንዳይበክል በአግባቡ ማስወገድ፡፡ ምልክቱ የታየበት ህመምተኛ ፈጥኖ ወደ ህክምና ተቋም በመምጣት ሊታከም ይገባል፡፡

ይህንን መሰረት በማድረግ ሁሉም ህብረተሰብ በሽታዉን በመከላከል ዙሪያ የተሰጡ መልእክቶችን በመተግበር እያንዳንዱ ግለሰብ እራሱንና ቤተሰቡን እንዲሁም አካባቢዉን ሊከላከል ይገባል፡፡

By Nikodimos Alemayehu and Marie Angeline Aquino

ADDIS ABABA, Ethiopia. August 2016 – Ethiopia launched throughout the country on 4 August 2016 a permanent, compulsory and universal registration and certification of vital events such as birth, death, marriage and divorce.

The inauguration ceremony took place in the presence of the Ethiopian President Dr Mulatu Teshome, UNICEF Representative Gillian Mellsop as well as representatives of other ministries and development partners.

“The Government of Ethiopia has given great emphasis to vital events registration across the country by putting the appropriate policies in place, establishing a system up to the lowest administrative level and deploying massive resources in this endeavor,” said Teshome at the ceremony. “I am confident that, with the collaboration and commitment of all stakeholders, we will succeed in the operationalization of the system, just like we have succeeded in other development sectors in the country.”

Mellsop underscored in her address the importance of the registry in protecting children and combatting child trafficking.

‘’With no proof of age and identity, Ethiopian children become a more attractive ‘commodity’ to a child trafficker, and will not even have the minimal protection that a birth certificate provides against early marriage, child labour, or detention and prosecution of the child as an adult.”

Ethiopia ranks among the lowest in sub-Saharan countries on birth registration with less than 10 per cent of children under the age of 5 with their births registered.

The issue is especially urgent because 48 per cent of the 92 million-strong population is under the age of 18 – 90 per cent of whom are unregistered. The Government has committed itself to reaching at least 50 per cent of children with registration and certification services over the next two years.

UNICEF’s support to Ethiopia’s national civil registration is based on a recognition that birth registration is an important element of ensuring the rights and protection of children.

For children, being registered at birth is key to other rights such as access to basic social services, protection, nationality and later the full rights of citizenship, including the right to vote. Moreover, not only is vital events registration essential for compiling statistics that are required to develop policies and implement social services, it is also, as Mellsop points out, “a pre-requisite in measuring equity; for monitoring trends such as child mortality, maternal health and gender equality.”

UNICEF has supported the Government in putting in place a decentralized registration and certification system, which is informed by a legislative framework promulgated in August 2012.

UNICEF is a catalyst in creating this new system with support that includes the reform of the legislative framework, the development of a national strategy and its implementation across the country.

An important element of the Civil Registration and Vital Statistics (CRVS) system is its interoperability with the health sector. On this aspect, UNICEF has worked in collaboration with the Ministry of Justice and Ministry of Health in its efforts to formalize the interoperability, culminating in the signing of Memorandum of Understanding (MoU) between the two ministries.

The important of involving the Health Ministry is because it already has its own well organized and decentralized network stretching across the country. This arrangement allows the health facilities found in nearly every community to manage notifications of births and deaths.

The actual registration and certification of all vital events started on 6 August 2016 at the lowest administrative level of the kebele (sub-district).

With Ethiopia’s new conventional vital events registration system in place, there are better opportunities for accelerating vital events registration in Ethiopia, and realizing one of the fundamental rights of children – the right to be registered upon birth.

28 million forcibly displaced by conflict and violence within and across borders

Across the globe, nearly 50 million children have been uprooted – 28 million of them driven from their homes by conflicts not of their making, and millions more migrating in the hope of finding a better, safer life. Often traumatized by the conflicts and violence they are fleeing, they face further dangers along the way, including the risk of drowning on sea crossings, malnourishment and dehydration, trafficking, kidnapping, rape and even murder. In countries they travel through and at their destinations, they often face xenophobia and discrimination.

A new report released today by UNICEF, Uprooted: The growing crisis for refugee and migrant children, presents new data that paint a sobering picture of the lives and situations of millions of children and families affected by violent conflict and other crises that make it seem safer to risk everything on a perilous journey than remain at home.  

“Indelible images of individual children – Aylan Kurdi’s small body washed up on a beach after drowning at sea or Omran Daqneesh’s stunned and bloody face as he sat in an ambulance after his home was destroyed – have shocked the world,” said UNICEF Executive Director Anthony Lake. “But each picture, each girl or boy, represents many millions of children in danger – and this demands that our compassion for the individual children we see be matched with action for all children.”

Uprooted shows that:

• Children represent a disproportionate and growing proportion of those who have sought refuge outside their countries of birth: they make up about a third of the global population but about half of all refugees. In 2015 around 45 per cent of all child refugees under UNHCR’s protection came from Syria and Afghanistan.
• 28 million children have been driven from their homes by violence and conflict within and across borders, including 10 million child refugees; 1 million asylum-seekers whose refugee status has not yet been determined; and an estimated 17 million children displaced within their own countries – children in dire need of humanitarian assistance and access to critical services. 
• More and more children are crossing borders on their own. In 2015, over 100,000 unaccompanied minors applied for asylum in 78 countries – triple the number in 2014. Unaccompanied children are among those at the highest risk of exploitation and abuse, including by smugglers and traffickers. 
• About 20 million other international child migrants have left their homes for a variety of reasons including extreme poverty or gang violence. Many are at particular risk of abuse and detention because they have no documentation, have uncertain legal status, and there is no systematic tracking and monitoring of their well-being – children falling through the cracks.

According to Uprooted, Turkey hosts the largest total number of recent refugees, and very likely the largest number of child refugees in the world. Relative to its population, Lebanon hosts the largest number of refugees by an overwhelming margin: Roughly 1 in 5 people in Lebanon is a refugee. By comparison, there is roughly 1 refugee for every 530 people in the United Kingdom; and 1 for every 1,200 in the United States. When considering refugee-host countries by income level, however, the Democratic Republic of the Congo, Ethiopia, and Pakistan host the highest concentration of refugees. 

The report argues that where there are safe and legal routes, migration can offer opportunities for both the children who migrate and the communities they join. An analysis of the impact of migration in high-income countries found that migrants contributed more in taxes and social payments than they received; filled both high- and low-skilled gaps in the labour market; and contributed to economic growth and innovation in hosting countries.

But, crucially, children who have left or are forcibly displaced from their homes often lose out on the potential benefits of migration, such as education – a major driving factor for many children and families who choose to migrate. A refugee child is five times more likely to be out of school than a non-refugee child. When they are able to attend school at all, it is the place migrant and refugee children are most likely to encounter discrimination – including unfair treatment and bullying.

Outside the classroom, legal barriers prevent refugee and migrant children from receiving services on an equal basis with children who are native to a country. In the worst cases, xenophobia can escalate to direct attacks. In Germany alone, authorities tracked 850 attacks against refugee shelters in 2015. 

“What price will we all pay if we fail to provide these young people with opportunities for education and a more normal childhood? How will they be able to contribute positively to their societies? If they can’t, not only will their futures be blighted, but their societies will be diminished as well,” Lake said. 

The report points to six specific actions that will protect and help displaced, refugee and migrant children:

• Protecting child refugees and migrants, particularly unaccompanied children, from exploitation and violence.
• Ending the detention of children seeking refugee status or migrating by introducing a range of practical alternatives.
• Keeping families together as the best way to protect children and give children legal status.
• Keeping all refugee and migrant children learning and giving them access to health and other quality services.
• Pressing for action on the underlying causes of large-scale movements of refugees and migrants.
• Promoting measures to combat xenophobia, discrimination and marginalization.

Ethiopia has a long history as both a sender and receiver of refugees, and its location in the Horn of Africa places it at the centre of one of the largest refugee-generating areas in Africa today. As of 1 July 2016, the United Nation High Commissioner for Refugees (UNHCR) reported a total of 741,288 refugees living in Ethiopia, of which nearly 60 per cent (57.2 per cent) are children. This is an increase of more than 600,000 since 2009 with the majority from South Sudan, Sudan, Somalia, and Eritrea. The volatility of this influx has put significant pressure on the government capacity to provide basic social services in affected areas. Host communities and refugees alike suffer from limited social services, including lack of schools, overstretched health facilities, shortage of water and sanitation facilities.

Afar Region – Ethiopia Ms Leila Pakkala and Ms Valerie Guarnieri, UNICEF and WFP Regional Directors for Eastern and Central Africa, have visited the ongoing government-led drought response where UNICEF-WFP are closely collaborating. The drought is affecting six regions in Ethiopia, and 9.7 million people are in need of urgent food relief assistance including approximately 5.7 million children who are at risk from hunger, disease and lack of water as a result of the current El Niño driven drought.

In Afar Region, where an estimated 1.7 million people are affected by the drought, including 234,000 under-five children, the Regional Directors visited UNICEF/WFP/Government of Ethiopia supported programmes. These included the targeted supplementary feeding programme (TSFP) and an outreach site where one of Afar’s 20 Mobile Health and Nutrition Teams (MHNTs) provides preventive and curative health, nutrition and WASH services to a hard-to-reach community in Lubakda kebele.

The Mobile Health and Nutrition Team provides Outpatient Therapeutic Programme (OTP) and targeted supplementary feeding programme (TSFP) services to remote communities. The TSFP is integrated with MHNT services that address under five children and pregnant and lactating women with moderate acute malnutrition, and link them to TSFP when they are discharged from OTP. This solves the challenge in addressing the SAM–MAM continuum of care and preventing moderate acute malnourished children deteriorating into severe acute malnutrition.

The Directors also visited a multi-village water scheme for Afar pastoralist communities in Musle Kebele, Kore Woreda (district) which suffers from chronic water insecurity.

“Valerie and I are hugely impressed by the work of the WFP and UNICEF teams in Afar,” said UNICEF’s Pakkala.  “The quality of the work being done in such difficult circumstances – from the mobile health and nutrition teams, to WASH, protection, education and advocacy – is remarkable. We were also immensely impressed with the national level partnership between UNICEF and WFP, and our credibility with government and donors. The relationship and collaboration is a model for other countries to learn from and emulate.”

“Ethiopia is showing us that drought does not have to equal disaster,” said Valerie Guarnieri of WFP.  “We can clearly see the evidence here that a robust, government-led humanitarian response – supported by the international community – can and does save lives in a time of crisis.”

UNICEF and WFP continue to support the Government in responding to the current drought with a focus on the most vulnerable and hard to reach communities by using proven context specific solutions and approaches.

NEW YORK/ADDIS ABABA,  04 October 2016 – Children are more than twice as likely as adults to live in extreme poverty, according to a new analysis from the World Bank Group and UNICEF. Ending Extreme Poverty: A Focus on Children finds that in 2013 19.5 per cent of children in developing countries were living in households that survived on an average of US$1.90 a day or less per person, compared to just 9.2 per cent of adults.  Globally, almost 385 million children were living in extreme poverty.

Children are disproportionately affected, as they make up around a third of the population studied, but half of the extreme poor. The youngest children are the most at risk – with more than one-fifth of children under the age of five in the developing world living in extremely poor households.

“Children are not only more likely to be living in extreme poverty; the effects of poverty are most damaging to children.  They are the worst off of the worst off – and the youngest children are the worst off of all, because the deprivations they suffer affect the development of their bodies and their minds,” said UNICEF Executive Director Anthony Lake. “It is shocking that half of all children in sub-Saharan Africa and one in five children in developing countries are growing up in extreme poverty.  This not only limits their futures, it drags down their societies.”

The new analysis comes on the heels of the release of the World Bank Group’s new flagship study, Poverty and Shared Prosperity 2016: Taking on Inequality, which found that some 767 million people globally were living on less than $1.90 per day in 2013, half of them under the age of 18. 

“The sheer number of children in extreme poverty points to a real need to invest specifically in the early years—in services such as pre-natal care for pregnant mothers, early childhood development programs, quality schooling, clean water, good sanitation, and universal health care,” said Ana Revenga, Senior Director, Poverty and Equity at the World Bank Group. “Improving these services, and ensuring that today’s children can access quality job opportunities when the time comes, is the only way to break the cycle of intergenerational poverty that is so widespread today.”

The global estimate of extreme child poverty is based on data from 89 countries, representing 83 per cent of the developing world’s population.

Sub-Saharan Africa has both the highest rates of children living in extreme poverty at just under 50 per cent, and the largest share of the world’s extremely poor children, at just over 50 per cent.  South Asia has the second highest share at nearly 36 per cent—with over 30 per cent of extremely poor children living in India alone. More than four out of five children in extreme poverty live in rural areas.   

In addition, the report reveals that even at higher thresholds, poverty also affects children disproportionately.  About 45 per cent of children are living in households subsisting on less than $3.10 a day per person, compared with nearly 27 per cent of adults.

UNICEF and the World Bank Group are calling on governments to:

• Routinely measure child poverty at the national and subnational level and focus on children in national poverty reduction plans as part of efforts to end extreme poverty by 2030.
• Strengthen child-sensitive social protection systems, including cash transfer programs that directly help poor families to pay for food, health care, education and other services that protect children from the impact of poverty and improve their chances of breaking the cycle in their own lives.  
• Prioritize investments in education, health, clean water, sanitation and infrastructure that benefit the poorest children, as well as those that help prevent people from falling back into poverty after setbacks like droughts, disease or economic instability.   
• Shape policy decisions so that economic growth benefits the poorest children. 
• UNICEF and the World Bank Group are working with partners to interrupt cycles of poverty and to promote early childhood development – with programs ranging from cash transfers, to nutrition, healthcare and education.

 Ethiopia specific information:

• There are 13 million Ethiopian children who live in poor households, 2 million of whom live in extreme poverty.
• Children are more severely affected by poverty (32.4 per cent) and extreme poverty (5.2 per cent) than adults (29.6 per cent and 4.5 per cent, respectively).
• The poorest children are found in households whose head is employed in the informal sector. 13.1 per cent of these children live in extreme poverty.

 NEW YORK/ ADDIS ABABA, 14 October 2016 – Five in six children under two years old are not fed enough nutritious food for their age, depriving them of the energy and nutrients they need at the most critical time in their physical and cognitive development, according to a new UNICEF report.

“Infants and young children have the greatest nutrient needs than at any other time in life. But the bodies and brains of millions of young children do not reach their full potential because they are receiving too little food, too late,” said France Begin, Senior Nutrition Adviser at UNICEF. “Poor nutrition at such a young age causes irreversible mental and physical damage.”

UNICEF data show that poor nutritional practices– including the delayed introduction of solid foods, infrequent meals and lack of food variety – are widespread, depriving children of essential nutrients when their growing brains, bones and bodies need them the most. The findings reveal that: 

• Young children wait too long for their first bites. One in five babies hasn’t been fed any solid foods by the age of 11 months.
• Half of children aged six months to two years are not fed the minimum number of meals for their age, increasing their risk of stunting.
• Less than one-third of children in this age group eat a diverse diet – meaning from four or more food groups daily – causing deficiencies in vitamins and minerals.
• Almost half of pre-school aged children suffer from anaemia.
• Only half of children aged six to 11 months receive any foods from animal sources – including fish, meat, eggs and dairy – which are essential to supply zinc and iron.
• The high cost of foods from animal sources makes it difficult for the poorest families to improve their children’s diet. In Sub-Saharan Africa and South Asia, only one in six children from the poorest households aged six to 11 months eats a minimally diverse diet, compared to one in three from the richest households.
• Improving nutrition for young children could save 100,000 lives a year.

Making nutritious foods affordable and accessible to the poorest children will require stronger and more targeted investments from governments and the private sector. Cash or in-kind transfers to vulnerable families; crop diversification programmes; and fortification of staple foods are key to improving nutrition for young children. Community-based health services that help caregivers learn better feeding practices, and safe water and sanitation – absolutely critical in preventing diarrhoea among children – are also vital.

“We cannot afford to fail in our fight to improve nutrition for young children. Their ability to grow, learn and contribute to their country’s future depends on it,” Begin said. 

Ethiopia has experienced rapid, sustained improvement in under-nutrition during the past 15 years. For example, the country has seen a steady reduction in stunting – the fastest rate of improvement in Africa – and a decline in the percentage of underweight and wasted children. Yet, Ethiopia remains in a precarious situation, with large absolute numbers of affected children: 5.3 million children are stunted and 1.2 million children suffer wasting. UNICEF’s nutrition programme collaborates with the Government of Ethiopia to reduce these numbers further, working on multi-sectoral coordination to improve the nutrition of all children, pregnant and lactating women and their families

The Government of Ethiopia recognizes that addressing malnutrition is essential to achieving sustainable development. It therefore has issued the Seqota Declaration to end child malnutrition by 2030. The Declaration lays out a plan to stop the cycle of under-nutrition by bringing together all sectors of the Government, paying particular attention to the importance of nutrition during pregnancy and in the first years of a child’s life. 

Over the past decade, Ethiopia has seen a steady reduction in stunting from 58 per cent in 2000 to 40 per cent 2014, in the percentage of underweight children from 41 per cent to 25 per cent, and in wasting from 12 per cent to 9 percent (Mini EDHS: 2014) 

These trends indicate an improvement in chronic malnutrition over the past 15 years. Yet, 28 per cent of child deaths in Ethiopia is associated with under-nutrition. In addition to this high contribution to the under-five mortality rate, high prevalence of various forms of malnutrition among vulnerable groups in Ethiopia has serious implications for social development and economic growth. In a study conducted in 2009, the total annual cost of under-nutrition was estimated at US$2,775,000, equivalent to 17 per cent of the country’s GDP in 2009.

UNICEF’s strategies for nutrition ensure the achievements of results in four areas: 1) upstream nutrition policy support and multi-sectoral engagement; 2) improved nutrition knowledge and caring behaviours; 3) strengthening of systems for nutrition service delivery; and 4) strengthening partner capacities to respond to nutrition in humanitarian crises.

To accelerate the reduction of chronic and acute malnutrition, UNICEF is working in partnership with sectoral government counterparts, including in health, agriculture, education, social protection, trade and industry, and women, children and youth affairs.

UNICEF also works with United Nations agencies such as the Food and Agriculture Organization (FAO), United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA), World Food Programme (WFP) and World Health Organization (WHO); UNICEF National Committees; donors such as the aid agencies of Canada, Ireland, Japan, the Netherlands, Spain, the United Kingdom and the United States, as well as the European Union; civil society organizations; and local and international academic institutions.

Gillian Mellsop, UNICEF Representative to Ethiopia

‘Children are today’s flowers and tomorrow’s fruit’ is a saying in Ethiopia and there is no better investment that cultivates the fruit and speaks to the ‘right in principle and right in practice’ mantra more than early childhood development.

Parents and communities want the best for their children and understand that the early years of a child’s life are crucial. However, they may not have the means or the knowledge on how to ensure their next generation best thrives.

Last week, the latest offering from the world-renowned Lancet, Advancing Early Childhood Development: from Science to Scale, showed that almost one in two – 43 per cent – of children under five in low-and middle-income countries are at risk of not achieving their cognitive potential. No country can risk losing nearly half of the brain potential of its youngest citizens – low- and middle-income countries least of all.

Advances in neuroscience show that experiences in early childhood have a profound impact on brain development and on subsequent learning and health. Children who are poorly nourished and nurtured, or those who do not receive early stimulation, are likely to learn less in school and go on to earn less as adults.

In Ethiopia, over 5 million children are stunted which has a serious impact on human development and economic growth. And currently, the most disadvantaged children in rural and hard to reach communities are either coming to grade 1 without having the necessary preparation or are enrolling late – under 40 per cent of children in Ethiopia have access to pre-school provision. Once in primary education, many are at risk of dropping out of school too early.

The good news is that early childhood development interventions, including parenting and care programmes, cost as little as 50 cents (US$) per child per year, when combined with existing services such as health – according to the Lancet Series. And much of what needs to be done at the community level can be achieved by mothers and fathers, grandparents, siblings and caregivers.

The findings in the Series underscore the importance of increased global dedication to early childhood development. Earlier this year, World Bank Group President Jim Yong Kim and UNICEF Executive Director Anthony Lake signalled a renewed commitment to prioritizing investments in the youngest children when they announced a new alliance urging global and national leaders to step up and accelerate action and funding for nutrition and early childhood development (ECD) programmes. The Lancet estimates that individuals who suffer a loss of about a quarter of average adult income per year, while countries may forfeit up to as much as two times their current GDP expenditures on health or education. Consequences of inaction impact not only present but future generations.

When children have the opportunity to develop their cognitive capacity, they will pass similar or even better opportunities to their children when they grow up.  Increasing investment in Ethiopia’s young children can break the vicious cycle of intergenerational poverty.

Therefore, prioritizing ECD at the national level is a way for governments to stimulate economic growth. Evidence suggests that every dollar invested in quality ECD programmes brings a return of between US$6 and US$17. Moreover, research by

Nobel Laureate James Heckman found that the rate of return for investments in quality early childhood development for disadvantaged children is 7-10 per cent per annum through better outcomes in education, health, sociability, economic productivity and reduced crime.

This year, the importance of interventions in early childhood was also recognized by the inclusion of an ECD target in the Sustainable Development Goals – indeed, this is the first time ECD has been explicitly included in global development goals. SDG Target 4.2 aims to increase the percentage of children under 5 years of age who are developmentally on track in health, learning and psychosocial well-being.

For many children, lack of educational support at home is one of the biggest obstacles to reaching their full potential. In light of differing needs of families, a range of early childhood education services are offered in Ethiopia, including kindergarten, pre-primary class (‘O-class’) and several school readiness programmes. Parenting education programmes are also provided so families can learn about the importance of early nutrition, hygiene, care and stimulation.

The evidence presented this past week, combined with the current momentum globally, speaks for itself. We are well versed in the elements that affect the development of children’s brains – good nourishment, stimulated minds, and protection from violence. It is now vital that we use this growing body of evidence to effect real changes for children, at both the community and policy levels.

Early child development has to be put on the agenda for children’s rights. In Ethiopia, UNICEF, with the support from partners, takes an integrated approach to addressing early childhood development within Ethiopia’s Early Childhood Care Education Policy.

We owe it to our future generations to prioritize and invest in young children. It is our moral, economic, and social imperative to enable all children to reach their full potential.

By Hannah Godefa

On August 6^th, I was fortunate to be a part of a campaign in Ethiopia when the establishment of the Vital Events Registration Agency (VERA) kicked off throughout the country.

VERA is an incredibly important institution for individuals, societies and government. For individuals, registration can be used as legal documents and proof for identification purposes. Information complied from these areas are then needed for admin applications like public health programmes and the electoral roll.

On the first day of the campaign, I visited the Gulele Sub City, Woreda 9 VERA team. UNICEF supports the campaign to ensure all resources needed for registration like registry, certificates, awareness creation, materials and logistics make it to all regions, all the way to the lowest levels of administration.

This process is incredibly important because it will ensure that every child will be accounted from the earliest days of life. This means big advancements for accountability when it comes to harmful traditional practices including child marriage, as every individual will have a marriage certificate with the new system from VERA. It will also make it easier for government, non-profit and civil society partners to identify when these practices are occurring.

Birth registration is the first recognition of a child’s existence by the state. Where births remain unregistered, there is an implication that these children are not recognized as persons before the law. The absence of the system of birth registration results in the violation of children’s rights to name and nationality; to protection from abuse, neglect, and exploitation, including early marriage, child labour  and trafficking; to basic social services, including education and health; and the personal rights of orphans and other vulnerable children.

Currently, birth, death, marriage and divorce will be kept recorded from the kebele civil status office to the federal level, so that there is less room for discrepancies and human rights crime.

Participating in the registration process was an incredibly humbling and powerful experience for me, and I am very excited to see how UNICEF will work with VERA and local partners to ensure that every child is accounted for, and no one is left behind.

By Bethlehem Kiros

ADDIS ABABA, 30 September 2016 – Mickias Fikre, a taxi driver keeps soap in his car and makes sure to wash his hands thoroughly before he eats. According to him, it is a new habit he developed after he saw his friend suffer from Acute Watery Diarrhea (AWD). “He was so sick that I thought he would not recover,” he remembers. His friend got better after few days and Mickias learned from the local health centre how to protect himself from the disease. Mickias adds, “It is really helpful that volunteers are travelling throughout our community on trucks, spreading the message on how to stay safe.”

Ayantu Dadi, 20, is one of the volunteers who is helping communities protect themselves from AWD. A recent college graduate and an Ethiopian Red Cross Society (ERCS) volunteer of over five years, she has been spending the last three months on the UNICEF and ERCS-supported audio truck that drives around the Nefasilk Lafto sub-city.   Since July 2016, UNICEF and ERCS have been conducting mass public awareness campaigns using 10 audio trucks deployed in each of the 10 sub-cities of Addis Ababa.

Ayantu and seven other volunteers meet early in the morning at the Nefasilk Lafto ERCS branch office, then visit the sub-city health office to obtain instructions on the exact locations they need to cover for the day. These locations are selected based on reported cases of AWD, as well as observed risk factors such as poor hygiene and sanitation practices. The volunteers spend about eight hours reaching out the public with awareness-raising messages on how to prevent AWD and recognize its symptoms. “We play music for few minutes to attract people’s attention and then we broadcast the Public Service Announcements on hygiene and sanitation,” she elaborates.

They also stop at designated priority locations, such as crowded locations where they can reach a large number of people, to distribute flyers, put up posters and have one-on-one talks with people who have questions about AWD. “We especially take time to talk with street food vendors and people in economically impoverished communities where the problem seems to be most prevalent,” she explains. According to Ayantu, the outreach helps prevent new cases of AWD as well as identify existing cases. “It is quite satisfying when you find out that your actions actually impact people’s lives. It is what encourages me to keep passing this message every day,” she says.

Since the AWD outbreak was reported in November last year, 7,769 cases have been identified in Addis Ababa alone.

The coordinated response by the Federal Ministry of Health (FMOH) and partners including UNICEF, cases have now continued to decline however, we should not let our guard down.

Sintayehu Tsegaye 45, is among the thousands affected by AWD and was treated for a week in the local AWD case treatment centre (CTC). A mother of two, she has a small business selling potato chips, flowers and grass that is used in Ethiopian coffee ceremonies. “It is hard to be clean all the time when you touch grass all day, use community latrines and live with a big family that does not have the same hygiene practices as you,” she explains, adding that after her recovery from AWD, she has become more careful about practicing proper hygiene measures such as handwashing with soap.

“People in the community don’t always take the information seriously unless they are personally affected by it, but with repeated teaching, I believe many will listen,” says Sintayehu. “Is especially important to spread the message in communities like mine that use shared latrines.”

In addition to public outreach, UNICEF is also supporting the Government of Ethiopia’s efforts to contain and prevent the spread of AWD  by providing supplies for case treatment centres, technical support for case management and infection prevention, and water treatment supplies to safeguard drinking water for households and communities.

By Endale Engida

AYSSAITA, AFAR REGION, 24 November 2016 – Asiya’s marriage was meant to be a joyful occasion, but on her wedding night, this 18-year-old found only pain.

Like nearly all young girls in Ethiopia’s Afar Region, she had undergone Female Genital Mutilation/Cutting (FGM/C) at a very young age and trying to consummate the marriage with her husband brought only pain and bleeding.

In the Afar region, a particularly severe form of FGM/C known as Type III or infibulation is practiced whereby the vaginal opening is partially sewn shut, condemning generations of women to pain.

Asiya’s husband, Burhan Helen, was determined to help his wife and he asked around and discovered that the hospital in their woreda (district) had recently set up a gynaecological unit specialized in opening up women who had been subjected to infibulation.

FGM/C has long been outlawed in Ethiopia, but is still widespread in the country with an estimated 65 per cent of women between the ages of 15 and 49 (EDHS 2016) having been cut – down from 74 per cent in 2005 EDHA

However, those numbers mask regional variations. In regions like Afar and the Somali it can reach up to 90 per cent while other areas have a much lower prevalence due to different cultural norms in the diverse nation of Ethiopia.

In regions where it is practiced across eastern Africa and up into Egypt, it is believed FGM/C is necessary to ensure a woman stays a virgin before marriage, and many men say they would not marry a woman who hasn’t been cut.

In 2014, the Government of Ethiopia committed to ending the practice by 2025 and has been working on discouraging it through public information campaigns. Penalties for carrying it out range from three to ten years in prison.

For those like Asiya who have already undergone the procedure, the new gynaecological unit established in May 2016 at the Ayssaita Woreda hospital is a life saver.

Thanks to the funds from Foundation Espoir through the Luxembourg Committee for UNICEF, the hospital now employs Dr. Hatse Abreha, the only gynaecologist in the hospital.

The hospital, which serves a mostly pastoral population of 90,000, can now treat gynaecological and obstetric cases, including FGM/C reconstructions. By October 2016, the hospital was treating 200 FGM/C cases a month. In many cases, patients can be discharged the same day after the surgery.

Dr. Abreha diagnosed Asiya’s condition and also noted that in addition to pain during intercourse, she suffered discomfort and slow flow during menstruation. She and her husband were counselled about the procedure and then she received the deinfibulation surgery.

“I want to see these innocent girls and women no longer be victims of FGM/C, though these kind of interventions are only part of the solution and will not solve the root cause of the problem,” he said.

After a careful period of outpatient monitoring, Asiya was pronounced cured.

“We have special gratitude to Dr. Hatse Abreha for his friendly care and follow up,” she said during a follow up visit. “We are here to teach our community not to practice FGM/C on their girls and our own children will not be victims of FGM/C.”

Story – Bethlehem Kiros

Photos – Meklit Mersha 

SOUTHERN NATIONS, NATIONALITIES AND PEOPLE’S REGION (SNNPR), November 2016- Poverty and drought have left people in many parts of Ethiopia to grapple with food shortage; SNNPR is no different. Children are most affected, as evidenced by a high number of severe acute malnutrition (SAM) cases. Fortunately, the Government of Ethiopia implements the Community-Based Management of Acute Malnutrition (CMAM) programme, supported by UNICEF with generous contribution from ECHO. The programme enables children affected by malnutrition to receive life-saving services at stabilization centres (SC) and health posts, such as 32-year-old Bogalech Boreda’s twin infants.

Bogalech’s 10-month-old twins Kibru and Tegegn have been in the Outpatient Therapeutic Feeding Programme (OTP) for SAM more than once. Since Bogalech has three more children at home, she says feeding the twins has not been easy.

She gets help from her older children when they return from school, such as Caleb, 12, pictured here holding one of the twins.  Still, taking care of the infants occupies most of Bogalech’s day, making it impossible for her to work. Her husband is unemployed with an additional two children from another wife, his earnings from a small plot of farm land are not enough to provide for them.

The health extension workers (HEWs) of Morancho Kutela health post have arranged for Bogalech to receive targeted supplementary food multiple times since the twins were born. “I normally had enough milk to nurse my children in the past,” explains Bogalech, “but now, there are two of them and I also do not eat enough at home, so they have been suffering since they were born.”

Three weeks before the picture was taken, Tegegn suffered from diarrhoea and was referred to the Stabilization Centre (SC) at the kebele’s (sub-district) health centre. After a few days of antibiotics and therapeutic milk treatment, he was referred to the health post for OTP to continue his treatment as an outpatient. Since his brother’s situation was not much better, both were enrolled to receive the RUTF.

In the two weeks since the boys’ treatment began, Bogalech says she has seen progress on her babies’ health and appearance. “They love the [RUTF], they just cannot get enough of it. And the thought of having something to give them when they are hungry gives me such relief,” she adds. Since she is nursing them and providing additional food in her home, she hopes they will grow strong and healthy.

Their middle-upper arm circumference (MUAC) and weight is measured every week until they reach their target weight for discharge. Currently at 6.2 kg, Tegegn’s target weight for discharge is 6.9 kg, which is still about 2 kg underweight for an average 10-month-old boy according to World Health Organization guidelines. His MUAC was 10.9 cm when he was first enrolled for treatment and has now reached 11.25 cm.

Bogalech dreams of starting an avocado and corn flour business in the market to support herself and her children.

Malnutrition poses “silent threat” to children, agency’s 2017 appeal says 

NEW YORK/GENEVA/ADDIS ABABA, 31 January 2017 – 48 million children living through some of the world’s worst conflicts and other humanitarian emergencies will benefit from UNICEF’s 2017 appeal, which was launched today.

From Syria to Yemen and Iraq, from South Sudan to Nigeria, children are under direct attack, their homes, schools and communities in ruins, their hopes and futures hanging in the balance. In total, almost one in four of the world’s children live in a country affected by conflict or disaster.

“In country after country, war, natural disaster and climate change are driving ever more children from their homes, exposing them to violence, disease and exploitation,” said UNICEF Director of Emergency Programmes, Manuel Fontaine. 

UNICEF’s Humanitarian Action for Children sets out the agency’s 2017 appeal totaling $3.3 billion, and its goals in providing children with access to safe water, nutrition, education, health and protection in 48 countries across the globe. 

An estimated 7.5 million children will face severe acute malnutrition across the majority of appeal countries, including almost half a million each in northeast Nigeria and Yemen.

“Malnutrition is a silent threat to millions of children,” said Fontaine. “The damage it does can be irreversible, robbing children of their mental and physical potential. In its worst form, severe malnutrition can be deadly.”  

The largest single component of the appeal is for children and families caught up in the Syria conflict, soon to enter its seventh year. UNICEF is seeking a total of $1.4 billion to support Syrian children inside Syria and those living as refugees in neighbouring countries.

In total, working alongside its partners, UNICEF’s other priorities in 2017 are:

• Providing over 19 million people with access to safe water;
• Reaching 9.2 million children with formal or non-formal basic education;
• Immunizing 8.3 million children against measles;
• Providing psychosocial support to over two million children;
• Treating 3.1 million children with severe acute malnutrition.

In the first ten months of 2016, as a result of UNICEF’s support:

• 13.6 million people had access to safe water;
• 9.4 million children were vaccinated against measles;
• 6.4 million children accessed some form of education;
• 2.2 million children were treated for severe acute malnutrition.

UNICEF Ethiopia’s 2017 Humanitarian Appeal for Children (HAC) is for US$110.5 million, which includes US$17.3 million required to provide assistance to refugees.  Together with the Government of Ethiopia and humanitarian partners, UNICEF Ethiopia aims to reach 9.2 million children and their families with access to safe water and hygiene, nutrition, health and protection services and give hope for the future by providing education in emergencies.

“In 2017, UNICEF Ethiopia prioritizes humanitarian needs of those affected by the Horn of Africa drought while continuing to support development initiatives to ensure all children and their families have clean water, adequate sanitation as well as access to nutrition and health services. Additional priorities are to support education for children facing emergencies and to protect children against violence and abuse,” said Gillian Mellsop, UNICEF Representative to Ethiopia. “Our ability to respond adequately to the needs of millions of children contributes to future growth and stability in Ethiopia. Through linked humanitarian and development programming, the Government of Ethiopia, UNICEF and our partners’ investments helps build families’ and communities’ resilience against future emergencies.”

While the funding will be critical to UNICEF’s ability to respond to immediate needs, it will also be used to take appropriate action to strengthen preparedness, improve early warning systems and reduce vulnerability as well as contribute to more resilient communities. 

In 2016, UNICEF raised US$108.7 million to provide around 7 million children and their families with life-saving humanitarian assistance to mitigate the impact of the El Niño-induced drought. With severe water shortages, malnutrition and disease outbreaks, the anticipated humanitarian need in 2017 has reduced only slightly, from 9.7 to 9.2 million people.

Though an adequate 2016 ‘kiremt’ rainy season was recorded in many areas of the country, drought conditions and residual effects from the El Niño emergency continue to cause water shortages, malnutrition, disease outbreaks and related protection and education issues, including the closure of hundreds of schools in drought-affected areas.

A new drought expanding across the lowland areas in the Horn of Africa, induced by another weather phenomena, the Indian Ocean Dipole (IOD), is further exacerbating humanitarian needs in the south and south eastern regions of Afar and Somali, as well as parts of Oromia and SNNP. Neighbouring country Somalia is also severely affected, causing 1,325 refugees crossing into the Ethiopian Somali region in the first 17 days of January. Ethiopia is already one of the top refugee-hosting countries in Africa, with 783,401 refugees as of November 2016 hailing from South Sudan, Somalia, Eritrea and Sudan.

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.

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.

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.

By Ayuko Matsuhashi

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 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, 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.

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

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.

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.

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.   

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.” 

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.

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.

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’

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.