Emerg Nutrition & Health Care, East Africa Crisis

The Food Crisis in Kenya

Since July 2011, Merlin’s emergency response in East Africa has saved lives, kept thousands (mostly children) from starvation & malnourishment, and supported & trained hundreds of local health workers. 

In Kenya, Merlin has up-scaled its activities quickly and effectively. See below:

Health Facilities - Before the food crisis Merlin supported 23 health facilities in the Turkana area.  Now, Merlin supports 30. 

Mobile clinics (outreach teams) - Before the food crisis Merlin supported 36 locations for mobile clinics.  Now, Merlin has 72 outreach sites, each location is visited twice a month by our teams.

Kenya - Fast Facts (up to end of Jan 2012):

• Focusing on communities living in very remote villages, Merlin screened 29,727 children under five for malnutrition.
• Of these, 257 were diagnosed with severe acute malnutrition, 246 were cured, and sadly, 13 children died.
• In general, the number of people that are severely malnourished in Turkana (an area in the northwest area of Kenya where Merlin focuses their work) has decreased from 30.8% to 13.9%. (Source: Dec 2011 Nutrition Survey from World Health Organization, in coordination with Merlin, UNICEF, IRC and World Vision).
• Merlin ran ante-natal classes for 5,431 women.
• Community health workers presented nearly 1,300 health education sessions to over 78,285 people, raising awareness on health and sanitation issues. 
• 10 health facilities had solar powered refrigerators installed, to keep vaccinations cool.
• This helped with the vaccination of 13, 468 people, this included 12,893 children under one year old and another 455 under five.
• 23 latrines were constructed in 23 health clinics, and 60 hand washing points were built in 30 health facilities.
• 125 local health staff were trained on preparing for emergency situations (such as the current food crisis, diseases outbreaks etc.) and how to respond effectively.

Summary

The significant drop in malnutrition rates was attributed to a number of factors:

-        A co-ordinated, efficient response by all those humanitarian agencies (including Merlin) who work in the affected region.

-        The General Food Distribution (GFD) program that offers families extra food was revived in July 2011.

-        The introduction of monthly food supplements to all children under five years old, pregnant women and new mothers.  This program was initially only for children under three.

-        Heavy rainfalls in late August – early September and again in late October - mid November.  Although this also hampered Merlin mobile teams from reaching those in the most remote sites for a short period.

The Disasters Emergency Committee (DEC) – a UK organization, who has given grants for Merlin’s food crisis emergency response, observed after a recent visit that Merlin was able to ‘rapidly and successfully scale up its operations and establish good links with other agencies working in the area’. 

The DEC also confirmed that Merlin should remain in a constant state of emergency preparedness, ready to respond to any sudden increase in malnutrition rates, while continuing to work to prevent additional malnutrition cases and offering care to those in need.

Merlin’s Promise

Merlin will continue to work in the Turkana area for as long as we are needed.  Our teams will offer health and nutritional care to the families and communities that need us most.  

If you are able to offer more support, via a second or recurring gift, we are very grateful and promise to use the donation wisely and effectively to save lives.  Thank you.

Links:

• Read about our work in Kenya

Highlighting the Food Crisis in Somalia

Over the last seven months Merlin’s emergency response in Somalia has seen successfully saving lives, kept families from being severe malnourished and seen a huge increase rise in support offered to local health workers. 

Health Facilities - Before the food crisis Merlin supported 15 health facilities.

Now, Merlin supports 27 (6 in South Central and 9 in Puntland) and we plan to increase our spread even further over the next few months.

Outreach sites (mobile clinics) - Before the food crisis Merlin supported 20 health facilities.

Now, Merlin supports 50 (40 in South Central and 10 in Puntland) with a plan to increase this number further in Quarter 1, 2012.

By the end of 2011:

• Focusing on communities living in very remote villages, 15,734 children under five and 6,145 pregnant women and new mothers were screened for malnutrition.

• Of the 15,734 children, 774 were diagnosed with severe, acute malnutrition.  These children were offered outpatient therapeutic feeding: when a child stays with their family and is fed a high calorie, peanut paste called ‘Plumpy Nut’ with added nutrients.  Only one child died.

• At remote health facilities Merlin staff support to local health workers to offer basic primary health care including vaccinations, nutrition and water and sanitation services, such as lessons on hygiene, sanitation supplies (Aquatabs, soap, chlorine and containers) and safe motherhood clinics.

• Over 155,660 patient consultations were offered, the top illnesses included respiratory infections, intestinal parasites and anemia.

• Community health workers completed 560 health education sessions to over 68,590 people, covering subjects such as, why vaccinating their children is important to protect them from illness and encouraging women to give birth at health facilities with trained maternity staff.

• 84 local health staff trained on managing acute malnutrition and nutrition services.

• 50 Community Health Workers trained (one male and one female health worker in 25 rural villages).

• Essential disease outbreak kits have been pre-positioned, for immediate response.

Summary

In Oct 2011, nutrition and mortality surveys indicated extremely high levels of global, acute malnutrition (GAM), rates were between 20 and 34.5%.  Severe, acute malnutrition (SAM) was between 6 and 11%, compared to the ‘normal’ levels of 15.9% (GAM) and 4.9% (SAM), for this time of year.  The number of children dying each month fell at the end of 2011.  However, levels are still high, with up to 8 children out of every 10,000 dying each day.   

On Nov 28, 2011 the Somali group which control  southern and central Somalia areas, banned 16 humanitarian agencies including: UNICEF, Concern Worldwide, World Health Organisation and several other UN agencies.  Most of these groups have been working in the region since the last famine in the 1990s.  Their dismissal has caused large gaps in aid coverage and access to the strong tribal systems that exist.  Merlin and other agencies that remain, are working hard to quickly establish and build relationships to continue an effective aid program.

Money transfers from Diaspora Somali groups have to date kept many Somali families from hunger and starvation.  The US Dept. Of Treasury estimates annual transfers from the US alone, is close to $100 million.

In 2012, the number of Somalis facing starvation - those who will die if not offered assistance - has fallen from 750,000 to 250,000.  This means that there are still a quarter of a million of men, women and children in dire need of help.

Merlin’s Promise

Merlin will continue to work in Somali for as long as we are permitted, offering health care and nutrition to some of the world’s most vulnerable people. 

If you are able to offer your continued support, via a second or recurring gift, we will use it effectively to save lives.

Thank you for your interest in our work.

Links:

• Read more about our work on the website
• How your donations help

Thank you for your support of Merlin's work in East Africa.  As you will read although numbers have dropped there is still a huge need.  If you can give another gift, Merlin teams and the families we care for would be very grateful.

Below is an Update on our work for the week commencing Jan 20, 2012

The revised Humanitarian Requirements Document (HRD) launched by UN’s OCHA ( Co-ordination of Humanitarian Affairs) on January 19, 2012 calls for an additional US$ 168.7 million in humanitarian funding to meet food and non-food needs in Ethiopia for some 3.2 million people between January and June 2012. According to the HRD, Ethiopia needs 403 tons of emergency food aid.

In the past the number of people in need of aid topped 4.5 million, the reduction of 1.3million is due to a coordinated effort by all the local, national and international humanitarian organizations.

Merlin in Ethiopia

• Unfortunately, food insecurity remains the same as at the end of 2011.  However, there is a slight improvement in water scarcity and pasture conditions in some districts.
• There is a great need to expand the supplementary feeding program throughout the region, so that every family is offered the corn-soya blend mix to add to their basic diet.
• Merlin plans to increase coverage of nutrition activities in the eight woredas (districts) which our teams work in.
• A delivery of 65 tons of corn-soya blend was dispatched to Gode on January 16.
• Activities to help teach local communities about how to eat and stay healthy continue.  These are led by Community Nutrition Volunteers (CNVs) with support from Merlin’s Health Nutrition Educators. 7,000 people were spoken to, the groups were a mix of 1 male to every 4 females.
• A delivery of 63 tons was dispatched to Ginnir on January 16, another 63 tons will be delivered in mid February.

Merlin in Kenya

• 32 outreach clinics were conducted from 11 health facilities. Activities included immunization, screening for malnutrition, admissions to the intensive feeding program and curative care.
• 15 Health and Nutrition Education sessions took place.  They focused on hygiene, the correct medicines to use and the importance of seeking early medical attention.
• On-the-job training and mentoring sessions were given to local health facility staff.
• Water and sanitation materials (hand washing points, waste bins, water filters and soap) were distributed to dispensaries.
• Outreach teams held ‘safe motherhood’ clinics in 7 different locations.
• 17 health education sessions were conducted to pregnant woman living in the Turkana area, with topics including; breastfeeding; child positioning and attachment, the importance of antenatal care, delivering in safe, clean places, ie. health facilities rather than at home, immunization and child growth monitoring.

Links:

• Humanitarian Requirements Document, Ethiopia
• Meet Faith, who work for Merlin in Turkana

November 2011 Activities

November brought very heavy rains to the regions that Merlin work in, and some health facilities and remote villages were difficult or impossible to access.  In some areas the rain meant there were less water shortages and pasture began to regenerate.

Bale region

• Nutrition activities were carried out in all 8 woredas  (districts) of Bale, covering 116 kebeles (villages).
• Merlin staff helped with a second round of polio immunisation.
• 4082 children between 0 and 5 years were checked to see if they were suffering from malnutrition.  Unfortunately, 142 children were found to be severely malnourished.
• Thankfully, 196 children who had previously been diagnosed as severely malnourished were given the ‘all clear’.
• Over 5100 men and women were given health education, when they came to Merlin’s mobile health clinics to collect food and medicines.  They were offered information on how to prevent and protect against acute watery diarrhoea (AWD).  AWD can easily lead to cholera, a disease which spreads rapidly and can be fatal within a few hours of being caught, especially if the child or adult’s immune system is weakened from lack of nutrition.
• Public bathroom facilities were built: 8 pit latrines, each with 4 seats and 1 trench latrine with 14 seats. 10 local cleaners were enrolled to make sure the bathrooms will be kept clean. Soap, hand bowls and washing facilities were also provided.

Borena Region

• Nutrition activities were carried out in 5 woredas, covering 73 health facilities.
• 715 children were checked for malnutrition, of which 69 were suffering from severe malnutrition and put into the therapeutic feeding program.  On average children stay in this program for 25 – 30 days.
• 65 children were allowed to leave the therapeutic feeding centre, having gained a sufficient amount of weight.
• More than 6140 people attended health education sessions.  Topics covered included; the importance of breast feeding, the need to give babies additional food from 6 months with continued breast feeding up to 2 yrs and beyond, the importance of continued feeding when a child is sick and what is nutritional food.

Gode Region

• 6 health teams covered 5 woredas and Merlin staff also supported six static clinics.
• Nearly 6200 people were seen by Merlin’s health teams.
• 1189 children were screened for malnutrition, of which 132 were admitted into the therapeutic feeding program.
• Another 39 children were allowed back to their families, fully recovered after being part of the program in previous weeks.
• Merlin staff supported the continuing polio campaign.  65 children were vaccinated.
• Over 7000 people attended health education sessions.
• The feeding program continues to expand to other areas of Gode region, including support to an additional 7 static health clinics.

A more general update will follow in a few weeks.  Thank you again for your support of our work.

Links:

• Find out more about our work in Ethiopia

The Holiday Season is upon us and I am sure you are thinking of what to give others, as well as what you may soon receive.  You generously supported Merlin's emergency response program in East Africa and below is an update on our work, to keep you informed.

Unfortunately, we continue to ask for support - with over four million in need of assistance in Somalia alone, there is still, so much that needs to be done.  If you are able to offer us an additional or recurring gift, please consider doing so.  Your gift will make a difference; it will give hope and help to save lives.  

Update on the general situation in East Africa

• The rainy season began in October.  However, floods were reported in southern parts of Somalia and south eastern Ethiopia, which has resulted in cases of water-borne diseases such as Acute Watery Diarrhoea (AWD), cholera, malaria, dengue fever, and pneumonia.  The World Health Organisation has also reported cases of measles.
• Weather forecasts predict a below average rainfall in most parts of Somalia, (especially in northern areas), until December.
• The security situation in the region has deteriorated significantly, particular in Kenya and Somalia. As a result of an increased number of kidnappings of international personnel, the Kenyan Government has responded by sending several hundred soldiers into Somalia’s border lands. This action has meant many Somalian familes have moved on again, after already being  displaced because of the drought.
• According to UNHCR – the UN refugee Agency - the number of Somalis crossing into Kenya has decreased.  However, the number of Somali arrivals in the Ethiopian refugee camps has significantly increased, with nearly 5,000 people crossing in the first half of October, brining the average daily arrival rate to 414, more than twice that of September.

Update on Merlin's work in October

Somalia

• Offering over 585 000 people health care.
• Expanded health and nutrition activities in Borama district.
• Staff given additional and refresher training in managing childhood illnesses in an integrated way.
• Merlin was awarded World Food Program funding and is now operating supplementary feeding programs in Somaliland, alongside the primary health services. 
• HIV/AIDS prevention and treatment services are now part of health care services in Puntland clinics.

Kenya

• Giving health care to 485,000 men, women and children in the Turkana region.
• Merlin continues to support 29 health facilities offering care to children with acute malnutrition.
• Outreach activities using mobile clinics took place in over 100 locations.
• Nearly 240 health education sessions were conducted to over 37,500 people.
• Drug kits were distributed to health facilities.

Ethiopia

• More than 635,000 people have direct access to health and nutritional care.
• Merlin is now working in Gode zone, after identifying five locations for outreach clinics.
• Mobile health and nutrition teams have been scaled up.  There are now five sites in West Gode, five in Gode, ten in Adadle and five in Kelafo.
• Staff launched an emergency response in Godere providing health and nutrition to approximately 2,000 extended families (around 80% of which were Somali refugees).
• Total number of those benefitting from direct services in October – 67,399.

From everyone at Merlin, thank you for your support and interest in our work.