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Cablegate: Usg Humanitarian Assistance Team: Field Visit #2 -Water,

VZCZCXYZ0001
OO RUEHWEB

DE RUEHDS #0120/01 0160545
ZNR UUUUU ZZH
O 160545Z JAN 08
FM AMEMBASSY ADDIS ABABA
TO RUEHC/SECSTATE WASHDC IMMEDIATE 9176
INFO RUEHAE/AMEMBASSY ASMARA 2068
RUEHDJ/AMEMBASSY DJIBOUTI 8860
RUEHNR/AMEMBASSY NAIROBI 3319
RUEHBS/AMEMBASSY BRUSSELS 3043
RUEHGV/USMISSION GENEVA 4120
RUEHLO/AMEMBASSY LONDON 2977
RUEHRO/AMEMBASSY ROME 6334
RUCNDT/USMISSION USUN NEW YORK 7179
RUEHC/DEPT OF INTERIOR WASHDC
RUEHRC/DEPT OF AGRICULTURE WASHDC
RHMFIUU/HQ USCENTCOM MACDILL AFB FL//CCJ2/CCJ5/CCJS//
RHEFDIA/DIA WASHDC
RHMFISS/CJTF HOA
RHEHNSC/NSC WASHDC

UNCLAS ADDIS ABABA 000120

SIPDIS

STATE DEPARTMENT FOR A/S FRAZER, DAS AF JSWAN, AF/E, AF/PDPA, OES,
A/S PRM SAUERBREY, AND PRM/AFR
AFR/AA KALMQUIST, WWARREN, JBORNS, KNELSON, CTHOMPSON
DCHA/AA MHESS, GGOTTLIEB
DCHA/OFDA KLUU, ACONVERY, CCHAN, PMORRIS, KCHANNELL
DCHA/FFP JDWORKEN, PMOHAN, SANTHONY, PBERTOLIN
LONDON, PARIS, ROME FOR AFRICA WATCHER
CJTF-HOA AND USCENTCOM FOR POLAD
USDA/FAS FOR U/S PENN, RTILSWORTH, AND LPANASUK
NAIROBI FOR OFDA/ECARO JMYER, GPLATT, RFFPO NCOX, USAID/EA
ROME FOR AMBASSADOR, OHA, HSPANOS
BRUSSELS FOR USEU PBROWN
GENEVA FOR NKYLOH, RMA
USUN FOR TMALY
NSC FOR PMARCHAN

AIDAC
SIPDIS

E.O. 12958: N/A
TAGS: EAID PHUM SENV EAGR PGOV ET
REF: A) ADDIS 3644 B) ADDIS 0064
SUBJECT: USG HUMANITARIAN ASSISTANCE TEAM: FIELD VISIT #2 -WATER,
HEALTH, AND NUTRITION UPDATE

-------
Summary
-------

1. Between January 2 and 9, U.S. Government (USG) Humanitarian
Assistance Team (HAT) in Ethiopia staff, traveled to Degehabur and
Fik zones in Somali Region as part of a second field visit to assess
the current humanitarian situation, including health, nutrition, and
water and sanitation conditions. USG HAT found that shallow wells
and traditional water harvesting points in areas visited in
Degehabur and Fik zones continue to provide sufficient quantities of
water for pastoralists and livestock. However, the poor performance
of the 2007 gu and deyr rains in parts of Somali Region have failed
to fully recharge traditional water points. USGHAT staff note that
current reserves are likely to be depleted over the next two months,
raising water availability concerns during the gap before the start
of the next rains in April. USG HAT staff verified that several
health posts in the area had recently reopened, but noted a lack of
capacity to provide primary health care services to local
populations. While USG HAT staff did not observe any indicators of
widespread malnutrition in areas assessed in Fik and Degehabur
zones, UNICEF reports chronically high levels of acute malnutrition
in Somali Region that exceed U.N. World Health Organization (WHO)
emergency thresholds. According to non-governmental organizations
(NGOs) operating in Fik District, Fik Zone, current levels of severe
acute malnutrition are consistent with historical levels and the
majority of cases are a result of pathological causes. End summary.


----------
Background
----------

2. Between January 2 and 9, USG HAT staff traveled to Degehabur and
Fik zones of Somali Region as part of a second field visit to assess
the current humanitarian situation, including health, nutrition, and
water and sanitation conditions. USG HAT staff included the team
leader, Food for Peace officer, safety and security officer, and a
USAID/Ethiopia Assets and Livelihoods Transition representative.
Accompanied by U.N. and NGO staff operating in Degehabur and Fik
zones, USG HAT staff conducted numerous site visits, including
interviews with local residents and military and government
officials. Cyclical droughts, underdevelopment, and limited
government capacity, exacerbated by an ongoing insurgency, have
resulted in chronic population vulnerabilities in Somali Region.

-----------------
Water and Hygiene
-----------------

3. Access to water in pastoral areas of Degehabur and Fik zones is
highly dependent on the quality and distribution of seasonal rains.
The majority of pastoralists and their livestock rely on rivers or
other natural water points during the wet seasons, and water
harvesting structures, such as man-made ponds, concrete-lined
reservoirs referred to as berkas, and shallow wells during the dry
season. USAID's Office of U.S. Foreign Disaster Assistance
(USAID/OFDA) recently awarded the International Rescue Committee and
Save the Children/U.K. (SC/UK) USD 1.7 million for emergency water

activities in Degehabur and Fik Zones and USD 1 million to UNICEF
for regional emergency mobile health, nutrition, water, sanitation,
and hygiene teams.

4. USG HAT staff report that shallow wells continue to be
productive in several areas visited. In addition, USG HAT staff
note that the majority of water points visited are protected,
including covered shallow wells and fenced reservoirs to prevent
animals from contaminating water sources. Pastoralists currently
draw water from hand-dug wells in dry river beds for animals. USG
HAT staff did not observe evidence of cross contamination of water
sources through the use of water points by both humans and
livestock. Berkas are a common method of water harvesting in Fik
and Degehabur zones. USG HAT staff note that berkas in several
areas visited, continue to hold water, which residents estimate to
be sufficient for the two months.

5. USG HAT staff collected information on water usage practices in
areas visited. Pastoralists do not treat water for household use to
improve quality. Residents interviewed in Hamero town, Hamero
District, reported drawing an average of 40 liters per day for
household use for an average family size of six people. USG HAT
staff noted that water containers were plentiful and no storage
issues were reported. Wait times to draw water from hand pumps did
not appear excessive and lines of recipients during morning hours
averaged six to eight people. USG HAT reported that most of the
hand pumps visited in the region were installed through previous
USAID programs and in all areas, except one, pumps were being
serviced and repaired.

6. USG HAT staff spoke with several pastoralists who reported
traveling extended distances with camels and donkeys to access
water. In Gunagado town, Aware District, in Degehabur Zone, several
pastoralists reported that some of the remote natural water points
had dried up earlier than normal as a result of the poor performance
of deyr rains. In three locations in Fik Zone, pastoralists
reported that turbidity and salinity of water from ponds and berkas
had increased in recent weeks. According to the November 24 to
December 14 DPPA Deyr/Karan Needs Assessment an estimated 400,000
people in Somali region are projected to require water tankering to
meet basic needs as the January to March jilal dry season continues.
However, USG HAT staff did not observe evidence of water tankering
in areas visited.

7. Hygiene issues were particularly acute in Kasangas village,
Hamero District, in southern Fik Zone. Several children displayed
obvious signs of skin disease, including conjunctivitis. In
addition, USG HAT staff report an absence of sanitation facilities
in the area. In general latrines were only found in trading centers
and only a limited number of people interviewed in rural areas
reported using soap. USG HAT staff reported that the primary cause
of morbidity in areas assessed was diarrhea, which Medecines Sans
Frontieres (MSF)/Switzerland attributed to poor water quality
aggravated by the onset of the jilal dry season.

------
Health
------

8. Despite USG HAT confirmation of the recent reopening of several
health posts in areas visited in Degehabur and Fik zones, USG HAT
staff report that limited capacity and medical supplies continue to
undermine the delivery of primary health care services. Health
posts visited were commonly staffed by one health care provider,
possessed few basic medicines, and offered no referral system. In
all health facilities visited, USG HAT noted the absence of
in-patient facilities and laboratory equipment to confirm
communicable disease, as well as an absence of emergency response
capacity to treat trauma or the capacity to treat malnutrition
cases. USG HAT staff reported an absence of vaccines and
immunization planning and observed inoperable cold chain equipment
in two clinics. Health professionals interviewed commonly reported
major causes of morbidity as diarrhea, upper respiratory infections,
and malaria. Health staff did not report any epidemics in the areas
visited to date.

9. In addition, USG HAT staff report that pervasive military
presence is undermining local access to health care services in
Degehabur and Fik zones. In Hamero town, the clinic was co-located
next to the military barracks. According to the clinic nurse,
people were intimidated from seeking health care assistance due to
the military presence. USG HAT did not observe any residents
seeking health assistance during the visit. However, the nurse
reported limited outreach activities in surrounding areas to expand
health coverage. The military's co-location and/or proximity to
health clinics and schools was common in all areas visited. In
Kasangas village, Hamero District, the clinic was locked and
residents reported only sporadic visits from government health care
providers.

---------
Nutrition
---------

10. Somali Region experiences chronically high levels of acute
malnutrition, with global acute malnutrition (GAM) rates that
consistently exceed the U.N. World Health Organization (WHO)
emergency threshold of 15 percent by 5 percent or more. In recent
years, the provision of emergency food assistance has become a key
coping strategy for vulnerable populations to maintain nutritional
levels, particularly during the jilal dry season.

11. The October SC/UK nutrition survey in Fik and Hamero districts,
Fik Zone, reported GAM rates of 20.8 percent. MSF/Switzerland
recently started operations in Fik zone in December 2007. According
to MSF/Switzerland, severe acute malnutrition cases appear to follow
historical trends for the area. MSF/Switzerland reports that the
majority of cases treated have resulted from secondary causes, such
as malaria or diarrhea. MSF cautioned that there is no capacity in
Fik Zone to treat malnutrition and that caseloads could increase as
the dry season progresses.

-----------
Conclusions
-----------

12. As of January 9, USG HAT staff report that water access,
quality, and storage capacity in areas visited during the second

field assessment to Degehabur and Fik zones appear adequate for
populations and livestock. However, due to the poor performance of
the gu and deyr rains in parts of Somali region and the onset of the
dry season, water availability is expected to become an increasing
concern in the coming months.

13. USG HAT staff report that health clinics have recently reopened
in several areas assessed. To date, these health facilities have
not reported any epidemics or morbidity above historical normal
levels. However, local infrastructure capacity to provide
vaccinations and health surveillance or respond to epidemics and
cases of malnutrition is extremely low and cannot be counted upon
should humanitarian conditions decline.

14. The combined effects of the jilal dry season and poorly
distributed food assistance on food security, as well as the lack of
local capacity to treat malnutrition, will continue to negatively
impact local food security and nutrition levels in the region.


YAMAMOTO

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