UNICEF SOUTH SUDAN COUNTRY OFFICE. Rapid Response Team Report

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1 Location (State/County/Payam/etc): Jonglei State, New Fangak County Date of the Mission: 28 th July to 8 th August 1 Name & Title of UNICEF Team Leader 2 Names & Titles (with org/depart/section) of other members of the team Nyauma Nyasani Nyauma Nyasani Nutrition, UNICEF Elena Velilla Health, UNICEF Innocent Mwofya Child protection, UNICEF Florence Okayo Education, UNICEF John Riek Education, CADA Anthony Milla Taban WASH, UNICEF David Lemiso Tolu Health & Nutrition, Nile Hope 3 Sites visited New Fangak New Fangak Child Friendly Space Phoum Girls Primary School Phoum Primary School New Fangak Civilian Hospital Nile Hope Compound County Commissioner s office WFP food registration Centre 5 boreholes sites Information and Data collected 4 General Information Provide the following general information about the mission site Number of registered people: 13,836 Number of households: 2,565 Total number of children under five (if available): 2,382 Total number of children under 18 years (if available): N/A Humanitarian situation and needs (IDPs, last time they received support, who is in control of the area etc.): New Fangak is controlled by the opposition. The area had not directly experienced fighting until in April when it was shelled from across the surrounding rivers. Because it has relatively been a peaceful area, New Fangak has become the natural destination for people fleeing from the fighting in Malakal, Bentiu, Bor among others. According to the RRC, New Fangak is now home to 46,000 IDPs. This figure however was difficulty for us to verify considering that only 15,000 came forward to register for food with our RRM partners WFP despite the registration period being extended. This figure included both host communities and IDPs. There are many school age going children and the security situation is calm but with a lot of military presence which provides risk of children involvement into military affairs. The war has grossly affected the people especially women and children, some women and children were killed in crossfire. Most of the basic services are lacking as a result of the war. The furniture and scholastic materials in the schools were destroyed. There is very little farming by host community and no 1

2 economic activities with exception of items like soap, salt, clothes and drugs being sold in makeshifts at very high prices. Most children in the area have not had access to basic education since the conflict started however, CADA started Child Friendly Spaces (CFS) in Phoum payam and four other schools were reopened. Children raised concern of missing going to school and are eagerly waiting for reopening of school in areas accessible. The area has also a number of child protection humanitarian needs such as missing/separated/unaccompanied children, inadequate child friendly spaces, lack of psycho social support among others. Currently 2 local NGOs (CADA and Nile Hope) are in the process of fully reestablishing their operations having left in December 2013 when fighting broke out in Jonglei State. 5 Name and contact of NGO partners in the field (existing, capacity, type of presence, ongoing programmes and services in place, staff capacity, logistics+storage capacity etc.) 7 Name and contact of authorities met, including in Health Centers, Schools etc. Provide name and contact details of the partners in the field (as described) Mr. Maet Yor Mot, Child Protection Officer-CADA Mr. Gai Gatkek, Child Protection Volunteer-CADA Mr. Bateah Gatluok, Child Protection Officer-Nile Hope Mr. John Riek Yior, Executive Director-Community Agri-business Development Agency (CADA). CADA had previously operated in New Fangak but pulled out in December 2013 when the fighting started and relocated to Old Fangak. However they are now in the process of fully reestablishing their operations since July They currently have a joint PCA with Education and Child Protection Sections focussing on CP and Education in Emergencies activities. So far they have 4 full time staff on the ground for Child Protection, Education, WASH and Livelihood, respectively. In addition they have 3 volunteers supporting Child Protection activities. In terms of their current CP programme, CADA is supporting Family Tracing and Re-unification (FTR) through the registration of unaccompanied, separated and missing children which they started in mid-july. Their compound is currently occupied by soldiers although they are discussing with the local authorities so that the soldiers can move out for CADA to re-occupy their place and start full operations. Apart from FTR, CADA is also running and supporting the only Child Friendly Space in New Fangak. Nile Hope, David Lemiso. In Fangak County, the organisation is implementing a nutritional programme and supporting 3 PHCU with PHCU kits. Nile Hope organised the mobile clinic during the WFP one day token distribution CMA, health sector leading agency in Fangak County. Staff is not permanently present in New Fangak Ujum, Education officer- Nile Hope Provide name and contact details of the authorities met (as described) John Matien Kuol Joc - County Commissioner Pajok - RRC Coordinator Health: Chuol Thomson Nuot - County Health Director Joseph Ruot Tot - Fangak County EPI supervisor ( josephruottot@gmail.com) Peter Gatliek Simon Fangak - County M&E and Surveillance Director, Dr. Gatkuot Mazir - Hospital Director. 2

3 Immediate Response Provided and Follow up Actions UNICEF SOUTH SUDAN COUNTRY OFFICE WASH: Besides the general meeting with the Commissioner and Relief and Rehabilitation Commission, there was no WASH technical personnel from the local authority and no WASH partners on the ground. Therefore the WASH team primarily had meetings with CADA and Nile Hope team mentioned above. Education: Mat Chuong Kor County Education Director Peter Gatluak New Fangak County Education supervisor William Wichar Nhial Head teacher Phom Mix Primary School Michael Gatkuoth Ngor Head teacher William Chuol Pr. School. Mat Nyal Bipal - Payam Education Supervisor Bayak Yor James Deputy Head teacher Phom Mix Primary School Child protection: Mr. John Riek Yior - Executive Director-CADA Mr. Maet Yor Mot - Child Protection Officer-CADA Mr. Gai Gatkek - Child Protection Volunteer-CADA Mr. Bateah Gatluok - Child Protection Officer-Nile Hope 8 Nutrition Situation Overview and Humanitarian needs: Immediate Response/Results: Provide a brief situation analysis and list down the critical humanitarian needs related to Nutrition In spite of the security situation being currently calm, building anxiety and anticipation of attacks have hindered the population from resuming their usual livelihood activities. This may, perhaps, go on for some time The current pre-harvest period making the population s susceptibility to food insecurity higher than in any other season of the year. Insecurity and limited access to/availability of food in the market compounds the situation It is the start of long rains, making movement in New Fangak and large parts of Jonglei difficult. The general population of New Fangak is a mixture of those displaced in other counties and the host community WFP registered 13,836 people out of whom 2,382 were identified and children under five years old. Summary of key interventions and results including challenges and how they were overcome 3,908 children identified as 6-59 months were screened for severe and moderate acute malnutrition. Treatment was initiated for all children identified with severe acute malnutrition. All children identified as MAM were provided with1 months treatment of Plumpy Supp through WFP GFD. Analysis of data collected revealed substantial discrepancy between number of children 6-59 months screened versus number of children under 5 years registered by WFP as well as a statistical disproportion between number of children identified as SAM and MAM. Consequently, these findings limit the validity of the data from the MUAC screening exercise. Additional assessment if required to verify findings from this rapid assessment. 3

4 More supplies, largely RUTF and anthropometric equipment were provided to Nile Hope in support of nutrition services. Lack of a stabilisation centre is a big challenge, Nile Hope offers medical care through mobile clinic and the hospital was supplied with health kit that has some basic drugs to address some complications. Follow up Actions required: 9 Health Situation Overview and Humanitarian needs: Provide data against the following indicators and mention the source of information in the end 3,908 # of children 6-59 months screened for malnutrition (MUAC) # of children 6-59 months with SAM # of children 6-59 months with MAM # of new SAM cases referred for treatment (OTP + SC) # of children 6-59 months in the affected areas who received the recommended dose of multi-micronutrient supplement # of pregnant and lactating women screened for malnutrition # of pregnant and lactating women referred for treatment # of pregnant and lactating women receiving multi micronutrient supplement (or iron and folic acid) # of pregnant and lactating women reached with key IYCF messages Source of information: Nile Hope, UNICEF What key actions are required and by whom? Operation of a Stabilisation Centre in New Fangak. Nile Hope can be supported to implement this (follow- up by UNICEF) Provision of Vitamin A and deworming tablet stock to Nile Hope( follow up by UNICEF and Nile Hope)Inclusion of TSFP targeting children with MAM and PALW (Follow-up b Nile Hope, WFP) Strengthening the IYCF component of Nutrition services to the population (Follow up by Nile Hope/UNICEF) UNICEF to ensure nutrition survey in the area to verify findings from MUAC screening. Provide a brief situation analysis and list down the critical humanitarian needs related to Health According to the Surveillance Director of Fangak County, acute respiratory infections, skin infections, malaria and diarrhoeal diseases are the top prevalent pathologies among children under 5 y in the County. There have not been measles cases reported in the last 3 months and the incidence of AWD cases remained stable. The last integrated measles, Polio, Vitamin A integrated campaign took place in November 2013 and Medair was in charge of the coordination. There is a secondary level County Hospital in New Fangak town where OPD, IPD, emergency surgery and lab services are provided. The Hospital staff includes: 1 MD, 4 CO and 9 nurses. The hospital pharmacy is well organised and supplies are inclusive of topic, oral and parenteral drugs (ORS, paracetamol, ibuprofen, amoxyciline, benzylpenicilline, ciprofloxacine, metronidazol, cloranphenicol, AS+AQ, aminophyline, prednisolone, furosemide, diazepam, pethidine, ketamine, atropine,..). Bupivacaine for raquiamesthesia is available but not used. There is a functional autoclave. IV fluids were unavailable and UNICEF made a donation of Ringer, norrnal saline and glucosed from the airlifted PHCC kit. Hospital medical supplies are usually coming from IMA. Nile Hope supplies PHCU kits for the rural peripheral health Units 4

5 Many private pharmacies in the town with a variety of oral and parenteral drugs and medical materials. The Hospital lab is able to carry out microscopy for stool and malaria BS. Rapid tests for pregnancy, siphyilis and hep B are available. There is an average of 50 OPD consultation/day. There are not routine immunisation services During the RRM mission, the MD performed 1 C-section and 1 surgical cleaning of a gunshot wound. The surgeries were performed under ketamine+atropine anesthesia. Pain management was done with pethidine. One newborn was successfully treated of neonatal sepsis with ceftriaxone. Cold chain equipment is available but not functional. The UNICEF cold chain expert visited them in November 2013 and a new visit is in the pipeline 2 hospital incinerators are in working conditions Solar and generator power is available. Immediate Response/Results: Follow up Actions required: 10 WASH Situation Overview and Humanitarian needs: Summary of key interventions and results including challenges and how they were overcome Training: measles and polio vaccination: epidemiology, cold chain, logistics, safe injection, tallying, waste management. 20 staff trained Measles and polio vaccination during distribution day by WFP (1 day) Mobile clinic consultations during token distribution day by WFP (1 day) PHCC donation for Nile Hope mobile clinics and New Fangak County Hospital pharmacy Provide data against the following indicators and mention the source of information in the end 2,190 # of children 6mo-15y vaccinated for measles 2,341 # of children 6mo-15y vaccinated for polio # of children 6-59 months receiving vitamin A supplement in the past 6 months # of children months receiving de-worming medication N/A # of pregnant women attending at least ANC 1 N/A # of pregnant women attending ANC counselled and tested Not airlifted # of households receiving 2 ITNs 123 # of adult consultation during token distribution day (Nile Hope) 22 # of <5 y consultations done *source of information: UNICFE and Nile Hope What key actions are required and by whom? UNICEF Cold chain expert visit Resume routine immunization Keep consistent and continuous medical supply to the Hospital Provide a brief situation analysis and list down the critical humanitarian needs related to WAHS New Fangank is an area located along the river Nile, more of an inland. The county authority do not have a WASH department and WASH interventions were previously implemented by NGO partners namely World Vision and Peacewind Japan. In New Fangank town there were 5 boreholes and all were functional although some had low yield which may be due to linkage or low yielding aquifer. Information from partner CADA indicated there were about broken boreholes out of the town in the neighbouring payams which needs repair or rehabilitation. 5

6 During the visit it was observed that majority of the population uses unsafe water directly from Nile, some people actually by passes the borehole and head to collect water from the Nile. From interactions with the some of these people by passing the boreholes, it was established that most people avoids the borehole water because they claim it was salty. During the water points assessment the team established that the water was safe to drink and there is need for more awareness about use of safe water and risk of drinking unsafe water from the Nile. Generally sanitation practices in the area is very poor with most households lacking sanitation facilities. Communities practices open defecation practices in open area around the settlement. Schools in the area were generally lacked sanitation facilities also. However, during the visit CADA, a national NGO, was supporting construction of temporary sanitation facilities in two schools. The county has no WASH department or partners on the ground. However, previous works on WASH were done by World Vision and Peacewinds Japan. Currently there are only two national NGOs, CADA and Nile Hope operating in the area with focus Nutrition, Education and Child Protection. There is generally need to address all the three WASH components in the area and develop local capacity for WASH activities implementation, with the greatest need being improved hygiene practices, water treatment, and improvement of sanitation situation. Immediate Response/Results: Summary of key interventions and results including challenges and how they were overcome The WASH immediate response initially had to focus on establishment of WASH (Hygiene Promoters) team, given the lack of WASH department or partner on ground to support the intervention. The WASH staff trained 14 hygiene promoters on hygiene promotion in emergency with focus on safe water access, treatment and handling, improved sanitation practices and better hygiene practices. The hygiene promoters were also trained on water treatment using PUR and how to create awareness during PUR demonstrations, explaining to communities the causes of water contamination and the risk associated with unsafe water including cholera. The trained hygiene promoters in turn worked for 2-3 days on various hygiene themes. During the headcount of the population WFP, the hygiene promoters team, distributed water buckets to mothers with malnourished children targeting 500 beneficiaries as the supplies were not enough reach a larger population. On the headcount day, the hygiene team issued out about 300 to the mothers with malnourished children. About the 120 buckets were issued at the OTP centre the following day and the remaining balance of 80 were left with NH, who were managing the OTP to issue to more beneficiaries Figure 1: Buckets Distribution expected to visit the centre. This enabled 420 households (mothers) to have water storage and/or collection facilities. Besides the distribution of buckets, the hygiene promoters also conducted demonstration on point of use water treatment using PUR on the day of the headcount as well as at water collection points along the river for three days. During the demonstration the hygiene promoters also raise awareness on 6

7 hygiene practices such as open defecation, safe water handling, cholera and handwashing with soap. The hygiene promoters distributed about 280 boxes of PUR (67,200 sachets) and 26 water filter rolls to about 5,600 people to improve access to safe water. About 200 boxes of PUR were left at custody of Nile Hope Nutrition team for further distribution to beneficiaries. It is also planned that the remaining PUR shall be used by the hygiene promoters through CADA once a PCA for WASH intervention is developed with the partner. To address the sanitation challenge in the short and medium term, UNICEF shall provide CADA with slabs and funds to rehabilitated water points in payams out of the town, promoter hygiene and sanitation practices in the county. Summary: 1. Improved access to safe drinking water through promotion of point of use water treatment to about 5,600 people both host community and IDPs. 2. Trained 14 hygiene promoters on three key WASH interventions namely, safe water, sanitation practices, handwashing with soap, cholera prevention and other hygiene practices. 3. Distributed WASH supplies (420 buckets, 280 boxes of PUR, and 26 rolls of water filters) to the population mainly targeting mothers with malnourished children. Figure 2: Water Treatment Demonstration Provide data against the following indicators and mention the source of information in the end 5,600 # of target population provided with access to water as per agreed standards ( litres of water per person per day) No sanitation intervention 5,600 people # of people reached with hygiene promotion messages 420 # of households received WASH supplies Please list supplies received: buckets boxes of water floc. (PUR) Rolls of Water filters sets of fast moving parts for hand pumps. # of target population provided access to appropriate sanitation facilities (as per Sphere Standards) Follow up Actions required source of information: UNICEF and CADA What key actions are required and by whom? Amend currently running CADA partnership to include WASH activities focusing on hygiene promotion, sanitation and water points rehabilitations. 7

8 11 Child Protection Situation Overview and Humanitarian needs: Immediate Response/Results: Provide a brief situation analysis and list down the critical humanitarian needs related to CP New Fangak is under the control of the opposition but has not directly experienced fighting apart from April. However since it has relatively been a peaceful place, it has become a safe destination for people fleeing from more direct fighting in Malakal, Bentiu, Bor among others. According to the RRC, New Fangak is now home to 46,000 IDPs. We could not verify this figure especially that only 15,000 (both IDPs and host communities) came forward to register for food with our RRM partners WFP despite the registration period being extended for a couple of days. Regardless of the actual figures, the coming of IDPs to an already resource constrained New Fangak has resulted in a number of child protection related humanitarian needs among them: i) Missing/separated/unaccompanied children especially among the IDPs ii) Inadequate and ill equipped child friendly spaces iii) Lack of psycho social support especially for IDP children who have witnessed so much conflict iv) Child Soldiers especially that schools have not reopened so children are vulnerable to recruitment Summary of key interventions and results including challenges and how they were overcome 1. During the RRM mission a tent provided by UNICEF was erected and is now serving as the new Child Friendly Space. Before that, CADA had improvised a CFS under a tree which was not conducive for the children especially given the heavy rains in that area. Apart from previously having the CFS under a tree, it had no recreation or learning materials. During the RRM UNICEF handed over 4 recreation kits and 5 ECD kits to CADA to be used by the CFS as well as other schools teachers and 10 Parents underwent a joint 2 day training on PSS and life skills. The training included Child Protection in Emergencies, Education and WASH and was conducted in conjunction with. For Child Protection, the UNICEF Child Protection Specialist did a presentation on Child Protection in Emergencies which included sessions on UASMC/FTR, Child soldiers, GBV/VAC, Mine Risk Education and PSS. The main objective was to equip the teachers with the basic knowledge on CPiE as they are critical partners in CP considering the amount of time they spend with children in schools. The challenge however is that almost all schools in New Fangak still remain closed. However the UNICEF Child Protection and Education team held discussions with the County Education Coordinator who assured us that the local authorities are doing everything possible to address the problem and ensure schools re-open as soon as possible. 3. A total of One Hundred and Fifty One (151) cases of unaccompanied, separated and missing children were registered for possible family tracing and reunification UNICEF also trained 2 CADA officers and 1 Nile Hope officer on registration of UASMC as part of the capacity building of the local partners. 8

9 12 : Follow up Actions required: Education Situation Overview and Humanitarian needs: Provide data against the following indicators and mention the source of information in the end 151 (Boys 99, # of UASC identified girls 52) 151 (Boys 99, # of UASC registered girls 52) 31 (19 boys and # of registered UASC receiving Family Tracing and Reunification services and familybased care or an appropriate alternative care services (cases that were registered by 12 girls) CADA in July before the RRM mission in New Fangak are currently going through 840 (449 boys and 391 girls) the FTR process) # of children benefitting from CFS activities (insert other indicator) (insert other indicator) source of information: CADA (NGO implementing partner) What key actions are required and by whom? Ensure all the 151 UASMC forms that were filled in by the UNICEF/Nile Hope/CADA team during the RRM mission are submitted to UNICEF and thereafter to Save Children to quickly begin the FTR process. FTR should not end at UASMC registration but rather at the actual re-unification of the family. Registration of separated/missing children in New Fangak should not end with the departure of the RRM mission team but rather should be a continuous process especially given the fact that UNICEF has a PCA with an implementing partner CADA who are operating in that place. With the training that both CADA and Nile Hope received on how to use the different forms this should not be a problem. (Action by CADA but UNICEF should monitor and ensure this is implemented since they have a PCA) Provide a brief situation analysis and list down the critical humanitarian needs related to Education Fangak county has eight Payams, five in old and three in New respectively, however, the mission covered only population of three Payams of New Fangak (Barbuoi, Phom and Manajang) prior to the conflict, there were fourteen primary schools of which 5 open air, six semi and 3 permanent structures functioning with population of 6,293(4407 boys & 1886girls). Three schools were occupied by both IDPs and armed forces. however, two (William Chuol by armed forces and Phoum Girls by IDPs) and Phoum Mix was first occupied by IDP then armed forces from March to May 2014 The presence of CADA an implementing patner to UNICEF through PCA have reopened four Primary schools (Tangang, Juaiboi, Koatnyakoang and Nyalual) prior to RRM mission with population of 1,325(556girls & 769boys and during RRM mission additional three primary schools (Phom Mix, Phom Girls and William Chuol Deng) were open with population of 737 (173 girl and 553 boys). Schools operational before the RRM mission: Payam Name of school Payam Population Total Boys Girls 1 Manajang Tangyang Manajang Manajang Juaibor Manajang

10 2 Barboui Koatnyang Barboui Barboui Nyalual Barboui Total ,325 Immediate Response/Results: Follow up Actions required PCAs: Summary of key interventions and results including challenges and how they were overcome Carried out back to school campaign through microphones and talking to parents and children aimed to mobilization community to send their children to schools. Held an advocacy meeting with the county education team to re-open schools and to share the kind of support they should expect from UNICEF as teachers trained on psychosocial support and emergency preparedness, scholastic materials and textbooks 738 (173 girls & 553boys) children both host & IDPs were registered from P1 8 and are attending classes with support of 30 (1female and 29 male) teachers. In collaboration with WASH and Child Protection an orientation training conducted to 30 male teachers and 15 parent teachers association (PTA) on concept of education in emergency and psychosocial support, hygiene and sanitation and protection of children issues. Two TLS established for 100 (45% girls) pupils at Phom girls Primary School and other for Phom Mix Primary. Provide data against the following indicators and mention the source of information in the end 738 # of students registered (pre-school, primary, etc)* # of pre-school children received supplies* 738 # of primary school children received supplies # of classrooms established/rehabilitated 2 # of TLCs established # of schools (in locations where schools are available) /Incl. Alternative Learning Centre source of information: UNICEF, CADA What key actions are required and by whom? UNICEF, CADA and NHDF any other partner that may have access to New Fangak to follow up on: Provision of additional teaching and learning materials including textbooks Training of teachers on psychosocial support Rehabilitation of schools destroyed during conflict There will be need for constructions of TLS for open air schools once they open Constructions of hygiene and sanitation facilities in the functional schools. Back to school campaign required for parents to allow children including girls to attend schools Establishment of ECD classes and orientation training to teachers on ECD Provision of more emergency supplies and text books Please note any expected changes to PCAs (new PCAs, amendments) 14 Summary of WFP response Registration of 13, 836 people was conducted with a view to distribute food to all Full report and details on interventions will be obtained later 10

11 Additional Information collected from the mission UNICEF SOUTH SUDAN COUNTRY OFFICE 15 Limitations of the mission 16 Recommendations (specific) Lack of WASH partners on ground to support response. WASH intervention limited to New Fangank town and not up to surrounding payams Follow up mission or partner to closely work with the local authority to implement education to the thousands of children affected by emergency. Amend CADA PCA to include WASH component covering the hygiene promotion, boreholes rehabilitation, and sanitation improvement. 17 Lessons Learned Need for continuous FTR registration especially given the fact that Child Protection has an existing PCA with CADA who are operating in New Fangak. Involvement of implementing partner in RRM is very important because it provides continuation of activity implementation after the team is out. 18 Suggested follow-up mission: date Given all the activities that UNICEF initiated during the RRM mission such as CFS, TLS there is need to have a monitoring mission to New Fangak after 3 months. Supplies distributed: Total # MT supplied by air: Item Quantity Consignee/Beneficiary Remarks RUTF 180 Nile Hope The current stock is sufficient for some months Buckets with lid 20lt. 500 Pcs Targeted beneficiaries 420 distributed during RRM and 80 balance to be distributed by Nile Hope. Water floc. & disinfectant (PUR) 500 boxes Targeted beneficiaries 280 boxes distributed, leaving balance of 220 boxes with Nile Hope Spare Parts for India Mark II 10 sets Targeted beneficiaries To be used later for Cloth, plain, cotton (Filter Cloth) rehabs/repair via CADA. 34 rolls Targeted beneficiaries 26 rolls utilised during RRM and balance to be issued by NH/CADA Tents 3 2 Schools 1 tent will be pitched in a school to be identified School in a box 7 CADA Recreation Kit 04 CADA Tarpaulin sheets 03 CADA ECD kit 04 CADA 11

12 Vaccines (pack) 16 Targeted beneficiaries Assorted medicine (Kit) 1 PHCC/MoH Vaccine carriers 08 PHCC *Remarks on the quality, package, visibility, and any other comment Distributed by: Acknowledged by Section Chiefs Supporting Documents (signed waybills) 12