CAR HUMANITARIAN SITUATION REPORT SEPTEMBER 2016

REPORTING PERIOD: 1 SEPTEMBER-30 SEPTEMBER 2016

Central African

Republic

Humanitarian Situation Report

Highlights Clashes between armed elements took place in Ndomete, located 10

km south of Kaga Bandoro, in Nana Grebizi prefecture, on 16

September. The insecurity led to a substantial halt in health services

for a week and exacerbated already existing inter-community

tensions. In addition, clashes in Kouango in Basse Kotto prefecture

have led to the displacement of at least 2,000 people, and fighting

between armed groups caused the displacement of at least 1,500

people in Koui sub-prefecture.

Over 838,000 people remain displaced or have been newly displaced

by the ongoing crisis in CAR. An estimated 384,884 people are

internally displaced, with 453,271 people across borders in

neighboring countries. 15,920 Central Africans who had fled across

borders have returned from neighbouring countries, largely from DRC

to the south, since the beginning of the year.

Since the beginning of the cholera outbreak in early August 2016, 266

cases (139 children under 15 years) and 21 deaths (including 9 children)

have been reported, with a case fatality rate of 7.8%. UNICEF

supported five WASH interventions for cholera, reaching 6,711

individuals in Mbomou, Basse Kotto, Ouham, and Haut Mbomou.

1.2 million CHILDREN AFFECTED (OCHA 2016)

2.3 million PEOPLE AFFECTED (OCHA 2016)

384,884

INTERNALLY DISPLACED PERSONS (CMP SEPTEMBER 2016)

453,271

REFUGEES IN NEIGHBOURING COUNTRIES (CHAD, CAMEROON, DRC, CONGO) (UNHCR SEPTEMBER 2016)

UNICEF APPEAL 2016

US$ 55.7 million

FUNDING GAP

US$ 25.2 million 55% of funds received against 2016 needs

$25,199,847 Funding Gap

45%

$10,312,056 Carry-forward

$20,183,097 Funds

Received

Key Programme Indicators

UNICEF

Sector/Cluster

UNICEF Target

Cumulative results (#)

Cluster Target

Cumulative results (#)

Number of affected people provided with access to improved sources of water as per agreed standards

400,000 348,310 700,000 708,016

Number of displaced children aged 3-17 with access to education in temporary learning spaces

60,000 30,481 70,000 30,781

Number of children under 5, including those in IDP sites and enclaves with access to essential health services and medicines

500,000 163,933 n/a

Number of children aged 6-59 months with SAM admitted for therapeutic care

29,250 18,208 29,250 18,208

Number of children released from armed forces and groups

3,000 2,607 5,660 2,643

Number of pregnant women living with HIV who received ARVs for PMTCT

4,060 2,100 n/a

SITUATION IN NUMBERS

©UNICEF/CAR/2016/LeDu

UNICEF’s Response with partners

©UNICEF/2016/LeDu

CAR HUMANITARIAN SITUATION REPORT SEPTEMBER 2016

Situation Overview & Humanitarian Needs Clashes between Anti-Balaka and Ex-Seleka elements took place in Ndomete, located 10 km south of Kaga Bandoro, in Nana Grebizi prefecture, on 16 September. The insecurity led to a substantial halt in health services for a week and exacerbated already existing inter-community tensions. MINUSCA decided to temporarily relocate UN and INGO staff members to MINUSCA and UN compounds. An inter-agency and RRM mission evaluated the humanitarian situation in Ndomete for some 5-6,000 people that fled into the bush to find refuge and provided first assistance. Attacks by armed groups near Kouango, a town along the Ubangi River on the border with DRC in Basse Kotto prefecture, led to the displacement of at least 2,000 people, according to initial estimates. In addition, clashes between Anti-Balaka and Ex-Seleka armed groups for the control of transhumance corridors in the north-western prefecture of Ouham Pende caused the displacement of at least 1,500 people from neighbouring Koui sub-prefecture. A reported 384,884 people are internally displaced (IDPs) in CAR, an estimated 61% of whom are living with host families and communities. There are currently 90 remaining IDP sites across the country, with 25 in Bangui and 65 located outside of the capitol (Commission Mouvements de Populations (CMP), September 2016). In addition to the internally displaced, a remaining 453,271 Central African refugees remain across borders in neighbouring countries (UNHCR September 2016). An estimated 15,920 Central Africans who had fled across borders have returned from neighbouring countries, largely from DRC to the south, since the beginning of the year. Since the beginning of the cholera outbreak in early August 2016, 266 cases, including 139 children under 15 years of age, and 21 deaths (including 9 children) have been reported, with a fatality rate of 7.8%. No further cases have been reported since 14 September.

Humanitarian leadership and coordination UNICEF actively participated in all coordination activities for the response to the cholera outbreak in Bangui together with Ministry of Health, Ministry of Social Affairs and humanitarian actors. UNICEF-led clusters were currently strongly focused on the Humanitarian Needs Overview (HNO) exercise to define the most pressing humanitarian needs in 2017, to estimate the number of people who will need assistance, and to provide a consolidated factual basis for the finalisation of the 2017 Humanitarian Response Plan (HRP) for CAR. The M’Poko IDP programme, designed by the CAR government to relocate some 28,000 people still living at the airport site, is progressing with the finalisation of the IDP profiling activity. UNICEF worked with HCT members to provide technical support to this state initiative and regularly participated in the Communication and Basic Social Services commissions’ activities.

Humanitarian Strategy UNICEF implements a strategy of mobile teams to expand response in areas affected by humanitarian crisis with an inadequate presence of actors under the principle of equity. To provide durable solutions for IDPs, UNICEF is developing a strategy to respond to return movements, coordinated by the Emergency Task Force and Programme Coordination Meeting (PCM). In addition, the Rapid Response Mechanism (RRM) provides assistance to acutely vulnerable populations affected by a sudden population displacement. Participating actors undertake rapid, multi-sector needs assessments to provide

Estimated Affected Population (Estimates calculated based on initial figures from OCHA, May 2016)

Start of humanitarian response: January 2014

Total Male Female

Total Affected Population

2.3 million 1.1 million 1.2 million

Children Affected (Under 18)

1.2 million 630,000 614,000

Children Under Five

370,520 185,330 185,190

Children 6 to 23 months

184,000 93,000 91,000

Pregnant women

87,000

CAR HUMANITARIAN SITUATION REPORT SEPTEMBER 2016

quality information to the humanitarian community while also delivering immediate assistance in non-food items (NFI), and water, sanitation and hygiene (WASH) to provide basic means of survival for vulnerable populations.

Summary Analysis of Programme response

Nutrition A total of 18,208 children (62% of the annual target) were admitted for treatment of Severe Acute Malnutrition (SAM), including children from host populations and IDP sites. The performance indicators for the treatment of SAM remain exceed minimum SPHERE standards, with an 87.88% cure rate (>75%), a 2.06% death rate (<5%) and a 10.06% defaulter's rate (<15%). The ongoing process of national capacity building on the integrated management of acute malnutrition (IMAM) has reached 84% of the targeted health staff (1,043 out of 1,235 staff). A qualitative survey investigating infant and young child feeding (IYCF) practices in CAR is upcoming, and the 20 sites to be covered by the exercise have been identified.

Education

Out of a total of 30,481 children enrolled in the UNICEF-supported temporary learning spaces (TLS), 27,186 took official exams and 22,589 students, including 10,722 girls, were admitted for an overall pass rate of 89%. During the summer holidays, catch-up classes were implemented on core subjects to prepare children for the upcoming school year. In addition, an assessment has been undertaken in order to inform UNICEF’s strategy for temporary learning spaces (TLS) for the upcoming school year. In certain areas, continued insecurity, displacement and lack of educational services require the continuation of TLS activities, whereas stability in others will enable children to reintegrate into public schools. At least 10 schools occupied by armed groups have been attacked or have barriers within close proximity, preventing children from returning to school and constituting a risk for schools to become possible military targets. UNICEF continues to work with relevant stakeholders to advocate for the liberation and protection of these schools. This resulted in MINUSCA issuing a communique warning the armed groups and informing on the next steps, including using force to kick them out of the occupied schools. A national-level Back to School campaign was conducted to support 662,317 children to return to school on 19 September. Various activities took place throughout the country, including a “Back to School” run in Bangui, as well as an official opening ceremony led by the Prime Minister and government members. In parallel, UNICEF provided support for the preparation of schools, minor rehabilitation, distribution of school kits, as well as hygiene kits in cholera-affected areas, in order to ensure a safe return to school.

Health and HIV/AIDS In September, 13,544 children under five, including those in IDP sites and enclaves, received essential health services and medicines with UNICEF support. In addition, 15 health workers from Mbaïki, Boda, and Bossembélé, Bégoua districts and the Bangui Paediatric Hospital were trained on the Kangaroo Mother Care technique. In the continued response to the Lake Chad Region polio epidemic after the detection of new cases of wild polio virus (WPV) in Nigeria, UNICEF (C4D section) worked with WHO to support government partners. Two health regions with low coverage rates have been identified for a vaccination campaign with a target of 332,607 children under 5 to be vaccinated. Partial data show a rate of 52% immunization coverage and a 57% completeness coverage rate. 35 central technical supervisors have been mobilized, trained, and deployed. 422 teams of vaccinators and mobilizers have been recruited, trained and deployed in the sub-prefectures. Vaccines have been made available for 380,000 children, and data collection is ongoing in the field. To strengthen the immunization cold chain, 119 solar refrigerators were deployed in the districts and sub-prefectures to strengthen the cold chain and increase the number of health facilities offering immunization services. UNICEF supported the Ministry of Health to train of 25 district technicians for installation and maintenance of the cold chain equipment. 22 installation kits were purchased and distributed to technicians trained in different districts. 2,100 HIV positive pregnant women received anti-retroviral therapy (ART) for the prevention of mother-to-child transmission (PMTCT) of HIV, and 1,294 children born to HIV positive mothers were put on ARVs. 10,015 people,

CAR HUMANITARIAN SITUATION REPORT SEPTEMBER 2016

including 408 pregnant women, were screened for HIV during a mass campaign in six regions. 32 health workers were trained on the prevention of mother-to-child transmission (PMTCT) of HIV in Brian, Haute-Kotto prefecture.

WASH With support from UNICEF, ANEA constructed nine new boreholes and repaired 70 boreholes in Bangui, Batangafo and Berbérati, reaching 20,173 new persons with access to safe water. As part of the ongoing response, aquatabs were provided to ANEA by UNICEF to disinfect 16,818 liters of water stored in 426 households in neighborhoods along the Ouham River. In addition, UNICEF partner TGH constructed 8 garbage pits and rehabilitated 76 latrines and 89 showers on IDP sites in Bambari and Ngakobo, providing continued access to sanitation for 77,504 people. ANEA conducted awareness campaigns on good hygiene practices in different zonal offices in eight prefectures, reaching 31,174 persons. In Kaga Bandoro, ANEA trained 75 parents from 20 schools in localities of Kaga Bandoro on the importance of sanitation and hygiene at home and in school. The health centers in Foh and Abba were provided basic family kits for the collection and conservation of drinking water for about 30 newborns. In continued response to the cholera crisis in Bangui, UNICEF supported IDC, OIM and ACF and the government to distribute WASH kits (Aquatab, soap, bucket, Purs, chlorine for disinfection, sprayers) to 558 households, or around 3,069 people. Water points were chlorinated and 5 manual boreholes were constructed in areas with little access to water.

Child Protection More than 280 children associated with armed groups affiliated to the Anti-Balaka were identified on the Kaga-Bandoro-Mbres axis in Nana Gribizi prefecture. A mission to demobilize these children was planned for 15 September but had to be postponed as a result of the deteriorating security situation in the region. Two women and nine men were trained on the verification of children associated with armed groups. An inter-agency mission including MINUSCA Child protection and national NGOs will visit the prefecture of Vakaga from 27 September to 11 October to start the verification of approximately 6,000 children allegedly associated with armed groups. In line with the annual MRM programme aimed at addressing countrywide MRM challenges, a one-day MRM training to strengthen the capacity of the Child Protection sub-cluster staff as well as the members of the RECOPE (Child Protection Community Network) took place in Bouar (Nana Mambere prefecture) by the regional MRM task forces (GTL/MRM) on 7 September. 24 men and 6 women participated in this training session. Since the beginning of the year, the total number of people who received MRM trainings is 254, including 36 women and 217 men who have been trained in Bossangoa (Ouham prefecture), Berberati (Mambere Kadei prefecture), Bambari (Ouaka prefecture), Bria (Haute Kotto prefecture) and Bangui. From 2 to 5 September and from 8 to 9 September, a specialized psychologist hired by UNICEF organized a training session for 20 social workers deployed in Dekoa (Kemo prefecture) to support survivors of sexual violence. The training was interrupted because of the deterioration of the security situation in Dekoa, but continued in Bangui where 9 staff working for our partner AFJC were relocated after the incident. On 19 September, one of the implementing partners of GBV/SEA activities registered 92 cases (82 women and 10 men) related to sexual violence including two cases of rape of minors whose age is between 11 and 17.

Rapid Response Mechanism (RRM) During the reporting period, the four implementing RRM partners (ACF, ACTED, PU-AMI, Solidarités International) received 20 alerts, undertook six exploratory mission in Bamingui-Bangoran, Ouaka, Mbomou, and Ouham prefectures, and conducted eight Multi-Sectorial Assessments (MSAs) in Nana-Gribizi, Bamingui-Bangoran, Ouham and Ouham Pendé prefectures. Three NFI interventions took place in Ouham, Ouaka, Ouham-Pendé and Haut-Mbomou, reaching a total of 189 households with plastic sheeting, blankets, soap, buckets, plastic mats, mosquito nets and kitchen kits. Five WASH interventions carried out in the framework of cholera prevention (hygiene promotion, water chlorination, sanitation of public places, water point rehabilitation, installation of emergency latrines and bacteriological analysis) reached 6,711 individuals in the prefectures of Mbomou, Basse Kotto, Ouham, and Haut Mbomou. Globally, since 1 January, a total of 23,246 households (107,392 individuals) have received NFI items, and 37,982 individuals have gained access to water and sanitation facilities thanks to RRM emergency interventions. This is a total of more of 145,374 beneficiaries.

CAR HUMANITARIAN SITUATION REPORT SEPTEMBER 2016

Media and External Communication

During the reporting period, the communications team worked with the Education section on the Back to School campaign; participated in the cholera task force and organised interviews for RFI and Radio Ndeke Luka with UNICEF WASH specialists; organised an interview with the representative with a Newsweek journalist on street children; and participated in the World Humanitarian Day celebration. The Facebook and Twitter pages were updated on a regular basis, attracting a growing number of interest and interactions. .

Supply and Logistics

Container movements proceeded at a normal pace in September. 70 containers were registered to be in the pipeline. Communications tools were order as part of the Back to School campaign. Implementation of the 2016 Supply Plan, which was at around 58% the previous month, has increased to 70%. Regarding construction activities, new projects are progressing satisfactorily (out of nine schools under construction, five are almost substantially completed). The heavy rehabilitation of six schools and construction of eight latrines in health centres is ongoing. Contracts for additional construction projects are signed and work will start in early October.

Security The security situation during the month of September was marked by a rise in intercommunal tension. The infiltration of Anti-Balaka elements into Ex-Seleka controlled areas towards Kaga-Bandoro in the north and Bria in the east resulted in a clash between Anti-Balaka and Ex-Seleka in a town called Ndomete, some 5 km south of Kaga-Bandoro. This resulted in a door to door search for Anti-Balaka elements by the Ex-Seleka, who used the opportunity to rob the homes of national staff working for NGOs and the UN. In the northwest, between Bouar and Bocaranga, repeated clashes have been reported between Anti-Balaka and Ex-Seleka elements. In bought cases, this resulted in a temporary cessation of activities and withdrawal of zonal offices of some NGOs. In the south, between Bambari and Kouango, clashes were reported between Anti-Balaka and MPC elements.

Funding Funding Requirements (as defined in Humanitarian Appeal of January 2016)

Appeal Sector Requirements Funds available* Funding gap

$ %

Nutrition 7,200,000 5,903,481 1,296,519 18%

Health and HIV/AIDS 9,250,000 4,069,783 5,180,217 56%

WASH 7,227,000 4,715,786 2,511,214 35%

Child Protection 12,900,000 6,366,275 6,533,725 51%

Education 6,118,000 1,354,049 4,763,951 78%

Rapid Response Mechanism 13,000,000 8,085,779 4,914,221 38%

Total 55,695,000 30,495,153 25,199,847 45%

* ‘Funds available’ includes funding received against current appeal as well as carry-forward from the previous year.

Next SitRep: 1 November 2016 UNICEF CAR on Twitter: https://twitter.com/UNICEF_CAR UNICEF CAR on Facebook: www.facebook.com/UNICEFCAR UNICEF CAR Humanitarian Action for Children 2016: http://www.unicef.org/appeals/car.html

Who to contact for further information:

Mohamed Fall Representative Central African Republic Tel: +236 7055 0205 Email: mmfall@unicef.org

Speciose Hakizimana Deputy Representative Central African Republic Tel: +236 7055 0206 Email: shakizimana@unicef.org

Suzanne Suh Fundraising and Reporting Central African Republic Tel: +236 7017 8040 Email: ssuh@unicef.org

CAR HUMANITARIAN SITUATION REPORT SEPTEMBER 2016

Annex A

SUMMARY OF PROGRAMME RESULTS1

1 An adjustment exercise is underway in different clusters and in line with Results-Oriented Monitoring in September and as a result, the HPM will reflect new indicators and targets in the next Sitrep.

Cluster Response UNICEF Results

2016

Target

Total Results

Change since last

report ▲▼

2016 Target

Total Results

Change since last report

▲▼

WATER, SANITATION & HYGIENE (WASH)

Number of affected people provided with access to improved sources of water as per agreed standards

700,000 708,016 ▲77,995 400,000 348,310 ▲20,173

Number of affected people provided with sanitation facilities as per agreed standards

700,000 265,037 ▲986 250,000 77,504 ►0

Number of internally displaced households provided with WASH NFI kits

50,000 65,386 ▲15,990 10,000 11,592 ▲3,069

EDUCATION

Number of children who received learning materials

350,000 54,477 ►0 300,000 46,337 ►0

Number of displaced children aged 3 to 17 years with access to education in temporary learning spaces with teachers trained in psychosocial support

70,000 30,781 ►0 60,000 30,481 ►0

HEALTH

Number of children under 5 immunized against measles in IDP sites and epidemic districts

n/a 100,000 22,746 ▲8,361

Number of children under 5, including those in IDP sites and enclaves, with access to essential health services and medicines

n/a 500,000

163,933

▲13,544

NUTRITION

Number of children aged 6-59 months with Severe Acute Malnutrition (SAM) admitted for therapeutic care

29,250 18,208 ▲2,860 29,250 18,208 ▲2,860

Recovery rate ≥75% 87.88% ▼0.72 ≥75% 87.88% ▼0.72

Death rate <10% 2.06% ►0 <10% 2.06% ►0

Default rate <15% 10.06% ▲0.01 <15% 10.06% ▲0.01

CHILD PROTECTION

Number of unaccompanied and separated children reunited with their families

3,500 288 ▲0 500 287 ▲0

Number of children released from armed forces and groups

5,660 2,643 ▲0 3,000 2,607 ▲0

Number of women and children identified as survivors of sexual violence have access to holistic support

7,000 631 ▲82 3,500 631 ▲82

HIV and AIDS

Number of children born to mothers who are HIV positive who have access to appropriate treatment

n/a 4,060 1,294 ▲106

CAR HUMANITARIAN SITUATION REPORT SEPTEMBER 2016

Number of pregnant women living with HIV who received ARVs for PMTCT

n/a 4,906 2,100 ▲712

RAPID RESPONSE MECHANISM

Number of acutely vulnerable households following a shock that received rapid assistance with NFIs

n/a 40,000 23,246 ▲189

Number of acute acutely vulnerable people following a shock that received rapid and appropriate assistance in WASH

n/a 80,000 37,982 ▲6,711