UNICEF Kenya Humanitarian Situation Report 1 September to 31 October 2018

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© UNICEF/2017/MUTIA

KENYA Humanitarian Situation Report

UNICEF’s Key Response with Partners in 2018

UNICEF Sector

UNICEF Target

Cumulative Results

Sector Target

Cumulative Results

Nutrition: children under 5 treated for SAM 77,2321 61,6862 77,232 61,6863

Nutrition: children under 5 treated for MAM 240,1964 127,1875 240,196 127,1876

Health: children under 5 accessing integrated package of health interventions including diarrhoea, malaria and pneumonia

814,500 306,514

WASH: persons affected by crises are reached with [permanent] safe water interventions

250,000 94,005 250,000 94,005

Child Protection: most affected boys and girls have access to protective case management services

30,000 22,535 95,000 22,535

Education: school-aged children (including adolescents) affected by crises accessing quality education

205,000 156,406 635,000 156,406

HIV: children, adolescents and pregnant women have access to HIV testing services

120,000 7,815

1 Target changed as per the results of the Long Rains Assessment 2018 2 Results are up to end of September 2018 3 Results are up to end of September 2018 4 Target changed as per the results of the Long Rains Assessment 2018 5 Results are up to end of September 2018 6 Results are up to end of September 2018

SITUATION IN NUMBERS

• A new wave of cholera cases was reported on 8 September. Measles outbreaks continue to be reported in Mandera, Garissa, Nairobi and Wajir counties.

• Heavy rainfall was recorded towards the end of October, resulting in flash floods in the coastal strip and northern counties.

• A total of 161,175 children have been vaccinated against measles during the campaign in Mandera county.

• Three million children have been reached in round two of the synchronized polio vaccination campaign for the Horn of Africa.

• With UNICEF support, 188,873 acutely malnourished children were admitted for treatment from 1 January to 30 September 2018.

• A total of 23,148 children were reached with life-saving health interventions during integrated health outreaches in the period under review.

• During the reporting period, 33,499 women, girls, boys and men had access to safe water from three rehabilitated water facilities in Garissa and Tana River counties.

• In 2018, UNICEF requires US$ 34.2 million for its Humanitarian Action for Children Appeal that has a funding gap of 60 per cent.

31 October 2018

700,000

People are food insecure (2018 Long Rains Assessment, August 2018)

329,000 Children are food insecure

(2018 Long Rains Assessment, August 2018)

85,105 Children under 5 in need of severe acute

malnutrition treatment (2018 Long Rains Assessment, August 2018)

*Funds available include funding received against current appeal as well as carry-forward from the previous year (US$ 5.5 million, which includes US$1.7 million for the refugee response).

UNICEF HAC Appeal 2018

US$ 34,235,000

UNICEF/2018/Duale

HIGHLIGHTS

UNICEF Kenya Humanitarian Situation Report 1 September to 31 October 2018

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Situation Overview and Humanitarian Needs The Kenya Meteorological Department has reported that the onset of the October to December short rains was timely over most parts of the country. Very heavy rainfall was recorded towards the end of October, resulting in flash floods in the coastal strip and northern counties. This affected access to communities in Mandera during the measles campaign, which was thus extended by two days to end on 2 November 2018. November is normally the peak month for the short-rains season, and the forecast indicates that several parts of the country are likely to experience enhanced rainfall with the likelihood of flooding, landslides/mudslides in prone areas and outbreak of diseases normally associated with excessive water. According to the Kenya Red Cross Society (KRCS), effects of floods including destruction of shelter, roads and water infrastructure and possible outbreaks of cholera, malaria, yellow fever and Rift Valley fever are expected in the coastal counties of Kwale, Tana River, Kilifi, Taita, Taveta and Lamu; western counties of Kisumu, Migori, Siaya, Busia and Homa Bay; north eastern counties of Garissa, Wajir and Mandera and upper eastern counties of Isiolo, Marsabit, Samburu; and North Rift counties of Baringo and Turkana.

According to the Famine Early Warning Systems Network (FEWSNET), the historically above-average 2018 March to May long rains have continued to drive food security improvements countrywide. With an average to above-average forecast for the October to December short rains, livelihood recovery from the severe 2016/2017 drought is expected to continue, however, majority of the poorest households are likely to take longer to recover, thus maintaining the pastoral areas in Stressed (IPC Phase 2) through to January 2019. In addition, critical global acute malnutrition (GAM) levels (15-29.9 per cent) are likely to be sustained to January 2019 in Mandera, Turkana, Samburu, parts of Baringo (East Pokot), and Marsabit (North Horr) counties, driven by various factors, including poor child care feeding practices and lack of suitable access to health facilities. Serious GAM levels (10-14.9 per cent) are anticipated in Wajir, Garissa, Isiolo, Laikipia, Tana River, and Marsabit (Laisamis) counties.

UNICEF Kenya Humanitarian Situation Report 1 September to 31 October 2018

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According to the latest Ministry of Health disease outbreak situation report, 20 counties have reported cholera in 2018. A total of 5,796 cases with 78 deaths (Case Fatality Rate – CFR - of 1.3 per cent) have been reported in the year. The outbreak was declared controlled on 3 September 2018, however a new case was reported on 8 September 2018 from Turkana County. Since then, two other counties (Embu and Isiolo) have been affected, though only Isiolo is reporting new cases. A pertussis outbreak has also been reported, with a total of six cases in Machakos, Nairobi and Kiambu counties and one death (CFR of 20 per cent). Since the beginning of the year, six counties (Mandera, Garissa, Wajir, Nairobi, Kitui and Murang’a) have had measles outbreaks - 612 cases with 52 confirmed cases and 1 death (CFR of 0.2 per cent) reported. No new cases have been reported from Kitui County though Mandera, Garissa, Nairobi, Wajir and Murang’a counties are still reporting new cases. According to the October 2018 UNHCR update, there are 468,261 refugees and asylum seekers in Kenya (78 per cent are women and children of whom 56 per cent are children), of which 208,595 are in Dadaab refugee camps, 186,384 in Kakuma refugee camps and 73,282 in Nairobi. Out of the total refugee population, 256,300 (54 per cent) are from Somalia and 114,862 (24 per cent) are from South Sudan. The Dambala Fachana camp that was hosting asylum seekers in Moyale was closed on 29 September, with 302 individuals transferred to Kakuma while 700 individuals opted to return to Ethiopia. Since the beginning of the year, 4,675 children (2,918 boys; 1,757 girls) have arrived in Kakuma refugee camps, of which 1,254 (887 boys; 367 girls) are separated children and 363 (272 boys; 91 girls) are unaccompanied children.

Estimated Population in Need of Humanitarian Assistance: 1,171,3307 (Estimates calculated based on Government Long Rains Assessment conducted in August 2018 and the UNHCR Refugee data)

Start of humanitarian response: 10 February 20178

Total Male Female

Total Population in Need 1,171,330 573,952 597,378

Children (Under 18) 550,525 269,757 280,768

Children Under Five 175,670 86,093 89,577

Children 6 to 23 months 70,268 34,431 35,837

Pregnant and lactating women 70,279 N/A 70,279

Humanitarian Strategy and Coordination Building on results achieved in 2017, UNICEF is continuing to strengthen engagement with the devolved system of governance in Kenya, especially in strengthening county capacity for emergency preparedness and response as well as direct implementation. UNICEF is focusing on strengthening sector coordination, multi-sectoral coordination both at national and sub-national levels and cross-border coordination. The four zonal offices (Lodwar, Kisumu, Garissa and Dadaab) continue to provide critical programme oversight, technical support to devolution and humanitarian response. Schools are an ideal platform where multi-sectoral integrated basic services are being availed to children and hence strengthening the overall shared goals for enhancing community resilience. In 2018, UNICEF and partners are responding to the survival and protection needs of more than 500,000 children in emergency situations including drought, flooding, disease outbreaks, refugee influx and inter-communal conflict by delivering nutrition treatment; increasing access to safe water, hygiene and sanitation; strengthening disease prevention and response, improving access to quality education; and providing protection mitigation services, particularly for refugee children and children affected by natural disasters and resource-based community conflicts. Communication for Development (C4D) strategies are being used to mobilize, engage and provide information for community response and contribute to resilience building. UNICEF continues to support basic services delivery in areas that were affected by floods during the long rains season, including longer-term humanitarian interventions, as well as enhancing preparedness for the expected floods during the short rains season between October and December 2018. The partnership engagement with KRCS, which has the comparative advantage of country-wide presence including in hard-to-reach areas is supporting implementation of life-saving interventions. Response to refugee influxes continues, including emergency WASH, health, nutrition and education and child protection services to new arrivals in Kakuma and children affected by the voluntary repatriation of refugees to Somalia in Dadaab refugee camps.

7 Food insecure population and refugees 8 The food security and nutrition situation has deteriorated significantly since the end of 2016, with the President of Kenya declaring a national disaster on 10 February 2017

UNICEF Kenya Humanitarian Situation Report 1 September to 31 October 2018

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UNICEF’s Response with Partners – Summary Programme Response

NUTRITION A total of 61,686 severely malnourished children (79.9 per cent of the annual target) and 127,187 moderately malnourished children (53 per cent of the annual target) were admitted for treatment from 1 January to 30 September 2018 indicating that the Integrated Management of Acute Malnutrition (IMAM) programme is on course to achieve its annual target. During the same period, 75,819 cartons of ready-to-use therapeutic foods (RUTF) were distributed by UNICEF across 1,854 health facilities in 23 arid and semi-arid (ASAL) counties through the Kenya Essential Medical Supplies Authority (KEMSA), sufficient to treat 75,819 severely malnourished children. Of these, 2,465 cartons were distributed in September 2018. Logistics Management and Information System (LMIS) reporting rates in the 23 ASAL counties integrating nutrition supplies through government led pipeline (KEMSA) for month of September stands at 95 per cent. UNICEF supported the updating of Feeding Guidelines for Maternal, Infant and Young Child Nutrition in Emergencies (MIYCN-E) following the assessment of infant feeding situation in Garissa and Tana River counties during the March-April-May rainy season. This guidance is expected to improve the timeliness and quality of emergency programming regarding MIYCN-E assessment and response, especially during rapid onset emergencies.

HEALTH A total of 155,750 children were reached with life-saving health interventions, including treatment for diarrhoea, malaria and pneumonia, during integrated health outreaches conducted in the reporting period. Through the KRCS partnership, UNICEF supported the Ministry of Health to establish Cholera Treatment Centres in Mombasa and Turkana and cholera isolation units in Isiolo, through which 32 cholera cases were managed. UNICEF has supported the Ministry of Health and partners to implement round two of the synchronized polio vaccination campaign for the Horn of Africa with bOPV which was concluded on 24 October reaching over 3 million children. Each round covered 12 high-risk counties in the country (Nairobi, Kajiado, Machakos, Kiambu, Meru, Isiolo, Tana River, Lamu, Garissa including Dadaab refugee camps, Mandera, Wajir and Kitui) with special emphasis being paid to ensure that hard-to-reach audiences such as the nomads, internally displaced persons (IDPs) and those living in urban high-density areas were reached during each of the campaigns. UNICEF also supported the measles campaign which ended on 2 November 2018, reaching 161,175 children in Mandera county against a county target of 205,000 (79 per cent coverage). Planning is ongoing for measles campaigns in Nairobi and Garissa counties in the month of November as well as for the 44,000 children who were missed in Mandera South sub-county due to access challenges. UNICEF has also supported capacity building of four county departments of health teams (Tana River, Turkana, Marsabit and Baringo), select community health assistants and volunteers, KRCS and UNICEF core teams on hazard, vulnerability and capacity assessment, mapping and implementation of key priorities related to the ranking of specific hazards (drought, floods, conflict) and corresponding vulnerabilities and capacities. UNICEF has also pre-positioned critical life-saving commodities in counties to support response to potential floods and disease outbreaks.

WASH During the reporting period, 33,499 drought and flood-affected people in Garissa and Tana River counties had improved access to permanent safe water through repair of water points, while 35,706 people received critical WASH-related information for the prevention of illnesses through UNICEF’s partnership with the Mandera County Public Health Department with funding from the Central Emergency Response Fund (CERF). Another 8,693 school children (5,407 boys; 3,286 girls) were reached with hygiene education messages. Up to 2,000 households (14,000 people) in Isiolo County benefitted from emergency WASH supplies in the ongoing cholera outbreak response. UNICEF supported capacity building of Water, Environment and Sanitation Coordination (WESCOORD) teams in Tana River and Garissa counties with more than 50 county and partner staff receiving emergency coordination skills.

CHILD PROTECTION During the reporting period, 7,513 children (3,874 boys; 3,639 girls and) affected by floods, as well as new arrivals in Kakuma and undocumented children in Dadaab were reached with protection services. In Garissa, West Pokot, Baringo, Tana River and Isiolo counties, 4,101 (1,594 boys; 2,507 girls) children displaced by floods were identified and provided with dignity kits and psychosocial support. UNICEF also facilitated home visits to the families of the affected children for assessments and to provide linkages with other service providers for recovery assistance. In Garissa County joint child protection, disease prevention and hygiene messages were shared through community forums and 10 radio spots aired twice a day in English and Somali. In Dadaab refugee camp, UNICEF facilitated support to 1,488 undocumented asylum seekers (814 boys; 674 girls) to address protection risks and complement support provided by UNHCR and other partners. The support provided included individual counselling, alternative family-based care for unaccompanied minors and provision of dignity kits. The number of undocumented children in Dadaab continues to increase and so are the protection risks and vulnerabilities. In Kakuma and Kalobeyei refugee settlement, individual assessments for 1,617 unaccompanied and separated children (1,159 boys; 458 girls) informed provision of care and support, including foster care, intra-camp family reunification with family members, child friendly play activities and referrals.

UNICEF Kenya Humanitarian Situation Report 1 September to 31 October 2018

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EDUCATION During the reporting period, 37,830 children, including 6,994 girls in Garissa, Turkana, West Pokot, Baringo, Marsabit and Nairobi counties, benefitted from Education in Emergencies (EiE) support. This included 1,455 refugee children (588 girls) in Dadaab refugee camp and 22,520 (41 per cent girls) in Kakuma/Kalobeyei who received supplies and floods SMS alert messaging in anticipation of the short season flash floods. The interventions involved distribution of 60 Early Childhood Development (ECD) kits, 71 recreational kits, 41 education kits and 13 classroom tents to children in 68 schools affected by floods. The capacity of 120 children (60 girls) was enhanced on child-to-child accountability and mobilization of out-of-school peers for enrolment. Another 209 adolescent girls were trained on life skills, Menstrual Hygiene Management, business entrepreneurship and employability. A total of 675 (260 female) Alternative Education Programme (AEP) learners were supported to continue their education in Dadaab with 98 of them registered to sit for 2018 national examinations. UNICEF supported a joint partners’ assessment on data, quality and standards that revealed high rampant absenteeism and low teacher capacity in Dadaab refugee camp, primarily due to high teacher attrition and newly employed untrained teachers. UNICEF supported the development of the near final version of the Refugee Education Policy by engaging stakeholders in two forums to review the zero draft. Additionally, the dissemination of the approved Education Sector Disaster Management Policy was completed for Isiolo; it will guide Ministry of Education officials and stakeholders in planning and responding to emergencies in education. With UNICEF support, the school-related gender-based violence and violence against children (SRGBV/VAC) study was completed, leading to development of standard operating procedures and checklists on SRGBV/VAC.

HIV During the reporting period, UNICEF provided technical support to the Turkana County Health Management Team to improve data reporting and quality. Following support provided in revising data reporting tools to include age-disaggregated data, 75 per cent of the facilities in Turkana County, including Kakuma refugee camp, are using the new and revised tools. Mentorship and quality improvements activities for HIV testing, counselling and treatment for children and adolescents, as well as prevention of mother-to-child transmission interventions are planned for the last quarter of 2018 and early 2019.

Social Protection/ Cash-based programming UNICEF is supporting the Government of Kenya to document best practices and lessons learned from the emergency cash top-up experience in Isiolo County. The exercise is ongoing and results will be reported in the next Sit Rep.

Communications for Development (C4D), Community Engagement and Accountability With UNICEF support, 40 health promotion officers, disease surveillance officers, community health officials and Red Cross county coordinators were trained as trainers in interpersonal communication skills and communication planning for cholera and other disease outbreaks. Following the training, UNICEF supported the airing of a cholera animation video on national television (NTV Kenya) for a period of four weeks reaching up to 9 million people, as well as radio spots and media interaction on Radio Maisha (national coverage), Radio Sifa (Turkana County) and Kaya Radio FM (Mombasa, Kwale and Kilifi counties) reaching over 12 million people. Media engagement was further enhanced with live coverage on cholera from a school in Mukuru kwa Njenga informal settlement in Nairobi and in Kalobeyei refugee settlement, as well as TV and radio talk shows for Nairobi, Turkana and Mombasa with live presenter mentions offered by all the selected stations. Through partnership with KRCS, 68,633 people (30,855 males; 37,778 females) continue to be reached with cholera awareness and behaviour change messages to stop cholera in Tana River County. In Mombasa County, hygiene promotion and health education sessions on how to prevent cholera continue to be undertaken, reaching 31,575 people. Community health volunteers, with the support of public health officers, continue to undertake door-to-door cholera awareness sessions distributing 23,817 aqua tabs (water treatment chemicals) to 30,747 individuals, sufficient to treat 476,540 litres of water for use over three months. The same individuals were shown how to wash hands with soap at critical times and also received 200 information, education and communication materials illustrating how to prevent cholera at household level. In Turkana, West Pokot and Garissa Counties, 13,145 children were also reached with cholera messages. To enhance preparedness, additional cholera materials including 25,000 cholera posters in English, 26,000 posters and 3,000 flip charts in Kiswahili have been printed and pre-positioned with KRCS and 17 County Ministries of Health.

Media and External Communications Several communication activities were undertaken to support advocacy in the emergency context including EU-supported programmes in Dadaab refugee camp. Human interest stories were collected and a photo bank of the response activities was built. Media and digital support was given for activities around subsequent rounds of polio immunization in September and October. Television spots and frequent social media updates were also provided on Twitter and Facebook. Media houses such as the KTN Kenya, KTN News, NTV Kenya and Standard Digital were engaged to amplify messages on social media, reaching over 13.3 million people with polio immunization campaign messaging.

Supply and Logistics UNICEF continued with the distribution of supplies to floods and disease outbreak-affected areas during the reporting period.

UNICEF Kenya Humanitarian Situation Report 1 September to 31 October 2018

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Security The security situation across the country remained generally calm in the reporting period.

Funding In 2018, UNICEF requires US$ 34.2 million for its Humanitarian Action for Children (HAC) Appeal in Kenya to respond to the humanitarian needs of children as a result of the ongoing drought, refugee response, inter-communal conflict, disease outbreaks and flash floods. In 2018, the Government of Japan, ECHO, CERF and USA (USAID) OFDA have generously contributed to UNICEF Kenya humanitarian funding needs. However, the 2018 HAC still has a funding gap of 60 per cent. To meet the immediate flooding response needs, UNICEF has reallocated US$ 385,000 from its regular resources and has also received US$ 200,000 from the regional thematic emergency funds, as well as US$ 400,000 global humanitarian thematic funds to procure urgent emergency supplies. In addition, an internal loan of USD 900,000 from the UNICEF Emergency Programme Fund was released to enable initial timely response to critical needs until further donor support was secured.

Appeal Sector HAC 2018

Requirements

Funds Available

Funding Gap*** Funds Received**

Carry-Forward Funds from

2017* $ %

Nutrition 10,000,000 3,412,999 2,409,124 4,177,877 42%

Health 6,300,000 1,598,695 497,651 4,203,654 67%

Water, sanitation and hygiene 4,000,000 1,332,064 311,705 2,356,231 59%

Child protection 1,000,000 1,081,197 232,991 0 0%

Education 5,935,000 0 1,617,881 4,317,119 73%9

HIV/AIDS 500,000 0 0 500,000 100%

Social Protection 2,000,000 0 0 2,000,000 100%

Cluster/sector coordination 4,500,000 550,069 500,081 3,449,850 77%

Total 34,235,000 7,975,024 5,569,433 20,690,543 60%

* Carry-forward from the previous year (US$ 5.5 million, which includes US$ 1.7 million for the refugee response). The carry-forward figure is provisional and subject to change. **Funds received is funding received against current appeal ***Funding gap excludes the surplus for Child Protection

Next SitRep: 31 December 2018 UNICEF Kenya HAC appeal: https://www.unicef.org/appeals/kenya.html UNICEF Kenya Crisis Facebook: https://www.facebook.com/UNICEFKenya/

9 Results have been made possible despite the funding gap thanks to a loan received through the UNICEF Emergency Programme Fund ( EPF) that enabled the procurement of supplies, and the use of UNICEF core resources for supplies and in support of emergency interventions.

Who to contact for further information:

Patrizia Di Giovanni Deputy Representative UNICEF Kenya Country Office Tel: +254 705 262285 Fax: +254 762 2045 Email: pdigiovanni@unicef.org

Patrick Lavand’homme Chief, Field Operations & Emergency UNICEF Kenya Country Office Tel: ++254-710 602326 Fax: +254 762 2045 Email: plavandhomme@unicef.org

Werner Schultink Representative UNICEF Kenya Country Office Tel: +254 711 946555 Fax: +254 762 2045 Email : wschultink@unicef.org

UNICEF Kenya Humanitarian Situation Report 1 September to 31 October 2018

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Annex A SUMMARY OF PROGRAMME RESULTS 2018

10 Target changed in August 2018 as per the Results of the Long Rains Assessment 11 Results are up to end of September 2018 12 Results are up to end of September 2018 13 Target changed in August 2018 as per the Results of the Long Rains Assessment 14 Results are up to end of September 2018 15 Results are up to end of September 2018 16 Results are up to November 2018 as per the latest data sets received by the KRCS 17 This indicator is for Measles Immunization Campaign targeting the most-affected counties of Mandera, Garissa and Nairobi between October and November 2018

Sector Response UNICEF and Implementing Partners

Overall needs

2018

Target

Total Results

Change since last

report ▲▼

2018 Target

Total Results

Change since last

report ▲▼

NUTRITION

Children under 5 treated for SAM 85,105 77,23210 61,68611 ▲9,997 77,232 61,68612 ▲9,997

Children under 5 treated for MAM 425,488

240,19613 127,18714 ▲ 21,005 240,196 127,18715 ▲ 21,005

HEALTH

Children under 5 accessing integrated package of health interventions including diarrhoea, malaria and pneumonia

814,500 306,514 ▲155,75016

Children under 5 vaccinated against measles17 641,817 161,175 ▲161,175

WASH

Persons affected by crises are reached with

[permanent] safe water interventions 3,500,000 250,000 94,005 ▲33,499 250,000 94,005 ▲33,499

People reached with hygiene education essential for

disease prevention and response 3,500,000 400,000 344,661 ▲35,706 400,000 344,661 ▲35,706

Children accessing appropriate hygiene education in schools, temporary learning spaces and other child friendly spaces

1,150,000 100,000 31,293 ▲8,693 100,000 31,293 ▲8693

CHILD PROTECTION

Most affected boys and girls have access to protective case management services

325,000 95,000 22,535 ▲7,513 20,000 22,535 ▲7,513

EDUCATION

School-aged children (including adolescents) affected by crises accessing quality education

1,150,000 635,000 156,406 ▲37,830 205,000 156,406 ▲37,830

HIV and AIDS

Children, adolescents and pregnant women have access to HIV testing services

120,000 7,815 No change

Adolescents receive age appropriate SRH/HIV messaging incorporated with life skills education in humanitarian settings

15,000 - No change

SOCIAL PROTECTION

Vulnerable households reached with cash transfer top up during crises

30,000 5,800 No change