Sharp rise in mortality seen at refugee camp in southeast Ethiopia

An assessment of mortality in one of four refugee camps at the Dollo Ado complex in Ethiopia has found that death rates have reached alarming levels among new arrivals. Since the Kobe refugee camp opened in June, an average of 10 children under the age of five have died every day.

While malnutrition is the leading cause of the high mortality, suspected measles is compounding the problem. Across all Dollo Ado sites we have seen 150 cases of suspected measles and 11 related deaths. The combination of disease and malnutrition is what has caused similar death rates in previous famine crises in the region.

UNHCR is urgently working with partners to respond to the emergency and control the suspected measles outbreak. A mass vaccination campaign against measles was completed in Kobe camp yesterday (Monday), targeting all children between the ages of six months and 15 years. It will continue in the other camps in the coming days.

The majority of refugees arriving from Somalia are from rural areas, and the camps in Ethiopia may be the first time they have been in contact with formal health facilities. A key priority for all partners working in the camps is to promote awareness of the health and nutrition programmes available for refugees, many of whom have not been accessing those services. There is a need to encourage parents to return with their children to health centres for continued treatment for malnutrition, and to actively identify children who are sick to ensure they receive immediate medical attention. UNHCR is already working with refugee leaders and outreach workers to raise awareness of measles symptoms and hygiene promotion. Together with the Ethiopian government and partners, UNHCR is addressing other, underlying causes of the high mortality rate by improving nutrition, water supply and sanitation, amongst others.

UNHCR's Public Health Officer, Dr. Christopher Haskew, says measles is a highly contagious disease which can have a devastating impact on children, especially those who are acutely malnourished. He notes that our number one priority now is to take action to prevent people dying as a result of this outbreak.

Elsewhere in Ethiopia, some 17,500 Somalis have crossed into the Gode and Afder areas over the last six weeks, according to a joint field mission led by UNHCR and the Government of Ethiopia. These are totally new entry points some 250 kilometres northeast of Dollo Ado, which has been the primary destination in Ethiopia for Somalis fleeing insecurity, drought and hunger in their homeland.

The week-long assessment mission began on 7th August and included other UN agencies and non-governmental organizations. The UNHCR- and government-led team visited Morodile, God Dheere, El-Harr and Bare - border localities in the Gode and Afder areas of south-eastern Ethiopia. The mission was mounted initially to assess the situation of a reported 2,000 new arrivals in the region, but found that the numbers had swelled to an estimated 17,500 as more Somalis arrive daily. Most new arrivals originated from the Bakool and Bay regions, with others coming from the Gedo and Hiran areas in Somalia. They are staying in make-shift shelters in five different locations. Discussions are under way with the government and partners for an immediate response.

Preliminary assessments showed that an estimated 95 percent of the new arrivals were women and children, with the majority in a very poor nutritional and health states. The mission described the overall situation as desperate and called for urgent humanitarian aid - particularly since local Ethiopians, themselves hit hard by the drought, have been sharing their meager supplies.

UNHCR and the Government of Ethiopia have decided to immediately provide a one-month food ration to the new arrivals. The mission voiced concern that a lack of shelter and health care, poor sanitation and overcrowding could lead to opportunistic diseases such as acute diarrhea, measles and whooping cough. The team recommended the urgency of rushing essential drugs to the area to make medical interventions before the situation gets out of hand. We are looking into possibilities for relocating this group to the camps in Dollo Ado.

In Somalia, the last of three scheduled flights of UNHCR humanitarian aid to Somalia landed in Mogadishu on Saturday morning, completing the consignment of some 100 metric tonnes of emergency assistance. Saturday's flight carried 45,000 boxes of high energy biscuits, plastic sheeting for shelter, sleeping mats and blankets, jerry cans for water and kitchen sets for collecting and cooking food.

The same day, we distributed some 500 emergency assistance packages (EAPs) in the Al Adala camp sheltering some 2,000 displaced Somali families (approx. 13,000 people). The camp is close to Mogadishu airport. Our team reported that the streets leading to the camp were calm, but there was clear presence of armed men in the area.

Before the current crisis, the Somali capital hosted some 370,000 internally displaced people (IDPs). An additional 100,000 flocked to Mogadishu during June and July alone - seeking food, water, shelter and medical help.

The majority of the displaced at the Al Adala site have fled from Somalia's drought and famine- affected southern regions. Most are farmers and cattle herders, keeping livestock and growing crops such as sorghum and maize. They told our team that they have lost everything and were hoping to start afresh in the Somali capital. Many were forced to leave elderly or disabled relatives behind, knowing they would not survive the arduous journey. Many walked for days without food or water. Some were confronted by Al Shabaab militants at roadblocks, apparently seeking to discourage people from moving.

The UNHCR team described the conditions at the Al Adala site as grim and dire. Voices of crying children and heavy coughing fill every corner of this IDP site. Small makeshift shelters with no sleeping mats or bedding are characteristic of this congested settlement. A number of children were lying helplessly on the ground, suffering from measles, which IDPs say are affecting many in the settlement.

We plan further distributions of emergency aid in Al Adala and other IDP sites throughout Mogadishu. The entire cargo of the three airlifts will be handed out to the displaced people in need in the Somali capital before the end of the month. We have more than doubled our distributions since early July and have delivered assistance to some 170,000 people in southern and central Somalia. Some 80,000 people were assisted in May and June.

Meanwhile in Kenya, our teams continue with their emergency work of increasing the capacity of the Ifo Extension (comprising what was previously known as Ifo2 and Ifo3 site) and Kambioos camp of the Dadaab refugee complex. The movement of refugees to the Kambioos site, initially scheduled for this past weekend and announced in UNHCR's last briefing note, has been delayed and is now expected later this week. Some 600 tents have been pitched there so far. Movements to the Ifo 3 area of the Ifo Extension are continuing. Since 28 July more than 15,000 Somali refugees have been moved to the new tents in this location. Demarcation works, installation of basic facilities and pitching of tents is ongoing at Ifo2 part of Ifo Extension. The Dadaab camps are now sheltering more than 440,000 Somali refugees.

Learn more about the crisis in the Horn of Africa and how to contribute by visiting the UNHCR Horn of Africa emergency donation site. For the latest updates follow us on Facebook or Twitter.

For further information on this topic, please contact:

• In Geneva: Andrej Mahecic on mobile: +41 79 200 76 17

• In Nairobi UNHCR regional office: Ron Redmond on mobile +254 734 564 019

• In Nairobi UNHCR regional office: Needa Jehu-Hoyah on mobile +254 734 564 018

• In Nairobi UNHCR Kenya office: Emmanuel Nyabera on mobile: +254 773 995 975

• In Dadaab camp, Kenya: William Spindler on mobile +254 71 545 5992

• In Kenya, UNHCR Somalia Office: Andy Needham on mobile +254 733 120 931

• In Ethiopia: Kisut Gebre Egziabher on mobile +251 911 208 901