INTER-AGENCY ASSESSMENT (21-31 DEC,2003) TOGDHEER REGION (HAWD PASTORAL).

21 –31st December, 2003

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Table of Contents Executive Summary..................................................................................................................... 3

a) Assessment findings......................................................................................................... 3 d) Recommended Actions ................................................................................................ 4

1) Overview of Togdheer ....................................................Error! Bookmark not defined. a) Area of Concern/ map................................................................................................... 6 b) Society............................................................................................................................. 6 d) Background to the Inter-Agency Emergency Assessment ..................................... 9 e) Objectives ....................................................................................................................... 9 f) Area surveyed, participation and methodology ......................................................10

2 Assessment findings ......................................................................................................11 Food security...................................................................................................................11

b) Health and nutrition .....................................................................................................15 c) Livestock .......................................................................................................................17 d) Environment .................................................................................................................19 e) Water .............................................................................................................................20 f) Education..........................................................................................................................23

3) Recommendations: short-term; long-term .....................................................................23 Appendix A: Checklists..............................................................................................................30 Appendix B: Project information – wealth groups...................................................................26 Appendix C: Historical Time line...............................................................................................27 Appendix D: Assessment participants .....................................................................................28

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Executive Summary The rapid assessment mainly covered the areas south of Togdheer, particularly the Hawd Food Economy Zone. Livestock production is the main economic activity providing food, income and employment. A combination of inadequate pastures, livestock diseases, high consumption and disposal has reduced livestock ownership with mortality rates estimated at 40-50% for shoats and 15-20% for camels. The assessment was to study the impact of the current drought on water, pasture, livestock, migration/displacement, food security, health and nutrition. Assessment Findings Wealth group asset ownership has shifted with most wealth groups having experienced asset reduction of about 50% for shoats and 15-20% for camels. Food security: Livestock and livestock products as the major food sources is on the decline. There is nil production and consumption of milk & ghee, with consumption of meat from dying stock contributing a significant food source. Food purchases from the markets have declined because of reduced livestock prices, and increased cost of imported food commodities. Local food production (sorghum and maize) was negligible. It is anticipated that the food security will deteriorate as the drought persists. Households energy intake has reduced. Milk, meat, ghee and other livestock products availability & sales had significantly declined, thus affecting household disposable income with health & nutritional consequences. The communities have coped by migrating to areas that received rains to save the surviving livestock. The drought has reduced the poor households’ food source and income. Livestock deaths are expected to increase during the coming dry season (from January to mid April) due to water and pasture depletion. School dropouts will increase in the affected rural areas. Health: There is limited access to health services though most villages receive the Renewal Health Post kits. Diarrhoeal diseases, measles, whooping cough and ARI where seen to have increased from the normal. Overall, environmental and water sanitation status is poor. There was a slight increase Global Acute Malnutrition compared to the August survey among all groups. Villages that did not receive any rains showed higher incidences. Livestock: Per capita livestock holding is on the decline compared to the baseline. Reproduction rate (conception rate) has significantly declined for all species. Their body condition is poor and weak. There are very limited marketable livestock, particularly by the poor and lower Middle Wealth Groups. High and increasing expenditure for water.

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There is a higher concentration of livestock in the in-migrated areas with consequent grazing pressures, which contribute further to land degradation. In medium term, pasture and water availability and access will diminish. There was a massive livestock migration into Ethiopia and the Golis Ranges to the north. Slaughtering weak animals. Likely medium to long-term effects if the rains fail would be the collapse of livelihoods as a result of livestock asset loss leading to destitution and massive migration into urban centers. There has been extensive range-land degradation leading to loss of nutritive forage and browse. The establishment of illegal private enclosure has reduced communal grazing land. There is significant tree cutting for charcoal production and for fencing off these enclosures. Gully formations have increased. Water: Berkads and Balleys, complimented by seasonal hand dug wells provide the bulk of human and livestock water requirements. However, access is limited for the poor groups. Generally, the water infrastructure is in poor condition with poor sanitary conditions. The quality of water is poor and deteriorating. Education: The schools’ drop out rate is about 43%, with two schools closed due to severe drought and migration . Recommendations Food security: Targeted Emergency free food distribution between January to May 04- Jilaal. Health and Nutrition: Support with medical supplies for most common human diseases e.g. ARI, diarrhoea, malaria, etc. Vaccination campaign to reduce the incidence of Whooping cough and Measles Health and hygiene Promotion

Livestock Immediate interventions: Establishment of mobile Veterinary teams. Vet drug distribution and training of paravets. Relief fodder for animals

Short and Long-term intervention: Introducing and/ or re-establishing range management plans such making reserve pasturelands to

assist the seasonal grazing of pasture resources. Restocking of the destitute and IDPs in the coming rainy season to help re-establish their normal

pastoral livelihoods. Community training and awareness rising on range-land resource utilisation. Encouragement fodder production in agri-lands. Establishment of pastoral associations to carry out range-land resource management. Diversification of pastoral economy (poultry and honey production) Control on charcoal production and the introduction of energy saving stoves.

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Water Emergency Trucking water for Human and livestock. Chlorinating all water sources. Cleaning campaign/ sanitation awareness for water sources before next rain

Medium and long term Rehabilitation of non functioning hand pumps, and providing hand pump spare parts De-silting and rehabilitation of Balleys and dams

Identify potential permanent water sources by conducting assessments + geophysical surveys Soil and forestry protection and conservation, including the banning charcoal production and

providing alternatives. Education Institute a school-feeding program as a component of the general feeding program. Support to teachers - Capacity building Provide alternative schooling models e.g. mobile schools Flexibility in transfer and admission of students in different regions Support with education and recreation equipment and materials

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Overview The Togdheer region, with a population of about 350, 0001 people, is one of the largest regions in Somaliland. Its inhabitants are 70-80% pastoralists, 10% agro-pastoral and the reminder settled in urban settlements areas. Livestock production is the main economic activity in the region providing food, income and employment opportunities and the main livestock species reared include shoats, camel and cattle. The rapid assessment mainly covered the south east and south west of Togdheer, particularly the Hawd pastoral Food Economy Zone. This zone is considered as one of the potential wet season grazing area and currently received below normal rains in the last Gu 03 followed by a failure of the Deyr 03 rains (see fig below). The zone’s ecology, aptly described as open savanna grassland characterised by woodland, has been greatly altered by the recurrent and prolonged droughts, overgrazing, deforestation (for charcoal production), and increased sedentazation due to unplanned proliferation of Berkads2and settlements. Before the collapse of the Somali State, the region had an effective range management program managed by government agencies and pastoral associations to ensure productivity and sustainability of the range-lands. In the course of civil wars, all pastoral infrastructure collapsed. The over-grazing and poor erratic rains made unsuccessful to regenerate the necessary vegetation in the past 10-15 years, leading to extensive land degradation and loss of the most nutritive and palatable grass species such as chrysopogon Aucheri, Cenchuris ciliaris, Aristida kelleri, cynodon dactylon and Dactilunium varigetus. A combination of inadequate pasture and grazing availabilty, livestock diseases, high consumption and sales has reduced livestock ownership. It was reported that there was the CCPP disease outbreak of goat during the assessment period. The mortality rate of the livestock was estimated about 40-50% of shoats, and 15-20% of camels. Generally, the zone has experienced a significant decline of herds by almost 45% in the last decade. Cattle declined by almost 95% - with the reminder mainly owned by the ‘richer’ households. Presently, shoats predominate. Society: Togdheer is predominantly occupied by Isaaq subclans of HabarJeclo and HabarYoonis. The same clans also lives and extend along the bordering villages in Ethiopia, neighbouring the Ogaden clan. To the east and north-eastern side, the clan has ties with the Dhulbahante and Warsangeli clans with whom they have close and inter-marriage relations. Traditionally, there are very solid and effective social support systems in times of crisis amongst the Togdheer Pastoral community both in kind and in cash and was effective during the assessment period.

1 WHO figures 2 Privately owned water reservoirs

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BURCO

District boundary

Regional boundary

# Settlement

# District town#Y Regional capital

Area AssessedSeverely Drought Affected Areas/

N

0 25 50 Kilometers

Kilomete rs

N

SOMALIA: TOGDHEER REGION

KEY:

0 100 200 300

Ind ian

Oce

an

ETHIOPIA

KE

NYA

Gulf of Eden

Food Economy ZonesHawd Pastoral: Camel, sheep & goats

North-W est Agro-Pastoral: Sorghum, cattle

Nor th-W est Valley Agro-Pastoral: Ir rigated vegetables, shoatsNugal Valley Pastoral: Sheep & cam elTogdheer Agro-Pas toral: Sheep, goats & vegetables

West Golis Pastoral: Goats, camel, sheep

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Background to the Inter-Agency Emergency Assessment After the Inter-Agency assessment of the Sool Plateau in October, and the partial failure of the Deyr rains across a wider area of northern and central regions of Somalia, it became clear that the drought has affected a much wider area. The Somaliland Authorities conducted an assessment in November, which concluded that the emergency extended into Togdheer and publicly called for international assistance. International agencies meeting in Hargeisa requested for an interagency assessment to be conducted to validate reports of the crisis and to raise awareness of the problem within the international and humanitarian community. The idea of an assessment was endorsed and referred to the Humanitarian Response Group (HRG) at the SACB Food Security and Rural Development Sector Committee on 10th December. Justification for the Inter-Agency Assessment Despite the information provided by FEWS-NET, FSAU and agencies working in the area such as SC-UK and Oxfam, there has been differences of opinion concerning the scale and severity of the current emergency in the Togdheer region. While there is no doubt that a humanitarian crisis needs a concerted response, it is equally true that there are chronic issues that also require attention. The scope of this assessment did not include long-term planning, but endeavoured to collect enough information such that short-term responses do not undermine longer-term priorities. An in-depth livelihoods based study will be required at a later date to suggest ways in which communities, authorities and the international community can work together to address the chronic problems of the area and thereby work towards preventing this kind of crisis developing in the future.

Objectives The assessment primarily focussed on the current drought and food security conditions prevailing in the most affected areas of the Hawd zone of Togdheer Region. ♦ Ascertain the severity and extent of the acute humanitarian problem ♦ Based on the short and long-term priorities of communities in the area, make recommendations

concerning appropriate short-term responses. In recognition of the underlying chronic issues affecting the livelihoods of the communities of the Togdheer Region, the assessment also looked to identify some of the key long-term factors. This was done with a view to ensuring that short-term humanitarian responses do not erode the long-term viability of livelihoods in the area, or undermine long and medium term interventions that are already in existence or could be put in place in the future. Participation, Area surveyed, Methodology and Sectors Covered The assessment was conducted by two multi-sectoral teams constituted by UNICEF, WFP, FSAU/FAO, FEWSNET, SC-Alliance, Oxfam, COOPI, Vetaid and government representatives.12 villages were selected through a purposive stratified sampling to ensure the widest possible understanding of humanitarian issues of the Togdheer Region. Household Economy Analysis (HEA) was used as the core approach for obtaining and analysing information on food and livelihood security. Semi-structured interviews with key informants and focal groups was used for collecting information more widely, together with a variety of other PRA tools including wealth ranking, mapping, seasonal analysis and problem tree analysis. Mid-Upper Arm

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Circumference (MUAC) of 1-5 year old children was used to collect information on child nutritional status, and followed standard random sampling methodology. The assessment focussed on collecting information on food security, livestock and pastoral livelihoods, health and nutrition, water and environment. The analysis was done by the field teams in Burao in a holistic manner to ensure that the cross-sectoral linkages were made. Interviews were held with key informants. These included: ▪ representatives of “poor” pastoral households; ▪ key informants (“middle” and “better-off” households with larger herds to discuss pastoral issues,

water and environment; ▪ key informants to discuss access to water availability and access in settled communities (with a

focus on water for humans) ▪ Health and nutrition assessment, including an assessment of health services available in the area,

discussions on nutrition and a rapid MUAC assessment. ▪ Education information was collected through key informant discussions with teachers and in

discussions with “poor “households”. Checklists for the initial discussions with Elders in each location, as well as the linked discussions with key informants, are included in Appendix A. Settlements visited are annexed. Brief desk review was conducted to collate relevant reports and assessments on Togdheer region with particular focus on the Hawd pastoral and Togdheer agro-pastoral areas. This included: FEWS: remote sensing: historical rainfall data / graphs; FSAU: nutrition surveys, maps, livelihood baseline information and recent Gu analysis, historical

market data, recent assessments, livestock studies, migration patterns etc. WFP: information on livelihood assessments and food distributions in the area in the last 3 years;

information on supplementary feeding interventions in the last 3 years Oxfam/COPI/SCUK: background information on the area, own or other agency project

information in area, maps and assessments etc. Oxfam and SCUK: information on water sources and projects; education – infrastructure,

enrolments and any studies on access to education UNICEF and Government: data from health centres (or other studies) on seasonal and long-term

trends in disease incidence; health infrastructure and access to health care. Details of interventions in the area.

The mission focused on the performance of the Gu rains and its implications from the perspectives of accumulated local experience of elders. Due emphasis was given to the impact such delays or failure have had on water, pasture, livestock condition, migration/displacement, food security, health and nutrition. Comparisons of impact were made with reference to past performances in discussions with community elders and selected representative pastoral families. Water supply sources were visited in order to observe the quality, present yield and their operational status and discussions held with users. In the field of health and nutrition, team members held discussions with health workers on the ground and the community. The team undertook rapid MUAC survey to assess the nutritional status of children < 5. The pattern of disease occurrence, availability of health infrastructure and provision of health services rendered by health facilities. Reports from the facilities were studied to corroborate information received.

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Mission members discussed the reports of the two rapid assessment teams and the summary was prepared and shared with participating agencies, NGOs, and the national/regional governments.

After detailed and lengthy preparatory sessions in Burao, two teams were set up to visit the said areas to cover two different parts of the region. Assessment Findings Food Security There currently is a severe drought in Togdheer region particularly south and north-west due to the successive seasonal rain failures. However, areas along the border with Ethiopia like Haji Salah, Mulaxo, Sibidhley and Balidhig received some localised precipitation in the first dekad of December 2003. Though these rains brought some relief in availability of water, the pasture and browse generation was poor due to the adequate rains. These rains were late compared with the normal rainfall calendar of the food economy zone. According to the majority of the key informants, about 50% the livestock in the drought affected areas died and the body condition of the remaining livestock is poor. Nevertheless, the ‘rich’ pastoralists were able to transport their livestock to areas along the Ethiopia border with many crossing into the Somali Region of Ethiopia where rains were received. The pastoralists’ who remained in the drought-affected areas are the ‘poor’ and ‘lower middle’ groups who were the most affected in terms of asset depletion. Due to the reduction of asset holding, there has been a shift in household food and income sources. Table 1. Wealth Breakdown and Asset Level (Baseline vs Current)

Current Baseline Poor Middle Better off Poor Middle Better off HH size 7-8 8-10 9-11 6-7 8-10 9-10 Shoats 30-40 50-60 150-200 50-60 80-100 250-300 Camels 0-5 10-15 20-25 4-6 8-10 40-50 Cattle 0 0 0 0 0 0 pack animal 0 1-2 2-3 1 2-3 4-6 No.of Berkeds 0 0-1 1-2 0 0-1 1-2 % pop 40-50% 40-60% 5-10% 20-35% 45-55% 10-15 Wealth group shifting: As shown above table, most wealth groups experienced asset reduction of about 50% for shoats and 15-20% for camels. The pack camels which are important for transport purposes, breeding females and Calves/ lambs and kids were the most hit by the drought due to exhaustion of pastures and lack of fodder. A considerable proportion of the poor wealth group went into destitution after losing their assets and became IDPs around the settlements and urban areas.

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HOUSEHIOLD BUDGET ANALYSIS: (Baseline versus current situation). POOR WEALTH GROUP: Food Sources: The major food sources of the poor households in a normal year (fig 1) are primarily purchases and livestock products (milk & ghee) respectively. In a normal year the purchases contribute about 80% of the annual energy needs whereas around 12% of the annual energy needs in the baseline year comes from livestock products (milk, ghee and meat) and the remaining comes from gifts and social support. Currently, the poor household’s food access (Fig 2) has changed from the baseline and most of the household purchases (mainly Rice, Sugar, Wheat flour and oil) is about 49%, with Gifts and social support contributing around 15 %. Meat consumption increased and currently contributes 3%, while other livestock products contributing almost zero. This leaves a food gap of about 33 %. Other current deviations from the baseline: Food purchases from the markets (rice, w/flour, sugar and oil) has declined by almost 50% due to reduced livestock prices, and increased cost of imported food commodities. Compared to the baseline, the prices of the livestock have declined by about 40%, while that of the imported foods went up by 20%. For instance, in a normal year, one shoat would exchange for one 50kg bag of rice, while currently 2 shoats exchange for 1 bag. Milk and ghee portions have completely vanished as a food source As a result, the current annual food access is only 67% leaving a deficit of around 33% due to deteriorated terms of trade, loss of animal products (milk & ghee) and migrations that have disrupted local coping mechanism. Although gifts (support from relatives either in kind or cash) and self-employment (firewood and charcoal production) options were maximized, the deficit gap was too huge to be covered by this options. It is anticipated that the food deficit will deteriorate as the drought persists. Local food production (sorghum and maize) was nil thus eliminating the purchase local foods as an alternative for the poor groups.

Poor Wealth Group Baseline Food

Access

Own Products

12%

Purchases78%

Gift10%

Current Food Access-PWG

Own Products

3%

Purchases49%

Gift15%

Deficit33%

Fig 1

Fig 2

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Current Income-PWG

Livestock Sales26%

Livestock Product Sales0%

Labour8%

Self-employmen

t34%

Income Gap32%

Baseline Income-PWG

Livestock Sales40%

Livestock Product Sales21%

Labour12%

Self-employmen

t27%

Baseline Expenditure-PWG

Food Purchases

78%

Social services

7%

Others13%

Water1%drugs1%

Current Expenditure-PWG

Food Purchases

39%

Others4%

Water4%

Transport3%

Expenditure Gap50%

Income Sources: Baseline: In the normal year, the livestock sales and the sales of the livestock products contribute about 61% of total yearly income while self-employment and labour contribute 27% and 12% respectively (see Fig 3). Currently: 40% of the income from the livestock and products sales has been lost. Income from the sale of the livestock products (milk & ghee) is nil, mainly due to lack of fodder for the livestock, which contributes to deteriorated production. As a result, the poor wealth group is facing approximately 32% of the income gap, (see Fig 4). In an attempt to bridge the income gap, the poor wealth group engaged the self-employment and gift options. Currently, proportional income from the self-employment has increased to 34% from the normal 27%. Expenditure Baseline: In the normal year, More than 70% of the normal annual income for the ‘poor’ wealth group is spent on food purchases (Staple: rice and w/flour, non-staple: sugar & oil). (see Fig 5).

Fig 3

Fig 4

Fig 5 Fig 6

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However, due to reduced income, this group is currently capable of meeting only 50% of their food needs (see Fig 6). This leaves a 50% deficit in purchasing their requirements. This is reflected by reduced meals, increased school dropouts, and split of family members in search of labour to save on the social costs. There are additional cost elements of food and transport, which do not exist during the normal period. Coping strategies: (Current & Projected including community support systems adopted)

Reduced meals (2 meals per day compared to the normal 3 meals) – because of affordability and to reduce the expenditure.

Family split in search of labour (herding, getting jobs in urban, etc) and self-employment

mainly firewood/charcoal production to contribute family income.

Increased migrations to the rained areas to save the surviving livestock.

Increased social supports (from 10% in the baseline to 15%)- mainly cash remittance from relatives in the towns and the diaspora.

Rainfall Performance

Togdheere: Rainfall Performance 2002 to 2003 vs. Average

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1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71Dekads

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Local Goat and Rice Terms of Trade in Burao Market, from 2000 to 2003

0.00

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So urce: F SA U & F EW S N ET

50 K

g of

rice

(kilo

gram

)

Goat/Rice (TOT)

Projection of the food security situation for the coming months. (up to April/May). The drought has reduced the poor households’ food source and income. This has jeopardised the nutritional status of children and the elderly. Livestock deaths are expected to increase during the coming dry season (from January to mid April) due to water and pasture depletion. A deterioration of the already precarious food insecurity for a significant proportion of the community and a surge in the population of the destitute and IDPs is anticipated. The rural to urban migration will increase, thus putting more pressure on the poor and inadequate social services in towns. The pastoral respondents indicated that there will be no alternative migration destinations once the existing browse is exhausted. The existing browse will not last long. School dropouts will increase in the affected rural areas. Water in the Berkads will decline or be exhausted in the in-migrated areas. The quality of this little water is expected to deteriorate further leading to an outbreak of disease with devastating consequences on the vulnerable animals and humans who have weakened immunity. A vicious circle of reduced food stocking by traders and food availability at household level due to declining purchasing power for the ‘poor’ and ‘middle’ households will ensue. Many traders will not send food to pastoral areas because the declining purchasing power and increased demand for credit. The prices of the imported food items, which currently stand at a high of 20% (compared to the normal season) will continue to increase. This will effect the already deteriorated terms of trade (see figure below). The imported food items mainly come through the Berbera and Bossasso ports. The Somaliland & Puntland territorial disputes is anticipated to contribute to a raise in food prices. The poor wealth group now constituting 40-50% of Togdheer pastoral food economy zone is likely to increase to about 60 to 70% as more middle group families join them after losing their livestock. Some of the poor households will further become destitute or/ and IDPs.

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Health and Nutrition The team conducted an evaluation of the status of health services, common health problems and any deviations from the normal. The nutritional status of the children under five years was assessed and gaining an insight into the feeding practices and childcare practices. Methods used included MUAC measurements for children between 12 – 59 months, Focus group discussions with groups of mothers, discussion with key informants (mainly health staff and elders), clinic records and general observations.

Findings: Access to health services is very limited, although most of the villages received Renewal Health Post kits. Most villages lack health posts premises and usually the drugs are dispensed by CHWs, who have no fixed abode.

The few MCHs seen in some villages carry out very limited activities, and no EPI services were provided in all the areas. There were no cold-chains either.

Current common diseases are watery and bloody diarrhoea, Acute Respiratory Infections (ARI), Whooping cough, Malaria and measles and maternal related problems. Diarrhoeal diseases, measles, whooping cough and ARI where seen to have increased from the normal. The relatively high incidences of Whooping cough & measles reported raises obvious concerns on the level of EPI coverage in the region. Availability of medicines for common ailments, as reported by many villagers, was either non-existent or woefully inadequate. The overall environmental sanitation status is poor in all villages visited. Carcasses were observed littering the area. There were no garbage disposal system, limited latrines and the quality of water was poor (discoloured, turbid, smelly with unique taste). This was attributed to Berked channels that had not been cleaned as the rains came unexpectedly. The MUAC was used to determine the GAM in all settlements surveyed with the rates ranging from 6% to 23%. The figures, however, represent mainly village dwellers who would be classed as a better off segment of the community as which compared to the actual pastoral community in the surrounding areas. According to MUAC results global Acute malnutrition of the 12 villages visited is 10.9% (<12.5cm or Oedema) and the severe Acute malnutrition is 1.3%.

Severe clinical malnutrition signs and symptoms were observed.

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MUAC Summary

Village name Oedema <11cm =>11 - <12.5cm

=>12.5 - <13.5cm

=>13.5 Total

Qoryale 0 0 5 5 28 38War-cimran 1 0 3 6 24 34Bali-Calanle 0 0 0 1 21 22

Q. Lugud 0 1 3 2 39 45Bali-Hiille 0 0 3 4 22 29

Harada G.X 0 1 6 10 13 30Nasiye 0 0 2 6 23 31

Duruqsi 0 0 0 1 16 17X. Salax 0 0 1 1 15 17Mulaxo 0 0 2 7 21 30

Dabagorayale 0 0 1 7 20 28Sibidhley 0 0 1 0 20 21Bali-dhiig 0 0 3 3 43 49

Total 1 2 30 53 305 391 • Global Acute Malnutrition rate is 8.4% (<12.5cm or oedema), while the severe malnutrition

rate is 0.7% ( < 11cm or oedema) and 13.5% are at risk (=> 12.5 – 13.5cm) • A survey done in August 2003 by FSAU and MOHL showed Global Acute Malnutrition rate

of 10%, which have higher results, and the main reasons could be: - In the survey up to 900 children were screened, but for the MUAC only 391 children

were covered, so the sample size is relatively small. - Higher number of villages were also covered in the survey, compared to this rapid

inter-agency assessment - MUAC assessments have been done in both the seriously affected villages and

villages that have received some rains in December 2003, and there are significant differences in terms of the malnutrition rate between the two.

MUAC summary for seriously affected villages

Village name Oedema <11cm =>11 - <12.5cm

=>12.5 - <13.5cm

=>13.5 Total

Qoryale 0 0 5 5 28 38War-cimran 1 0 3 6 24 34Bali-Calanle 0 0 0 1 21 22Q. Lugud 0 1 3 2 39 45Bali-Hiille 0 0 3 4 22 29Harada G.X 0 1 6 10 13 30Nasiye 0 0 2 6 23 31Total 1 2 22 34 170 229

• Global acute malnutrition rate is 10.9% (< 12.5 cm or oedema), while the severe acute malnutrition rate is 1.3% and 14.8 are at risk. Global acute malnutrition is showing slight increase if compared August survey.

• Villages with high malnutrition rate were always associated by Infectious diseases (watery and bloody diarrhoea, Measles, Whooping cough, ARI etc) low energy and other nutrients intake and poor feeding practices.

17

Scenario in the coming months

With no immediate appreciable intervention, the health and nutrition impact of the drought during the coming months would deteriorate leading to increasing morbidity especially in children and elderly through: -

The health status of the population could deteriorate further if current conditions prevail for the next month or two (Jan/Feb.04). With the limited access to health services, there is a likelihood of increased infectious diseases, (Diarrhoea, measles, Whooping cough etc) fuelled by the deterioration of environmental and water sanitation in overcrowded villages and declining nourishment.

Conclusions: Children under five years and the elderly are the most vulnerable segments of the community. Malnutrition among all groups was rife in most village communities. The effect of livestock loss has had an unprecedented impact on the quality of life of all groups across the wealth divide.

The most affected villages showed higher malnutrition rates compared to villages that received some rains (during 1st week December.03). There have been no EPI services in all villages assessed. Health facilities were on the whole non-existent and services, if any, extremely poor. Health & nutritional problems observed in the region at the time of the Inter-agency assessment could most certainly be attributed to the lack of adequate rainfall, insufficient pasture and loss of livestock. Households energy intake has reduced. Milk, meat, ghee and other livestock products availability & sales had significantly declined, thus affecting household disposable income with health & nutritional consequences. Mothers highlighted the reduced frequency of meals for young children to between 1- 3 per day, consisting mainly of rice, anjela, tea and oil. This food regime, considered as adult food, is difficult for the children who are accustomed to milk, meat and Ghee. The ban on the livestock export to the Arabian Gulf has for some time had its own effect on the livelihood of these populations. Livestock – assessment findings Livestock holdings: In the course period, it was noted that livestock holding by pastoral households (within same wealth Group) differs from the baseline (22nd August 02, FEZ profile). Heavy losses of cattle and pack camels were recorded since the 1999-2003 droughts. The mortality rate of livestock was estimated at about 40 –50% for shoats and 15-20% for camels. Livestock reproduction and production: Reproduction rate (conception rate) for all species has significantly declined. The camel calving rate dropped by 37.5%, while the shoats kidding and lambing rates were 57% (between 15-25% compared to 30-40%). Due to the frequent droughts, a significant proportion of the kids, lambs and calves have been wiped out. Goats and camels are currently predominant in the herd size.

18

Drought Affected Area

N

0 50 100

Kilometers

Gulf of Eden

ETHIOPIA

DJIB

OUTI

Livestock migration

SanagBari

Sool

Nugal

Awdal

Galbeed

Export & Local Goat Prices in Burao Market, from 2000 to 2003

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

450,000

Jan-

00

Mar

-00

May

-00

Jul-0

0

Sept

-00

Nov

-00

Jan-

01

Mar

-01

May

-01

Jul-0

1

Sept

-01

Nov-

01

Jan-

02M

ar-0

2

May

-02

Jul-0

2

Sept

-02

Nov-

02

Jan-

03

Mar

-03

May

-03

Jul-0

3

Sept

-03

Nov

-03

Source: FEWS NET and FSAU

Som

ali S

hilli

ng p

er H

ead

Goat ExportGoat Local

DroughtPeriod

Livestock markets: comparison of the livestock prices in affected areas and Burao town main markets. Animal grade Price in

assessed area So.Shs(,000)

Current price in Burao town So.shs. (, 000)

Export quality

250-300 420-500

Local quality

200-250 400-460

Lambs 120-150 280-300

The livestock prices in Burao market have been on the increase due to the declining supply in the markets. Pastoralists are reluctant to dispose off their animals during the wet season in anticipation of fetching better prices for the fattened animals. The Haj season heralds increased demand, therefore, better prices. The loss of animals due to drought entails restraint in selling off of production stock.

Currently, the volume of livestock trade in Burao market ranges from 3000-5000 heads/day. The volume traded is expected to increase during the peak periods of Hajj. On the contrary, the drought-affected villages have experienced a dramatic decrease of livestock prices due to the poor and weak animal condition and inability to access market ( see Figure 8.)

Livestock Migration: There was a massive migration of pastoral household (between 70-85%), with about 60% crossing into Ethiopia. The ‘upper middle’ and the better-off households migrated first, while the poor households were left behind. The movement was not systematic with households migrating in different directions including to the Golis range and Sarar plain (north east of Burao) and Tuuyo plains where late rains were received in December. Massive transportation of animals (Shoats) by trucks took place in a short span of time, saving lots of the animals from certain death due to exhaustion from trekking. Transport charges ranged from 150-200$ per trip.

19

Camels were moved first in late September, followed by shoats transported by trucks. A small proportion of goats were left behind to provide milk ( caddeys) to the vulnerable household groups (elderly and children). The main coping strategies: The main coping strategies adopted by the pastorals in the course period of the drought include the following:

• Early transportation of shoats by trucks to the rainy areas. • Social support among relative. • Remittance from Diaspora • Splitting family members and animals species to different areas. • Shift to urban centers in seeking job opportunities. • Slaughtering weak animals. • Charcoal burning and firewood collection. • Support of food items and water by business groups and the Somaliland Gov’t.

Constraints: Although the drought affected all pastoral community, the main constraints can better be categorized in accordance to out-migrated and in-migrated areas. In the out-migrated areas the current constraints include: ♦ Livestock body condition is poor and below the normal. ♦ Calving, lambing, and kidding rate are below normal. ♦ Lack of forage ♦ Very limited marketable livestock, particularly by the poor and lower Middle Wealth

Groups. ♦ Loss of income by the poor households (animal products). ♦ Declining terms of trade e.g. 2 heads of shoats to one bag (50kg) of rice (compared to

normal 1 head for 1 bag). ♦ High and increasing expenditure for water. ♦ Low access to credit and increasing social support fatigue.

In the in-migrated areas, following are the main constraints: ♦ A high concentration of livestock with consequent grazing pressures contributing

further land degradation. ♦ Possible transmissions and outbreaks of infectious diseases. ♦ Diminishing pasture and water availability and access Long term effects if the trend continuous: ♦ Collapse of livelihoods as a result of livestock asset loss leading to destitution. ♦ Massive migration of pastorals to the urban centers. ♦ Adoption of more disruptive coping strategies e.g. increases in charcoal production

and sales. ♦ Decreased access and availability of water and forage – with possible social upheavals.

20

Environmental trends: In the past five years, there has been extensive range-land degradation due to successive failure or erratic rainfall with the consequence of nutritive forage. This includes Indigofera, Acacia, and commiphora sub-species. Live tree cutting for charcoal production (Black Gold) and to feed weak animals has reduced most potential forest tree cover, resulting in the depletion of browse. This has enable water and wind erosion in wide spectrum. The significant number of weather roads have led to gully formations. The establishment of illegal private enclosure, particularly in the west, east and the north of the region have reduced communal grazing land thus contributing to increased pressure on the limited grazing areas. Lots of trees were cut down for fencing these enclosures with consequences on the environment. Effects of livestock trade ban:

Livestock asset reduction due to sale of female stock at local markets to compensate

for the loss of exportable stock. Many female shoats (breeding) are also used as local consumption

Export quality stock is sold at the low local quality stock prices Low prices of livestock in local markets due to increased supply. Increased prices of food commodities. Devaluation of Somali Shillings due to loss of hard currency earned from livestock

exports leading to a higher price of all import items (food and non-food items). Increased charcoal production with negative impact on the environment. Encouragement illegal private enclosures in pastoral areas. Loss of access to loan and barter facilities by the pastorals from the business groups. Discouragement of livestock keeping by most young generation who have shifted to

the urban centers. Increase in family conflicts due to sale of animals at lower prices rather than keeping

the zeriba.

Water and other community issues

Water Availability and Accessibility There are no permanent water sources like Bore wells in the assessed area, streams and springs in the Hawd. Traditional barkads and balleys provide the bulk of human and livestock water requirements, complimented by seasonal hand dug wells. Due to the insufficient rain seasons for the last 2-3 years, most of these water sources are empty. The subterranean water tables have dramatically declined resulting in the drying up of most wells. 1638 Berkads were observed in the nine out of twelve villages assessed. 60% of them were either in disuse or damaged – reportedly during the civil wars. Of the functional 40%, only 16% had water with levels ranging between 75% and 25% of their capacity. The remaining three villages, relied on seasonal dug wells, which mostly located in the effected areas. Currently, water availability in the in-migrated areas is increasing becoming difficult to access, due to the increased demands occasioned by new immigrants. The available water in the barkads and balleys will not sustain the water needs for both livestock and human until the coming next rainy season “GU”.

21

The distance to the water points is increasing for the women and children as the nearest Barkads dry out with consequent increase of water prices (in addition to transport cost). Access is, therefore, limited for the poor groups including orphans, women-headed households and destitute families. Generally, the water infrastructure is in poor condition. All non-functioning Barkads require rehabilitation and reconditioning. The pastoral communities tends to contribute in cash or kind to Barked rehabilitation. The seasonal hand dug wells also require deepening and rehabilitation to increase availability of water. Functioning Barkads, Balleys and seasonal dug wells of the visited villages had poor sanitary conditions. Animal and human faeces, dead animal carcasses were observed scattered around water points and villages soundings, which would inevitably contaminate water sources. Respondents indicated that many of Barked and Belays were destroyed during the civil wars and have not been rehabilitated. There is a dire lack of permanent water sources in the area, with bore-holes being very far with a consequent high water cost. Range-land management by government has virtually collapsed and effect on law and order. Land enclosures have sprang up dramatically leading to disputes among the pastoralist.

22

Table: Water access and availability in the assessed Area.

Definitions Balley (dam): natural or human dug dam used for harvesting rain water. Barkads: reservoir constructed and lined with masonry walls with inlet drainage and silt trap to trap rainwater. Hand dug wells: deep hole dug into the ground until the water table is reached. The diameter of the holes varies from 0.8 to 1.2m with depths of between 5 - 30m. Water is extracted using is local mud buckets. Where there is no underground water, some of these wells would act as Barkads - used to store water from the rain and run off water. Borehole: deep holes dug/drilled into the ground till ground water table is reached. The depth varies between 70 – 200m with a diameter of 5-12 inches. The bore is protected with a plastic or iron casing and water is extracted with a pump.

District Water source Status Bark ad Dug well Balleys Bore

hole

Total Functioning Damaged With water

Functioning

Damaged With water

Burao Qoryale 0 0 0 0 500 2 500 0 0 5 wells with hand

pumps, 3 operational, 2 not operational. Water levels drown down up to 13m. Wells need deepening.

Warcibran 105 45 60 0 0 1 0 Price of water increase due to additional transportation cost from source to Household.

Balidhiig Sibidhley Balihiile 130 36 4 0 0 0 1 0 Harada

dubato 35 5 Nil 1000 0 20 0 0

Nasiye 160 200 160 0 0 0 2 0 Duruqsi 15 145 15 0 0 0 1 0 Buhodle 37 35 6 0 0 0 2 0 Balicalan 0 0 0 775 725 775 2 0 Qorilugud 49 50 49 0 0 0 2 0 30 341 4 0 0 0 2 0 Odwane 40 65 40 0 0 0 1 0 Mulaxo 75 40 35 0 0 0 1 0 Dabogoraya

le

Total 676 962 309 1778 727 1395 15 0

23

Education Drought effect on Education of Children in the 12 sites visited.

September 03 Quarter I

December 03 Quarter II

School Pupils Pupils Dropout School Shifts

Grades ClassesBoys Girls Total Boys Girls Total Boys Girls Total

%

Qoryale 1 5 5 69 36 105 39 34 73 30 2 32 Warcibran 1 2 2 68 13 81 21 9 30 47 4 51 Balicalanle 1 2 2 69 28 97 45 15 60 24 13 37 Qorlugud 1 5 5 66 51 117 61 37 98 5 14 17 Balidhig 1 6 6 111 34 145 85 25 110 26 9 35 Sibidhley 1 2 2 52 11 63 Closed 52 11 63 Mulaho 1 5 5 36 17 53 Closed 36 17 53 Balahile 1 2 2 71 12 83 46 8 54 25 4 29 Dabagorayale 1 2 2 45 28 73 24 6 30 21 22 43 Duruqsi 1 5 5 53 25 78 20 12 32 33 13 46 Harada 1 2 2 37 22 59 18 16 34 19 6 25 Total 43 713 294 1007 359 162 521 318 115 433

N.B. Nasiye village has no primary school and no information collected. Out of the 12 villages assessed by the rapid drought situation assessment team there was no school in Nasiye village and two schools are closed in Sibidhley and Mulaho villages due to severe drought and migration. The drop out rate records indicate about 40%. Out of 54 urban and rural schools, 7 schools in the rural areas were not operating due to migration and in some villages even the teachers moved with their families. 8 schools offered the final exams and closed in December 2003. Thus, the number of schools closed during the December 2003 schools’ supervision were 153.

Recommendations Food security: Targeted Emergency free food distribution between January to May 04- (Jilaa period)l. Health and Nutrition: Support with medical supplies for most common human diseases e.g. ARI, diarrhoea, malaria,

Dysentery etc. Vaccination campaign to reduce the incidence of Whooping cough and Measles Health and hygiene Promotion

Livestock Immediate interventions: Establishment of mobile Veterinary teams. Vet drug distribution and training of paravets.

3 SC-UK schools assessment report

24

Relief fodder for animals Short and Long-term intervention: Introducing and/ or re-establishing range management plans such making reserve pasturelands to

assist the seasonal grazing of pasture resources. Restocking of the destitute and IDPs in the coming rainy season to help re-establish their normal

pastoral livelihoods. Community training and awareness rising on range-land resource utilisation. Encouragement fodder production in agri-lands. Establishment of pastoral associations to carry out range-land resource management. Diversification of pastoral economy (poultry and honey production) Control on charcoal production and the introduction of energy saving stoves.

Water Emergency Trucking water for Human and livestock for the coming Jilaal season. Chlorinating all water sources. Cleaning campaign/ sanitation awareness for water sources before next rain

Medium and long term Rehabilitation of non functioning hand pumps, and providing hand pump spare parts De-silting and rehabilitation of Balleys and dams

Identify potential permanent water sources by conducting assessments + geophysical surveys Soil and forestry protection and conservation, including the banning charcoal production and

providing alternatives. Education Institute a school-feeding program as a component of the general feeding program. Support to teachers - Capacity building Provide alternative schooling models e.g. mobile schools Flexibility in transfer and admission of students in different regions Support with education and recreation equipment and materials

25

Prioritisation of interventions

Village Number of H/H Number of affected H/H

% of the affected households

Qoryaale 1500 450 30

W/Cimran 900 360 40

Balli Calanle

2000 800 40

Qurilugud 3000 1200 40

Balli Dhiig 5000 2000 40

Sibidhley 2500 1000 40

Dabagoryahle 800 500 35

Laan Mulaaxo 2000 400 20

Duruqsi

1200 600 50

Harada G.X 3000 1500 50

Nasiye 1400 850 65

Balli Hiile 1500 700 47

Total 25300 10210 30-50%( 45%)

26

27

HISTORICAL TIME LINE

Year Ranking seasons Gu Deyr

Description of livelihoods

2003 Bajiya, kala Quba

oo o Inter-regional and crossed border mov’t, high animal deaths, particularly shoats, low production and animal marketing.

2002 Cigaal Dhimay

oo oo In- migration from Sanaag and Sool. Livestock body condition started to decline. Low animal sales

2001 Waqooyi u yaac

oo o Escalation of pasture and water. Massive move to highlands.

2000 Siiga weyne

oo oo 2nd livestock Ban. High mortality of cattle and migrating to Ethiopian Soimali region.

1999 oo oo Pasture adequate from Elnino with small rains received.

1998 oo oo Ist livestock Ban imposed. Livestock in good condition from El-nino fodder.

1997 Bululuqo

ooo ooo High livestock production, pasture and water.

1996 ooo ooo Good livestock production with good animals sales

1995 Gacma-dheere

oo oo Deaths of livestock, low prices, huge out-migration

N.B: O= VERY BAD, 00=BAD, 000=NORMAL, OOOO= GOOD, OOOOO VERY GOOD. Chronological drought 1952 Siiga-Casse 1959 Gaadhi-gaadhi Saar 1964 Shan Shilin 1969 Food khasaare 1972 Dabaylaale. 1974 Daba-dheer 1978 Col iyo Abaar 1979 Qorrax Madoobaad 1981 Dhummato 1983 Caalle 1985 Jimce 1988 wax la cuno waa. 1991 Naxash ka qaad 1995 Gacma dheere 2000 Siiga Weyne 2001 Waqooyi yaac 2002 Kala Quba, Bajiya Starting from 1997- 2003, the frequency of the droughts range from 1-2 years.

28

Participants

Sectors Name Organisation

Overall Lead Technical coordinator

Abdinasir O. Elmi FSAU/FAO

Team Leaders Dr Abdirahman Abdinasir Elmi

SC Alliance FSAU/FAO

Food Security Abdikarim Hussein Mohammed Abdi Sidow Addow Muse Awale Good

WFP MOA FEWSNET/USAID SC ALLIANCE

Health and Nutrition

Fuad Yusuf Khalif Abdullahi Dr Hasssan Ismail Fuad Hassan

MOH FSAU/FAO COOPI FSAU/FAO

Livestock and Pastoralism

Ali Haydar Dr Mahdi Ghedi Kayad Ali Mohamed Yusuf Warsame

MOL FSAU/FAO VETAID MOP and environ

Water and community isuues

Osman Abdi Hayd Dahar Mohammed Abdi Farah Eng Hassan Barkad Guleed Ibrahim Abdulahi

MRRR MOW and Mineral resource Oxfam MOW Vice Governor UNICEF

Technical collaborator

Robert Orina SC Alliance

Logistics Abebaw Zeleke SC Alliance

29

Selected Villages

Team B Team A

Visit Sequencing

Visit Sequencing

1. Balli Hiile 2. Nasiye 3. Harada G 4. Duruqsi 5. Laan Mulaexo 6. Dabagoryaale

1 2 3 4 5 6

N/A HP HP MCH HP HP

7. Warcimraan 8. Qoryaale 9. Qorilugud 10. Balli Calanle 11. Balli Dhiig 12. Sibidhleey

2 1 4 3 5 6

HP HP HP N/A MCH HP

Criteria

Security – non of the areas has a security problem Accessibility Availability of health facilities

Scheduling

Location Departure

Arrival Activity

First Village

8.00 fr Burao

1000 Elders meeting/interview/ discussion Identify focus groups

Day 2 2 villages

Day 3 2 villages

Day 4 1 villages and return to Burao

Day 5 Analysis

30

Appendix A: Checklists

Community Level Interview Checklist Ideally teams will arrive in the village late afternoon and after initial explanation of the purpose of the visit, will begin with Elders’ interview after prayers. The next morning (early) will be for sectoral interviews and other means of triangulation of information from Elders. Composition of interview: village leaders and representatives; the group should include women’s representatives Goal: • Introduce team and purpose for the visit/ assessment. • Find out about the current drought situation and similar shocks over recent years. • Find out about the distinguishing characteristics of various socio-economic (wealth) groups within the

community (quantify proportions). • Identify key informants for further interviews:

o poor wealth group (food security team) o livestock owners (middle/better-off) (livestock/water team) o health/nutrition (women)

• Make appointments for interviews next morning. Process: 1. Introduce selves and explain purpose of the assessment, trying to keep expectations low; community to

introduce themselves, giving titles if applicable; 2. Run through historical timeline to break the ice and understand the development of the drought. 3. Discuss the community as it is now and compare with baseline: differences between wealth groups,

activities and coping strategies, household composition, inter-dependencies between wealth groups. Output: Key questions to be answered: ▪ Population, recent in-migration and out-migration ▪ Current situation summary:

▪ Geographic extent of drought – which villages are similarly affected ▪ Who is affected, how are they affected (changes in livestock holdings, movements, access to

water, access to food (for HH and vulnerable groups), change in productive activities, health issues etc.)

▪ How have people coped; costs of coping ▪ Food security constraints – short-term and long-term – for individuals and community ▪ Interventions: emergency interventions and sustainable development

• Ask community leaders to identify key informants as follows (involving women wherever possible) ▪ Representatives of the poor group ▪ Environment/livestock ▪ Water ▪ Health ▪ Nutrition assessment assistant.

• Continue with community leaders informally. • Transect walks etc if time or early in morning.

31

Food Security – household level interviews Ideally interviews will start early (7am). Check key informants meet critiera for group. Tips: ▪ Remember the information gained in the Elders’ interview and check ▪ Use any PRA tools which help reduce misinformation, increase participation and improve quality of

information. A seasonal calendar is one example and helps get information disaggregated by season ▪ Emphasise what people do, or can do, for themselves. ▪ Use proportional piling to check which items of a certain category are the most important, and check it

makes sense. ▪ Focus on current year so far (April – September 2003: Gu and Hagaa seasons) and compare with baseline or

normal year. ▪ Try to get some idea of the respondents’ predictions of the future and implications for them. Focus on current year so far (May 2003-September 2003) and get: • Current asset levels and condition • Activities

o what food they get from each (compared to normal) o income they get from each (compared to normal) (consider net profit – note input costs),

discuss markets • Key expenditure items and change from normal; implications • What are the predicted changes in activities through to next Gu rains? or discuss the outlook: when will be the

difficult months and why? • Implications of the above for food security/livelihoods Composition of Interview: • The interview should be composed of representatives of the selected wealth group, identified by community

leaders; • There should be about 4 men and/or 4 women in each interview; Goals: key questions to be answered: Constraints to food security and changes from normal • Changes compared to baseline/normal year in

▪ Household composition ▪ Asset levels, herd composition, herd dynamics ▪ Access to resources (pasture, water, markets) ▪ Productive activities (including coping strategies (esp charcoal burning)

• Livestock market – effect of trade ban and projection for future. • Long-term implications of this • Intra-community support, what are the gaps; discuss community ideas on key problems and practical

issues around intervention in pastoral areas; community contribution Procedures: 1. Introduce team and explain objectives 2. Check that you have the right wealth group (eg. assets) 3. Explain that we are talking about households like theirs, typical of the group. 4. Following the checklist, discuss the last 2 seasons and predictions for Deyr and Jilaal. 5. Through this activity explore risk and vulnerability, possible solutions. Notes: ▪ The goal is to get an idea of changes in livelihoods compared to what is normal for the season. We don’t

expect to quantify food sources, income or expenditure. ▪ Price comparisons should be in US$ or in SSh with the exchange rate. ▪ Don’t miss activities which women are doing if you are talking to men (and vice versa). ▪ Through these discussions you should be able to gather other information on risk and vulnerability, why

certain options are taken, why others are not.

32

Household questions: NB: All information should be compared with baseline information 1. Assets: (where are they; who is looking after them etc.)

▪ Camel (and pack camels); # Milking ▪ Cattle; # milking ▪ Sheep & goats; # milking ▪ Donkey

2. Productive Activities: NB: If time, get actual quantities/prices; if no time, ask how it has changed compared to normal Milk: Camel: # milking, daily production per animal, amt sold and price, amt consumed Goat: # milking, daily production per animal, amt sold and price, amt consumed Cattle: # milking, daily production per animal, amt sold and price, amt consumed (discuss difference from normal; change in proportion sold vs consumed) Livestock sales: change in number sold, and price Shoats Camel Cattle number sold in Gu; price number sold in Hagaa; price (Discuss current markets, trade ban). Self employment: Quantity sold and price (check all activities including poles and sticks, grasses, honey, gums, charcoal, firewood, crafts) (Discuss charcoal trade, who controls it, where the primary and secondary market is etc.) Employment: (herding, migrant labour, construction of berkads etc). # days/wk; daily rate; # labourers (Discuss household splitting etc.) Remittances and gifts: income and food Loans: amount, pay-back terms. (Discuss where they get credit from etc.) 3. Expenditure items: Food: Cereals purchased: price & quantity; Sugar, oil, milk: price & quantity Inputs: Water; Drugs; Fodder Other: Education: number of children, cost Health care: recent spending, common diseases Household items 4. Coping Strategies (apart from above): Splitting households/herds, borrowing, remittances, change in expenditure patterns Limits to coping and cost of distress coping strategies

5. Outlook: discuss key changes in the environment and livelihoods over the next 6 months 6. Interventions: discuss priority problems, and pros and cons of different interventions for them and their community (and what they can do for themselves)

33

Rapid Assessment Guidelines for Health/Nutrition Team

At the end of the assessment, questions that need be answered are:- i) What is the current nutrition status of under-five children in the Sool plateau? ii) What are the major health and nutrition constraints currently (particularly for

children)? iii) How does this differ from normal?

Malnutrition data MUAC screening will be used in determining the levels of malnutrition Target Population/Sampling Purposively select a representative number of villages based on:-

a) Geographic representativeness of Sool plateau covering the three regions (Sool, Sanag and Bari) - the team to decide on representative villages

b) Severity of the drought – be sure to include in each area villages that are perceived to be ’less affected’ and those ‘badly affected’ by the drought.

In the chosen villages, target children will be: At least 30 – 50 children aged 12-59 months in a particular village/cluster. Due to the complexities of sampling it would be ideal if all children in a given village/cluster were included in the assessment. The assessments should be undertaken at household level. Resources

MUAC tapes At least two people. Measurer – Person taking the measurement and Recorder – Person recording the

reading and generally assisting the measurer Data forms Checklist and MUAC data recording forms (this side and reverse) Pens

Steps in measuring MUAC Note: If the parent or carer or other untrained person is acting as the assistant, the measurer should carry out and record the measurement.

1. Record the form/child’s details on the data form namely: - Child’s name Child’s sex Presence of oedema (yes/No) MUAC measurement

2. Remove any clothing that covers the child’s left arm 3. Calculate the midpoint of the left upper arm:

First locate the tip of the child’s shoulder (arrows 1 & 2) with your fingertips. Bend the child’s elbow to make a right angle (arrow 3). Place a measuring tape at zero (indicated by two arrows) on the tip of the shoulder (arrow 4) and

pull it straight down past the tip of the (arrow 5); read the number at the tip of the elbow to the nearest 1 cm. Divide this number by two to find the midpoint, which you and your assistant should mark on the arm with a pen (arrow 6)

4. Straighten the child’s arm and wrap the measuring tape around the arm at the midpoint (ensuring that the numbers are right side up). Make sure the tape is flat against the skin (arrow 7)

5. Check that the tape around the child’s arm is neither too tight nor too loose (arrows 8 & 9). Correct if necessary.

6. When the tape is correctly positioned and under the correct tension, read the measurement to the nearest 0.1 and call it out to your assistant who then correctly, records this reading

7. Remove the tape from the child’s arm.

34

MUAC Data Recording Formats

Village/Cluster Name: ___________________________Date: _____________________________

MUAC measurement (tick box) Child’s name Sex Oedema

(Y/N) <11.5cm 11.6 – 12.5 12.6 – 13.5 >13.5cm 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 QUALITATIVE INFORMATION COLLECTION In each of these villages visited for MUAC assessment qualitative should be collected based on: a) Observations: Food preparation, sanitation, water quality, food baskets, childcare, breastfeeding etc b) Focus group discussions (FGDs) to be conducted with mothers (Min.6 and max.12 mothers). Probing

questions should be used to investigate key issues. Guiding questions:- • What are the main current constraints for health and nutrition (focus on children)

− Disease patterns and access to health care − Child care and child feeding practices − Availability of food at the household level and appropriateness for children

• Discuss how this compares with the same season in a normal or good year

35

Health Composition of interview: Key informants. Mothers of children; health post staff if any. Goals/key questions to be answered:

• Assess nutritional status of 1-5 year old children using MUAC with a standard methodology of random cluster sampling;

• Gain information concerning the main health issue in the settlement, and recent changes; • Assess relative level of access to primary health services

Process: a) Using standard random cluster sampling techniques, measure the mid upper arm circumference of 30 (50?)

children between the ages of 1 and 5 years; b) While measuring nutritional status of children (MUAC), discuss the major health issues with the mothers of

children:

• What are the main health problems in the village/ settlement?

• Is this normal for the time of year? If not, what are the reasons?

• Are there particular (geographic) areas where health problems are especially bad? In what way? What might the reasons be?

• Are there particular groups of people whose health problems are especially bad? In what way? What

might the reasons be?

• What health services exist? Where/ how far? What staff? Do you use them? If not, what are the reasons?

c) Triangulate information with other key informants such as health post staff and/or village leaders.

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Livestock, Livelihood strategies, and the Environment Interview composition: focal group discussion, with approximately 4-6 men and women from a variety of socio-economic backgrounds (will need some elderly members to recall 50 years back on environmental comparisons) Goals/Key questions to be answered:

• What is the current status of livestock in and outside of the area in comparison with ‘normal’; • What have been the main coping strategies adopted with regard to livestock and other forms of income; • What are the main constraints facing livestock production and pastoralist livelihoods and what are the

main mid to long-term trends. • How has the environment changed recently and in living memory/what are the causes and the solutions; • What impact has the drought had on the environment (especially charcoal);

Procedure: Semi-structured interview mapping, piling, problem tree and prioritisation exercises addressing the following key areas: a) Livestock/pastoralism:

• Types of livestock (relative importance of the different species in livelihoods) and herd composition • Changes in herd size of different wealth groups over the last 4 years • Livestock reproductivity and productivity, milk availability and quantity at HH level • Livestock migration within and outside the area (normal, current, constraints to movement) • What category of animals moved out first to where and when did it happen? • Over the successive rain failures, are there any changes in the out-migration areas, If yes to where and

why? • What proportion of the total livestock population has moved out and when? • Of those that remained, what are the categories within the herd composition? • What category of wealth group remained behind and in which proportions and why?. • What effect did the ongoing drought have on the remaining livestock population? • What are the current livestock and milk prices in the local market? • What are the volume of sales, both for live animals and milk in the local market. • Are livestock traders or their agents operating in the area. If yes, Why ?If no why? • Of the livestock remained in the area what was the livestock mortality due to drought

(malnutrition)(current) ? • What is the mortality rate per species at the HH level ranked by wealth group in your area • Livestock disease patterns. Are there any outbreaks of livestock disease that has also caused production

losses and mortalities. (current) • If livestock production is severely affected what alternative practices pastoralists carry out to ensure

food security • What would be the appropriate intervention to save livelihoods of the severely affected pastoral

communities. b) Environmental Issues:

• Time line/ comparison with 50 years ago: what has changed in terms of people’s livelihoods (range management/migration patterns, livestock holdings, water management, coping strategies etc); and how has the environment changed (tree species/ cover; grass species/cover; gullies; sink holes; erosion; localised/ extensive over-grazing etc).

• List main causes of environmental degradation over the last 50 years: probe each cause to understand its own causes. Prioritise importance of causal factors (tip: problem tree)

• What are the solutions to each of the casual factors; are there any overlaps/ interlinks? • What have been the more recent (last 3 years) impacts on the environment, and what role has the recent

drought had? • Importance of charcoal production; changes in prices; effect on environment; who is engaged in

producing charcoal, and how is it being traded (markets, export etc); what is the future for charcoal production/ how can it be controlled and made more sustainable?

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Water

Availability of water. If not available why? If available, type of water sources: Bore Hole: Number functioning and yield per day dry season, wet season. Hours of operation If not functioning? Number of BHs out of function & why? Berkads: Number, Are Berkads full, half-full or empty. Balleys: Number, Are Balleys also Full, Half Full or Empty and since when Is accessibility of water normal, if not why? How far do pastoralists come to visit this water source (kms) Transport used for water trucking: Water tanker, pack animals. Who controls or manages the water sources (Communal or private property). The price of water x drum: From the source and at HH level. Number of trucks fetching water from the water points in the area per day? Is water accessible to all communities? If no, Why?