Ethiopia - Situation Report, 10 June 2024

HIGHLIGHTS

  • More than 1,000 refugees from Sudan leave settlements in West Gondar, Amhara citing insecurity and lack of protection. Partners support the Government in finding solutions.
  • High malnutrition in Ethiopia is compounded by disease outbreaks and other shocks.
  • The UN and humanitarian partners are engaging with the Government to support the implementation of principled relocations/ returns of IDPs.
  • Flooding leaves thousands affected, displaced in several parts of the country.

Situation Overview

In March 2023, Ethiopia’s refugee population exceeded one million, making it the second largest host country in Africa, as it continues to open its borders for those seeking asylum and refuge. This surge emphasizes the country’s enduring challenges and the pressing humanitarian needs stemming from internal and regional conflicts and disasters and the critical necessity for scaled up assistance to provide life-saving support to those affected. In addition, at least 4.5 million Ethiopians were displaced in the country as of December 2023, due to conflict, violence, drought, and flooding. Immediate action is crucial to reduce people's vulnerability to protection risks caused by these multifaceted shocks. This includes addressing displacement and preventing reliance by internally displaced persons (IDPs) on harmful coping mechanisms.

Refugees who fled the conflict in Sudan since April 2023, and are now hosted in the Kumer and Awlala camps located in the West Gondar Zone of the Amhara Region, are expressing their dissatisfaction over camp services and heightened safety concerns, according to a partner. The sites are reported to have been experiencing attacks, robbery, and abductions by unknown armed groups. As a result, some 1,300 refugees left Awlala and Kumer settlements on 1 May, moving towards Gondar City. Several of them are currently camping by the roadside around 1.5 km from the settlement, while around 300 refugees from the Kumer site are seeking shelter near a nearby police post. Some families have returned to the Awlala site while others go back and forth to access services such as water, according to partners. A mobile health clinic deployed by a partner is providing medical/ health assistance to refugees in the area. Scaled up support is, however, necessary to meet the needs. Partners are liaising with local government forces to bolster security to the sites. Security patrols have been reinforced in both Kumar and Awlala, and with the support of a partner an additional police post is under construction at Awlala. There are currently some 150 security officers deployed in both settlements. Similar security incidents (attacks and abductions) by unknown armed groups/bandits in the area in February and March had led to the closure of the main highway limiting humanitarian movement.

The humanitarian situation in West Gondar is exacerbated by limited humanitarian action due to access constraints and limited resources, adding to the overstretched public services such as water and health, following the influx of Sudanese refugees and asylum seekers since April last year.

Since it was established in June 2023, the Kumer refugee site has hosted about 6,500 people as of the end of April 2024. In November 2023, the Awlala site (newly constructed) started receiving refugees from transit sites at the Metema border and accommodates some 2,000 people. Overall, more than 130,800 people (returnees, refugees, and third-country nationals) fleeing the conflict in Sudan have entered Ethiopia, of which over 123,900 people have arrived at the Metema border point of entry since 26 May 2023.

Meanwhile, refugees and asylum seekers from Sudan continue to cross Ethiopia’s Kurmuk point of entry in the Benishangul Gumuz Region, seeking protection and assistance. Partners continue to provide support. About 94 per cent of the more than 22,000 people in the area received food assistance in April. Partners are also providing shelter assistance with the construction of an additional refugee site in Ura. Water, sanitation, and hygiene (WASH) interventions are also underway in the site, including the installation of water pipelines and latrine pit construction. Shortage of fuel in the regional capital’s market is however affecting the pace of the site construction and humanitarian operations. Moreover, shortage of essential drugs and medical supplies are impacting health service delivery.

The UN and humanitarian partners are engaging with the Government to implement principled relocations/ returns of IDPs.

The Tigray Interim Administration on 31 May announced its grand plan to return 690,000 displaced persons to their places of origin in Southern North Western and Western zones, calling for resource mobilization, including from humanitarian partners, to support the return process. The return plan is timed for mid-year ahead of the 2024 meher(summer) planting season to allow for returnees to engage in livelihood activities. Partners have acknowledged the commitment of the national and regional authorities in their primary duties and responsibilities for providing humanitarian assistance and solutions to IDPs. Partners are also engaging with authorities regarding the need to adhere to international principles and guidelines for IDP returns. Lack of resources available to humanitarian partners has previously affected principled, safe, voluntary and organized returns.

Separately, the relocation of nearly 5,000 IDPs, including 255 households (HHs) and over 1,200 individuals affected by conflict and climate issues, was undertaken from the Endabaguna site in Shire district, Tigray to a site in Maidimu in three phases from 23 April to 1 May. The relocation aims to improve the services for IDPs and alleviate significant overcrowding at Endabaguna that had led to unsafe and unsanitary conditions, that have been highlighted in many previous reports. IDPs in Maidimu are now receiving multi-sectoral assistance as part of the partners’ planned response activities. Accordingly, shelter support (maintenance), water supply (trucking) and distribution of WASH, non-food items (NFIs), registration of IDPs for continued food assistance, health services at the Maidimu clinic, ambulance services, as well as distribution of mosquito nets and dignity kits – are all being provided at the site. A gap remains in the education sector, where there has been a delay in transferring IDP children from schools in Endabaguna to schools in Maidimu kebele and Shire, leading to family separation and interruption of learning, raising protection concerns.

The UNSG Special Adviser on Solutions to Internal Displacement (Mr Robert Piper) visited the Somali Region in May (6-7 May 2024). A visit to Qoloji facilitated by the regional government revealed the need to leverage existing durable solution efforts, although shortage of resources has been a challenge in the past. During Mr Piper’s visit, the regional government disclosed of its plans to relocate 59,000 HHs (nearly a third of the total IDPs in the region). The relocation activity is part of the costed menu of options (MoO) for Durable Solutions Strategic Plan for IDPs in the Somali Region (2024-2027). The implementation of the Plan requires a funding of US$178million, with $35 million (19 per cent) having already been funded by the Ethiopian Government, humanitarian partners, and communities and gone into relocation activities, according to the Durable Solutions Working Group. In line with this, arrangements are underway to relocate an estimated 6,000 IDPs in protracted situations at the Qoloji site (Fafan Zone) to two locations in Bayahaw (Shabelle Zone) and Gorayocawl (Fafan). In 2022, an intention survey conducted in four zones, revealed that most IDPs opted to be integrated with their host communities. While the MoO does not cover local integration, partners are engaging with the government to find solutions.

The Oromia Regional Government seeks humanitarian support from partners for the return of 60,000 to 70,000 IDPs from Amhara and Benishangul Gumuz regions to their places of origin in Oromia Region by June 2024, before the meherplanting season. In three rounds of the government’s planned exercises between February and May 2024, about 4,300 IDPs have returned from Amhara Region to East and West Wellega zones, as well as West Shewa zones in Oromia Region, according to the regional Busa Gonafa Oromia (BGO)/Disaster Risk Management Office. At least 14,300 conflict-IDPs displaced from Oromia Region in 2021 reside in Bambasi district (Assosa Zone) of Benishangul Gumuz. Engagement and collaboration by the Ministry of Peace, EDRMC, BGO, Amhara and Benishangul Gumuz regional authorities to facilitate the return process is ongoing.

The Government has disclosed several gaps and challenges in the return processes, including with regards to the provision of adequate shelter, food, agriculture inputs, reconstruction/ rehabilitation of damaged basic services/infrastructure, transportation, psycho-social support for survivors of protection violations, peace building, and security concerns in some areas. Humanitarian partners are looking for ways of engagement to ensure principled returns with durable solutions for the IDPs.

The March to May rains (belg/gu) have caused flooding, impacting and displacing tens of thousands of people across several regions.

In the Somali Region, heavy rains in early May caused flooding, affecting 247,000 people, and displacing at least 51,000 people across 13 districts. Primary needs include food, health, shelter, and water/sanitation. Physical access constraints hamper relief efforts, particularly in the southern zones.

In Sidama, floods since late April affected around 30,000 people, damaging crops, houses, schools, and health facilities. Approximately 9,000 people urgently require food assistance until the next harvest in August, along with basic non-food items and agriculture support.

In South Ethiopia, floods impacted over 19,000 people in several zones, displacing over a thousand and causing damage to livelihoods and infrastructure. Coordination committees are managing response efforts, with needs including food, veterinary drugs, agriculture seeds, and water treatment chemicals.

In Oromia, over 285,000 people were affected (at least 38,300 displaced) by belg rainy season flash floods in six southern zones, with significant damage to crops, houses, schools, and health facilities as of 21 May. Response has been minimal, with assistance primarily from host communities.

At least 7,000 people in Central Ethiopia Region were affected by strong winds, hail, and heavy rainfall in April. Houses, cropland, and infrastructure suffered extensive damage as well.

Overall, early warning and preparedness planning have helped mitigate flooding impacts, but risks persist until the end of the rainy season. Awareness, early warning dissemination, and water management are crucial for preparedness. For further information please refer to OCHA’s update on flooding (24 May 2024).

High rates of malnutrition in Ethiopia compounded by a variety of shocks urgently require a multisectoral response.

The nutrition situation in Ethiopia is already alarming as indicated by recent surveys(1), particularly in zones of Afar, Amhara, Somali, and parts of South Ethiopia Region (SER) where communities have been affected by drought, fuelled by El Niño.

Malnutrition rates in parts of these regions have already shot past high thresholds, and very high in Somali Region, according to the Nutrition Cluster. Reports show high numbers of children dying due to medical complications and severe malnutrition in Oromia and in South Ethiopia. The proportion of severely malnourished children with complications had already reached 10.3 per cent as of March 2024, compared to 9.4 per cent registered during the same time last year, according to the Cluster.

Ethiopia’s population faces multiple forms of malnutrition, including acute malnutrition (wasting) and chronic malnutrition (stunting). These issues are exacerbated by food insecurity, poor dietary diversity, recurrent droughts and floods, conflict, disease outbreaks, inadequate access to health and nutrition services, and low awareness and practice of optimal infant and young child feeding.

According to the Ethiopian Emergency Nutrition Coordination Unit (ENCU) and Nutrition Cluster, recent surveys reveal high prevalence of Severe Acute Malnutrition (SAM), especially in drought-affected regions such as Afar, Amhara, Oromia, and Tigray. The situation has deteriorated since last year, with an increase in SAM cases and medical complications. Areas such as Wag Hamra, Amhara (11.9 per cent), Asale, Afar (11 per cent) and Degahbur Agropastoral (DAP) livelihood in Somali (16.2 per cent), report high Global Acute Malnutrition (GAM) rates and stunting prevalence, while Adadle district in Somali has a high GAM (17.3 per cent), but low stunting prevalence (5.9 per cent).

Rapid Nutrition Assessments in districts in Amhara (December 2023) and South Ethiopia Region (February 2024) and Central Ethiopia Region (April 2024) show high proxy GAM rates, with Argoba district (South Wello Zone), Kinfaz district (Central Gondar Zone), and West Soro (Hadiya Zone) reporting rates of 22.9 per cent, 60.2 per cent and 25.7 per cent, respectively. Argoba has been amongst the hardest hit in the South Wello Zone by the El-Niño-induced drought during the 2023 Meher season (October-December), affecting the food security of at least 39,000 people, and who require assistance until the next harvest.

Malnutrition, coupled with measles outbreak in parts of the country, including in areas such as Kinfaz Begela that reported 144 measles cases as of 28 April, pose a high risk of morbidity and mortality amongst children under five years of age. The measles outbreak is worryingly expanding, currently affecting close to 100 districts across the country, with emergency vaccination campaigns delayed due to shortage of vaccines.

In drought-affected districts in Amhara Region, overall high rates of acute malnutrition are prevalent amongst children under five years of age. According to the Amhara Public Health Institute’s (APHI) Drought Related Public Emergency Nutrition Situation Report, No. 10, (1 May 2024) more than 1.8 million children in drought affected areas were screened for malnourishment. Out of these, 342,697 children with MAM and 35,981 children with SAM were identified with a proxy GAM rate of 20.8 per cent as of 1 May. Despite the high figures, only 54.8 per cent SAM and 15.9 per cent MAMwere linked to treatment programs due to nutrition supply shortage for MAM cases and last mile delivery challenges for SAM supplies.

Despite an overall high burden of acute malnutrition in drought affected areas, the emergency nutrition response efforts are reportedly weak due to limited partner capacity and shortage of nutrition supplies. Drought related diseases such as measles and cholera continue to spread in Amhara threatening the immunity of the malnourished. The Ethiopian Public Health Institute (EPHI) reported over 5,100 cholera cases in the region as of 21 May.

Afar and Oromia are the regions where an increase in admissions of SAM cases had been observed in March. The number of deaths in the stabilization centers is high and is related to late referrals and health outbreaks, according to the Nutrition Cluster. Malnutrition is worsening among 355,257 IDPs and returnees in hard-to-reach areas of Western Oromia due to severe food insecurity. Government assistance provided 532 metric tons of food to 69,913 individuals 6-12 months ago, allocating 7 kg per person instead of the usual 15 kg, according to East Wellega zonal office for disaster risk management (BGO).

More than US$276 million in funding is required to meet the nutrition needs of a targeted 3.5 million children and women this year (Humanitarian Response Plan - HRP). Close to 30 per cent of the required fund has been received by nutrition partners three months into the year. An estimated 20 per cent of the people in need have so far been assisted this year with services, including, life-saving nutritional feeding programmes for infants and young children, assistance to MAM for children under five, access to quality treatment for outpatient programmes and in outreach activities.

Stabilization centers are also providing care for under-five children severely acute malnourished with medical complications. Overall, the number of children with SAM admitted to treatment programmes in the first quarter of 2024 reach to more than 161,900 (close to 18 per cent of the HRP). March 2024 revealed 57,517 new admissions by children with SAM, a 7 per cent increase in admissions compared to the same period in 2022 and a 10 per cent decrease in admissions compared to 2023.

The situation underscores the urgent need for comprehensive and targeted nutritional interventions across the affected regions to address the crisis. Food relief/ emergency food assistance to households with SAM/MAM children as well as access to health services to treat diseases remain critical to avoid worsening of malnutrition cases.

The cholera outbreak continues to spread in 78 districts across eight regions of Ethiopia, more than 46,800 cases reported as of 21 May, according to the EPHI.

In April, the Afar Region witnessed a surge in cholera cases with over 730 cases and six deaths reported by the end of the month. The Afar Public Health Institution noted that at least 533 patients suffered from severe dehydration, highlighting challenges in accessing healthcare due to low awareness and poor referral systems. The institution has called for humanitarian support to contain the outbreak, which has been escalating since January 2024, focusing on active case search, risk communication, and community engagement. Some areas face a double challenge: food insecurity and outbreaks such as measles, particularly impacting children under five. The cholera outbreak is prevalent in drought and flood affected areas exacerbating humanitarian needs in areas with limited access to health and WASH services.

The outbreak, the longest recorded in decades, was first reported in Ethiopia on 27 August 2022, with the index case identified in Harena Buluk, Bale Zone, Oromia according to EPHI. It has since affected a total of 46,883 people with 600 death and at a 1.28 per cent Case Fatality Rate, higher than the 1 per cent standard as of 21 May 2024.

As of the reporting date, with eight rounds of oral cholera vaccination campaigns and support to 691 treatment centers, the outbreak has been controlled in 275 districts with the help of public health institutions and partners.

COORDINATION AND FUNDING

The 2024 Ethiopia Humanitarian Fund (EHF) First Standard Allocation was launched on 1 April 2024 with US$30 million to kickstart the response to newly prioritized humanitarian needs. These were identified in the Inter-Cluster Coordination Group (ICCG) Priority Humanitarian Response and Critical Funding Gaps addendum to the 2024 HRP, which was published on 11 March 2024.

The First Standard Allocation adopted an area-based approach, promoting an intersectoral response to save lives. Eligible partners were required to adopt the intersectoral Nutrition-Health-WASH-Agriculture package of interventions to improve the nutrition status of the target population. When integrating these sectors, partners are also expected to incorporate protection principles. The allocation also targeted at hard-to-reach locations with limited or no NGO operational presence. It advances localization through funding National NGOs as directly as possible, and prioritizing partnerships that add value in terms of capacity-strengthening, coverage in underserved locations, and ensuring an intersectoral approach. This allocation also responds to alarming reports of gender-based violence, as well as allocating funding to ensure continued rapid response capacity in hard-to-reach areas.

The EHF responded to the most pressing needs on the ground and allocated US$60 million to assist people in 2023. The Fund was a vital tool for the provision of life-saving assistance and essential protection services for about 2.9 million women, men, and children, including 1.6 million women and girls and 158,000 people with disabilities. The Fund responded rapidly to multiple emergencies, including supporting responses to drought, floods, and cholera outbreaks in several regions of the country. Please refer to the Ethiopia Humanitarian Fund Annual Report 2023 for further information.