Juba, South Sudan 06 March 2019: More than 75,000 measles vaccines have been airlifted to South Sudan’s Gogrial West County in response to an outbreak declared by the State Ministry of Health. There are 98 suspected measles cases, with one death reported. Medair, an international humanitarian organisation, has mobilized an Emergency Response Team to vaccinate children under five years of age in an area where the population is estimated at over 400,000 people. The campaign is expected to be conducted from 07-17 March, 2019.

Responding to this measles outbreak is made even more urgent by high levels of Global Acute Malnutrition (GAM) among children in Gogrial West County . “This is an area where the population is incredibly vulnerable,” said Jennifer Turner, Health Manager with Medair’s Emergency Response Team. “Children who are malnourished are more at risk of being infected with measles, and the complications are often more severe. The food insecurity in this region is rated at a ‘Crisis’ level. ” To reach so many children with vaccinations over a short period of time, Medair will train and deploy more than 800 people from the affected communities who will work steadily for ten days.

Teams of eight will head out each day carrying a supply of vaccines which must be kept cold despite day time temperatures of 40C. During shipping, storage and distribution, the ice packs will be frozen using generator power and, where available, solar powered vaccine fridges. All vaccines and supplies must be transported by air from Juba.

Measles is a highly infectious transmissible disease spread mainly by coughing and sneezing from the nose mouth or throat of infected people, causing fever, runny nose, red eyes, and a rash. Complications of measles can include pneumonia, diarrhoea and encephalitis, which is an infection causing swelling in the brain. Worldwide, measles is the leading cause of vaccine-preventable deaths in infants .

Medair South Sudan’s Emergency Response Team is always available to respond to healthcare emergencies. In 2018, the team completed 23 emergency interventions in health, nutrition, water and sanitation, and the distribution of critical items.

Please contact:

In South Sudan: Sue O’Connor, Communications Officer (English) comms-sds@medair.org +211 (0)92 747 5150

In Switzerland: Paola Barioli, Media and Press Officer (English, French, Italian) paola.barioli@medair.org +41 (0) 78 635 30 95

The UAE Ambassador to Rwanda, Hazza Mohammed Al-Qahtani, Thursday received the Representative of the United Nations High Commission for Refugees to Rwanda, Ahmed Baba Fall, to review prospects of enhancing cooperation between the two sides.

The UAE boasts longstanding relations with UNHCR as part of the State's well-established policies supporting global peace and stability as well as its solid contribution to resolving issues addressing the status of refugees and asylum.

The UAE and the UNHCR had signed a US$4 million agreement to provide emergency relief to South Sudanese refugees in Uganda. The signing marked the culmination of a pledge made by the UAE during the "Uganda Solidarity Summit on Refugees" held in the Ugandan capital Kampala.

MANAGING RISK IN INTERNATIONAL AND LOCAL NGO PARTNERSHIPS

An in-depth study of the realities and recommendations for improving risk management in humanitarian crises

Lindsay Hamsik
Senior Manager, Humanitarian Policy and Practice, InterAction

In humanitarian emergencies where access is limited and risk is high, people’s ability to obtain vital assistance often depends on partnerships between national and international aid organizations. In recent years, driven by the Syrian conflict, significantly larger portions of international humanitarian aid have been implemented through and alongside national and local entities. Building off InterAction’s 2016 research on NGOs and Risk, InterAction and Humanitarian Outcomes are releasing the findings of an 18-month study that examined how risk is perceived and managed in partnerships in high-risk settings.

Competing Pressures on Humanitarian Delivery

Globally, there has been a mounting call for more support and a greater share of funding to go to national and local NGOs for the sake of better humanitarian outcomes. From Somali to Syria and beyond, an effective response to humanitarian crises is often advanced through partnerships.

However, humanitarians often face countervailing pressures that complicate these partnerships, including:

• Intensifying financial scrutiny - Legal constraints - Repercussions for losses in highly volatile and high-risk environments

These challenges create obstacles to effective and quality partnerships. Growing demand for international-local partnerships, increasing humanitarian needs around the world, and deepening risk aversion distorts partnership dynamics, resulting in greater risks and hindrances for humanitarian delivery.

InterAction, along with 10 INGOs and supported by Humanitarian Outcomes, initiated a follow-up study to explore these dilemmas. The findings of this study, which was funded by USAID/OFDA, are reflected in a new report titled, “NGOs and Risk: Managing Uncertainty in Local-International Partnerships.” The findings provide an overview of how risk is perceived and managed in partnerships between international and national NGOs working in humanitarian crises.

“Competing factors such as an increased need for partnering and growing risk aversion has distorted national-international partnership dynamics.”

Case Study Findings

Accompanying the report are two case studies that take a closer look at partnerships and risks in northeast Nigeria and South Sudan.

One important research finding was that contracting vehicles and funding disbursement models often lead to cash-flow challenges for local NGOs, leading them to take unnecessary risks such as taking less safe modes of transport, reducing resources to rotate staff in and out of volatile contexts, and other practices that diminish both the timeliness and quality of humanitarian assistance delivery.

Another key finding from both the Global Report and case studies was that most partnerships take a “directive” or sub-grant orientation. In these arrangements, local NGOs have limited agency and essentially treat INGOs as donors. Where these approaches exist, INGOs’ risk management practices exhibit greater emphasis on the risks of their local partners as opposed to the risks to them. Similarly, the prevalence of partnerships in a humanitarian response context is determined primarily by the INGOs’ individual programming orientations, risk assessments, and perception of local civil society capacity, rather than following general patterns by country.

At the same time, the researchers found encouraging examples of risk management in partnerships, which the humanitarian actors can replicate and resource across the sector. These recommendations are grouped under five categories:

• Shifting from risk transfer to risk sharing - Taking a capacity-building approach to risk management in partnerships - Strengthening security risk management,

• Strengthening NGO coordination - Practicing ethical duty of care.

Read the report

Kerrie Holloway

Dignity is evoked specifically in many humanitarian sectors – including food and cash-based aid, livelihoods, education, health and hygiene, shelter, protection and psychosocial support. But despite a strong emphasis on dignity within the policies and rhetoric of the international humanitarian system, there is a dearth of literature analysing whether, and in what ways, humanitarian action upholds and furthers, or indeed detracts from and undermines, the dignity of crisis-affected people, particularly in displacement responses.

This series, focusing on displacement in Afghanistan, Colombia, the Philippines and South Sudan, contributes four contextual examples of what dignity in displacement means. Each case study, written by a local researcher, explores the following questions:

• How is dignity understood in the local context?
  
• How is dignity perceived differently by different people (e.g. men, women, youth, elderly, minority groups)?
  
• How have people experienced the international and local aid response in their location? Are there differences in the way that dignity is upheld in local or international aid responses?
  
• Are there good or bad practice examples of how organisations try to uphold dignity in these responses?
  

Read the report on ODI - Humanitarian Policy Group

Nancy Perrin, Mendy Marsh, Amber Clough, Amelie Desgroppes, Clement Yope Phanuel, Ali Abdi, Francesco Kaburu, Silje Heitmann, Masumi Yamashina, Brendan Ross, Sophie Read-Hamilton, Rachael Turner, Lori Heise and Nancy Glass

Conflict and Health 2019 13:6

Received: 7 September 2018, Accepted: 20 February 2019, Published: 8 March 2019

Abstract

Background

Gender-based violence (GBV) primary prevention programs seek to facilitate change by addressing the underlying causes and drivers of violence against women and girls at a population level. Social norms are contextually and socially derived collective expectations of appropriate behaviors. Harmful social norms that sustain GBV include women’s sexual purity, protecting family honor over women’s safety, and men’s authority to discipline women and children. To evaluate the impact of GBV prevention programs, our team sought to develop a brief, valid, and reliable measure to examine change over time in harmful social norms and personal beliefs that maintain and tolerate sexual violence and other forms of GBV against women and girls in low resource and complex humanitarian settings.

Methods

The development and testing of the scale was conducted in two phases: 1) formative phase of qualitative inquiry to identify social norms and personal beliefs that sustain and justify GBV perpetration against women and girls; and 2) testing phase using quantitative methods to conduct a psychometric evaluation of the new scale in targeted areas of Somalia and South Sudan.

Results

The Social Norms and Beliefs about GBV Scale was administered to 602 randomly selected men (N = 301) and women (N = 301) community members age 15 years and older across Mogadishu, Somalia and Yei and Warrup, South Sudan. The psychometric properties of the 30-item scale are strong. Each of the three subscales, “Response to Sexual Violence,” “Protecting Family Honor,” and “Husband’s Right to Use Violence” within the two domains, personal beliefs and injunctive social norms, illustrate good factor structure, acceptable internal consistency, reliability, and are supported by the significance of the hypothesized group differences.

Conclusions

We encourage and recommend that researchers and practitioners apply the Social Norms and Beliefs about GBV Scale in different humanitarian and global LMIC settings and collect parallel data on a range of GBV outcomes. This will allow us to further validate the scale by triangulating its findings with GBV experiences and perpetration and assess its generalizability across diverse settings.

In Summary
- The returnees came from Uganda, Ethiopia, Central African Republic and Sudan.
- A peace deal brokered by the Intergovernmental Authority on Development ensured a ceasefire and return of relative peace in October last year.
- Returnees will take six to 12 months under the care of the UN and government but are expected to provide for themselves thereafter.

By JONATHAN KAMOGA

Over 140,000 South Sudan refugees who fled the country at the height of the civil war have returned home six months after a peace deal was signed between warring factions of President Salva Kiir and Dr Riek Machar.

The returnees, according to South Sudan’s Ministry for Humanitarian Affairs and Disaster Management came from Uganda, Ethiopia, Central African Republic and Sudan.

Peter Kulang Gatwech, Undersecretary at the ministry told The EastAfrican on Thursday that the government was working with the United Nations High Commissioner for refugees and the International Organisation for Migration to rehabilitate, resettle and reintegrate the returnees into their previous communities.

“We have set up an emergency fund through which we provide foodstuff, medical care and a few other social services to individuals and families of returnees,” Mr Gatwech said.

South Sudan plunged into a civil war in December 2013 pitting President Kiir against his sacked deputy Dr Machar.

More than two million of its citizens fled the country.

A peace deal brokered by the Intergovernmental Authority on Development ensured a ceasefire and return of relative peace in October last year.

Mr Gatwech said returnees will take six to 12 months under the care of the UN and government but are expected to provide for themselves thereafter.

Verification of ownership of property such as land will be conducted. The government is also organising national dialogue at village level as part of the re-integration.

Although the current number of returnees remains small, the government had not expected to make repatriations at this time because of a wide spread doubt among the refugees on whether the peace deal will hold for long.

In the Ugandan refugee camps, this newspaper has reported earlier that many South Sudan refugees do not wish to go back home immediately as they believe the peace deal could come apart forcing those who make an early return into fresh flight.

The government and rebel groups are supposed to form a transitional government by May 12 under terms of the peace deal that they signed last year.

The UAE Ambassador to Rwanda, Hazza Mohammed Al-Qahtani, Thursday received the Representative of the United Nations High Commission for Refugees to Rwanda, Ahmed Baba Fall, to review prospects of enhancing cooperation between the two sides.

The UAE boasts longstanding relations with UNHCR as part of the State's well-established policies supporting global peace and stability as well as its solid contribution to resolving issues addressing the status of refugees and asylum.

The UAE and the UNHCR had signed a US$4 million agreement to provide emergency relief to South Sudanese refugees in Uganda. The signing marked the culmination of a pledge made by the UAE during the "Uganda Solidarity Summit on Refugees" held in the Ugandan capital Kampala.

SAMIRA Y. SALIFU

“I cannot be the only one, surely there are other educated young women in Torit!” protested Flora Sebit, a representative of the youth wing in the women leaders’ association.

Ms. Sebit’s outburst came during a radio discussion on Radio Miraya, which focused on social exclusion issues faced by women in the Eastern Equatoria region of South Sudan. She explained that she is very often delegated as a spokesperson on women’s issues at functions because organizers know she is literate and can express herself well.

Fortunately, she does indeed have some eloquent peers and sisters.

“In this society, a (young) woman with children sees her children as a rope. She feels tethered and unable to continue with her education or seek a better life,” said Joyce Amito, secretary of the women leaders’ association.

Education for women and girls is often relegated to the background in this region. Women are frequently considered and treated as items to be bartered for more cattle to raise a family’s fortunes, and challenging this norm can be dangerous. Against this backdrop, many a young woman gives up her dreams even before trying to achieve them.

“When you come to Torit, you will find the streets teeming with young women selling tea. This is because they either did not go to school or dropped out of school, so they lack the necessary employable skills,” Ms. Sebit continued.

Ms. Sebit and Ms. Amito are two of the women leaders in the region who defy the status quo. Their association, Women Leaders’ Association in Torit, counsels young women who have been the victims of early or forced marriages, or sexual and gender-based violence, or both. Their organization raises awareness on the importance of girl child education. In addition, with the support of development partners, it also provides young girls and women with vocational trainings, like baking and dressmaking.

Under this year’s local theme for International Women’s Day, “Think Equal: Make 35% + Count for Women’s Participation’’, their association joined hands with the United Nations Mission in South Sudan, the Ministry of Gender and other partners to increase the reach of their advocacy for women’s rights.

“Eastern Equatoria has made some strides in engaging women at all levels of government. However, in the spirit of reinforcing gains, the government has committed to further increasing female participation to exceed the 35 per cent rate,” said the Torit governor Tobiolo Alberio Oromo.

His words resonated with those used by the United Nation’s Secretary-General, António Guterres, in a speech read on his behalf at the launch:

“We live in a male-dominated world with a male-dominated culture. Only when we see women’s rights as our common objective, a route to change that benefits everyone, will we begin to shift the balance. … Increasing the number of women decision-makers is fundamental.”

The United Nations Mission in South Sudan continues to engage with the women leaders association and other gender based groups to build on and consolidate social integration efforts.

“We are ready, willing and committed to this process of working with state institutions to eradicate common social exclusion ills like early and forced marriages, sexual and gender-based violence and the neglect of girl child education in Eastern Equatoria,” assured Anthony Nwapa, a representative of the peacekeeping mission.

EU response to Ebola What is it?

The Ebola virus is a severe and often fatal illness in humans. The virus is transmitted to people from wild animals and spreads further through human-to-human transmission. Beyond the human suffering and loss of life, the disease has a devastating impact on the security, economies, and healthcare systems of the affected regions. The European Union appointed an Ebola Coordinator in 2014, at the height of the pandemic in West Africa, and has since mobilised all available political, financial, and scientific resources to help Ebola patients and contain the disease.

Why is this important?

When Ebola ravaged previously unaffected countries in West Africa between 2014 and 2016, leaving in its wake a huge death toll and paralysed economies, the world woke up to the potential global threat of the disease. Until then, Ebola had been mostly limited to East and Central Africa, with the number of reported cases never exceeding 500 at each outbreak.
However, in 2014, the Ebola virus found a new conducive environment in Guinea, Sierra Leone, and Liberia. It was only two years later that an end could be put to the outbreak, thanks to the combined efforts of the international community. In the meantime, nearly 30 000 cases were reported and over 11 000 lives were lost.

In 2018, Ebola returned to the Democratic Republic of Congo (DRC) where the first ever outbreak of the Ebola virus disease was reported back in 1976. The DRC declared its ninth outbreak in May 2018 in Equateur province, in the west of the country, and its tenth outbreak on 1 August, barely a week after the previous one had come to an end. Despite the intensive response that has been put into place since the outbreak was declared, the disease is still not under control.

According to the World Health Organization (WHO), the public health risk from Ebola is considered to be "very high" at a national and regional level, given the proximity of the affected area to the borders of South Sudan, Uganda, Rwanda, and Burundi. The European Centre for Disease Prevention and Control (ECDC) considers the risk of the virus reaching the EU to be low.

Based on incidents where aid workers1 were reportedly killed, kidnapped or arrested (KKA), identified through open sources and verified submissions from our 28 partner agencies.

KKA data overview

• The number of incidents and affected aid workers peaked in the first three months of 2018. April and May also recorded high numbers.

• There was an overall downward trend in reported incidents and the number of aid workers affected in the second half of 2018 (from 176 incidents/358 aid workers to 73 incidents/152 aid workers).

• During the first three months of 2018, 53 aid workers in Bangladesh were detained during passport and visa checks at or near IDP camps in Chittagong division.

• In January, five aid workers were killed in Jalalabad, Afghanistan, in an ISIS attack on a NGO compound that lasted eight hours; 27 other staff members were also injured in the incident.

• Between February and May, 36 aid workers were kidnapped while travelling in the central and western Equatoria states, South Sudan.
Many incidents occurred as agencies entered previously inaccessible areas where there have been reports of mistrust between conflict parties who have accused aid workers of being spies.

• In March 2018, 26 aid workers were killed in Syria during the fall of Eastern Ghouta to Syrian government forces.

• In August, 17 aid workers were kidnapped in eastern DRC by armed groups that included the Forces Démocratiques de Libération du Rwanda (FDLR) and Mai-Mai.

Aid workers reportedly killed

• 155 aid workers killed in 108 incidents across in 18 countries.

• A high number of aid workers were reportedly killed in Syria (81), followed by South Sudan (15) and Afghanistan (14).

Aid workers reportedly kidnapped

• 171 aid workers kidnapped in 64 incidents across 21 countries.

• A high number of aid workers were reportedly kidnapped in South Sudan (52), the DRC (32), Afghanistan (17).

Aid workers reportedly arrested

• 184 aid workers arrested in 81 incidents across 27 countries.

• A high number of aid workers were reportedly arrested in Bangladesh (61), South Sudan (53) and Syria (11).

KKA 2018 dataset and quick charts are available on HDX

Overview

This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 60 events in the region. This week’s edition covers key new and ongoing events, including:

• Plague in Uganda
  
• Ebola virus disease in the Democratic Republic of the Congo
  
• Hepatitis in Namibia
  
• Lassa fever in Nigeria.

For each of these events, a brief description, followed by public health measures implemented and an interpretation of the situation is provided.

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have largely been controlled and thus closed.

Major issues and challenges include:

• The Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo continues, with the prevailing insecurity and community mistrust posing significant challenges to the response efforts. Deeper engagement and involvement of the communities in the ongoing response is critical as well as ensuring the safety of patients and the response staff.

• Namibia has been experiencing an outbreak of hepatitis E since September 2017. While good progress has been made to lower the incidence of the disease, the ongoing response measures have not been able to interrupt further transmission. The outbreak has now affected eight out of 14 regions in the country. Lately, the Minister of Health and Social Services has renewed efforts to control the outbreak.
  However, to turn this proclamation into tangible actions on the ground requires commitments and resources. All key stakeholders, including the national authorities, partners and the community are urged to embrace the renewed efforts to bring this outbreak to an end. the national authorities, partners and the community are urged to embrace the renewed efforts to bring this outbreak to an end.

Highlights

• In January, Uganda received nearly 5,900 refugees, including 3,534 children, from South Sudan, Democratic Republic of the Congo (DRC) and Burundi.

• Uganda continues to be free of the Ebola Virus Disease (EVD) with no cases reported. This is attributed to the heightened Ebola preparedness and prevention interventions in the areas of WASH and risk communication and social mobilisation.

• Nearly 200,000 household visits were conducted through UNICEF supported risk communication and mobilisation activities.

• The Government of Uganda with support from UNICEF is containing the on-going cholera and measles outbreaks.

• The draft Education Response Plans for Arua, Moyo and Yumbe have been shared with task force members for review, and a training on Minimum Standards for Education in Emergencies was conducted with education stakeholders in Arua district.

• UNICEF’s Humanitarian Appeal for Children is only nine per cent funded, potentially hindering the organisation’s response to the urgent needs of children and women affected by emergencies in 2019.

Situation Overview and Humanitarian Needs

According to UNHCR and Office of the Prime Minister (OPM), Uganda received nearly 5,900 refugees from South Sudan, Democratic Republic of Congo (DRC) and Burundi, with the majority coming from DRC in the month of January. Sixty percent of the refugee population are children. The political and humanitarian situations remain unpredictable in both South Sudan and the DRC. Refugees from South Sudan are in fear of attacks by fighters from either side of the conflict inside the country, while those from DRC report inter-ethnic clashes and fear of post -election violence. Burundians indicate several reasons for leaving their country including insecurity and family reunification.

In January, the Ministry of Health (MoH) launched the Health Sector Integrated Refugee Response Plan 2019 – 2024. The plan is expected to cost an estimated $583.4 million and will see the Government strengthen the provision, quality and coverage of health services in refugee hosting districts. Speaking at the launch, Uganda’s Prime Minister Ruhakana Rugunda said including refugees in the National Development Plan demonstrates Uganda’s commitment to the principle of ‘leave no one behind’ in line with the 2030 Agenda for Sustainable Development.

Disease outbreaks

Ebola preparedness: Uganda remains EVD free, and the MoH has not reported any confirmed cases in the country. Community based surveillance for EVD cross border activities between DRC and Uganda continues, including coordinated contact tracing.

Cholera: As of 31 January 2019, 45 cumulative cases had been reported with two community deaths (CFR is at 4.4 per cent). Since the outbreak on 4 January 2019, 12 out of 15 samples collected tested positive for Vibrio Cholerae 01 Ogawa.

Measles: As of 31 January 2019, the expanded programme on immunisation (EPI) of the Ministry of Health investigated and confirmed a measles outbreak in seven out of 12 districts that had suspected cases. This outbreak is a continuation of the 2018 measles outbreak that affected 79 districts in Uganda.

Highlights

• On 15 January 2019, Ethiopia’s parliament passed a new law allowing refugees to move out of camps for regular education and work opportunities and improve access for refugees to documentation and financial services. This law is part of the “Jobs Compact,” a US$ 500 million programme, aiming to create 100,000 jobs (30 per cent will be allocated to refugees).

• The mobile health and nutrition teams in Somali and Afar regions made a total of 39,661 new medical consultations in December 2018; 42.8 per cent were for under five children and 32.3 per cent for women.

• Programme interventions in Oromia region have been limited by continued insecurity and instability which consequently restricted access to IDPs and IDP hosting woredas.

Situation Overview and Humanitarian Needs

UNICEF requires US$124.1 million to meet the humanitarian needs of women and children in Ethiopia in 2019. The cost per sector incorporates the needs on the ground, agreed targets, and UNICEF and partner capacities to deliver. The costs reflect an increase in the targeted number of beneficiaries for nutrition and WASH compared with the 2018 Humanitarian Action for Children appeal mostly due to the rising IDP numbers (2.95 million) and the suboptimal rainfall affecting recovery of the population. The cost of reaching new refugee arrivals is also included. The limited number of operational partners, insecurity and inaccessibility due to poor infrastructure continue to hamper humanitarian assistance.

On 15 January, the House of Peoples' Representatives passed a law that allows refugees in Ethiopia to enjoy more rights. The new legislation is part of the “Jobs Compact,” a US$ 500 million programme to create 100,000 jobs - 30 per cent of which will be allocated to refugees. The law allows refugees to move out of the camps, attend regular schools, and travel and work across the country. They can also formally register births, marriages and deaths, and will have access to financial services such as bank accounts. Ethiopia currently hosts over 900,000 refugees mainly from neighbouring South Sudan, Somalia, Sudan and Eritrea, as well as smaller numbers of refugees from Yemen and Syria, making it host to Africa's second largest refugee population.

OVERVIEW

The flow monitoring surveys are part of the IOM’s Displacement Tracking Matrix (DTM) data collection activities in West and Central Africa, East and Horn of Africa, Libya and Europe (Albania, Bulgaria, Greece, Hungary, Italy, Kosovo, the former Yugoslav Republic of Macedonia, Montenegro, Romania and Spain), that are conducted within the framework of IOM’s research on populations on the move through Africa, the Mediterranean and Western Balkan. Data was collected between January and December 2018 in the above mentioned countries.

Migrants on the move are interviewed by IOM field teams; the surveys collect information on migrants’ profiles, including age, sex, areas of origin, levels of education and employment status before migration, key transit points on their route, cost of the journey, reasons for moving and intentions.

The present brief highlights of some of the main characteristics of women migrants of 39 nationalities from West and Central Africa, North Africa, East and Horn of Africa, Middle East and the Gulf Cooperation Council. Further information about the questionnaire, sampling and survey implementation can be found on DTM Methodological Framework.