Venantie holds her 5-year-old son, Valens, at the Gisenyi Hospital where he is being treated for malnutrition. | © UNICEF Rwanda/2011

In the busy lakeside town of Gisenyi, a UNICEF-supported therapeutic nutrition rehabilitation unit is helping give babies a healthy start in life. Report by Jenny Clover, UNICEF.

The pediatric ward at Gisenyi Hospital sees around three new cases of malnutrition each week, and is working to bring this number down to zero.

The hospital’s community teams are working with families around Gisenyi to identify child malnutrition. Those in need of medical attention are referred to the hospital, where their parents can attend daily classes on proper nutrition to help the whole family remain healthy in the future.

Lessons in nutrition

Venantie, mother of 5-year-old Valens, is just one beneficiary of Gisenyi Hospital’s effective program.

Valens was identified as malnourished by regular community-based growth monitoring in his home area. When he was brought to the monitoring session, he had diarrhea, fever and vomiting, and he refused to eat or drink. He was taken to Gisenyi Hospital, where he stayed for a week.

“He became ill because I was giving him the wrong things to eat, and slowly he just got weaker and weaker, and then got sick,” Venantie said.

At the hospital, Valens was treated with fortified milk and high energy biscuits. Meanwhile, Venantie was referred to the hospital’s nutrition education program, where she was shown how to prepare healthy meals for her son and family.

“The nurses gave us lessons in nutrition every day,” she said. “I learnt how to prepare food that is high in energy and vitamins. Now I give him not only carbohydrates, but also bananas, beans and carrots.”

Valens will be monitored for three months after he leaves hospital, with health workers regularly checking his weight. His mother will continue to receive support on how to care for him, and she will bring him to the hospital twice a month for check-ups.

Reaching every child

Women and their children stand in a ward for malnourished children at Gisenyi Hospital. | © UNICEF Rwanda/2011

According to the 2010 Rwanda Demographic and Health Survey, 44% of all children in Rwanda are chronically malnourished or stunted—shorter than they should be for their age—mostly due to insufficient food intake, recurrent illnesses, lack of knowledge about proper infant and young child feeding, inadequate hygiene and sanitation, poor primary health care, and household food insecurity.

With UNICEF support, the Government of Rwanda has put in place community-based nutrition programs to help communities monitor children’s growth, provide demonstrations on proper nutrition practices, and start home or community gardens. UNICEF is also helping the country’s 30 districts develop plans to eliminate malnutrition.

“Nutrition is the foundation for sustainable development,” explained UNICEF Nutrition Specialist Abiud Omwega. “This is why we take this issue so seriously and have helped the Government develop district plans to eliminate malnutrition and put in place community-based mechanisms to promote good nutrition.

“It is also why we support national Mother and Child Health Weeks twice a year, so we can ensure that every child is reached with vitamin A supplements to boost immunity and necessary immunizations.”

These efforts to empower communities to care for their youngest members will help ensure every child gets the healthy start they deserve.

Related Nutrition Links

More on UNICEF’s fight against childhood malnutrition

VIDEO: UNICEF correspondent Bob Coen reports on joint emergency interventions by UNICEF and partners to help protect vulnerable families from the threat of malnutrition in Niger.

Once again, the harvest has been disappointing.

“This year’s crop was so bad that it will not even last us three months,” she said. “For three years now, we have had very poor rains in this area. Before that we had better rains, but now it’s three years in a row that we don’t have enough food to sustain our family.”

Like much of the country, this arid region bordering the Sahara desert is prone to seasons of drought, but in recent years the situation has worsened. Today, millions across Niger face severe malnutrition due to food shortages.

It is part of a food crisis looming over the entire Sahel region – the result of drought, poor harvests and rising food prices. Six million people in Niger and millions more in Mali, Mauritania and Chad are affected. Communities in Burkina Faso, Senegal, northern Cameroon and Nigeria are also at risk. Many governments have declared a state of emergency.

Need for assistance

As her husband led the ox and its precious load of grain back to their compound, Ms. Isaka got on her knees, a sieve in hand, and scraped the ground for fallen scraps. UNICEF Image © UNICEF/2011/Niger/Coen

A woman receives 20,000 CFA, about US$40, through a cash transfer distribution in the village of Gawounawa, Niger. The money is given to the most vulnerable families to buy food.

“I try to look for and gather up as many of the fallen grains as possible,” she said. With seven children to feed, and at least six months before the next harvest, every bit of food matters.

“I’ve been able to gather almost two full bowls of millet, which will be enough for one family meal,” she said when she had finished.

But Ms. Isaka’s family will soon receive additional assistance in the form of a cash transfer.

It is part of a bold joint emergency intervention by UNICEF, the US Agency for International Development (USAID), the European Community Humanitarian Aid Department (ECHO), the government and other partners, helping vulnerable families in Magaria District purchase food with monthly cash allowances.

Empowering mothers

Mothers with children between 6 and 23 months old were already receiving monthly rations of enriched foods under a ‘blanket feeding’ programme – but it was not enough.

“What we discovered during the blanket feeding is that if we give a food ration to protect the child, the whole family ends up using it,” said Hamid Diourro, the Regional Director of Niger’s Ministry of Health. “So the government thought it necessary, in order to protect that food ration, to put in place the cash transfer project.”

More than twenty thousand vulnerable households in Magaria have been targeted by the cast transfer programme, which started in September 2011. Each mother receives a monthly cash payment of 20,000 CFA, or approximately US$40 dollars, for three months. Save the Children, a UNICEF partner, runs the distributions and works closely with community leaders to ensure that the poorest and most vulnerable are reached.

These mothers “are the ones who are struggling for food to nourish, to feed their children” said Hélene Kouyaté of UNICEF, “and we would like to empower these women.”

Halima Isaka, holds 10-month-old daughter as she prepares to cook foraged leaves to supplement her family’s meal, in Magaria District, Niger. UNICEF Image © UNICEF/2011/Niger/Coen

A life-saver

The day after the distribution, Ms. Isaka was more at ease.

“Before we received this money, we were forced to go out in the bush to gather leaves in order to feed out family and children,” she said while preparing the family’s midday meal. “If we were lucky, we cooked the leaves with a very small amoung of millet soup, but we still went to bed hungry.”

UNICEF hopes to receive donor support to expand the programme to other regions of Niger in 2012, which would not only benefit families but also strengthen the government’s capacity to respond to food crises.

“All of the partners who have contributed to making this project happen can replicate this experience elsewhere,” Mr. Diourro said.

Still, chronic malnutrition is not simply a problem of inadequate food – it is also one of poor feeding practices and insufficient access to safe water and health care, noted a recent report by Olivier De Schutter, the UN Special Rapporteur on the right to food. For long-term success, additional interventions must address the root causes of chronic malnutrition, including poverty and inequity.

In the meantime, cash transfers are reaching those most in need, like Ms. Isaka and her family.

“This project,” she said, “has been a life-saver.”

UNICEF Director of Emergency Programmes Louis-Georges Arsenault discusses UNICEF’s annual appeal for emergency funding. The report appeals for $1.28 billion to respond to the needs of the world’s most vulnerable

UNICEF Executive Director Anthony Lake visits drought-affected Turkana District, Kenya. The crisis in the Horn of Africa is the largest of the many protracted emergencies that challenged the rights and welfare of children in 2011. UNICEF Image © UNICEF/NYHQ2011-1121/Holt

In the report, UNICEF asks for US$1.28 billion to meet the needs of the most vulnerable children and their families in 25 countries and territories. This figure represents a 9 per cent decrease from last year’s appeal.

Continuing crisis in the Horn of Africa

The crisis in Somalia and other Horn of Africa countries accounts for one third of the total amount.

UNICEF’s funding request reflects serious concern that the lives of hundreds of thousands of children in the region remain threatened because they don’t have enough to eat – nearly half of all the funds requested for Djibouti, Ethiopia, Kenya and Somalia will go to purchasing food and nutrition supplies.

“The focus of 2012 will continue to be on the Horn of Africa, but with much more focus this year on Somalia and the refugee situation in Dadaab in Eastern Kenya,” said UNICEF Director of Emergency Programmes Louis-Georges Arsenault.

Meeting urgent and long-term needs

The report also highlights the needs of children and families displaced by the violence in Cote d’Ivoire and South Sudan, the second year of flooding in Pakistan, and the ongoing operation to rebuild Haiti following the January 2010 earthquake.

“We have achieved many positive results in emergency settings in 2011, but the urgent and long-term needs of millions of children and their families will continue in 2012. UNICEF requires adequate funding in order to fulfil its commitments towards children. They not only represent the future but are the most vulnerable, and deserve generous and consistent support from the donor community,” said UNICEF OIC Deputy Executive Director Rima Salah.

The funding appeal also addresses so-called ‘silent’ emergencies such as that in the Democratic Republic of the Congo where, as of June 2011, more than 1.5 million people – half of them children – were displaced by ethnic violence. Millions more were affected by sexual assault and lack of schooling.

Women use a pump at the edge of rising floodwater during Pakistan’s second year of extreme flooding. Climate-related disasters, are exposing children to repeated cycles of crisis. UNICEF Image © UNICEF/NYHQ2011-1379/Page

Responding quickly, flexibly

“In the Sahel, we are facing a nutrition crisis of a larger magnitude than usual; the Democratic Republic of the Congo, Chad and the Central African Republic, to name just a few, are all emergencies requiring funding if the most vulnerable people, children and women, are to survive,” said Ms. Salah.

The report stresses the critical need for predictable, flexible funding to respond to both major and ‘silent’ emergencies.

“One of the main reasons is to be able to respond to where there is no attention, and to have the flexibility to move in very quickly where there is a sudden onset of an emergency, so we don’t have to wait for funding,” said Mr. Arsenault.

This responsiveness will enable UNICEF to fulfil its commitment to, as the report states, “the fullest realization of the rights of all children’s in all emergency situations.”

People bathe, wash clothes and collect drinking water from the same water source in Mbandaka, DR Congo. Lack of access to safe drinking water contributes to the spread of cholera. UNICEF Image © UNICEFDR Congo/2011

MBANDAKA, Democratic Republic of the Congo, 16 January 2012 – “At the beginning I thought she had just diarrhea, but when she didn’t stop vomiting I took her to the hospital, where they told me it might be cholera,” said Getou Bofala, 35. Report by Cornelia Walther

She had been sitting at the bedside of her 1-year-old daughter, Rihanna, for the past 12 hours and could hardly keep her eyes open.

Cholera, an infection that causes severe dehydration, can be deadly if left untreated. But thanks to the staff of Mbandaka’s Cholera Treatment Center (CTC) – which receives support from UNICEF, the World Health Organization and NGO partner Oxfam – Rihanna can smile again.

Six nurses and two doctors work in 12-hour shifts at the CTC, which can hold up to 80 cholera patients at a time. An additional six hygiene agents are tasked with spraying the centre with disinfectant throughout the day.

“Whenever the chlorine smell fades, the rooms need to be disinfected anew. It is crucial to constantly eliminate the bacteria,” said Esperance Nzabongo, a nurse at the CTC. “Lack of discipline is deathly.”

High-risk surroundings

Mbandaka is located in Equateur, the province worst affected by the country’s 2011 cholera outbreak. Over 3,000 cases and 165 deaths have been reported in the province. Throughout the country, over 21,500 cases have been reported, and at least 575 Congolese have died.

Fidele Bokinyo, 5, sits with his mother in the cholera treatment centre in Mbandaka, DR Congo. He has been at the centre for three days. UNICEF Image © UNICEFDR Congo/2011

Modern sewage and water treatment systems virtually eliminated cholera in industrialized countries, yet the disease persists in locations where poverty or disaster force people to live in crowded conditions without adequate sanitation. According to the recent Multiple Indicator Cluster Survey (MICS), barely half of DR Congo’s population has access to safe drinking water, and 72 per cent of people are relegated to using unimproved sanitation facilities. The situation is worst in rural areas.

“Many families know that it is not good to drink straight water from the river, but they have no alternative,” said Christian Bolondo, a UNICEF water emergency specialist in Mbandaka. “One Aquatab [water purification tablet] costs 50 francs and suffices for 20 liters – not many can afford this for each drop of water they consume. They are aware that boiling water is efficient for disinfection, but they don’t want or can’t spend the money for the necessary firewood.”

Motoki Kitalo, 27, has suffered the consequences of poor water and sanitation. He is about to be return home after spending three days in the CTC. “One of my neighbors had cholera a week ago, and the 12 people of our two families share the same latrine,” he said.

Motoki and Rihanna were treated in time, but many are not so lucky. “At the beginning of the epidemic, families were waiting at home and came to seek treatment only when it was too late. Many died on the way, too weak to even reach the CTC,” said Dr. Eli, who works at the centre.

Making hygiene a priority

UNICEF is helping address both the immediate needs of cholera patients and the long-term causes of cholera. In addition to supporting CTCs, UNICEF is helping organize mass communication campaigns to raise awareness of important hygiene practices. Through partnerships established to fight polio – another disease that haunts the country, with 92 cases in 2011 – these campaigns mobilize religious and traditional leaders, parents and authorities to spread and adopt healthy practices.

A hygiene agent from NGO Oxfam uses chlorine to disinfect water collected from a river in Mbandaka, DR Congo. UNICEF Image © UNICEFDR Congo/2011

Families in areas at risk are also receiving safe water access through water chlorination points and free water purification tablets. And the ‘Healthy Villages’ programme, a government programme supported by UNICEF, is helping communities defend against cholera through improved water infrastructure and hygiene, sanitation and behavioral changes.

Meanwhile, the outbreak appears to be winding down in the worst-affected areas, even as new cases are being reported in other areas.

“At this stage it looks as if we have the worst behind us,” said Dr. Eli. But communities must remain vigilant against the disease. “Negligence of hygiene can destroy any progress made,” he said.

PIBOR, South Sudan, 12 January 2012 – It was 7 a.m. when I boarded a UN MI8 helicopter with colleagues from the Human Rights and Child Protection section of the United Nations Mission in South Sudan (UNMISS), as well as representatives from the South Sudan Human Rights Commission, the South Sudan Peace Commission, the World Food Programme, and media representatives from South Sudan Radio and Television.

A UNICEF child protection officer gives an orientation to social workers on child protection measures at a temporary settlement in Pibor, South Sudan. UNICEF Image © UNICEF South Sudan/2012/Verma

As we approached Pibor, we could see some ‘tukuls’ (huts) had been burned down, surrounded by barren land with no sign of life.

‘Situation unpredictable’

We were welcomed at the airstrip by UNMISS Security Officer Ravi Nair, who gave us a security briefing.

Pibor saw an exodus of its residents when violence between the Lou Nuer tribe and Murle tribe erupted on 23 December, in the village of Kurwanya, in Likuangole Payam. The conflict escalated toward the end of the year.

“Everything is calm as of now,” he said, “but the situation is unpredictable.” Therefore, we needed to stay close together. We were all prepared to comply.

Together, we went to the County Commissioner’s Office. The route took us through a residential area, where soldiers of the Sudan People’s Liberation Army (SPLA) live with their families. We also saw many families living under trees and under makeshift shelters – people displaced by the conflict, we were told.

Allan Joko speaks about being abducted from his home in Kongor Village, South Sudan. UNICEF Image © UNICEF South Sudan/2012/Verma

Displaced and abducted children

I went with Abraham, a UNICEF child protection officer, to meet unaccompanied and orphaned children in the area. The children, who ranged between one month and 14 years old, were sitting on the ground of a secure compound, with little to wear and hardly anything to eat. They were cared for by a group of women volunteers who had also been displaced by the violence.

One boy, Allan Joko, was around 10 years old. He spoke of his recent escape after being abducted from his home in Kongor Village about ten days ago. He was forced to travel with his captors and other abductees until two days ago, when the men were distracted. Allan slipped away and spent the night in the bush before walking to the nearest community. He has no idea where his family is.

“They never ill-treated me,” Allan said of his captors. “But I don’t know if my parents are still alive and if they will come looking for me.”

I also saw an 8-month-old baby whose parents were killed in an attack. He had been tied to his mother’s back, and when she was killed, she fell backwards, injuring the baby’s back and head. Medical attention has been difficult to obtain since the health centre, run by Médecins Sans Frontières (MSF), was ransacked.

‘We need your help’

The entire town showed evidence of the disaster, and we only saw limited external assistance being provided to the affected.

Time was running out; the mission was permitted only three hours in Pibor. On our way back to the helicopter, we saw some people emerge from hiding, carrying their possessions and their children.

“It is not over yet, they are just two hours away by the river, carrying out their attacks, and can return any time,” said County Commissioner Joshua Konyi. “Juba needs to send reinforcements for our protection and food for the children.”

In response to the crisis, UNICEF is participating in assessments and reviews organized by the government. UNICEF is also deploying professionals from its nutrition, child protection and communications programmes, and from its water, sanitation and hygiene (WASH) programme. UNICEF has also pre-positioned supplies for a humanitarian response, which will be initiated as soon as access to the affected population is established.

With partners, UNICEF has also begun a family reunification programme and registration activities designed to help return displaced and abducted children to their families. But there is much more work to be done.

“We need your help,” Mr. Konyi said.

VIDEO: Watch Pierre Lucson Bellegarde’s film, ‘The Compass’, about a woman who was seriously injured in the 2010 earthquake.

“This film project is all about listening to the Haitian voice and understanding children’s lives,” said Thomas Nybo, coordinator of the project. “We issued a call for short-film proposals, either fiction or documentaries, and we chose four filmmakers, three of whom are from Cine Institute” – Haiti’s only film school, located in the Southern city of Jacmel.

The short films feature some of the biggest challenges facing Haiti’s children: losing parents to the earthquake; the plight of a girl working as a restavek, a domestic servant; and the challenges, especially economic, confronting families when they send their children to school.

A range of perspectives

The filmmakers came at the project from a variety of perspectives and backgrounds.

“One of the filmmakers, Pierre Lucson Bellegarde, profiled an older woman who was seriously injured in the earthquake, and adopted two children after the quake, despite living in a camp and being of limited financial means,” said Mr. Nybo.

VIDEO: Michelle Marrion’s film, ‘The Stray, features a young domestic servant hired as a professional mourner.

Mr. Bellegarde became interested in the arts at the age of 7, while he was recovering from surgery.

“After my operation, my best friend was a pencil and a notebook, which held all my secrets,” he said. At Ciné Institute, Mr. Bellegarde trained in cinematography, performance, script writing and sound. His work frequently focuses on the plight of marginalized communities and people living with disabilities.

Michelle Marrion took an unflinching look at a restavek enlisted to be a professional ‘crier’ at a funeral for someone she had never met.

Ms. Marion was born in the United States to Haitian parents, and studied film and photography at Howard University. In 1999, she began her first photographic project in Haiti, and subsequent projects always seemed to bring her back to the country. Since 2009, she has split her time between Haiti and the United States, and is currently working on several international multimedia projects, including a feature-length documentary taking place in Port-au-Prince.

VIDEO: Watch Ebby Angel Louis’s ‘Late for School’, a film about a father trying to get his daughter to school on time in a wheelbarrow.

Families in the aftermath

The other filmmakers explored the theme of families struggling in the aftermath of the earthquake.

Ebby Angel Louis made a playful film about an illiterate father and his mad dash to get his young daughter to school on time using his wheelbarrow.

Mr. Louis is currently a student at Ciné Institute. He grew up in Haiti’s countryside, where his family helped him cultivate an interest in storytelling.

“The countryside was a refuge for me,” he said. “At night after dinner, under a full moon, my grandmother would tell us the family stories of all our cousins.”

VIDEO: Macdala Prevot’s film, ‘A Refuge in the Garden of My Parents’, tells the story of a girl fighting to keep her family together after the death of her parents. Watch in RealPlayer

Finally, Macdala Prevot told the story of a teenage girl fighting to keep her family together after the death of her parents.

Ms. Prevot studied at Ciné Institute and has worked on several films as an art director, sound technician, cinematographer and producer. She is also a singer, and in 2010, she travelled to the United States to help record ‘We are the World,’ a song whose proceeds benefited earthquake survivors.

Together, their films offer a glimpse into the lives and struggles of Haiti’s children.

“By giving a voice to Haiti’s youth,” said UNICEF Representative in Haiti Francoise Gruloos-Ackermans, “we are not only able to listen to what they want to say, but we can also encourage their creativity and we can better understand their reality.”

The education system – like many of the country’s essential systems and infrastructure – was crippled by the disaster.

“I was overwhelmed by the destruction and by the daunting task we had before us,” he recalls.

But two years later, UNICEF Representative in Haiti Francoise Gruloos-Ackermans has no doubt that the situation facing children is slowly improving.

“There is evidence of little victories everywhere, although serious gaps and inadequacies in Haiti’s basic governance structures remain,” she said.

And with continued efforts, these victories offer the promise of lasting, meaningful progress – even surpassing pre-earthquake conditions.

“There is clear evidence of healing and progress for children, particularly in the areas of education, health, nutrition and child protection,” Ms. Gruloos-Ackermans said.

Children complete a year-end final examination at a school in Port-au-Prince. This semi-permanent facility was built by UNICEF after the school collapsed during the earthquake. UNICEF Image © UNICEF/NYHQ2011-2092/Dormino

Victories for children

“By planning together with UNICEF, children were able to go back to school shortly after the earthquake. The Ministry was able to move quickly to start up schools in tents and then in semi-permanent structures,” said Mr. Telford.

Since the 2010 catastrophe, UNICEF has helped more than 750,000 children to return to school. Some 80,000 of these children now attend classes in 193 safe, earthquake-resistant schools constructed by UNICEF.

In addition, with UNICEF support, over 120,000 children are enjoying structured play in 520 child-friendly spaces. More than 15,000 malnourished children have received life-saving care through 314 UNICEF-supported therapeutic feeding programmes. And 95 rural communities have launched programmes to improve sanitation.

Recovery efforts have also helped the Government of Haiti commit to improving protective environments for children.

“Prior to the earthquake, the government did not know how many children were living in institutions – or even where they were,” said UNICEF Child Protection Officer Christina Torsein. “Now, with UNICEF’s support, the first-ever directory of residential care facilities has been launched. So far, more than half of the country’s 650 centres have been assessed, and over 13,400 children, out of an estimated 50,000 living in residential care, have been registered.”

UNICEF Representative in Haiti Francoise Gruloos-Ackermans visits a woman and her newborn baby in Port-au-Prince. UNICEF Image © UNICEF Haiti/2011/Dormino

In fact, UNICEF is working with a network of child protection partners that has never before been as extensive, cohesive or powerful. One of these partners, the local non-governmental organization MOSAJ (‘Mouvement Social pour l’Avancement de la Jeunesse’), was one of the first groups to offer psychosocial care after the earthquake

MOSAJ Director Alexandre Clarens Jr. suffered his own losses in the disaster. “I lost everything in the earthquake,” said Mr. Clarens. “But what is important is what is in my heart. UNICEF supports me to do what is really important, and that’s helping these children.”

A long road ahead

Nevertheless, there is a long road ahead.

A report released on 9 January 2012 about the disaster’s lingering after-effects notes that more than 500,000 people are still living in displacement sites in quake-affected areas. The country’s cholera epidemic also continues to burden Haiti’s limited infrastructure.

And despite recent progress, the most vulnerable and hardest-to-reach children are in danger of being left behind, particularly those living in camps, residential care centres, on the street or in rural areas far from the earthquake zone, where access to health, nutrition, sanitation, education and protective services are limited.

Students stand in the debris of their school in Port-au-Prince. Twenty-seven students and teachers were killed when the building collapsed in the 2010 earthquake. The school is being rebuilt with UNICEF support. UNICEF Image © UNICEF/NYHQ2011-2102/Dormino

“Make no mistake: The country remains in a fragile state, beset by chronic poverty and under-development. Its weak institutions leave children vulnerable to shocks and the impact of disaster,” emphasized Ms. Gruloos-Ackermans.

UNICEF will continue its efforts with the government and other partners to ensure that children not only recover but thrive.

“Each of us has a role to play,” Ms. Gruloos-Ackermans writes in report. “And in Haiti, it is a long-term commitment.”

Mr. Telford couldn’t agree more. “The work was enormous. But actually, the easy part is behind us,” he said. “Now the hard work begins.”

Your crucial support has helped drive some extraordinary successes for children over the past year, as detailed below.

Education

• More than 80,000 children are now learning in 193 semi-permanent schools constructed by UNICEF since the earthquake
• Some 750,000 children and more than 15,000 teachers in 2,500 schools received learning and teaching materials in support of the October 2011 Back-To-School campaign and President Martelly’s initiative for free education
• 1,497,900 children in 5,760 schools received hygiene promotion materials including soap to protect against cholera

Child Protection

• Over 120,000 children in nine departments benefit from structured activities and referral networks in 520 Child Friendly Spaces managed by 92 different community-based organisations supported by UNICEF
• All ten departments equipped with psychosocial rehabilitation services specialized in emergency response
• 8,780 separated children have been registered and over 2,770 reunified with their families since the earthquake, thanks to the support of UNICEF and the Family Tracing and Reunification network
• An additional 13,440 children living in 336 of the estimated 650 residential care centres have been registered to provide social documentation, improved case management and family reunification where possible
• 336 residential care centers have been evaluated with standardized tools and a directory of all Residential Care Centres has been launched by IBESR, with UNICEF support
• 18,000 children were screened at border points and airports since the earthquake, by a division of the national police supported by UNICEF

Water, Hygine & Sanitation (WASH)

• In response to the continuing cholera outbreaks in 2011, the UNICEF WASH programme worked through 14 partners to provide hygiene promotion and cholera supplies for an estimated 2.2 million people
• In 2011, improved water supplies, safe sanitation and better management and monitoring of services reached about 600,000 people in camps and earthquake affected communities, and urban neighbourhoods to which displaced people are returning
• Some 95 communities hosting 89,000 persons launched the Community-Led Total Sanitation (CLTS) approach to expand WASH services
• Declining from a peak of 680,000 persons, some 196,000 persons in camps had access to at least 10 litres of safe water per day, supported by UNICEF
• The first human waste disposal site was established for Port-au-Prince (with UNICEF support) and UNICEF continues to finance the desludging fleet for the removal of liquid waste from CTCs/CTUs in Port-au-Prince and in camps

HEALTH

• Some 800 HIV positive pregnant women gained access to Prevention of Mother-to-Child Transmission (PMTCT) services as UNICEF supported the establishment of 11 new PMTCT sites in under-served areas
• More than 15,000 vulnerable adolescents in Port-au-Prince were sensitised on HIV prevention and 2,500 adolescents tested for HIV and 522 placed on antiretroviral treatment
• UNICEF supported 37 trainers and 115 service providers with enhanced knowledge and capacity to implement PMTCT
• Almost 170,000 children were protected against vaccine preventable disease in Haïti as the routine immunisation coverage increased from 58 per cent to almost 80 per cent between 2010 and 2011 with UNICEF support to the “RED approach”
• UNICEF provided medicine, equipment and technical support to the placement of international midwives in emergency obstetric clinics for at-risk pregnant women
• UNICEF supported the training of four trainers on the promotion of Kangaroo Mother Care to prevent neonatal deaths

Nutrition

• Some 393,000 children screened and over 15,300 treated for acute malnutrition in 2011 in one of the 290 out-patient treatment units and/or 24 Nutrition Stabilisation Units (which address malnourished children with complications). A recovery rate of 76 per cent and mortality rate under 2 per cent in patients indicates good quality of service
• Some 500,000 mother and baby pairs were provided with nutrition counselling and breastfeeding coaching in the 198 Baby-Friendly Corners established and maintained since the earthquake. Meanwhile, 40 Infant and Young Child Feeding committees and mothers clubs were created
• Over 500,000 women received iron-folic acid tablets in 2011 to prevent anaemia
• Over 775 health professionals and healthcare providers trained in Community Management of Acute Malnutrition (CMAM) and Infant and Young Child Feeding (IYCF)

Photograph by Mark Stedman, Photocall Ireland

I was fearful of going back to Haiti because I was afraid I wouldn’t see enough progress.  I was afraid I wouldn’t see hope. The scale of the disaster was such that I wondered how long it would take for conditions to really begin improving for children. Then, to really compound matters, a cholera epidemic broke out in late 2010, which has killed nearly 7,000 and sickened close to half a million people.

Nearly 18 months on from an earthquake that had killed over 250,000 people and left 1.5 million people homeless, I returned to Haiti in June of last year and I was really heartened by the progress I saw.

A whopping 5 million cubic metres (about half) of the rubble had been cleared. The traffic situation in Port au Prince was just as crazy as ever but with less rubble clogging up the streets, getting around the city had become a whole lot easier. In the space of a year, nearly two thirds of the people made homeless by the earthquake have been moved out of overcrowded camps across the city.

Photograph by Mark Stedman, Photocall Ireland

We visited Champs de Mars and walked through the camp meeting families and children.  Heavy tropical rain began to fall and the ground underfoot became really muddy and the children laughed as my feet got stuck right in it. Think of your worst camping weekend ever at an Irish music festival with rain and mud everywhere and it doesn’t even begin to compare with the conditions these families have lived in for the past eighteen months. These vulnerable children, women and men are just some of the more than 550,000 Haitians continuing to shelter in 800 over-crowded sites, patiently waiting to be re-housed.

But there were also clear examples of development and things changing for the better and nowhere could this be seen and felt more than in the schools we visited during our trip. Before the quake, it is estimated that less than half of the children in Haiti ever got the chance to see the inside of a classroom and even if a child was enrolled in school, there was only a one in 3 chance of the little one finishing primary school. The 2010 earthquake further crippled the education system, with almost 4,000 education buildings damaged or destroyed, which interrupted the schooling of over 2.5 million children.

Since the earthquake, UNICEF has helped construct nearly 200 semi-permanent schools, which are now used by 80,000 children every day.  Standing in a school set up by UNICEF and watching children take part in a maths class was a special moment for me in Port au Prince last June. One by one, the kids went up to the blackboard to do their sums. Who can forget the fear you’d have as a child as you made your way up to the blackboard in front of everybody!  So many of the kids there that day were getting their very first taste of education and the classroom buzzed with energy and excitement. An eagerness to learn was etched on every happy little face in the class.

Photograph by Mark Stedman, Photocall Ireland

Just think what the future of Haiti would be like if we get every Haitian child access to a quality education – their potential to end the cycle of poverty and contribute to the recovery of their nation would increase exponentially. It’s no wonder President Martally has made it one of his priorities to get free education for every child and UNICEF will work closely with the Haitian government to make this a reality. Do you know your support helped us provide some 750,000 children and more than 15,000 teachers in 2,500 schools with learning and teaching materials last October for Haiti’s Back-To-School campaign?

UNICEF’s work has moved on in Haiti – it’s not all about recovery and re-building any longer, but a critical time for change and progress. Change that you could see on the ground and feel reflected in how people spoke with hope and optimism about the future for Haiti’s children. This change wouldn’t have been possible without you, our supporters, and so thank you to everyone who supports our work for children in Haiti.  We couldn’t achieve all that we do, without you.

Download the PDF version of Julianne’s Report here:

Haiti_Earthquake_2_Years_On

VIDEO: December 2011 – UNICEF correspondent Priyanka Pruthi reports on the growing crisis in Africa’s Sahel region, where more than a million children are at risk of becoming severely malnourished.

More than a million children in the Sahel region of West and Central Africa are at risk of becoming severely malnourished. Inadequate rain, poor harvests and rising food prices have left hundreds of thousands of children vulnerable and weak.

Preventing an emergency

Along with partners on the ground, UNICEF has begun distributing life-sustaining supplies, but the region is vast and humanitarian workers are struggling to reach the hardest hit before it is too late. UNICEF estimates more than 1,025,000 children will need life-saving treatment for severe and acute malnutrition in 2012.

“Specially developed ready-to-use therapeutic foods are the best way to treat severe acute malnutrition among children under five so they have a chance to survive and recover,” said UNICEF Executive Director Anthony Lake.  “The biggest challenge we face now is getting sufficient amounts of these critical foods to children as the need increases in the coming months – and the window is closing.”

Niger will be among the countries hardest hit, with roughly 330,600 children under-five at risk of severe and acute malnutrition. The government has already issued an alert stating more than half of the country’s villages are vulnerable to food insecurity. Other countries and regions where children are expected to require treatment are Burkina Faso, northern Cameroon, Chad, Mali, Mauritania, northern Nigeria and northern Senegal.

Children eat cooked leaves in Guidan Bawa Village, Niger. In 2010, drought forced many households to forage for wild fruit and leaves. UNICEF Image © UNICEF/NYHQ2010-1592/Holtz

“In many of these countries, the level of existing chronic malnutrition – children who miss a little bit of food every day, children who are too frequently ill and as a result become chronically undernourished, which impacts their health, their learning capability, their school performance and which will impact ultimately the way they can live and perform as adults – that situation is far too common in the Sahel zone countries,” explains UNICEF Chief of Nutrition Werner Schultink.

Simple measures, lasting impact

Averting a tragedy in West Africa will require an intensive response. Interventions over the course of the coming year must involve not only nutrition and health programmes but also the provision of clean water, sanitation facilities at feeding centres, as well as emergency education for children displaced with their families

“We need to undertake actions to bring the level of chronic undernutrition down, and that can be done by relatively simple things: If mothers would breastfeed more frequently, if the hygiene situation would improve, if hand-washing would improve, if effective diarrhoea treatment would improve, if … simple packages of vitamins and minerals would be provided at low-cost, you would already achieve a great reduction in this chronic undernutrition,” said Mr. Schultink.

Appealing on behalf of the children in the Sahel region, one of the poorest regions in the world where people have been plagued by malnutrition for decades, Mr. Lake called on the global community to step forward.

“The children at risk today in the Sahel are not mere statistics by which we may measure the magnitude of a potential humanitarian disaster,” he said. “They are individual girls and boys, and each has the right to survive, to thrive and to contribute to their societies. We must not fail them.”