Djibouti sits in a strategic position in the Horn of Africa.  It is a small country (23,200 sq. km.) with an estimated population of 500,000 to 800,000 people, living mostly in urban areas (85 percent of the population).  The rest of the population lives in rural areas and is composed of pastoralists and agro-pastoralists. 

Most areas are barren deserts, with an average rainfall of 200 mm per year.  Because of the aridity, the volcanic nature of the soil and the very high temperatures, agriculture accounts for less than five percent of the Gross Domestic Product .  Djibouti imports more than 80 percent of its requirements, of which food constitutes more than 25 percent.  Djibouti is also a disaster-prone, low-income, food deficit country (LIFDC) and recurring droughts, floods, earthquakes, and health hazards affect the country continuously.  About 42 percent of the population lives in extreme poverty with less than $1.8/day.  Infant morbidity and infant mortality rates are very high at 103 and 124 per 1,000 live births, respectively.  The maternal mortality rate is 546 per 100,000 live births.

A Multi-Indicator Cluster Survey (MICS), undertaken in 2006 by the Ministry of Health and the Department of Statistics and Demographics (DISED), in collaboration with UNICEF and the Pan Arab Project on Family health (PAPFAM) reported that Global Acute Malnutrition (GAM) and Severe Acute Malnutrition (SAM) rates were well above the emergency threshold.  According to the preliminary report released by the Ministry of Health, the nutritional status of children under five years of age deteriorated since a similar survey conducted in 2002.  The rate of GAM (weight for height) was 20.4 percent, against 17.9 percent in 2002, while the rate of SAM was 7.1 percent against 5.9 percent in 2002.  High malnutrition rates could be attributed to persistent droughts in earlier years, which affected the household food security status in all pastoral livelihood zones.  Acute food insecurity was also compounded by poor hygiene conditions (water and sanitation), poor childcare practices, as well as poor dietary diversity. 

As a result, severe health risks appeared due to the food security situation and recent rains have triggered an outbreak of diarrhea diseases.  Cholera cases were also confirmed in both rural and urban areas due to poor hygiene and high dependence on unsafe water sources.  In the agriculture sector, it would take several years and intensive asset building programmes for pastoralists to recover, notably after a significant depletion of livestock assets.  The drought thus worsened poverty by threatening livelihoods of local populations, which was further compounding the humanitarian situation in sectors such as health and malnutrition.

Click here to download the full 2006 CERF report for Djibouti.

Agro-pastoral perimeter of Aor-Aoussa, September 2006 [Photo: UN/Djibouti]

In the food sector, CERF funding helped to reduce or stabilize prevalence of acute malnutrition among 47,500 drought-affected pastoralists through the provision of minimum energy and dietary requirements, in accordance with WFP strategic priority No1, “Saving Lives in Crisis.”  The $500,000 in CERF funds were used to purchase 860 metric ton of mixed food commodities (including cereals, vegetable oil, pulses and sugar) and to ensure operational costs for a one-month distribution period for beneficiaries.  Prior to the arrival of the purchased commodities, the WFP was also able to access more commodities on a loan basis from a different project implemented in response to refugee flows into Djibouti.  This arrangement ensured a steady and regular flow of food aid and a seamless implementation of the WFP Emergency Operations (EMOP). 

The impact of food aid distribution has also helped decrease further massive migration of drought victims from rural areas towards urban centers, thus avoiding further strains on the already overburdened water, health, and sanitation infrastructures.

In addition, WFP was able to create a Monitoring and Evaluation Unit at the beginning of 2007 in order to measure the impact of projects on the targeted beneficiaries.  Data was successfully collected in the field by WFP monitors to undergo analysis.  The key indicators used in this new capacity developed by WFP include, amongst others, food availability, food access, number of beneficiaries, sale of livestock and other assets, food consumption patterns, and percentage of women receiving food through food distribution committees.

Distribution of farming hardware kits to Aor-Aoussa beneficiaries, September 2006 [Photo: UN/Djibouti]

CERF funding also made a significant difference in the health sector in as much as the CERF projects came as the first substantial and comprehensive response the Government appeal.  The funding contributed dramatically to save lives and to mitigate the impact of the drought.  Lack of interventions would have created a situation of serious emergency with heavy loss of human lives and chronic depletion of livestock.  Mobile units were deployed in all three districts (Dikhil, Ali Sabiej, Tadjourah and Obock) targeted by the CERF projects.  An emergency expert was contracted for three months to implement the mobile units programme and three vehicles were purchased to allow this initiative to reach those districts lacking transport means (including Tadjourah, Obock and Arta districts). 

Health equipment including child-care material was also procured and handed over to the Ministry of Health for the deployment of the Mobile Health Units.  Nutrition surveillance systems have been designed following two evaluation missions conducted by WHO Geneva and WHO Cairo to assess technical support needs of the Ministry of Health.  Tools and materials were prepared to monitor malnutrition and coordination meetings were held with WFP on the choice of sentinel sites and stakeholders.  A nutrition expert was also hired for a two-month period to implement the nutrition surveillance system.

Additionally, an early warning system was in place in the Djibouti District, which has benefited from the input of local authorities and health care providers.  The system was in the process of being reinforced in other districts with the procurement of communication systems for medical centers, hospitals as well as the organization of training session for health staff.  Furthermore, an Integrated Child Sickness Care programme as well as parental education regarding breastfeeding was put in place in 19 health centers.  Health education and promotion was carried out at community levels.

Sensitization and awareness raising session being conducted at Doudouballalé [Photo: UN/Djibouti]

Training and technical support was provided by the contracted experts in all districts on the operation of the mobile units, including nutritional surveillance and early warning systems.  Some 57 persons received training in early warning on epidemic disease and nutrition, including five hospital directors, four mobile clinic doctors, nurses in 22 health centers and nurses and midwives in five district hospitals.  Training in management and planning of health-related activities was given to 25 staff member of the mobile clinics.  As part of technical and capacity building support, computer equipment was procured for the Ministry of Health, which also benefited from support in the development of nutrition, monitoring, and evaluation protocols. 

 

Terms of reference were systematically elaborated and validated with the Ministry of Health for all components of the CERF supported health response, including the mobile units, the nutrition surveillance systems, and the early warning systems. 

As a result, the Ministry of Health was strengthened through the combination of training, improved access to rural populations, improved monitoring systems and increased service delivery to drought-affected populations for effective health and malnutrition management.  It is estimated that the number of beneficiaries targeted and reached with CERF funding was 88,000 people in rural drought-affected districts as of March 2006.

The UNDP Djibouti project in the logistics and communication sector supported capacity building for ONARS through the provision of technical equipment, including four radio systems and the improvement of trucks tracking, as well as better coordination and data collection.  As a result, ONARS capacities have been strengthened in order to respond to emergency needs of drought-affected communities.

In the agriculture sector, the two FAO coordinated projects helped restore livestock health and establish small agro-pastoral perimeters for local farmers to be able to maintain livelihoods and food security.  Significant results were achieved thanks to CERF funding.  Veterinary medicines amounting to $155,000 were distributed and care was provided to over 200,000 livestock (essentially small ruminants).  In support of animal care, 50 veterinary auxiliary workers were trained and deployed and 3,000 small ruminants received vaccinations against brucellosis.  This has also supported zoonosis control by preventing the transmission of diseases affecting livestock to the local population.  A sensitization campaign was also led on hygiene and safeguarding water sources and boreholes, reaching over 12,000 agro-pastoralist and pastoralist families, while 40 hygiene and community liaison workers were trained.  These awareness campaigns were conducted on highly frequented locations for herders and their livestock (water sources, boreholes and known shelters in the area) to ensure maximum outreach.  Radio programs were broadcast as part of this campaign and targeted agro-pastoralists and pastoralists in the wider drought-affected areas.

Pastoralists with their herds at Daguirou [Photo: UN/Djibouti]

The CERF II project focusing on the establishment of agro-pastoral perimeters also achieved significant results as nine sites were prepared for use by nomadic herders, farmers, and their livestock.  Sites were located in all five districts of the country and represented 12 hectares of land.  Borehole and water source sites to be converted in agro-pastoralist perimeters were chosen according to the level of output and availability of water to ensure all needs could be met for populations, livestock, and land cultivation.  Water output also determined the total surface area to be fitted for agro-pastoral activities.  Following identification of sites, enclosures and underground irrigations systems were installed, and 49 hardware and farming kits were distributed to beneficiaries, as well as fodder and other seeds.  Close to 500 vitro-plants of date palm trees were also procured for 49 agro-pastoralist families.  Training on new agricultural techniques was provided to targeted beneficiaries, and proper follow-up was ensured by technicians from the Directorate for Agriculture and Forests.

The combination of CERF funding to maintain livestock health and to help establish agro-pastoral perimeters have had a strong positive impact on the sanitary and health conditions of cattle.  In turn, this has supported efforts to mitigate the impact of cumulative drought on food security and livelihoods.  The UNCT also underlined that CERF funds will serve as a catalyst to mobilize further funding sources amongst development partners.

[Last Update: 4 September 2007]

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Click here to download the 2006 CERF report for Djibouti