The health system, although reactivated in 2005, is still lacking qualified personnel, thus increasing child and infant mortality rates Access to safe drinking water is scarce, especially in FN-controlled areas, due to a high number of broken water pumps and absence of public administration personnel The education sector has also been affected - excess in enrollment demands in government-controlled areas and shortage of teachers and deterioration of infrastructures in FN-controlled areas Over an estimated 750,000 IDPs, as well as other vulnerable groups, are exposed to violence and other forms of sexual exploitation, including rape

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Assistance to populations affected by the protracted crisis in Côte d’Ivoire

1 August 2007: CERF allocates US$ 2.5 million to Cote d'Ivoire as part of the second under-funded allocation in 2007

After more than four years, the complex socio-political crisis appears to be over. But the widespread food insecurity and other humanitarian needs will probably persist, especially as an overall economic upturn is not imminent.

The World Food Programme (WFP) is assisting 794,000 internally displaced persons (IDPs) with 15,169 tonnes of food aid. Recovery-type activities, such as food-for-work and food-for-training, are focused on agriculture, infrastructure rehabilitation and training. More than half of the food resources are set aside for the education sector. WFP is providing hot meals and take-home rations for girls, in particular in regions with low enrolment rates. Other activities include nutrition programmes for HIV-affected people, vulnerable mothers and children under five.

Children pumping water from the only well in a northern village [Photo: IRIN]

 

In the IDP camp in Guiglo the International Organization for Migration (IOM) is reinforcing the existing protection mechanism with all the humanitarian actors and rehabilitating basic infrastructure, including hydraulic pumps. It is also developing cultural and other social activities to reconcile communities, while facilitating the return of IDPs in safety and dignity by providing transport, as well as individual and family return kits.

The Food and Agriculture Organization (FAO) is using a CERF grant to boost agricultural activities. It is distributing a market garden kit to 5,500 households, so that they can grow vegetables in their villages. The beneficiaries will produce rice, niébé (pulses), okra, hot pepper, eggplants and tomatoes. The crops are supposed to improve the daily food ration of families during the hunger gap period and supply additional income through the sale of the production surplus.

The UN Children’s Fund (UNICEF) is repairing or setting up latrines and water points in 16 primary schools (representing 96 classrooms) in Western cities that have been affected by the armed conflict. The UN agency is also supplying school furniture, as well as school kits for children and teachers.

Another UNICEF project is seeking to improve the nutritional status of children in seven health districts in Western Côte d’Ivoire. Project activities include the training of health workers on how to treat severely malnourished children and how to provide adequate nutrition for persons living with HIV/AIDS. UNICEF is also supplying essential drugs for malnutrition treatment, therapeutic foods and anthropometric equipment.

A CERF allocation is enabling the World Health Organization (WHO) to reinforce the delivery of minimum health care packages to health centres and communities in the Northern and Western regions of the country. The packages are covering basic services for curative, preventive and promotional health care, including reproductive health. WHO is also training health personnel in prevention and care of the main illnesses, while providing health facilities with essential drugs, vaccine, net beds and other medical materials.

The UN Development Programme (UNDP) is establishing teams offering counseling and legal assistance in mobile clinics for those facing obstacles to a sustainable return. The part of the project concentrating on education is identifying students and training teachers, while equipping classrooms to support a catching-up programme aimed at reintegrating out-of-school children into the formal system.

Another UNDP project is responding to the basic needs IDPs are facing upon the return. The UN agency is providing initial training to a point person among the IDP population in several locations who will engage in social cohesion activities in the host communities. UNDP is also facilitating go-and-see visits to areas of return, and go-and-talk visits during which representatives from areas of return call on the displaced to share information. In addition, the programme is rehabilitating schools and equipping them with furniture and latrines. Finally, UNDP is repairing water pumps not covered by other interventions in the area of return.

[Last Update: 1 August 2007]]

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CERF responds to underfunded humanitarian interventions

1 March 2007: CERF allocates US$ 4.5 million to ensure the continuation of humanitarian assistance to vulnerable populations in Côte d’Ivoire.

Côte d’Ivoire remains one of the most complex protection crises in the region, reflecting the adverse impact of a political-military crisis that erupted in September 2002 following the failed coup attempt against President Laurent Gbagbo.  After more than three years of stalemate, the signing of a peace accord on 4 March 2007 in Ouagadougou, Burkina Faso, gave new impetus tothe peace process. The accord envisages that the holding od elections in 10 months. It also stipulates that government and troops from the Forces Nouvelles start deploying in the buffer zone - known as the Zone of Confidence - currently manned by the United Nations and the French Licorne forces as of 16 April 2007. The UN and French forces in the zone are then expected to start reducing their presence in the area.

Against this backdrop of political fragility, the humanitarian situation in the country continues to deteriorate, with devastating effects particularly for approximately 700,000 displaced and other vulnerable groups in the volatile West and an increasingly impoverished North.  Côte d’Ivoire experiences serious challenges within the social and health sectors, with saturated and inadequate health infrastructure, an upcoming shortage of stocks of essential drugs and resources, shortages of potable water, poor sanitary conditions, and weak epidemiological surveillance systems.  This environment poses serious challenges to humanitarian efforts to overcome the deterioration of basic health services as well as the resurgence of diseases like yellow fever, cholera and meningitis.  This situation was further exacerbated last summer by the dumping of 500 tonnes of toxic waste in the economic capital, Abidjan, which led to 15 deaths and necessitated treatment for several thousand patients. 

Two boys search for anything usable in a dumpsite, Abidjan. [Photo: IRIN]

In such a fragile socio-political context, persistent violations of human rights and humanitarian law, inter-community tensions and widespread impunity continue to aggravate the social fracture.  These abuses and the impunity that fuels them raise serious concerns about the potential for sudden violence whenever the peace process is stalled.  The protection of displaced populations and host families, especially in Government-controlled areas in the West and in the Zone of Confidence, remains one of the most urgent humanitarian challenges, as well as that of children associated with armed forces and children victims of violence and sexual abuse, or deprived of access to education.

The CERF grants totalling US$ 4.5 million will allow UN agencies to respond to the most pressing of humanitarian concerns. WFP will provide food assistance and humanitarian air service, while UNFPA will supportthe integration of reporductive health components in the Centre and East of the occupied zones. UNICEF will provide emergency obstretric care for women as well as provide improved access to water for rural communities inadequately covered by humanitarian assistance. While IOM will provide assistance to the voluntary return of about 1,000 internally displaced people (IDPs), UNDP will provide coordination and support services.

In 2006, Côte d’Ivoire received US$ 1.7 million from the rapid response grants window of the CERF, and another US$ 4 million from the under the underfunded grants window in 2006.

One third of all funds from the Central Emergency Response Fund is earmarked for use in underfunded emergencies, in order to help redress imbalances in global aid distribution, as a result of which millions of people in so-called neglected or forgotten crises remain in need.

This allocation to Côte d’Ivoire in March 2007 forms part of the third allocation from the underfunded window of the CERF.  

[Last Update: 12 April 2007]

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CERF helps control meningitis outbreak in northern Côte d'Ivoire

1 March 2007: CERF allocates US$ 1.7 million to control a meningitis outbreak in the northern part of Cote d'Ivoire

With the CERF grant, the World Health Organization (WHO) will seek to control a meningitis outbreak in the Northern, Central, South Western and Western regions of Côte d’Ivoire and prevent the disease to expand to other areas. During January 2007, district administrations in the aforementioned areas reported 58 cases of meningitis, including 15 deaths. The WHO projects targets 80 per cent of the population in these districts or 3.6 million people. Activities include a strenghtened epidemiological surveillance in the region as well as the purchase and delivery of drugs, vaccine, syringes and other medical supplies as part of a mass immunization campaign.

The on going meningitis epidemic in West Africa is of great concern to regional health partners. While Burkina Faso has been hardest hit, a total of ten countries have so far been affected namely: Burkina Faso, Benin, Côte d’Ivoire, Ghana, Guinea, Mali, Niger, Nigeria, Chad and Togo. Since 1 January 2007, Burkina Faso alone has registered nearly 5,000 cases and 324 deaths. Regionally, WHO has received reports of over 6,000 cases and 526 deaths.

The main risk is the generalization of the epidemic in countries located in the meningitis belt reaching across the continent from Senegal to Ethiopia. Last year, WHO carried out a risk assessment for 2007 and the organisation is particularly concerned with the current situation due to appearance of a new serotype of meningitis in Burkina Faso and Niger in 2006, as well as resurgence of the epidemic in countries that had otherwise been quiet for a while, notably Sudan and Nigeria in 2006.

Meningitis Belt 1995-1999 [Source: WHO]

An aggravating factor in a worst case scenario could be an insufficient number of vaccines globally available to cover the needs for vaccination campaigns in all countries. The population living in the meningitis belt is estimated at around 300 million people. MSF recently pointed out that the current availability of the vaccine worldwide is estimated at 25 million doses, and only 7 million doses have been reserved for epidemic response. Furthermore, the production of additional vaccines this year for the meningitis belt is jeopardized since the unique provider of the vaccine, Sanofi-Pasteur, is in the process of transferring its production site and will therefore not have capacity to produce additional vaccines this season.
Between 1995 and 1997 the meningitis belt experienced the largest recent epidemic, with over 250,000 cases and 25,000 deaths registered. A worst case scenario would involve a generalization of the epidemic in the meningitis belt and the lack of sufficient doses of vaccines to protect people at risk. Weak health infrastructures would quickly become overwhelmed and some 30,000 human lives could potentially be at risk.

What is meningitis?

The cause of meningitis is the Bacterium Neisseria meningitidis. Strains A, B, C, Y, and W135 are the most common. Infected people typically carry the disease without showing symptoms and spread the bacteria through coughing and sneezing. Meningitis causes sudden and intense headaches, fever, nausea, vomiting, photophobia, and stiffness of the neck. Death may occur within hours of the onset of symptoms. The disease occurs sporadically throughout the world, but the vast majority of cases and deaths are in Africa. Epidemics regularly hit countries in the area referred to as the African "meningitis belt," which stretches across the continent from Senegal to Ethiopia. The total population at risk in these countries is around 300 million.

Without treatment, bacterial meningitis kills up to 50 percent of infected people. Even if the disease is diagnosed early and treated with appropriate antibiotics, such as chloramphenicol or ceftriaxone, the case fatality rate remains 5 to 10 percent. As many as one out of five survivors will suffer from neurological after-effects such as deafness or mental retardation. Timely mass vaccinations are the most effective means of limiting the spread of epidemics. The World Health Organization (WHO) has estimated that mass immunizations have managed to prevent up to 70 percent of expected cases in individual meningitis outbreaks in Africa.

[Last update: 15 March 2007]

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CERF in Côte d'Ivoire 2008

CERF in Côte d'Ivoire 2006

Meningitis Epidemic in West Africa (OCHA Press Release, 23 March 2007)
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