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Afghanistan
Winter Child Mortality in Badakhshan Province

This report is produced by OCHA in collaboration with humanitarian partners. It was issued by OCHA
Afghanistan. It covers the period from 28/02/2012 to 29/02/2012.

I. HIGHLIGHTS/KEY PRIORITIES
1. 54 children have died due to ARI / Pneumonia in 4 remote and inaccessible districts of Badakhshan
2. Medicine, blankets and children’s clothes are transported by truck, horse and on foot to the districts. Access is hampered by snow, ice and high altitude. 3. Mobile medical teams provide emergency medical assistance. 4. Communities are drought affected and show high levels of malnutrition. Villages are snow-bound six months per year. Food and NFIs have been pre-positioned and contingency stocks established. II. Situation Overview
54 children under 5 years have died due to ARI / Pneumonia in four remote districts of Badakhshan province. 19 out of the 54 deaths are not verified and no autopsies have been performed on any of the cases. The cause is not yet confirmed as pneumonia, hypothermia, acute respiratory illness or if related to severe malnutrition. No further reports about child deaths have been received so far. Winter related child mortality reports are received from four districts: Kohistan, Khwahan, Raghistan and Yawan. The districts are very isolated, extremely remote and surrounded by high mountains with altitudes between 1,400 and 3,000 meters. Many villages can only be reached on small trails by horse or on foot. Access by vehicle is only possible in summer. Many villages are completely inaccessible for up to seven months. Affected districts are snow-bound for up to six months. The affected districts are chronically vulnerable and in 2011 were affected by drought. The child deaths have happened at the end of the seasonal hunger gap. District The four districts are covered in snow, making access extremely difficult. Snow height in district centres is 50 – 70 cm, in villages up to 120 cm. The further remote the villages are the colder temperatures get and the higher snow levels are. February was severely cold with average temperatures of minus 20 degree Celsius. Repeated snowfall has blocked most access roads in the province. Road Access in Badakhshan
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January and February is the high snow and avalanche season in the area. Access is extremely difficult due to repeated snow fall and avalanche risks. There is no proper road network in place and dirt roads are blocked in winter. PACTEC, the NGO air service, operates in Badakhshan and serves two out of the four affected districts. Helicopter use is not an option because of the mountainous terrain, high altitude and risk of rotor movement triggering avalanches. Kohistan, Khwahan, Raghistan and Yawan districts were affected by the January 2012 avalanche disaster in which 43 people were killed and 65 injured. Overall, where roads are closed, people rely on foot and animal transport (horses and donkeys). Horse trails are icy and muddy. In the winter travel from Faizabad to districts is done by a 9 hour horse ride. Travel time between villages is 5-6 hours. Relief organizations have been able to reach affected districts on foot and by horse. Because of snow, villagers have difficulty in accessing health facilities which are located in district centres. III. Humanitarian Needs and Response
Government and humanitarian organizations provide emergency medical assistance to affected communities. Sufficient medical supplies are in the region. Medical facilities are equipped with emergency medical supplies and staffed. Government and Relief organizations provide the following assistance: IEHK supplementary unit Remark: Covers the need of 10,000 people for 3 months 30 Pneumonia kits Remark: Can treat 12,000 ARI cases 30,000 units of Amoxicillin caps (250 mg) 10,000 tab Salbutamol 20,000 tab Paracetamol 100 blankets 20000 Afs to cover transportation costs Relief supplies from Kabul have arrived and transportation of relief supplies from Faizabad to affected districts started on 29 February. Medair is planning to operate a mobile clinic in Kohistan, Raghistan and www.unocha.org
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Yawan for the next months. The following medical facilities are available in the affected districts: Basic Health Center, Community Health Center, District Health Center and mobile clinics. NGOs working in affected districts District Pre-positioning of medicine: Kohistan, Khwahan, Raghistan and Yawan districts are snow-bound and inaccessibly by road in winter. Medical supplies are therefore pre-positioned in autumn. MoPH, WHO, Kinder Berg, CAF and other health providers have pre-positioned medical supplies for 6 months. Pre-positioning of non-food items (NFIs): Concern, FOCUS, IOM and Kinder Berg have pre-positioned NFIs in affected districts prior to winter. FOCUS has the largest NFI stock in the province with items located in Kishim, Shiki, Jurm, Ishkashim and Baghlan province. FOCUS NFIs include children clothes, blankets, tarpaulins, plastic sheets, tents, family kits, hygiene kits, jerry cans, gloves, wheelbarrows, and gloves. IOM has NFI stocks in Faizabad. Further, the following emergency NFI contingency stocks are available: Emergency Contingency Stocks in Affected Districts 13 tents, 200 family kits, 68 blankets, 82 rain jackets, 11 tarpaulins. 153 tents, 90 family kits, 724 blankets, 36 rain jackets, 204 tarpaulins. Multiple Khawhan district with no emergency stocks Pre-positioning of food: WFP has pre-positioned the following amount of food in autumn 2011: In addition, WFP is providing the following drought assistance: WFP FSAC CAP 2012 Drought Affected Beneficiaries by Interventions and Food Tonnage by Affected Districts Nutritional Status: Medair implements a nutrition program in Kohistan, Raghistan and Yawan districts. The program focuses on integrated nutritional treatment and community health and nutrition education. A Medair nutrition survey carried out in the affected area in October to December 2011 showed that rates of global and severe acute malnutrition remain high. The food security outlook for winter 2011/12 was mentioned as a concern because of the poor harvest and reduced labor opportunities for landless families in response to the drought. The report mentions early depletion of food stocks to be expected. A Medair nutrition survey carried out in the three mentioned districts in July 2011 further indicated that the younger children were more affected with acute malnutrition than the older children. IV. Coordination
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The Badakhshan Provincial Disaster Management Committee (PDMC) meeting addressed situation and needs in its February meeting. Provincial health organizations and DoPH were tasked to assess needs and provide the four affected districts with emergency medical assistance. Ad hoc health coordination meetings are held in Faizabad city. For related maps see: V. Funding
At this point in time, no additional funding is required. All humanitarian partners, including donors and recipient agencies, are encouraged to inform OCHA's Financial Tracking Service (FTS - http://fts.unocha.org) of cash and in-kind contributions by e-mailing: [email protected]. VI. Contact
Please contact: Joseph Inganji Deputy Head of Office OCHA Afghanistan, Kabul e-mail:Tel: +93 793001126 For more information, please visit www.unocha.org
The mission of the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) is to mobilize and coordinate effective and principled humanitarian action in partnership with national and international actors. Celebrating 20 years of coordinated humanitarian action

Source: http://afgarchive.humanitarianresponse.info/sites/default/files/290212_ocha%20afg_IncRep_winter_child_%20mortality_%20badk.pdf