Ethiopia Humanitarian Update, 04/20/01

20 April 2001



Continued concern for the situation in Somali Region

Regional authorities and many of their national and international operational partners continue to point to unresolved humanitarian concerns in the region. There are a number of factors contributing to continued levels of malnutrition including limited potable water supplies, inadequate coverage of health services and the as yet insufficient availability of locally produced milk, a major part of the regular diet in the region during more prosperous times. Significant numbers of persons --- some of them quite distant from their places of usual residence --- are as yet unable to engage in their normal livelihoods and are dependent on relief assistance. Vulnerability remains high and hopes for the future depend on the collective commitment of communities, Government, aid organisations and donors to continue to meet immediate humanitarian needs, to redirect their respective programmes to more vulnerable areas as necessary and to come up with programmes that will provide longer-term solutions to persistent problems in the region and elsewhere.

UN Secretary General’s Special Envoy Visits the Horn

The UN Secretary General’s (SG) Special Envoy for the Drought in the Horn of Africa and the Executive Director of the World Food Programme, Ms. Catherine Bertini, visited Ethiopia from 29 March to 1 April 2001 to give a presentation on "Meeting the Challenges to Food Security in the Horn of Africa" at the International Livestock Research Institute (ILRI). In her presentation, Ms. Bertini emphasized the gender factor in addressing food security. She stated that while everyone has the right to food security and the challenges are many, targeting women was necessary to ensure that families are fed. She went further to say that one of the challenges to food security, but integral to it, was the promotion of girl education. Better-educated women lead to better choices for the food security of families. While in Ethiopia, Ms. Bertini, who was appointed by the UN Secretary General to evaluate the response to the widespread needs caused by the recent drought, met with the DPPC Commissioner, the donor community, NGOs and the UN Country Team. Ms. Bertini thanked donors for the support over the past year, but stressed that the recovery process was far from over and highlighted the need for donor support in the non-food sectors. She pointedly remarked that "drought was not only a food emergency" and that an interdependent approach was needed to address the country’s recovery.

UN High Commissioner for Refugees Visits Ethiopia

The UN High Commissioner for Refugees (UNHCR), Ruud Lubbers, visited Ethiopia for four-days in mid-April traveling to some of the major refugee camps in the eastern part of the country. The High Commissioner went to Camaboker refugee camp to see the departure of the first convoy in 2001 carrying 1,760 refugees who volunteered to be repatriated to home areas in Northwest Somalia. These refugees are the first group from the 60,000 Somalis that UNHCR plans to repatriate during this year. While in Addis Ababa, High Commissioner Lubbers met with H.E. Prime Minister Meles Zenawi, H.E. Foreign Minister Seyoum Mesfin, OAU’s Secretary-General H.E. Dr. Salim Ahmed Salim, representatives of the international donor community and UNHCR’s partners to assess refugee protection and assistance issues in the country. High Commissioner Lubbers concluded his visit with a press conference where he expressed gratitude to the Ethiopian government and people for their hospitality to refugees from the region.

WFP Drought EMOP Approved

A new WFP drought emergency operation (EMOP 10030) was approved on 22 March. The EMOP is for 206,202 mts to cover the needs of 2.5 million people from April 2001 to January 2002. WFP has received confirmed pledges from several donors: USDA for 42,000 mts of cereals, US$ 632,108 from Austria and US$ 462,478 from Finland (both to be used for the local purchase of cereals) and 451 mts of famix from Switzerland. Confirmation of additional pledges is crucial for WFP if disruptions in food positioning and distribution are to be avoided. Cash pledges would be especially welcome in order to promote the local purchase of both cereals and blended foods.

Civilian Mine Action Office Gazetted

The Ethiopian Mine Action Office (EMAO) was created as a civilian entity charged with the responsibility for Mine Action in Ethiopia by the office of the Prime Minister and gazetted officially on February 16, 2001. The training/re-training of the first group of deminers is scheduled to commence in late April 2001.

The Information Management System for Mine Action (IMSMA) system along with its Geographic Information System has been fully set-up and is now operational. Training and data entry of minefield data has commenced. See special focus on

Food Security Retreat held in Addis Ababa

A two-day food security 'retreat' was held at a hotel venue in Addis Ababa on 26 & 27 March. Participants included USAID, the EU, WFP, UNOCHA and the UN Emergencies Unit for Ethiopia . The retreat was the result of two months of donor dialogue on major food security issues in Ethiopia and the desire to develop a coherent policy platform to address these at the highest level. The retreat focused on areas of mutual concern, including a variety of food aid, donor and Government related policy issues. Consensus was reached among participants in a number of key areas and findings were presented to the Food Security and Agriculture Committee (FSAC) on 28 March at the EU. Participants are presently prioritising their agenda and further information will be available pending the outcome of a series of follow-up meetings, beginning 9th April. Informal information in this regard is available from: Jo Raisin USAID, Tom Vens EU, Rebecca Hansen WFP and Bronek Szynalski UNOCHA.

SOFA Signed between UNMEE and Ethiopian Government

The United Nations and the Ethiopian Government have signed a Status of Forces Agreement (SOFA) concerning the United Nations Mission in Ethiopia and Eritrea (UNMEE). The SOFA, which is a significant step, outlines the rights, privileges and obligations between the UNMEE mission and the host country within a legal framework. As part of the agreement, the freedom of movement for all UNMEE military and civilian staff is guaranteed. The agreement was signed on 23 March in New York.

Meanwhile, the fifth meeting of the Military Coordination Commission (MCC) was held on 6 April in Djibouti. The meeting was chaired by Major-General Patrick Cammaert, the Force Commander of the UN Mission in Ethiopia and Eritrea (UNMEE), and attended by senior military delegations from Ethiopia and Eritrea and representatives of the Organization of African Unity (OAU). At the meeting, the Eritrean delegation confirmed that Eritrean Defence Forces resumed their repositioning on 5 April 2001. The establishment of joint investigation teams, which could address possible future military incidents, was also discussed along with the need for both countries to identify how NGOs, UN agencies, and members of the international press corps can cross the southern boundary between Ethiopia and Eritrea.

SC-UK in Somali Region

Though SC-UK's emergency feeding programme in Fik was phased out in January; monitoring continues in 10 sites. As the dry season progresses, the health and nutritional situation is getting worse. It is difficult to say if this is part of a normal trend for the time of year or worse than other years because of the 2000 drought. Shortages of water are acute and there has been a deterioration in water quality and an increase in waterborne diseases. SC-UK secured US$ 211,713 from OFDA for development of clean water supply in Fik.

The loss of livestock has left a significant portion of the population destitute and dependant on food aid. The price of goats and sheep has fallen to 30/40 Birr (from 80/100 Birr in November). In some areas food has not been distributed since December. In Fik town the situation is fairly normal, whereas in some pocket areas there is a visible deterioration on the nutritional status of children. SC-UK has distributed 150 mts of Unimix (supplementary food), donated by CIDA and 200 mts Sorghum, donated by (ICRC) to an estimated 15,000 beneficiaries in Fik , at a ration size of 10kg Unimix and 13kg Sorghum per beneficiary.

Food Economy Zone (FEZ) Project - Somali Region
A discussion session was organised by the Save the Children-UK in collaboration with WFP and the UN Emergencies Unit for Ethiopia in Jigjiga, the Somali Regional capital, from 13-14 March 2001. The objective of the session was to identify primary food economy zones in the region and introduce a proposal for the establishement of a food security monitoring system in the Somali region to different stakeholders. Fifty participants from Government, local/international NGOs and UN agencies working in the region attended the session. A preliminary mapping of the food economy zones of the region was one of the outcomes of the workshop. Currently, DPPC is using three categories to define food economy zones: pastoral, crop-producers and market dependent. The discussion was the first step in identifying areas with relative homogeneity and will be the basis for an in-depth baseline study during the second half of the year, an exercise which is intended to establish the basis for a sustainable and effective food security monitoring system in the region.

Still a Shortage of Supplies and Funds as Meningitis Outbreak Spreads

WHO and UNICEF are reporting that though there has been a very favourable response by donors to the meningitis crisis, 1.5 million doses of vaccine were still required to arrest the spread of the outbreak as it continues to advance throughout Ethiopia. In already vaccinated areas the number of cases has subsided but cases of meningitis in new areas are being reported.

Health offices in the regions, zones and weredas do not have budget lines for the control of epidemics, limiting their ability to conduct mass vaccination campaigns. Operational expenses for heath workers to carry out these vaccinations also need to be met externally. A field visit undertaken by the Ministry of Health and WHO to the most affected regions in Ethiopia, Amhara and Southern Nations Nationalities People’s Region (SNNPR), have verified these shortcomings. The UN country team have appealed to the donor community to respond with immediate action to meet the current shortfall of vaccines and to respond to a US$ 200,000 requirement for local costs, logistic support, coordination, social mobilization and case management, channeled either through the Ministry of Health or an agency or organisation currently involved in the campaign.

The outbreak began with a reported 17 cases in October 2000 rapidly rising to 1,656 cases in March 2001 and bringing the total number of cases to date to 4,131, with a total of 242 registered deaths throughout Ethiopia.

The spread of the disease to areas outside of the traditional meningitis belt is particularly alarming. Typically, meningitis outbreaks have occurred in western Ethiopia. During the current outbreak, cases have been identified in four additional regions of southern and eastern Ethiopia where they have rarely occurred before. The total number of regions affected has risen from one in October to ten in March affecting a total of 36 zones and 97 weredas. The majority of the cases are from Amhara region followed by SNNPR. The significance of this trend lies in the mechanisms in place to control the disease. These regions have little or no experience with meningitis outbreaks and are not well equipped to manage the epidemic properly. They are slower at identifying cases and are not used to treating the disease. More importantly, the population’s immunity is lower than in other regions where vaccination levels are higher and people may have been previously exposed to the organism.

The Ministry of Health, together with its partners, has taken swift action to avert a worsening of the epidemic by ensuring a coordinated response. The Ministry issued an appeal for "Rapid Intervention in the Control of the Meningococcal Meningitis Epidemic in Ethiopia" and chair regular coordination meetings with involved partners.


Access to Water Remains a Challenge

UNICEF reports that access to adequate supplies of clean water remains a major challenge in the Somali region of Ethiopia. A UNICEF water consultant recently undertook a three-week mission to Afder and Liben zones to monitor the water and sanitation situation and recommend possible interventions for which the Regional Water Bureau should prepare detailed proposals. A previous visit by UNICEF staff to Chereti and Harghele (Afder) in mid-March found that most hand-dug wells had dried up in the area. The lack of water was affecting people and the local administration reported two deaths in Afcade village of Harghele wereda. The local DPPD said that 47,000 people were affected by the shortage of water and was planning to start emergency water tankering. The DPPD has requested assistance in terms of fuel, jerrycans and tanks. Difficulties remain in assessing the critical point at which water tankering should begin. UNICEF will continue monitoring the situation through its technical personnel based in the field and will continue supporting the Regional Water Bureau in prioritizing areas of intervention.

The water situation remains difficult also in Gode town, as the Regional water bureau seems unable to deliver fuel for the town water supply system on time. Pumps operate for only seven hours a day and night shifts have been instituted to conserve fuel.

UNICEF assistance in the water sector in Somali region continues, based on carry-over activities from 2000 funding.

In Tigray, the rehabilitation of a deep well in Gehursenay, Central Zone has been completed and water is distributed in four points in town. Water is currently shared by the new town inhabitants and by over 1,800 IDPs, who have not returned yet to their places of origin. Also in Tigray, latrines have been constructed in Fatsi , Sebeya, Dewhan and Alitena. Latrine slabs are being constructed for Gulomehda (60) and Irob (30). In Gulomehda and Irob, a total of 24,000 children have received soap, as part of a distribution for most vulnerable families.


FAO Launches Relief Project to Assist IDPs in Tigray and Afar

As part of overall UN country team assistance to war-affected IDPs, FAO recently launched a US$ 1.8 million emergency recovery project funded by the Government of the Netherlands. This project will be implemented during the coming nine months in three zones and six weredas in Tigray region and zones one and two in Afar region. Actual project locations will be areas where shelter, water supply and security problems (land mine threat) are not limiting factors for the immediate resettlement and resumption of farming during the coming meher cropping season. The project will give priority to assist the most needy and destitute IDPs including women headed households. Up to 23,000 of the most needy and destitute IDP households will be assisted (20,000 in Tigray, 3,000 in Afar) with minimum packages of basic agricultural and livestock interventions. The Ministry of Agriculture and the Regional Bureaus of Agriculture are the project counterparts at the federal and region levels, respectively.

In order to facilitate effective implementation, the project will be integrated with the existing World Bank-assisted Emergency Recovery Programme (ERP) in both regions. While the regional bureaus of agriculture will take the responsibility for routine tasks, the Emergency Recovery Project Management Unit (ERPMU) already organized across regional, zonal, wereda and tabia levels will coordinate the project centrally including beneficiary selection and purchasing of local inputs.

It believed that the assistance, which will be provided on a no-cost recovery basis (free distribution of inputs to the needy beneficiaries), will contribute to the restoration of assets, resumption of farming, improve food supply and reduce dependency on external food assistance of the destitute IDPs.

Belg Rains Improved in March, then Tapered Off in early April
(courtesy of WFP)

Belg (short season) rains, which had improved significantly in amount and area covered in the second half of March after a late onset and poor performance at the beginning of the season, tapered off, at least temporarily, in early April. As per the National Meteorological Services Agency (NMSA), during the first half of April, north-eastern Amhara and south-eastern Somali Region received below normal rainfall while most of SNNPR, western Amhara and some pocket areas of western Oromiya received normal to above normal rainfall. The rainfall situation, as compared to March, was reduced in both distribution and amount over most belg producing areas, which could result in negative impact on the development of crops as well as availability of pasture and drinking water if rain does not resume within the next couple of weeks.

Belg areas that were reported to have undertaken dry planting (due to delayed onset) such as Hadiya, Welaita, Gamo Gofa, North Shewa, North and South Wello are expected to benefit from the improved performance of rains in late March. Some areas of central, northeastern, eastern and southern highlands had heavy rainfall, which could have a negative impact on crops. Rainfall in the lowlands of Bale and East and West Hararghe has been below normal. These areas have been reporting water shortage problems.

In Somali Region, rains have generally been scattered and erratic over the first weeks of April. The onset of rains in Shinnile zone in late March alleviated the water problem that was being reported from various weredas in the zone. Significant rainfall was reported in the first week of April in the area between Negele and Filtu in Liben zone, and has filled ponds and eased the critical water situation in this area. More recently, rain has been falling in Afder zone, and the road between Gode and Hargele was temporarily impassible due to flooding of the Weib River. Severe water shortages are still reported in many other parts of Somali Region, but some of this is the normal situation at the end of the long hot dry Jilaal season.


Mid-Season DPPC/WFP/USAID Belg Assessment in Tigray and Amhara

Two missions, one in late March (MOA/FAO/EUE) and one in early April (DPPC/WFP/USAID) have visited the belg producing areas of South Tigray, North/South Wello and North/Northwest Shoa. Both groups report that the belg rains were late by two weeks to two months and there is concern that the delayed harvest of the belg crops, in July and August, may coincide with the onset of meher rains. Preparation for the meher season was evaluated as very good. For further information see Special Report on Belg 2001.

Cereals and Supplementary Food Being Sent to Bale Lowlands

In response to the deteriorating situation in the Bale lowlands in Oromiya Region, DPPC and WFP have agreed to send cereals and supplementary food to the affected weredas. The reasons for a high level of malnutrition in these lowlands include the poor performance of rains in the past 3-4 years which led to a gradual depletion of assets, mainly livestock, the major source of livelihood in these weredas, and irregular and insufficient relief food distribution since November. There is also concern for the situation in some parts of East Haraghe Zone and West Haraghe Zone.

Micronutrient Pilot

A pilot micronutrient initiative through fortification of cereal flour is being developed in close collaboration between WFP and Canadian CIDA to meet the vitamin and mineral requirements of beneficiaries. The GoE has responded favorably to the pilot project, which will be undertaken at Sodo Zuria in SNNPR and Lay Gaint in Amhara Region. Joint WFP-CIDA teams have already visited both areas to brief the regional DPPB and proposed NGO partners on this micronutrient initiative (from 29 to 31 March in the south and from April 4 - 6 for Amhara). Regional authorities, World Vision and CPAR (the NGOs in Sodo Zuria and Lay Gaint respectively) in both areas were found to be very enthusiastic and supportive. It was agreed that the DPPB in SNNPR will assign a focal point with an alternate for the pilot project; In both areas a tripartite agreement will be prepared and signed by WFP, DPPC and implementing NGO partners.


Belg 2001: Late but Farmers Remain Optimistic

Farmers in the north-central region of Ethiopia have suffered repeatedly in the past three to five years from insufficient or totally failed belg seasons. Belg is the short rainy season between January and May — depending on the location — that is used to produce up to 15% of annual cereal production and facilitates the planting and early development of the important long cycle sorghum, maize and millet varieties. Because of the failure of these rains it is not surprising that a large number of people in the north-central belg producing zones (South Tigray, North and South Wello, Oromiya and North Shewa Zones of Amhara Region and Northwest Shewa Zone of Oromiya Region) have required emergency food aid in recent years.

This year the weather pattern seems to be back on a more normal track. The question is whether farmers have recuperated enough from previous drought years to be able to take advantage of favourable conditions. In the second half of March a FAO/Ministry of Agriculture (MoA)/UN Emergencies Unit for Ethiopia team took a closer look at the conditions belg producing farmers are working under this year. The mission found that belg rains this year were again late by two weeks to two months — depending on the location. Since end of February/beginning of March, however, belg rains have been present in all northcCentral zones in good quantities and with favourable distribution. By the end of March farmers in all the zones had finished planting belg cro ps — mostly barley, wheat and teff.

Due to the delayed planting of belg crops, there is a risk that the harvest may coincide with the peak of the meher rains later in the year. This could result in smaller yields, problems with drying the harvested cereals and consequently with threshing. Farmers point out that they do have coping techniques to overcome the difficulties to a certain extent.

In some areas farmers complained of not having enough seed or the right varieties of cereals to plant late in the season. Generally however, most farmers were able to benefit from the relatively good meher harvest in 2000 and poorer farmers have been able to borrow from more fortunate colleagues on favourable terms. Farmers usually do not use inputs (fertiliser, improved seeds) for the often-erratic belg season for fear of losing the harvest and preserve these inputs rather for the more reliable meher season.

There were few pest reports on standing crops up to the end of March. This however is not a surprise, as most of the crops were not yet beyond germination stage.

One of the most important effects of a "normal" belg season with sufficient quantities of rain is that it enables the farmers to prepare seed-beds for long-cycle meher crops. Long-cycle cereals (maize, sorghums, millet) are much higher yielding crops and enhance food security in the north-central area considerably. In the last three years, due to the poor rains long-cycle meher crops had to be replaced by low yielding varieties, as meher crops could not be prepared in a timely manner. This year farmers have been able to prepare land on time and in some areas they had started planting long-cycle cereals as early as the beginning of April. Chances are — weather co-operating — that in 2001 these areas will see a normal to good crop of maize, sorghum and millet.

Livestock — especially in the highland weredas of North and South Wello — was decimated during the drought years 1999 and 2000 and herd numbers have yet to fully recover. However, because of favourable conditions, the health of animals has improved considerably; milk and other dairy products were available in all zones of north-central Ethiopia.

How can the farmers in these belg producing and partially belg dependant areas best be supported in their quest for future food security? The mission report* recommends:

* Full report is available from the UN Emergencies Unit for Ethiopia

Chat: A Well-known but Little Understood Cash Crop

Chat, with its mildly narcotic leaves, stands among the more important foreign currency earning crops in Ethiopia. It is consumed by millions of people in the country, neighbouring Somalia, Djibouti, Yemen and the Gulf States; however, there appears to be little understanding of the cultivation, botanical characteristics or economics of the plant. This is because chat is considered a socially undesirable "drug plant" by some international and national institutions and officials at all levels. In Ethiopia, despite its contribution to the livelihood of some farming communities and to the economy, the cultivation of chat has been actively discouraged by the authorities for some time. It is the only crop, among all foreign exchange-earning commodities in Ethiopia, that is not accorded the support services of the Ministry of Agriculture (MOA) at any technical or administrative level though in parts of the country the area under cultivation is similar or even greater than that of coffee.

The consumption of chat is of major concern to many countries, especially Djibouti, Somalia and Ethiopia, where it has been found necessary to prohibit its cultivation at different times. In 1982 Somalia bulldozed a large chat plantation and paid compensation to the crop owners. Chat was banned in Djibouti in 1957 by the French colonial government. Nevertheless, banning practices in these countries and efforts to replace it with coffee in Ethiopia had little effect. The failure was not due to difficulties of implementation but due to the exclusion of the farmers from the decision-making process and the lack of a viable alternative. Recently, the UN-Commission on Narcotics and Drugs (UNCND) found the issue of chat consumption and its effects controversial, and the organization has postponed several meetings due to the lack of research on the clinical effects of the narcotic found in the plant.

A recent study conducted by the UN Emergencies Unit for Ethiopia has attempted to gather, document and disseminate comprehensive information on the husbandry, economic, social and ecological importance of chat. In a preliminary review of the literature it was found that past reearch has focused on the chemical compositional analysis of the plant and there was no prior research into the cultivation of the crop. Haromaya (Alemaya) wereda of East Hararge Zone in Oromia Region was selected for the study for its extensive chat production and well-developed chat culture in the area. Lessons learnt and information gathered in the paper focus on predominantly on chat husbandry. It is hoped the information will contribute to improved understanding of the subject and in paving the way for future research for development agencies, researchers, extension agents, policy makers and government officials and other interested stakeholders. For a complete copy of the study, please contact the UN Emergencies Unit for Ethiopia.

TB - Number Two Killer Disease in Ethiopia (source: WHO)

Worldwide, 22 countries are identified as being "high burden countries" for tuberculosis. Ethiopia ranks high on this list, given the large population, the high incidence of TB, the concomitant HIV epidemic and the overall level of poverty. TB heavily affects all regions and it is the number two killer in Ethiopia after Malaria.

TB is a contagious disease spreading through the air like the common cold. Only people who are sick with pulmonary TB are infectious. When infectious people cough, sneeze, talk or spit, they propel TB germs into the air. A person needs only to inhale an infinitesimally small number to be infected. A person with TB will not necessarily get sick with the disease. Five to ten percent of people infected with TB will become sick or infectious at some time during their lives. If left untreated, each person with active TB will infect an average of 10 to 15 people per year.

HIV is accelerating the spread of TB

HIV and TB form a lethal combination, each speeding the other's progress. HIV weakens the immune system. Someone who is HIV-positive and infected with TB is much more likely to become sick with TB than someone who is HIV-negative. HIV is probably the most important factor determining the increased incidence of TB in Ethiopia in the past ten years. Trends in notification rates over the past years identify a constant increase of reported cases. The increase is also attributable to the expansion and strengthening of the TB and Leprosy Control Programme (TLPC) within the country.

Tuberculosis and the HIV epidemic in Ethiopia

Information on the association between HIV and TB in Ethiopia is scarce. In 1994, 44% of 450 TB patients in Shashemene, Oromiya Region, were HIV positive, and 25% of 78 cases with a pathology diagnosis of lymphnode TB in 1997 in Butajira (SNNPR) were HIV-positive. A cross sectional survey under smear-positive TB patients in Addis Ababa showed 45% co-infection. It appears that AIDS patients, many of them co-infected with TB, occupy the majority of hospital beds. The rapid progress from TB-infection to clinical disease in HIV-positive persons fuels the steady increase of new TB cases, in spite of effective control efforts. In addition, HIV-infection alters the presentation of TB and causes substantial problems in the diagnosis. The stigma around HIV/AIDS in Ethiopia appears to have an adverse effect on the TB control efforts. Currently both diseases are so much associated by the population, that persons coming forward for TB treatment are at risk being indiscriminately stigmatized as AIDS sufferers. This may delay and even deter patients coming for diagnosis or cause interruption or discontinuation of treatment.

Control of Tuberculosis in Ethiopia

A comprehensive TB and Leprosy Control Programme (TLCP), has been gradually implemented by the Ethiopian Ministry of Health (MOH) from 1997 onwards, supported and funded by WHO and other partners. The main objectives of the programme are to bring quality diagnostic and therapeutic services as close to the community as possible and integrated within the developing Health Sector Development Plan.

Ethiopia has adopted Directly Observed Treatment Short-course (DOTS) as the key strategy for TB control. The strategy is based on 5 essential components: 1) Government commitment, 2) Treatment under direct observation with effective Short Course Chemotherapy (SCC), 3) Uninterrupted supply of drugs for SCC, 4) A laboratory network for microscopic examination of sputum smears for TB bacillus (AFB-smears), and 5) An elaborate registration and reporting system.

The TB & Leprosy (TBL) services are provided through the general health services and are based on passive case findings. Hospitals and health centres function as diagnostic centres, having AFB microscopy services. After diagnosis, the daily-observed treatment (DOT) is given in the health facility nearest to the patient's home for the first 2 months, out of total 8 months treatment duration. Every region has a TBL coordinator who is a member of the Disease Control Department of the Regional Health Bureau. Even at zonal level there are zonal TBL coordinators. At wereda level, if operational, the Wereda Communicable Disease Coordinator is responsible for TBL control.

Apart from Benshangul, Gambella and Afar regions, which will be included in 2001, all regions are now participating in this programme. In the past three years the number of zones in which the DOTS strategy has been introduced has risen from 27 to 42 out of a total of 62 zones (68% geographical coverage). However, only 32% of all health facilities are yet implementing DOTS.

At the present time TB & Leprosy (TBL) services are only provided in health facilities and consequently it is assumed that in a country with 50% overall health service coverage, a large part of the population has no access to quality TB and leprosy services. However, for diagnosis, patients will be ready to cover large distances and travel even more than a day. For treatment access depends on the economic situation or presence of relatives around the treatment centre. Access to treatment could improve by including Health Posts in DOT and Multiple Drug Therapy (MDT), if they are staffed with professional health workers, as some regions are preparing for.

For the complete WHO report of Tuberculosis and its Control in Ethiopia, access the EUE web site at

FOCUS Series: mine action

UN Mine Action Service’s Information Management System for Mine Action (IMSMA)

IMSMA was developed in close cooperation with the United Nations and other users by the Swiss Federal Institute of Technology on contract to the Geneva International Centre for Humanitarian Demining (GICHD). GICHD has developed IMSMA on behalf of the United Nations Mine Action Service (UNMAS).

The Field Module, which is the UN system for mine action, provides a ready to use tool for mine action coordination centers to meet their data collection and information requirements. It allows the users to record, evaluate and visualize information related not only to minefields but also on geographic, socio-economic data and information on incidents and mine victims. All data is linked to a geographic information system (GIS) and allows for a variety of special analysis and interpretation.

As part of the Ethiopian Mine Action Office’s (EMAO) plan for mine action in Ethiopia, IMSMA was deployed to assist EMAO in their mine clearance, mine awareness, quality assurance and victim assistance initiatives. An international IMSMA specialist has been initially posted to assist and build EMAO’s capacity in information management.

Other agencies and organizations with humanitarian mine action focus, will also benefit from data collected through IMSMA, in particular mine awareness and victim assistance. The general public in mine-affected areas will benefit from IMSMA by educating them on the damages and injuries that may be caused by explosives and minefields.

A COMMUNITY IN FOCUS: The Aftermath of A Golden Harvest

Saturday market in Bahir Dar is always a colourful picture of abundant life. Fresh fruits and vegetables, bright shiny plastic wares and local handicrafts, aromatic spices and processed cereals …everything about it indicates that this place is busy and live, that this is a land of plenty.

Yet all is not what it seems. As you go towards the back of the market and come into the grain quarter, you can see groups of farmers huddled together against their heavy sacks of maize or teff. They are waiting for a sale, with equally heavy hearts. Birr 50 for a quintal (one quintal is 100 kgs) of maize, and Birr 135 to 150 for a quintal of teff — both almost half the price of last year, but that’s the best they could hope for at present.

Bahir Dar, one of the most attractive cities in Ethiopia, lies at the centre of a high potential agricultural area. With fertile soil and plenty of rain, farmers in East and West Gojam have had an easier life than their neighbours in South Wello, a traditionally food deficit zone. Last year, blessed with good weather and thanks to improved seeds and technology, Gojam has had a golden harvest with an especially high maize production. Nevertheless, this was where the trouble began.

The story is not a new one - things go cheap when they are in plenty. As an economic rule, this happens everywhere. However when the same occurs in Ethiopia, where there is virtually no efficient marketing to speak of, and where the farmers are financially vulnerable, it becomes a nasty shock which the country has not seen for a long time. Trapped in an accumulated imbalance between high production and low demands, farmers’ hearts sink with the price of their grains.

To sell cheap or to be ‘imprisoned’. Currently there is little choice for farmers, most of whom rely heavily on an annual loan from their local cooperatives for their inputs of fertilizer and seed. If they do not pay back the debt after harvest, not only is there no chance of them getting fertilisers or cash for the next cropping season, but they could also lose their freedom until they come up with the money.

In a small village town called Meshenti 20 kilometres from Bahir Dar, a few of the guilty - 5 women, 5 men, and an ox are rounded up in a circle a few hundred metres away from their local cooperative office. A wooden shed serves as their prison cell, and a guard with a rifle on his shoulder is keeping close watch. The cooperative will not release these people, the guard explains, until their families come to clear the debts. And the same goes for the ox, which belongs to a debtor. One young woman has been in here for a week, and she hopes that her husband will be able to borrow money from the local church and get her out. An old man has given himself up to the authorities in the place of his son, who has not been able to repay the loan. " I’d rather be imprisoned," he says, "than to see my son selling maize at such a low price. The market is blind!"

While the number of those detained is bound to increase in the next few weeks, there is no lack of sympathy from the cooperative office which has been forced to take such a measure. The problem is, as a staff member explains, that every cooperative in the country is facing enormous pressure these days to stand on its own feet without government subsidies, and they simply cannot afford to lose money.

There have been, with some cooperatives, feeble attempts to purchase grains from local farmers and to invite tenders for fertilisers. However, a lack of funds, human resources and marketing knowledge has determined that multi-purpose cooperatives are still very much a theory in Ethiopia.

Merawi is a rural town 35 kilometres from Bahir Dar. Currently there are 3 sale prices for a quintal of maize. Birr 40 to traders in the local market, Birr 41 to 43 to the local cooperative, and Birr 52 to the local branch of the Ethiopian Grain Trade Enterprise. In reality, the local market is the only option for most farmers in the area.

Standing only a few hundred metres from each other, the cooperative’s shabby mud store contrasts sharply with the Enterprise’s smart cement store which is several times larger in size. Despite the difference in their looks, the two competitors share many problems in common. Both are saturated in their buying capacity under the pressure of the current crisis, and both are struggling for survival as a stabilising mechanism in a market economy. The Enterprise, the once all-powerful state monopoly, is also yet to win back the trust of the public. One farmer in Merawi comments, justifiably or not, that the Enterprise’s policy is confusing, and that they cheat on scales. Others farmers in the area are simply not aware of their current purchasing prices.

Everywhere you go now, the word ‘fertiliser’ is having an explosive effect on farmers. While the sale price this year is not enough to cover the production cost, and some farmers are having to sell their oxen to pay off the debt, fertilisers are still getting more expensive.

The greatest irony behind this golden harvest is that while the grain in the so-called surplus areas are crying for an outlet, the neighbouring deficit areas will probably be waiting to receive emergency relief food from abroad.

Has the Ethiopian market gone ‘blind’ indeed?