Vietnam Humanitarian Situation Report No.9
originally posted on September 15, 2016
Fresh water has been available due to seasonal rain fall in Mekong Delta, South Central Coast and Central Highlands region. The annual flood of Mekong Delta has so far not reached the delta. It is important to note that people in the region depend on the river and its tributaries for food, drinking water, irrigation, transportation and many other aspects of their daily life particularly during the flood season. If the level of water remains the same or slight increases for the next two months, the drought and salt water intrusion could come back in early 2017.
It is foreseen that with the impact of climate change, sea level rise, reduction of water flow from upstream to lower Mekong basin, natural and man-made disasters have been and will be more intensified and unpredictable. Under that backdrop, UNICEF Viet Nam has engaged strategically with Ministry of Agriculture and Rural Development – MARD, the focal agency of the Government of Viet Nam on this work, to discuss a long term cooperation on risk informed programming, disaster preparedness, building resilience and disaster risk reduction – DRR.
With current situation demand for clean and safe drinking water is needed for household consumption. Lack of safe drinking water and poor hygiene conditions poses high public health risks to vulnerable communities in affected provinces. Impact for affected households is severe and needs are still pertinent particularly in terms of water purification, hygiene promotion, nutritional support and livelihood recovery.
Situation overview and Humanitarian Needs
The ongoing El Niño-induced drought and saline intrusion emergency has adversely impacted the lives of people in 52 out of 64 provinces. In the most affected 18 provinces, 2 million people including 520,000 children and 1 million women, are in need of humanitarian assistance. Of the total 2 million people affected, some 500,000 live in the drought-affected South Central and Central Highlands Regions, and 1.5 million live in the Mekong Delta, where water shortages have been exacerbated by the saltwater intrusion.
With recent rainfall, the situation in the Mekong Delta has improved although impact of saline intrusion is yet to change.
Reduced water use for washing, ablution, and hand-washing, have already resulted in increased incidence of diarrhoea, dysentery, hand, foot and mouth disease, and skin diseases.
The poor access to water has also had an impact on children’s health, exacerbating the prevalence of malnutrition. The forecast of likelihood occurrence of La Niña is now 50-60% compared to previous forecast of 75%. La Niña, which is characterized by cooler than normal water temperatures in the Pacific Ocean, usually results in greater than average rainfall, increasing the risk of large flooding in Mekong delta provinces – particularly in drought-affected areas. The Mekong River delta plays an important role in the Vietnamese economy and it has been severely impacted by a series of unusually drought and large floods. In the dry season the delta is impacted by salinity intrusion and tides. These effects have caused severe human hardship.
Humanitarian leadership and coordination
A joint Government, UN and INGO assessment confirmed the urgent needs in the sectors of water, sanitation and hygiene (WASH), health and nutrition, and food security. There are challenges to reach the most vulnerable in hard-toreach locations and to strengthen coordination mechanisms at provincial/district levels. The overall sectoral response is led by the Ministry of Agriculture and Rural Development (MARD) which targets through water trucking the 2 million people affected by the lack of regular access to drinking and domestic water sources. With the onset of rain, especially in the Mekong Delta, water trucking has been reduced. However the emergency response to support purification of water, micro-nutrient supplements, and hygiene behaviour promotion continues to remain important and valued by MARD.
The Department of Agriculture and Rural Development (DARD) in provinces under the leadership of the Provincial People’s Committee (PPC) is coordinating the response at provincial level. In severely affected provinces, the Viet Nam Red Cross (VNRC), Oxfam, Care International, World Vision, and Save the Children are responding and reaching out to the most vulnerable populations, though on a limited scale.
Humanitarian Strategy – The Humanitarian Response – Development Nexus
Based on the results of the 21-24 March joint multi-sector rapid assessment and subsequent monitoring and reporting by Government and partners, the Viet Nam Emergency Response Plan (ERP) outlines the funding requirements to respond to the needs of 2 million people suffering from acute water shortages, 1.1 million who require food assistance, 500,000 in drought-affected areas at risk of water-related diseases, and 66,500 acutely malnourished under-five children and pregnant and lactating women. The UNICEF response strategy involves life-saving support to approximately 358,954 vulnerable people with household water treatment and safe storage, and hygiene promotion to prevent communicable diseases. Interventions will also improve WASH facilities in schools which will be used in conjunction with health centres as entry points for hygiene, sanitation and emergency nutrition interventions. These response activities provide long-term benefit to affected communities’ awareness and coping strategies in future emergency situations, and they serve as an important link between emergency response and on-going WASH and Nutrition resilience. Assessment of the vulnerability to natural disasters in addition to drought is being undertaken and forms the basis for promoting Risk Informed Programming in the drought and saline intrusion affected provinces. Through engagement with Government and other UN agencies, UNICEF aims to prioritise the most vulnerables in affected provinces for further interventions in its on-going programmes, thereby improving long-term community resilience.
Summary Analysis of Programme response
UNICEF has procured PUR sachets and Aquatabs for household water purification for approximately 360,000 people in 10 target provinces. As of 14 September all 4 million Aquatab tablets, 15.9 million PUR sachets have arrived in Viet Nam and are ready for distribution. National Center for Rural Water Supply and Sanitation – NCERWASS has printed 80,000 PUR instruction leaflets and 80,000 Aquatabs instruction leaflets to distribute to the targeted beneficiary households. UNICEF has also printed 4,000 booklets of joint UN key messages for emergency situation, 500 posters of handwashing with soaps, 80,000 household WASH booklets focusing on water treatment, and behavior change communications on hygiene and sanitation. They have been delivered to all 10 provinces for distribution together with WASH Supplies in 176 communes of 39 districts in 10 provinces.
All WASH supply items including instruction leaflets, and all WASH C4D materials have been delivered and ready for distribution to 26,500 people of 5,900 households in 9 communes of 5 target districts in Gia Lai province this week (12-16 Sept).
59 provincial-level participants from Center for Rural Water Supply and Sanitation – PCERWASS, Center for Preventive Medicine – CPM, Department of Education and Training – DOET, Center for Health Education – CHE, Viet Nam Red Cross – VNRC, and Women Union from 5 Mekong River Delta provinces of Ben Tre, Tra Vinh, Soc Trang, Hau Giang, and Ca Mau attended a TOT training and demonstration on using Aquatabs and PUR sachets, communications for behaviour change, and finance management, organized by NCERWASS in Can Tho from 5- 7 Sept. These officials will form resource trainer teams to roll out training for district and commune facilitators by end of Sept. After TOT training, there will be approximately 1,050 people trained to later guide people on how to use Aquatabs and PUR. A similar TOT training will be organized by Viet Nam Health Environment Management Agency- VIHEMA for 5 Central Highlands and South Central provinces of Ninh Thuan, Binh Thuan, Gia Lai, Kon Tum, and Dak Lak on 22-23 Sept 2016.
High level meetings between UNICEF – MARD Vice Minister and UNICEF – Red Cross President have opened new windows of opportunities for strategic partnership in current on-going emergency response and future endeavors in disaster risk reduction and resilience development in communities for a safe and enabling environment for women and children. This will form a strategic cooperation framework for 2017-2021. In This woman gets water from a stream 500m away from her house. Water is muddy and dirty (Sept. 2016) immediate future, MARD and UNICEF will co-organize an international workshop to discuss on DRR and its implication on Children to the experience of the on-going humanitarian action and its linkages to development.
For immediate future, VNRC will be a key implementing partner for the on-going emergency response relating to school WASH, Community-Led Total Sanitation (CLTS), upscaling Open Defecation Free (ODF), citizen feedbacks in emergency response. In a longer term, a number of potential thematic focuses have been identified, including child protection, Core Commitment to Children (CCC) in Emergency, vulnerability assessment, disaster risk reduction, resilient community development, integrating DRR and CCA into Social Economic Development Plan – SEDP planning, improving damage and need assessment taking into account children’s issues for effective disaster response, and joint efforts in programme fund raising. A UNICEF-VNRC partnership agreement shall be developed and finalized by the end of September to set out specific areas of cooperation.
In Ninh Thuan, there have been 62 new cases of SAM children detected and admitted for treatment in Ninh Thuan. The total number of SAM cases detected and treated is 712. The number of pregnant and lactating women having been treated with multiple -micronutrient supplements is 5,549 cases. The number of children 6- 23 months receiving multiple micro-nutrient sachets for home food fortification is 13,314 children.
The implementation has been started in Gia Lai. The total number of SAM cases detected is 855. The number of children 6-23 months identified for receiving multiple micro-nutrient sachets for home food fortification is 19,546 children.
The national guideline for implementing nutrition emergency intervention was issued by the National Institute of Nutrition – NIN and sent to all provinces. Accordingly, provincial health authorities adapted the guideline and issued instruction to the districts for the implementation. 5,000 MUAC tapes, 30 tons of Ready to Used Therapeutic Food (RUTF) and 8,700,000 multi-micronutrient tablets for pregnant and lactating women, 8.4 million micronutrient powder sachets for 6-23 month children were distributed to the 6 provinces at the end of August 2016. Ninh Thuan, Gia Lai and Tra Vinh had distributed their nutrition supplies to all districts.
Child Protection UNICEF is also exploring ways to support Child Protection by carrying out a sector-specific assessment. A child protection rapid assessment has been conducted in Ninh Thuan province, a south central coast province seriously affected by drought. Led by UNICEF and the Ministry of Labour and Social Affairs (MOLISA), in collaboration with Save the Children and Plan International, the assessment looks at emerging or escalated child protection issues due to the magnitude of the drought. The assessment also identifies response gaps and makes recommendations for immediate interventions to address child protection concerns, as well as medium and long-term solutions for strengthened child protection in emergencies.
Key findings and recommendations from the report are as follows:
Family separation is common during drought period, either long term as some parents have to migrate to other localities to earn living, or short term when other parents have to work in remote paddy fields far away from home for a few days, leaving the children behind either alone, with their siblings to take care of each other, or with the grandparents and relatives for care.
Child neglect is of concern as the result of family separation, or because parents have to work longer hours, or experience increased stress, thus give less care to the children, both physically and emotionally.
Sporadic absence from school of children is reportedly more common during the drought period. While primaryschool children skip classes for few days to go with their parents to the paddy field in remote locations, secondary-school children sporadically drop out of school to do part-time works (such as herding cows and sheep, cutting sugar cane and harvesting coffee) or to take care of their younger siblings while parents are working away from home.
Increased psychological stress of children was also reported during the assessment due to prolonged heat and water shortage, lack of parental care, witnessing domestic violence, and verbal abuse of the parents.
Violence against children continues to occur, and neglect and the lack of parental care are reported to be the cause of some cases as parents were busy working or working far from home. However, existing data does not show an increase of child abuse incidents as an impact of the drought.
Child labour was also raised as a concern as it leads to not only dropping out of school but also the risk of exploitation. However, there is no data indicating that the situation is escalated during the drought period
The local government, agencies and mass organizations have taken a number of interventions and provided various support help the people coping with the drought. Child protection concerns, however, have not been adequately recognized in order to identify effective responses.
To strengthen data collection and monitoring of the situation children affected by the drought.
To pilot short-term foster care model or community-based child friendly shelter to care for children in the community while parents are absent from home for several days in remote field.
To strengthen capacity of the Child Protection system, especially during natural disaster, particularly through enhanced community child protection network and the role of social work center.
To integrate CPiE into the welfare sectoral and the local plan to ensure that child protection is considered as a key response in the drought and advocate for additional government budget allocation to welfare sector to address CP issues.
To set up support groups for parents affected by the drought at community level. These could be places where mothers particularly could receive counseling support.
To strengthen effort to retain children in schools, including school feeding programmes.
To strengthen communication on prevention of family separation, neglect, abuse and exploitation of children.
To increase children’s participation in prevention of and response to the drought’s impact, especially the detection and timely intervention of the risks of abuse, violence and exploitation of children in the areas affected by natural disasters. Findings and recommendations from the assessment was disseminated in Ninh Thuan and the report was shared with leaders of MOLISA for follow-up actions.
Communications for Development (C4D)
C4D activities on life-saving behaviours promotion of Nutrition and WASH in emergencies are under implementation in 10 affected provinces (Ca Mau, Gia Lai, Hau Giang, Kon Tum, Ninh Thuan, Tra Vinh, Ben Tre, Binh Thuan, Dak Lak, Soc Trang). C4D activities aim to response to the impact of both El Niño and La Niña phenomenon. Emergency C4D activities include IEC (Information, Education and Communication) materials’ production and distribution, training, provincial mass media activities, community media (using commune loud speaker system to disseminate messages) and interpersonal communication activities implemented at community and school level. IEC materials on Nutrition and WASH in emergencies were produced and distributed to different groups of target audiences in project site of 10 affected provinces:
1. UNICEF took the leading role in coordinating with other UN agencies to produce the booklet. The booklet was developed based on key emergency messages of WHO, FAO, UN Women, UNDP, and UNICEF and helps provincial C4D managers and planners to develop and implement provincial c4D related activities responding to emergencies. 4,000 copies of the booklet on UN emergency key messages and emergency IEC materials development guidelines were produced and distributed to provincial counterparts of 10 targeted provinces.
2. 80,000 copies of the booklet on Hygiene promotion were printed and are in the process of distribution to households 10 targeted provinces.
3. 500 copies of the Poster on Handwashing with soap were printed and in the process of distribution to national implementing partners and will be used as advocacy tool during the celebration of global hand washing day.
4. 156,000 copies of 2 Leaflets on water treatment using Aquatabs and PUR were printed and are in the process of distribution to households of 10 affected provinces.
5. 180,000 copies of 2 Leaflets on Nutrition were printed and are in the process of distribution to households of 06 affected provinces where nutrition in emergencies is prioritized namely Ca Mau, Gia Lai, Hau Giang, Kon Tum, Ninh Thuan, Tra Vinh.
6. 3,600 copies of the Poster on Nutrition were printed and are in the process of distribution to households of 06 affected provinces (Ca Mau, Gia Lai, Hau Giang, Kon Tum, Ninh Thuan, Tra Vinh).
Besides, the desktop-publishing files of all produced IEC materials were sent to national and provincial counterparts for its customization and uses in future emergency responses.
The IEC materials for school activities are under development. Materials will focus on hygiene promotion/child injury prevention in emergencies and climate change. There are 2 types of materials for school activities facilitated by teacher and student-led activities that will be developed for primary school student. It is recommended to develop a story board for activities facilitated by teacher and board game for student-led activities.
In student-led activities, student will learn through playing game in extra curriculum activities. From 5-7 th Sept 2016: the TOT training in Can Tho was organized for 59 provincial C4D managers and planners (from Tra Vinh, Hau Giang, Ca Mau, Ben Tre, Soc Trang) of emergency of PCERWASS, Preventive Medicine Centre, Health Productive Centre, and Centre for Health Education. In the training, participants were provided within the UN’s key messages in emergencies; Interpersonal communication skill in emergencies response; The guideline for provincial C4D manager and planner on the implementation of C4D activities in emergency at provincial and community levels. After TOT training, provincial C4D managers and planners will organize 1 day-training for commune/village health workers and collaborator and support them in implementing C4D activities at community level.
In the context of the instutionalization and strengthening of the emergency response capacity of the education sector in general, the Ministry of Education and Training (MOET) has worked with country partners (UNICEF, Plan International, Save the Children) to refine the Viet Nam’s Framework for Comprehensive Safe School which was adapted and contextualized from the Global Framework. The Comprehensive Safe School for Disaster Prevention in Viet Nam includes 3 main pillars namely the (i) Safe infrastructure for disaster prevention; (ii) Disaster risk management in schools; and (iii) Education for disaster prevention, control, risk reduction and adaptation to climate change in schools. Specific evaluation criteria for each pillar are also included in this framework. The approval of the revised Viet Nam’s Framework for Comprehensive Safe School for national application is expected by the end of this year.
Supply and Logistics
Of the total procurement value, 81% of supplies have been received and are under distribution in 10 provinces.Nutrition supply distribution has been transported to all six targeted provinces. Distribution has been commenced at district and commune level in Ninh Thuan. Tra Vinh and Gia Lai province. WASH supplies – 15,892,800 sachets of water flocculation, 4 million tablets of Aquatabs, 78,000 Buckets, 78,000 filter cloths and 89,200 pieces of anti-bacterial soaps are ready for distribution at the provincial level. All WASH supply items including instruction leaflets, and all WASH C4D materials have been delivered and ready for distribution to 26,550 people of 5,900 households in 9 communes of 5 target districts in Gia Lai province this week (12-16 Sept). 5,000 MUAC tapes, 30 tons of Ready to Used Therapeutic Food (RUTF) and 8,700,000 multi-micronutrient tablets for pregnant and lactating women, 8,400,000 micronutrient powder sachets for 6- 23 month children were distributed to the 6 provinces at the end of August 2016. Ninh Thuan, Gia Lai and Tra Vinh had distributed their nutrition supplies to all districts.
Nutrition, WASH and Supply team are spending more time in the field for effective distribution monitoring. Nutrition monitoring was initiated late August and is ongoing in the six coverage provinces of Ninh Thuan, Kon Tum, Gia Lai, Tra Vinh, Hau Giang and Ca Mau, WASH monitoring activities kicked off last week in the key priority provinces.
Of the total procurement, 19% balance of supplies are enroute to the country and are expected in late September, early October, 2016. This includes: Resomal – 6 cartons (or 600 sachets), F-100 therapeutic- 30 cartons (or 2700 sachets), F-75 therapeutic -50 cartons (or 6,000 sachets), balance of Micronutrient tablets -4,200 packs of 1000 tablets and multiple micronutrient -50,000 packs of 30 sachets, are expected to arrive in the country by 3rd week of Sept by air and Sea transport. The last emergency shipments of therapeutic spread – 1450 cartons of 150 sachets and Micronutrients tab 4,800 packs of 1000 tablets are expected to arrive in the country late Sept or mid Oct, 2016. Partial Bucket, Soap, filter cloths procurement by NCERWASS will also be delivered by late September.
So far, the ERP (seeking US$48.5 million) is 33% funded thanks to contributions received from CERF, ADB, Government of Japan, ECHO, USAID, DFAT, Government of Lao PDR, Government of Thailand, Government of New Zealand and various other sources. UNICEF has received about US$1.5 million from CERF for the humanitarian response for 6 months and US$2.5 million from the Government of Japan for 9 months for WASH and Nutrition sectors.