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HNO Gambia - Humanitarian needs overview 2015 (Dec. 2014)

PRIORITY NEEDS
Food and Nutrition Security
All efforts at recovery since the massive crop failure in 2011 have, from one year to the other, been aborted by climate-related shocks. In 2014, the late onset of rains led to low agricultural production. The significant number of dry spells caused a lot of destruction, particularly on the rice fields. As a result, the estimated production of most crops has drastically reduced. Rice and groundnuts performed particularly badly in almost all regions, except the Upper River Region. Drought and poor distribution of rains are estimated to result in a 52 per cent reduction in cereal production compared to 2013, and a 47 per cent reduction compared to the last five years’ average CILSS Midterm review 2014). Households in almost all regions are affected by low purchasing power due to poor harvests, especially where agriculture is the main source of employment and income. Food prices continue to increase mainly due to the reduced production of cereals, especially rice. The unfavourable exchange rate of the Dalasi against major currencies is expected to worsen in the coming months from the combined effects of poor production of the export crops and very low tourist arrivals. This price increase will be compounded directly through importation, and indirectly through its impact on fuel and transportation whichhave further affected households.
The nutrition status of children under five is likely to worsen in 2015 due to several factors including: poverty; increasing household food insecurity; poor infant feeding practices; increased disease burden particularly related to inadequate WASH services; limited knowledge and low awareness of care givers with regard to essential nutritional and hygiene practices. Notable is a negative trend in the prevalence of both wasting (acute malnutrition) and stunting (chronic malnutrition). According to the 2010 Multiple Indicator Cluster Survey (MICS IV), the prevalence of wasting among children under five at the national level increased from 6.4 per cent in 2005, to 9.5 per cent in 2010. The 2012 Standardised Monitoring and Assessment in Relief Transitions (SMART) indicated 9.9 per cent were wasted while 1.6 per cent was severely wasted. In 2013, the Gambia Demographic Health Survey (GDHS) estimated that 11.5 per cent were wasted and 4.2 per cent severely wasted. Stunting rates among children under five also show the same trends. The MICS 2005 estimated stunting at 22.4 per cent compared to 24.5 per cent as reported by the DHS (2013). The estimated burden of moderate acute malnutrition (MAM) among children under five is currently estimated at 56,839, while severe acute malnutrition (SAM) is at 10,217 children between 6-59 months based on the 2013 national population census projections and SMART 2012. The prevalence of malnourished pregnant and lactating women in the reproductive age group (15-49) is estimated at 45,944.

Poor access to basic services
Inadequate access to basic social services such as health, safe and clean water, basic sanitation and hygiene aggravates high prevalence of childhood diseases, especially malaria and diarrhea, which have devastating effects on the nutritional status of children. Access to primary health care services is also inadequate as a number of PHC villages are not functioning optimally due to several factors: ineffective village development committee (VDC); lack of support for community health workers; shortage of drugs; weak linkages with basic health facilities; minimum supervision and inadequate demand for sustained preventive health services in the general population, particularly for services requiring multiple follow-up contacts or visits to health facilities. The under-five mortality has decreased from 131/1000 live births to 109/1000 live births over a period of five years (MICS 2005 and 2010). However, children continue to die, particularly in the rural areas, due to diseases related to water, sanitation and hygiene. In 2010, 33 per cent of all under-five mortality occurred during the first four weeks of life mainly due to neonatal infections (WHO, 2010).This has been attributed to the prevalence of unhygienic practices during delivery, leading to death among newborn babies and poor health of mothers. Water and sanitation related-deaths represent 20 per cent of under-five (U-5) deaths. Poor coverage of proper sanitation facilities, lack of knowledge of hygiene practices, and limited access to clean water are the main causes of water-borne diseases, particularly diarhoea, among children under-five. The World Health Organization (WHO) estimates that diarrheal diseases are responsible for the deaths of some 880 children under five years in The Gambia each year (WHO, 2008). In 2012, at least 231 meningitis cases caused by the MnW135 virus and 12 deaths -a case fatality rate of 5.3 per cent- were reported in government health facilities. Despite the reduction in incidence reported over the years, cholera and meningitis continue to be a major public health concern. According to the 2011 Comprehensive Food Security and Vulnerability Analysis (CFSVA)i Report, 15 per cent of food insecure households use unimproved sources of water for drinking compared to 10 percent of food secure households. And this is more acute for sanitation as 16 per cent of food insecure households use unimproved sanitation compared to only 5 per cent of the food secure ones. The report concluded that households without access to adequate sanitation facilities are more likely to be food insecure, heightening their vulnerability to diseases, malnutrition and poverty, and further limiting their access to basic services.

Protection
In Education, the impact of the refugee influx from Southern Senegal (Casamance) puts strains on the educational facilities and services that are provided in the Foni districts of The Gambia. The refugee children and their families also need psycho-social support to be able to rebuild their lives and participate in their learning tasks. For the rest of the country, the capacity to put in place resilient structures and measures to withstand heavy rains and storms during the rainy season is weak. As a result, in many schools classrooms, kitchens and toilets were damaged. With the outbreak of the Ebola Virus Disease (EVD) in West Africa, the country’s preparedness is being strengthened through awareness creation and preventive health practices. Should an outbreak of EVD occur the potential impact on families would have detrimental consequences particularly on primary caregivers. Children would need alternative care arrangements during the first 21 days, be placed in treatment centres if affected and, if not, in foster or adoptive care. Throughout the process children would need psycho-social counseling. Experience from Sierra Leone, Liberia and Guinea shows that these children face stigma and discrimination. Where the EVD leads to population movements there would be the added need of preventing family separation and, if needed, family tracing and unification.

Enhanced support to refugee and host family needs
The total number of refugees registered in The Gambia is 11,4271 - of this total 5886 are females (of which 48.8 pre cent are children under 18 years of age) and 5541 are males (of which 54 per cent are children under 18 years of age). Most of the refugees reside in the districts of Foni Kansala (37 per cent), Foni Bintang (35 per cent) and Foni Berefet (25 per cent) with the remainder living mostly in Kombo Central and Kombo East (3 per cent) and in the Greater Banjul Area. Within these districts the refugee population is dispersed and integrated across 71 rural communities and the Greater Banjul Area.
Strengthening Early Warning and preparedness support to manage crises In the Gambia there has been growing awareness of the role played by the Early Warning system/Service in reducing local risks, facilitating coping and adapting strategies to the impact of extreme weather events. A wide variety of sector-wide warning measures is now established and piloted in food security, surveillance of disease outbreaks, nutrition situation and climatic hazards and risks. However, these sector-wide warnings need to be implemented as part of an integrated Early Warning System/Service that can steer communities towards future disaster resilience. Previous reports on disaster risk reduction and climate change adaptation in The Gambia recognized demographic, economic, land use, technological, behavioural change on dietary intake and extreme weather impact as drivers that will shape the future of sustainable development in the country.

Organization(s): 
United Nations Office for the Coordination of Humanitarian Affairs
Original Publication Date: 
15 Dec 2014
Document type: 
Humanitarian Needs Overview
Location(s): 
Gambia
Theme(s): 
Needs Assessment
Disaster(s)/Emergency: 
Sahel Crisis: 2011-2017