نوش نیش

Joint Mission Report of WHO/WFP/UNICEF/FOCUS Faizabad

  Shewa Villages of Arghanjkhwa District

17 – 19 June 2009 

Itinerary:

17 June 09: Faizabad To Shewa Clinic and meeting with Community Leaders.

18 June 09: Assessment of hunger and nutrition situation

19 June 09: Return back to Faizabad

Mission members:

-         Mr. Nasratulla Food Monitor WFP Faizabad Sub-Office

-         Dr. S. Mazari Nasiri NHC/WHO Faizabad Sub-Office

-         Dr. Zahir Fazil PPO UNICEF Faizabad

-         Mr.  Safder Zaheer FOCUS Faizabad

Purpose of the mission:

-         To assess hunger and Nutrition situation of Shewa people particularly children under 5

-         To assess the Health Situation of the people

-         To deliver some Emergency Medical kit to the local clinic

Background:

Shewa which has 10354 population is part of Arghanjkhwa District. It is located 140 Km  in the  east of Faizabad ( 3 hours drive). It is a pasture high land territory.  Nomads from Kunduz and Baghlan bring their animals for feeding during the summer . Wheat and barley are the main crops of the area which cover 3 to 5 months of the year. For the remaining part of the year, they have to purchase from the neighbor markets or Faizabad.  The villages are located scattered in vast area of Shewa with 10 to 100 families each. Farming and livestock are the main occupation of the people. There is no safe drinking water for the people as well as sanitary latrine.  

The altitude of the area is 2500 m high above sea level and has long and harsh winter with short and cool summer.

Five percent of the people are literate specially men. Since 4 years MoE established new primary schools there. These schools benefit from WFP Food program for education.

Findings:

The mission held a meeting with some community leaders of Shewa on 17 Jun.09. They highlighted the main problems of the district as below:

-         Due the poverty and blockade of the roads to Shewa, most of the people particularly children and pregnant women faced to malnutrition. Seven death cases in one village in short time is an example of poverty. Last year the agriculture production was not sufficient and covered only 5 months of the year ( November 08 to March 09). Due to  long winter, heavy snowfall and closure of the roads, their stock of food was finished and resulted to hunger. Seven death in a week time in a village is an example of harsh winter and serious hunger.

-         Due to the heavy snow ( 2 to 3 meters thickness) and shortage of food for animal 70% of animals died.

-         Due to the shortage of medicine most of the children were affected by ARI and some of them lost their lives.

-         So far non of Aid Agencies assisted this people.

The community leaders said the actual death of children was happened in Dowlatshahi Village which is located 3 days by walk from this clinic. They introduce Mr. Sarwar who was the representative of the people as well as Community Health Worker (CHW) of the village. We found him with some of his villagers and held a meeting with them. They reported the life situation of the people as the community leaders said before.      

They reported the name of the death cases during the month of May and half of June as below:

According to CHW,pneumonia, Tuberculosis, Diarrhea, stomach pain are the main diseases of the people particularly ARI and Pneumonia.

Mushung ( bean ), mashroom in the spring, Shourchai ( Water with 5% milk & salt) and some wild vegetables are the staple food of the people.

He said that, Dowlatshahi villages has 3000 to 5000  population and have no accessibility for 7 months to Shewa clinic.

Mr. Sarwar said the mortality rate of children under 5 gradually increased in the past 3 months. All the children have received 3 rounds routine vaccine like DPT, measles and  TT. He added that, since the beginning of March 09, the people use wild grass (vegetable) as their food.

According to his registration book of CHW:

-         From 120 pregnant women in the past 12 months, 6 of them died due to maternal  delivery problems (5%MMR) or 5000/100000 lives birth.

-         24 children under 5 out of 600 children died in the past 12 months( 400/1000 L.B)

-         15 out of them was under one ( 250/1000 IMR)

He said that, due to hunger 70% of animals died during the past 2 months. Because of heavy snow and blockade of the roads and tracks to the village.

Due to lack of seed , the people could not cultivate wheat.

Assessment of malnourished children under 5:

Dr. Mazari NHC of WHO started weighing of the children, measuring height and Mid Uper Arm Circumference (MUAC) which is attached as ANEX-I

Ø      Measuring the Mid Upper Arm Circumference ( MUAC ) :

ü      24.2% Sever malnutrition and

ü      30.3% moderate malnutrition             (Total 54.5%)

ü      45.5% Normal

Ø      Measuring Weight for Hight

                                                                 Girls                 Boys               Average

ü      Sever malnutrition:            1 3.3%                40%                  26.7%

ü      Moderate malnutrition:      53.3%                33.3%               43.3%

ü      Normal:                               33.3%               26,7%                30%

Delivering Emergency Kits and drugs to Shewa BHC:

WHO Faizabad Sub-Office delivered the following drugs and emergency kits to Shewa BHC:

1-  Pneumonia Kit A          2 Kits

2- Pneumonia Kit B           2 Kits

3- Sol. Ringer Lactate 1000 ml         60 Bags

4- Erythromycin 250 mg                2000 Tablets

5- Erythromycin  Suspension           96   Bottles

6- Scale for adult                              One each

7- Measuring height equipment        one each

Recommendations:

ü      Construction of road between Dad Ali and Daolat Shahi Village

o        From Dad Ali  village to Zanjeer Kaba approximately  15 km    New road construction

o        From Zanjeer Kaba to Andarab approximately   5 Km   New road construction

o        From Adarab to Dawlat Shahi approximately                   10 Km             New road construction

o        From Dawlat Shahi to Seh Dara approximately    5 Km               New road construction

o        From Dad Ali to Sah Darah village approximately           55 Km             Road rehabilitation

ü      Open a new Health Sub-Center in Dowlatshahi Village to cover all the villages of the area (3000 to 5000 population).

ü      There is need for provision and distribution of supplementary food such as biscuit, milk and micronutrients or drugs.

ü      Livestock  and animal husbandry  through provision of  technical assistance and establishing veterinary clinic.

ü      Promotion of local Primary School to Intermediate School

ü      Conducting Literacy Courses particularly for illiterate women.

ü      Distribution of seed and fertilizer for improving and increasing their agriculture production through technical assistance and guidance.

Annex-I

S©: Sever        M¤: Moderate