Jigjiga, April 27, 2017 - The World Health Organization delegation conducted a four day field visit to Dollo and Korahey zones from 22-26 April, 2017, as part of WHO’s interventions in the Acute Watery Diarrhea (AWD) outbreak emergency response, in the Ethiopia Somali Region. The aims of the visit are, among others, to effectuate a rapid assessment of the situation and to identify the needs and gaps so as to strengthen the response to the outbreak. The AWD outbreak was reportedly exacerbated due to an on-going drought in the region, which has also resulted in water scarcity, food shortages and an increase of Internally Displaced People (IDPs). 

As one of the main causes for the spread of AWD outbreak is the lack of safe of water. The members of the response team, in particular WHO WASH expert used this opportunity to evaluate the source of the water, and conduct tests to assess the level of chlorination and the safety of the water. In the visited areas, three main source of water were identified, bore holes, wells and rain water. At the boreholes, administered by the government, the water is pumped to government owned, NGOs and private trucks and is chlorinated on the spot. In this regard, UNICEF, MSF, OWDA, OXFAM and other partners are involved in water trucking and supplying water to the inhabitants. These trucks circulate around the city to distribute water to the population into plastic drums grouped in one area or private metallic tanks, underground tanks or even individual jerrycans. Individuals with jerrycans and metallic drums, though very few, collect water from the bore halls, and bucket chlorination is expected to follow, as recommended by RWB officials. 

Moreover, water trucking seems crucial in delivering treated water to CTCs, remote areas, especially in availing water to IDP settlements which are mostly far from the cities and also to areas where the pastoralist population have their temporary settlements. In these areas, the trucks fill personal jerrycans, holes cover with plastic sheet, rotos (plastic tanks) and open water tanks where the population can come and collect water.

Other sources of water observed, during the visit were on the one hand wells, from where inhabitants collect their water with their jerrycans, their metallic water drums on donkeys’ backs. As for chlorination, at this source it is done on the site by government staff, though, not in a systematical manner. 

And on the other hand rain water is used as a source of water mainly by IDPs and the pastoralist population. 

The water test conducted at different water points by the WHO WASH expert revealed mixed results. Water trucks are well chlorinated by the zonal and woreda health bureau as well as partners. However, the level of chlorine is sometimes very low at the point of use, especially in holes covered with plastic sheeting and in open water tanks.  Special attention needs to be given to water monitoring so as to ensure water safety in each water point.

The delegation led by Dr William Perea, WHO Surge Team, Health Operations Lead also got the opportunity to visit Kabridahar, Danot, and Warder CTCs, to discuss with zonal health and water bureau officials on the ongoing AWD outbreak and to find ways to better coordinate efforts to control the breakout.

In response to this AWD outbreak, WHO has deployed teams on the ground and is working in close collaboration with the government and other partners to support the region in controlling and preventing the outbreak.