D.I.CA.F

By Shantha Bloemen

DORI, Burkina Faso, 16 May 2013 - After 35 days at Dori Hospital, 15 of them in a coma, 2-year-old Mariama now weighs 6.5 kilograms and is on the road to recovery. When she arrived, she weighed just five kilograms and was suffering from severe malnutrition with complications. Over the last two years, this referral hospital in the hot and dry north of Burkina Faso has seen a steady flow of such cases, as a large-scale nutrition crisis across nine countries of the Sahel region has left more than a million children at risk for or suffering from severe acute malnutrition.

A landlocked and poor country of 17 million people, Burkina Faso may be one of Africa’s biggest gold producers, but it remains one of its poorest. In the northern region, increased desertification has seen the expansion of the Sahara desert southward, while pressure from population growth has made the area increasingly fragile. Although reports indicate this year’s agricultural harvest has improved, estimates suggest that around 430,000 children will suffer from acute malnutrition in 2013, including 100,000 with severe acute malnutrition.

A mix of factors

Mariama’s story illustrates the complex mix of factors behind these numbers. When Mariama was just 14 months old, her 30-year-old mother, Aissato Hame, became pregnant again and stopped breastfeeding. The decision left Mariama without enough to eat. With four other young mouths to feed, and little food in their village, her parents started prospecting for gold. But the family was still unable to earn the 2,000 CFA a day (around US$4) needed to feed everyone. As a result, Mariama’s health deteriorated until her mother finally brought her to the hospital.

Now her mother has been taught how to make an affordable nutritious porridge with peanuts and has received a week’s supply of ready-to-use therapeutic foods, and Mariama can go home. The hospital, with support from UNICEF and Médecins du Monde, provides transport so she can return the following week for a check-up and receive another week’s supply of Plumpy’Nut, a high-energy peanut paste. Treatment will continue until her health is better.

From cure to prevention

Community Health workers Matrama and Amado Diallo go door-to-door in their village to educate parents and check for cases of children who may be suffering from malnutrition. One of their biggest challenges is not just the shortage of food, but also entrenched cultural attitudes that prevent children from getting nutritious food. “If children eat eggs, the father will leave you,” says one mother as she pounds sorghum into powder for porridge.

By educating families on good nutritious food practices, Matrama and Amado are starting to see a difference in the communities they serve. They say families are now aware of the link between nutrition and disease and illness. They can also identify the signs of acute malnutrition.

To help expand services like this across the country, a multi-sector Scaling Up Nutrition roadmap was adopted in May 2012, led by the Ministry of Health, with backing from UNICEF, WFP and NGOs, and supported by the European Union.

“This plan provides a way to get us to shift the focus to prevention of malnutrition, without losing sight of the need to treat new cases of acute malnutrition,” explains Marco Brero, a nutrition specialist with UNICEF Burkina Faso. “The focus is very much on building the institutional systems to deal with the crisis now, but also invest in the future.”

Homegrown solutions

Students from Foundation 2LE in Burkina Faso’s capital, Ougadogou, have built Inne Faso, a local factory to produce Plumpy’Nut. Just becoming operational, this franchise of Nutriset, the developer of Plumpy’Nut, is awaiting a final audit before it starts to sell its product locally, and eventually across the region. Managing Director Abdourazackou Sanoussi believes this investment will not only help address the high rates of acute malnutrition, but also create employment as well as a market for high-grade local peanuts.

For Burkina Faso, the hope is that with the right investments in education and resilience-building, acute malnutrition will be a thing of the past, and life for those living in the poorest parts of the Sahel will not be on the edge of survival.

Updated: 17 May 2013

Floods damaged significant riverine and rainfed cropped areas

KEY MESSAGES

• Despite the improvements in the current food security conditions due to good Gu rains since March, over onemillion people estimated by the Food Security and Nutrition Analysis Unit-Somalia (FSNAU), FEWS NET, and partners during January 2013 will likely still remain food insecure through September, primarily at Stressed or Crisis (IPC Phases 2 or 3) (Figures 1 and 2).

• High productivity riverine and agropastoral areas of the South will likely experience a below average crop harvest due to flooding. Early estimates are for up to 6,000 hectares (ha) of crops being flooded and up to 1,500 households displaced. This situation will likely result in increased local cereal prices and deteriorating food security outcomes.

• Improved livestock production and values in most pastoral areas of the country will likely result in increased access to milk and meat. As a result, pastoral food security outcomes will likely improve through September. However, coastal areas of the central and northeastern regions will likely face deteriorating food security between now and September due to declining livestock production.

CBM and partners launch key publication on Disability Inclusive Disaster Risk Management

As disasters have such a huge impact on human lives, it is important to make Disaster Risk Management inclusive to all. CBM and its partners have launched a key publication on good practices in this important field. It gives great examples of disability inclusive Disaster Risk Management, showing persons with disabilities as active participants in Disaster Risk Response interventions.

What Inclusive Disaster Risk Reduction means?

Disasters have a huge impact on human infrastructure, lives and livelihoods. They can result from natural causes (earthquakes, floods, cyclones, etc.) or from human-influenced factors (like climate change and conflicts), which can lead to food insecurity and displacement of large populations.

While it remains crucial to understand and reduce the human effect in creating disasters, natural causes will continue. The key in diminishing their impact is to reduce people’s vulnerability. Through inclusive Disaster Risk Reduction (DRR) programmes, incorporated in human development plans and poverty reduction programmes, risks can be reduced and communities’ resilience to disasters can be strengthened.

Persons with disabilities are often overlooked throughout the disaster management cycle and especially during relief operations, and are seldom considered as important actors in conflict prevention even though they are often more exposed during conflicts and displacement. The UN Convention on the Rights of Persons with Disabilities (CRPD), in its articles 11 and 32, requires that persons with disabilities benefit from and participate in disaster relief, emergency response and disaster risk reduction strategies.

About this publication

This publication would like to contribute with advocating for a more inclusive DRR where persons with disabilities are active participants and not overlooked in relief and response actions. The practices and experiences presented here are challenging the stereotype of persons with disabilities as helpless victims, and instead showing them as effective agents in changing this exclusionary system. Their voices are introduced here to demonstrate that with the right attitude, knowledge and by making sure to provide equal opportunities for all, inclusion is possible.

Through these testimonies and individual stories, the capacity of persons with disabilities and their families in making disaster risk reduction plans and programs inclusive are shown. If supported by well-informed and disability-aware humanitarian organisations, governmental authorities and international organisations, there is possibility to make sure that persons with disabilities, 15% of the world’s population, have equal opportunity to improve their resilience towards disasters.

The good practices

Eleven good practices of Disability inclusive Disaster Risk Reduction experiences have been gathered that show concrete practical examples of how persons with disabilities are active participants in various DRR interventions. Organisations developing sustainable resilience mechanisms to disasters and climate change effects have become aware of the added value that trained and knowledge persons with disabilities bring.

For over 50 years, the United Nations has supported public administration in developing countries. From helping newly independent countries in Africa and Asia to build essential public institutions in the 1950s and 60s, to running transitional administrations in Kosovo and East Timor, the UN has understood that core public administration capacity is essential for development and indeed statehood.But, as the Secretary General recognised in his 2009 report on ’Peacebuilding in the Immediate

Aftermath of Conflict’, appreciation of the critical role of “core government functions, in particular basic public administration and public finance“ has faded. This is true not only within the UN, but within the broader development community. ODA to peacebuilding and statebuilding, for example, increased from 2005 to 2009, except for ‘ODA to strengthen core public sector management systems and capacity’ (OCED 2011). Although the UN has produced important reports and policy on the rule of law, gender equality, and other post-conflict challenges in the decade since Report of the Panel on UN Peace Operations (the Brahimi Report), very little has been produced on public administration in fragile environments.

The UN Lessons Learned review rectifies this gap and captures the experience of the UN System in working on public administration in post-conflict environments. Reviewing external and internal literature as well as seven case studies it provides recommendations for more predictable, efficient and timely UN support in this area. The findings and recommendations focus on the immediate aftermath of conflict, defined as the first two years after the conflict has ended. The report is not to be seen as the conclusion of a comprehensive research initiative but rather as the first step in a process of re-directing the UN’s work on post-conflict public administration, in collaboration with recipient countries and other development partners.

The review is focused on ‘core’ or ‘basic’ public administration functions, as opposed to service delivery functions. This builds on the Secretary General’s Report on Civilian Capacities in the Aftermath of Conflict, which identified five core functions: policy formulation and public financial management, managing the centre of government, civil service management, local governance, and aid coordination as essential for government ownership of the political and development process.

Five countries were visited by the team (Burundi, Guinea-Bissau, Kosovo, Liberia, and Timor-Leste), while two countries (Afghanistan and Sierra Leone) were covered through desk reviews. In addition to the country case studies, the lessons learned review situates UN experience in the wider policy and ‘lessons learned’ context. Undertaken as part of the preparation of this report, there are three main sources of lessons the review has drawn on: (1) the practice of state and peacebuilding over the past decade or so; (2) the much longer tradition of public administration reform (PAR); and (3), recent academic research into governance and institution-building.

HIGHLIGHTS

• Focus on implementation
• Need to make countries accountable
• A human rights-based approach to making people safer
• New-found attention to resilience could help

JOHANNESBURG, 17 May 2013 (IRIN) - A month after the Indian Ocean tsunami struck in December 2004, affecting millions, 168 countries signed on to a 10-year plan to make the world safer from natural hazards. Yet the plan, the Hyogo Framework for Action (HFA) 2005-2015, focused primarily on “what to do to prevent disasters, but not enough on how to implement it,” says Neil McFarlane, chief coordinator and head of all regional programmes at the UN Office for Disaster Risk Reduction (UNISDR).

Countries have since begun discussing what a follow-up action plan, the Hyogo Framework for Action 2 (HFA2), should look like. The results of these talks, a sketch of the HFA2, will be presented at the Fourth Session of the Global Platform for Disaster Risk Reduction, which begins in Geneva on 19 May.

A draft will be finalized towards the end of 2014, for consideration and adoption at the World Conference on Disaster Reduction in Japan in 2015.

The HFA2 will need to take on a number of emerging risks and concerns. While the HFA has helped countries reduce the loss of human lives, the economic consequences of natural disasters have continued to rise. For three consecutive years, natural hazards have cost the world more than US$100 billion a year, according to data from the Brussels-based Centre for Research on the Epidemiology of Disasters (CRED) released in March 2013.

Additionally, disaster risks are changing: The effects of the changing climate are expected to prompt more intense and frequent extreme natural events, including floods, droughts and cyclones. Urban populations are growing, as is demand for food, ratcheting up pressure on resources like land and water.

Accountability

In tackling the HFA2, experts are discussing how to improve accountability. "We have a framework with options to develop good disaster plans in the Hyogo, but how do we make governments, agencies… ensure it is implemented?" Tom Mitchell, head of the climate change programme at the Overseas Development Institute (ODI), told IRIN.

Mitchell says one of the major weaknesses of the HFA is its failure to ensure that "well-crafted" disaster risk reduction (DRR) policies were actually implemented. The agreement is voluntary, and there are no penalties for failing to put in place measures to protect citizens.

"Because it [HFA] is voluntary, we have to ask how… effective it can be," remarked Frank Thomalla, senior research fellow with the Stockholm Environment Institute (SEI) in Asia.

Some question whether the world should consider a legal disaster-prevention treaty with a provision for penalties.

The new plan’s timing is significant for the global community; 2015 also marks the end of the Millennium Development Goals and possibly the implementation of new Sustainable Development Goals (SDGs), which are still under discussion. A new agreement on addressing and adapting to climate change is also likely to be put into place around that time. Aid agencies and think tanks are all calling on the global community to consider the synergies among these policy-shaping developments.

Many observers now question whether DRR policies should become a part of the legal climate deal, which might ensure their implementation. Countries’ DRR activities are increasingly considered part of their climate change adaptation plans, and are being funded as such.

But there is no appetite for a legal treaty on DRR, says UNISDR's McFarlane.

Harjeet Singh, ActionAid's international coordinator for DRR and climate change adaptation (CAA), says he is uncertain if a legal treaty “will bring about a dramatic change… After all, we have seen how [the UN’s] climate convention (UNFCCC) … failed to deliver in the last 20 years."

Besides, the climate change deal will not consider geophysical events such as earthquakes and other triggers of potential disasters unrelated to climate, he added.

That fact, plus the range of social and economic factors contributing to disaster risk, calls into question the rationale for viewing DRR, CCA and development from a purely climatological perspective, SEI's Thomalla told IRIN in an email.

McFarlane added that the Cancun Adaptation Framework, which was adopted by countries at the UNFCCC talks in Mexico in 2010, urged countries to implement the HFA, which, in a way, does make DRR part of a legal climate treaty.

Taking measurements

Under the HFA, countries are required to report on how far they have complied with implementing DRR strategies and policies. But how "reliable is this data?" asked Thomalla. "How much opportunity is there for governments to 'manipulate' the information in order to be seen to be doing something?”

For instance, a country might report to the HFA that it has established an early warning system to reduce hazard vulnerability. “But how can we be sure that the system works…? That people know how to respond to the warnings?” Thomalla said.

There is no proper baseline at the start of HFA, nor are there specific targets for countries to follow, said Singh.

"Targets and milestones for implementation should... be relevant and realistic for each country and agreed on through multi-stakeholder consultations," noted Mitchell in a briefing paper co-authored with colleague Emily Wilkinson.

McFarlane and Mitchell suggest the development of a peer-review mechanism, which is just taking off in some developed countries, could be an effective way to ensure countries comply.

UNISDR Chief Margareta Wahlstrom said there has been a change in mindset since HFA: “The most visible signs of this change are summarized by the facts that 121 countries have enacted legislation aimed at reducing the potential impact of disasters, and 56 countries have national disaster-loss databases, which illustrates the growing recognition that you cannot manage risk management if you are not measuring your disaster losses."

Mitchell’s ODI briefing paper also suggests "a human rights approach, in which countries fulfil obligations to respect, protect and fulfil basic human rights, including the 'right to safety' of vulnerable people exposed to hazards."

This suggestion has support. Singh says, “Legislation to ensure safety and security of people is a good first step.” But it has to be implemented effectively all the way down to the community level, and must take into account the voices of the poor and women, he added.

Thomalla says a rights-based approach would be a good way to address DRR "because many of the drivers of vulnerability result from inequality and marginalization, meaning certain regions and social groups are more vulnerable to hazards than others and are more strongly affected by the impacts.”

But, again, creating global legislation could be problematic, he noted. "Monitoring and enforcement will also be difficult. Rich countries must come forward to provide resources and transfer skills to developing countries to reduce disaster risks."

Resilience is key

Most experts pin their hopes on the new-found interest in "building resilience". Resilience is billed as a concept that will better link development, DRR and CCA by bringing the humanitarian aid community, which deals with disasters, closer together with development agencies. A focus on resilience might also help push for the implementation of DRR plans and promote funding.

“The current separation of what is mainly [a] humanitarian response to disasters, through DRR and CCA, from business-as-usual development funding no longer makes sense," said Thomalla.

In fact, disasters routinely reverse development gains. For example, floods in Thailand in 2012 cost three percent of the country’s annual GDP, affected education and caused the loss of vulnerable families’ household assets.

“New development goals must factor in risk, whereby all goals, to the extent possible, are risk- informed,” said Antony Spalton, the DRR specialist with the UN Children's Fund (UNICEF). "Given the significance of the risks posed by climate change, fragility and conflict, a post-2015 framework that better draws together DRR, climate change adaptation and conflict prevention/peace building under a goal or target for resilience could be considered.”

UNISDR has already drafted a resilience-based disaster plan for the post-2015 development agenda, the Plan of Action on Disaster Risk Reduction for Resilience. It calls for an assurance that “DRR for resilience” is central to post-2015 development agreements and targets. It calls for timely, coordinated and high-quality assistance to countries where disaster losses pose a threat to development, and for making DRR a priority for UN funds, programmes and specialized agencies.

Singh says countries "should develop a comprehensive resilience strategy rather than a piecemeal …strategy, when ‘pushed’ by donors.”

Building resilience to a range of changes and risks does make sense, according to Thomalla. But we have a long way to go.

"While we have made a lot of progress in thinking about resilience as a unifying concept, we need to strengthen our methods and tools to help… develop the institutions and governance structures that enhance resilience and enable them to measure and demonstrate success," he said.

Ultimately, Singh says, "it all depends on the willingness of country governments to take concrete steps from local to national levels and enhance [the] resilience of poor and vulnerable communities."

McFarlane says there are lots of ideas and suggestions on the table. Stay tuned.

jk/rz

L’épidémie de choléra a refait surface le 6 Mai dernier dans le district sanitaire d’Ayorou où plusieurs cas ont déjà été enregistrés. Ceux-ci sont pris en charge dans un centre de traitement du choléra (CTC) mis en place par les autorités sanitaires avec le soutien de MSF-Suisse. Les acteurs humanitaires se mobilisent pour apporter une réponse coordonnée et efficace en vue d’arrêter la propagation de la maladie.

This is a summary of what was said by the UNHCR spokesperson at today’s Palais des Nations press briefing in Geneva. Further information can be found on the UNHCR websites, www.unhcr.org and www.unhcr.fr, which should also be checked for regular media updates on non-briefing days.

UNHCR is prepositioning aid for tens of thousands of Darfur refugees in eastern Chad amid fears heavy rains will cut off access to the group. Almost 30,000 people recently fled communal violence in North and West Darfur, Sudan. The refugees are mainly women and children and they urgently need shelter, food, clean water and medical assistance. They say that they fled because people were killed during the violence and that many houses were torched by armed men.

A first wave of Sudanese refugees started arriving in Tissi in eastern Chad between January and March when clashes over goldmines in Jabel Amer, North Darfur, turned into ethnic violence (between the Ben Hissein and the Rizeigat.) A second group began arriving in early April due to tribal conflicts (opposing Misseriya and Salamat tribes) around the Um Dhukun area of West Darfur. In addition to the Darfur refugees, the violence also forced almost 20,000 Chadians to cross into Tissi, as well as 458 refugees from Central African Republic (CAR) who had been in Darfur for years.

Tissi is in a remote and volatile Chadian border area straddling troubled parts of northern CAR and Darfur. Roads to the area become impassable during the rainy season lasting from May to November and the first rains have already started. The region has little infrastructure and new arrivals’ presence is a strain on the local communities.

To date, UNHCR has registered 28,278 Sudanese refugees in the Tissi area. They are settled across 16 sites within a 100 km radius. Most are herders moving frequently in search of pasture land and water for their livestock and this makes it extremely challenging to register and assist them.

To ensure UNHCR is able to offer protection and assistance to the refugees until the next dry season, we have prepositioned enough aid in the area to cover the needs of 3,000 refugee families. Aid distribution will start on the weekend. Additional supplies are due to arrive from our regional stockpile in Douala, Cameroon, to cover the needs of another 4,000 families.

Due to the rains, we are in a race against time. Road transport between Doula and Tissi takes 20 days – to speed up the delivery of aid- UNHCR plans to hire a helicopter.

After the rains, UNHCR plans to relocate refugees to safety further inland once available water sources are located in sites given to UNHCR by the government. In the meantime, we are working with our partners on rehabilitating some existing water pumps while we drill boreholes. Refugees currently drink from a river, and so put themselves at risk of contracting waterborne diseases.

Meanwhile, we have managed to relocate about 1,500 refugees to Goz Amir a camp located around 250 kilometres north of Tissi. We provided the relocated refugees with shelter, food and household items. We halted the transfers due to heavy rains. An average of 300 refugees a day continues to cross into Tissi as communal tensions persit in Darfur. The new arrivals say that many more are on their way to Chad but that armed groups are preventing them from crossing.

Before the latest influx, there were some 300,000 Darfur refugees in Chad.

For further information on this topic, please contact:

In Geneva, Fatoumata Lejeune-Kaba on mobile +41 79 249 34 83

END

This is a summary of what was said by the UNHCR spokesperson at today’s Palais des Nations press briefing in Geneva. Further information can be found on the UNHCR websites, www.unhcr.org and www.unhcr.fr, which should also be checked for regular media updates on non-briefing days.

The number of Syrian refugees who have now left their country has surpassed 1.5 million. The Syrian conflict continues to have a devastating impact on the lives of those who are forced to flee.

The fact that more than 1.5 million people have registered or have appointments with UNHCR sadly means the actual number is much higher. This is due to concerns that some Syrians have regarding registration

The increasingly widening gap between the needs and resources available is a growing challenge. UNHCR has registered close to one million refugees since 1 January this year – this is about a quarter of a million people each month.

Refugees tell us the increased fighting and changing of control of towns and villages, in particular in conflict areas, results in more and more civilians deciding to leave. Over the past four months we have seen a rapid deterioration when compared to the previous 20 months of this conflict.

UNHCR continues to respond to the emergency needs of those in desperate need inside Syria and in neighbouring countries.

Syria

On the outskirts of Tartous inside Syria, UNHCR continued this week to follow up on the needs and situation of several hundred families displaced in the village of Zamarin.

They fled Banias district in Lattakia Governorate where clashes erupted in early May. Some families found shelter in a mosque and local schools, but the majority have been hosted by families in Zamarin.

These families received UNHCR emergency relief assistance last week. Follow-up of the situation with partners in Zamarin show that many families have returned to Banias, where children have to take their exams very soon.

This assistance was part of a collaborative UN inter-agency effort. UNHCR aid benefitted 3,000 people and was distributed between the 4th to 11th May by partners. The items included blankets, mattresses, hygiene kits, children’s diapers and sanitary napkins.

UNHCR has been present in Tartous since early April and is permanently present in five cities – the others are Damascus, Aleppo, Hassakeh and Homs.

Overall in Syria UNHCR’s relief assistance (non-food items only) has reached 860,000 displaced Syrians since the beginning of the year.

Lebanon

UNHCR's registration operation in Lebanon is one of the largest and most complex urban registration programmes in the world. In Lebanon, UNHCR has now stepped up its capacity to register refugees.

Every day over 4,200 people approach our offices for registration. In April, over 90,000 refugees were registered in our centres. This is more than a ten-fold increase when compared to the same month in 2012.

Waiting periods for registration have also decreased with an average waiting time of between 16-30 days throughout the country, apart from the south where our registration centre has just become operational. But there too, each week the waiting period for refugees is decreasing.

The UNHCR Lebanon office is also reducing the backlog by over 8,000 individuals per week.

UNHCR has opened new registration centres, is using enhanced registration mechanisms, ensuring that individual protection interviews still take place, providing transportation assistance to refugees, aswell as expanding the number of shifts we operate.

Latest regional figures:

REGIONAL number of Syrians registered and pending registration: 1,515,639

JORDAN as of 15 May

Number of Syrians registered and pending registration with UNHCR: 473,587

Registered / Pending registration: 390,371 / 83,216

LEBANON as of 15 May

Number of Syrians registered and pending registration with UNHCR: 470,457

Registered / Pending registration: 375,624 / 94,833

TURKEY based on Government of Turkey figures as of 15 May

Total number of Syrians registered in camps and in urban areas and Syrians awaiting registration in urban areas: 347,157

Registered / Pending registration: 316,772 / 30,385

IRAQ as of 15 May

Number of Syrians registered with UNHCR: 147,464

EGYPT as of 14 May

Number of Syrians registered and pending registration with UNHCR: 66,922

Registered / Pending registration: 48,429 / 18,493

North Africa as of 15 April

Number of Syrians registered with UNHCR: 10,052

For more information, please check the Syria Refugee Response portal: http://data.unhcr.org/syrianrefugees/regional.php

For further information on this topic, please contact:

In Beirut: Reem Alsalem on mobile + 961 71 911 388 In Amman: Tala Kattan on mobile: +962 79 978 3186 In Baghdad: Natalia Prokopchuk on mobile +964 780 921 7341 In Abu Dhabi: Mohammed Abu Asaker (Arabic) on mobile + 971 50 621 3552 In Geneva: Daniel McNorton on mobile +41 79 217 30 11

Myanmar, Bangladesh and India have avoided a potential catastrophe as Cyclone Mahasen weakened to a tropical storm as it made landfall in Bangladesh on Thursday.

But fears remain that some remote areas may have experienced some destruction. IOM staff are taking part in joint assessments in the Chittagong division of Bangladesh and western Myanmar to determine if assistance is needed.

"The storm was weaker than expected, but we have to commend the preparedness work done by the governments of Bangladesh and Myanmar and their partners to get people to safety and ensure that communities were ready," said Brian Kelly, IOM's Asia-Pacific Emergency Advisor.

"If this same storm had hit 20 years ago, we might have seen thousands of deaths. As it is, people are already leaving the storm shelters to go home," he added.

Some deaths have been reported in Bangladesh, where over a million people were evacuated to purpose-built storm shelters and public buildings. The caution was justified: in 1970, Cyclone Bhola killed some 400,000 people, Cyclone Sidr killed nearly 4,000 people in 2007, and Cyclone Aila killed some 200 people two years later.

Earlier this week seven persons died and thousands were displaced in Sri Lanka when heavy rains, caused by Mahasen, washed over the north and east of the island.

Concerns in Myanmar have also eased. Over 200,000 people were evacuated from vulnerable locations, and humanitarian aid was pre-positioned. Initial impact assessments in and around the city of Sittwe started this morning. While information is still scant, initial indications seem to suggest that the damage has been minimal.

IOM will continue to play an active role in the humanitarian community's ongoing efforts to help communities impacted by the storm.

For more information, please contact Brian Kelly at IOM's Regional Office in Bangkok - Tel:+ 6623439404. Email: bkelly@iom.int

Brussels, 17 May 2013 – Médecins Sans Frontières (MSF) strongly condemns the destruction at its hospital in Pibor town, South Sudan, purposefully conducted to render the hospital inoperative. This leaves around 100,000 people, who had fled into the bush seeking safety from the conflict between the SPLA (South Sudan Army) and the David YauYau armed militia group, deprived of healthcare.

Therapeutic medical food and hospital beds were looted from MSF’s hospital over the weekend of 11 and 12 May. But more extraordinary is the systematic and purposeful damage to the infrastructure that renders the hospital unusable until major repair work has been conducted. “A special effort was made to destroy drug supplies, strewing them on the ground, to cut and slash the warehouse tents, to ransack the hospital wards, and even to cut electricity cables and rip them from the walls,” says Richard Veerman, MSF coordinator of operations for South Sudan.

The MSF hospital is the only hospital facility for Pibor county, the nearest alternative being more than 150km away. 3,000 patients have been treated over the first three months of the year in this hospital. More than 100 patients, including SPLA soldiers, received surgery for war wounds.

“The rainy season has just started and we know from previous years that malaria and respiratory diseases such as pneumonia will start to claim lives if there is no healthcare available,” says Veerman. In a report issued in November last year, ‘South Sudan’s Hidden Crisis’, MSF documented the devastating health consequences when people have to flee to the bush and when medical assistance is unavailable.

Humanitarian access and medical assistance need to be resumed in Pibor county in the coming days or weeks. “It is unthinkable that there will be no healthcare whatsoever for the next six months for some 100,000 frightened and vulnerable people hiding in the swamps ,” continues Veerman. “But unless we can return to resume medical activities and have the freedom to move to wherever people need assistance, this unthinkable scenario may become the horrific reality.”

This is the sixth time an MSF medical facility has been looted or damaged in Jonglei State in the past two years. More recently, MSF had suspended activities in Pibor on 19 April this year because of threats and intimidation of staff and patients. Having sought assurances that medical humanitarian activities and staff would be respected and could be pursued without hindrance or obstacles, an MSF team was preparing to return and restart medical activities when the looting and destruction occurred.

MSF urges the Government of South Sudan to meet its responsibilities to ensure full respect of medical humanitarian facilities and activities. MSF also calls urgently for assurances from all parties in the Jonglei State conflict that its medical teams will have unhindered freedom to return to Pibor and impartially reach out to any people on either side of the conflict in need of medical assistance.

MSF works in Akobo, Nyirol, Pibor and Uror counties in Jonglei State. The activities in all locations, including Gumuruk clinic in Pibor county, continue to function, with the exception of the hospital in Pibor town, and the MSF clinic in Lekwongole village in Pibor County which was targeted and damaged in August last year and where insecurity and fighting have since made access impossible for MSF.