24,521 children with severe acute malnutritution (11,770girls and 12,751boys) were admitted for treatment throughout the country, which is 76per cent of the estimated national caseload of 32,244 SAM cases for 2018 (100% of national burden), based on available data as of the end of December2018. The 2018 SMART survey showed that the national nutrition situation remains serious with 11.6 per cent of GAM and 2.3 per cent of SAM. Also, 23 districts out of 58 are in nutrition emergency situation (GAM>15 percent and/or SAM >2 per cent). UNICEF has ensured the timely distribution of Ready to Use Therapeutic Food (RUTF) and other life-saving nutrition supplies and trained 1,156 health workers and 457 community health workers to support 722 out-patient therapeutic and 19 in-patient facilities (86 per cent of all health facilities) throughout the country.
4,350 mother/child and 272 nutrition centres received hygiene kits.
Education in emergencies activities addressed the education needs of 19,777 children,including 9,655 Malian refugeeschildren in the M’Berra Camp and 10,122 in host communities
An SOP for case management for refugee children at risk or victims/survivors of violence, abuse and exploitation was developedand signed by the members of the Child protection working group in Bassikounou. 316 new cases (including 131 girls) were identified and benefited from an improved case management thanks to these SOP. This makes up to a total of 2,197 (935 boys, 1262 girls)children exposed to violence, abuse and exploitation from the M’Berra refugee camp and host communities were identified and referred to government/CSO services including legal assistance, medical services, psychosocial support and vocational/education services since January 2018.
SITUATION IN NUMBERS
143,187 Number of children in need of humanitarian assistance
217,000 Number of people in need
57,673 Number of Malian refugees, including 33,642 children (UNHCR 2018)
UNICEF Appeal 2018 US$ 19.1 million
Situation Overview & Humanitarian Needs
Frequent climatic shocks and high vulnerability in Mauritania mean hundreds of thousands of people face the painful consequences of food insecurity and malnutrition every year. Rainfall has steadily declined since the 1950s, and water is retreating deeper underground. As the fourth most vulnerable country in the world to climate change, natural hazards in Mauritania are long-term challenges that generate long-term needs. The country still struggles to recover from one of the world’s biggest food crises that wreaked havoc on the Sahel in 2011 and 2012. In 2017 the country was hit by a severe drought and confronted by an unusually long lean season, exhausting vulnerable communities’ coping mechanisms. Access to water and sanitation services in Mauritania is low and remains an aggravating factor in malnutrition. Only 47 per cent of malnutrition centres in rural and semi-urban areas have access to drinking water and sanitation services, reducing the quality of care and increasing the admission time of children in treatment. Compounding these issues, the population is expected to double by 2039, and there is a growing youth demographic bulge with limited livelihood options. With 45 per cent (or 455,000) of children outside the formal education system, young people searching for opportunities are at risk of radicalization.
Mauritania is experiencing a severe drought, affecting agro-pastoralist communities in the central, southern and eastern regions of the country. Irregular rainfalls during the 2017 rainy season have led to dry pastures, reduced biomass and agricultural production, and low-surface water availability in most areas, which consequently triggered an early transhumance and destocking of livestock. Analysis of available data indicates that from January to October 2018, the proportion of new SAM cases admitted increased by 10 per cent per month (on average) compared to the same period in 2017. Peaks of over 12 per cent per month were observed in March, April and October. The second peak following the rainy season underscores the precarious situation of many children. Furthermore, the proportion of new SAM cases admitted has been higher in Hodh El Chargui (20 per cent), Assaba (16 per cent), Nouakchott (12 per cent), Guidimakha (12 per cent). Mauritania reached 29 per cent more children with SAM than over the same period in 2017 and 15 per cent more children than in 2015.
For the second consecutive year, irregular rainfall has negatively impacted crops and pastures, eroding household resilience and capacity to absorb shocks. Projections of the “Cadre Harmonisé” (West Africa’s version of the Integrated Food Security Phase Classification) indicate that over 575,602 people will be in a critical food security situation during the lean season in 2019 – which is projected as much more severe than the average and expected to start much earlier than normal (possibly as early as February rather than June in some areas). The 2018 SMART survey conducted at the end of the lean season (July) showed that the nutrition situation remains serious in Mauritania with a small increase of GAM, 11.6 per cent compared to 10.9 per cent in 2017; whereas the incidence of SAM was similar to 2017 (2.3 per cent), just above the critical threshold (2 per cent). In addition, 23 out of 58 districts faced nutrition emergency conditions (GAM > 15 per cent and/or SAM > 2 per cent) compared to 21 districts in 2017. The nutrition situation remains fragile; more vigilance and integrated nutrition intervention are required. The 2019 SAM burden is estimated at 31,682 children under five years, representing a 40 per cent increase compared to the average annual burden over the last five years. The nutrition sector is planning to treat 26,930 children under five years of age with SAM (85 per cent of the annual burden) throughout the country. The percentage of SAM treated is revised from 100% in 2018 to 85% in 2019 due to the difficulty in achieving 100% of the burden in 2018. Indeed, the health system is still too weak to ensure 100% coverage; in addition, only 23 districts out of 58 will be supported by UNICEF and NGOs with the aim to intensify IMAM activities in 2019.
Established in 2012 and located 30km from the Malian border, the refugee camp in M’Berra, which currently hosts 57,673 refugees, including 33,642 children, continues to depend on Government, external and humanitarian assistance, in addition to the generosity of already impoverished local communities in the Bassiknou district (which has a population of approximately 55,000 people).
The district hosting refugees already struggled with drought impact and scarce resources prior to the arrival of refugees when access to safe drinking water was only 36 per cent. As many refugees fled with their livestock, the strain on the limited water supply pasture and other natural resources has been further exacerbated. Competition over access to pasture, cross-border movements of livestock and water are likely to increase the risk of tension and conflict in this agro-pastoral area.
It is important to note that restrictions of UNHAS operational capacity might limit ability to respond in a cost-efficient, timely and secure manner. UNHAS indicated the risk to definitely shut down operations on 31 December 2018 if no new funding or pledges were received. Without UNHAS services, more than 30 humanitarian and development organizations would no longer have practical access to the most remote areas in Mauritania (e,g. Bassiknou district where Malian refugees is 1,300 km from Nouakchott capital city). UNHAS transported 1,930 passengers in 2018 to the most difficult-to-reach parts of the country. The implications are critical for the thousands of vulnerable Mauritanians and Malian refugees who are the immediate beneficiaries of programs, for which effective implementation and monitoring relies heavily on UNHAS. UNHAS is not only the most cost-efficient, safe and effective means of transport for humanitarian and development operations, but it is also critical when it comes to medical evacuations of staff who work in remote hardship areas.
While UNICEF continues to work with the Mauritanian government, UN agencies and partners to strengthen access to basic services at the decentralized level, thereby boosting the synergy of interventions along the humanitarian-development nexus, the difficulty to mobilise resources to respond to both development and humanitarian issues continued to be an important challenge during the reporting period.