Lifesaving Health, WASH, and Protection in Tigray, Ethiopia

Project snapshot:

Lifesaving Health, WASH and Protection Assistance for Crisis-affected IDPs (Internally Displaced People) and Host Communities in the Eastern Zone of Tigray Region
Goal: To provide lifesaving health, protection, WASH (Water, Sanitation and Hygiene) and gender equality services to 65,000 crisis-affected people in Eastern Tigray, Ethiopia, focusing on immediate humanitarian needs and longer-term development outcomes.
Target group: Internally Displaced Persons (40%), host communities (60%), women/girls, elderly, people with disabilities (total reach: 65,000)
Where: Ethiopia, Tigray Region, Eastern zone: Hawzen, Ganta-hafeshum, Erob and Gulomekeda woredas (districts)
Duration: 2 years (May 1 2022 – April 30 2024)

The situation

Humanitarian conditions continue to deteriorate across Ethiopia, with 23.5 million people requiring life-saving assistance in the first quarter of 2021. The conflict in Tigray began in November 2020, and a State of Emergency was declared on November 4, 2021, exactly one year later. Humanitarian needs in the Tigray region are extremely dire, with 5.2 million (90%) of its six million people requiring urgent assistance.

There are over 2 million people who are displaced within the country, living in centres and host communities in Tigray. The Eastern zone of the Tigray region faced chronic food shortages and above average malnutrition rates even before the conflict erupted. Disrupted supply chains, unstable markets, and a missed harvest are making the already critical nutrition situation worse. The four targeted woredas (districts of Ethiopia) have extremely limited access to markets and face security threats including looting, theft, killings, and abductions. Most water sources (boreholes and hand pumps) are not functioning due to the lack of fuel and electricity, damage, looting, and vandalism.

There has been an alarming rise in sexual and gender-based violence and psychosocial trauma as a result of the conflict. CARE’s Rapid Gender Analysis (April 2021) found an overwhelming amount of reports of sexual violence when the conflict broke out, while women fled to safety and in the camps. Further impacts are regularly being reported, including early and forced marriage. There have been reports of abduction of girls, and of boys being abducted and pulled into the violence by Tigrayan forces. As a result of the conflict and sexual violence, many women and girls have experienced unwanted pregnancies, and pregnant women and girls are being denied access to the care they need.

What we are doing

CARE is providing lifesaving health, Water, Sanitation and Hygiene (WASH), protection, and gender equality assistance to people affected by the conflict in Eastern Tigray. As an innovative new “nexus” pilot, this project aims to respond to the immediate and urgent needs of the conflict-affected community, while also bridging the gap to work towards longer-term sustainable development.

CARE is providing essential primary health care, including acute malnutrition and sexual and reproductive care services. CARE is mobilizing mobile health and nutrition teams to provide primary health care, nutrition, and sexual and reproductive health services, and is strengthening the existing primary health care centres with training, equipment, medicines and supplies. CARE will also focus on longer-term capacity building for health institutions, and improving women’s access to vital health services. CARE will also establish mother-to-mother support groups at the community level to identify and refer cases of acute malnutrition, and prevent and respond to COVID-19.

CARE is restoring water supply systems for schools and primary healthcare centres, building gender-sensitive and ventilated pit latrines, establishing gender-balanced water management committees, conducting hygiene promotion campaigns, and distributing hygiene items to IDP households. For the longer term, CARE will upgrade water supply systems to solar powered systems, expand existing or create new water systems, and train auto-mechanic students on solar-power maintenance.

CARE will support survivors of gender-based violence (GBV) with psychosocial support and first aid and referrals to other services, as well as hosting awareness-raising sessions with the community. CARE will train local service providers on GBV response best practices, conduct safety audits in targeted locations, and distribute dignity kits to affected women and girls.

CARE will implement the ‘Social Analysis and Action’ approach which will bring together groups to discuss and challenge social norms related to gender. In addition, CARE will work with women and girls to build their confidence, negotiation, and communication skills.

Project targets

Train 160 women and girls in confidence, negotiation, and communication skills
Provide 21,648 patients with primary health care consultations
Train 460 health staff
Support 47,250 people with access to safe drinking water
Provide 7,200 individuals with access to ventilated pit latrines
Support 80 survivors of gender-based violence with response services
Reach 32,000 people with community awareness-raising activities to prevent gender-based violence and response to it
Support 2,000 people to challenge gender norms through the “Social Analysis and Action” approach
Establish 4 mobile health and nutrition teams

Support 25 primary healthcare centres with training, equipment, medicine and supplies
Establish 40 mother-to-mother nutrition groups
Train 135 community health workers on COVID-19 prevention
Rehabilitate 6 water supply systems
Train 78 water management committee members to operate and maintain water supply systems
Distribute 7000 gender-sensitive water, sanitation and hygiene (WASH) and non-food item (NFI) kits
Upgrade 46 water supply systems, construct 24 new systems, and expand 4 existing systems
Provide 7000 women and girls with dignity kits