The year 2015 had a particularly unique humanitarian operational context that necessitated the International Rescue Committee (IRC) to constantly adapt to the ever-changing context. The first quarter of 2015 was still engulfed in emergency response with 100% of the humanitarian support tailored to reach the Internally Displaced Persons (IDPs) living in formal IDP camps, Informal IDP camps and with host communities. The IRC was predominantly in the state capital of the Adamawa state with all humanitarian interventions directed towards the IDPs living in Yola South, Yola North Fufore and Girei Local Government Areas (LGAs). In addition to these four LGAs, the IRC provided technical supervision to the five sub-grantees that are directly implementing Education Crisis Response (ECR) activities in the LGAs of Numan, Shelleng and Song.
For the most part of the first quarter of 2015, the IRC predominantly relied on the Emergency Response staff from the IRC HQ structure of the Emergency Preparedness and Response Unit (EPRU) for technical support to the country team! At close of April 2015, all EPRU staff had left the program and a transition had been finalized with the country office taking charge of the interventions.
The second half of 2015 had a blend of emergency response, responding to the needs of the returnees in LGAs further north of Adamawa state (Mubi South, Mubi North, Maiha and Hong LGAs) and expansion into Borno state with a field office operationalized in Maiduguri metropolitan providing humanitarian assistance to IDPs in the Jere and Maiduguri Metropolitan Center LGAs.
Above all, in 2015, IRC provided employment opportunities to more than 164 staff on long term contracts and 30 short term temporary staff.
 These within the NE Nigeria context refer to the officially recognized IDP designated spaces where the affairs are majorly run by the joint team of the National Emergency Management Agency and the State Emergency Management Agency
 The Informal IDP camps are the random spots or areas hosting IDPs and are usually within religious compounds or vacant spaces where the IDPs erect makeshift structures for accommodation
 These are usually homesteads that have opened their doors to IDPs
The IRC team meeting with His Excellence the President of the Federal republic of Nigeria at the State House on December 7 2015
End of 2015, the IRC Nigeria country program had the opportunity of hosting the organization’s president, Mr. David Miliband, from December 7th to 10th. The visit was an opportunity to Mr. Miliband to gain a better understanding of the crisis in the NE through a visit to the area where discussions with affected communities, service providers and local authorities took place. Mr. Miliband’s visit to the NE was followed by high level visits in Abuja which were used to advocate on the plight of the displaced and host communities in NE Nigeria. Mr. Miliband visited Maiduguri and Yola during his time in country: He spent two nights in Yola and carried out a multitude of visits and meetings. He met the Royal Highness the Lamido of Adamawa state, Mohammadu Barkidu Aliyu Musdafa; the State Governor, Mohammed Umaru Jibrilla;, and the State Emergency and Management Agency (SEMA) Permanent Secretary. On the evening of December 8th, he dined with representatives of UN, INGO, and local NGO representatives operational in Adamawa state at the AUN hotel. In Abuja, Mr. Miliband met with the EU Ambassador and Minister Counsellor; the US Ambassador, OFDA Representative, and the Deputy Head of Mission for USAID; and President Buhari with his Chief of Staff, Foreign Minister, and NEMA’s Director of Disaster Risk Reduction. Mr. Miliband also dined at the British High Commissioner’s residence where he met with DfID’s Humanitarian Advisor, the Deputy High Commissioner, and the Political Officer for NE Nigeria as well as active members of Nigerian civil society and representatives of key INGOs active in NE Nigeria. The visit was climaxed with a courtesy call to His Excellency the President of the Federal Republic of Nigeria, an opportunity he used to thank the government for the support to the humanitarian community in their work and also advocated for the IDPs who are still trapped and afraid to return home, whose plight is exacerbated by food insecurity
Eight local NGOs worked closely with the IRC to ensure quality program delivery to targeted individuals: three of these Local NGOs are IRC sub-grantees
- Caring Center for Empowerment and Peace Initiatives (CCEPI)
- Goggoji Zumunchi Development Initiative (GZDI)
- Centre for Women and Adolescent Empowerment (CWAE)
The other five are the sub-grantees on the ECR project who are being supervised directly by the IRC in Adamawa state:
- Nigeria Association of the Physically Challenged – Adamawa;
- Garga Foundation;
- Centre For Health and Development in Africa (CHEDA);
- CSACEFA Civil Society Action Coalition on Education for All;
- FOMWAN Federation of Muslim Women’s Associations in Nigeria
Programs delivered to targeted beneficiaries are: Environmental Health; Women Protection and Empowerment; Child Protection; Education; Health and Nutrition; Food Assistance and General Protection.
Three different multi-sectorial rapid assessment exercises were conducted in 2015 with the primary aim of: 1) To better understand how IDPs in camps and host communities are meeting their basic needs, including water, sanitation, food, health, and protection 2) To identify immediate protection concerns for children and women, including the availability of services for survivors of sexual violence and needs of unaccompanied and separated children and 3) To identify humanitarian gaps to shape humanitarian programming.
The first rapid multi-sectoral assessment was conducted March 12-20 2015 in exclusively IDP informal and host communities’ settings in Yola South, Yola North, Fufore and Girei. While the second assessment was conducted in the areas of return of Mubi South, Mubi North, Maiha and Hong from June 3-6 2015 and the third assessment in Maiduguri from July 8-14 2015.
Summary of achievements in health sector in 2015
The IRC conducted an assessment on tracer drugs/supplementary medicines for outpatient emergency treatment in 50 health facilities in Adamawa state. The result of the assessment revealed gaps in service delivery including: lack of trained health staff, and inadequate supplies, drugs, and equipment. The IRC health team held two trainings on July 15th and 17th with a combined total of 32 (27male and 5 female) health workers participating. The trainings covered best practices in monitoring, recording, and dispensing drugs at health facilities. The July 15th session for 17 participants was conducted in Mubi town while that for July 17th with 15 participants was conducted in Yola town.
IRC pharmacist distributing drugs to the Fufore IDP mobile clinic that was established in August 2015
The IRC distributed medical equipment/furniture, supplies and drugs to targeted 50 selected health facilities in 8 targeted LGAs within Yola and Mubi. The IRC has signed an MOU with the Federal Medical Center and the General hospital in Mubi to support and provide emergency response to medical referrals and life threatening complications in pregnancy and childbirth.
The IRC supported 52 (42 adults and 10 children) emergency medical referrals to the Federal Medical Centre and German Hospital in Yola. Cases referred included gunshot wounds and complicated pregnancies. IDPs referred were from Fufore, Malkohi, NYSC and St. Theresa IDP camps including some Host communities.
The IRC also provided delivery kits, which included sanitary pads, baby oil, and wrappers to 50 pregnant women and 42 lactating mothers in Mubi.
As part of the outreach activities at the community level, the IRC in collaboration with a local radio station (Gotel radio station) which has both wider coverage and is fondly listened to- conducted a live program on reproductive health to sensitize the community. The 45-minute program first aired on October 16th, 2015 and repeated three days following. People throughout the community of all ages and sex called in to ask questions.
The IRC facilitated a Training of trainers (TOT) session for 12 participants identified and fronted by the Primary Health Care Development Agency to be trainers on a variety of health related topics. Two national Master trainers conducted trainings July 21st for the 5 participants in Yola and July 24th for the 7 trainers in Mubi. Subsequently, these 12 trainers cascaded trainings for health workers from targeted 28 health facilities on (Emergency Obstetric Neonatal Care, Expanded Program on Immunization (EPI), Family Planning (FP), Integrated Management of Neonatal and Childhood Illness (IMNCI) and Clinical Care for Sexual Assault Survivors (CCSAS). In total, the 12 trainers were able to reach 125 (50 female & 75 male) health staff through their trainings.
The IRC identified 311 community health volunteers (CHV) in the communities where the IRC-supported health facilities are located. These 311 CHVs (164 male and 147female) benefited from a training organized by the IRC over a course of four days, July 28th-31st, with each day attracting on average 70 participants. The IRC trained these 311 CHVs as part of the outreach activities at the community level. The CHVs are responsible for dissemination of key messages on Family Planning proper hygiene promotion and encourage women to attend Ante Natal Care, Post Natal Care and access medical services.
The IRC identified and established 20 mother to mother support groups (MtMSG) comprised of 15 members each in Yola (10) and Mubi (10). Key mother to mother support group activities included health presentations to community members where the groups are based on exclusive breastfeeding and hygiene promotion. Cooking demonstrations are yet to be conducted but are planned to take place next quarter. In the first half of the project, the IRC identified and trained 120 women in Mubi from within the MtMSGs on hygiene promotion, optimal breastfeeding, proper infant feeding and family planning so that they can cascade these messages to members of their groups as well as members of their community during sensitization sessions. The trainings took place August 3rd to 6th, 2015.
The Community Based Management of Acute Malnutrition (CMAM) was largely implemented in the areas of return, Mubi South, Maiha and Hong. 12 health facilities with Out-Patient Therapeutic Program (OTP) and 2 stabilization center were supported with relevant consumable and non-consumable supplies to be able to address the needs of the identified severely and acute malnourished and moderately acute malnourished under five children.
30,000 children under five years were screened for malnutrition and both community volunteers and MtMSGs members were helpful in the screening of children at community level using the Mid-Upper Arm Circumference (MUAC) tape.
In 2015, IRC nutrition staff and partners detected, referred, and treated a total of 4,557 children under five suffering from SAM in Yola and Mubi, reflecting the gravity of the nutritional status in the state.
In consultation with the Adamwa State Primary Health Care Development Agency (ADSPHCDA), the approach to use the Community Management of Acute Malnutrition (CMAM) was preferred and IRC-supported health facilities.
Over 76 health workers were trained on CMAM for five days. The training was conducted in collaboration with the state nutrition officer ADSPHCDA and UNICEF. IRC procured and distributed medical supplies, equipment, drugs and anthropometric tools such as an infant scale beam, infant scale salter thermometer, MUAC tape, and others 12 OTP centers and two stabilization centre.
The IRC developed a clear outreach mechanism for mothers with children under five, which fostered active identification of cases among beneficiaries at the community level and enabled referrals to be carried out to the respective primary health care facilities at OTP sites. As Mother to Mother Support Groups (MTMSGs) have been a pillar in the promotion of optimal breastfeeding and referral of children with acute malnutrition, the IRC established more 100 in all the three bases of operation (Yola, Mubi and Maiduguri) each with 10 members.
These MTMSGs conducted weekly meetings where they discussed the importance of exclusive breastfeeding, how to identify locally available food, and techniques and cooking demonstrations to prepare nutritious meals for their children. The IRC conducted approximately 250 cooking demonstrations and each session attracted approximately 50 participants. The Mother Infant and Young Child Nutrition (MIYCN) program is another component of the CMAM activities that was carried out in the community in order to counsel lactating mothers on hygiene promotion, case detection, and timely referrals for children with signs of malnutrition. The program also involved provision of support for mothers experiencing problems with breastfeeding.
Women in these communities are typically the primary caregivers of children and are responsible for overall household hygiene practices. Recognizing this, IRC identified women as the primary audience for hygiene behavioral change communication activities. Hygiene promotion methods were designed to be culturally and gender sensitive, and women and girls were consulted on the design, scope of activities and location of WASH infrastructures. The IRC also ensured that hygiene messages reached a balanced cross-section to raise awareness and encourage behavior change for the whole community. To contribute to this effort, the 350 trained CHVs in both Yola and Mubi also conducted activities to raise awareness about the signs of malnutrition. These activities were part of IRC’s mandate to do case assessment of children under five at the community level, provide referrals and support community mobilization.
Community and religious leaders were engaged on key health and nutrition messages in communities where all the health facilities are located. These individuals are known to be the gate keepers in their communities, and have played a major role during community mobilization on the importance of hand washing and Infection Prevention Control (IPC).