EMERGENCY OPERATION

EMERGENCY OPERATION 10811.0 Title: Emergency Assistance to Communities Affected by the 2008 Drought in Karamoja, North-Eastern Uganda Duration: 9 months (20 February 19 November 2009) Number of Beneficiaries: 970,000 WFP food tonnage: 89,085 mt WFP food cost: US$ 42,156,551 Total cost to WFP: US$ 77,773,275 EXECUTIVE SUMMARY At the end of 2008, the Karamoja region of north-eastern Uganda is facing a severe humanitarian crisis, following a drought which has reduced agricultural output to an estimated 30 percent of normal levels. Although Karamoja s lean season does not traditionally begin until March, global acute malnutrition is already bordering on emergency levels, with some districts recording rates of 12.7 percent in September 2008. With the next harvest not due until October 2009, the situation will deteriorate drastically unless urgent remedial action is taken in the interim. Given the scale of the food security crisis, the Government of Uganda has requested WFP assistance in Karamoja. In response to the impending disaster in Karamoja, the proposed Emergency Operation (EMOP 10811.0) will fill a critical food gap until the harvest of October 2009. The multi-tiered intervention will provide: general food assistance to all food insecure households; and supplementary and therapeutic feeding to treat persons who have already become moderately and severely malnourished, respectively. Reflecting the seriousness of the situation, this operation is more than double in monetary terms than WFP Uganda s relief activities in Karamoja in 2008. The overall objective of the intervention is to save lives in Karamoja until the 2009 harvest. However, it will also contribute to prevent a vicious cycle, in which negative coping strategies undermine rural livelihoods and further deteriorate an already precarious security situation. While the proposed emergency operation will respond to the immediate crisis, WFP Uganda s country programme will, at the same time, help address some of the key underlying causes of food insecurity in the region. The emergency operation is firmly anchored in the findings and recommendations of a range of baseline assessments and nutrition surveys that have been conducted in Karamoja over the course of 2008, and has been conceived as part of a broader consultative process with the Government at the national, district and local levels. It contributes to the advancement of the Government s goals, as outlined in their Poverty Eradication Action Plan (PEAP) and the Karamoja Integrated Disarmament and Development Plan 2008-10 (KIDDP). The emergency operation also responds directly to WFP Strategic Objective One ( To save lives in emergencies and reduce acute malnutrition caused by shocks to below emergency levels ) and addresses Millennium Development Goal (MDGs) 1 ( Eradicate extreme poverty and hunger ). 1

SITUATION ANALYSIS AND SCENARIOS (a) Causes of the 2008 Crisis 1. Food availability is not a major problem for Uganda as a whole, but food access and food utilization are inadequate in many locations. Against this backdrop, there is a long history of severe, localized food insecurity in the country s chronically poor north-eastern region of Karamoja, the causes of which include a range of interwoven natural and man-made factors. For several years, these factors have been progressively eroding the local population s coping capacity, leaving them food-insecure. By the beginning of 2008, many households in Karamoja were net buyers, as opposed to net producers, of food. This heavy dependence on the local market for access to food meant that they were especially vulnerable to market fluctuations. The hope for 2008 was that a successful harvest in October coupled with favourable conditions for raising livestock - would boost local food production and help the population to achieve a greater degree of self-reliance whilst, in the interim, the market would remain broadly accessible to the local population. Unfortunately, the exact opposite occurred. The 2008 shock: 2. On the agricultural side, the annual rains - normally expected in late June/early July - arrived late. This resulted in a crop yield of less than 30 percent in the worst-affected districts 1. Unlike the rest of Uganda, Karamoja benefits from only one annual harvest, normally around the month of October. This means that the effects of a poor harvest are felt more keenly in Karamoja than elsewhere in the country, as the resulting food gap lasts for twice as long. 3. On the livestock side, there was a spread of livestock diseases - Pestes des petite ruminants (PPR) and Contagious Bovine Pleuropneumonia (CBPP) - which killed up to 40 percent of goats in some districts 2. Pastoralist activities are an integral component of food security in the region, providing both a livelihood and a direct source of protein, such as blood, milk and meat. 4. The immediate result of the 2008 crisis was a decreased accessibility to food. As the population s capacity to live from its own food production decreased, its reliance on the local market increased. At the same time, however, the overall availability of food on the local market was decreasing. Monthly market monitoring conducted by WFP revealed a rapid disappearance of food commodities from trading centers in the region. This was caused, on the one hand, by farmers holding on to their stocks and, on the other, by limited food supplies being imported into the region from neighbouring districts as a result of poor road conditions and insecurity (e.g. road ambushes). The lack of commodities on the local market caused prices to rise, thereby making it increasingly difficult for the Karamajong to gain access to essential foodstuffs. Exacerbating factors: 5. To make matters worse, a number of exacerbating factors added to the crisis. Sharp rises in global food prices were experienced in early 2008 due to increased demand, limited supply, and the rising price of fuel. In Uganda, these global trends combined with a significantly increased demand for Uganda s produce from Kenya and South Sudan. Over the course of the first 6 months of the year, the prices of basic staple commodities - such as maize and beans - rose by about 50 percent in Uganda 3. Figure 1 1 Food and Agriculture Organization of the United Nations (FAO) and Moroto Local Government, 2008, Rapid Food Security and Livelihoods Assessment. 2 Office for the Coordination of Humanitarian Affairs (OCHA)/Office of the Prime Minister of Uganda, 2008, Joint Factsheet on Karamoja, 18 April 2008. 3 International Food Policy Research Institute (IFPRI), 2008, An Assessment of the Likely Impact on Ugandan Households of Rising Global Food Prices. 2

illustrates the rising trend in the prices of three basic food commodities -sorghum, maize and beans - in one district of Karamoja (Moroto) over the period from December 2007 to December 2008. Although there has been a slight decrease in prices associated with the harvest, prices are significantly higher than the previous year and are expected to rise further in the lean season. Figure 1 Rise in food prices in Moroto district, Karamoja (2008) Average Price Trends in Moroto District December 2007-December 2008 2500 Price in Uganda Shillings per Kg 2000 1500 1000 500 0 2000 1620 1925 1800 1600 1625 1786 1800 1575 1714 1190 1333 1317 505 505 505 495 514 541 541 541 507 473 335 396 387 225 304 324 360 378 369 405 405 405 473 473 412 446 Dec-07 Jan-08 Feb-08 Mar-08 Apr-08 May-08 Jun-08 Jul-08 Aug 08 Sep-08 Oct-8 Nov-08 Dec-08 Sorghum Maize Beans 6. In a pastoralist region such as Karamoja, ensuring access to livestock and animal health is essential to food security. In response to the high levels of violence caused by cattle rustling, the Government of Uganda has promoted the protected kraal 4 as a means of safeguarding livestock and banned the interdistrict movement of livestock. This virtual embargo on the migration of livestock into neighbouring districts has interfered with the traditional way of life in Karamoja, in which freedom of movement allows pastoralists to seek out fresh grazing pastures for their livestock. An unwanted side-effect of the Government s policy, therefore, has been to increase pressure on existing land and water resources, affecting some 1.2 million animals regionally. (b) Effects of the 2008 Crisis Rising prevalence of hunger 7. In February 2008, a comprehensive health and nutrition assessment 5 was conducted in Karamoja by the Ministry of Health in conjunction with the International Baby Food Action Network (IBFAN), with support from WFP and United Nations Children s Fund (UNICEF). The specific focus of the assessment was on children aged 0-5 years and women of reproductive age (15-49 years). The results (presented in Figure 2) showed that the nutrition situation in Karamoja region was serious with a global acute malnutrition (GAM) above 10 percent 6, coupled with a high mortality rate of above 1 person per 4 The communal protected kraals were established to prevent the escalating internal and cross-border cattle raids in Karamoja region. Livestock in a given area is kept near an army detach for night protection and is taken for grazing in the morning. 5 Ministry of Health. Summary of the Nutrition and Health Assessment in Karamoja Region. February 2008. 6 Prevalence was calculated using National Center for Health Statistics (NCHS) standards. 3

10,000 per day. The GAM rate was above the emergency threshold of 15 percent in the districts of Moroto and Nakapiripirit, calling for urgent interventions. Figure 2 Health and Nutrition Assessment results Karamoja, February 2008 District Global Acute Malnutrition (%) Severe Acute Malnutrition Abim 8.3 (6.3-10.3) 1 Kaabong 9.1 (7.0 11.2) 2.6 Kotido 6.3 (4.6 8.1) 0.2 Moroto 15.6 (13.1 18.1) 2 Nakipiripirit 15.1 (12.6 17.6) 2.2 Regional average 10.9 1.6 8. In September 2008, a second health and nutrition assessment was carried out as a follow up to the one conducted in February. The results, shown in Figure 3, show a marginal improvement in acute malnutrition, with small declines in GAM across the board. There were impressive declines in the worse-affected districts (e.g. Nakapiripirit), which can be explained in large part by the positive impact of food, health and nutrition interventions conducted by WFP, UNICEF and others, which commenced in January 2008 7. Nonetheless, the overall situation remained serious and fragile. In a couple of the districts, GAM continued to be above the emergency threshold limits. In others, it hovered just below emergency levels (e.g. regional average of GAM at 9.5 percent - just below the emergency threshold). In the same assessment, Crude Mortality Rate was also measured at 1.2 persons per 10,000 per day - the humanitarian emergency level according to the Integrated Food Security and Humanitarian Phase Classification (IPC). Figure 3 Health and Nutrition Assessment results Karamoja, September 2008 District Global Acute Malnutrition (%) Severe Acute Malnutrition Abim 7.2 (5.1 9.3) 1.4 Kaabong 8.6 (6.5 10.8) 1 Kotido 10.5 (6.6 14.5) 1.1 Moroto 12.7 (9.6 15.8) 1.9 Nakipiripirit 8.4 (6.1 10.6) 0.6 Regional average 9.5 1.2 9. The health and nutrition assessment also highlighted how utilization problems contribute to the high levels of acute malnutrition: Poor hygiene and sanitation conditions are a particular problem, since they lead to diseases such as diarrhea. 10. As Karamoja moves into the traditional hunger season and with the next harvest not due until October 2009, the already high rates are likely to skyrocket unless decisive remedial action is taken in the interim 8. 7 In 2008, WFP targeted food assistance at 750,000 people who were worse-affected by the drought 8 There is a clear historical precedent for this. In 2002 following a similar crisis GAM quickly rose to 22 percent. 4

Wide proliferation of negative coping mechanisms 11. The lack of access to food on local markets has resulted in an increasing prevalence of negative coping mechanisms, destroying traditional rural livelihoods and further undermining development progress in the region. The recent Comprehensive Food Security and Vulnerability Analysis (CFSVA) showed that almost 50 percent of the population in Karamoja skipped meals for at least one whole day within the last 7 days prior to the survey, with Moroto having the highest proportion (72 percent). Other negative coping mechanisms that have been reported include cutting down trees for charcoal production (thereby resulting in further environmental degradation in an already semi-arid region); the removal of children from school (to participate in household income generation and to save on school fees); distress selling of livestock (Nakapiripirit 65 percent, Moroto 24 percent). Significant outward population migration was reported from Moroto (40 percent) and Kotido (25 percent) districts. This outward migration (e.g. in search of work in towns in other regions) is different from the seasonal movements of the agropastoralist populations with their livestock to areas with greater water and pasture. Populations migrating out of the region due to food insecurity may be more exposed to HIV and contribute to its spread on their return 9. This situation is a perpetuation of a negative cycle associated with underdevelopment and recurrent shocks. Increased violence 12. In spite of the ongoing deployment of the army in the region (the Uganda Peoples Defence Forces, or UPDF), there are continued occurrences of cattle rustling and increased incidences of ambushes of commercial vehicles, reflecting the challenges faced by the Government of Uganda in its efforts to bring greater peace and security to the region. The difficult security situation and the current widespread food insecurity in the region have also posed a direct challenge to WFP. Of particular concern are reports of WFP beneficiaries being subjected to physical assault and food grabbing at general food distributions, and even of households being subjected to armed raids after receiving food assistance. In response to this situation, a WFP protection mission was conducted in the region 10, the objective of which was to assess how best to deliver food assistance whilst remaining in line with the do no harm principle. A number of recommendations were made (all of which have been incorporated into the design of the proposed operation). These protection challenges are compounded by the poor infrastructure and lack of cooperating partners. (c) A Crisis Situation in 2009 13. At least 80 percent of the population of Karamoja (970,000 persons) are now estimated to be highly food insecure 11. With no new harvest due until October 2009, and with the traditional lean season fast approaching, the situation can only deteriorate. Most likely scenario in 2009 14. In the absence of a multi-tiered intervention that provides general food assistance to all highly foodinsecure households - complemented by supplementary and therapeutic feeding to moderately and severely malnourished persons respectively global acute malnutrition rates are likely to soar and result in increased mortality rates before the 2009 harvest. In addition, the destruction of rural livelihoods and serious setbacks in the disarmament process will significantly impede recovery. 9 The HIV prevalence is 4.5 percent in Karamoja, which represents a rise from previous years. 10 WFP, Protection in WFP Operations: Analysis of activities in Karamoja, Uganda. January 2009. 11 This figure is based on the findings of a range of assessments and monitoring reports using an estimated population figure for Karamoja of 1.2 million people. See the section on Beneficiaries and Targeting for details. 5

Other possible scenarios 15. In the best-case scenario, a significant decline in food prices in early 2009 will increase the population s access to food in the local market until a successful harvest in October 2009 restores self-reliance. In the worst-case scenario, food prices will climb higher, the spread of livestock disease will increase and the rains will arrive late, causing the October 2009 harvest to fail. POLICIES, CAPACITIES AND ACTIONS OF THE GOVERNMENT(S) AND OTHERS (a) The Government of Uganda 16. For many years, Karamoja was marginalized in government-sponsored development programmes and from allocations of the national budget fact which has been recognized by both the Government of Uganda and the World Bank. More recently, however, attempts have been made by the Government to address this imbalance. In June 2008, the Government of Uganda launched the Karamoja Integrated Disarmament and Development Plan (KIDDP) initiative. The KIDDP provides an over-arching framework for the Government s interventions, in recognition of the complex inter-relation between underdevelopment and insecurity in the region. The overall goal of the KIDDP is to improve human security and to promote conditions for recovery and development. The means for achieving this end, as outlined in the KIDDP, is the simultaneous creation of a gun-free society and the establishment of development parity between Karamoja and the greater north. 17. Throughout 2008 the Government of Uganda has tried to complement WFP s efforts in Karamoja by providing limited quantities of food, as well as seed and agricultural inputs. The current urgency and scope of the food security situation in the region, however, far exceeds its budgetary and operational capacity, which has motivated the Government of Uganda to request an emergency intervention by WFP in 2009. 18. WFP will co-ordinate the proposed EMOP with the Ministry of Disaster and Preparedness, under the Office of the Prime Minister of Uganda (OPM) to ensure overall synergy with the ongoing interventions of the Government of Uganda. The Government-chaired District Disaster Management Committees (DDMCs) oversee emergency planning and response at the local level. (b) Other Actors 19. WFP s interventions in Karamoja to date have been complemented by the interventions of nongovernmental organizations (NGOs) and United Nations agencies, as represented in Figure 4: Figure 4 Overview of selected agencies working on complementary interventions in Karamoja Type of intervention Supplementary and therapeutic feeding programmes Provision of seed Vaccinations of livestock against disease Basic education Establishing village health teams, school feeding and other nutrition interventions Agency UNICEF; MSF-Holland; MSF-Spain; Action contre la Faim (ACF) OXFAM FAO Save the Children; UNICEF Belgian Survival Fund; UNICEF; FAO; and WFP 6

20. Given the scale of the 2008 crisis in Karamoja, the interventions outlined in Figure 4 are limited in scope and geographical coverage 12, leaving many communities marginalized. WFP will maximize the synergies between its proposed EMOP and the interventions of other actors by carrying out a broadbased food assistance programme (targeting all food insecure households) and providing support to moderately malnourished persons through supplementary feeding programmes 13. (c) Coordination 21. Within the humanitarian community, the Humanitarian Coordinator and the Inter-Agency Standing Committee/United Nations Country Team lead response efforts applying the cluster approach. The clusters include: food security; emergency education; water and sanitation; health, HIV/AIDS and nutrition; protection; and early recovery. Clusters are composed of line ministries, United Nations agencies, NGOs and interested donors and meet on a monthly basis both in Kampala and at the district level. 22. Under the Consolidated Appeal Process (CAP), the humanitarian community in Uganda requested a total of US$77,210,740 to meet the most urgent humanitarian needs of approximately 800,000 vulnerable individuals in Karamoja region in 2009. The appeal included US$53,175,291 of WFP requirements for targeted food and nutrition assistance for food-insecure communities in Karamoja. However, these requirements have been reassessed and increased since the CAP was issued in November 2008. OBJECTIVES OF WFP ASSISTANCE 23. The proposed EMOP is conceived within the framework of WFP Uganda s country strategy for 2009-14 14. It responds to Strategic Priority One of the country strategy - Emergency and Humanitarian Action which, in turn, takes its lead from Strategic Objective One of the WFP corporate Strategic Plan (2008-11), namely: To save lives in emergencies and reduce acute malnutrition caused by shocks to below emergency levels. 24. The objective of the proposed EMOP is: To stabilize and reduce acute malnutrition in the targeted population until the harvest of October 2009. BENEFICIARIES AND TARGETING 25. The total number of beneficiaries in the proposed EMOP is 970,000, constituting around 80 percent of the population of Karamoja. Although this represents an extremely high percentage of the population, it is necessary to target this number of people for two reasons. 26. First, the findings from the assessments conducted in 2008 suggest that acute malnutrition is extremely widespread across all districts, and on an upward trend. WFP is using geographic targeting at the parish level. Most areas in Karamoja currently meet the targeting criteria: (a) GAM of more than 10 percent, or trending towards it; (b) average household expenditure on food of more than 70 percent; (c) projected food stocks for 3 months or less; and (d) heavy dependence on distress coping strategies. However, 12 For example, the Belgian Survival Fund targets three sub-counties in Abim and Kotido districts. Similarly, OXFAM is targeting 13,000 households in Kotido and Kaabong districts. 13 UNICEF and ACF have confirmed that their supplementary and therapeutic feeding programmes in Karamoja will continue in 2009. MSF has indicated that it may pull out from Karamoja. WFP is in the process of identifying new partners to provide community-based supplementary feeding in order to fill any gaps. 14 See WFP Uganda Country Strategy Document (2009-2014), draft. 7

based on a rapid assessment, certain parishes in Abim district which lies in the green belt were not deemed to require food assistance 15. The people living in these parishes represent approximately 20 percent of the total population of Karamoja. As a result, WFP will provide blanket coverage of all districts in 2009 (excluding the food secure parishes in Abim) until the October harvest. 27. Second, the findings from a WFP Protection Mission to Karamoja, which was conducted in November 2008, suggested that the WFP intervention in 2008 may have overlooked some parishes. Earlier in the year, this group of overlooked parishes had been relatively better off. However, over time, they have developed levels of food insecurity comparable to those of communities that were receiving food assistance. This situation was inadvertently increasing tensions in the region between beneficiary and non-beneficiary communities. As a result, an unacceptable level of violence was prevailing at WFP general food distributions, which became a serious protection issue for WFP beneficiaries. It therefore recommended covering all parishes (with comparable levels of food insecurity) within each district. 28. This approach makes the EMOP significantly larger than any other recent relief interventions in the Karamoja region. In 2007, WFP distributed 25,000 mt of food to approximately 560,000 people at a food cost of US$20 million. In 2008, it reached 750,000 people with 41,000 mt of food valued at over US$33 million. In 2009, the proposed EMOP will target 970,000 beneficiaries with 89,084 mt of food valued at US$ 42 million. These figures demonstrate overall growth in the size of WFP s interventions in Karamoja (in terms of both beneficiaries and tonnage). They also indicate that the rate of growth has been greater for tonnage than for beneficiaries. This can be explained by both the addition of corn-soya blend to the food basket in EMOP 10811.0 and the fact that the duration of assistance was extended from 4-6 months in 2008 to 9 months in 2009. 15 WFP and Abim Local District Government, 2008, Rapid Assessment of Food Security in Abim District, Karamoja. 8

NUTRITIONAL CONSIDERATIONS AND RATIONS Figure 5 Ration distribution Food assistance modality General food distribution (GFD) Supplementary feeding Therapeutic feeding Therapeutic Feeding Caretakers Rations 200g maize grain 40g pulses 10g oil 5g salt 50g CSB (50% rations) Duration: 270 days K/Cal: 1,123 229g CSB 15g sugar 25g oil Duration: 90 days K/Cal: 1,197 60g CSB 10g sugar 10g oil Duration: 30 days K/Cal: 369 50g CSB 30g oil 55g pulses 400g maize meal 5g salt Duration: 30 days K/Cal: 2,102 Beneficiary numbers Male Female Total 475,300 494,700 970,000 43,430 57,570 101,000 4,983 6,607 11,590 696 10,894 11,590 29. General food distribution will be targeted at 970,000 food-insecure persons. The use of only 50 percent rations will allow WFP to strike a suitable balance in its response to the crisis, filling the household food gap whilst not over-compensating. Based on CFSVA, the food gap was estimated at 50 percent. Assistance under WFP s country programme (particularly MCHN, school feeding, and food-for-assets) should meet another 10 percent of the households needs. 40 percent of the food consumed by Karamojongs is derived from a combination of own production (which is extremely low this time), hunting-gathering, gifts and purchases from the market. Cash for market purchase coming from harmful and unsustainable practices such as selling firewood and grass has not been factored in since it represents a further exploitation of the already fragile natural resource base. 30. 101,000 moderately malnourished individuals will benefit from a supplementary feeding programme. 9

Figure 6 Admission and discharge criteria for supplementary feeding programme Target group Admission criteria Discharge criteria 16 Children (from 6 to 59 months) W/H 70% to 79% of the median without W/H 80 percent of the median and oedema above MUAC from 115mm and <125 mm MUAC 125mm and above Children (from 5 years to 10 years) Adolescents (from 11 years to 18 years) Discharged from the Therapeutic Feeding Centre Discharged from the Therapeutic Feeding Centre Discharged from the Therapeutic Feeding Centre Ill adults (>18 years) BMI >16 and <17 Men: MUAC >= 224mm and < 232mm Women: MUAC >=214mm and <222mm Discharged from the Therapeutic Feeding Centre BMI greater than the values for 2 standard deviations from the growth reference BMI greater than the values for 2 standard deviations from the growth reference BMI 18.5 or above Elderly people (>60years) MUAC >160mm and <185mm MUAC >185mm At closure of SFP Pregnant & lactating women MUAC <23cm Discharged from the Therapeutic Feeding Centre Six months after delivery Mother without breast milk Child unable to suckle Stagnant/decreasing weight trend of child Able to suckle Mother has breast milk Child s growth curve increasing 31. 11,590 severely malnourished persons will benefit from therapeutic feeding. UNICEF will take the lead on this aspect of the programme, though WFP will support with the key commodities outlined in Figure 5. 32. It is also planned to give food assistance to 11,590 caretakers accompanying severely malnourished persons receiving therapeutic care. This takes into account not only the direct needs of the caretaker, but also another likely dependant (e.g. another child). This model of support will be given during phase 2 (i.e. the rehabilitation phase ). 16 Although there are currently no internationally agreed discharge criteria for children (5-10 years) and adolescents, WHO has developed growth references that will be used as the basis for discharge decisions in this EMOP. For more information, see http://www.who.int/growthref/who2007_bmi_for_age/en/index.html. 10

IMPLEMENTATION ARRANGEMENTS (a) Partners and Participation 33. WFP will take responsibility for the management of the emergency operation and to ensure smooth communication between all key stakeholders at the national level (through WFP country office) and at the district and local levels (through WFP sub-offices in Moroto and Kotido). WFP will also be responsible for monitoring and evaluating the intervention (see below). 34. WFP will work along with co-operating partners including World Vision (in northern Karamoja) and Samaritan s Purse (in southern Karamoja). In line with the increased requirements in Karamoja, additional partners will continue to be sought. Field Level Agreements with co-operating partners will be signed prior to the start of the proposed operation. The co-operating partners will undertake general food distribution in conjunction with Food Management Committees established at the local level. 35. The Food Management Committees will also act as the major screening body for beneficiaries at subcounty and parish levels. They will liaise closely with local authorities, including manyatta leaders and elders within communities, in order to ensure that eligibility criteria are strictly applied and that assistance only reaches targeted beneficiaries. In 2008, WFP beneficiary lists were established on the basis of Birth and Death Registers. While local authorities periodically update the registers, there are some problems with their accuracy. Therefore, before the EMOP commences, WFP and co-operating partners will undertake a registration and verification exercise with village leaders to produce a complete list of households by village. The beneficiary numbers will be reviewed again in March/April 2009, when the full results of the CFSVA will be available. 36. For the supplementary and therapeutic feeding programmes, WFP will work in partnership with stateowned health facilities in Karamoja. In order to strengthen the government health workers capacity, WFP conducted trainings at the national teaching hospital (through a training-of-trainers approach). In addition, UNICEF and ACF support the capacity development of health staff in order to improve the management of moderate and severe malnutrition. (b) Cross Cutting Issues 37. Care will be taken to ensure the equitable representation of women on Food Management Committees, and in beneficiary groups. 38. The proposed EMOP will be sensitive to HIV/AIDS-related vulnerabilities associated with the food and nutrition security conditions among the target populations, addressing special needs where appropriate, while keeping in mind the short term and temporary nature of the current emergency operation 17. 39. Following the recommendations of the protection mission to Karamoja, conducted in November 2008, extra steps will be taken to safeguard the welfare and dignity of WFP beneficiaries and to reduce incidences of food diversion. The following concrete measures are planned: More inclusive targeting, incorporating food-insecure parishes that were not assisted by WFP in 2008 Adoption of a village-based system (i.e. engagement with villages leaders) for beneficiary registration and verification and food distribution monitoring to ensure that all targeted households received food assistance Improved co-operation with the Ugandan military (UPDF) to ensure a more organized and secure food distribution site 17 HIV/AIDS will be mainstreamed in WFP Uganda s new PRRO and CP. 11

Training of UPDF in the basic rights of WFP beneficiaries Improved public communications about which areas are to be covered by general food distributions These measures are expected to result in both increased personal safety for WFP beneficiaries and less food diversion. More broadly, they should reduce the risk of the intervention contributing towards increased social unrest in Karamoja as a whole. (c) Food Assistance Strategy General food distribution 40. General food distribution will be targeted at 970,000 food insecure people through a village-based system. Given the particular nature of the situation in Karamoja, food distribution is the only appropriate modality. On the one hand, a cash-based intervention would incur an unacceptable level of risk that intervention might contribute to further inflation - the consequences of which would be disastrous. For as long as prices are high, the purchasing power of cash is also reduced, thereby decreasing the effectiveness of cash-based interventions. On the other hand, a voucher-based intervention would also pose risks and be difficult to implement in a large region with a scattered and widely dispersed population. Requiring the local population to travel long distances in order to redeem a voucher might place WFP beneficiaries at further risk. Basic sensitization will be conducted as part of general food distributions about how the food basket can best be used, including a strong recommendation that CSB should be prioritized for children under 5. Supplementary and therapeutic feeding 41. Supplementary and therapeutic feeding will be targeted at 101,000 moderately malnourished individuals and 11,590 severely malnourished individuals respectively. At the start of the operation, much of the supplementary and therapeutic feeding will be facility-based. However, during the course of the operation, community-based approaches will be piloted and scaled up to the extent possible in partnership with the Government, UNICEF and NGOs. A further 11,590 therapeutic feeding caretakers will receive an additional ration. (d) Non-food Inputs 42. The September 2008 health and nutrition assessment highlighted the importance of hygiene in preventing malnutrition and recommended that interventions be designed to address the poor living conditions particularly access to water and sanitation facilities. WFP will strongly encourage UNICEF, the United Nations Population Fund and the World Health Organization to provide soap and water purification tablets. In places where there is a gap, WFP will consider providing these items to help ensure that the lack of hygiene does not undermine the effectiveness of WFP food assistance. (e) Procurement 43. In the proposed EMOP, most of the food commodities will be purchased locally from central and southern Uganda. WFP already has an established track record in local purchase 18. For many years, WFP has been major purchaser in Uganda s food producing areas, which has endowed it with an extensive network of reliable producers and extensive knowledge about trends in agricultural production. Under the Purchase for Progress Initiative, WFP is carrying out a baseline survey (to be completed prior to the beginning of the proposed EMOP), which will help identify the most suitable producers. 18 For example, WFP is currently the largest purchaser of maize in the country 12

44. Aside from the practical advantages of using local procurement, it also has an inherent added value to other areas of WFP s work in Uganda. Strategic Priority Three of the WFP country strategy for Uganda (2009-14) Agricultural and Market Support aims to strengthen critical food supply and to raise standards in agricultural production. Whilst it is hoped that a large amount of the commodities can be procured locally, any shortfall will be met through international procurement. (f) Logistics 45. WFP has operated in Karamoja since 1963 and has a well developed and efficient logistics network in Uganda, which is a significant comparative advantage for the organization. WFP will transport food from its warehouses to Extended Delivery Points (EDPs) located in each of the five districts of Karamoja. Following this, WFP will carry out secondary transport to the final distribution points (FDPs) immediately prior to general food distributions. To enable this to happen, the current WFP fleet of 20 trucks will be augmented - especially with regard to trucks that have smaller tonnage capacity. This is essential for making the management of general food distributions run more smoothly 19. 46. WFP currently has over 50 field staff, based in two sub-offices, located in the town of Moroto (which covers the districts of Moroto and Nakipiripirit) and the town of Kotido (which covers the districts of Kotido, Kaabong and Abim). Road infrastructure in Karamoja is exceptionally poor, requiring long hours of travel. In response to this problem, it is proposed to establish two additional sub-offices in Nakapiripirit and Kaabong. This will significantly strengthen the capacity of WFP on the ground in Karamoja to implement and monitor the proposed operation. PERFORMANCE MONITORING 47. In Uganda, WFP uses a results-based approach in all of its programming. Critical to the success of this approach is the quality and accuracy of data concerning the food security situation in Uganda. Baselines for Karamoja have been drawn on a range of empirical data gathered throughout 2008. Baselines are constantly updated by the country office s Vulnerability Analysis and Mapping (VAM) Unit. Data is captured and stored in the WFP Integrated Programme Activity Database (IPAD), from which regular reports are generated and analyzed. Nutritional surveys will be undertaken towards the end of the project to measure outcome indicators, such as GAM and mortality rates. 48. In addition to the information that is captured in the IPAD and nutritional surveys which is largely of a quantitative nature qualitative data will be captured in post distribution monitoring exercises. Whilst statistical measurements such as GAM provide valuable insights into the levels of hunger in a given region, this information must be supplemented with qualitative explanations in order to understand the full causes and effects of acute malnutrition. It also provides WFP with an early warning system, helping to ensure that food assistance through local procurement does not inadvertently have unwanted side-effects - either at the supply side (through, for example, inflation) or the demand side (through, for example, endangerment of WFP beneficiaries). In this sense, WFP benefits strongly from having suboffices at both the supply and demand ends of the anticipated process. This means that close monitoring of the evolving situation can be conducted by staff members who are permanently embedded in the respective regions. 19 It was recognized in the WFP Protection Mission to Karamoja that a smooth and streamlined management of general food distributions is essential for minimizing the security risks both to WFP staff, to co-operating partners and to WFP beneficiaries. The importance of this should not be underestimated. 13

49. At the operational level, the following existing monitoring and evaluation mechanisms will be utilized: Weekly situation reports (submitted by sub-offices to the country office) Tracking of commodities using WFP s COMPAS system Monitoring of distributions Post distribution monitoring Nutrition survey HANDOVER STRATEGY 50. The proposed EMOP should be understood as one part of a two-pronged strategy for addressing food insecurity in Karamoja in 2009. 51. First, the proposed operation will enable WFP to plug a critical food gap in Karamoja over a 9-month period and thus avert a potential disaster in the region. The intervention is essential for ensuring that the humanitarian situation does not deteriorate any further before the 2009 harvest. Furthermore, by reducing the proliferation of negative coping strategies, the emergency operation should protect the capacity for self-reliance in Karamoja throughout the course of 2009. 52. Second, during the EMOP implementation, WFP will also begin the process of phasing in activities to address some of the key underlying causes of food insecurity in the region through its country programme. Under the new WFP country strategy (2009-14), the country programme covers activities for Priority Area 2 (Food and Nutrition Security) and Priority Area 3 (Agriculture and Market Support). In Karamoja, the country programme s specific activities will help provide the right incentives for production, support livelihoods (thereby helping agro-pastoralists respond to these new incentives), and develop social protection (through the introduction of productive safety nets). The ultimate aim of these interventions would be to transform the development dynamic in Karamoja, which would see communities break the cycle of hunger and the current over dependence on humanitarian assistance. 53. Because this new approach places much greater emphasis on addressing the underlying causes of hunger, WFP does not foresee a situation in which it is responding to repeated emergencies in the region for years to come. It is expected that at the end of the proposed EMOP in October 2009, relief activities will no longer be needed and will be quickly phased out. For this reason, and as a signal of its shift in strategy, WFP has decided to place this intervention under an EMOP rather than a PRRO. Once the EMOP is completed, the country programme will then be the main mechanism through which WFP works to build resilience to shocks and address the root causes of food and nutrition insecurity and underdevelopment in Karamoja. Should a major shock occur, WFP would consider EMOP assistance in consultation with the Government and partners. 14

SECURITY CONSIDERATIONS 54. Insecurity and violence continue to be a major concern for the local population in Karamoja. The region is classified by the United Nations as in Security Phase 3. The main types of incidents reported include raids, inter-community violence, attacks on vehicles 20, violent robberies, shootings and murder as well as shoot-outs between illegally armed Karamojong and the Uganda People s Defence Forces (UPDF). 55. WFP activities figure prominently in the United Nations Area Security Plan. Currently, all WFP convoys to Karamoja travel under armed escort at all times, which is provided by either the UPDF or the police. WFP complies with minimum operational security standards and minimum telecommunications standards. Escort vehicles, armed vehicles, telecommunications equipment, bulletproof vests and security enhancements to storage and field offices have been duly budgeted for under the proposed EMOP. RECOMMENDATIONS 56. The Executive Director and the Director-General of FAO are requested to approve the proposed Emergency Operation to provide relief food assistance to 970,000 vulnerable people in Karamoja for a 9 month period. APPROVAL Josette Sheeran Executive Director World Food Programme Date:. Dr Jacques Diouf Director-General of FAO UN Food and Agriculture Organization Date: 20 In August 2008 a WFP convoy was ambushed on the road between Moroto and Kotido. 15

ANNEX IA WFP PROJECT COST BREAKDOWN Quantity (mt) Average cost (US$) per mt Value (US $) COSTS A. Direct operational costs Cereal Grain 21 52,334 349.14 18,272,079 Maize Meal 1,252 450.00 563,400 Pulses 10,639 751.00 7,989,889 Vegetable oil 3,424 1,367.50 4,682,320 Corn Soya Blend (CSB) 19,672 519.62 10,221,965 Sugar 440 400.00 176,000 Salt 1,324 189.50 250,898 Total commodities 89,085 42,156,551 External transport 6,700,874 Landside transport 7,766,887 ITSH 7,209,470 Total LTSH 14,976,357 Other direct operational costs 2,366,622 Total direct operational costs 66,200,404 B. Direct support costs (see table below for details) 6,484,900 C. Indirect support costs (7 percent of total direct costs) 5,087,971 TOTAL WFP COSTS 77,773,275 21 This is a national food basket used for budgeting and approval purposes. The precise mix and actual quantities of commodities to be supplied to the project, as in all WFP-assisted projects, may vary over time depending on the availability of commodities to WFP and domestically within the recipient country. 16

ANNEX IB DIRECT SUPPORT REQUIREMENTS (dollars) Staff International professional staff 1,310,130 National professional officers 528,000 National general service staff 544,500 Temporary assistance 549,000 Overtime 31,590 Incentives 28,300 International Consultants 126,225 National Consultants 28,800 UNVs 126,225 Staff duty travel 402,650 Staff training and development 125,300 Subtotal 3,800,720 Office expenses and other recurrent costs Rental of facility 270,000 Utilities (general) 36,100 Office supplies 52,000 Communication and IT services 83,700 Insurance 22,050 Equipment repair and maintenance 47,180 Vehicle maintenance and running cost 720,000 Other office expenses 220,000 United Nations Organizations Services 76,100 Subtotal 1,527,130 Equipment and other fixed costs Furniture tools and equipment 460,000 Vehicles 220,500 TC/IT equipment 476,550 Subtotal 1,157,050 TOTAL DIRECT SUPPORT COSTS 6,484,900 17

ANNEX II: Log Frame Summary ANNEX II: LOGICAL FRAMEWORK SUMMARY Emergency assistance to communities affected by the 2008 drought in Karamoja, north-eastern Uganda Results hierarchy Performance indicators Means of verification Risks/assumptions Impact Lives have been saved, and acute malnutrition reduced, in Karamoja until the October 2009 harvest Outcome 1 Crude mortality rate less than 1/10,000/day End of project evaluation report Sufficient and timely resources secured from donors Reduced or stabilized acute malnutrition in the targeted population (SO1) Prevalence of acute malnutrition among children under 5 (weightfor-height-as-%) is stabilized at reduced below 10 percent Mortality rate at therapeutic feeding centres is less than 5 percent Nutrition surveys Emergency Food Security Assessment (EFSA) Monthly reports from Therapeutic Feeding Centres No major outbreaks of diseases occur in Karamoja No serious deterioration in the security situation in Karamoja Adequate human resources at health centres Recovery rate at therapeutic feeding centres is more than 75 percent Monthly reports from Therapeutic Feeding Centres Mortality rate at supplementary feeding centres is less than 2 percent Monthly reports from Supplementary Feeding Centres Recovery rate at supplementary feeding centres is more than 75 percent Monthly reports from Supplementary Feeding Centres Default rate at supplementary feeding centres less than 15 percent Monthly reports from Supplementary Feeding Centres 18

ANNEX II: LOGICAL FRAMEWORK SUMMARY Emergency assistance to communities affected by the 2008 drought in Karamoja, north-eastern Uganda Results hierarchy Performance indicators Means of verification Risks/assumptions Output 1.1 Food-insecure persons receive food assistance in sufficient quantities Output 1.2 Moderately malnourished persons receive supplementary feeding Output 1.3 Severely malnourished persons receive therapeutic feeding Output 1.4 Therapeutic Feeding Caretakers receive supplementary feeding 970,000 beneficiaries reached 79,809 mt food distributed 101,000 beneficiaries reached 7,336 mt food distributed 11,590 beneficiaries reached 250 mt food distributed 11,590 beneficiaries reached 1,690 mt food distributed Monthly progress reports Food distribution reports Supplementary feeding records Therapeutic feeding records Therapeutic feeding records No significant food pipeline breaks No major access problems to Supplementary Feeding Centres No significant food pipeline breaks No major access problems to Therapeutic Feeding Centres No significant food pipeline breaks No major access problems to Therapeutic Feeding Centres No significant food pipeline breaks 19

ANNEX III: Map KARAMOJA LIVELIHOOD ZONES SUDAN N Kathile D.R.CONGO Karamoja Karenga Kapedo Kalapata KENYA KAABONG Kaabong Kaabong Tc RWANDA TANZANIA Lolelia Sidok Kacheri Rengen Loyoro Nakapelimoru Kotido Tc Abim Alerek ABIM Morulem Lotukei Kotido Rupa KOTIDO Panyangara Lopei Ngoleriet Nyakwae Lokopo Northern Division MOROTO Katikekile Nadunget Matany Lorengedwat LEGEND Agricultural Agropastoral Pastoral District Subcounty Primary roads Lotome Nabilatuk Loroo Iriiri Moruita Kakomongole Amudat Nakapiripirit Tc Lolachat Namalu NAKAPIRIPIRIT Karita 0 50 100 Kilometers 20

ANNEX IV: Abbreviations BMI CBPP CFSVA CP EDP EMOP FDP FMC GAM IBFAN IPAD Body mass index Contagious Bovine Pleuropneumonia Comprehensive Food Security and Vulnerability Assessment Co-operating partner Extended Distribution Point Emergency Operation Final Distribution Point Food Management Committee Global Acute Malnutrition International Baby Food Action Network Integrated Programme Activity Database KIDDP Karamoja Integrated Disarmament and Development Plan 2008-10 MUAC PEAP PPR SAM UNICEF UPDF VAM WFP Mid Upper Arm Circumference Poverty Eradication Action Plan Pestes des petite ruminants Severe Acute Malnutrition United Nations Children s Fund Uganda People s Defence Force Vulnerability Analysis and Mapping United Nations World Food Programme 21