icrc-annual-report-2013

also allowed the ICRC to further expand its assistance activities incentral and southern Somalia.Many communities still faced insecurity associated with the activitiesof military forces and/or armed groups, violations of applicablelaw, such as sexual violence, the presence of mines/explosive remnantsof war, intercommunal tensions and criminal activities suchas banditry and kidnapping. Attacks against patients and medicalservices continued to be reported. In response, the ICRC remindedthe authorities, weapon bearers and other influential players of theneed to protect those who are not/no longer fighting, in accordancewith IHL or other applicable law. It made representations onreported violations urging the relevant authorities to take correctiveaction, fostered respect for the applicable law during trainingsessions for armed forces, including peacekeeping troops, andarranged for public communication and events – using opportunitiesprovided by the Health Care in Danger project and the “150years of humanitarian action” initiative – to underscore the importanceof ensuring the safe delivery of medical/humanitarian aid.Where the lack of resources and attacks against patients and medicalpersonnel and facilities reduced access to health care, the ICRCscaled up its medical activities, as in the CAR, Somalia and SouthSudan, to help local health workers and National Societies addressgrowing medical needs. Victims of abuses, including sexual violence,and other vulnerable people availed themselves of care atprimary health care centres run by local authorities or NationalSocieties with support in the form of funds, supplies, training andinfrastructure improvements. Mobile clinics addressed the healthneeds of people in areas where health structures were non-existent,or closed because of insecurity, as in the CAR and Somalia. Supportwas provided to 34 fixed and mobile Somali Red Crescent clinicsin Somalia and to a stabilization centre for malnourished childrenin Kismayo, notably to fill gaps left by the departure of otherhumanitarian agencies. Health authorities in Harare, Zimbabwe,strengthened their capacities to run 12 polyclinics independently,allowing the ICRC to withdraw its support by year-end.Immunization activities conducted in several countries, includingMali and Niger, helped prevent the spread of disease. Dialoguewith the Mouvement des Forces Démocratiques de Casamance(MFDC) paved the way for State health workers, accompanied byNational Society/ICRC teams, to conduct vaccination campaignsin the Casamance region in Senegal. An ICRC review providedguidance for improving existing services for victims of sexual violencein the DRC; assessments helped define future action in thisfield, for example in the CAR and Mali.People wounded in clashes received first aid from National Societyteams, who also facilitated their evacuation to hospitals and helpedmanage human remains. ICRC medical/surgical teams backed upthe casualty care chain in the CAR, Chad, the DRC, Mali, Nigeria,Rwanda and South Sudan, where up to four teams worked simultaneouslyin order to treat the wounded from all sides. Hospitals werebetter able to cope with mass-casualty influxes, thanks to supplydeliveries and upgraded facilities. Patients needing physiotherapywere referred to ICRC-supported physical rehabilitation centres,as in Burundi, Chad, the DRC, Ethiopia, Guinea-Bissau,Niger, South Sudan and Sudan. An ICRC-supported centre insouth-western Algeria served Sahrawi amputees and other disabledpeople.Vulnerable communities, including where climate shocks exacerbatedthe effects of conflict, benefited from emergency provisions offood, water and other essentials. Across Africa, over 2.1 million displacedor destitute people, including over 800,000 in Mali, receivedfood supplies, often accompanied by hygiene/household items. Inareas with functioning markets in Nigeria and Somalia, familiesexchanged cash or vouchers for food or other items. Where fightinghad damaged water systems, as in the CAR and the DRC, theICRC worked with the local authorities to restore access to water,including by trucking in water, installing/repairing water pointsand providing water treatment chemicals. In Mali, it providedfuel to enable water supply/treatment stations serving three townsto remain operational. It built latrines in areas hosting IDPs tohelp prevent the spread of water-borne diseases. Over 3.9 millionpeople benefited from such activities, enhancing their access towater and mitigating health risks.Although insecurity prevented many communities from resumingtheir livelihood activities, whenever possible, early-recovery initiativeshelped people build their resilience to the effects of conflict/violence.Farmers, including in Côte d’Ivoire, Eritrea, Maliand Niger resumed/improved production using ICRC-suppliedseed, sometimes distributed with food to tide them over until thenext harvest. Pastoralists, as in the Casamance region in Senegal,Somalia, South Sudan and Sudan, maintained their herds’ healthwith the help of livestock treatment/vaccination campaigns conductedby trained/equipped local veterinary workers. Some inMali and Niger sold weaker animals at competitive prices to theICRC, which donated the meat to vulnerable families. Strugglinghouseholds, including in Côte d’Ivoire and Ethiopia, often led bywomen, started small-scale businesses with the help of cash grantsand training. Others supplemented their earnings by participatingin projects to improve irrigation systems or other communityinfrastructure in exchange for cash. Such projects allowed Kenyancommunities previously involved in disputes to work togetherbuilding shared facilities.Whenever possible, assistance activities were designed to mitigatecivilians’ vulnerability to risks. For example, residents in Uganda’sKaramoja region no longer needed to fetch water in unsafe areasafter water points were installed close to villages. In the CARand Sudan, farmers provided with carts were able to transportcrops faster, thus lessening their exposure to risk while travelling.Communities in Libya, Western Sahara and Zimbabwe wheremines/explosive remnants of war continued to pose threats learntsafety measures during National Society-facilitated courses, whilethe authorities were helped to address weapon contamination. Forexample, Zimbabwe mine-action experts drew on ICRC advice todevelop national mine-action standards in line with internationallyrecognized standards.Separated family members restored contact with their relativesthrough National Society/ICRC-run family-links services. Phoneservices enabled IDPs and refugees to re-establish contact withtheir relatives more efficiently. When appropriate, children werereunited with relatives. Those formerly associated with weaponbearers were prepared for reintegration into family/community lifethrough community-based initiatives, as in the DRC. In Angola,the ICRC helped migrants awaiting deportation to contact theirfamilies and discussed their concerns with the relevant authorities.INTRODUCTION | 107