Lifesaving health services to conflict IDPs and host communities in Gedeo, SNNPR and West Guji, Oromia Region In August 2018, following extensive peace and reconciliation efforts related to the Gedeo/West Guji conflict, the government began to facilitate the return of IDPs from the areas of displacement back to their kebeles of origin.  Despite the return efforts many of the displaced are affected by damaged or destroyed houses, loss of livestock and a missed planting season and as a result many of the returnees are living in collective centers in their woredas or kebeles of origin because they were not able to move back to their homes. In addition to the status of the displacement and return some of the health facilities in the affected woredas were damaged in the conflict, are providing limited services and there is insufficient capacity of the temporary clinics and mobile health and nutrition teams to provide primary health services to the return population which increases the risk of the spread of communicable disease in the host and IDP communities. According to estimates from the Emergency Operating Centers in Gedeo and West Guji there are now 294,565 IDP/Returnees (and 979,323 in the host community at risk) in West Guji and 145,856 IDPs still in Gedeo (with 1,165,796 host community at risk) and so after the return the community at risk is now approximately 50% in each zone.
The project will address the increased risk of communicable disease by supporting the strengthening of zonal PHEM to carry out health surveillance/early warning, rapid response and containment as well as operational support for rapid response mechanism for the two affected zones of Gedeo and West Guji. The project will provide DSA and logistics for rapid response teams so that they can immediately investigate outbreak alerts. The project will also strengthen the rapid response by providing refresher training for zonal PHEM surveillance/early warning teams in the two-targeted zones on the integrated early warning system, maintenance of the database of PHEM alert and investigation operations using the standard recommended format (national and WHO). This includes information on the date/time of the notification, date time of the event and lag time until investigation initiated, alert type, number of cases and deaths, samples, numbers, laboratory results (and the lag time) and interventions carried out. 
The project will also support the deployment of additional health teams (static and mobile) through a regional/zonal surge mechanism to support the overburdened existing services in response to the increased demand. Medicines and medical supplies will be procured and logistics will be provided to fill in for increased consumption and present shortages to support services to the conflict affected communities in Gedeo and West Guji. Additionally, the project will preposition CTCs, provide a surge stock for AWD and identify staff for eventual re-purposing in both zones. The AWD surge stock provided by WHO 1 month ago has been depleted, as it was used to treat the excess load of other diarrheal diseases. The medicines and medical supplies necessary for the response to an AWD outbreak will also support the treatment of increasing number of endemic communicable diseases that threatens to reach epidemic levels especially among the most vulnerable conflict affected communities and IDPs. Laboratory supplies from sampling material, rapid diagnostic tests to reagents for confirmation of cases ensures that the treatment is the most appropriate and in accordance with national guidelines.