SHO Famine Response Somalia Gedo is among the most drought affected regions of South Central Zone in Somalia. Many of the agro-pastoral rural communities have lost their animals and crops, and moved to urban areas to access humanitarian aid. This is especially the case in Dollow and Luuq districts where Cordaid through Caritas sister organisation Trócaire operates; UNOCHA report indicates that more than 3,000 new households have arrived and settled in the IDP camps in Luuq and Dollow. Others have crossed over to Ethiopian refugee camps near the shared border. The majority of these households are from Bay and Bakool regions, as well as rural Gedo. The effects of this intensified movement and settlement are many; among them is the congestion in the IDPs camp related to shelter supply, poor hygiene and sanitation coupled with poor access to safe water. The rivers have almost dried up, and the water in boreholes has turned very saline for human consumption. Consequently, cholera outbreaks in the region have been ongoing since late February 2017. These began in Garbaharey district and rapidly spread to other districts due to the movement of people. Since the first outbreak incident in late February, a total of 3,677 cases have been reported, of which more than two thirds (2,503) of the cases were treated in Trócaire-managed cholera treatment centres (CTCs). Luuq and Dollow districts were the worst hit with 1,289 and 1,214 cases having been managed to date, which included 36 deaths (the majority were children under the age of five years). In the past two weeks, the admissions have drastically reduced from an average of 20 admissions in the early days of the outbreak to an average of 3 – 4 admissions in a day at all CTCs. The exception is in Dollow where the numbers (between 3 and 10 admissions per day) are still fluctuating despite the significant reduction in new admissions. In addition to the cholera outbreaks, malnutrition rates have skyrocketed compared to 2016. The number of sick children admitted to hospital with severe malnutrition has tripled in the last 3 months. Outpatient consultations have also increased with more cases of malaria, pneumonia, diarrhoea and skin infections being seen. During this reporting period, Trócaire met with international organizations acting in Gedo to discuss a strategic approach to cholera treatment/prevention preparedness and response for the region. Best practices for prevention and control of cholera outbreaks were identified to help with the intervention. Community sensitization campaigns were also carried out on AWD/cholera prevention using public address systems in the regions affected. Following the cholera outbreaks, Trócaire lobbied other stakeholders to provide support in setting up and running the CTCs. Some of the stakeholders who have supported include: · International NGOs such as World Vision International and MSF Spain, who supported in building structures for the CTCs; · Local organizations such as Somalia Humanitarian Relief Action (SHRA) and the Elbon Development Relief Organization (EDRO) who supported hygiene promotion and prevention activities; · Local authorities which supported with security for staff and fuel for patient referrals; · The regional government supported with food stuff for patients; · The MOH supported with medical supplies as well as technical expertise; · Local communities and business people supported with food stuff, building materials as well as beds and mattresses for caregivers.