Soaring food and fuel prices are worsening the humanitarian situation in the Horn of Africa, where drought, poverty, and conflict have caused major food and water shortages. Malnutrition is rising in the region and floods are expected in the coming months. Wairagala Wakabi reports.
Humanitarian agencies are reporting a grave situation in the largely arid Horn of Africa region, where conflict, drought, and cattle raids fuelled by the proliferation of illegal guns are placing a worrying number of people—in UNICEF's words—“on the brink of disaster”.
Much of the affected areas have long experienced conflict and perennial food shortages. However, rising food and energy prices, disease, and increasing levels of poverty are exacerbating the situation. According to UN figures, parts of Ethiopia and Somalia are the worse affected, but parts of Eritrea, Djibouti, Kenya, and Uganda are also experiencing similar problems.
“The food crisis, with recurrent disease outbreaks—[such as] acute watery diarrheoa in all Horn of Africa countries—has increased malnutrition risks”, Eric Laroche, assistant director-general for WHO's Health Action in Crises, told The Lancet. The reduced intake of food and the lack of varied diet is leading to malnutrition and micronutrient deficiencies in the population, and subsequently increased morbidity and mortality, especially from communicable diseases.
This year, the food crisis will probably cause an increased demand for food aid. In Somalia, for instance, the number of vulnerable people needing humanitarian assistance has increased by 40% since January, 2008, to 2·6 million people, representing 35% of the country's population.
Findings from WHO's latest nutrition assessment indicate a continuing critical situation with the rates of global acute malnutrition (all types of malnutrition) way above the emergency threshold of 15%, at between 18% and 24%. According to UN officials, the situation is likely to deteriorate in the coming months, resulting in a humanitarian emergency for 3·5 million people.
Per Engebak, UNICEF's regional director for east and southern Africa, said national governments and international partners need to take committed and decisive actions to mitigate the multiple threats to children and families in the Greater Horn of Africa. “The signs are there, and governments and international partners must heed them and act on them”, he said.
Engebak said Uganda was recording a new wave of malnutrition in the Karamoja region, which had endured flooding, drought, and devastating animal diseases, with malnutrition rates above 15%. “Malnutrition will add to the burden of children in the area who face high levels of malaria and pneumonia and where child mortality is already 30% higher than the national average”, Engebak said.
Karamoja, an area along the borders of Sudan, Uganda, and Kenya, is testimony to the grim effects of the confluence of conflict, aridity, and food shortages. The area faces a vicious climatic pattern of drought that spells peril for its nomadic population. It has a high saturation of illegal guns, testimony to conflicts that have persisted here for decades, and the culture of armed cattle raids is rampant among nomadic groups in Kenya, Sudan, and Uganda.
With a drought which has persisted for months, the closest things to green that can be spotted throughout this expansive area are the leafless thorny acacia trees. The rest are dirt roads and parched grazing fields. North of Uganda's Karamoja area is Sudan, where drought is wreaking havoc and where war ended 3 years ago. To the east are the semi-arid Turkana and Pokot areas of Kenya, experiencing similar circumstances, and the pattern goes on through to Somalia, Ethiopia, and Djibouti.
The rains will provide some relief in the coming months. But they bring their own problems: large-scale flooding and outbreaks of diarrhoeal diseases, measles, and meningitis are expected.
Meanwhile, the current drought in Karamoja, the worst in decades, has left a harrowing spate of hunger and death. “The worst spell of drought this region has ever seen is upon us”, said Andrew Leru, administrator of Kotido district in Karamoja. “It has not rained since August-September last year.” The few health centres in this remote region can no longer cope with the demands placed upon them. At the St Kizito Hospital Matany—the largest hospital in Karamoja which can accommodate 260 patients—records indicate that a consistently rising number of patients are being admitted with severe malnutrition. They are mainly children, mothers, and elderly women.
Six countries form the Greater Horn of Africa
In the coming months rains are expected to cause flooding in the Horn of Africa
In the first 3 months of this year, the average monthly figure of patients admitted with severe malnutrition was 25. Since April, it has risen to 53, with a staggering death statistic, of 16%, as opposed to 8% that was recorded in 2007 when the monthly patient average was 23. According to the records, a total of 405 marasmus and kwashiorkor patients have been admitted at the missionary hospital since late last year, 63 of whom have died.
“We receive acute cases of children who are extremely malnourished. And the number has been rising in Moroto and Nakapiripirit districts. It is now at 16%, which according to WHO criteria means that this is a crisis”, the hospital's superintendent James Lemukol told The Lancet. “The current death rates have also doubled compared to 2007”, he added.
The drought, hunger, and associated health problems being faced in Karamoja are a microcosm of the situation in much of the Horn of Africa. In Ethiopia, 4·6 million people need emergency food aid through to the next harvest in November, and the government says 75 000 children already have the most severe form of malnutrition. Humanitarian workers said that the number of people who needed food assistance was increasing noticeably, and their situation is further worsened by health risks, the effect of drought on agricultural production, and the country's weak health system.
Besides, the soaring cost of basic commodities had compounded the crisis, with high prices and a lack of food supplies in Ethiopia forcing the World Food Programme (WFP) to bring in food aid from such sources as South Africa and the Black Sea region. The agency estimates that the cost of white maize in the country—the staple food for most poor people—has risen more than 150% over the past year.
Across from Karamoja into Kenya's Pokot region, global acute malnutrition rates jumped from 19% to 28% in July. “People cannot afford food, as prices are going up every passing day”, said local leader Billy Kamket. He explained that it was also becoming increasingly hard to get water for people and their livestock, “and the deteriorating condition of the livestock means that our livelihoods are under greater strain”.
Most of the residents in semi-arid Horn of Africa depend on land and livestock, but both have been ravaged by the drought. Cattle keepers were being forced to sell their livestock to buy food, while the drought and pasture shortages resulted in greater clashes between rival pastoralist groups. At the end of July, up to 30 people were killed in Kenya's north-western Turkana region in clashes between Pokot and Turkana pastoral communities over scarce pasture and water sources for livestock.
In Djibouti, where there is a high population of nomadic pastoralists, drought has taken a heavy toll on the livestock, with 40—70% dying in various parts of the country, according to WFP. It added that food insecurity had forced the nomadic people to cut the number of meals they ate per day and reduce the quality of the food they consume.
Observers say that the high inflation affecting most countries in the Horn of Africa region for energy and basic food commodities was hitting both rural and urban households hard, and that this posed new challenges to governments and humanitarian organisations, as response strategies to the food crisis in rural and urban areas generally differed substantially.
According to WHO officials, diseases related to malnutrition such as diarrhoea, and pulmonary, eye, and skin infections were increasing among children in areas affected by food shortages. Recent years have also seen increases in acute watery diarrhoea and cholera in many of the countries.
Humanitarian workers are urging donors to provide increased support for nutritional interventions targeting women and children. In particular, they said that breastfeeding and appropriate maternal nutrition for pregnant and lactating mothers, supplementary and therapeutic feeding, nutrition and school-feeding programmes were needed. Additionally, they are encouraging donors to provide increased assistance to the health, nutrition, and water and sanitation sectors, although they lamented that appeals for funding were not receiving sufficient donor support.