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Cablegate: Somalia - Further Nutritional Decline

R 150949Z JUL 08
FM AMEMBASSY NAIROBI
TO SECSTATE WASHDC 6459
INFO SOMALIA COLLECTIVE
USMISSION UN ROME
USMISSION USUN NEW YORK
NSC WASHDC
CJTF HOA
CDR USCENTCOM MACDILL AFB FL

UNCLAS NAIROBI 001732

AIDAC

USAID FOR DCHA/AA MHESS, GGOTTLIEB
AFR/AA KALMQUIST, EGAST, CTHOMPSON, JCICCARONE
DCHA/OFDA FOR KLUU, CCHAN, ACONVERY, PMORRIS, KCHANNELL
DCHA/FFP FOR JBORNS, JDWORKEN, SANTHONY, PMOHAN
DEPT FOR AF/E AND A/S FRAZER

E.O. 12958: N/A
TAGS: EAID PHUM PREL PREF SO
SUBJECT: SOMALIA - FURTHER NUTRITIONAL DECLINE

REF: Nairobi 1128


-------
SUMMARY
-------

1. Increased levels of malnutrition and food insecurity have
deepened the humanitarian crisis across Somalia. Chronic emergency
levels of malnutrition are exacerbated by rising food prices,
below-normal April-June (gu) rainfall, poor rainfall distribution,
market disruptions, protracted conflict, and limited humanitarian
access. The results of a recent series of nutrition assessments
indicate that the region is suffering from continued high rates of
malnutrition, with further deterioration in some areas.
Humanitarian agencies expect nutrition conditions to further worsen
during the mid-June to mid-September dry season. In June, USAID's
Office of U.S. Foreign Disaster Assistance (USAID/OFDA) provided USD
2 million to the U.N. Children's Fund (UNICEF) to support innovative
projects to prevent malnutrition, as well as to augment current
therapeutic and supplementary feeding programs (reftel) and
integrate nutrition, health, and water, sanitation, and hygiene
interventions. End summary.

-----------------
CURRENT SITUATION
-----------------

2. In early July, the U.N. Food and Agriculture Organization's Food
Security Analysis Unit (FSAU) for Somalia released the results of 11
nutrition assessments conducted by FSAU, NGOs, and U.N. agencies in
May 2008 in Shabelle, Gedo, Bakool, Hiran, and Nugal regions. The
FSAU report indicated that acute malnutrition rates in central and
southern Somalia remain persistently high and have further increased
in some areas. According to FSAU, a variety of factors are causing
the poor nutrition situation, including conflict, drought, high
incidence of diarrhea, poor breast-feeding and weaning practices,
rising food prices, and insufficient access to clean water, adequate
health care, and sanitation facilities.

3. FSAU and partners assessed survey participants by region and
livelihoods group, such as riverine agrarian, pastoralist,
agro-pastoralist, internally displaced person (IDP), and urban
dweller. This approach highlighted the different food security and
nutritional concerns among the various livelihood groups.

4. The most significant deterioration in nutrition conditions
occurred in Bakool Region, where the May 2008 assessment identified
global acute malnutrition (GAM) rates of 24.1 percent and severe
acute malnutrition (SAM) rates of 3.2 percent, in comparison to 14.3
percent GAM and 3.4 percent SAM recorded in November 2007. The FSAU
report also indicated a deterioration in nutrition levels from
critical to very critical among riverine and pastoral populations in
Gedo Region. The nutrition situation among agro-pastoralists and
IDPs in the Shabelle regions and among agro-pastoralists in Gedo
Region remained stable, but critical.

5. Both crude mortality and child mortality rates among riverine
households in the Shabelle regions and assessed populations in Adale
District, Middle Shabelle Region, were above the U.N. World Health
Organization (WHO) alert thresholds of one death per 10,000
individuals per day and two deaths per 10,000 children under five
per day, respectively. The crude mortality and child mortality
rates in Adale District were 1.31 and 2.43 deaths per 10,000
individuals per day, respectively. The crude mortality and child
mortality rates among riverine Shabelle households were 1.39 and
2.20 deaths per 10,000 individuals per day, respectively, presenting
no improvement from previous assessments. Crude mortality and child
mortality in other assessed locations remained stable and below the
WHO alert threshold. According to UNICEF, water-borne diseases due
to lack of adequate water, sanitation, and hygiene constitute 20
percent of mortality among children under five in Somalia.

-------------------------------------------
MULTIPLE FACTORS, MANY LAYERS TO THE CRISIS
-------------------------------------------

6. Local, regional, and global factors are contributing to
malnutrition in central and southern Somalia. These factors include
drought, rising global and local food prices, trade disruptions,
conflict, and limited access for humanitarian agencies, as well as
early infant weaning, insufficient breast-feeding, poor infant and
child-feeding practices, and inadequate access to safe drinking
water and sanitation facilities.

7. In each assessed community in southern and central Somalia, FSAU
reported that the lack of dietary diversity, poor child feeding
practices, and poor water, sanitation, and hygiene conditions were
associated with high rates of acute malnutrition. Early
introduction of complementary foods and early infant weaning, as
well as inadequate treatment of childhood diseases, are factors
contributing to malnutrition in children under five years.

8. Drought and food insecurity are also major contributing factors
to malnutrition in Somalia. According to the USAID-supported Famine
Early Warning Systems Network (FEWSNET), approximately 2.6 million
people in Somalia are experiencing high or extreme food insecurity.
Relief agencies are preparing for a worst-case scenario in which up
to 3.5 million food insecure Somalis will require livelihood support
or emergency assistance by the end of 2008.

9. FEWSNET projects that the poor performance and distribution of
the recent long rains will result in a below-average cereal harvest.
Successive seasons of poor cereal production in key agricultural
areas, as well as reduced cereal imports, have reduced available
staple foods and contributed to sharply rising cereal prices. Since
April 2008, cereal prices have risen between 35 and 45 percent in
local markets. As of June 30, maize prices in the Shabelle regions
and Juba regions were between 302 and 405 percent higher than the
five-year average. Rising global food and fuel prices, as well as
limited regional food availability, compound the problem.

10. In March and April 2008, FSAU and partners conducted a rapid
urban food security and nutrition assessment in 27 towns throughout
Somalia to determine the impact of increased food and non-food
prices on urban populations. The assessment concluded that the cost
of minimum food and non-food commodity expenditures increased
between 55 and 130 percent from March 2007 to March 2008. FSAU is
currently repeating the assessment in 60 urban sites throughout
Somalia, with results expected by late July.

11. In addition, the deteriorating security situation and continued
targeting of national and international relief workers present
significant challenges to humanitarian interventions (to be reported
septel). According to the U.N. Office for the Coordination of
Humanitarian Affairs, 82 incidents of looting or attempted looting
of food aid have occurred to date in 2008. In late June, CARE
International, an NGO with a significant role in food distribution,
suspended all operations in Galgadud, as a result of the abduction
of a CARE staff member on June 14.

--------------
USAID RESPONSE
--------------

12. In response to the escalating malnutrition rates, USAID/OFDA is
working with UNICEF to scale up supplemental and therapeutic feeding
programs throughout Somalia. USAID/OFDA has also provided funding
to Merlin, Mercy USA, and International Medical Corps to initiate
new and expand existing feeding programs for malnourished children
in affected regions of central and southern Somalia.

13. In addition, USAID/OFDA provided USD 2 million to UNICEF for an
innovative, preventative approach to malnutrition in the Shabelle
regions and Bossaso IDP camp utilizing ready-to-use foods (RUF).
UNICEF estimates that 30-40 percent of all moderately or severely
malnourished children in Somalia reside in the Shabelle regions.
UNICEF plans to reach at-risk children from 6 to 36 months old with
the preventative RUF product Plumpy-doz, water purification tablets
for home water treatment, and oral rehydration salts for early
treatment of diarrhea. UNICEF also plans to conduct nutritional
screenings during the distributions and provide hygiene education
for families, community leaders, and community health workers.

14. USAID's Office of Food for Peace has recently provided an
additional USD 90 million to CARE and WFP for expanded food aid
programs (reftel), bringing total fiscal year (FY) 2008 funding to
approximately USD 200 million compared to USD 35 million in FY 2007.
In many parts of South/Central Somalia, WFP is working through
supplementary feeding centers in collaboration with UNICEF to
provide family rations and ensure a more integrated approach to
addressing high malnutrition.

15. USAID/OFDA will closely monitor the success of this integrated
intervention to determine if it is a cost-effective, replicable
strategy for potential use in other regions of Somalia. As
highlighted by FSAU, UNICEF, WFP, and FEWSNET, the answer to the
escalating malnutrition rates in Somalia is not food aid alone, but
rather a coordinated approach by donors, government, and aid
agencies to improve access to and availability and utilization of
food, while at the same time increasing access to adequate health
services, clean water, and sanitation.


SLUTZ

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