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Somalia: malnutrition in young children on the rise

23-04-2010 Operational Update No 02/10

Ongoing fighting and recurrent droughts have left many Somalis, especially young children, without enough food and medical care. Malnutrition rates in central and southern Somalia are extremely worrying. Indiscriminate fighting in Mogadishu has resulted in many civilian casualties.

  General humanitarian situation  

The humanitarian situation in Somalia remains very precarious. Fighting between government forces and opposition groups, and among the groups themselves, is dragging on and raising concerns about the population's security to a new level. Drought in central Somalia continues unabated as people wait for the gu rains to begin, which should happen in April or May. So far, indications are that these areas are not going to have a good rainy season. Luckily, the southern and northern parts of the country received substantial, though early, rains.

Four years of drought in the central region have depleted cattle herds and significantly reduced the number of goats and sheep. Camels are getting weaker and are starting to die in numbers. This is extremely worrying, because they serve not only as a source of milk and meat but also as the main means of transportation for pastoralists. The situation has resulted in widespread poverty among civilians, pushing tens of thousands to seek refuge with already overstretched family members in cities, or in camps for internally displaced people (IDPs).

Because so many livestock have perished, and the animals still alive scarcely produce any milk or have any market value, basic foods such as vegetables, meat and milk needed for a properly balanced diet have become virtually unobtainable. Markets are almost empty and prices of the few available items are forbiddingly high. All this culminates in worryingly high numbers of young children suffering from severe acute malnutrition, a condition defined by a very low weight for height, by visible severe wastin g, or by the presence of nutritional oedema. According to data collected in the 34 Somali Red Crescent clinics across southern and central Somalia, the number of severely malnourished children receiving treatment more than doubled between February and March.

In Mogadishu, fighting has continued unabated. The use of indiscriminate weaponry such as mortars has taken a heavy toll on the civilian population. Hundreds of civilians have been killed as a result of the fighting and many more have suffered severe wounds requiring surgery in one of the few medical facilities in the city where operations can still be performed. Between January and mid-April, 1,900 weapon-wounded patients were admitted to both ICRC-supported hospitals in Mogadishu, Keysaney and Medina.

The ICRC is concerned about the situation and is monitoring it closely. Together with its primary partner, the Somali Red Crescent Society, it is working to improve health care, nutrition, water supply and crop productivity.

" Where we have been able to independently observe and verify needs, we also carry out emergency food distributions, " said Pascal Mauchle, who heads the ICRC delegation for Somalia. " The distributions are limited in scale and of short duration – they do not replace aid provided by other humanitarian organizations. "

 
Helping severely malnourished children  

Earlier this year, with ICRC support, the Somali Red Crescent launched a new outpatient therapeutic feeding programme for malnourished children in Dhusamareb, central Somalia, and reinforced its three existing facilities in the central part of the country, in Abudwak, Galinsoor and Adado (Galgaduud region). The ICRC provided measuring equipment, medicine and other items, and trained staff in order to better cope with the continuous influx of patients. Three hundred ch ildren suffering from malnutrition were successfully cured in Galgaduud in the first quarter of the year. The feeding programmes continue to expand, with Somali Red Crescent staff and volunteers conducting screening and other activities in rural communities where no facilities are available.

" My child was so weak and she refused to eat or be breastfed, " explained Kahdija, one of the mothers benefiting. " I took her to the clinic and they managed to get her to eat. Now she is healthy and happy. I can't believe it. "

In March, together with the Somali Red Crescent the ICRC distributed two-month food rations to 60,000 people in the Abudwak district of central Somalia to meet urgent acute needs. It also provided supplementary food for 4,800 children.

" The aim of the supplementary distribution was to reduce the levels of acute malnutrition in the district, which were critically high – approximately 30% – prior to the launch of the therapeutic feeding programmes, " explained Hilary Floate, ICRC nutritionist for Somalia.

The ICRC also trained staff and launched five new outpatient therapeutic feeding programmes in Lower Juba, in southern Somalia, where levels of severe acute malnutrition have been consistently high over the past two years. The programmes are much appreciated by the communities they serve, especially because there are few health-care facilities in the region.

 
Increasing productivity  

The ICRC distributed seed to 40,000 farming households – 240,000 individuals – in all parts of southern and central Somalia to help them increase their crop production so that in the long run they can provide for themselves again. Increased productivity should also result in the creation of jobs in areas where very few are available. In order to ensure that the seed is actually planted rather than consumed as food, the ICRC distributed two-month food rations to the same households.

The organization also helped people with access to land but unreliable water supplies by providing them with irrigation pumps and upgrading irrigation canals. In addition, cash-for-work programmes were started in various parts of southern and central Somalia to give poor people some needed wherewithal.

 
Providing water for drought-stricken communities  

As drought has left more and more people in the central regions distraught and increasingly destitute, the ICRC has had to resort to delivering water by truck.

" Water trucking is not a sustainable way to provide water, " said Alexandre Farine, the ICRC's water and habitat coordinator for Somalia. " But in an emergency situation it is the only option until more long-term solutions can be found. "

The water benefited more than 283,000 residents and displaced people in the Hiraan, Galgaduud and Mudug areas. Meanwhile, a new borehole was drilled in Qodaxtoole, in the Hobyo district of Mudug, which could eventually provide water for up to 5,000 people and their livestock.

Since the beginning of 2010 the ICRC has completed 10 infrastructure projects providing water for some 54,000 people in four regions.

 
Providing basic shelter for the newly displaced  

As fighting in and around the capital Mogadishu intensified at the start of the year, many people were forced to flee from their homes. In order to provide the displaced with at least the bare minimum they needed to survive, the ICRC distributed household essentials such as kitchen sets, blankets and tarpaulins to 48,000 people.

As drought has exhausted ever more water sources and pasture areas in Mudug, rival clans have clashed with each other over diminishing resources. The fighting has been particularly fierce in the Ba'adweyn area, in Mudug, where it has resulted in serious loss of life and in further displacement. The ICRC has provided some 12,000 displaced people with basic household items.

 
Protection of the civilian population  

The ICRC remains deeply concerned about the devastating effects of the ongoing fighting on the civilian population.

All warring parties must comply with the rules of international humanitarian law. In particular, they must distinguish between civilians and civilian objects on the one hand, and persons taking a direct part in hostilities and military objectives on the other. Attacks may be directed only against persons taking a direct part in hostilities and against military objectives.

Warring parties must take all feasible precautions, particularly in the choice of means and methods of warfare, to spare the civilian population and civilian objects, including medical facilities. Respect for these elementary rules is especially important in densely populated areas, where the use of weapons such as artillery and mortar shells has proven particularly devastating.

The ICRC and the Somali Red Crescent again call for greater respect for international humanitarian law as a means of protecting the civilian population.

  For further information, please contact:
  Nicole Engelbrecht, ICRC Geneva, tel: +41 22 730 22 71 or +41 79 217 32 17
  Hugo van den Eertwegh, ICRC Nairobi, tel: +254 20 272 3963 or +254 726 844 984