Somalia: rainfall brings some hope for the next harvest
The situation in Somalia remains tense. The onset of rains in the southern and central regions has brought some hope for the next harvest. In the meantime, people are still struggling to access food. Hilary Floate, ICRC nutritionist for Somalia talks about the challenges of trying to improve the nutritional status of thousands of children.
Can you describe the situation in Somalia today?
After an extended dry spell that started at the end of last year, rain is finally falling in central and southern Somalia. The farmers planted cereals and vegetables and are hoping to harvest in January. For the time being however, access to food remains extremely difficult. Prices are still high and many families cannot afford to buy what some of the local markets have to offer.
Grassland is now more available for livestock. But most of the animals are very thin and many have already died due to the lack of pasture. The rain has brought some hope for a brighter future. But however good the harvest might be, Somali agriculture cannot produce enough food to cover domestic needs. In the best-case scenario, only half the needs can be met. And it would take years to replace the lost cattle. The population will remain dependent on aid for some time to come.
How can a nutritionist help?
A nutritionist analyses the access a given population has to food. He or she assesses interruptions in the food supply chain such as a bad harvest, and the impact this might have on the nutritional status of a population. It could for example result in high prevalence of acute malnutrition in children under five, which is the case in Somalia.
Whenever there is a breakdown in the food supply chain, the nutritionist helps determine the most appropriate intervention to increase food production and to create livelihood opportunities. Examples are seed and tool distributions, agricultural services like ploughing or a livestock programme. The treatment of acute malnutrition, for example, through supplementary feeding, is also part of the nutritionist's responsibility.
What do you do to respond to food insecurity in Somalia?
The ICRC supports 27 fixed outpatient therapeutic feeding centres and 13 mobile health teams run by the Somali Red Crescent Society in southern and central Somalia, where children under five who are suffering from severe acute malnutrition are being treated. Overall, more that 13,000 children are currently benefiting from the outpatient therapeutic feeding centres. Six thousand pregnant women and those who are breastfeeding also receive therapeutic food, which helps increase the weight of their babies.
Together with the SRCS, we also launched 11 wet feeding programmes targeting moderately malnourished children plus one caregiver, with cooked supplementary porridge provided twice a day. Health care and hygiene promotion activities are also provided at each of the sites. Over 25,000 children have benefited from the wet feeding programme in October.
The families of children under treatment in the feeding centres also benefit from general food distributions, which are currently underway in southern Somalia. The food distributions prevent families from sharing therapeutic food amongst themselves, so that they keep it all for the children suffering from severe acute malnutrition.
What exactly is "acute malnutrition"?
There are two main types of acute malnutrition, termed marasmus (wasting) and kwashiorkor (oedema). A child with marasmus appears with severe weight loss (frequently with a distended and bloated abdomen) and the child with kwashiorkor appears swollen (due to excessive fluid) and will frequently present with a distended abdomen. Marasmus can be either moderate or severe malnutrition -- depending on the anthropometric (size and proportion) measurements of the child, whilst kwashiorkor is always classified as severe. Children with severe acute malnutrition require both medical support and nutritional rehabilitation to recover.
What are the chances of survival for children?
A child who is admitted in one of our therapeutic feeding programmes has more than a 90 per cent chance of recovery from severe acute malnutrition. It takes between 40 and 50 days on average to cure a severely malnourished child.
The highest risk for a child with severe acute malnutrition are infections, which can prolong the recovery and lead to medical complications. It is essential to identify these cases and refer them first to an inpatient facility, where they will be closely followed for a minimum of one week. We ensure that our therapeutic feeding centres are strategically close to such specialized facilities and we provide transport. At the moment, we transfer eight per cent of new admissions to such facilities. The figure usually decreases two or three months after we open a new centre, as we can generally treat the severely malnourished child before complications occur.
Do you think the situation is likely to improve within the next few months?
Unfortunately, the harvest is not likely to alleviate the prevailingly high malnutrition rates. There are other factors like poor health care, poor water and sanitation conditions, poor mother and childcare practices that also cause malnutrition and remain present. You cannot solve the problem with one good harvest alone.
What makes me nevertheless optimistic is the dedication of the nutrition and medical staff from all the regions in which we implement nutrition programmes, whom I have met for training sessions in Mogadishu. They work extremely hard around the clock. Many sacrifice their personal lives to alleviate the suffering of their people. Many of them could have a better life abroad but decided to stay. The attitude and motivation of these people to turn things around is definitely a reason to hope for the better in spite of all the difficulties that the population is facing.