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Viewing cable 07NAIROBI369, SOMALIA DART SITUATION REPORT 6 NUTRITION IN
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Reference ID | Created | Released | Classification | Origin |
---|---|---|---|---|
07NAIROBI369 | 2007-01-22 08:51 | 2011-08-24 01:00 | UNCLASSIFIED | Embassy Nairobi |
VZCZCXRO4091
RR RUEHDE RUEHROV RUEHTRO
DE RUEHNR #0369/01 0220851
ZNR UUUUU ZZH
R 220851Z JAN 07
FM AMEMBASSY NAIROBI
TO RUEHC/SECSTATE WASHDC 6855
INFO RUCNSOM/SOMALIA COLLECTIVE
RUEHRN/USMISSION UN ROME 0045
RHEHNSC/NSC WASHDC
RHMFIUU/CJTF HOA
RHMFIUU/CDR USCENTCOM MACDILL AFB FL
RUEKJCS/SECDEF WASHINGTON DC
RUEKJCS/JOINT STAFF WASHINGTON DC
UNCLAS SECTION 01 OF 05 NAIROBI 000369
SIPDIS
AIDAC
USAID/DCHA FOR MHESS, WGARVELINK, LROGERS
DCHA/OFDA FOR KLUU, GGOTTLIEB, AFERRARA, ACONVERY,
CGOTTSCHALK, KCHANNELL
DCHA/FFP FOR WHAMMINK, JDWORKEN
AFR/AFR/EA FOR JBORNS
STATE/F FOR ASISSON
STATE FOR AF/E AND PRM
STATE/AF/E FOR NGARY
STATE/PRM FOR AWENDT, MMCKELVEY
NSC FOR TSHORTLEY
USUN FOR TMALY
BRUSSELS FOR PLERNER
GENEVA FOR NKYLOH
USMISSION UN ROME FODAG FOR RNEWBERG
SIPDIS
E.O. 12958: N/A
TAGS: EAID PREF PHUM PREL SO
SUBJECT: SOMALIA DART SITUATION REPORT 6 NUTRITION IN
SOUTHERN AND CENTRAL REGIONS
NAIROBI 00000369 001.2 OF 005
SUMMARY
¶1. In 2006, nutrition surveys revealed high rates of
malnutrition in Bakool, Bay, Gedo, Lower Juba, and
Middle Juba, while Hiraan, the Shabelle Valley, and
parts of central Somalia had slightly better rates. In
response, the UN Children?s Fund (UNICEF), the UN
cluster lead for nutrition, is scaling-up supplemental
feeding programs and is introducing community
therapeutic care (CTC) initiatives. However, UNICEF
reports that Juba and Shabelle riverine areas and Bay
Region lack sufficient nutritional program coverage.
The USG Disaster Assistance Response Team (DART)
recommends the integration of health, nutrition,
livelihood, and water, sanitation, and hygiene
interventions in order to produce sustainable
achievements in the nutrition sector. End Summary.
¶2. The following cable reviews nutritional trends in
2006, analyzes factors that may affect the food
security and nutritional status of Somali communities
in the coming months, and makes recommendations for
nutrition programs. The DART is closely monitoring the
impact of flooding and conflict on nutritional
indicators as well as the progress of interventions to
improve malnutrition rates in Somalia.
OVERVIEW OF NUTRITION IN SOMALIA
¶3. According to the 2007 UN Consolidated Appeals
Process (CAP), approximately 60,000 children under five
years of age are in need of nutritional support in
Somalia, with the majority residing in southern and
central regions. Somalia?s nutrition indicators
continue to be poor following successive years of
drought, flooding, and conflict. Technical capacity,
community support, and the transition of non-government
supported nutrition programs to a functioning system
under the Somali Transitional Federal Government (TFG)
are primary concerns for the nutrition sector.
¶4. UNICEF is the lead agency coordinating activities
in the nutrition cluster. As the lead agency, UNICEF
monitors and reports on outcomes of nutrition surveys,
identifies geographic priorities for nutrition support
services, makes recommendations for nutrition
assessments and surveys, identifies gaps in nutrition
interventions, reviews and formulates survey
guidelines, and establishes nutrition intervention
policies and priorities. UNICEF works closely with the
UN Food and Agriculture Organization?s (FAO) Food
Security Analysis Unit (FSAU), and other agencies
providing nutritional support services. FSAU routinely
monitors the nutritional status of children through
formal nutritional surveys as well as through sentinel
site surveillance, which highlights trends in
malnutrition levels over time.
¶5. At the January UN nutrition sector meeting, aid
agencies reported that the immediate impact of recent
conflict on the current nutritional situation was
minimal. However, the November-December floods are
expected to have an impact on the availability of food
resources in the coming months because the high water
levels destroyed crops, irrigation canals, underground
food and seed stores, and interrupted transport of
commercial and relief food.
NAIROBI 00000369 002.2 OF 005
RECENT NUTRITION STUDIES
¶6. The emergency thresholds for malnutrition are
global acute malnutrition (GAM) rates exceeding 15
percent and severe acute malnutrition (SAM) rates
greater than 1 percent. According to UNICEF and FSAU
nutrition surveillance reports, across the conflict and
flood-affected regions of southern and central Somalia,
malnutrition rates of 15 percent and higher persist.
¶7. In December, a cluster survey conducted by UNICEF,
FSAU, and the non-governmental organization (NGO)
International Medical Corps (IMC) in El Barde District
of Bakool Region showed a GAM rate of 17.7 percent and
a SAM rate of 3.2 percent, signifying a critical
situation. A similar study conducted in the same
district two years ago showed only slightly lower rates
of 15.7 percent GAM and 1.3 percent SAM. While direct
comparison of the studies is not feasible due to the
different times of the year the studies were
undertaken, the rise in GAM and SAM rates indicates a
trend of increasing acute malnutrition in the region.
¶8. In February 2006, in Wajid District of Bakool
Region, Action Contre la Faim (ACF), UNICEF, and FSAU
conducted a nutrition assessment of 142 children from
two internally displaced person (IDP) camps in Wajid
town. The assessment found 27 percent GAM and 8.6
percent SAM. While the assessment sample was small,
the results did provide alarming information on the
nutritional status of these IDP children. In response,
the UN World Food Program (WFP) commenced food
distribution, and Medecins Sans Frontieres (MSF)-
Belgium assisted the severely malnourished through
their therapeutic feeding program. Research found that
many of these families had migrated from Gedo and Bay
regions during the drought in search of water and
animal fodder.
¶9. In Bay Region, FSAU analyzed nutritional data from
15 sentinel sites that was collected from January 2006
to June 2006. Data from these sites indicated a high
proportion of malnourished children, with GAM rates as
high as 28 percent in Baidoa, Burakaba, and Berdale
districts. While this data is not as accurate as a
formal nutritional survey, it does provide a picture of
the ongoing nutritional situation of children under the
age of five over several months.
¶10. In March 2006, a formal nutrition survey was
conducted in northern Gedo Region that showed rates of
23.8 percent GAM and 3.7 percent SAM. In May 2006,
Bardera town in southern Gedo Region was surveyed and
results indicated a similar situation with rates of 19
percent GAM and 3.9 percent SAM. While this data was
collected at the end of the dry season (after two years
of poor crop harvest), it does highlight the need for
nutritional support programs in this region.
¶11. Lower and Middle Juba regions also have alarming
malnutrition rates. The Juba River basin has suffered
significantly from drought, ongoing inter-clan
conflict, and a paucity of NGO-supported health and
nutrition interventions, which is in part due to
inaccessibility and insecurity. In May 2006, FSAU and
UNICEF surveyed Afmadow District, Lower Juba Region,
and reported 22 percent GAM and 4.2 percent SAM.
During the same month, MSF-Holland conducted a similar
NAIROBI 00000369 003.2 OF 005
nutrition survey in Marere, Middle Juba Region, that
showed rates of 16.2 percent GAM and 4.2 percent SAM.
Also during May and just north of the location of MSF?s
survey, World Vision and UNICEF conducted a nutrition
survey in Sacco District and found rates of 21.9
percent GAM and 6.6 percent SAM.
¶12. In central Somalia, Galgadud District has
malnutrition rates ranging from 15 to 19 percent GAM
and Mudug District 10 to 14 percent GAM. Causes for
these high rates are consistent with those identified
in southern regions, while a stronger social support
system of a more homogeneous clan structure prevents
these rates from worsening.
¶13. In 2006, data from the sentinel sites in Hiraan
and the Shabelle Valley regions show a somewhat better
picture, indicating lower levels of malnutrition when
compared with neighboring regions. These regions had
GAM rates of less than 10 percent. In these regions,
dietary diversity exists; more households consume
micronutrient-rich foods such as fruits and vegetables,
and have low morbidity levels, which are linked to
their healthier nutritional situation.
¶14. In 2006, the nutritional surveys reviewed indicate
critical situations in Bakool, Bay, Gedo, Lower Juba,
and Middle Juba, while Hiraan, the Shabelle Valley, and
parts of central Somalia had slightly better rates.
CAUSES OF POOR NUTRITION IN SOMALIA
¶15. Poor diet and the presence of communicable
diseases contribute to the high malnutrition rates in
Somalia. The high disease prevalence is related to
limited access to preventive and curative health
services, lack of sanitary facilities, and consumption
of water from unsafe sources such as rivers, surface
water, unprotected wells, and water catchments.
Additionally, poor breastfeeding and weaning practices,
lack of diversity in diet, and limited consumption of
fresh fruits and vegetables also contribute to poor
nutrition.
NUTRITION REPONSE ACTIVITIES
¶16. As the lead nutrition agency, UNICEF is currently
scaling-up supplemental feeding programs (SFPs) and has
increased the number of SFPs in Gedo, Bakool, and
Middle Juba regions through partnerships with local and
international NGOs. UNICEF has begun to adopt the CTC
approach to address severe malnutrition and has
partnered with a number of local and international NGOs
to roll out CTC, primarily in southern and central
Somalia. CTC allows mothers of severely malnourished
children to provide ready-to-use therapeutic food to
their children at home, decreasing the burden that
residential care brings to the family.
¶17. IMC, ACF, World Vision, and MSF are some of the
agencies moving away from the traditional residential
therapeutic feeding programs to the CTC approach and
report initial success.
¶18. According to UNICEF, regions in southern Somalia
that remain underserved for supplemental and
therapeutic feeding programs are Juba and Shabelle
riverine areas and Bay Region.
NAIROBI 00000369 004.2 OF 005
¶19. UN agencies and NGOs have recently reported
difficulties in getting supplies to nutrition programs
in Somalia due insecurity and the Kenya-Somalia border
closure. While in-country stocks are adequate for the
short-term, unless stocks are replenished soon,
shortages may occur.
COMPLEMENTARY ACTIVITIES
¶20. Health, nutrition, livelihood, and water,
sanitation, and hygiene interventions need to be
integrated to produce sustainable achievements in the
nutrition sector. For example, increasing access to
safe drinking water will have a direct impact on
community-level health and nutrition status. Nutrition
and health education for mothers on optimal
breastfeeding, weaning, and basic sanitation practices
will also affect family nutrition and household health.
Additionally, increasing access to preventive and
curative health and nutrition services, including
vaccination and maternal child health services, helps
to mitigate high malnutrition rates.
¶21. While it is too soon to determine the full impact
that the flooding and conflict have had on food
security, flood recovery efforts remain a priority for
the humanitarian community, as these will have a direct
impact on household food availability. Recessional
planting, riverbank rehabilitation (a priority before
the onset of the long rains in March), desilting of
wells, decontamination of water points, and rebuilding
of sanitary facilities are complementary activities
that will also help to improve the nutritional
situation in Somalia.
CONCLUSIONS AND RECOMMENDATIONS
¶22. The DART recommends supporting the closer
integration of nutrition, health, and livelihood
initiatives with water, sanitation, and hygiene
activities to enhance the resilience of vulnerable
populations.
¶23. The DART also supports the UNICEF CTC strategy of
treating severely malnourished children through
partnerships with local and international NGOs.
¶24. In 2007, nutrition will continue to be among
USAID?s Office of U.S. Foreign Disaster Assistance?s
(USAID/OFDA) funding priorities along with health,
livelihood, and water, sanitation, and hygiene sectors.
USAID will prioritize funding of multi-sectoral
strategies. An example of a multi-sectoral approach is
a water, sanitation, and hygiene project that uses
well-water runoff for community gardens, which enhance
dietary diversity and provide a source of income for
women selling produce. Another successful approach is
a feeding program that links mothers of malnourished
infants to income-generation activities.
¶25. The DART will continue to monitor nutrition
indicators and support implementing partners in the
nutrition sector. The DART will also closely monitor
nutrition supply stocks and advocate with the UN, the
TFG, the Government of Kenya, and air transport
organizations to facilitate the transport of life-
saving humanitarian supplies.
NAIROBI 00000369 005.2 OF 005
RANNEBERGER