Diseases Associated with Malnutrition Are Likely to Increase

Ethiopia

April 2000

at a glance

• at least 4 million children will suffer from food shortages this year; the situation in most critical in Somali region where 3-5 people are reported to be dying every day
• diseases associated with malnutrition are likely to increase.
• the cumulative impact of consecutive droughts and crop failures is pushing more and more families into poverty and destitution.

• in 1999 Save the Children provided over 36,000 metric tonnes (MT) of food aid. This year, the organisation has already secured and is distributing 16,500 MT of food and has applied for a further 37,000 MT
• 4 nutritional teams have been deployed to some of the most vulnerable areas in the north to closely monitor the situation of children
• Save the Children has approached donors for supplementary food for 8,000 children and therapeutic food for 1,000 malnourished children
• The organisation is implementing strategies that help Ethiopia to overcome its food security problems in the longer term.

current crisis

Ethiopia again faces a famine. The situation is most critical in the south where about two million people are at risk and there are already reports of starvation: in parts of Somali Region 5, 400 people died in March and at present 3-5 people are dying every day. However, there is also deep concern about the situation in the northern and eastern highlands, where five million people will soon be at risk of famine unless food aid is provided now.

In January the government issued an appeal for 900,000 MT of food aid, the largest issued since 1992, a particularly bad year. It covers the needs of 8 million people affected by drought and by the conflict with Eritrea. The current crisis is not new – it is the result of a succession of poor harvests, combined with increasing poverty and destitution.

the southDrought, combined with on-going difficulties with access to water, has had a devastating impact on the pastoral rangelands in the south. There is now an advanced emergency in parts Somali Region (principally Gode Zone), and in the Borena and Bale Zones of Oromiya Region. People are moving to towns in search of assistance and aid workers report severe malnutrition and deaths from starvation.

This immediate cause of the crisis in the South is the failure of the deyr rains in October-November. This caused a loss of grazing land and severe shortages in water for human and animal consumption. In addition, crop production in rain-fed areas has been insignificant for the past two years. The death toll of livestock has been extraordinary: at least 90 per cent of cattle and 65 per cent of sheep have already died in some areas. There has also been a decline in livestock prices due to their poor condition, diminished demand for livestock in local markets, and a corresponding increase in cereal prices. (Cereals form the major part of the nomadic diet during dry season.)

In the highly-populated Northern and Eastern Highlands the current crisis is the result of a complete failure of the belg rains (February-May) in 1999. This year’s belg is now quite late and is forecast to be erratic, compounding the problem still further. This is the fourth consecutive year that these vital rains have failed.

The failure of the 1999 belg led to crop and livestock losses in North and South Wollo, South Tigray, North Shoa, East and West Hararghe. Yields for the main kremt season (July-November) throughout the country also suffered. Food aid distributed through 1999 and this year helped to prevent a deterioration in nutritional standards.

Given the lack of rain earlier in the season, many farmers were unable to plant high-yielding, long-cycle crops. Some farmers in the highlands attempted to make up for a failed belg by planting short-cycle varieties. However, in the high altitudes these crops are vulnerable to extreme weather conditions such as heavy rain, frost and hail.

The 350,000 people displaced by the war with Eritrea are particularly vulnerable to food shortages – the majority are entirely dependent on relief assistance. In 1999, less than two-thirds of the food needed reached the displaced in Tigray, resulting in a food basket that was both inadequate and unbalanced. Save the Children undertook a nutritional and food security assessment of the displaced in August 1999. The survey found “acceptable” levels of child malnutrition, but a high risk of malnutrition and morbidity among younger children.

The immediate cause of Ethiopia’s crisis is 3 years of drought, but the current food shortages are also a symptom of more deep-rooted problems. Increasing poverty and destitution has pushed several millions of families in Ethiopia to the limit.They can barely sustain themselves, even in a good year. Many families are now without livestock, and plough oxen and seeds to farm their land. They are increasingly vulnerable to any fluctuation in the weather. Unless these underlying issues are tackled, food crises will continue to occur for many years to come.

Research by Save the Children suggests that families in vulnerable areas are becoming poorer and that many have exhausted all their normal coping mechanisms. This trend is affecting all income groups: wealthier households have been forced to sell-off their herds, have stopped hiring agricultural labourers, and have started collecting water and firewood themselves rather than employing others to do it for them. This has had a knock-on effect on poorer income groups who normally depend on wage labour.

Distributing food to those in need is hampered by two factors. First, although substantial food aid has been promised (approximately 570,000 MT has been pledged so far), very little has actually been delivered. Following the 1984/85 famine Ethiopia established an Emergency Food Security Reserve to act as a buffer. However, the Reserve currently at a critically low level, containing just 51,000 MT of stock of which 43,000 MT is being withdrawn. This is less than is required for a single month’s distribution. Donors have now promised substantial deliveries in April, May June and July – over 100,000 MT is due each month – and this will go some way to alleviating immediate food needs.

Second, even if food is delivered, getting it into the country and distributing it to remote regions is problematic. Ethiopia has lost access to Massawa and Assab ports in Eritrea. However, substantial investment in Djibouti has increased its capacity, and the World Food Programme is also exploring the possibility of using the port of Berbera in Somalia.

Last year, the maximum monthly distribution within Ethiopia was 64,000 MT, and this amount severely stretched available trucking capacity. This year, up to 120,000 MT in a single month will need to be distributed - and this does not include stocks that must be pre-positioned before the main rains start in July, when roads become impassable.

background

Ethiopia is one of the poorest countries in the world with appalling poverty and large areas permanently vulnerable to food insecurity. It has the world’s lowest average income - just $100 per person per year – and the government faces an external debt of more than $10 billion, equivalent to 131 per cent of GNP.[1] More than half the population lives below the poverty line, and about 30 per cent live in absolute poverty.

Food insecurity remains the principal obstacle to development in Ethiopia. Agriculture is the mainstay of the economy, but over a third of rural households farm less than 0.5 hectares of land, and the majority of farmers are dependent on highly variable rainfall. In the face of a rapidly growing population, per capita food production and domestic food availability have been declining since the 1960s. Even in a year of excellent harvests, approximately 26 million Ethiopians – more than 40 per cent of the farming population – do not produce enough food and income to meet their families’ nutritional requirements[2]. The consequences are evident in the very high levels of under-nutrition in Ethiopia. According to the World Bank’s Social Sector Report (1998), almost two-thirds of children under six years of age suffer from stunting, and over ten per cent from wasting. Furthermore, in rural areas, the stunting figures have increased, from 60 per cent in 1983 to over 68 per cent in 1995/96.

People are more vulnerable to food shortages today than they were at the time of the 1984/85 famine. Save the Children research suggests that this is because land holdings are getting smaller as the population increases; basic assets remain scarce as poor harvests force households to sell what belongings they have in order to purchase food; and farmers are increasingly buying, rather than growing, their own food leaving them dependent on earning income. However, employment opportunities are also declining in the face of rapidly increasing demand.

A further problem is that changing weather patterns are leading to shorter and weaker belg rains. Some farmers in the extreme highlands are totally dependent on belg rains to plant short-cycle crops that are harvested before the heavy rains and frost in July and August. But many more farmers plant their main, long-cycle crop during the belg rains. If the belg fails, these farmers are also forced to switch from long-cycle to short-cycle crops planted during the later rains. These short-cycle varieties produce far lower yields.

There are also structural causes behind food insecurity. Central and western regions of Ethiopia often produce a grain surplus – indeed, Ethiopia has in the recent past exported food to neighbouring countries. However, a poor road network and the lack of inter-regional trade means that this food rarely reaches areas with a food deficit.

The other key weakness in Ethiopia’s economy is its dependence on coffee as an export. The price of coffee on the international market is notoriously volatile, and is determined mainly by production in Latin American countries. If Latin America has a poor harvest, the price of coffee goes up and Ethiopia’s foreign-exchange earnings rise, while a good harvest in Latin America has the opposite effect.

In May 1998, a border dispute between Eritrea and Ethiopia escalated into an armed conflict. The war has resulted in an estimated 40,000 – 60,000 deaths and created some 350,000 homeless people, either deported refugees from Eritrea or internally displaced within Ethiopia. However, the war is not the cause of the food crisis, and it is important that the international community does not use the war as an excuse for failing to respond to food aid needs.

Save the Children’s response

reliefSave the Children responded to food shortages in mid-1999 by providing 36,000 MT of relief grain in North and South Wollo, Wag Hamra and East Haraghe. In Region 3 (Amhara), Save the Children provided 1,600 MT of supplementary food (for severely malnourished children) and 12 portable warehouses.

This year, the organisation has secured and is distributing 16,509 MT of food aid and 300 MT of seeds in the Wollo Highlands of Amhara region. Of the 16,509 MT already secured, 6,240 MT is from the UK’s Department for International Development (DfID), 5,269 MT is from the EU, and 5,000 MT is from the Dutch government.

Save the Children is also applying for further supplies:

• The EU has been approached for 25,000 MT of food for North and South Wollo and 5,000 MT for East Haraghe (in the highlands);
• DfID has been asked for 7,000 MT of food aid for Fik and Gode zones in Somali region;
• OFDA has been asked for supplementary food for 2,000 children and therapeutic food for 70 children in South Wollo, and supplementary food for 6,000 children and therapeutic food for 900 children in Fik
• DfID has been asked to support the provision of clean water to Fik, Warder and Degehabour in Somali Region 5.

Save the Children is also assisting the government to develop guidelines on the targeting of food aid, which aim to ensure that those most in need are reached.

In response to the major food shortages that emerged last year, Save the Children deployed five emergency nutrition monitoring teams: four in Wollo and one in East Hararghe. They produced monthly updates on the nutritional status of children in these areas, which in turn informed ongoing relief operations. Reports showed that the quantity of relief food provided was far from adequate, and that rations meant for one family were being shared among many. By early autumn 1999, the nutritional status of children had deteriorated to an alarming level. These findings were supported by a major assessment of the impact of food aid using the Household Food Economy methodology (see below), completed in February 2000[3]. It found that not enough food aid is being distributed and that rations are far too small.

This year, Save the Children will continue its monitoring of children’s nutritional status in the Northern Highlands. Four nutritional teams have been deployed to vulnerable areas in the highlands to monitor the situation of children and assess whether relief supplies are meeting nutritional needs.

Save the Children has also maintained an active involvement in monitoring the needs of families displaced by the Eritrean war. A September 1999 survey revealed that nutrition status was relatively stable but that the population was entirely dependent on relief food.

Save the Children’s monitoring work is well-established in Ethiopia. The Nutritional Surveillance Programme, set up after the 1973-4 famine, developed into a nation-wide monitoring system that provided early warning of developing food crises and confirmation of existing food shortages. The programme also makes extensive use of the Household Food Economy Approach, developed by Save the Children in Ethiopia and elsewhere, which provides more detailed information about food security at a household level.

preparednessThe 1999 food crisis arose in part because of inadequate assessments in 1998 – both the government and donors were convinced that 1999 would be a year of minimum food aid needs and as a result gave very little in food aid contributions. Only a few voices, including Save the Children’s, warned that there might be problems.

In the event a major famine was avoided, though only narrowly, by the existence of a large food security reserve. This allowed the government to begin delivering food aid as soon as it became clear that harvests had failed, rather than waiting on new food aid shipments. Save the Children works closely with the government’s Disaster Prevention and Preparedness Commission (DPPC) to maintain the reserve (by encouraging donor contributions) and to monitor and respond to potential food shortages.

Understanding the underlying problems of poverty and destitution is crucial to developing long-term solutions to Ethiopia’s food security problems. As each new emergency develops, there is a tendency to ignore the chronic problems that underpin it. Research suggests that livelihoods are becoming increasingly unsustainable, because of the following trends:

• Consecutive poor harvests in recent years, with an inadequate relief response
• Household coping strategies are exhausted – families have sold most of their assets and livestock
• Families do not have adequate resources, such as plough oxen and seeds, to prepare land
• Employment opportunities are limited, so few can earn a cash income
• Farms are getting smaller, and thus soil is becoming over-used and degraded, and families are unable to meet annual food needs from their own production.

Save the Children is planning to coordinate a ‘destitution’ study that will look at these trends in greater detail.

Save the Children first delivered food aid to Abyssinia, as Ethiopia was then called, in 1932; programme work begun during the famine of 1973-74. Today, the focus of SCF’s long-term development work in Ethiopia is food security, that is, helping rural families achieve sustained and secure access to food. There are projects on monitoring and surveillance, improving agriculture, livestock health and emergency relief and rehabilitation. Other work includes health, child rights, education and community water development. For a more comprehensive overview of SCF’s long-term work in Ethiopia, including food security work, see the Ethiopia Country Report, 1999.

1

save the children emergency update: ethiopia food crisis 2000

[1] World Bank, Entering the 21st Century - World Development Report 1999/2000 Oxford University Press 1999

[2] “Special Report: FAO/WFP Crop and Food Supply Assessment to Ethiopia” , 21 December 1998

[3]Mathys, E. “Assessment of the Impact of Food Aid on Household Economies of North Wollo, South Wollo and East Hararghe