Wednesday, 31 October 2012

MALNUTRITION: Nutrition getting the attention it deserves?

Children need quality food to to be able to lead quality lives
JOHANNESBURG, 31 October 2012 (IRIN) - Two years after the launch of a global effort to mobilize countries in the use of scientific approaches to improve nutrition, the movement seems to be gaining momentum. More than 30 countries have signed up with the Scaling Up Nutrition Movement, better known by its acronym SUN. 

But some countries are still reluctant to join amid questions and criticism over its lack of clarity and perceived relationship with companies that have controversial nutrition records, say experts. 

“I don’t think anyone will deny that the movement is based on sound scientific principles and has managed to provide nutrition the profile it desperately needed, but there is still confusion around how it actually works and what it stands for,” said Purnima Menon, a nutrition expert with the International Food Policy Research Institute (IFPRI). 

Studies published in The Lancet in 2008 showed that inexpensive nutrition interventions - such well-balanced meals fortified by micronutrients and breastfeeding until a child is two years old - not only reduce infant and maternal mortality but also boost economic growth in developing countries. The Framework for SUN, developed in 2010, was based in part on the Lancet series’ findings; it also recognized the need to address the underlying determinants of poor nutrition, including poor access to nutritious food, drinking water and sanitation. 

A big tent 
SUN is considered a “big tent, designed to create the political space within which various nutrition initiatives can be implemented to best effect”, said David Nabarro, coordinator of the movement and Special Representative of the UN Secretary-General for Food Security and Nutrition. 

The movement provides space for countries to establish their own approaches to nutrition, based on each country’s individual needs and capacity, Nabarro said. “The movement sets out to ensure that countries are in the lead and that efforts of multiple stakeholders are aligned in response to people’s needs and requests from countries.” 

But this could be its undoing. “While one can understand the need to provide enough room to accommodate everyone’s needs and be acceptable, it has to draw the line somewhere and develop a sharp focus,” said a nutrition expert in South Africa, who did not want to be named. 

''I don’t think anyone will deny that the movement is based on sound scientific principles and has managed to provide nutrition the profile it desperately needed, but there is still confusion around how it actually works and what it stands for''
In its attempts to be a church for all religions, SUN might lose much-needed support from champions of nutrition, who are often purists in their approach. In their view, the movement’s affiliation with private sector companies like Unilever, which are not traditionally associated with healthy foods, sits uneasily with its science-backed effort to overhaul nutrition strategies and implement low-cost nutrition interventions. 

SUN is not promoting any specific affiliations, said Nabarro. All stakeholders, including businesses, commit to the movement’s principles of engagement. “If anyone is abusing the message or using our language for interests that are not in line with those of the movement, please report it to us,” he said. 

Refusing to participate 

South Africa has yet to join SUN, with some experts saying that it is overly focused on packaged interventions such as ready-to-use-therapeutic foods. These approaches seem to be donor-driven, and would not suit the country’s needs, said the South African nutrition official who preferred to remain anonymous. 

“We don’t depend on donors, and over-nutrition rather than under-nutrition is our bigger problem, and SUN does not speak to us about that. We are under the impression that SUN is just a movement for poor countries that have under-nutrition as a problem and need funds to address that.” 

Besides, the official pointed out, "it is not clear how any country can sign up. Are we invited?" 

Nabarro says, “SUN Movement countries - and no one else - set their strategies for scaling up nutrition. Any country is welcome to join the movement. There are no onerous procedures: Once they have joined, countries share their experiences with developing and implementing national strategies.” 

Milla McLachlan, research director at the Division of Human Nutrition at Stellenbosch University in South Africa, reckons the country has a limited capacity to engage on nutrition issues. “I think for South Africa, the question is whether devoting very limited senior nutrition capacity to a slow-to-take-off international initiative versus getting it on the National Development Plan agenda (which I believe is happening), provincial agendas, and strengthening implementation of solid…and contested existing policies is the way to go... It shouldn't have to be one or the other, but maybe [it is].” 

In a recent blog post following a nutrition conference in South Africa, Lawrence Haddad, head of the Institute for Development Studies, noted, “It is interesting that not too many people here are talking about the Scaling Up Nutrition (SUN) Movement. For example, when asked why they had not signed up [for] SUN, senior nutrition representatives from the South African government said they were waiting for an invitation. Of course they don’t need an invitation - that’s the point. 

“There may be political reasons for South Africa not signing up - they don’t need the money, they might think the hassle of dealing with donors is not worth it, and making yourself accountable to a wide audience is not an easy decision to make - but I found the disconnect rather stunning.” 

The movement probably needs a more effective communication strategy to reach out to countries and explain what it is about, says a nutrition expert from a developing country in Asia. 

Werner Schultink, chief of nutrition at the UN Children’s Fund (UNICEF), said there were several reasons why other countries had not signed up, from a lack of capacity by fragile governments to nutrition not being a priority. 

Harmonizing nutrition approaches 

Read more
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 AID POLICY: Call for local manufacture of nutrition-rich foods
 Analysis: Do subsidies improve nutrition? 
 Analysis: The fortified food conundrum in Afghanistan
 Food crisis in-depth
 Food films
UN is attempting to bring a range of stakeholders together to ensure that everyone is speaking the same language in terms of interventions and policies - and the movement provides a framework to do this, explained Nabarro. 

The first step is to bring a range of people from different groups together around nutrition in each country. This is followed by establishing strategies and legislative frameworks to address issues, such as the fortification of foods like flour and salt with micronutrients, and the promotion of exclusive breastfeeding for babies under six months of age through the provision of maternity leave benefits or the restriction of commercial advertising for infant formula. 

SUN countries also set their own nutrition targets or expected outcomes; targets could include getting malnutrition down by a certain percentage within a certain timeframe or eradicating micronutrient deficiencies such as anaemia or iodine deficiency. This is followed by raising the funds and building the capacity needed to achieve these targets. 

Nabarro says that the SUN Secretariat monitors the progress of all the countries though six weekly conference calls with country focal points. “If they have problems, my team and I in Geneva try to address their concerns and find solutions.” 

UNICEF’s Schultink said there are signs that the movement is already having an impact. He said during a recent review of SUN’s progress that Nigeria’s finance minister - not the health minister - reported to the UN. “I thought that was very telling of the kind of priority and attention nutrition was now being given in countries thanks to SUN.” 

NGOs like Médecins Sans Frontières (MSF) see merit in countries using SUN as a “hub to interexchange and gather support for what they intend to do, and also to seek inspiration from South and Central American countries like Peru and Guatemala, which are implementing large nutrition programmes with much success,” said Stephane Doyon, head of the nutrition team at MSF. 

Lingering disagreement 

But the South African nutrition official says South American success stories like Brazil’s Zero Hunger campaign, which reduced child malnutrition by two-thirds without using packaged interventions or being driven by donors, are not highlighted enough by the SUN campaign. 

“A commodity-driven campaign contradicts the current emphasis in many developing countries on home-based nutrition interventions, be it developing chickpea-based ready-to use-therapeutic food or promoting vegetable gardens,” the official said. 
Nabarro says the movement does not put emphasis on “biomedical nutrition”, meaning packaged interventions, but “some countries have chosen to encourage a greater availability of such products, especially for the treatment of severe acute malnutrition, which is often lifesaving.” 

The cheapest interventions are also not always the best option, an expert on nutrition aid noted. “Often there is an over-focus on cost rather than on effectiveness.” 

One problem facing countries in the SUN Movement is estimating funding shortfalls for implementing their plans, Nabarro says. “We are helping them set up good financial tracking systems.” 

There are 165 million stunted children and more than 2 billion suffering micronutrient deficiencies, he points out. "Watching governments give increased attention to nutrition and checking for results is very inspiring and shows how commitment is on the increase." 

[This report does not necessarily reflect the views of the United Nations]

Tuesday, 30 October 2012

ODI e-Newsletter

ODI - Shaping Policy for Development

Overseas Development Institute (ODI) newsletter 
October 2012
 ODI on... the post-2015 High-Level Panel 
 There is already an active debate on what might follow the Millennium Development Goals (MDGs), when they expire in 2015. ODI is right at the heart of it, with our research and policy advice linking directly to governments, NGOs and UN agencies. 
Our 2011-2012 Annual Report: impacts and priorities
Our 2011-2012 Annual Report reveals how we ensure ODI stays at the forefront of global thinking on the key development issues of today and tomorrow.
Without precedent: financing climate change action in vunerable countries
The climate finance debate has now turned attention to issues of national budgets but as Neil Bird argues 'there is no simple solution to the question of how to place a cost on the national response to climate change'.

The relevance of 'resilience'?
Resilience increasingly dominates debates in climate change adaptation and humanitarian aid, but as this paper argues current ways of portraying resilience are not always useful in diagnosing vulnerability.
Some relief for food prices?
The latest ODI Food Price Update finds some relief on food prices after the shock of US maize losses, as fears over the Indian monsoon abate and rice harvests are set to equal records.

POVERTY: BURKINA FASO: Preventing conflict between farmers and herders

Some farmers do not respect nomadic grazing routes (file photo)
OUAGADOUGOU, 30 October 2012 (IRIN) - As violent incidents between animal breeders and sedentary farmers soar across northern and eastern Burkina Faso northern Burkina Faso, the Ministry of Animal Resources has been holding a series of workshops for the two groups, alongside community leaders, local governors and mayors. 

The Ministry estimates some 600 conflicts occur each year involving the death of pastoralists, farmers or government workers, the destruction of farms or houses and the injury or death of animals. According to Edithe Vokouma, director of pastoralist affairs in the Ministry, some 55 people have been killed in 4,000 recorded clashes over the past four years, with cases rising year on year. 

"It is very serious," said Jérémie Ouedraogo, minister of animal resources in the capital, Ouagadougou. "How can we come to a place where we can use our natural resources together without resorting to conflict? This is the goal we hope to reach." 

The most recent recorded case occurred in June in Tapoa in East Region, a largely agro-pastoralist zone where herders attacked the dwellings of forestry agents after a herder was arrested for cutting leaves from a tree to feed his animals, according to Bertin Somda, governor of East Region. 

Livestock are an economic mainstay for many families across Burkina Faso, with 80 percent of rural families keeping at least one or two animals to fall back on during hard times. "They act much like a bank account," said Ouedraogo. 

Why clashes up 

As in much of the Sahel, conflict arises when farmers have encroached on transhumance paths, leading herders to move onto agricultural land to enable their animals to feed. Competition over scarce agricultural land is also mounting as the population grows by 3.1 percent per year, one of the highest rates in the world. 

Land scarcity has also been accentuated by land-grabbing by agro-businesses following new land laws that encourage private land ownership; and by the growth of artisanal gold miners who both squeeze herders off transhumance routes but also poison water points with chemicals. Some 800 artisanal mining sites have opened since 2007. 

Many of the clashes in the northern Sahel region fall along ethnic divides between Fulani herders and Mossi farmers. 

According to Hassan Barry, president of the Association Tabital Pulaaku, which has worked on mediation since 2010 in high-risk areas across the country, (including Zoundweogo and Nahouri in South-Central Region, Gourma and Kompienga in East Region, Sissili and Ziro in Central-West Region, and Poni and Noumbiel in Southwest Region), conflicts started to become more violent in the early 2000s, a turning-point occurring in 2003 in Balere in East Region, when 10 herders were killed by locals following conflicts over destruction of their crops. 

The arrival of 35,000 Malian refugees from the north, most of them pastoralists, is not significantly exacerbating these tensions at the moment said government officials, as pasture remains abundant following the rainy season. However, should tens of thousands more refugees arrive in the wake of military intervention in the north, tensions could rise. 


The key is prevention, said Barry. 

"It is difficult to bring an end to conflict once it has begun. To prevent conflicts from escalating into bloody confrontations between different groups - or even worse, ethnic clashes between people who attend the same mosques, the same markets, who bury their dead together - is very important," he stressed. 

Most conflicts arise out of a misunderstanding, on both sides, of land regulations and rules that protect both agricultural land and transhumance paths, he noted. 

Understanding has diminished as many pastoralists now send their children (many of whom are illiterate and unaware of the rules) to mind the animals. ''When we were kids there were fewer conflicts because herders were knowledgeable and respectful men,” Barry explained. 

Problems often occur at night when animals wander off to graze while farmers are asleep, said Somda. 

Under discussion at the workshops are: land regulation; why it is important to protect nomadic paths; and how both farmers and pastoralists or agro-pastoralists can work together to sustainably use natural resources. 

Local officials will also encourage farmers and pastoralists to agree on transhumance paths together, to make agreements more binding. 

While most conflicts are sorted out by community leaders, a minority are sent to local courts, which need more support to clear cases, said Hassan, as cases may languish for years, keeping community tensions boiling. 

He recommends a special court be set up to manage tensions over natural resources to clear outstanding cases; and that a corps of special offices be set up in each municipality to map sites, monitor livestock trails and prevent and settle conflicts. 

But to move forward, all groups must also learn how to use limited natural resources more efficiently, said Ouedragogo, noting some 110,000 hectares of forest is cut down each year in Burkina Faso, much of it for commercial purposes, but also to feed animals. 

Ouedragogo said the Ministry of Natural resources is trying to encourage herders to store some grass at the end of each harvest so they rely less on wild grass and trees. The Ministry of Animal Resources says it will fund projects that help pastoralists and farmers to harvest six million hay-bales to be stored across the country this year, and will invest US$7 million over several years, to create more water points, reservoirs and holding areas for animals. 

But Barry says not enough money goes into protection or promotion of herders: Government spend on livestock was roughly 1.13 percent as of 2005 (more recent figures are not available), despite the sector bringing in 18 percent of GDP and making up a quarter of exports. 

Unless more is invested in both herders' needs and to make agriculture more productive, agricultural land will just continue to grow and clashes continue to mount, warned Vokouma from the Ministry of Natural Resources. 


[This report does not necessarily reflect the views of the United Nations

Monday, 29 October 2012

MALNUTRITION: The UK grant £35 million towards malnutrition in Yemen

In a press conference held in Sana'a Tuesday October 9th , Minister of International development Alan Duncan said that the UK has granted £ 35 million for malnutrition programs in Yemen which will treat and prevent under-nutrition over the next three years. 

The world must take long-term action to tackle malnutrition in Yemen before it becomes a “death sentence for tens of thousands”, International Development Minister Alan Duncan warned today, as he announced a new UK package of long-term support to help improve nutrition for 1.65 million women and children across Yemen.
 Over ten million people in Yemen are currently thought to be at risk because of insufficient food and in the worst affected parts of the country as many as one in three children are suffering from life-threatening acute malnutrition.
 The UK has committed to provide critical support over three years, allowing UNICEF to work with the Government of Yemen to plan long term solutions to the current crisis that will address the root causes of malnutrition rather than simply tackling the symptoms. The UK is the first donor country to take this approach - funding is normally provided for six months or a maximum of a year, making it difficult for aid agencies in Yemen to commit to long term initiatives such as training health workers or improving health systems in case funding runs out half way through a project.
Mr Duncan, who announced the new funding during a visit to Sana’a, has driven efforts over the last four months to secure international commitments to support to support Yemen’s development and to address humanitarian needs. This process culminated in the Friends of Yemen meeting in New York last month, which saw total funding pledges exceed $7.8 billion.

MALNUTRITION: Mali: A slow burn emergency

Mali is struggling to cope with a prolonged drought and food crisis that is affecting large areas of the Sahel region of West Africa. The crisis has been made worse by a spreading internal conflict.  On World Food Day, the International Rescue Committee's Peter Biro reports on the worsening crisis and what the IRC is doing to help. Posted on October 16, 2012

Video Transcription

[A doctor is seeing to infant patients in a small health center.]
PETER BIRO: Keita Cheick Oumar, a doctor with the International Rescue Committee, checks on patients in a health clinic located in the densely populated Kati district of Mali. Kati, near the Malian capital of Bamako, has been hard hit by the country’s deepening hunger crisis, which has had an especially devastating impact on children. More than 14,000 children under the age of five are thought to be suffering from severe acute malnutrition in Kati alone.  This is Jabadjie. She was rushed to the clinic by IRC volunteers who travel throughout Kati district to identify malnourished children, informing villages about the help available at the health clinic. She is 16 months old and weighs only a little over 9 pounds, or 4 kilograms. Severely malnourished, Jabadjie also is suffering from pneumonia and anemia, ravaging her already weakened immune system.   

TASHA GILL, IRC director, Mali and Niger:  Mali has a chronic food and nutrition crisis that has been aggravated this year in 2012. The lean period, the hungry period you could call it, that usually starts in April, started early this year because of the drought last year. However, Mali’s case is particularly complicated because there’s not just the food and nutrition crisis that’s affecting all the Sahel region—there’s also a conflict going on. Starting in January an armed conflict began in the northern part of Mali; in March there was a coup d’état.
PETER BIRO:  Despite political chaos in the south and an Islamist militant takeover in the north, native Malian IRC staff members have managed to deliver health services, water and education across Mali. At 35 community health centers in Kati, they provide additional medical staff, procure essential medicines and organize mothers’ groups to improve infant and child nutrition.
KEITA CHEICK OUMAR, IRC doctor [translated from French]:  Here, we treat cases of severe acute malnutrition with complications. We collaborate with other services here, with the radio, with other doctors on how to address problems, and we treat them until they are cured.
SEYDOU DIARRA, Malian father [translated from local language]:  The health of my child has worried me for what must have been over two years that he was sick. Upon my arrival, the doctors welcomed me warmly and treated my child. They taught us many things. I salute them and I’ll spread the message everywhere. I thank them for their courage.
[Outside, a group of actors performs a skit for a large audience of community members of all ages.]

PETER BIRO: IRC workers are also training community members to recognize the symptoms of severe malnutrition so that they can get children like Jabadjieto the clinic for treatment before it’s too late.  To help identify symptoms, such as a swollen abdomen, listlessness and excess fluids under the skin, the IRC uses a local theater group to get the message across. The actors visit villages and put on open-air skits in the evening, always attracting hundreds of men, women and children. Because of poverty and lack of education, parents often do not recognize the symptoms of malnutrition, or know where to go for treatment. Small and underdeveloped children are common, and sometimes the most severely malnourished children are beyond help when they’re finally brought to the health facilities. This year and the next, the IRC will treat over 8,000 children at health centers in Kati, as well as improving water and hygiene at community health centers serving thousands of people. Approximately 160,000 children will be screened for malnutrition, and their families informed on good child care and feeding.  But there is still more to be done.

TASHA GILL: This crisis is still ongoing, and we’re afraid that we’re going to see it continue for quite some time. This is what I would call a “slow-burn emergency.” The food crisis and nutrition crisis in the Sahel is not going away.
Thanks to volunteer Meg D. for transcribing this video.  

MALNUTRITION: CNN and UNICEF Raise Awareness of the Silent Emergency of Child Stunting


© UNICEF/MLIA2012-00029/Dicko
Konate, 12 months old, in Djenne, Mali, suffers from stunted growth and severe malnutrition. Damage from stunting is irreversible.
NEW YORK (October 25, 2012) — CNN has partnered with UNICEF to put the international spotlight on the global crisis of stunting, or low height for age in children. About 165 million children under the age of five suffer from stunting, with more than 90% of them living in Africa and Asia. 
Stunting is a hidden tragedy—the outcome of chronic nutritional deficiency during the first 1,000 days of a child’s life. The damage it causes to a child’s development is irreversible. That child will never learn, nor earn, as much as she or he could have, if properly nourished in early life.

Tackling Undernutrition

Tackling the problem of undernutrition, which leads to stunting, is achievable and cost effective. Leading development experts have ranked providing young children with micronutrients as the most cost-effective way to advance global welfare.
UNICEF is a leader in a global effort to deliver a life-saving package of interventions to the world’s poorest communities during the critical 1,000-day period. These interventions include: promoting breastfeeding and good infant and child feeding practices; micronutrient supplementation and fortification; treatment of severe acute malnutrition; and community support for nutrition programming.
Children worldwide have the same capacity to reach their height potential if they receive adequate nutrition, their caregivers follow recommended feeding, care and health practices, and they grow up in healthy environments. By raising awareness of this problem, CNN is helping to make this happen.

CNN and UNICEF, Partners in Awareness-Raising

© UNICEF/NYHQ2008-0051/Turnley
UNICEF Goodwill Ambassador David Beckham holds two-day-old Mariatsu. He is accompanying community health workers on a home visit, in the town of Mangorea in Sierra Leone.Tackling the undernutrition that leads to stunting is achievable.
CNN has worked with UNICEF to tell the story of stunting, starting with, where essays by world-class footballer and UNICEF Goodwill Ambassador David Beckham and internationally acclaimed actress and UNICEF Goodwill Ambassador Mia Farrow have been highlighted. CNN’s Mallika Kapur has reported on an Indian state’s battle to build up its babies.
CNN has also visited three countries in which stunting is a problem and is airing the pieces on CNN International, bringing the problem to life by showing mothers and children who are suffering from undernutrition.
In Afghanistanthe story is told in the context of a country ravaged by many years of war.
In Kenya, undernutrition has had profound effects on child development. Grammy Award winner and UNICEF Goodwill Ambassador Angelique Kidjo has visited Samburu, in northern Kenya, and expressed her concerns about the problem.
CNN has also traveled to India to report on the stunting epidemic in that country.
Christiane Amanpour is drawing attention to the issue on her CNN showby interviewing Ms. Kidjo and UNICEF Executive Director Anthony Lake.
CNN has also posted links to other relevant stories on their website, from the Sahel, Mauritania and Yemen.
More About UNICEF’s Work in the Area of Stunting:

MALNUTRITION: The Current Reality Of Malnutrition In Yemen

National Yemen
Rural women receive emergency donation
By Jihan Anwar
Considering that no less than 10 million people in Yemen suffer from severe to moderate malnutrition, U.K. Development Minister Alan Duncan wasn’t exaggerating when he recently referred to malnutrition as a “death sentence for tens of thousands” of Yemenis.
Food insecurity comes in different degrees of seriousness. Severe food insecurity means that people cannot produce their own food – nor do they have the necessary money to buy it at the marketplace.
The most affected regions of Yemen are the 13 poorest governorates which run through the country’s highlands. According to the Comprehensive Food Security Survey, CFSS, published last May by the World Food Programme (WFP), 5 million people in Yemen have been estimated to be suffering from malnutrition, based on a sample size of 2000 people interviewed across the country.
A further 5 million people are food insecure, living without a constant supply of adequate food items. Although placed at a lower imminent threat level than the severely food insecure, following Yemen’s 2011 humanitarian crisis, the situation for this last category has worsened. High food and fuel prices have further worsened their state, so that they risk becoming severely food insecure, according to Mr. Barry Came, WFP Yemen’s spokesman.
Caroline Gluck, an Oxfam Humanitarian Press Officer, remarked, “With Yemen, we are dealing with a long-term chronic emergency situation. People have very little in the best of times and these are not the best of times; these are some of the worst times Yemeni people have faced.” Caroline spoke about families she had visited in Hodeida and Haradh in which sons or daughters had died, and it was believed the reason for the children’s deaths was as simple and tragic as a lack of basic nutrients.
“In early January, WFP planned to feed 1.2 million people. In May, we had to revise the figure to 1.8 million, and in September to 3.9 million. We are planning to feed almost 4 million this year,” declared Barry Came.
What is malnutrition?
Malnutrition refers to the condition in which the nutrient intake of an individual has consistently been so low that the body’s physical activities have slowed down, been impaired or altogether arrested. This condition ultimately leads to death.
Malnutrition is measured by taking the weight-height ratio and circumference of the middle upper arm.
One WFP program has 675,000 women and children who have been diagnosed with a moderate form of malnutrition. They are provided with both curative and preventative measures; children and mothers are given specialized micronutrient-enriched food products. UNICEF treats cases of acute malnutrition.
Mr Came has noted that malnutrition in Yemen has seen an age-related trend. A UNICEF Yemen Situation Report for September 2012 estimated that children under the age of five suffered from a normal chronic malnutrition level of 16.7%, a seriously underweight ratio of 24.4%, and critically acute malnutrition rate of 18.9%. These figures add up to a total of 47% of Yemen’s children under the age of five.
Looking at the statistics, Mr. Came said, “47% under 5 is almost half of the children under the age of five in the country. There are about 4 million children in Yemen under five years of age, which means that about two million of them are chronically malnourished and another one million of those acutely malnourished. That’s a huge number of children.”
It was also found that around 13% are acutely malnourished, which was assessed using wasting measurements. WHO sets the critical wasting threshold at 15%. In Hodeida, the number is almost doubled, at 28%. “They could die at any time,” said Mr. Came.
One of the problems in the country is that less than 5% of the land is arable, which leads Yemen to import about 90% of its staple foods. As fuel prices rise, the cost of food increases.
The situation has been progressively worsening because of population growth, post–revolution conflict, political instability and massive population displacement, mostly Yemen’s northern and southern reaches.
While in previous years people had been able to get through difficult periods by selling land or animals, the current crisis has affected them so gravely and for such a relatively extended timeframe that their economical and material reserves have progressively and drastically thinned down. People are now left with close to nothing.
Gluck said, “Many farmers told me that they haven’t planted any seeds. Because diesel prices have gone so high, they can’t afford to hire a tractor, they didn’t have the money to pay for water to irrigate the crops. In some cases, they ate the seeds because they had absolutely nothing else to feed themselves.”
Came provided the example of a man in Aljabin, in Raymah. “He was a laborer who used to go to Sana’a to work, but he hasn’t had a job for about a year now. There was absolutely no money for him and his seven children to get by on and he was so happy to receive the modest ration we distributed as part of our programs that he kissed me.”
The reasons for child malnutrition are complex. Poor sanitation, the lack of a variety in diets, general illiteracy and ignorance concerning proper types of diet all contribute to the current level of malnutrition.
For instance, the CFSS has revealed that 40% of children below six months’ old were breastfed in the 24 hours preceding the taking of the survey; only 32% of children aged 6 to 23 months had been breastfed and had consumed at least one other food item.
Child malnutrition needs to be tackled early; if it goes uncured, it will set a trend for a child’s future development. The first thousand days of a child’s life are considered to be the most critical in this regard. With this in mind, troubling statistics concerning breastfeeding practices should be regarded as causes for real concern.
In addition, many communities don’t have access to clean, drinkable water, and are thus left to drink water which is unsafe and contaminated. “Sometimes even dirty water from which they risk suffering of diarrhea, and when you are 5 and undernourished that’s a potentially life threatening illness,” said Came.
Malnutrition is not necessarily connected only with poverty. UNICEF, WFP and Save the Children have taken food surveys throughout the country and found that malnutrition was also present in families that were relatively wealthy.
Education plays a role. Many women have not had the opportunity to study. Their notions of hygiene or eating practices are influenced by the environments in which they live, and knowledge of best practices are often absent.


If malnutrition is present in an infant from around birth to 24 months of age, the damages caused by under-nutrition on a child’s physical and mental development will likely be irreversible and result in permanent consequences.
Gluck emphasized that if the humanitarian crisis isn’t addressed immediately, it will jeopardize both Yemen’s short and long-term development. “Malnutrition affects future generations; it will affect their development and IQ and it will be the generation which is expected to be leading Yemen in the future.”
Stunting has been a generational problem, present in Yemen for decades. It’s usually experienced by infants whose mothers are malnourished and who had had a poor diet in early childhood. Since organs haven’t fully developed, stunting is also believed to be a factor in premature death.
“Nearly half of that generation of future-builders face stunted growth and delayed mental development as a result of under-nutrition, and over a quarter of a million more face an immediate risk of death,” declared Alan Duncan in a press release from his recent visit to Sana’a.
“It will negatively affect the child’s ability to concentrate in school, his thinking faculties and that, in turn, will reduce his ability to work and, as a consequence, his potential income,” added Came.

Coping Mechanisms

Some very extreme coping mechanisms have been adopted across the most afflicted governorates. People have resorted to purchasing food items on credit, particularly in rural areas, where it was estimated that the practice is common in 28% of the households. People are left indebted to shopkeepers, in some cases for a sum of several hundred dollars.
The situation is even worse in Abyan, Shabwa, and Lahj, where close to half of food items are bought on credit. Meanwhile, children have been pulled out of school to work for their families, selling bottles and tins or performing casual labor.
Caroline Gluck recalled a 14-year-old boy who lived near the Saudi border: “He showed me the bruises he had on his legs. He had been caught by border guards and beaten up and ordered not to trespass the border again. What he confessed to me was that there was no other choice for him – at 14, he had a father who was disabled, his mother couldn’t work, and his family relied on him to provide them with food.”
Though already present in Yemeni culture, another phenomenon which has become increasingly widespread is the marriage of young girls. Mrs. Gluck reported that families justify the practice by saying that they needed the dowry money to feed their families. Moreover, by marrying off one daughter, they would have one person less to provide for.
Several programs have been launched to tackle malnutrition. WFP has projects that join the treatment of child malnutrition with UNICEF and the Ministry of International Planning and Coordination, the Ministry of Health and Population, and the Ministry of Education.
While Oxfam doesn’t specifically deal with the nutritional and health sector, it has recognized that malnutrition is a factor in current crises and developed Emergency Response programs. Cash transfers represent one of the largest current responses undertaken by Oxfam. Officially launched in July, the Cash Life Line has targeted over 103,000 people by providing them with $50 a month.
The money allows them to meet a few basic needs. In some cases, they spend some of the money on medicine or clothes, but through monitoring how beneficiaries use the money, it has been discovered that in 97% of cases it is used to buy food. Actually, many instances have been registered in which poor households don’t buy food directly but instead use the money to clear the debt they owe to shopkeepers so that they may again purchase food using credit.
While Caroline admits that giving cash is not the solution to the wider problem – and that people need to be able to earn their own money – she argued that the situation is so precarious at the moment that it demands an emergency response. She expressed the NGO’s plans to replicate the same program in Haradh in November provided there are sufficient funds.
In an attempt to prevent malnutrition, Oxfam is working with farmers, providing them with tools and seeds, hiring tractors and paying for diesel so that they can plant crops. Women are being trained to sew and weave so as to allow them to have a source of income and an opportunity to earn money. Community veterinarians are also given courses so that they may rear and cure cattle.
Barry Came illustrated the Emergency Safety Net WFP has designed. It has 6 thousands ratio distribution points, with most of them elementary schools. In September alone, two million people throughout the country have been reached by the program.
Despite the fact that the major road network is a good one, once you deviate from it, sometimes there are no roads at all sometimes; otherwise, they may be very poorly constructed. This creates difficulty for trucks, especially considering that some locations are situated in mountainous areas, which leads to challenging logistical issues.
There is also an absence of quality infrastructure, trained staff, midwives, nurses and health clinics. This is especially true for the most affected areas.
“You go to these clinics in Hodeida, Mahwit and Raymah and they don’t have water, they don’t have sewage, and there’s no qualified staff. The room capacity is too limited, the place is mostly too hot and crowded,” said Came.
Even with support from the government, local infrastructures are inherently weak, with staff changing continually, thus necessitating the training of newcomers every six months.
A lack of funding is an additional issue. “In addition to our other programs, we are also feeding 500,000 IDPs and 50,000 refugees, most of whom are Somalis. The total cost of our operation this year is $223 million, but we are about $50 million short,” said the WFP spokesman.
Kelly Gilbride, Policy Advisor for Oxfam in Yemen, stated, “Friends of Yemen met in New York on the 27th September, this is the second meeting in four months. The international community has pledged 7.9$ billion. This is a generous amount. We think that they should be directed to the people who need it, to get on the ground to help people who cannot afford to eat”.
Minister Alan Duncan urged donors to follow the U.K.’s newly launched long-term program and provide predictable, long-term funding, without which agencies wouldn’t be able to commit to tackling the root causes of malnutrition as it occurs when funding is stopped half way through.
“Now is the time to invest in the future, in the children who will help to rebuild and stabilize Yemen over the next 20 or 30 years.”