Shared experiences of Southern Africa crisis

Malawi 2002, Medical Missionaries of Mary distribute Concern funded maize to most needy in Lilongwe

Summary of meeting

By Marie McGrath (ENN)

On November 5th, 2002 a meeting was convened by MSF Belgium on the nutritional situation in Southern Africa. Representatives from Save the Children UK (SC UK), Oxfam GB, Action Against Hunger (AAH), MSF International, MSF Luxembourg (MSF Lux), MSF Belgium (MSF B), MSF Holland (MSF H), MSF France (MSF F), MSF UK, MSF Switzerland (MSF CH), and the Emergency Nutrition Network (ENN) were present.

The impetus for the meeting was a growing perception that conflicting information was emerging regarding the nature and severity of the situation in Southern Africa. The purpose of the meeting was to share analyses and agency perceptions of the crisis, to identify and explore any differences, and to build a common understanding - with the aim of making recommendations for the future.

To set the scene, an overview of the Southern Africa crisis was presented by MSF B. This was followed by a number of country-specific reviews by different agencies, around which there were considerable discussion and debate. The afternoon session focussed on perspectives of the Angolan situation.

Country reviews¹

In terms of anticipated food shortages and populations affected in Southern Africa, it was estimated that one-quarter of the population, nearly 14.5 million people, in six countries (Zimbabwe, Mozambique, Malawi, Zambia, Lesotho, and Swaziland) were in need of food aid for the period September 1, 2002 to March 31, 2003². In Angola, an additional 1.4 million people were considered in need³.

Summaries of agency experiences in Mozambique (MSF Lux), Zambia (MSF H), Zimbabwe (SC UK) and Malawi (Oxfam GB) highlighted, to varying degrees, increased livelihood vulnerability, declining food security, but relatively low levels of malnutrition. MSF-Hs review of the situation in Zambia, for example, highlighted the considerable shortfall in maize supply, both through aid networks and government sources - a situation complicated by Zambia refusing genetically modified maize in October. At the time of the meeting, nutrition surveys⁴ had demonstrated relatively low prevailing levels of malnutrition. While MSF expected "pockets" of deterioration in nutritional status, Oxfam GB's experiences from the south were that coping mechanisms were already stretched (due to crop failure), and the hungry season had started early. Although the rates of global acute and severe acute malnutrition found in July 2002 were not at emergency levels⁵, they were higher than expected. Oxfam GB also described how HIV/AIDS was also impacting on the population's ability to cope, and risk of infection was increased as women resorted to sex to secure food or income.

How information was interpreted varied between agencies. Based on their experiences in Mozambique, MSF Lux expressed doubts over the predicted numbers in need and did not consider the situation a crisis, despite reports of deteriorating food security. However, SC UK suggested that there was considerable variation between the north and south of the country. This view was shared by Oxfam GB, who voiced that the anticipated poor harvest and increasing vulnerability of the population warranted immediate preventive interventions.

The multi-sectoral and often complex influences of individual country situations were highlighted in reviews of both Zimbabwe (SC UK) and Malawi (Oxfam GB). SC UKs experiences in Zimbabwe highlighted how climatic, economic, political and social factors - not just land reform issues, had all contributed to the emergency. Although prevalence rates of malnutrition have varied⁶, SC UK felt the prognosis until March 2003 was poor, with limited expectations for the winter harvest (estimated 40% reduction) and increasing government-imposed limits on NGO operational space. Meeting immediate food needs was only a stop-gap, and did not address the underlying political and social reforms necessary to prevent the situation recurring - a point made by MSF, and reflected in SC UK and Oxfam GB's outline of activities in regional advocacy and livelihood support.

In Malawi, Oxfam GB described how chronic poverty, HIV/AIDS, erratic weather patterns (leading to two consecutive poor harvests) and a steady decline in national food security had all contributed to a crisis of livelihoods. Shortfalls in WFP funding (Emergency Operation (EMOP) only 50% funded), and limited supplies of expensive agricultural inputs were also compounding the issue. Estimates suggested that 28.5% of the population (3.25 million people) would be in need of food assistance for the period December 2002 and March 2003⁷. Although malnutrition and mortality rates were low⁸ at the time of the meeting, Oxfam GB felt that multi-sectoral interventions were essential to prevent further deterioration.

Outlining their recent experiences in Angola, MSF described how, following the April 4th ceasefire, there was suddenly access to a population which had been largely inaccessible for 3-4 years previous. Numbers presenting to MSF centres dramatically increased and, between May and June 2002, MSF B doubled the number of feeding centres (30,000 patients). Further indications of the scale of the situation were reflected in a UN assessment in April/ May 2002, which estimated 500,000 to 800,000 people were affected by malnutrition. Also, a retrospective mortality survey, conducted in the famine areas by Epicentre, showed that the situation had passed the emergency threshold for almost a year.

By November 2002, the situation in Angola had stabilised (malnutrition rates had fallen), but high mortality rates and poor vaccination coverage persisted. A lack of harvest in 2002, considerable shortfall in the food pipeline supply to Angola, and inadequate funding of the WFP EMOP (27% funded) all contributed to an ongoing emergency situation. Furthermore, resettlement and closure of the Family Quartering Areas (FQAs)⁹, strongly promoted by the Angolan government, was placing agencies under considerable pressure to meet the needs of an increasingly dispersed population.

Topical issues

Throughout the day's proceedings, a number of issues emerged which were debated at length, in particular, MSF's experiences in Angola, how different agencies quantify and define a crisis, the politicalisation of resource allocation in humanitarian response, and how information is communicated and interpreted in a complex emergencies.

The Angolan situation

Regarding Angola, MSF voiced strong opinions regarding the humanitarian response to the recent crisis there. In particular, they felt that:

• There was an unacceptably slow international response to this major crisis.
• Delivery of essential aid to the population was delayed by 4-6 weeks, due to lengthy UN negotiations at higher levels. In contrast, MSF had secured earlier access through negotiations at a provincial level.
• There was a lack of initiative and diversity amongst NGOs, with many operating as a homogeneous group within the UN system. According to MSF, this problem persists and could lead to a loss of NGO neutrality and impartiality.
• The WFP failed to grasp the scale and the urgency of the crisis and although the WFP experienced genuine financial and logistical constraints, MSF feel these did not entirely account for their slow reaction.
• Considering the UN shortfall, more NGOs should have become involved in food distributions.

In response to the criticisms levied, a number of agencies outlined their activities, which reflected that Angola was a serious consideration for them even before the current crisis. SC UK outlined their strong advocacy role e.g. through the British Overseas Agencies Group (BOAG), demonstrating that Angola has always been high on their agenda. It was also countered that strong co-ordination within the UN system had made several actions possible in Angola, particularly in light of the limited resource capacity of some agencies. In terms of food supply shortfalls, one unofficial source suggested that WFP were so pessimistic about meeting targets that they were approaching petrol companies to lobby donors for funds, as any deterioration in the Angolan security and food security situations might compromise access to oil.

Defining a crisis

MSF's field experience of relatively low levels of malnutrition, which they initially thought might prove contrary to others, was shared by all those present. Based on these criteria, MSF felt the situation was not at crisis level. However, SC UK, Oxfam GB and AAH felt that elevated rates of malnutrition were not a pre-requisite for defining a crisis situation.

'Promising' a famine

There were a number of interpretations of the appropriateness of the Southern Africa appeal, the level of crisis in Southern Africa, and whether the crisis should have been defined as a famine. Both MSF and AAH felt the use of the term 'famine' risked promising the world starving millions, while in reality, it has proved very difficult to predict the outcome of the current fragile situation in Southern Africa. Furthermore, MSF suggested that potentially "crying wolf" at this point risked exhausting capacity to mobilise funds and response when a "real" emergency actually occurred. A case in point, they felt, was the Angolan situation which due to the Southern Africa appeal, did not receive the level of attention that it warranted.

MSF also suggested that indicators of one type of nutrition assessment approach should not be used to describe or predict scenarios that they cannot accurately measure. Thus, a food security assessment could not predict a famine with certainty.

A different perspective was held by other agencies, such as SC UK and Oxfam GB. Rather than promising a famine, they felt the Southern Africa appeal anticipated a famine and could therefore be seen as 'a preparedness measure'. As such, it was justified in securing resources to act before the nutritional situation deteriorated.

Communication

The meeting questioned the extent to which NGOs should use the media, and considered possible repercussions for other operations. For example, MSF felt that the NGO instigated media attention around the Southern Africa appeal negatively influenced coverage of the Angolan crisis.

All agreed that accuracy and transparency were essential in any communications around an emergency. However, questions remained regarding the aid communities' capacity and required strategies to maintain attention and mobilise resources for chronic emergencies.

Politics

Considerable criticism was levied by MSF at the UN in Angola, in particular at how the UN framework for operation allied humanitarian intervention and response too closely with political goals. MSF suggested that since NGOs were co-ordinated by the UN system, they risked losing their own impartiality and neutrality. Furthermore, the high level of UN funding in Angola gave them considerable control over agencies, which may have discouraged freethinking and action.

Donor reluctance to fund interventions in Angola was cited as a problem by all agencies. Apparently, many donors needed evidence of clear benefits before committing funds and also argued that responsibility lay with the Angolan government to use its resources to support its people. Many of those present at the meeting felt that this position was disingenuous, and was a convenient smoke screen for the 'political' basis of donor funding decisions.

Validity of data

The accuracy and interpretation of information was called into question, with particular reference to crop assessments in Malawi where predictions varied widely from one week to another. For some, this undermined the strength of the argument that a crisis was looming. For others, irrespective of the disagreement between figures or methods used (e.g. maize versus maize equivalents), there was enough evidence to suggest a significant shortfall and a worsening trend. It was agreed that greater standardisation of assessment approaches was needed.

Conclusions

Gaining an insight into the rationale behind aid responses and strategies in Southern Africa was considered a valuable outcome of the meeting, and was deemed essential to understanding diverse agency activities. Discussions also gave an insight into the detailed conceptual frameworks and analysis that underpin agency positions, communications and activities in complex emergency situations.

Irrespective of varying agency perspectives, and persisting difficulties in ascertaining the level of "crisis" risk of different countries, it was felt that the situation in Southern Africa was serious and likely to deteriorate. All of those present agreed that a similar type meeting, to share agency operational experiences and strategies, would be valuable and should be timed for early 2003.

¹Country reviews were based on agencies experiences and activities at the time of the meeting (5th November 2002). These may not necessarily reflect the situation current at time of publication.

²Source of figures: USAID, October 4th, 2002. Anticipated population size affected and food aid needs are based on SADC (Southern African Development Community) FANR (Food, Agriculture and Natural Resources) assessments released on September 16, 2002.

³Estimated figures have since been revised to 1.9 million by WFP (Dec, 2002)

⁴ Surveys in western (MSF-H) and southern Zambia (MSF-H, World Vision) have shown low levels of malnutrition, ranging between 3.3-4.3% global acute malnutrition and 0.7-1.2% severe acute malnutrition. The surveys covered various periods between May and July, 2002.

⁵Oxfam GB nutrition surveys of Southern and Western Provinces. Prevalence of global acute malnutrition <6%, prevalence of severe acute malnutrition 1-2% (July, 2002)

⁶ UNICEF nutrition survey found an average 6.4% prevalence of acute malnutrition, but in some areas this was as high as 18.2% (May, 2002). In July 2002, surveys by SC UK in the Zambezi valley area found an acute malnutrition prevalence of 5.1%.

⁷ SADC/FANR Vulnerability Assessment Committee (VAC) Report (August, 2002)

⁸Oxfam GB surveys: Mulanje: 1.7% GAM, 0.5% SAM and Phalombe: 0.85% GAM, 0.3% GAM (September, 2002)

⁹Family Quartering Areas now officially referred to as gathering areas (Dec, 2002)