Chronic Malnutrition: a Problem not Addressed by SFPs

An Appeal for a Development Programme by MSF Spain in Mandera District, Kenya

The chronic nutritional emergency in Central Mandera, north east Kenya, was the subject of an article in the last Field Exchange. Lourdes Vasquez of MSF Spain asserted that emergency selective feeding programmes (SFPs) were no solution to the chronic problems in the area and that without considerable development initiatives such measures will remain nothing more than palliatives in a cycle of soaring rates of malnutrition temporarily reduced by sporadic emergency interventions. The dramatic results of a recent nutritional survey conducted by MSF Spain lend considerable weight to her arguments and conclusions.

The survey, which was conducted in May 1999 found a 39.2% rate of global acute malnutrition with 6.9% severe wasting. This is compared with a global acute malnutrition (GAM) rate of only 21% in November 1998 when MSF Spain stopped their emergency selective feeding programme. The results of this survey have prompted the MSF Spain country director to make an appeal for development programmes in the district.

He argues that the GAM of 21% recorded in November 1998 is a normal rate for the district where malnutrition has become a chronic problem. This is caused by recurrent drought and floods over the last decade during which many pastoralists lost all their livestock. The population has therefore become destitute with many moving to Mandera town to eke out a living selling firewood or grass. Many of the destitute are female headed households that have come from Somalia years ago. An added problem is that the area has always been neglected by the Kenyan government and humanitarian agencies. Food distributions by the government and/or WFP, if implemented, have been insufficient. In April 1999, people received a 1 kg distribution of maize per family! UNICEF have excluded the district from their new 5-year plan for Kenya. In the appeal, the MSF Spain country director complains that what happens in Mandera is what usually happens in the "arid lands"; short term funds are being released to pull the area out of an acute crisis phase (due to drought or flood) and back into its usual chronic difficulties, and then left struggling without assistance until the next emergency. He argues that what is needed is a joint effort of NGOs willing to work for a longer time frame in Mandera and co-ordination between these agencies to avoid duplication and to pool resources and knowledge.

The MSF Spain appeal is for both short term measures, e.g. general or targeted food distributions and medium/longer term programmes, e.g. livestock re-stocking, seeds and tool distributions, water projects and income generating schemes.

For more information contact: Graham Carrington, DFID East Africa, Upper Hill Road, PO Box 30465, Nairobi