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East Africa Hunger Crisis: Concern's Response

by Concern Worldwide US
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
East Africa Hunger Crisis: Concern's Response
Ng'ikario. By: Gavin Douglas (Concern 2019).

Dear Supporter,

As of August 2019, the Horn of Africa is in the grip of drought. Large parts of Kenya, Ethiopia and Somalia have experienced insufficient rainfall for two consecutive rainy seasons, with devastating consequences for people living in those areas due to lost crops and livestock deaths. Food prices have increased and the number of people across the region who do not have enough food to eat has reached 12 million.

If this news induces a perverse sense of déjà vu, that is because it is the third major drought in the past three years. While droughts can occur in almost all types of climate and are not a new experience for people living in this part of the world, what is new is the frequency with which they are happening. It used to be that they would occur maybe every 15 or 20 years. However, from the late 90s onwards, this cycle was reduced to every five years and over the last decade, it has reduced to every second year. Very simply put, this does not give anywhere near enough time for families to recover and is placing them in increasingly desperate situations.

“The recovery period has become shorter or almost non-existent. If people lost their livestock or their assets and had years to re-build, then recovery might be possible. But when it is every second year, you lose more each cycle. Your ability to bounce back becomes less and less. So it has made people more vulnerable and deepened levels of poverty,” explains Amina Abdulla, Concern Kenya Country Director.

Ng’ikario is a 37-year-old pastoralist in a semi-arid county of Kenya called Turkana. She became the head of her household when her husband became disabled due to injury. Of her six young children, three are severely malnourished. As the land has dried up, so too have her options for keeping food on the table.

She used to have a herd of 100 goats. However, in 2017, extreme drought wiped out half of her herd. With little time to recover in between, this current crisis has left her with only five goats remaining. With no pastures for them to graze on, all five have stopped producing milk. The family had relied on that milk as their primary source of nutrition. Now, she, her six children and her five goats all rely on the same source of food — a wild fruit that grows in the bush. When there is no fruit to pick, Ng’ikario has no option but to turn to the animal hides that line the floor of her home, a small round hut made from wood. “I turn to the old hides and skins. I roast them and that is what we consume,” she explains.

Ng’ikario is not alone. Malnutrition rates in Turkana have reached 30% in some areas with this current crisis. To put that into perspective, rates of 15% or higher are considered a ‘critical emergency’ situation. The strain it is placing on local health services is immense.

So what are we doing about it? With the generous support of supporters like you, Concern Worldwide started programming in Turkana last year and is working to support malnourished children and pregnant and breastfeeding mothers. We are working with the Ministry of Health and with partners such as Save the Children to reach more mothers and children with vital nutrition support and to strengthen the local health systems that are in place to enable them to better cope with the demand for increased services that comes with recurrent drought.

As the climate crisis escalates on a global level, vulnerable communities around the world are confronting the consequences. We are reaching as many people as we possibly can, but we need your help to reach more. Ng’ikario recognizes the need for outside support for her family. “If I didn’t receive this support, I know my children would have been dead by now.”

Banadir Hospital in Mogadishu
Banadir Hospital in Mogadishu

Dear Supporter,

Somalia has endured decades of conflict and drought, which has led to constant displacement of the population. This mass movement is most heavily felt in Somalia’s capital, Mogadishu, where resources and services are being pushed to breaking point.

Banadir Hospital, a national referral hospital for maternal and child health, operates in the midst of this displacement and insecurity, caring for approximately 1,000 inpatients at any one time. Under seemingly impossible conditions, the dedicated staff admit up to 100 children daily for pediatric care, deliver 15-16 babies a day, treat HIV, TB and Cholera, and perform lifesaving surgeries.

At Banadir Hospital, Concern Worldwide supports the stabilization center for under-5 children from all over Somalia suffering from the most life threatening form of malnutrition – severe acute malnutrition. This includes supporting payments for doctors and nurses, providing specialized training to build the capacity of staff, as well as supporting the day-to-day running of the center.

All of the hospital’s lifesaving services are reliant on water, and unfortunately Banadir has only one water supply – from a well. When the water supply failed there was no backup plan and by the time the staff at the hospital had noticed the failure, the water tanks had already emptied.

As Doctor Lul Mohammed, the Assistant Hospital Director explains, this put the lives of patients in critical danger.

“This was really a crisis that needed immediate attention. Services would have to stop. We would have to refuse new admissions. Mothers were already referred to another center that morning. However no other hospital could absorb all our patients and most were too unwell to go home.

There was the serious potential of an outbreak of disease. Imagine no water for staff to wash their hands, for sanitation, for cleaning. The situation doesn’t bear thinking about. It really was an imminent crisis.”

Hospital management immediately contacted Concern Health Officer, Dr. Hodan, about the water supply cut and Dr. Hodan was on-site within an hour. He coordinated Concern managers and technicians to identify the problem and fix the water supply as fast as possible. The team of technicians worked late into the evening to install the new pump and the supply of water was restored by nightfall.

“We are very thankful. Concern always responds with urgency. We are confident when contacting Concern, as they always assist. Their support to the stabilization center is deeply appreciated here.”

Concern crew working to restore water
Concern crew working to restore water
Water restored to Banadir hospital
Water restored to Banadir hospital
A mother and child affected by drought in Ethiopia
A mother and child affected by drought in Ethiopia

Dear Supporter,

Forced migration of people as a result of conflict, natural or environmental disaster, or other stress factors is one of the biggest causes of hunger in the world today. Writing in the 2018 Global Hunger Index, published jointly by Concern Worldwide and Welthungerhilfe, Dr. Laura Hammond of SOAS University of London outlines the challenges and some possible solutions. Below are some key extracts:

During periods of conflict, hunger may be both a cause and a consequence of forced migration. People affected by conflict experience it not only as a threat to their lives but as an assault on their livelihoods that can undermine their ability to provide for their most basic needs, including food. Conflict can restrict people’s movement and their access to markets, farmland, and jobs. If they cannot produce the food they need to survive or earn an income to purchase that food, their nutritional well-being is compromised.

Some people do indeed manage to flee to safety with the bulk of their savings or assets intact and so do not face the immediate threat of hunger before they are displaced. Others are not as fortunate. By the time they move, they have lost everything. Still others are displaced multiple times, with each move further eroding their resilience, livelihood, and food security.

Common Misperceptions

An analysis of the interplay between hunger and forced migration reveals four common misperceptions.

  1. Hunger and displacement should be recognized and dealt with as political problems.
  2. Humanitarian action alone is an insufficient response to forced migration, and more holistic approaches involving development support are needed.
  3. Food-insecure displaced people should be supported in their regions of origin.
  4. The provision of support should be based on the resilience of the displaced people themselves, which is never entirely absent.

Long-term thinking

Overall, the tools currently used to respond to forced migration are insufficient, because they focus on technical, short-term humanitarian responses rather than addressing the political economy of displacement and the longer-term needs of the displaced.

The Sustainable Development Goals (SDGs) promise to “leave no one behind,” and SDG2 commits the world to ending hunger by 2030.  Yet for regions hosting millions of displaced persons, the prospects for meeting those goals without considering how to include displaced populations are slim.

Lip service not enough

Policy documents, international agreements, advocacy pieces, and academic writing often pay lip service to these four points, but they are rarely incorporated into action on the ground. Addressing the challenges effectively requires going beyond humanitarian responses, recognizing the political solutions that must be encouraged and strengthened, and engaging in longer-term development efforts in the meantime.

This approach must extend to all sectors: facilitating mobility and income-generation opportunities, supporting education and training linked to employment opportunities in and around areas of displacement, providing health care support to people with chronic illnesses, and ensuring that people have access to markets so they can obtain enough high-quality food for the long term.

From the outset, displacements should be seen not as short-term crises but as potentially long-term moves that will extend over many years. If such a view is taken from the start, a great deal of time, resources, and suffering can be saved.

They received therapeutic food for a full recovery
They received therapeutic food for a full recovery
A woman
A woman's self-help group in Somalia.

Dear Supporter,

In many of our contexts where food crises are common, but where markets are still functioning, we implement unconditional cash transfer programming in order to allow people to directly purchase food and other necessary goods. The traditional image of aid may be crates of supplies being shipped by land, air, and sea into countries in crisis, but for more than a decade Concern Worldwide has been helping to change the paradigm.

In 2017, we distributed almost $35 million worth of cash. And we’re not alone – it’s becoming more and more common in humanitarian efforts worldwide. Why? Because it works.


  • It’s cheaper. It is far less expensive to get cash into a country than it is to ship thousands of metric tons of food.
  • It’s quicker. In a humanitarian crisis, it can take weeks or even months to transport supplies into hard to reach areas. By contrast, once a cash distribution system has been put into place, vital funds can instantly reach thousands of people, regardless of their location.
  • Cash gives people choice. Instead of giving each family one bag of grain, which may not be their most urgent need, cash allows them to purchase precisely the resources they judge to be most essential.
  • Cash can empower. Our mission is to empower people to transform their own lives. Providing cash gives people autonomy and responsibility to help pull themselves out of poverty.
  • It helps the economy. Traditional aid, like shipments of free grain, can sometimes hurt an economy by undercutting local farmers. By contrast, when people are given cash aid, they spend it in local stores and support the local economy. (Of course, this only works if local markets are functioning — so in some cases traditional aid still works better.)
  • Cash can be invested. Just a small amount of seed funding can help people start their own businesses and become self-sufficient.


One of the great advantages of cash is that it does not need to be distributed in physical form. Concern uses many different forms of cash depending on the logistical and economic realities in each country. One form of cash-based assistance used quite often in East Africa is mobile money transfer, where participants receive funds via their mobile phones.


Concern has found that under the right conditions, cash-based assistance has more positive outcomes for recipients than traditional assistance. And of course, the more efficiently we can deliver aid, the better — because it means we can reach more people who desperately need our help.

In part thanks to you, last year 1,130,808 people in 20 countries directly benefited from Concern’s cash-based assistance… and that number is set to rise in the year ahead. As simple as it might seem, cash is a powerful agent of change that will continue to transform the way we provide aid to vulnerable people in the future.

Theresa Abuk Dut outside of a new latrine
Theresa Abuk Dut outside of a new latrine

Dear Supporter

Please find this update from David Traynor, Concern's Programme Quality Coordinator, below. South Sudan still faces chronically high malnutrition rates due to a conflict the country has faced since 2013. It has disrupted food production, leading to high levels of illness among the population and widespread poor hygiene, health and nutrition practices.

Much of the country remains in what the Famine Early Warning Systems Network classifies as 'Crisis and Emergency' levels of food insecurity. While also contending with the impacts of conflict, South Sudan faces more erratic weather patterns, resulting in prolonged drought periods or late rains disrupting the normal agricultural seasons.

The former Northern Bahr el Ghazal (NBeG) State is no exception. Despite having escaped much of the direct impacts of the conflict, NBeG has faced unacceptably high rates of malnutrition. In 2016, people said that it was “worse than the hunger in 1988” during the civil war with northern Sudan.

Global Acute Malnutrition rates for children under five in the area are as high as 32%, according to the Food Security and Nutrition Monitoring System of the South Sudanese government and various international bodies. A recent survey conducted by Concern found the rates above emergency thresholds of 15% in the two worst affected counties in NBeG.

Children suffer frequently from illnesses such as malaria and diarrhea, which then results in malnutrition and high levels of infection, further compounded by poor hygiene and sanitation practices. Other findings shows that only 30% of households knew the three critical times to wash hands and only 2.5% had a functional handwashing station.

Responding to Malnutrition

Concern first began operations in NBeG in 1998 and has since moved into long-term recovery and resilience building programs. While NBeG remains fragile, it is relatively stable compared to other parts of South Sudan. However, the continuing high levels of malnutrition requires Concern to implement emergency responses to save lives and prevent malnutrition rates from increasing.

Last year, Concern implemented an emergency program with the aim of providing treatment to children under five-years-old and pregnant and lactating women with acute malnutrition. This program also assists in preventing malnutrition through Infant and Young Child Feeding education to caregivers.

In total, 49 health facilities were supported. Children, along with pregnant and lactating women who have Moderate Acute Malnutrition were treated in the Targeted Supplementary Feeding Program. Young children with Severe Acute Malnutrition (SAM) were treated in the Outpatient Treatment Program, while Children with SAM and medical complications were treated as inpatients in Concern Stabilization Centers.

Empowering Volunteers

Mary Nyandit and Mol Garang, both volunteers in their communities, understand the importance of getting malnourished children to the health facility for treatment. They were selected by their communities and trained on their roles as community health volunteers.

The training, as they explained, involves knowing how to screen for malnutrition using the Mid Upper Arm Circumference (MUAC) strips and being able to teach mothers the causes of malnutrition. Mary described how the erratic climate and problems with food affect malnutrition and how the chronic food insecurity situation impacts on malnutrition.

“People do not have anything to eat. Some people sleep without eating. I visited homes, and they had no food and they are sick. When I see their gardens, they have food but have problems with insects, because they planted late.”

However, lack of food is not the main reason for malnutrition. Having recently come from a refresher training, Mol says:

“We were trained last week on the symptoms of Severe Acute Malnutrition. We see that there is decreasing malnutrition and fewer children with diarrhea.”

Mary and Mol explain how illness drives malnutrition rates up. As it was dry season, there was less contaminated water around and thus fewer children with diarrhea. With the recent arrival of the rainy season, the numbers of mosquitoes increases and with it the prevalence of malaria and diarrhea due to contaminated water. Increased illness means increased malnutrition. Mary and Mol say that they need to teach mothers to put children under mosquito nets and to connect them to basic hygiene and sanitation services in order to protect children from illness and resulting malnutrition. When treatment is not possible in the communities, the volunteers refer children to health centers.

Thanks in part to your generous contributions, brave volunteers like Mary and Mol are able to target children most in need, preventing malnutrition when possible and treating it when necessary. For this, we deeply thank you.


A young child attending a nutrition checkup
A young child attending a nutrition checkup

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Concern Worldwide US

Location: New York, NY - USA
Facebook: Facebook Page
Twitter: @concernGCC, @concern
Project Leader:
Alexandra Strzempko
New York, NY United States
$3,748 raised of $10,000 goal
85 donations
$6,252 to go
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