East Africa Hunger Crisis: Concern's Response

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.

WHY USE CASH?

• 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.

CASH IN ACTION

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.

THE POWER OF CASH

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.

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.

Dear Supporter 

Thanks in part to your generous contributions, we continue to provide life-saving services in Somalia, Kenya, Ethiopia, and South Sudan.

Early last year, when Somalia was cited as one of four countries on the brink of famine, it brought on a grim sense of déjà vu. Five years before, over 250,000 people — many of them children — had died of hunger and related diseases in the first famine of the 21st century. Luckily, that didn’t happen in 2017. Here are some reasons why:

Information:

Gathering and analyzing information is key. Early Warning Early Action (EWEA) — identifying and responding more quickly to the signs of coming crisis — is a central part of the Building Resilient Communities in Somalia (BRCiS) program, which Concern is implementing together with Norwegian Refugee Council, International Rescue Committee (IRC), Save the Children and CESVI. It systematically monitors conditions in its program areas and includes a mechanism to trigger a rapid localized response when signs of a potential crisis emerge.

Rapid Response:

Most of Somalia depends on two annual rainy seasons for agriculture and livestock production, and when there were signs - as early as June 2016 - that the April to June Gu rains would not perform well, we began responding with cash transfers of $30 per month to 803 of the poorest households in Gedo, in south west Somalia.

In November, as the subsequent Deyr rains appeared to be failing and the probability of disaster had therefore increased, Concern increased the amount to $50 per month and doubled the number of recipient households to 1606, now including the poorest 20% of households.

By January 2017, with the failure of the rains confirmed, Concern was able to increase the cash transfers to $60 per month. Despite the crisis, markets continued to function and food remained available for purchase, minimizing displacement to urban centers.

Increased Resilience:

Our approach to early warning meant that by the time the Food Security and Nutrition Analysis Unit — the leading source of food security and nutrition surveillance in Somalia — indicated the possibility of famine in Somalia on 16 January, 2017, Concern staff had already been responding to that possibility in half of our target communities for 7 months.

Ongoing discussions with the target communities and observations by Concern field staff suggest that as a result of this early action, the villages in which the resilience program operates are faring considerably better than might have been expected. While over 900,000 households have been displaced across the country since November 2016, none of our target villages have experienced significant numbers of people leaving due to the drought.

In fact, even though these communities were originally targeted as the most vulnerable in their respective areas, most have since become hosts to displaced people from nearby and previously “better off” villages. That’s amazing progress.

With millions of people still affected by food crisis in Somalia, it remains imperative to learn the lessons of the past two years and continue to respond to emerging needs early and effectively, in order to continue to keep famine at bay.

It is important, of course, to keep these successes in perspective. This program was a pilot through which Concern supported fewer than 30 villages, a number that pales in comparison to the 900,000 people forced to leave their homes and seek refuge in urban centers due to the food crisis. But this does show what can be achieved in mitigating the impacts of major slow onset disasters in Somalia.

Thanks in part to your contributions, we were able to respond to the crisis to the best of our ability, sharing information, responding rapidly, and focusing on increasing for resilience. For that, we deeply thank you.

Dear Supporter,

Concern Worldwide continues to respond to the hunger crisis in Somalia, South Sudan, Ethiopia, and Kenya. Thanks to your generous support, our 1,200 staff members on the ground throughout these four countries continue to provide emergency nutrition programming, safe drinking water and latrines, emergency cash transfers, and other life-saving interventions. Today, I would like to again take the time to spotlight Concern’s work in Somalia. 

Even though it is now 2018, Somalia continues to suffer from an extreme drought, which has in turn led to crop failures and a loss of livestock. This has severely affected production systems, and has caused a spike in food insecurity and malnutrition. We are combating the crisis by assisting internally displaced persons (IDPs) with unconditional cash transfers (UCT), which are an effective intervention during droughts when markets are still functioning, as they allow people to purchase life-saving food, water, and non-food items for themselves. This gives them choice and dignity while also supporting local livelihoods and markets by providing cash inputs into the local economy. 

We target new arrivals in the IDP camps, as they generally have very few resources when arriving from the countryside. Concern and partner staff work closely with community and IDP camp leaders to identify families most in need of cash support and subsequently select households based on a number of key vulnerabilities. I would like to highlight a story of a family who has benefited from emergency cash transfers. 

Jamilah* is a 41-year-old mother of seven children (2 girls and 5 boys) between the ages of 3 and 13. They are originally from Furuqlay in the Lower Shebelle region of Somalia, and they have been living in Nasib camp for Internally Displaced Persons in the Garasbaley District of Mogadishu for eight months. Jamilah recalls her life back in Furuqlay:

“We faced big problems. I will never forget and cannot describe enough here of what I have passed through with the children. My children are from different fathers and no one has been helping me with anything, as the fathers of my children are dead. So all in all, I’m the only one struggling with the children, no one is raising them with me. They are not in school.”

Before the fighting began, Jamilah’s daily routine in Furuqlay consisted of working on her farm and looking after her livestock in order to earn money to feed her children. On top of this she also performed all of the family’s chores.

“I normally faced some challenges like not having enough to eat three times a day. It is difficult to be with your children because as children they don’t understand that there is nothing to eat. The three year old, when she was younger, used to scream for my breast but the breast did not have enough milk to breast feed so the baby cried throughout the day and night. I became stressed mentally and physically due to the fighting and hunger that persisted.”

Concern Worldwide came to Nasib camp in August 2017 and started the process of beneficiary registration, selecting those in most need to receive unconditional cash transfers. Based on her difficult circumstances, Jamilah and her family were selected as beneficiaries and received unconditional cash transfers from Concern.

After receiving the unconditional cash transfers from Concern for the past four months, Jamilah says:

“With the cash I have started a small business selling small goods. I sell my goods outside of my shelter because I do not have enough money to build a shop. In the coming months I want to grow my business and build a shop. I thank Concern Worldwide for giving me this kind of opportunity.”

Thanks in part to your generous contributions, Jamilah now feels more hopeful and happy as a result of the income she has received from Concern.

“My highest desire is being able to feed my children every day. I’m thanking God and Concern Worldwide that I can now feed my family.”

*Name has been changed to protect Concern’s beneficiaries

Dear Supporter,

Concern Worldwide continues to respond to the hunger crisis in Somalia, South Sudan, Ethiopia, and Kenya. Thanks to your generous support, our 1,200 staff members on the ground throughout these four countries continue to provide emergency nutrition programming, safe drinking water and latrines, emergency cash transfers, and other life-saving interventions. Today, I want to spotlight Concern’s work in Somalia. 

Somalia has been suffering from an ongoing drought, due most recently to poor consecutive rainy seasons. The lower than expected rainfall of the “Deyr” rainy season in October through December 2016, followed by the shorter than expected “Gu” rainy season in 2017, leading to a serious drought, which has resulted in crop failure and loss of livestock, causing a spike in food insecurity and malnutrition. The situation has caused many to leave their homes in search of food and water, and most of these people eventually end up in internally displaced persons (IDP) camps, outside of Mogadishu. People arrive at these camps with only what they can carry, and are acutely in need of assistance.

An important line of assistance for IDPs is unconditional cash transfers (UCT), which are an effective intervention during droughts when markets are still functioning, as they allow people to purchase life-saving food, water, and non-food items for themselves. This gives them choice and dignity while also supporting local livelihoods and markets by providing cash inputs into the local economy. 

This system is especially beneficial because it protects staff and beneficiaries in Somalia’s highly insecure environment, as no actual cash exchanges hands. Concern and partner staff work closely with the community and IDP camp leaders to identify the families most in need of cash support and subsequently select households based on a number of key vulnerabilities. The cash transfers take place using mobile money systems, with families registered through their phone numbers. 

I want to now take the time to share the story of one of our beneficiaries, Uba.

Uba was living with her elderly husband and six children in Furuqlay in the Lower Shebelle region of Somalia when encroaching violence and fighting forced her family to leave. In Furuqlay, Uba’s family had a farm and livestock, but they left everything when they fled. They ended up in a camp for internally displaced persons in Mogadishu. 

“It is not something that I imagined having to one day think about, running and staying with my children in a place that doesn’t belong to us.” Says Uba.  

To make matters worse, Uba’s ninety-year-old husband became sick in the camps. Uba was able to borrow money from a neighbor in order to take him to the hospital, but even after he recovered, he was malnourished. Uba could not afford to feed her family more than one meal a day, if that.

Concern arrived at the camp in August 2017 and began the process of selecting beneficiaries to receive unconditional cash transfers. When selecting beneficiary households, Concern focused on newly arrived families like Uba’s. Uba’s family has so far received two months’ worth of cash transfers. 

When asked about her life since receiving the support, Uba says, “My life is much better than the life my family and I had in Furuqlay. If I compare both, today I’m eating at least two times a day while before there was only a 50% chance to get something to eat once a day. Now I am comfortable and enjoying a less stressful life that Concern Worldwide has enabled inside the camp.”

The cash transfers are not only enabling Uba and her family to eat more full meals every day. With the leftover cash, Uba has also started a small business selling fruits and vegetables. She is currently selling the produce outside of her shelter because she does not yet have enough money to buy a table, but she is hopeful that in the coming months her business will grow.

Uba says that her greatest pleasure is being able to feed her children every day, and thanks to your support, Uba and her family can look towards a brighter and more stable future.