Food Crisis in the Horn of Africa

Horn of Africa - One Year On
Horn of Africa - One Year On

July 2012

CARE has responded to drought and food insecurity in the Horn of Africa with crucial immediate and long-term aid to approximately 2.8 million people, including more than 460,000 residents of the Dadaab refugee camps. On an average day of food distribution, CARE distributes 300 metric tons of food to 39,000 people.


On July 20, 2011, the United Nations declared a famine in parts of Somalia – an extremely serious designation, indicating that hundreds of thousand s of people were at imminent risk of starving to death. The declaration cast a spotlight on a crisis that had been developing for many months: in the face of a devastating drought and food crisis, over 12 million people in the Horn of Africa region, including parts of the nations of Djibouti, Ethiopia, Kenya and Somalia, were in need of immediate food aid.

In the year since then, much has been accomplished. Large-scale humanitarian interventions by CARE and other agencies have helped save many lives. But families still struggle to feed themselves, and remain highly vulnerable to future events such as poor harvests, conflict-related displacement or a rise in commodity prices. Many who survived the worst of the crisis have been left without the reserves to withstand further shocks.

The outlook for seasonal rains during the remaining months of 2012 is fair but cannot be guaranteed. As the Sahel region, in northwestern Africa, also descends into a similar crisis, CARE is redoubling our efforts in the Horn of Africa to implement long-term solutions to build communities’ resilience and combat the repeated cycle of food crises.

The support of donors in providing flexible resources is crucial to allow us to respond to signs of an impending food emergency. CARE advocates with governments, communities, individuals and the international community for the necessary political will to act quickly. The experience of the past year has taught us that early warning and monitoring systems are only as valuable as the commitment to intervene in time to avert crisis.

CARE’s Response

During the reporting period, CARE reached some 2.8 million people in the worst-affected countries, Djibouti, Ethiopia, Kenya and Somalia, with crucial assistance including food, safe water, sanitation, health, education, livelihood assistance and protection for the most vulnerable people, including survivors of gender-based violence.

In addition to immediate relief, we support a number of long-term responses to the reality of recurrent drought – including innovative livelihood approaches to help vulnerable people earn a living in ways less dependent on the unpredictable rainfall.

Examples of CARE’s primary focus areas in the Horn of Africa include:

Food and nutrition assistance: Distributions of food supplies, including staples targeted at pregnant women, nursing mothers, children and other vulnerable people; emergency treatment for child malnourishment through stabilization centers, outpatient therapeutic programs and supplementary feeding programs; and distribution of materials such as Plumpy’nut, a fortified peanut-based paste used as a front line treatment for severe acute malnutrition.

Water, sanitation and hygiene (WASH) activities: Water trucking, construction and rehabilitation of latrines, boreholes, water pans, hand washing stands, livestock water points and water storage tanks; hygiene promotion and training; distribution of water purification tabs; and distribution of soap and water cans.

Livelihood activities: Distribution of seeds, agricultural inputs like fertilizer, provision of small farm animals like goats, sheep and chickens, veterinary services and training for pastoral communities, targeted reduction of herd sizes with compensation to owners, cash for work, unconditional cash transfers, and monthly distribution of food vouchers.

Details on the reach of CARE’s work in affected countries include:


As part of our commitment to building long-term drought resilience, CARE works closely with the Ethiopian government and communities to strengthen the social safety net in heavily affected areas. These include the East and West Hararghe zones of Oromia region and the southern region of Borena, home to traditional pastoral populations whose way of life is increasingly threatened by drought, climate change and reduced access to water and range land. Targeted food distributions, supplementary nutrition and emergency treatment for child malnutrition have been particularly effective in staving off the worst effects of the crisis.

CARE’s response to food insecurity in Ethiopia focuses on water and sanitation, food distribution and livelihoods, with a strong focus on addressing traditional gender inequities. Ongoing challenges include overreliance on rain-fed agriculture, population pressure, recurrent drought, land degradation and stringent government regulations of nongovernmental organizations.

Total number of individuals reached: 1,239,618

Food and nutrition

  • Number of people reached through food and nutrition interventions: 562,250
  • Number of families that received food distributions: 106,952
  • Number of children treated for acute malnutrition: 54,314
  • Number of pregnant and nursing women treated for acute malnutrition: 20,390
  • Basic monthly food package distributed, per person: 15 kilograms(kg.) of cereals (wheat or sorghum), 1.5 kg. yellow split peas and 0.45 kg. vegetable oil
  • Cost of one monthly food distribution package, per person: $9.77


  • Number of people reached through livelihoods interventions: 164,795
  • Number of families receiving seed distributions: 15,594
  • Number of families receiving animals:
    • Poultry: 480 families
    • Goats or sheep: 439 families


  • Number of people reached by WASH interventions: 512,573
  • Number of individuals reached by water trucking activities: 97,140
  • Total number of water points rehabilitated: 13


Despite the inherent challenges to humanitarian work in Somalia, CARE continues to maintain and expand our response in areas including WASH (water points, latrines and hygiene interventions); nutrition; supply of non-food items (NFIs); food security through cash-for-work activities, food vouchers and cash relief; and protection for vulnerable populations including women threatened by sexual and gender-based violence. Our existing program areas in the relatively secure Puntland and Somaliland regions are being supplemented by new program areas in Lower Juba and Mogadishu. CARE is able to maintain and expand our reach through longstanding relationships with local partners.

Challenges to our work in Somalia include insecurity and military intervention; threats to aid workers and decreasing respect for humanitarian neutrality in southern Somalia; weak local authorities and communities; difficulties inherent in remote management; limited capacity of some local partners; overtaxed CARE staff; the chronic nature of drought and food insecurity; and the rise of new “states” in already volatile areas.


Total number of individuals reached: 588,101

Food, nutrition and livelihoods

  • Number of people reached through food, nutrition and livelihoods interventions: 220,988
  • Value of food voucher per household (average six persons) per month: $70
  • Items provided with one food voucher: 25 kg. rice, 2.5 kg. sugar, 25 kg. wheat flour, 6 kg. oil, 3 kg. dates, 25 kg. beans
  • Value of unconditional cash grant per household per month: $80

Non-food items (NFIs)

  • Number of people reached through distribution of NFI (kitchen/sanitary) kits: 52,158
  • Content of one NFI kit: plastic sheets, sanitary cloth, kitchen utensils, jerry cans, sleeping mats, blankets, soap
  • Cost of one NFI kit: $62


  • Number of people reached through WASH interventions: 314,955
  • Number of latrines constructed : 1,250
  • Number of displaced people reached by water trucking activities: 11,432
  • Number of water filters distributed: 1,495


A major focus of CARE’s food security response in Kenya involves distribution of food and water to the entire population of the three refugee camps at Dadaab, the world’s largest refugee site (see details below). At the same time, we are continuing our long-term response to drought-affected parts of northern Kenya, with a broad range of programming in water, sanitation, hygiene, and efforts to help communities become more resistant to shocks.

Our ongoing priorities in Kenya include cash-for-work activities to rehabilitate water infrastructure; building natural resources management and water infrastructure management capacity of communities; and continuing to expand our community-managed disaster risk reduction programming to minimize impact of future droughts. Challenges facing CARE’s operations in the country include severe threats in the Dadaab camps; insecurity in parts of northern Kenya; and the potential risk of conflict in the 2013 election year.

Total number of individuals reached: 940,294 (includes beneficiaries of long-term resilience programming in northwestern Kenya, not counted in the Dadaab figures below)

Details on CARE’s response in the Dadaab refugee camps, the world’s largest

  • Number of people reached through food distributions and WASH interventions: 463,512 (total population of the camps)
  • Number of people reached through education activities: 16,945
  • Number of children enrolled in accelerated learning in primary schools: 902
  • Number of hand-washing stations constructed in 14 refugee schools: 28
  • Number of families receiving food distributions: 97,818
  • Number of families receiving NFIs, including sanitation kits: 115,183
  • Content of sanitation kit: wheelbarrow, rake, shovel, nose mask, gloves, rubber boots, overalls, hat
  • Number of families receiving hygiene training: 1,902
  • Number of people receiving psychosocial counseling and services responding to sexual and gender-based violence: 49,977 (including 29,427 women and girls)


The small country of Djibouti – site of the most recent expansion of CARE’s response in the Horn of Africa – has received insufficient rainfall since 2005. Two-thirds of the country received below-average rain during the 2012 March-May rainy season, causing a further depletion of water reserves, deterioration of livestock health and milk production, and massive loss of livestock and livelihoods.


CARE’s work in Djibouti focuses on health and nutrition services, including a health center serving mostly Somali refugees in the Ali-Addeh camp, as well as the surrounding host population. The camp was established in 1991 to accommodate about 7,000 refugees, but currently hosts more than 21,000. Due to influxes of refugees fleeing the 2011 drought, the camp is overcrowded, with services and infrastructure under extreme pressure. A second camp was opened at Holl Holl in June. Absorbing these refugees has placed a major strain on Djibouti’s 800,000 people – two-thirds of whom already lived below the poverty line before the crisis, and one-fifth of whom are themselves in dire need of humanitarian assistance.


Levels of emergency funding are very low in Djibouti compared to other countries in the Horn of Africa. Aside from United Nations agencies, there are very few humanitarian actors. CARE has been operational in Djibouti since January 2012.


Total number of individuals reached: 50,000

  • Refugee camps provided with health and sanitation services: Ali-Addeh and Holl Holl
  • Population of Ali-Addeh camp: 21,000, mainly Somali refugees (in a camp intended for about 7,000 refugees)
  • Additional water and sanitation project serving host communities in the district of Ali Sabieh where the camps are located


The food security crisis in Horn of Africa was thrown into sharp relief one year ago with the declaration of famine in parts of Somalia. Donors responded generously, and CARE was able to scale up our lifesaving emergency response. But this is not a short-term crisis. People whose age-old lifestyles are under threat need help adapting to the realities of a changing climate. CARE is committed over the long term to helping communities develop more diverse and sustainable livelihoods. We offer our sincere thanks for your support as we take on those challenges.


Theresiah Nthiani visits a school in Dadaab
Theresiah Nthiani visits a school in Dadaab



On July 20, 2011, the United Nations took the drastic step of declaring parts of southern Somalia in famine. In so doing, it recognized that hundreds of thousands of people were at imminent risk of starving to death. As the crisis spread to more regions, the number of people in famine zones eventually reached 750,000. An estimated 13 million people were in critical need of food aid. Suddenly the Horn of Africa, a region seemingly so often in crisis, was in the global spotlight again. The world finally took notice of a dire situation.


In reality, the emergency in Somalia – and neighboring countries including Djibouti, Ethiopia and Kenya – had been long growing. Drought, a recurring phenomenon in this part of the world, has become increasingly devastating, due to factors including climate change, population pressures, new limits on access to water and pastureland, conflict, and poor or non-existent governance in some places. Six months later, the same number of people remain food insecure, in what remains the world’s worst humanitarian crisis.


The relief effort faces sobering new challenges, particularly in the area of security. Several national and international military forces are now involved in the conflict in southern Somalia. Escalating violence, suicide bombings, attacks on civilians, kidnappings and killings of aid workers, and the wholesale expulsion and looting of 16 U.N. agencies and other humanitarian groups by militants are leaving hundreds of thousands of desperate people without help, at a time of enormous need.


And yet we have made important progress. In the six months since the famine declaration, the situation has become marginally less critical. Today, “only” 250,000 Somalis remain in a famine situation, thanks to rapid humanitarian response and resumed rains in some areas. CARE and our partner agencies continue to scale up our emergency aid and longer-term efforts to help people become more resilient in the future. But the challenges remain huge, even as global attention has shifted elsewhere.


This will not be the last or the worst crisis of its kind. Traditionally, nomadic herders have responded to periodic drought by migrating to fresh sources of water and pasture. As climate change and environmental degradation continue their grim march, these age-old coping mechanisms are no longer sufficient. The only question is when, and how severe, the next drought will be. And the only solution is long-term adaptation.


The winds of change are blowing across the Horn of Africa, and its people critically need assistance adjusting to a new age.


CARE’s Response


CARE has scaled up our response in the worst affected countries. Currently we are reaching over 1.8 million people with crucial assistance including food, safe water, sanitation, health, education, livelihood assistance and protection for the most vulnerable people, including survivors of gender-based violence.


In addition to immediate relief, we support a number of long-term responses to the reality of recurrent drought – including innovative livelihood approaches to help vulnerable people earn a living in ways less dependent on the unpredictable rainfall.



Some examples of CARE’s most recent emergency operations, by country, include:




The most recent expansion of CARE’s response in the Horn of Africa is to Djibouti. This small country bordering Eritrea, Ethiopia and Somalia faces a disproportionate burden from the effects of drought, not just on its own people, but also due to the influx of refugees from neighboring countries. After six consecutive years of drought and erratic rainfall, more than 200,000 of Djibouti’s 800,000 people – two-thirds of whom already lived below the poverty line – are considered in need of humanitarian aid. The country has absorbed more than 22,000 refugees.


After conducting an assessment of the most critical needs, CARE determined that the best use of our resources is in Ali Addeh district, which hosts most newly arrived refugees but struggles with poor health, nutrition, hygiene and sanitation conditions.


Our approach, focused on refugee camps, will reach both refugees and host community members with health and nutrition services, including the opening of a health center with a target population of about 19,000.  The emergency response will focus on providing first aid, nutritional screening, vaccination, referral to secondary health care. As well, the activities will include ensuring access to safe water and improved hygiene practices.


CARE will pay special attention to the most vulnerable refugees and host communities affected, including women and children, and will provide psychosocial support to survivors of trauma and sexual violence. CARE’s intervention will have an emphasis on building local capacity, in order to ensure sustainability.




As elsewhere in the region, CARE’s long-term objective in Ethiopia is to promote resilience in the face of future food emergencies. In the meantime, to meet immediate needs, we are continuing relief operations, reaching more than 709,000 people to date with interventions in four sectors: food assistance; water, sanitation and hygiene; nutrition; and support to livelihoods including agriculture and livestock rearing.


CARE’s emergency food distributions, in cooperation with the government and our humanitarian partners, are in their seventh round, reaching a total of about 450,000 people in Oromia Regional State, East Hararghe, West Hararghe and the Borana and Dewe zones of Afar region.


Other recent activities include:


Nutrition and Food


  • In urgent cases of malnutrition, especially involving children, CARE supports emergency treatment through stabilization centers, outpatient therapeutic programs and supplementary feeding programs. Each month CARE reaches more than 3,800 individuals in East and West Hararghe and Borana with these lifesaving services.
  • We distribute about 300 cartons of Plumpy’nut, a fortified peanut-based paste used as a frontline treatment for severe acute malnutrition, each month.


Water, Sanitation and Hygiene


  • Each month, health education programs focusing on nutrition and hygiene in West Hararghe and Borana reach over 3,700 people.
  • More than 2.3 million packets of water purifying chemicals were transported in late 2011 for delivery to East and West Hararghe.




  • The three livelihoods projects run by CARE in Borana and East and West Hararghe zones of Oromia region had reached a total of 107,180 individuals as of December 13, 2011. Through these projects, CARE provided nearly 50,000 individuals with seed and planting materials, while the rest were assisted in maintaining the health of their animal herds by reducing herd sizes. Animals are slaughtered when they still have value, rather than waiting for them to starve, and when possible the meat is distributed to families. Herders receive cash compensation and feed for their remaining animals.


  • In addition to direct food assistance, CARE is providing water purification and treatment products to pastoralist families and others, and supporting the construction or rehabilitation of water points and ponds.




1. The Dadaab refugee camps


CARE distributes lifesaving aid, including food and water, to more than 460,000 refugees in the Dadaab camps in Kenya, the largest refugee site in the world.


The operating environment remains complex due to ongoing security concerns. In recent months escalating conflict between the Kenyan military and militants has been accompanied by fatal attacks on camp residents, threats to community leaders and the discovery of landmines and explosive devices within the camp area. The flow of new refugees into the camps has declined dramatically due to the conflict and Kenya’s official sealing of the border with Somalia.


As a result of the tense situation, many CARE activities and those of our humanitarian partners remain suspended. However, all lifesaving interventions, including regular food and water distributions to the all of the camp’s registered residents, continue uninterrupted. Furthermore, CARE’s dedicated team of 1,600 refugee workers, who live and work in the camps, continue to provide services including education and psychosocial support even in locations that are inaccessible to non-refugee staff.


CARE’s work in Dadaab falls into the following sectors:


  • Water, sanitation and hygiene (WASH): CARE’s work providing safe drinking water and sanitation is more crucial than ever given a recent outbreak of cholera. Our system of boreholes and tap stands provides an average of 18 liters of water per day per person in the three main Dadaab camps – more than the international humanitarian standard of 15 liters. Monitoring staff continue to test the water quality twice daily.


  • Public health promotion: In response to the steadily rising number of cholera cases, and unabated rains, CARE is scaling up our hygiene promotion activities, and taking the lead in mobilizing WASH and health partners in coordinating our response. Activities include soap distribution, jerry can cleaning, household hygiene visits, and disinfection of latrines with 1 percent chlorine solution. CARE is distributing sanitation tools in collaboration with WASH committees, constructing solid waste collection points in Hagadera camp, and overseeing the collection of animal carcasses under police escort.


  • Food security: CARE is the primary distributor of food donated by international humanitarian partners to registered camp residents. Every day our logistics team oversees the distribution of 389 metric tons to 45,000 people. Due to security concerns and the sharp decline in the arrival of new refugees, immediate distributions of food to unregistered new arrivals remain suspended. 


  • Education: CARE operates five schools serving 15,000 students in Dagahaley camp at Dadaab. Some services, and registration of new students, remain suspended for security reasons. Refugees who workfor CARE are a vital support in keeping classes operating, and Kenyan national primary and secondary school examinations were successfully conducted in November. School buildings remain severely overcrowded, with overflow classes held in tents and courtyards, and more space is urgently needed.


  • Gender-based violence and psychosocial support: Newly arrived refugees have consistently reported an extremely high rate of violence, rape or abduction, and women and girls always face an elevated risk in refugee camp situations. Although the security situation currently prevents CARE from operating our regular system of psychosocial counseling through drop-in centers, we are continuing door-to-door campaigns, focus group discussions and road shows on sexual and gender-based violence and psychosocial support services. Our recent campaigns, with the crucial participation of CARE refugee workers, have reached over 34,000 people in Ifo and Dagahaley camps. 


2. Other affected areas in Kenya


In addition to hosting large numbers of refugees, parts of northern Kenya are themselves severely affected by drought. CARE maintains a broad range of programming in water, sanitation, hygiene, and longer-term efforts to help communities become more resilient. To date almost 477,000 people have received CARE’s help directly or indirectly through family members. Examples of our recent activities include:


  • In Garissa, CARE scaled up emergency animal health interventions including mass treatment and vaccination, de-worming, active disease surveillance and training of disease surveillance committees.
  • CARE and our partners in the Arid and Marginal Lands Recovery Consortium supported the district veterinary offices of Garissa, Mandera West and Wajir South on mass treatment, vaccination and de-worming and disease surveillance. A total of 208,351 livestock were treated.
  • We identified vulnerable families, including those in Dadaab host communities, to receive emergency cash transfer payments – which have been demonstrated to be effective in addressing immediate food insecurity, while supporting local economies.
  • A baseline survey on sexual and gender-based violence is currently ongoing in host communities.
  • Water, sanitation and hygiene activities in the area included cash-for-work projects to improve infrastructure; training of community members as borehole pump attendants; and community hygiene training.
  • ·         Drought emergency and resilience projects have included cash-for-work activities designed to rehabilitate range land and de-silt and expand rainwater harvesting pans. Members of the most vulnerable households are targeted as cash-for-work participants, with an emphasis on equal opportunity for women.
  • CARE is working with community members to begin constructing latrines and hand washing facilities in six schools, benefiting 3,214 students including 1,737 girls.




Despite the critical security situation in south central Somalia, CARE continues to scale up our humanitarian response. We operate both independently and through local partners in various parts of the country. Our priority regions include relatively stable parts of northern Somalia that are struggling to accommodate displaced people from the south.


Our emergency work in Somalia covers the sectors of water, sanitation and hygiene; food security; livelihoods; health/nutrition; and the distribution of other critical supplies. Our longer-term objectives include a variety of approaches to help communities build resiliency and sustainable livelihoods.


Recent activities include:


Water, Sanitation and Hygiene:


  • In the semi-autonomous northern region of Puntland, CARE continues to conduct water quality tests on new and rehabilitated water sources and storage facilities completed under the recently completed Puntland Emergency Response Project. Communities took part in the work and are responsible for the long-term maintenance and upkeep of the infrastructure.
  • In Galkacyo and Berbera, sanitation and hygiene promotion activities in schools including training to primary school teachers are ongoing.
  • In Lower Juba, we provided clean, safe water, and aqua tabs for water treatment to 8,400 families.  
  • To date, CARE has reached 63,000 individuals through WASH projects in Somalia.


Other activities:


  • CARE’s distribution of essential non-food items kits, including kitchen and hygiene necessities, is reaching 2,400 people in Burao, Somaliland, who have been displaced from other parts of Somalia, as well as members of the host community.
  • An additional 1,400 non-food item and 4,200 hygiene kits are destined for affected drought-affected households in Lower Juba.
  • Given the crucial role played by CARE’s local partner agencies, especially in areas highly affected by insecurity, we continue to provide training in areas such as CARE's principles and procedures, quality and accountability, cross-cutting issues such as conflict sensitivity/do no harm, gender and prevention of sexual exploitation and abuse.                   
A Somali child in Dadaab
A Somali child in Dadaab



In Ethiopia, Kenya and Somalia, CARE is mounting a large-scale crisis response, including general food distributions, emergency stabilization for malnutrition cases, water, essential household items, education and psychosocial support, reaching 1,758,825 people through the end of October.  In addition to immediate aid, CARE is also providing long-term assistance to reduce vulnerability to future disasters.

Some updates on CARE's activities in the Horn of Africa

In Kenya:

In Dadaab:

  • Water/Sanitation/Hygiene (WASH) programs have been conducted.
  • Public Health Promotions, including animal carcass collection, have been implemented. Communities are taking an active role in effective and hygienic collection and disposal of carcasses.
  • CARE will be distributing Common Relief Items (CRIs) - including over 28,000 jerry cans - this month

Beyond Dadaab:

  • Scaling up animal health interventions
  • Training communities on disaster risk reduction
  • Providing WASH services (including rehabilitation of boreholes and earth pans) through cash-for-work programs 

In Ethiopia:

  • Nutrition and Food - Well over 1,000 children under five have been treated for malnutrition through stabilization centers, supplementary feeding and outpatient therapeutic programs. Thousands more are expected to be treated.
  • The Productive Safety Net Program (PSNP) has begun, in collaboration with the World Food Programme, to shift chronically food-insecure rural people from recurrent emergency food aid to a more secure and predictable, and largely cash-based, form of social protection. The program has reached a total of 14,168 individuals.

In Somalia:

  • WASH: Thousands have benefitted from clean water trucking, rehabilitation of water points, hygiene and sanitation training, provision of water filters, latrine construction and water quality training.
  • Nutrition and Food: Food Security and Livelihoods: Supplementary Feeding Programs have reached 4,929 children under five and pregnant and lactating women. Additionally, hundreds of newly displaced families have received essential non-food items.
Dadaab - Connections
Dadaab - Connections


The CBS Early Show profiled a CARE food distribution in Dadaab on Aug. 9. The segment included an interview with CARE Kenya’s Michael Adams and extensive coverage of CARE’s work on the ground.



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Organization Information


Location: Atlanta, GA - USA
Website: http:/​/​
Project Leader:
Melanie Minzes
Washington, DC United States

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