Save Somali Refugee Children from Malnutrition

by US Association for UNHCR (UN Refugee Agency)
Per Heggenes, IKEA Foundation, with young refugees
Per Heggenes, IKEA Foundation, with young refugees

Bonkay may seem a bit old to be going to school but, like her classmates, the 23-year-old mother and refugee missed out on a proper education while growing up in her village in central Somalia's Bay region.

Now, Bonkay and her classmates are catching up on their schooling in a refugee camp located in Ethiopia, thanks to the Youth Education Pack, or YEP, a UNHCR-backed program implemented by the Norwegian Refugee Council and funded by the IKEA Foundation. It helps Somali refugees and local Ethiopians aged between 15 and 24 who have little or no formal education. Students initially focus on literacy and numeracy training, followed by vocational and life skills classes. The aim is to teach people new skills and help them become self-sufficient.

Bonkay is illiterate and has never studied before. In July 2011, the combination of general insecurity and the worst drought in more than half-a-century forced her and her husband to leave their village with their two children. "We used to farm and keep livestock, but they all died because of the drought and we were also in danger of losing our two children," she explained.

They walked for nine days to Dollo Ado in south-east Ethiopia, joining tens of thousands of others in what is now the world's second largest refugee complex, after Dadaab in Kenya. The five camps in Dollo Ado, including Kobe where Bonkay lives, host more than 170,000 refugees, mostly from Somalia.

After arriving in Kobe camp, Bonkay and her husband spent time getting settled before thinking of the future and how to make the best use of their time. Her husband failed to find work and the family were completely dependent on assistance from UNHCR, its partners and the government.

But Bonkay was not content to sit back and rely on others, she wanted to "study and work to support myself and my children." Then, as she recently explained to Per Heggenes, the visiting chief executive officer of the IKEA Foundation, she heard about the YEP program, which is only run in Kobe.

She enrolled to take a basic literacy course and to study math, followed by vocational skills training, and told Heggenes, "I want to become a cook and open my own restaurant." She will learn culinary skills once she has finished the literacy and numeracy training.

The various YEP courses  all free  run for one year and the students are encouraged to use what they have learned to set up their own businesses, with help from the Norwegian Refugee Council.

About 400 students, half of them women, are taking part in the program, studying in a makeshift building while the Norwegian Refugee Council builds something sturdier. About 280 are refugees and the rest come from the host community, with the teachers recruited locally.

Moses Okello, the UNHCR representative in Ethiopia, welcomed the program and the IKEA Foundation's support.

"When the refugees arrived here in 2011, we were focused on life-saving activities," he noted, while adding that "now we are able also to turn our attention to consolidate the gains made by offering the refugees an opportunity to study and acquire skills that they will eventually take home with them."

His enthusiasm was echoed by Hegennes, who said those working on the program in Dollo Ado had "embraced the concept of innovation and efficiency" and were "creatively pursuing opportunities to improve the services for refugees in ways that have not been done before."

The YEP initiative is part of a three-year partnership between the UN refugee agency and the IKEA Foundation to support refugee and host communities in the Dollo Ado region. The overall aim is to reduce dependency on aid and promote self-sufficiency in this arid, isolated region.

This includes helping the host community that has welcomed so many vulnerable people. During his visit, Heggenes handed over water pumps to local farmers and visited 120 transitional shelters built for them by UNHCR and the Norwegian Refugee Council with IKEA Foundation funding.

The local population will have access to all the infrastructure built under the program, including health facilities, schools, water systems and solar power systems.

Other important aspects of the IKEA Foundation-UNHCR program include a shelter project to research, pilot and develop alternative ways to lay out a refugee camp. Another project is the construction of a new health center in Kobe which will be able to provide minor surgery and treat emergency cases and pregnant women. As it stands now, mothers-to-be must travel for about three hours on a bumpy road to receive specialist care.

Bonkay, meanwhile, is starting to feel hopeful again. "Nobody can take my skills away from me, they will not disappear like my farm and livestock did," she said as she played with her two-year-old son during a break from class.

Somali refugee receives English-Somali dictionary
Somali refugee receives English-Somali dictionary

SHEDDER REFUGEE CAMP, Ethiopia, November 1 (UNHCR) Seventeen-year-old Hodan's eyes sparkle with joy as she clutches her new English-Somali dictionary a congratulatory gift from UNHCR on passing a national high school exam.

She's one of 35 teenage refugee girls in Shedder and Awbare camps, near Jijiga in north-east Ethiopia, who recently passed the national exam to make it into Grade 11. An impressive 85 per cent of Hodan's classmates passed, triumphing over hardships that usually hold girls back in her traditional Somali society and in the refugee camp she has called home for the last three years.

"I have to help my mother," says Hodan. "I spend most of my time cooking, taking care of my brothers and sisters, cleaning our place. There is no time to do my homework during the daytime." When she does have time to study after finishing her chores, "it is already dark and there is no electricity in the camp."

Undaunted, Hodan adds: "Sometimes I get up at two in the morning and light a candle to read my textbooks and write exercises."

Against odds like those, fewer than 20 per cent of teenage girls were attending schools in the three refugee camps in Jijiga that host more than 41,000 Somali refugees. That was before UNHCR launched a special programme at the beginning of this year aimed at getting more girls to attend and stay in school. Since then female attendance has soared to 32 per cent.

Even though education is free, families still struggle to pay for uniforms, books and supplies. If they have to make a choice, they educate their sons rather than their daughters.

With support from the United Nations Foundation, the UN refugee agency began putting more books into refugee camp school libraries and hiring women teachers as role models and mentors. Girls got their own space in the schools where they could spend their breaks and do schoolwork.

Even better bathrooms made a difference in boosting girls' attendance and classroom performance. In Shedder Camp, all 28 of the Grade 10 girls who sat for the national examination passed, and 75 out of the 76 male students.

Another important ingredient of success was convincing parents and the rest of the community of the importance of educating girls. "We want to encourage more girls to continue studies," says Agnes Mukantwali, head of the UNHCR sub-office in Jijiga.

Hodan, who fled the embattled Somali capital, Mogadishu, lives with her mother and five younger brothers and sisters. She says girls are often forced to drop out of school to get married at a tender age often because desperately poor parents need the dowry money the daughters attract.

"I am not yet married and hope to be able to complete the secondary school first," says Hodan.

Mukantwali agrees that girls' education is essential. "If educated, refugee girls can change the life of the entire community not only in the refugee camps, but also when they return to Somalia one day," she says. "These girls are the future of Somalia."

The education project is now giving solar lanterns to all boys and girls in both camps in Grade 4 and above. For Hodan, it's a chance to study, do homework and read even after the sun has gone down.

"My dream is to get a scholarship and go to university to study computer sciences," she says. "Can you imagine a Somali female information technologies specialist? I want to prove that it is possible. I can do it."

By Natalia Prokopchuk in Shedder Refugee Camp, Ethiopia


Aden Yusuf Kabey, soon after arriving in Ethiopia
Aden Yusuf Kabey, soon after arriving in Ethiopia

A year after the onset of the Somalia famine, Yusef Kabey can laugh at the pain he endured. He has regained the body weight he lost over the past year. He can walk, eat and sleep.

"I've come back from the dead," says the 22-year-old. "Now I want to have a future and take full advantage of my life. I'm even handsome."

A year ago, Kabey lay in his father's shelter wrapped only in a flimsy blue cloth. The wind blew incessantly around the hut, which was constructed of just of sticks and cloth. Kabey had arrived in Ethiopia starving and desperate from Baidoa, Somalia. Almost immediately after his arrival in July of last year, he contracted measles and could no longer take in food or sleep.

When he became so weak that he was unable to move, his father found a man with a donkey cart and took him to a stabilization center. After five days, he could begin to use his legs again. After a month, he was no longer on death's door.

Kabey's story and that of other refugees who survived the Somalia famine is not just the tale of an individual. It is a case study of how UNHCR responded to a life and death crisis.

In July of last year the mortality rate for children under five in Kobe camp was well over 16 per 10,000 a day, about three times the rate that by any account would be considered catastrophic.

A year after the crisis, mortality rates have plummeted to levels well below the emergency threshold.

"Last year there was measles and hunger; there were storms that would take the houses away. There was a shortage of tents there was nothing but problems," said refugee community leader Mire Ahmed Adu Rahman, 44. "But now the dying time is over thanks to God. This year, there is life."

Making the transition away from the dying time was not easy. A series of innovations were necessary in order to save lives. The changes that took place in the camp were about cultural as much as they were about logistics or nutrition.

Medical facilities in Kobe were immediately enhanced. A system of donkey cart ambulances was created to transport those who could not walk to the hospital. Stabilization centers, usually used to treat severe cases of malnutrition in children under five, expanded to include all who were suffering.

After being stabilized, those stricken with severe acute malnutrition were given healthy doses of plumpy-nut, a therapeutic food designed and formulated to treat the severely malnourished.

Immunization programs against measles, which in most emergencies also focus on young children, were expanded to include adults up to 30 years of age.

By September, a clear strategy was in place to save the dying, rehabilitate the malnourished and educate the rest of the camp about the importance of nutrition.

Supplementary feeding centers and outreach workers were reaching every corner of the camp. But training those workers also presented challenges.

The vast majority of refugees at the camp was unfamiliar with the basic tenants of Western medicine and had never seen a doctor or a hospital. Some did not know what a doctor was.

"Training was about changing mentalities," said Dorothy Gazarwa, a UNHCR nutrition officer who has worked in Dollo Ado since last September. "It was important for us to constantly perform refresher trainings and repeat the nutrition message over and over."

By October, the death rate among children in Kobe camp had dropped dramatically. But malnutrition rates were still dangerously high. More children were now living due to health interventions and it would take some time for everyone to recover from malnutrition.

UNHCR and its partner agencies began to realize that they faced another dilemma: while therapeutic foods and general food rations were available, these products were new to a population that did not understand their value in saving lives.

"People who for their entire lives drank camel milk had to learn that Plumpy-Nut was more efficient," said Gazarwa. "Our task was cultural as well as nutritional."

In February, the World Food Program, partnering with UNHCR, expanded its feeding program for children to include nutrient-dense cereals. UNICEF expanded its mother and child feeding program in the camp, teaching mothers about age appropriate feeding.

By late September, the threat of measles had receded. Camp residents were healthier and could begin to see beyond their own day to-day needs. The fabric of a community began to form out of the crisis.

While the crisis in Kobe is waning, other camps in the region remain in crisis.

At Bur Amino camp, 32% of children are still underweight. At the same time hundreds more refugees cross the border into Ethiopia each day, with Bur Amino camp reaching its capacity at the end of July.

And, with the political instability continuing in Somalia, tens of thousands more could me coming. 

A smiling, healthy Aden in July 2012.
A smiling, healthy Aden in July 2012.


A young Somali refugee in Dadaab, Kenya. (c)UNHCR
A young Somali refugee in Dadaab, Kenya. (c)UNHCR

The UN Refugee Agency says that growing numbers of displaced Somalis have been citing difficulty in providing for themselves as the main reason for fleeing their homes.

Most of the hundreds of thousands of displaced Somalis have fled to escape insecurity, including 146,000 so far this year. But UNHCR spokesman Adrian Edwards said that in recent weeks "we have seen an increase in IDPs [internally displaced people] and refugees also citing difficulty in providing for themselves."

In the past seven weeks, UNHCR has registered some 6,000 Somalis who have cited such difficulties arising from meager seasonal rains and resulting food insecurity. The majority are from Somalia's Bay, Lower Juba and Bakool regions.

For 2012 to date, UNHCR has recorded 13,000 such displacements. However, in May alone, the refugee agency registered 4,400.

In Lower Juba region, people are moving to the towns of Diif, Qoqani, Tabta and Dobley in search of water and pasture. They have settled in areas around Dobley and Diif, close to the border. Many are now integrated with host communities, while others have settled on the outskirts of the towns. There are similar displacements in and around the Dollow, Gedo region bordering Ethiopia.

In Ethiopia, as of this week, there are more than 157,000 Somali refugees in the five camps and transit center at Dollo Ado. Since the beginning of June, Somali refugees have continued to arrive in increasing numbers, with an average of almost 1,200 new arrivals every week.

These refugees consistently cite growing physical and food insecurity as their reasons for flight, including fear of forced recruitment by the Al Shabaab militia group.

"Many new arrivals are coming with all of their belongings, including donkey carts and whatever livestock they still possess. Many say that other family members and neighbors in Somalia intend to follow," Edwards said. UNHCR and Ethiopian authorities have agreed to extend the capacity of the Buramino camp to above 25,000, while finalizing site selection for a sixth camp.

There are also reports that the regular commercial traffic carrying food and other commodities from the Somali port town of Kismayo to Afmadow, Lower Juba Region and Dobley has been hampered by roadblocks since late last week.

"We note with concern that the continuation of such paralysis would have negative consequences for already vulnerable internally displaced people and host communities in the region and will likely increase local commodity prices," Edwards said. 


Somali Refugee children in Dadaab. UNHCR/B.Bannon
Somali Refugee children in Dadaab. UNHCR/B.Bannon

This year is the 20th anniversary of the world's biggest refugee camp, Dadaab in north-eastern Kenya.

The UN High Commissioner for Refugees (UNHCR), which manages the Dadaab complex, set up the first camps there between October 1991 and June 1992. This followed a civil war in Somalia that in 1991 had culminated in the fall of Mogadishu and overthrow of the central government.

"The original intention was for the three Dadaab camps to host up to 90,000 people," said UNHCR spokesman Andrej Mahecic. "However today they host more than 463,000 refugees, including some 10,000 third-generation refugees born in Dadaab to refugee parents who were also born there."

During last year's famine in Somalia, arrival rates frequently exceeded 1,000 people a day. Around 30,000 arrived in June, 40,000 in July and 38,000 in August. This has placed additional strain on existing resources. Together with the local authorities and humanitarian agencies, UNHCR managed to address the influx by establishing reception centers and rapid response assistance for new arrivals.

"That Dadaab has been able to provide refuge for so many years and to so many people is thanks first and foremost to the Government and people of Kenya," the UNHCR spokesman said.

UNHCR, together with the Government of Kenya and working with other aid agencies has provided protection, shelter and humanitarian assistance, often under difficult and complex circumstances. Chronic overcrowding, risk of disease, and seasonal floods are among the challenges.

"On the occasion of this anniversary UNHCR is renewing its appeal to the international community to ensure continued support to the approximately 1 million Somali refugees in the region, and to Kenya and the other countries that are hosting them," Mahecic said.

A third of this refugee population left Somalia in 2011 in the face of crippling conditions of drought, famine, and violence.

The 20 years that have passed since the camps opened also underline the need for peace in Somalia, an end to the violence there, and the possibility of refugees being able to return home.

"UNHCR hopes that deliberations during the London Somalia Conference, which starts on February 23, will act as a catalyst for a permanent solution to the perennial issue of the Somali situation  something that UNHCR has long pressed for," the UNHCR spokesman said.

Currently, the situation at Dadaab is extremely challenging. The kidnapping of three aid workers last autumn and more recently, the killing of two refugee leaders and several Kenyan policemen, as well as threats against humanitarian staff have forced UNHCR and its partners to rethink the way that aid is delivered.

Since October and until recently, there were security restrictions on movement around the camp. However, life-saving assistance such as the provision of food, water and health care never stopped and has always been UNHCR's priority. In addition, schools run mostly by refugee teachers have been open and managed to conduct Kenyan national exams at the end of 2011 despite the insecure environment.

Since the end of last year, humanitarian actors have looked at various ways to resume activities, using different methodologies and most importantly, shifting more responsibilities to the refugee communities.

As such, the crisis also presents an opportunity to more actively empower refugees to manage the day-to-day aspects of camp life. This includes the engagement of youth in providing informal education to new arrivals in Kambioos, water committees coordinating and ensuring sufficient water per household, refugee reporters publishing their own newspaper, and women forming groups for livelihood opportunities for mothers.

Services in the areas of health, water and sanitation have also been scaled up. On a typical day, some 1,800 refugees now get outpatient treatment in hospitals and health posts in the camps. Service provision in Kambioos has also improved. However, UNHCR is still seeing new measles cases (11 in the last week) and is focusing on vaccinating all new arrivals over 30 years of age.

UNHCR teams are involved in protection and community-services work including carrying out regular protection monitoring and livelihoods projects. Refugee teachers are receiving training on child-centered approaches, classroom management and psycho-social support. Activities focused on youth, women and refugees with disabilities are running again.

Earlier this month, UNHCR also resumed the relocation of refugees from the less secure outskirts of Dagahaley camp to Ifo 2 camp, where they receive family tents and basic assistance and services. Some 2,000 refugees have been moved so far, with another 3,500 set to join them in the coming weeks. By the end of the exercise, the entire camp of Ifo 2, with a capacity for 80,000 people, will be filled.

More than 968,000 Somalis live as refugees in countries neighboring Somalia primarily in Kenya (520,000), Yemen (203,000) and Ethiopia (186,000). A third of them fled Somalia in the course of 2011. Another 1.3 million people are internally displaced within Somalia.



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US Association for UNHCR (UN Refugee Agency)

Location: Washington, DC - USA
Website: http:/​/​
Project Leader:
Lauren Meling
Washington, District of Columbia United States

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