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Nutrition Information in Crisis Situations - Djibouti
NICS 7, August 2005
The situation is still precarious in Djibouti where high temperatures and
continuing food deficits are putting many pastoralists at risk. The physical
condition of livestock is deteriorating and rural exodus to urban areas has been
witnessed (WFP, 12/08/05). Furthermore, prices in urban areas have exceeded the
alert level for poor households (FEWS, 07/05). The food aid pipeline is not
sufficient to guarantee proper distributions to the needy populations (FEWS,
07/05). A rapid assessment done in May 2005 in three sites in each of the five
districts most affected by the drought, and where all the 6-59 month olds were
measured, showed contrasting results. A significant level of acute malnutrition
(up to 33%) was found in some of the sites surveyed, while the situation was
acceptable in other sites. The populations the most at risk seemed to be the
refugees from Ethiopia and the nomadic population which had lost their animals
and were dependent on food aid (WHO/MOH, 05/05).
NICS 6, May 2005
Djibouti is a small country of about 500,000 inhabitants. Because only 3% of
the land is arable, most of the inhabitants were nomadic pastoralists. However,
due to adverse climatic conditions and national border limitations, most of the
population (an estimated 85%) have shifted to an urban way of life. They mostly
rely on the activity of the port of Djibouti.
The last three rainy seasons were poor and this was compounded by the
migration of pastoralists from Somalia, Ethiopia and Eritrea in search of
pasture and resulted in the deterioration of the food security situation (OCHA,
21/04/05). At the beginning of April 2005, the government of Djibouti asked for
support from the international community for the provision of the humanitarian
assistance to 28,650 persons affected by the drought (OCHA, 21/04/05). A flash
appeal was then launched by the international agencies for providing emergency
assistance such as food to 28,650 people, water to 18,000 people, implementing
nutrition programmes for malnourished children, and animal feed, water and
emergency veterinary care for 50,000 heads of livestock (OCHA, 2005).
A further assessment carried out at the end of April estimated that the
number of people in need of emergency food assistance had increased from 28,650
to 47,500 due to additional migration of pastoralists (WFP, 13/05/05). Food
deficits of between 17% and 50% are expected to start in June and to last for at
least six months in pastoral areas (FEWS, 13/05/05). The most affected areas are
the Southeast pastoral zone, the Roadside sub-zone and the Northwest pastoral
zones (see map). NICS is not aware of any nutrition survey recently conducted in
Djibouti.
The government of Djibouti has started to provide water to the population of
the Roadside pastoral zone. Food is currently distributed, but is only
sufficient to cover the needs until the end of May. Further pledges towards the
appeal are urgently needed.
Recommendations
Requirements for international assistance to the needs of the government of
Djibouti:
- Expertise in appropriate and effective emergency livestock interventions
- Water, food and veterinary care for livestock
- Support for water purification and distribution as well as logistical
assistance in terms of fuel and spare parts for borehole generations and for
water tankers
- Emergency food rations
- Supplementary food
- Support for national disaster management structures
- The provision of non-food items, especially containers for storing water
RNIS 4, April 1994
The nutrition and health situation of the estimated 32,000
Ethiopian and Somali refugees in Djibouti remains stable. Repatriation plans are
under way although refugees have not yet started to return.
In January 1994 crude mortality rates were near normal varying
between 0.1-0.3/10,000/day. Although the beri-beri out-break (caused by lack of
vitamin B1) reported earlier (RNIS #2) is now said to be under control as a
result of vitamin (thiamine) treatment and addition of com soy blend to the
ration, some cases are still being reported. For example, 142 cases were
reported in January 1994. Aour-Aoussa and Assamo camps (estimated population
10,000) had the most cases of beri-beri reported. However, it should be noted
that mild cases can be very difficult to diagnose correctly so there may be some
over-reporting [UNHCR 18/02/94, WFP 25/03/94]. There have been some anecdotal reports of a newly displaced
population in the North who may require assistance, although no details are
currently available [ICRC 28/03/94]. While most of the refugee population are probably not
currently at risk (category IIc in Table 2), the estimated 10,000 in Aour-Aoussa
and Assamo camps are still at high risk due to the existence of beri-beri
(category Ia in Table 2). How could external agencies help? The
main priority here, is to ensure that the food pipeline is not disrupted, paying
particular attention to availability of micronutrients, either as thiamine
supplements, and/or as com soya blend.
RNIS 2, December 1993
There are currently 30,000 Somali and Ethiopian refugees
residing in four camps in Southern Djibouti, who have fled civil wars in former
Northern Somalia and Eastern Ethiopia. The government has recently been
requesting the transfer of urban refugees to two additional camps which it is
estimated would create an overall camp population of 32,000 refugees. The
previous RNIS report drew attention to anecdotal reports of beri-beri amongst
this refugee population. This condition is caused by lack of thiamine and
associated with rice based diets. Subsequent investigation by a UNHCR
nutritionist (October 1993) confirmed the existence of this problem,
particularly amongst children under five and women of child bearing age. Most
cases were reported between August 1st and September 30th but there were no data
on the prevalence of the condition. Although other possible factors were cited,
e.g. sharing of food ration, lack of adequate cooking fuel, the occurrence of
beri-beri appeared to coincide with a change in the ration whereby rice became
the main cereal in the ration between July and September thereby reducing the
thiamine content. Between January and June the ration had contained more than
sufficient thiamine. The nutritionist recommended that, starting with the
November ration, the wheat flour in the food aid pipeline be replaced by maize
or whole wheat. The addition of corn soy blend in order to improve thiamine
content of the ration was also recommended. These recommendations were accepted
and are being implemented. The overall prevalence of wasting is 8%. In Table 2 we have placed this refugee population (32,000) in
column IIb on the basis that the distributed food ration has been modified to
account for thiamine deficiency. However, we have placed an asterisk in column I
to indicate that an unknown number of people affected by the reported outbreak
of beri-beri may still be recovering. |
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