Days of disaster for the people starved of food and hope for a brighter future

In the heat of the midday sun, children patiently wait to register for food in one of the sprawling refugee camps which have sprung up on the Somali border with Kenya. They won’t get enough to satisfy their hunger, they never do and they know that even if they had the energy to fight for more, it would make no difference.

Elsewhere, a mother struggles to build a makeshift shelter for her family. Her baby is strapped to her back while she works. Once she has finished fashioning a home out of whatever materials lay nearby, she will work out how she can pay for that evening’s dinner.

At the Dagahaley camp, one of three on the outskirts of the town of Dadaab, the scenes of human tragedy increase by the day. More than 10,000 malnourished and destitute Africans arrived last week; next week there will be another 10,000 and the same the week after that.

The camp’s basic facilities were only meant to cater for 90,000, but its population has now swelled to four times that number. There is not enough food or medicine to go round, but the families stay because there is nowhere else to go.

As the East African crisis, caused by a lethal combination of drought, conflict and escalating food prices, deepens 480,000 children are severely malnourished and risk death, a further 1.6 million are moderately malnourished and more than nine million require urgent assistance. So great are the numbers in need, the figures almost become meaningless.

Not for the first time, Ethiopia, Kenya and Somalia are starving and the rest of the world, which has become so used to footage and photographs of famine, has been slow to wake up to the fact this time it could be worse than ever before.

Just last month, the Famine Early Warning Systems Network ordered large-scale emergency assistance to the Horn of Africa and stressed the current humanitarian response was inadequate. Yet even when Kenya, which has seen hospital admissions rise by three-quarters on last year, declared a national disaster, the rallying cry was muted.

The UK Government has tried to lead from the front, recently providing a £52m aid package, but more will be needed. In excess of 10 million people are now threatened by the impact of the worst drought in the region for 60 years, tens of thousands have already been made homeless and as they go in search of food, UNICEF is appealing for help.

The aid organisation has already set up feeding programmes, immunisation campaigns and projects to improve access to safe water and improved sanitation, but pulling a nation back from the brink of catastrophe does not come cheap. To provide humanitarian assistance to women and children in the most affected areas for the next three months, UNICEF estimates it needs to raise £20m.

Money alone will never provide a cure all, but it will allow feeding programmes like the one in the Korogocho settlement in Nairobi to continue. There, 200,000 people – more than the population of York – are crammed into one square kilometre and the little resources available are being stretched to breaking point.

“There are no basic services to speak of, water supplies are inadequate, there are hardly any schools and as well as a malnutrition, the threat of HIV and Aids looms large,” says a UNICEF spokesman, adding that soaring inflation has made an already dire situation much, much worse. “The cost of basic foodstuffs have risen by 133 per cent in recent months and while crops have failed, cereal prices have remained high. Many families are now spending 75 per cent of their entire income on food, which is simply not sustainable.

“When they inevitably run out of money, the boys turn to crime and the women to prostitution. It’s the only way they can think of to earn more. Others borrow from neighbours but when they can’t repay the debt as so often happens, they pack up the few belongings they have and move on elsewhere.

“It really is a desperate situation.”

Among these now nomadic families are many single mothers, who each day face impossible dilemmas. Like most parents, earning enough money to support the family and safeguarding their children are their main priorities. However, in the Somalian dust bowl, most can’t do both.

“About 60 to 65 per cent of the women are single mothers between the ages of 17 and 24,” says the spokesman. “To earn a living, many of them take work as casual labourers, which means leaving their children at home.

“Severe malnutrition is a problem in the settlement and these women often have to make difficult decisions – do they take a sick child to the health centre or do they look for work to earn money to feed their other children.

“Many choose to work and consequently by the time they seek medical care for the child, it is a matter of life and death. The reality is that in many cases these desperately sick children don’t even make it to the referral hospital because their mother can’t afford the transport. It only costs $2, but in the context of what they earn that is a huge amount.

“Even those that do get there for initial treatment, afterwards they struggle to keep up the outpatients visits.”

UNICEF has set up a system of community health workers. Representatives from the nine informal villages which make up the Korogocho settlement have been recruited to monitor the hospital attendance and those who fail to turn up for an appointment are now being chased up.

Young mothers are also being encouraged to join support groups which meet regularly to discuss issues such as child-rearing, family planning and sources of income. Raising awareness of the threats to their health and livelihoods is as much a part of the solution to the East Africa crisis as the handing out of direct aid.

Elijah was one of the fortunate ones who did make it to hospital before it was too late. Now 11-months-old he was diagnosed with a severe case of malaria and measles in May. Critically ill, and painfully thin – he weighed just 9.5lb, less than half the ideal weight of a baby his age – his chances of survival appeared slim, even his mother was convinced her son was going to die.

However, the family were spotted by one of UNICEF’S community health workers during her door-to-door visits and Elijah was immediately admitted to the settlement’s Provide Clinic where he began a course of life-saving treatment. Fed on Plumpynut, a high protein, peanut-based food which has been used in famine relief since the late 1990s, Elijah’s condition gradually began to improve. The last time he was put on the scales he weighed 11.4 lb, still some way shy of the ideal, but moving definitely in the right direction.

Sadly many babies in Korogoch don’t always get their full course of Plumpynut. For many families it’s one of the few things of value in their possession and the food is often sold for money.

“They do it out of desperation,” says the spokesman. “However, the Provide Clinic requests that parents bring back their empty sachets in order to qualify for the next dose and the community health workers act as a vital connection between the medical staff and those in need.”

Following Sir Bob Geldof’s impassioned appeals which in July 1985 resulted in Live Aid, it was tempting to think that the Third World would never again be allowed to slip unnoticed into a humanitarian disaster. However, the crisis engulfing the Horn of Africa countries is a stark reminder of just how fragile the future remains and worse is to come.

According to the Government’s chief scientific adviser Professor Sir John Beddington, a perfect storm of growing population, climate change and diminishing resources for food production, is heading our way.

“We know that in the next 20 years, the population will increase to something like 8.6 billion people,” he said recently. “We know that urbanisation is going to be a driver and that something of the order of 65-70 per cent of the world’s population will be living in cities at that time.

“We know that the world is getting more prosperous and that the demand for basic commodities – food, water and energy – will rise as that prosperity increases. We have 20 years to arguably deliver something of the order of more than 40 per cent more food, 30 per cent more available fresh water and 50 per cent more energy. Nothing less is required than a redesign of the whole food system to bring sustainability to the fore.”

Next month, when Elijah turns one, his mother hopes to have enough money to buy chicken and chapattis. It’s not a lot to ask, but in Kenya, sometimes realising even the smallest dreams is impossible.

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Small sums – big difference

33p buys one packet of therapeutic peanut paste – a life-saving food to help malnourished children begin to recover.

£19 is enough to provide 100 vaccines to protect 50 children against measles.

£23 would buy 5,000 water purification tablets for families who cannot access fresh, clean water.

£25 is enough to provide a month’s supply of therapeutic peanut paste for one severely malnourished child

£95 would pay for water kits for 10 families, so that they can collect, store and even purify water.