Chronic Malnutrition: a Problem not Addressed by SFPs
An Appeal for a Development Programme by MSF Spain in Mandera District, Kenya

The chronic nutritional emergency in Central Mandera, north east Kenya, was the subject of an article in the last Field Exchange. Lourdes Vasquez of MSF Spain asserted that emergency selective feeding programmes (SFPs) were no solution to the chronic problems in the area and that without considerable development initiatives such measures will remain nothing more than palliatives in a cycle of soaring rates of malnutrition temporarily reduced by sporadic emergency interventions. The dramatic results of a recent nutritional survey conducted by MSF Spain lend considerable weight to her arguments and conclusions.
The survey, which was conducted in May 1999 found a 39.2% rate of global acute malnutrition with 6.9% severe wasting. This is compared with a global acute malnutrition (GAM) rate of only 21% in November 1998 when MSF Spain stopped their emergency selective feeding programme. The results of this survey have prompted the MSF Spain country director to make an appeal for development programmes in the district.
He argues that the GAM of 21% recorded in November 1998 is a normal rate for the district where malnutrition has become a chronic problem. This is caused by recurrent drought and floods over the last decade during which many pastoralists lost all their livestock. The population has therefore become destitute with many moving to Mandera town to eke out a living selling firewood or grass. Many of the destitute are female headed households that have come from Somalia years ago. An added problem is that the area has always been neglected by the Kenyan government and humanitarian agencies. Food distributions by the government and/or WFP, if implemented, have been insufficient. In April 1999, people received a 1 kg distribution of maize per family! UNICEF have excluded the district from their new 5-year plan for Kenya. In the appeal, the MSF Spain country director complains that what happens in Mandera is what usually happens in the "arid lands"; short term funds are being released to pull the area out of an acute crisis phase (due to drought or flood) and back into its usual chronic difficulties, and then left struggling without assistance until the next emergency. He argues that what is needed is a joint effort of NGOs willing to work for a longer time frame in Mandera and co-ordination between these agencies to avoid duplication and to pool resources and knowledge.
The MSF Spain appeal is for both short term measures, e.g. general or targeted food distributions and medium/longer term programmes, e.g. livestock re-stocking, seeds and tool distributions, water projects and income generating schemes.
For more information contact: Graham Carrington, DFID East Africa, Upper Hill Road, PO Box 30465, Nairobi
More like this
FEX: Nutrition causal analysis: planning and credible advocacy
By Paul Rees-Thomas Based primarily in Eastern Europe and the Horn of Africa, Paul Rees- Thomas worked for five years with Action Contre Le Faim (ACF), latterly in the food...
FEX: Supplementary Feeding in Mandera: The Right Intervention?
View of the Mandera Camp Lourdes-Vazquez-Garcia worked for MSF Spain in the Mandera feeding centres during the period covered by this article. She subsequently qualified with...
FEX: References for Special Supplement 1
Women selling food in South Sudan AbuSaleh A, 1993. Cost effectiveness of feeding programs in Hartisheik A camp, for Somali refugees, Ethiopia 1988-1989. Unpublished report...
FEX: Issue 06 Editorial
Dear Readers, This issue of field exchange heralds the second phase of the ENN. Our first two years appear to have been sufficiently successful to prompt continued support...
FEX: Food distribution in Mandera district (Kenya)
By Manuel Duce-Marques The author, Manuel Duce-Marques is a qualified nurse who spent several years working for MSF Spain in Mandera District, Northeast Kenya. He has just...
FEX: Letter of thanks, by Ibrahim Abdi Dalahow
Dear ENN I was delighted by the report written in Field Exchange by Manuel Duce-Marques of MSF Spain in Mandera District, Northeast Kenya, I obtained from your website. My...
FEX: Postscript to 'Outbreak of micronutrient deficiency disease'. By Emma Naylor, Oxfam GB
Response to SCF Wajir Article By Emma Naylor, humanitarian programme coordinator, Oxfam GB Kenya Programme Oxfam Great Britain has been working in Kenya since the 1960s, and...
FEX: Livestock and livelihoods in emergencies
Lessons learned during the 1999 - 2000 emergency response in Kenya Summary of report* "The provision of veterinary drugs, such as de-wormers, prolongs the life of an animal...
FEX: Selective Feeding Programmes in Wadjir: Some Reasons for Low Coverage and High Defaulter Rate
By Fabienne Vautier The coverage and default rate in selective feeding programmes are taken as proxies of the accessibility and acceptability of these programmes. This article...
FEX: Evaluation of the Wajir Relief Programme 1996-98
Published Evaluation OXFAM (UK and Ireland) were engaged in relief work in Wajir District of Kenya from September 1996 until October 1998. The interventions were a response to...
FEX: Taking the politics out of resource allocation: the Kenya experience
By Jeremy Shoham Jeremy Shoham is co-director of the ENN and editor of Field Exchange. Over the past two years he has been working periodically as a consultant for the...
FEX: Critical gaps in drought response in Greater Horn of Africa
Summary of published research1 The drought currently affecting an estimated 11 million people in the Greater Horn of Africa is said to be the worst in more than a decade, with...
FEX: Issue 18 Editorial
By Fiona Watson Fiona Watson has been involved in assessment and evaluations of emergency nutrition and food security programmes for the last 10 years. She is currently a...
FEX: Trends in malnutrition prevalence and mortality
The May 2010 issue of the Centre for Research on the Epidemiology of Disasters (CE-DAT) publication, CE-DAT Scene1 includes a summary of the 2009 trends in malnutrition and...
FEX: References for Special Supplement 3
Beatrice, a beneficiary of the CRS seed voucher scheme in Burundi 1. Abdulai A., Barret, C., Hoddinott, J. (2004, June). Does food aid really have disincentive effects? new...
FEX: Practical challenges of evaluating BSFP in northern Kenya
Summary of published study1 Beneficiaries of BSFP in Kenya A mass or ‘blanket’ supplementary feeding programme (BSFP) was implemented by the World Food Programme (WFP) and...
FEX: Kosovo Evaluation
During 1998 and early 1999 the Federal Republic of Yugoslavia (Serbian) forces increased their efforts to 'ethnically cleanse' Kosovo. They justified this on the basis that...
FEX: Determining eligibility (Special Supplement 1)
Children are often a group targeted in emergencies Eligibility criteria, i.e. the characteristics of those individuals or households to be targeted with food, arise from the...
FEX: Action Contre la Faim
Name Action Contre la Faim Address rue Niepce, 75014 Paris, France Year formed 1979 Telephone +33 (1) 43 35 88 88 Director Jean Luc Bodin Fax +33 (1) 43 35 88...
FEX: A Review of the advances and challenges in nutrition in conflicts and crises over the last 20 years
Abbreviated version of unpublished paper Food distribution at the ICRC kitchen in Tonj. By Frances Mason and Anna Taylor This paper is a shortened version of the complete...
Reference this page
Chronic Malnutrition: a Problem not Addressed by SFPs. Field Exchange 7, July 1999. p11. www.ennonline.net/fex/7/chronic
(ENN_3385)