On Jan. 28, 2022, in Ndjamena, Chad, a child's upper arm circumference is measured by a health worker to screen for malnutrition at a UNICEF-supported outpatient nutrition unit.
Emergency Response

Inside Look: How UNICEF Delivers in Complex Crises

UNICEF’s Chief of Emergencies for West and Central Africa Nicola Bennett recently met with UNICEF USA to discuss multiple crises and related impacts on children and families in the central Sahel and neighboring nations — and how UNICEF is able to deliver urgently needed humanitarian support to those living in one of the most dangerous and challenging environments in the world. "We try to be creative to keep the assistance going," Bennett explained, "and sometimes that means changing the way we work."

Brittany Taylor, formerly UNICEF USA’s Assistant Director of Emergency Programs, now High-Value Partnerships Consultant for UNICEF in West and Central Africa, led the discussion.

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In humanitarian emergencies, children tend to suffer first

Q: What does it mean to be the Chief of Emergencies for West and Central Africa Regional Office? What does your job entail?

NICOLA BENNETT: There are a lot of places in the world where children find themselves in the middle of a conflict or natural disaster. And whenever there is an emergency, children tend to suffer first, and often they suffer most.

Our job is to be present, to stay and deliver. We coordinate with others, mobilize funds and negotiate with governments and others, to ensure that children have access to water and sanitation, that’s number one; that children also have access to nutrition; that they have access to education and that they are protected. We are the lead UN agency for those four sectors.

Children wash hands outside their school in Dedougou, west Burkina Faso, where UNICEF helped install a solar-powered water system.
© UNICEF/UN0753041/Dejongh
Students at Grand Foray B School, in Dedougou, west Burkina Faso, have access to safe water and regular handwashing thanks to a solar-powered water system provided by UNICEF.

Now, ‘protected’ is a bit of a broader term. When families are separated during a natural disaster or while fleeing conflict, we do family reunification. When children have been recruited to be a member of an armed group, we work to demobilize child soldiers and reintegrate them back into their communities.

The region I work in, West and Central Africa, is the region with the highest number of emergency situations for UNICEF. We have 24 country offices. And specifically, my job is that I lead a small team that works across all of these programs and interventions and supports all 24 country offices. We also coordinate with our colleagues at HQ — for example, our fundraising teams, global supply division and the HR division here in New York to make sure that we call attention to the crisis, that we mobilize funds and deploy enough staff and start transporting supplies.

The most important job: to make sure children are not forgotten when disasters strike

Our most important job is to support the country teams and the field offices as they engage with the government and with other actors — regional organizations, UN agencies, the security council, the international community — all to make sure that when there's a disaster — especially when there's a disaster — that children are not forgotten, that we keep the focus on children.

Q: The current crisis in the Sahel has been described as the least talked about and most unsupported humanitarian crisis in the world. Why is that, and can you explain what makes this crisis so complex and unique?

NICOLA BENNETT: ‘The Sahel’ refers to 10 countries in West and Central Africa — Burkina Faso, Cameroon, Chad, The Gambia, Guinea, Mauritania, Mali, Niger, Nigeria and Senegal. It is a region that rarely makes the front page or leads the news cycle. It is one of the toughest places in the world for children to grow up.

UNICEF-supported child refugees from Nigeria eat a meal inside a crowded tent at the Dar es Salam displacement camp in Chad.
© UNICEF/UN0594587/Dejongh
Displaced children receive a meal at the UNICEF-supported Dar Es Salam refugee camp in Baga Sola, in west Chad, where UNICEF provides psychosocial support in Child-Friendly Spaces, water, sanitation and hygiene (WASH) services and child protection services. Most refugees at the camp fled violence in Nigeria.

Twelve percent of the world's children live in the region, but that 12 percent suffers a disproportionate burden of child deprivation. For example, the region is home to one-third of the world's children who die before they reach age 5, and one-third of the world's children who are out of school. Forty percent of all mothers who die in childbirth are in this region.

In the last five or 10 years, especially in the Sahel, the situation has become a lot more complicated because of conflict. With conflict comes violence and displacement. We’ve seen a significant increase in attacks against civilians. We’ve seen attacks on infrastructure. The central Sahel countries — Burkina Faso, Mali and Niger — right now host 3 million displaced people.

And these conflicts have been deeply disruptive to a lot of other people, to their way of life. We have more than 8,000 schools in Burkina Faso, Mali and Niger that are closed, either because they were attacked or because they were threatened.

Food insecurity and other crises impacting children in the Sahel — all complicated by ongoing conflict — rarely make the front page of the news 

UNICEF monitors and reports on grave violations against children, and we’re seeing a lot of children getting directly caught up in conflict and even directly attacked. Looking at just Burkina Faso, the number of children killed [in 2022] was 300 percent higher than the number of children killed [in 2021]. It used to be fewer than one child every day and now it is three children killed in Burkina Faso every day.

So the impact on human lives, I would say, is at very similar levels to what we’re seeing in other parts of the world, with other conflicts that are making the front pages of the media, likeUkraine and Afghanistan. But it's a region that perhaps is not always thought of as having the same geopolitical significance, and so sometimes, even when we have incidents happening at the same time, of similar magnitude, it doesn't often get featured as heavily as it should. 

Q: What is the nature of the conflict? Is it civil, inter-communal, cross-border….? 

NICOLA BENNETT: There are different levels of violence and the conflicts do span borders. I think part of the reason it’s not so much on the international radar is that it's a complicated situation. Climate change is a factor. The climate crisis has brought a lot of droughts and a lot of floods. There is underlying food insecurity and malnutrition. So there is conflict over resources — water, grazing land. 

Many people in this part of the world primarily survive through either agriculture or through raising livestock, and so the few resources that are available are hotly contested. Some of the traditional conflict resolution mechanisms that used to exist between communities, between the farmers and the herders, are becoming more and more fragile. Politically, the region is fragile. Two of the three countries in central Sahel— Mali and Burkina Faso — have had two military coups in the last three years. 

And then you have armed groups that have taken up weapons against their own governments or, in some cases, against governments in neighboring countries. They have a presence in the country where there's a vacuum of authority and where they can be present. And some of those groups are linked to global conflict dynamics. The Islamic State and Al-Qaeda support some of the armed group activities in these states.

Q: The children and families who are displaced — are they staying inside the country, crossing borders or both?

NICOLA BENNETT: In all three countries, there are more internally displaced people than refugees, but there are also refugees going in both directions. There are language groups and ethnic groups that span borders, so for those groups, borders are fairly meaningless. People might flee to where it's safer temporarily and then go back. We are talking about multiple displacements, or circular displacement.

In the last couple of years, the conflict has been spilling over to some of the countries on the West African coast, on the Gulf of Guinea, into countries that have previously not been considered conflict-affected, like Benin, Togo, Ghana and Cote d'Ivoire. And so in those countries we're now also seeing security incidents. We're seeing displacement, both internal displacement and refugees crossing the borders. 

Q: In December of 2019, there were about 560,000 internally displaced people, or IDPs, in Burkina Faso. In December 2022, just three years later, that number had more than tripled to what, 1.9 million? 

NICOLA BENNETT: Yes, that just shows you how quickly things have escalated. The pace at which things are deteriorating, especially in Burkina Faso and to some extent Mali, has been really worrying. Parts of Burkina that were previously relatively more stable are now also very insecure. And there have been more attacks, more fighting. 

We don’t actually have the full data regarding the numbers of displaced people because both Burkina Faso and Niger have not updated their figures this year, but we know that every day more and more people are being displaced. The numbers are rising quite rapidly. 

Q: What is UNICEF’s presence like inside central Sahel countries?

NICOLA BENNETT: We have field offices in all of the conflict-affected areas. We work at the decentralized level with our counterparts — for example, in our education response, we work with the Ministry of Education. We look at the curriculum, we help train teachers, and we help improve the school infrastructure while linking that work to other areas of development, like making sure that a school has latrines and support for best hygiene practices.

Critical to reaching children with education, safe water and other essential services: relationships with local partners and community leaders

Our local partners and community leaders help us by providing information about what is happening in different areas. These relationships are critical. UNICEF has been on the ground in West and Central Africa for 40-plus years, so we have longstanding partnerships. We work very closely with the government on their core development strategies, to make sure that the country is supplied with health services, nutrition services and education.

We have the largest footprint of any other humanitarian organization in the central Sahel, and in the entire West and Central Africa region, in fact.

Q: Can you share a personal experience that will help show our supporters that supporting UNICEF does translate into real impact on the ground? 

NICOLA BENNETT: I've been working mainly at the country level and field level for 20 years. When you go into these communities, you see a lot of things that are difficult and that make you angry, but you also see a lot of things that you really admire and that really give you hope. You see the humanity between people. You see that, even in places where there’s extreme violence, there are people supporting each other. When people are affected by a crisis, the first people who help them are other community members, often complete strangers.

I was in Dori in northern Burkina Faso recently. We were at a water point chatting with a group of women and I was asking them where they were staying. They told me they had arrived about eight months earlier, that they had fled with their children and that they had fled because their village was attacked or because nearby villages were being attacked. Many of the men and boys had been killed, so many of these women had lost husbands and other family members. Some were quite young, as a lot of girls are married before 18 in this region. There was a woman in her early 20s who had three young children. 

When you go into these communities, you see a lot of things that are difficult and that make you angry, but you also see a lot of things that you really admire and that really give you hope.

One of the women showed me the home she was staying in, and it was a home of a local family. And this family had taken in five other families. There were 25, 30 people staying in what is really a very, very modest dwelling — complete strangers staying not for a couple of days, but for weeks, months, in some cases, years. It doesn’t even get discussed. For them, it is something that just needs to be done.

Q: When  I was in Burkina Faso in mid-2022,  I was in awe at what I saw among the field staff. Despite the escalation of conflict and the insecurity, the tenacity of the country office and the staff on the ground, the innovative methods they were using to continue to reach children and their families within these conflict settings was amazing to see. 

NICOLA BENNETT:  Definitely. I fully agree. Our national staff, especially our young national staff, they are really committed. They say, ‘This is my country, my country is in crisis, I want to address this and I want to help the children who are affected by it.’ Even when areas become very difficult to access. 

In 2019, when we opened the field offices in the north of Burkina Faso, we could drive everywhere, but now there's only one that we can drive to. We can’t reach the other ones anymore by road because there's fighting on the road and cars or convoys get attacked. So now we fly in by helicopter when we go there. We still try to see what can go by truck. Sometimes there are certain suppliers who are still be able to bring supplies by road. We find ways of reaching towns that are under siege.

UNICEF delivers to hard-to-reach places, despite security threats, complex logistics and other challenges

There is a town called Djibo. There used to be fewer than 100,000 people there, and now the population has tripled because everybody who was displaced by the surrounding villages has come there. And now it’s essentially encircled. There is fighting on all the roads leading into and out of Djibo. And as soon as convoys or cars try to pass, even if the military tries to go, they get attacked. We try to make sure there is still water and sanitation. The generator was broken and the generator got attacked, so you have to bring spare parts to fix it. So then we do that by helicopter.

For certain projects, there are windows of opportunity. For example, there is less fighting during the rainy season, so that time of year is when we might go drill a borehole, for example, to create a new safe water access point. We help set up community water committees — making sure to include the village elders, local youth, local men and local women, people from the host community and people from the displaced community — and see that they're trained to manage, maintain and repair the new access point. 

An Immunization Officer and Community Health Nurse supported by UNICEF travel by motorbike to a camp for displaced families in Sapelliga where they will provide services..
© UNICEF/UN0798317/
In Ghana, and in other countries across West and Central Africa where UNICEF works, community health workers play a critical role in reaching vulnerable children with essential vaccines and other services.

And then of course the children need to be vaccinated. This is where I think the work with the local partners is really crucial. We listen to the communities and we say, "Who can go safely where?" And it will vary from one area to the next.

Our local partners tell me that in certain parts of the country, it’s the community health workers — not like an official high-level government medic, but community health workers — who can move pretty freely. People trust you and people don't suspect you of being part of the conflict. They also tell me that women are safer to move around than men. Women are not suspected of being somebody who's spying. So there are some people who can travel by road. And that might not be by car or by truck, it might be by tricycle.

In certain parts of the country, it's the community health workers... who can move pretty freely.

For nutrition, we have our community-based nutrition programs, where we train the mothers and caretakers in how to check if their children are malnourished and how to monitor that over time. We have this very simple measuring tape that measures the middle-upper arm circumference (MUAC) of a child, and it's very simple for anybody to use. 

So caretakers are trained on how to take the measurement. If it's in the red, they know that that means the child needs to get the nutrition treatment, the Ready-to-Use Therapeutic Food, or RUTF, which is a kind of peanut paste. And then the community health worker can give them the supply of the peanut paste. This way, if a UNICEF nutritionist is unable to travel to that village — because they're not trusted enough or it might be too dangerous for them — then the community health worker can bring the supplies and make sure the mothers are monitoring the nutritional status of their children.

Q: UNICEF reported that in Burkina Faso, in September 2022 alone, UNICEF trained 54,927 parents, including 1,583 men, on the MUAC measurements; that this enabled household screening of acute malnutrition among 158,700 children, aged 6 months to 59 months; and that through this screening, 5,120 children were identified as acutely malnourished and referred to nutrition services. This was within one month, just through the household training. 

NICOLA BENNETT: Yes, especially because it's something that has to be done very regularly, right? So it makes much more sense for the community to be leading it themselves than for pediatricians to come in from the outside and do it for them. 

Q: More RUTF is being manufactured in the region now, is that right?

NICOLA BENNETT: Yes. So the product was developed originally in Europe, and the main company that produced it was based in France, so that meant that we had to procure it from there. If we had time, we brought it by boat, but the boat takes three months, so in an emergency we would fly it in and that's super expensive. So UNICEF invested in bringing RUTF manufacturing to countries that had the interest and the capacity to set up factories. 

We have two factories in Nigeria now, one in Lagos and one in Kano. We’ve worked with them to get them certified because the product still has to meet quality standards. They are working on improving their production levels so they can produce at scale. 

Woman and children at a malnutrition screening session in the village of Ngolo, in the Northern region of Burkina Faso.
© UNICEF/UN0640856/Dejongh
Woman and children at a malnutrition screening session in the village of Ngolo, in the Northern region of Burkina Faso. Mothers learn how to measure their children's upper arms so they can do the screenings at home, and there is a demonstration on how to prepare enriched porridge using micronutrient powders provided by UNICEF.

RUTF is also being produced in Niger, in Burkina Faso, in Sudan and in Chad, which is good for the local economy, and makes it faster and easier for us to transport. But we’re still working towards getting the levels of production up to meet the level of demand that exists.

Now RUTF is something that we prefer to transport by truck rather than by helicopter. But there are parts of Burkina Faso where our local partners tell us ‘the more low-key, the better’ — warning us that delivering by truck is too risky. That means instead of pre-positioning a three-month supply of RUTF in those areas, it will have to be transported by tricycle, maybe a few boxes at a time every week or two.

Q: How is UNICEF supporting education for displaced children and for children living in host communities?

NICOLA BENNETT: In Burkina Faso, armed groups will often deliberately attack schools that are using the official government curriculum and that use French language education. They are less likely to attack a school that is not seen as directly linked to the government, a school that teaches in the local languages or has a bilingual curriculum. Some of the armed groups are supportive of Quranic schools, and so UNICEF works with the imams of the Quranic schools to integrate some of the basics of primary education into their curriculum. It remains a Quranic school but literacy and numeracy and lessons in basic life skills are also covered. UNICEF has been doing this for years, even in peace times.

When I was based in UNICEF’s Nigeria country office, back before I moved to [the West and Central Africa Regional Office in] Dakar, we used to see in certain parts of Nigeria — areas where there was no conflict — many children were out of school and or were being sent to Quranic schools. They were being sent by their parents, parents who were religious and felt it was an important part of their child’s social education to be in a Quranic school and to memorize the Quran. UNICEF’s view was that while they're doing that, they can also learn how to read and write and do basic math. In some countries in the Sahel, it's a little bit more challenging but we are taking a similar approach.

Q: Our supporters often ask us, how is UNICEF able to operate in such a complex environment with such high levels of insecurity?

NICOLA BENNETT: It’s hard. We do our best. Sometimes it takes time. We have these large country offices with hundreds of staff — 90 percent of them are from that country. They do not pack up and go. But neither do the internationals. I mean, even throughout the COVID pandemic, everybody stayed on the ground. We are always asking ourselves: What can we do to stay and deliver? And how can we do this while still adhering to certain humanitarian principles, like neutrality. We don’t take sides in a conflict. Like independence — delivering using our own means and based on our own assessments and our own data, and using our own vehicles, rather than an escort. 

Sometimes — especially in natural disasters — there's sometimes even a very well-intentioned offer from the national military or even from international military to use their helicopters, and we have to tell them no, that's not going to be the best way of doing this, because if we use that helicopter to fly over an area that you're normally bombing, then we're likely to come under fire ourselves. We have the Humanitarian Air Service, which is a different color; it's a white helicopter with a big blue logo. We try to differentiate ourselves to show that neutrality. It’s a means to an end, it's a way of reaching people. 

The third principle is impartiality. That means that when you assist people, it's based on need and need alone. We don’t ask what their religion is, or who they voted for in the last election. We look at who has the greatest injury, like triage. The person who's the most in need, the vulnerable, is prioritized. That is what allows acceptance from the communities where we work. Acceptance by communities most importantly, but also from the armed groups. 

We're not here to get involved in politics. We are unarmed. We're not siding with anybody over somebody else.

Many armed groups — for example in the [Democratic Republic of Congo] and in Central African Republic — understand this very well. When you're a parent, whether you're a commander either in the army or whether you're a commander with an armed group that is challenging the army, you want your own malnourished child to have access to treatment. You understand that all children should be vaccinated. Nutrition, water and sanitation, health care and immunization — these are all entry points for us to explain to people why it's important for us that we help every child, no matter who their family is, no matter where in the country they are. 

And it takes time to establish that trust. So sometimes it may be weeks or months before we're able to get to a place, because the community doesn't know us yet or isn't sure who we are, or the armed group doesn't know us yet, even if the community wants us to come.

We're not here to get involved in politics. We are unarmed. We're not siding with anybody over somebody else. We're here to make sure that all the children are treated and have water and are vaccinated. And that normally gets us the acceptance we need, but it doesn't always work, with every armed group, and often it can take time. 

Q: Is lack of funding an obstacle, keeping UNICEF from reaching children in need, and if so, how do you get around that? 

NICOLA BENNETT: Lack of attention — the fact that the Sahel is not on the front pages of the news — often means lower levels of funding. Every year we issue an appeal for the funding that UNICEF needs to provide water and sanitation, nutrition, education and child protection, and every year we get about 20 or 30 percent of what we need. The impact of that is very direct and measurable.

A student at a UNICEF-supported school in the Lac region, western Chad.
© UNICEF/UN0794811/Dejongh
One way UNICEF helps girls stay in school — and avoid early marriage — is with cash transfers to families in need, to help cover school fees. Above, students attend class in Kaya, Lac region, western Chad.

And market prices for things like RUTF have gone up so much, with the global inflation crisis related to the war in Ukraine. The operational costs of using a helicopter to transport supplies have gone up. 

When we can't buy enough, it means we stock out. Then a mother comes in with her malnourished child and the box is empty. That means that, not only does the child go without treatment that day, but now the mother has less confidence in us. Maybe she had to walk far to get to the UNICEF-supported facility. Maybe next time she’ll choose not to make the trip. One in five children with severe acute malnutrition die if they don’t get treated. 

1 in 5 children with severe acute malnutrition die if they don't get treated

It’s the same with clean water. It's the same for child protection. We have a program that is about raising awareness within the communities about unexploded ordnance. It’s important that when a child sees that shiny object that they know not to touch it and to tell somebody it’s there. When we don’t get enough funding, these kinds of activities don’t happen, or only happen in some parts of the country.

Q: As you continue to coordinate emergency activities on the ground, what gives you hope?

NICOLA BENNETT: I was recently in N'Djamena, the capital of Chad, where 1.2 million people were affected by very heavy flooding in 2022. It's incredible; all the houses were still underwater several weeks later. And there were these young people, teenagers and people in their 20s who had been using U-Report, our social media platform, to connect with each other.

So when the flood started, completely unprompted, on their own initiative, they immediately went out into the most affected districts there and organized search and rescue. They were helping kids down from roofs. They were helping elderly people who couldn't flee and bringing them to safety. One had a picture on their phone of an old man with two U-Reporters — they were wearing their U-Report T-shirts! — who had basically built a little float and they were pulling him out on the float because everything was underwater. 

On Oct. 15, 2022, a U-Reporter in N'Djamena, Chad, helps a family to safety in an area affected by flooding, the result of the heaviest rainy season in 30 years.
© UNICEF/UN0724693/Banyo
In mid-October, 2022, as massive flooding engulfed N'Djamena, Chad, over 200 U-Reporters — local young people and other volunteers communicating over U-Report, a UNICEF-supported mobile platform — sprang into action to coordinate rescue efforts. Above, a U-Reporter helps a family to safety.

UNICEF set up tents near where people were staying to organize vaccinations and birth registration, the normal assistance activities that UNICEF does. The U-Reporters had their own tent and they were organizing different activities. They put on plays.

They especially try to help children to deal with the trauma and they talk about their own experience. And it's incredible to listen to them speak, when you hear young people say, "This is my country and I want to help people in my country."

And the Sahel is a region where, in most countries, more than half of the population is under 18. So especially, I think, if you look at young people, you can't help but feel hopeful and feel optimistic because you can see that they have that hope and they have the initiative to change things. 

Learn more about UNICEF's work for children in families in the Sahel region and across Africa.

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TOP PHOTO: In Ndjamena, Chad, a child is screened for malnutrition at a UNICEF-supported outpatient facility offering a range of services including treatment with Ready-to-Use Therapeutic Food. © UNICEF/UN0594516/Dejongh